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Classification trees, well-known for their ease of interpretation, are a widely used tool to solve statistical learning problems. However, researchers often end up with a forest rather than an individual classification tree, which implies a major cost due to the loss of the transparency of individual trees. Therefore, an important challenge is to enjoy the benefits of forests without paying this cost. In this paper, we propose the R-package C443. The C443 methodology simplifies a forest into one or a few condensed summary trees, to gain insight into its central tendency and heterogeneity. This is done by clustering the trees in the forest based on similarities between them, and on post-processing the clustering output. We will elaborate upon the implementation of the methodology in the package, and will illustrate its use with three examples. [ABSTRACT FROM AUTHOR]

Lester Packer was an exceptional scientific leader, whose radiant personality inspired and encouraged generations of students and scientists for research to pursue oxidants and antioxidants in biology and medicine. For the FORUM dedicated to Professor Packer, we here describe key aspects of his professional career, from the early years at Brooklyn College, Yale University, and the Johnson Research Foundation at Philadelphia to his long-term base at the University of California, at UC Berkeley. The concept of the "Antioxidant Network" formed the core of his activities in later years. His welcoming and integrative personality led to a worldwide network of colleagues, starting with the Bay Area Oxygen Club, which turned into the Oxygen Club of California, and his leadership in the Society for Free Radical Research-International. To illustrate his warmth and outreach, which enabled him to form borderless global collaborations, we conclude with words from some of his many friends also from outside academia: Lester Packer's legacy. Antioxid. Redox Signal. 38, 768–774. [ABSTRACT FROM AUTHOR]

For many problems in clinical practice, multiple treatment alternatives are available. Given data from a randomized controlled trial or an observational study, an important challenge is to estimate an optimal decision rule that specifies for each client the most effective treatment alternative, given his or her pattern of pretreatment characteristics. In the present paper we will look for such a rule within the insightful family of classification trees. Unfortunately, however, there is dearth of readily accessible software tools for optimal decision tree estimation in the case of more than two treatment alternatives. Moreover, this primary tree estimation problem is also cursed with two secondary problems: a structural missingness in typical studies on treatment evaluation (because every individual is assigned to a single treatment alternative only), and a major issue of replicability. In this paper we propose solutions for both the primary and the secondary problems at stake. We evaluate the proposed solution in a simulation study, and illustrate with an application on the search for an optimal tree-based treatment regime in a randomized controlled trial on K = 3 different types of aftercare for younger women with early-stage breast cancer. We conclude by arguing that the proposed solutions may have relevance for several other classification problems inside and outside the domain of optimal treatment assignment. [ABSTRACT FROM AUTHOR]

Advances in biomedical artificial intelligence may introduce or perpetuate sex and gender discriminations. Convolutional neural networks (CNN) have proven a dermatologist-level performance in image classification tasks but have not been assessed for sex and gender biases that may affect training data and diagnostic performance. In this study, we investigated sex-related imbalances in training data and diagnostic performance of a market-approved CNN for skin cancer classification (Moleanalyzer Pro®, Fotofinder Systems GmbH, Bad Birnbach, Germany). We screened open-access dermoscopic image repositories widely used for CNN training for distribution of sex. Moreover, the sex-related diagnostic performance of the market-approved CNN was tested in 1549 dermoscopic images stratified by sex (female n = 773; male n = 776). Most open-access repositories showed a marked under-representation of images originating from female (40%) versus male (60%) patients. Despite these imbalances and well-known sex-related differences in skin anatomy or skin-directed behaviour, the tested CNN achieved a comparable sensitivity of 87.0% [80.9%–91.3%] versus 87.1% [81.1%–91.4%], specificity of 98.7% [97.4%–99.3%] versus 96.9% [95.2%–98.0%] and ROC-AUC of 0.984 [0.975–0.993] versus 0.979 [0.969–0.988] in dermoscopic images of female versus male origin, respectively. In the sample at hand, sex-related differences in ROC-AUCs were not statistically significant in the per-image analysis nor in an additional per-individual analysis (p ≥ 0.59). Design and training of artificial intelligence algorithms for medical applications should generally acknowledge sex and gender dimensions. Despite sex-related imbalances in open-access training data, the diagnostic performance of the tested CNN showed no sex-related bias in the classification of skin lesions. • Artificial intelligence systems may introduce sex and gender discriminations. • Convolutional neural networks (CNN) are increasingly used for skin cancer diagnosis. • We investigated CNN training data and diagnostic performance for sex-related biases. • Training data: Images of females were under-represented in open-access archives. • Diagnostic performance: The tested marked-approved CNN showed no sex-related bias. [ABSTRACT FROM AUTHOR]

Research on oxidants and electrophiles has shifted from focusing on damage to biomolecules to the more fine‐grained physiological arena. Redox transitions as excursions from a steady‐state redox set point are continually ongoing in maintenance of redox balance. Current excitement on these topics results from the fact that recent research provided mechanistic insight, which gives rise to more concrete and differentiated questions. This Commentary focuses on redox eustress and the feedback restoration of steady state as concepts in active maintenance of physiological health, with brief discussion of redox stress response to viral infection, exemplified by COVID‐19. [ABSTRACT FROM AUTHOR]

Studies systematically unravelling possible causes for false diagnoses of deep learning convolutional neural networks (CNNs) are scarce, yet needed before broader application. The objective of the study was to investigate whether scale bars in dermoscopic images are associated with the diagnostic accuracy of a market-approved CNN. This cross-sectional analysis applied a CNN trained with more than 150,000 images (Moleanalyzer-pro®, FotoFinder Systems Inc., Bad Birnbach, Germany) to investigate seven dermoscopic image sets depicting the same 130 melanocytic lesions (107 nevi, 23 melanomas) without or with digitally superimposed scale bars of different manufacturers. Sensitivity, specificity and area under the curve (AUC) of receiver operating characteristics (ROC) for the CNN's binary classification of images with or without superimposed scale bars were assessed. Six dermoscopic image sets with different scale bars and one control set without scale bars (overall 910 images) were submitted to CNN analysis. In images without scale bars, the CNN attained a sensitivity [95% confidence interval] of 87.0% [67.9%–95.5%] and a specificity of 87.9% [80.3%–92.8%]. ROC AUC was 0.953 [0.914–0.992]. Scale bars were not associated with significant changes in sensitivity (range 87%–95.7%, all p ≥ 1.0). However, four scale bars induced a decrease of the CNN's specificity (range 0%–43.9%, all p < 0.001). Moreover, ROC AUC was significantly reduced by two scale bars (range 0.520–0.848, both p ≤ 0.042). Superimposed scale bars in dermoscopic images may impair the CNN's diagnostic accuracy, mostly by increasing the rate of the false-positive diagnoses. We recommend avoiding scale bars in images intended for CNN analysis unless specific measures counteracting effects are implemented. This study was registered at the German Clinical Trial Register (DRKS-Study-ID: DRKS00013570; URL: https://www.drks.de/drks_web/). • Dermoscopic images of melanocytic lesions with different scale bars were assessed. • Some scale bars significantly reduced CNN specificity. • Dermoscopic images intended for CNN analysis should not include scale bars. • Specific measures counteracting effects of artefacts on CNN analyses are discussed. [ABSTRACT FROM AUTHOR]

Repetitive hypoxia seen in obstructive sleep apnoea syndrome (OSAS) may affect bone metabolism increasing the risk for secondary osteoporosis. This study investigates the association between OSAS in children and secondary osteoporosis. This cross-sectional study included 150 children aged 10–17 years: 86 with OSAS and 64 with no OSAS. OSAS was confirmed by polysomnography. Quantitative ultrasound (QUS) of calcaneum measuring speed of sound (SoS) and broadband ultrasound attenuation (BUA) were collected. Other parameters collected including bone profile, vitamin D levels, physical activity scoring and dietary calcium intake. Majority were male and Malay ethnicity. OSAS children were mostly obese (84%) and 57% had moderate to severe OSAS. Most had lower physical activities scores. Mean (SD) phosphate and Alkaline phosphatase were lower in OSA children compared to controls: PO4, p = 0.039 and ALP, p < 0.001. Using both single and multivariate analysis, children with OSAS had a lower mean SoS value, p < 0.001 and p = 0.004 respectively after adjusting for age, BMI and bone profile. Children with OSAS had lower SoS suggesting risk for secondary osteoporosis. QUS calcaneus is a non-invasive, feasible tool and can be used to screen risk of osteoporosis in children. Further bone mineral density assessment is needed in these groups of children to confirm diagnosis of osteoporosis. [ABSTRACT FROM AUTHOR]

Often tree-based accounts of statistical learning problems yield multiple decision trees which together constitute a forest. Reasons for this include examining tree instability, improving prediction accuracy, accounting for missingness in the data, and taking into account multiple outcome variables. A key disadvantage of forests, unlike individual decision trees, is their lack of transparency. Hence, an obvious challenge is whether it is possible to recover some of the insightfulness of individual trees from a forest. In this paper, we will propose a conceptual framework and methodology to do so by reducing forests into one or a small number of summary trees, which may be used to gain insight into the central tendency as well as the heterogeneity of the forest. This is done by clustering the trees in the forest based on similarities between them. By means of simulated data, we will demonstrate how and why different similarity types in the proposed methodology may lead to markedly different conclusions, and explain when and why certain approaches may be recommended over other ones. We will finally illustrate the methodology with an empirical data set on the prediction of cocaine use on the basis of personality characteristics. [ABSTRACT FROM AUTHOR]

My interest in biological chemistry proceeded from enzymology in vitro to the study of physiological chemistry in vivo. Investigating biological redox reactions, I identified hydrogen peroxide (H2O2) as a normal constituent of aerobic life in eukaryotic cells. This finding led to developments that recognized the essential role of H2O2 in metabolic redox control. Further research included studies on GSH, toxicological aspects (the concept of "redox cycling"), biochemical pharmacology (ebselen), nutritional biochemistry and micronutrients (selenium, carotenoids, flavonoids), and the concept of "oxidative stress." Today, we recognize that oxidative stress is two-sided. It has its positive side in physiology and health in redox signaling, "oxidative eustress," whereas at higher intensity, there is damage to biomolecules with potentially deleterious outcome in pathophysiology and disease, "oxidative distress." Reflecting on these developments, it is gratifying to witness the enormous progress in redox biology brought about by the science community in recent years. [ABSTRACT FROM AUTHOR]

Ebselen is an organoselenium compound exhibiting hydroperoxide- and peroxynitrite-reducing activity, acting as a glutathione peroxidase and peroxiredoxin enzyme mimetic. Ebselen reacts with a multitude of protein thiols, forming a selenosulfide bond, which results in pleiotropic effects of antiviral, antibacterial and anti-inflammatory nature. The main protease (Mpro) of the corona virus SARS-CoV-2 is a potential drug target, and a screen with over 10,000 compounds identified ebselen as a particularly promising inhibitor of Mpro (Jin, Z. et al. (2020) Nature 582 , 289–293). We discuss here the reaction of ebselen with cysteine proteases, the role of ebselen in infections with viruses and with other microorganisms. We also discuss effects of ebselen in lung inflammation. In further research on the inhibition of Mpro in SARS-CoV-2, ebselen can serve as a promising lead compound, if the inhibitory effect is confirmed in intact cells in vivo. Independently of this action, potential beneficial effects of ebselen in COVID-19 are ascribed to a number of targets critical to pathogenesis, such as attenuation of inflammatory oxidants and cytokines. Image 1 • Ebselen, an organoselenium compound, exhibits anti-inflammatory and antiviral activity. • Ebselen is a glutathione peroxidase and peroxiredoxin mimetic. • Ebselen reacts with a multitude of protein thiols, resulting in pleiotropic effects. • Ebselen is an effective inhibitor of Mpro, the main protease of SARS-CoV-2. • Ebselen may serve as lead compound for drugs targeting COVID-19. [ABSTRACT FROM AUTHOR]

Convolutional neural networks (CNNs) have shown a dermatologist-level performance in the classification of skin lesions. We aimed to deliver a head-to-head comparison of a conventional image analyser (CIA), which depends on segmentation and weighting of handcrafted features, to a CNN trained by deep learning. Cross-sectional study using a real-world, prospectively acquired, dermoscopic dataset of 1981 skin lesions to compare the diagnostic performance of a market-approved CNN (Moleanalyzer-Pro™, developed in 2018) to a CIA (Moleanalyzer-3™/Dynamole™; developed in 2004, all FotoFinder Systems Inc, Germany). As a reference standard, we used histopathological diagnoses (n = 785) or, in non-excised benign lesions (n = 1196), expert consensus plus an uneventful follow-up by sequential digital dermoscopy for at least 2 years. A total of 281 malignant lesions and 1700 benign lesions from 435 patients (62.2% male, mean age: 52 years) were prospectively imaged. The CNN showed a sensitivity of 77.6% (95% confidence interval [CI]: [72.4%–82.1%]), specificity of 95.3% (95% CI: [94.2%–96.2%]), and receiver operating characteristic (ROC)-area under the curve (AUC) of 0.945 (95% CI: [0.930–0.961]). In contrast, the CIA achieved a sensitivity of 53.4% (95% CI: [47.5%–59.1%]), specificity of 86.6% (95% CI: [84.9%–88.1%]) and ROC-AUC of 0.738 (95% CI: [0.701–0.774]). The data set included melanomas originally diagnosed by dynamic changes during sequential digital dermoscopy (52 of 201, 20.6%), which reduced the sensitivities of both classifiers. Pairwise comparisons of sensitivities, specificities, and ROC-AUCs indicated a clear outperformance by the CNN (all p < 0.001). The superior diagnostic performance of the CNN argues against a continued application of former CIAs as an aide to physicians' clinical management decisions. • We compared two market-approved computer-algorithms for skin cancer detection. • A conventional image analyser (CIA) was compared with a deep learning convolutional neural network (CNN). • The CNN significantly outperformed the CIA in sensitivity, specificity, and area under the receiver operating characteristic curve. [ABSTRACT FROM AUTHOR]

Deep learning convolutional neural networks (CNNs) show great potential for melanoma diagnosis. Melanoma thickness at diagnosis among others depends on melanoma localisation and subtype (e.g. advanced thickness in acrolentiginous or nodular melanomas). The question whether CNN may counterbalance physicians' diagnostic difficulties in these melanomas has not been addressed. We aimed to investigate the diagnostic performance of a CNN with approval for the European market across different melanoma localisations and subtypes. The current market version of a CNN (Moleanalyzer-Pro®, FotoFinder Systems GmbH, Bad Birnbach, Germany) was used for classifications (malignant/benign) in six dermoscopic image sets. Each set included 30 melanomas and 100 benign lesions of related localisations and morphology (set-SSM: superficial spreading melanomas and macular nevi; set-LMM: lentigo maligna melanomas and facial solar lentigines/seborrhoeic keratoses/nevi; set-NM: nodular melanomas and papillomatous/dermal/blue nevi; set-Mucosa: mucosal melanomas and mucosal melanoses/macules/nevi; set-AM skin : acrolentiginous melanomas and acral (congenital) nevi; set-AM nail : subungual melanomas and subungual (congenital) nevi/lentigines/ethnical type pigmentations). The CNN showed a high-level performance in set-SSM, set-NM and set-LMM (sensitivities >93.3%, specificities >65%, receiver operating characteristics-area under the curve [ROC-AUC] >0.926). In set-AM skin , the sensitivity was lower (83.3%) at a high specificity (91.0%) and ROC-AUC (0.928). A limited performance was found in set-mucosa (sensitivity 93.3%, specificity 38.0%, ROC-AUC 0.754) and set-AM nail (sensitivity 53.3%, specificity 68.0%, ROC-AUC 0.621). The CNN may help to partly counterbalance reduced human accuracies. However, physicians need to be aware of the CNN's limited diagnostic performance in mucosal and subungual lesions. Improvements may be expected from additional training images of mucosal and subungual sites. • The diagnostic performance of a market-approved convolutional neural network (CNN) was tested across different melanoma subtypes and localisations. • The CNN showed a high-level performance (sensitivities >93.3%, specificities >65%) in superficial spreading, lentigo maligna and nodular melanomas. • In melanomas of acral skin, a reduced sensitivity (83.3%) at high specificity (91.0%) was found. • The CNN's performance in mucosal and subungual melanomas was limited, demanding for a more cautious interpretation of results. [ABSTRACT FROM AUTHOR]

When multiple treatment alternatives are available for a disease, an obvious question is which alternative is most effective for which patient. One may address this question by searching for optimal treatment regimes that specify for each individual the preferable treatment alternative based on that individual's baseline characteristics. When such a regime has been estimated, its quality (in terms of the expected outcome if it was used for treatment assignment of all patients in the population under study) is of obvious interest. Obtaining a good and reliable estimate of this quantity is a key challenge for which so far no satisfactory solution is available. In this paper, we consider for this purpose several estimators of the expected outcome in conjunction with several resampling methods. The latter have been evaluated before within the context of statistical learning to estimate the prediction error of estimated prediction rules. Yet, the results of these evaluations were equivocal, with different best performing methods in different studies, and with near-zero and even negative correlations between true and estimated prediction errors. Moreover, for different reasons, it is not straightforward to extrapolate the findings of these studies to the context of optimal treatment regimes. To address these issues, we set up a new and comprehensive simulation study. In this study, combinations of different estimators with .632+ and out-of-bag bootstrap resampling methods performed best. In addition, the study shed a surprising new light on the previously reported problematic correlations between true and estimated prediction errors in the area of statistical learning. [ABSTRACT FROM AUTHOR]

Background: Urine metanephrines are used to screen for phaeochromocytoma or paraganglioma (PPGL). Current reference intervals (RI) derived in healthy individuals are not age or sex-stratified, and lower than in hypertensive patients, leading to high false positive rates. This study aims to determine age and sex-stratified RI from a contingent screening population. Methods: Patients with 24-h deconjugated urine metanephrines from 3/6/2010 to 27/8/2022 were included (2936 males, 5285 females), initially by liquid chromatography-electrochemical detection (LC-ECD) then liquid chromatography-tandem mass spectrometry (LC-MS/MS). Bhattacharya analysis was used after log transformation to determine age and sex-stratified RI for metanephrine excretion, normetanephrine excretion, metanephrine/creatinine and normetanephrine/creatinine ratios. Results: Normetanephrine excretion increases with age (RI: males: 18–<30 years: <3.4 µmol/24 h, 30–<40 years: <3.7 µmol/24 h, 40+ years: <5.3 µmol/24 h; females: 18–<30 years: <2.7 µmol/24 h, 30–<40 years: <3.1 µmol/24 h, 40+ years: <3.7 µmol/24 h), while metanephrine excretion was consistent across adulthood (RI: males: 18+ years: <1.8 µmol/24 h; females: 18+ years: <1.2 µmol/24 h). However, normetanephrine/creatinine and metanephrine/creatinine increase steadily with age after early adulthood, likely due to a decrease in muscle mass, with females having higher normetanephrine/creatinine and metanephrine/creatinine ratios. Conclusions: Age and sex-stratified RI were derived for metanephrine excretion, normetanephrine excretion, metanephrine/creatinine and normetanephrine/creatinine ratios. This is expected to reduce false positives while flagging most PPGL. [ABSTRACT FROM AUTHOR]

Precision medicine, in the sense of tailoring the choice of medical treatment to patients' pretreatment characteristics, is nowadays gaining a lot of attention. Preferably, this tailoring should be realized in an evidence-based way, with key evidence in this regard pertaining to subgroups of patients that respond differentially to treatment (i.e., to subgroups involved in treatment–subgroup interactions). Often a-priori hypotheses on subgroups involved in treatment–subgroup interactions are lacking or are incomplete at best. Therefore, methods are needed that can induce such subgroups from empirical data on treatment effectiveness in a post hoc manner. Recently, quite a few such methods have been developed. So far, however, there is little empirical experience in their usage. This may be problematic for medical statisticians and statistically minded medical researchers, as many (nontrivial) choices have to be made during the data-analytic process. The main purpose of this paper is to discuss the major concepts and considerations when using these methods. This discussion will be based on a systematic, conceptual, and technical analysis of the type of research questions at play, and of the type of data that the methods can handle along with the available software, and a review of available empirical evidence. We will illustrate all this with the analysis of a dataset comparing several anti-depressant treatments. [ABSTRACT FROM AUTHOR]

Background Identification of patients with thiopurine S -methyltransferase (TPMT) deficiency prior to thiopurine drug therapy has become routine clinical practice worldwide. To measure TPMT activity, traditional radiochemical assays have been replaced by chromatographic methods. Method Inspired by the increasing number of isotope labelled sources that may be of benefit for the TPMT assay, a new LC-MS/MS method for TPMT activity was developed and validated. Isotope labelled d3- S -adenosyl- l -methionine (d3-SAM) was selected for the enzymatic methylation of mercaptopurine during sample incubation; d3-6-methylmercaptopurine (d3-6-MMP) with d2-2, 8-hypoxanthine as the internal standard was quantified to ascertain individual TPMT activity. Results The validation of the analytical part of this method showed good linearity (coefficient of determination 0.9999 in the range of 1–500 ng/mL) with the intra-and inter-day impression CV% between 7.6% and 9.1% and 3.7% and 9.2%, respectively. Recovery ranged from 94.9% to 112.3%. The specificity of the enzymatic reaction was validated by using 108 clinical check samples. After compared with traditional radiochemical assay and genotype results, all homozygous and heterozygous deficiency clinical checks fitted into the nominal groups, inter-batch and intra–batch impression CV% were between 2.3% and 9.7%. Conclusion With the inclusion of isotope labelled substrate, interfering non-enzymatic methylation no longer results in potential false assignment of abnormal patients. Furthermore, the method can be applied to patients who have already been prescribed thiopurine drugs. This new LC-MS/MS is therefore a favourable clinical routine application to test TPMT activity, as it shows excellent performance in identifying patients with TPMT deficiency. [ABSTRACT FROM AUTHOR]

Oxidative stress is two sided: Whereas excessive oxidant challenge causes damage to biomolecules, maintenance of a physiological level of oxidant challenge, termed oxidative eustress, is essential for governing life processes through redox signaling. Recent interest has focused on the intricate ways by which redox signaling integrates these converse properties. Redox balance is maintained by prevention, interception, and repair, and concomitantly the regulatory potential of molecular thiol-driven master switches such as Nrf2/Keap1 or NF-κB/IκB is used for system-wide oxidative stress response. Nonradical species such as hydrogen peroxide (H2O2) or singlet molecular oxygen, rather than free-radical species, perform major second messenger functions. Chemokine-controlled NADPH oxidases and metabolically controlled mitochondrial sources of H2O2 as well as glutathione- and thioredoxin-related pathways, with powerful enzymatic back-up systems, are responsible for fine-tuning physiological redox signaling. This makes for a rich research field spanning from biochemistry and cell biology into nutritional sciences, environmental medicine, and molecular knowledge-based redox medicine. [ABSTRACT FROM AUTHOR]

Significance: The redox code is a set of principles that defines the positioning of the nicotinamide adenine dinucleotide (NAD, NADP) and thiol/disulfide and other redox systems as well as the thiol redox proteome in space and time in biological systems. The code is richly elaborated in an oxygen-dependent life, where activation/deactivation cycles involving O2 and H2O2 contribute to spatiotemporal organization for differentiation, development, and adaptation to the environment. Disruption of this organizational structure during oxidative stress represents a fundamental mechanism in system failure and disease. Recent Advances: Methodology in assessing components of the redox code under physiological conditions has progressed, permitting insight into spatiotemporal organization and allowing for identification of redox partners in redox proteomics and redox metabolomics. Critical Issues: Complexity of redox networks and redox regulation is being revealed step by step, yet much still needs to be learned. Future Directions: Detailed knowledge of the molecular patterns generated from the principles of the redox code under defined physiological or pathological conditions in cells and organs will contribute to understanding the redox component in health and disease. Ultimately, there will be a scientific basis to a modern redox medicine. Antioxid. Redox Signal. 23, 734-746. [ABSTRACT FROM AUTHOR]

Hydrogen peroxide (H2O2) is a stable product of water radiolysis, occurring at nanomolar concentration upon low-dose ionizing radiation (LDIR) (<100 mGy). In view of the recent recognition of H2O2 as a central redox signaling molecule that, likewise, is maintained in the nanomolar range in cells, we propose a role for H2O2 in radiation hormesis. LDIR is capable of utilizing known molecular redox master switches such as Nrf2/Keap1 or NF-κB/IκB to effect adaptive resistance. This leads to the hypothesis that, as a normal component of the exposome, LDIR mediates hormetic effects by H2O2 signaling. Antioxid. Redox Signal. 27, 596-598. [ABSTRACT FROM AUTHOR]

Hydrogen peroxide, the nonradical 2-electron reduction product of oxygen, is a normal aerobic metabolite occurring at about 10 nM intracellular concentration. In liver, it is produced at 50 nmol/min/g of tissue, which is about 2% of total oxygen uptake at steady state. Metabolically generated H2O2 emerged from recent research as a central hub in redox signaling and oxidative stress. Upon generation by major sources, the NADPH oxidases or Complex III of the mitochondrial respiratory chain, H2O2 is under sophisticated fine control of peroxiredoxins and glutathione peroxidases with their backup systems as well as by catalase. Of note, H2O2 is a second messenger in insulin signaling and in several growth factor-induced signaling cascades. H2O2 transport across membranes is facilitated by aquaporins, denoted as peroxiporins. Specialized protein cysteines operate as redox switches using H2O2 as thiol oxidant, making this reactive oxygen species essential for poising the set point of the redox proteome. Major processes including proliferation, differentiation, tissue repair, inflammation, circadian rhythm, and aging use this low molecular weight oxygen metabolite as signaling compound. [ABSTRACT FROM AUTHOR]

Abstract: Ebselen (2-phenyl-1,2-benzisoselenazol-3(2H)-one; PZ-51, DR-3305), is an organoselenium compound with glutathione peroxidase (GPx)-like, thiol-dependent, hydroperoxide reducing activity. As an enzyme mimic for activity of the selenoenzyme GPx, this compound has proved to be highly useful in research on mechanisms in redox biology. Furthermore, the reactivity of ebselen with protein thiols has helped to identify novel, selective targets for inhibitory actions on several enzymes of importance in pharmacology and toxicology. Importantly, the selenium in ebselen is not released and thus is not bioavailable, ebselen metabolites being excreted in bile and urine. As a consequence, initial concerns about selenium toxicity, fortunately, were unfounded. Potential applications in medical settings have been explored, notably in brain ischemia and stroke. More recently, there has been a surge in interest as new medical applications have been taken into consideration. The first publication on the biochemical effects of ebselen appeared 30 years ago (Müller et al. [4]), which prompted the authors to retrace the early development from their perspective. It is a fascinating example of fruitful interaction between research-oriented industry and academia [Copyright &y& Elsevier]

Highlights: [•] Selenoprotein P is a key player in brain selenium homeostasis. [•] Impaired biosynthesis of neuronal selenoproteins results in neurological dysfunction. [•] Selenoproteins are up-regulated in astrocytes upon brain injury. [•] Low selenium status is associated with faster cognitive decline in elderly persons. [Copyright &y& Elsevier]

Background/Aim: Microcirculation in the dermis of the skin is important for nutrient delivery to this tissue. In this study, the effects of a micronutrient concentrate (Juice Plus+®; 'active group'), composed primarily of fruit and vegetable juice powder, on skin microcirculation and structure were compared to placebo. Study Design/Methods: This 12-week study had a monocentric, double-blind placebo and randomized controlled design with two treatment groups consisting of 26 healthy middle-aged women each. The 'oxygen to see' device was used to evaluate microcirculation. Skin density and thickness were measured using ultrasound. Measurements for skin hydration (Corneometer®), transepidermal water loss and serum analysis for carotenoids and α-tocopherol were also performed. Results: By 12 weeks, microcirculation of the superficial plexus increased by 39%. Furthermore, skin hydration increased by 9% while skin thickness increased by 6% and skin density by 16% in the active group. In the placebo group, microcirculation decreased, and a slight increase in skin density was observed. Conclusion: Ingestion of a fruit- and vegetable-based concentrate increases microcirculation of the skin at 12 weeks of intervention and positively affects skin hydration, density and thickness. Copyright © 2011 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Abstract: Current issues in research on health effects by polyphenols are addressed. As to the cardiovascular system, flow-mediated dilation (FMD), a functional biomarker, can be used as surrogate marker for cardiovascular risk. Acute short-term effects peaking at 2h after ingestion of polyphenol-rich food items are distinguished from longer-term effects over days and weeks. The role of polyphenol metabolites as bioactives is presented, underlining that specific target enzymes such as NADPH oxidases or lipoxygenases provide a basis for molecular action of polyphenols, rather than unspecific direct antioxidant effects. Cautionary words are given for the use of non-compositional assays of ‘total antioxidant capacity’ (TAC) in blood plasma. Enhanced interest emerges for polyphenols in the gastrointestinal tract. Recommendations for health professionals and the public are summarized, as well as prospects and challenges for future research. [ABSTRACT FROM AUTHOR]

The extended abstracts in this report are based on presentations from the 12th Special Conference on Functional Foods for Health Promotion, cosponsored by the North American branch of the International Life Sciences Institute (ILSI North America) Project Committee on Flavonoids and the American Society for Nutrition at the Experimental Biology meeting in April 2009. The theme of this year's special conference was “State-of-the-Science on Dietary Flavonoids.” The conference began with a general introduction and overview of flavonoids and their presence in the diet as well as the estimated intake levels in the US population. Subsequent presentations addressed issues pertaining to study design and interpretation, mechanisms of action, and the potential health impacts related to inflammation, the vasculature, and the brain. The present summary of the current science indicates that dietary flavonoids, particularly flavanols, show promising potential for reducing cardiovascular disease risk via reduction of inflammation and improvement in vascular function. However, the existing data must be interpreted cautiously, with consideration given to the compound tested (i.e., parent or metabolite), the use of controls, and the practicality of the concentrations used. While more data are needed on the long-term health impacts of dietary flavonoids in humans, including the efficacious dose, current data indicate it may soon be possible to develop public health messages about flavonoid-rich foods. [ABSTRACT FROM AUTHOR]

Abstract: Reactive oxygen species (ROS) are derived from cellular oxygen metabolism and from exogenous sources. An excess of ROS results in oxidative stress and may eventually cause cell death. ROS levels within cells and in extracellular body fluids are controlled by concerted action of enzymatic and non-enzymatic antioxidants. The essential trace element selenium exerts its antioxidant function mainly in the form of selenocysteine residues as an integral constituent of ROS-detoxifying selenoenzymes such as glutathione peroxidases (GPx), thioredoxin reductases (TrxR) and possibly selenoprotein P (SeP). In particular, the dual role of selenoprotein P as selenium transporter and antioxidant enzyme is highlighted herein. A cytoprotective effect of selenium supplementation has been demonstrated for various cell types including neurons and astrocytes as well as endothelial cells. Maintenance of full GPx and TrxR activity by adequate dietary selenium supply has been proposed to be useful for the prevention of several cardiovascular and neurological disorders. On the other hand, selenium supplementation at supranutritional levels has been utilised for cancer prevention: antioxidant selenoenzymes as well as prooxidant effects of selenocompounds on tumor cells are thought to be involved in the anti-carcinogenic action of selenium. [Copyright &y& Elsevier]

Abstract: High serum selenium levels have been associated epidemiologically with increased incidence of type 2 diabetes. The major fraction of total selenium in serum is represented by liver-derived selenoprotein P (SeP). This study was undertaken to test for a hypothesized effect of hyperglycemia and the antihyperglycemic drug metformin on hepatic selenoprotein P biosynthesis. Cultivation of rat hepatocytes in the presence of high glucose concentrations (25mmol/l) resulted in increased selenoprotein P mRNA expression and secretion. Treatment with metformin dose-dependently downregulated SeP mRNA expression and secretion, and suppressed glucocorticoid-stimulated production of SeP. Moreover, metformin strongly decreased mRNA levels of selenophosphate synthetase 2 (SPS-2), an enzyme essential for selenoprotein biosynthesis. Taken together, these results indicate an influence of metformin on selenium metabolism in hepatocytes. As selenoprotein P is the major transport form of selenium, metformin treatment may thereby diminish selenium supply to extrahepatic tissues. [Copyright &y& Elsevier]

This account revolves around fascination and excitement with science. Early curiosity and fortunate opportunities can lead to a satisfying career. The privilege of performing basic research in biochemistry and molecular biology at a university coupled with teaching motivated students and working with dedicated co-workers makes for sustained thrust in the advance of knowledge. Research fields centered around cellular redox systems, oxidants and antioxidants, and the concept of oxidative stress. A noteworthy aspect is the global network of scientists joining in these endeavors worldwide. [ABSTRACT FROM AUTHOR]

The impact of nutrients on gene expression can be mediated by the availability of amino acids. The aim of this study is to examine the effect of limited availability of l-arginine on the DNA-binding activity of NF-κB, a dominant transcription factor in inflammation, and the consequence for the expression pattern of inducible nitric oxide synthase (iNOS) in murine keratinocytes. Low availability of l-arginine leads to activation and increased DNA-binding activity of NF-κB and induction of iNOS messenger RNA (mRNA) in the absence of cytokines, but not to translation into iNOS protein. Cytokine challenge at low l-arginine also enhances iNOS mRNA expression, but translation into iNOS protein is diminished, leading to lowered nitric oxide production. The decrease in iNOS protein expression is mediated by the phosphorylation of the translation initiation factor eIF2α subunit, a key regulator of cellular translation. In contrast, the mRNA expression of the NF-κB-dependent genes IL-1α and cationic amino acid transporter-2 (CAT-2) are not affected by the availability of l-arginine. These results demonstrate that the availability of l-arginine can play a role in the control of gene expression by augmenting the DNA-binding activity of NF-κB, which can affect the initiation and progression of dermal inflammation. [ABSTRACT FROM AUTHOR]

The article relates the author's experience in becoming a chemist. His first exposure to the delights of nature in his hometown in Seesen, Northern Germany made lasting impressions. His sense of appreciation of the treasures provided by nature was fostered by his parents and to a large extent by his first teacher in elementary school.

Background: Neuroblastoma patients may be classified as normal or abnormal depending on reference interval and decision points for urine catecholamine metabolites. We therefore evaluated the utility of positive likelihood ratios (LR+) based on data from patients in whom the diagnosis was suspected. Methods: Urine samples from 249 patients (122 male, 127 female) suspected of neuroblastoma were assayed for VMA by spectrophotometry and dopamine by HPLC. Ratios of VMA to creatinine (VMA/Cr) and dopamine to creatinine (DA/Cr) were calculated and age-related median scores derived relative to patients without neuroblastoma. Receiver operator characteristic (ROC) curve analysis was undertaken for the ability of median scores to identify neuroblastoma. Results: Of the 249 patients, there were 20 confirmed cases of neuroblastoma, with ages ranging from 0 (congenital tumour) to 8.4 years. From ROC curves, VMA/Cr was found to have an area under the curve 0.96 (95% confidence interval [CI] 0.92–0.98) compared with 0.72 (95% CI 0.66–0.77) for DA/Cr, P=0.001. At the optimal decision point for VMA/Cr, LR+ was 7.2, identifying cases with a sensitivity of 95% and a specificity of 86%, and comparing favourably with published intervals. Conclusions: VMA/Cr is more accurate than DA/Cr for the diagnosis of neuroblastoma. Reporting LR+ may also be more informative than using reference intervals and decision points. [ABSTRACT FROM AUTHOR]

Astaxanthin is a carotenoid found in plants and algae; it provides the color of marine seafood such as salmon, lobster, or shrimp. Carotenoids are antioxidants and exhibit other biological functions, including effects on gap junctional communication important for homeostasis, growth control, and development of cells. Cancer cells have an impaired gap junctional intercellular communication. The objective of the present study was to determine the effects of astaxanthin and canthaxanthin on gap junctional intercellular communication in vitro. Primary human skin fibroblasts were exposed to carotenoids from 0.001 to 10 micromol/L, and gap junctional communication was measured with a dye transfer assay. After incubation with canthaxanthin for 24 and 72 h, intercellular communication increased, whereas it was strongly diminished by astaxanthin at levels > 0.1 micromol/L. Inhibition was reversed when astaxanthin was withdrawn. Western blot analysis showed that after exposure to canthaxanthin, the amount of the gap junction protein connexin43 was increased. Incubation with astaxanthin led to a change in the phosphorylation pattern of connexin43, shifting from higher to lower phosphorylation states. We suggest that astaxanthin affects channel function by changing the phosphorylation pattern of connexin43. [ABSTRACT FROM AUTHOR]

Cocoa beans have historically been used as a treatment for diarrhea, leading us to hypothesize that polyphenols contained in cocoa inhibit intestinal Cl- secretion. In this study, the dose-dependent effects of flavonoid compounds present in cocoa, or molecularly closely related compounds, were tested on forskolin- stimulated cystic fibrosis transmembrane conductance regulator (CFTR)-mediated Cl- secretion across T84 colonic epithelia in Ussing chambers. Addition of cocoa extract or cocoa flavanols to the mucosal side of tissues caused partial inhibition following Michaelis-Menten kinetics and resulted in a rank order of maximum blocker effects as follows: epicatechin > catechin ⩾ standardized cocoa preparation ⩾ procyanidin B2. Half-maximal blocker concentrations (Ki) were not substantially different between the tested preparations and were in the range of 100 μmol/L. For comparison, the structurally related flavonoids, quercetin and luteolin, caused a total block of Cl- currents with Ki values similar to the cocoa flavanols tested. Morin and baicalein were less effective blockers. Effects of test compounds on mucosal redox potential did not correlate with blocker activity. These data indicate that cocoa flavanols target intestinal CFTR CL transport and may serve as mild inhibitors of cAMP-stimulated Cl- secretion in the intestine. [ABSTRACT FROM AUTHOR]

Abstract: Carotenoids comprise a class of natural fat-soluble pigments which are found in numerous fruits and vegetables. The consumption of a diet rich in carotenoids has been epidemiologically correlated with a lower risk for several diseases. The antioxidant activity of carotenoids and biochemical properties influencing signaling pathways have been discussed as basic mechanisms of prevention. Conflicting data from intervention studies with β-carotene to prevent cancers and cardiovascular disorders have challenged the concept. However, there is convincing evidence that carotenoids are important components of the antioxidant network. Photooxidative damage is suggested to be involved in the pathobiochemistry of several diseases affecting the skin and the eye, and carotenoids may protect light-exposed tissues. Lutein and zeaxanthin are the predominant carotenoids of the retina and are considered to act as photoprotectants preventing retinal degeneration. The unique distribution, localization and high levels of both carotenoids within the macula lutea as well as their physicochemical properties make them suitable candidates for photoprotection. β-Carotene is used as an oral sun protectant for the prevention of sunburn and has been shown to be effective either alone or in combination with other carotenoids or antioxidant vitamins. Protective effects are also achieved with a diet rich in lycopene. [Copyright &y& Elsevier]

Lipid peroxidation (LPO) of low-density lipoprotein (LDL) is believed to be a pivotal process rendering this plasma lipoprotein atherogenic. Several endogenous factors have been proposed to mediate LPO of LDL, among them myeloperoxidase (MPO), which is active in atherosclerotic lesions, and the plasma level of which has been proposed to be a prognostic parameter for cardiac events. Nitrite, a major oxidation product of nitric oxide, is substrate of MPO and a cofactor of MPO-mediated LPO under physiological conditions. Dietary flavonoids including (-)-epicatechin, a major flavan-3-ol in cocoa products, grapes and wine, are substrates of MPO as well as potent inhibitors of LPO in LDL at micromolar concentrations. Moreover, they strongly suppress protein tyrosine nitration of LDL by MPO/nitrite or peroxynitrite. By blunting undesirable MPO-mediated actions of nitrite, presumably via scavenging of the strong prooxidant and nitrating ^{}NO_2 radical, dietary flavonoids modulate NO metabolism in a favorable direction and thus counteract endothelial dysfunction. This article gives a survey on recent progress in this field with special reference to own recently published work. [ABSTRACT FROM AUTHOR]

Nutritional, or dietary oxidative stress denotes a disturbance of the redox state resulting from excess oxidative load or from inadequate nutrient supply favoring prooxidant reactions. Low intake or impaired availability of dietary antioxidants including vitamins E and C, carotenoids, polyphenols, and other micronutrients (e.g., selenium) weakens the antioxidant network. Postprandial oxidative stress, as a subform of nutritional oxidative stress, ensues from sustained postprandial hyperlipidemia and/or hyperglycemia and is associated with a higher risk for atherosclerosis, diabetes, and obesity. In Western societies, a significant part of the day is spent in the postprandial state. Unsaturated fatty acids incorporated into LDL and oxidized LOL are an atherogenic factor. Lipid hydroperoxides present in the diet are absorbed, contributing to the prooxidant load. In hyperlipidemic and hyperglycemic subjects, endothelium-dependent vasodilation is impaired in the postprandial state, making postprandial oxidative stress an important factor modulating cardiovascular risk. Postprandial oxidative stress is attenuated when dietary antioxidants are supplied together with a meal rich in oxidized or oxidizable lipids. Ingestion of dietary polyphenols, e.g., from wine, cocoa, or tea, improves endothelial dysfunction and lowers the susceptibility of LDL lipids to oxidation. Polyphenols affect endothelial function not solely as antioxidants but also as modulatory signaling molecules. [ABSTRACT FROM AUTHOR]

The article presents information on affordable housing. Having a home is having peace of mind that one has one's own place. There is no county in the united states where a household with one wage earner at minimum wage can afford a modest one-bedroom apartment. The United States has an affordable housing crisis. Affordable Housing provides a range of concrete examples of historical and current design solutions and, to a lesser extent, of the amalgam of public and private resources that helped them come to be.

The concept of systemic photoprotection by dietary means is gaining momentum. Skin is continuously exposed to ultraviolet (UV) radiation, the major cause of skin disorders such as sunburn, photodamage, and nonmelanoma skin cancer. Most of the erythemal annual UV dose is encountered under nonvacation conditions, when no sunscreen is applied. In the absence of topically added compounds, skin protection depends solely on endogenous defense. Micronutrients can act as UV absorbers, as antioxidants, or can modulate signaling pathways elicited upon UV exposure. UV-induced erythema is a suitable parameter to assess photoprotection. Dietary protection is provided by carotenoids, tocopherols, ascorbate, flavonoids, or n-3 fatty acids, con-tributing to maintenance resistance as part of lifelong protection. [ABSTRACT FROM AUTHOR]

Carotenoids are pigments which play a major role in the protection of plants against photooxidative processes. They are efficient antioxidants scavenging singlet molecular oxygen and peroxyl radicals. In the human organism, carotenoids are part of the antioxidant defense system. They interact synergistically with other antioxidants; mixtures of carotenoids are more effective than single compounds. According to their structure most carotenoids exhibit absorption maxima at around 450 nm. Filtering of blue light has been proposed as a mechanism protecting the macula lutea against photooxidative damage. There is increasing evidence from human studies that carotenoids protect the skin against photooxidative damage. [Copyright &y& Elsevier]

The inflammatory mediator peroxynitrite, when generated in excess, may damage cells by oxidizing and nitrating cellular components. Defense against this reactive species may be at the level of prevention of the formation of peroxynitrite, at the level of interception, or at the level of repair of damage caused by peroxynitrite. Several selenocompounds serve this purpose and include selenoproteins such as glutathione peroxidase (GPx), selenoprotein P and thioredoxin reductase, or low-molecular-weight substances such as ebselen. Further, flavonoids, such as (−)-epicatechin, which occurs in green tea or cocoa as monomer or in the form of oligomers, can contribute to cellular defense against peroxynitrite. [Copyright &y& Elsevier]

We have recently reported that flavonoids of cocoa inhibit the mammalian 15-lipoxygenase-1—a catalyst of enzymatic lipid peroxidation. To elucidate the structure–activity relationship of the inhibitory effect, we investigated the effects of 18 selected flavonoids of variable structure on pure rabbit reticulocyte and soybean 15-lipoxygenases using linoleic acid as substrate. Moreover, the inhibition by quercetin was studied in detail to gain insight into the mode of action. Quercetin was found to modulate the time-course of the reaction of both lipoxygenases by three distinct effects: (i) prolongation of the lag period, (ii) rapid decrease in the initial rate after the lag phase was overcome, (iii) time-dependent inactivation of the enzyme during reaction but not in the absence of substrate. A comparison of the ic50 for the rapid inhibition of rabbit reticulocyte 15-lipoxygenase-1 revealed that (i) the presence of a hydroxyl group in the flavonoid molecule is not essential, (ii) a catechol arrangement reinforces the inhibitory effect, (iii) in the presence of a catechol arrangement the inhibitory potency inversely correlates with the number of hydroxyl groups, (iv) a 2,3-double bond in the C ring strengthens the inhibitory effect. The flavone luteolin turned out to be the most potent inhibitor of the mammalian enzyme with an ic50 of 0.6 μM followed by baicalein (1 μM) and fisetin (1.5 μM). [Copyright &y& Elsevier]

Presents an obituary for Catherine Pasquier, President of the Society for Free Radical Research (Europe).