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A numerical, three-dimensional model with coupled biogeochemistry and physics is applied to the South China Sea's monsoon-forced marine productivity. The model describes a weak peak during the summer and a strong peak during the winter for primary productivity.

Objectives: Rural-urban differences in health remain a concern worldwide. Few studies have investigated the dynamic changes in health between rural and urban areas. This study aims to examine whether the rural-urban gap in patients' receipt of guideline-recommended care and avoidable hospitalizations has decreased in 10 years under a universal coverage health system. Study design: A retrospective cohort study design. Methods: This study utilized nationwide health insurance claims data of 3 representative cohorts of patients with newly diagnosed type 2 diabetes in 2000, 2005, and 2010 in Taiwan. The two outcome variables were receipt of guideline-recommended care and avoidable hospitalizations for diabetes. Generalized estimating equations models were used to estimate the rural-urban differences while controlling for physician-clustering effects. Results: Rural diabetic patients were less likely to receive guideline-recommended examinations/tests in 2000 (eβ = 0.97; 95% confidence interval [CI]: 0.96-0.99); however, the average number of examinations/tests increased and the rural-urban difference had diminished in 2010. The likelihood of avoidable hospitalizations for diabetes among rural diabetic patients was higher than that for their urban counterparts in 2000 (odds ratio [OR]: 1.13; 95% CI: 1.01-1.25). Although the likelihood of avoidable hospitalizations for diabetes decreased from 2000 to 2010, the rural-urban gap remained during this period. Conclusions: The rural-urban disparity in receiving recommended diabetes care diminished over the past decade. However, significant gaps between rural and urban areas in avoidable hospitalizations for diabetes persisted despite the universal health system. [ABSTRACT FROM AUTHOR]

Using a personalised medicine perspective, ECOTECH aims at developing new tools and methodologies to characterise and overcome at-risk situations for patients with Parkinson's disease in their daily life activity. With the cooperation of a multidisciplinary research group, patient situations have been studied in real life context in both hospital environment and home and community settings. Gait, in particular, has been assessed by combining data from an onboard sensor system, ethnographic observations and self-confrontation interviews. We discuss the results of this study with respect to the so-called activity analysis framework which is considered both as a resource for the design of new technologies and as a technology of design in the healthcare domain. In particular, we consider the potential for innovations regarding here, with the integration of onboard sensors, 1) the design of training 2) the design of artefact and work formats 3) the design of new mechanisms for health knowledge generation and validation. [ABSTRACT FROM AUTHOR]

Highlights: [•] We examined the relationship between grip strength and anthropometric factors and the benefit of a single bout of exercise on grip strength in young men with Down syndrome. [•] Greater grip strength was related to higher age, weight, body mass index and waist circumference. [•] Grip strength was improved after a single bout of exercise intervention but decreased after the control condition. [Copyright &y& Elsevier]

Abstract: Background: Orthotopic liver transplantation (OLT) is the definitive treatment for patients with end-stage liver disease. Many post-OLT patients have psychiatric comorbidities. The relationship between psychiatric comorbidities and biological factors, such as C-reactive protein (CRP) and albumin levels, in OLT recipients has seldom been investigated. Methods: We analyzed medical charts of all patients aged over 18 who underwent orthotopic OLT at a tertiary medical center between September 2008 and July 2010 for serum CRP and albumin levels before and 1 month after OLT. Data for baseline characteristics, such as gender, age, and body mass index (BMI), were also collected. Patients who had a psychiatric consultation or took psychotropic medications during the hospitalization were categorized as “with psychiatric comorbidities.” Results: Psychiatric comorbidities existed in 51 (33.8%) of 151 OLT recipients. By analysis of covariance adjusted for age and BMI, post-OLT CRP levels in patients with psychiatric comorbidities were significantly higher than those without psychiatric comorbidities (P = .015). For patients with psychiatric comorbidities, the paired t test showed significantly increased CRP levels at 1 month after when compared to the pre-OLT baseline levels (P = .044). Patients without psychiatric comorbidities had significantly decreased CRP levels at 1 month after when compared with the pre-OLT baseline levels (P = .009). Conclusions: Elevated CRP levels may indicate activation of a systemic inflammatory process caused by psychiatric comorbidities in OLT recipients. [Copyright &y& Elsevier]

Highlights: [•] We examined the relationship between sleep disturbance and executive functions in individuals with Down syndrome. [•] Sleep disturbance related to greater impairments in executive functions, including verbal fluency and inhibitory control. [•] Higher body mass index related to increased caregiver reports of OSA symptoms. [•] The presence of OSA could relate to early Alzheimer's disease; more work is needed to examine this hypothesized association. [ABSTRACT FROM AUTHOR]

This study aimed to project future temperature-associated mortality risk and additional deaths among Taiwan's elderly (aged >65 years) population. This study investigated retrospective temperature-mortality risk associations and future mortality projections. A distributed lag non-linear model and random effect meta-analyses were employed to assess the risk of daily temperature-associated deaths in all-cause, circulatory, and respiratory diseases. Using the statistical downscaling temperature projections of the Representative Concentration Pathways (RCPs; i.e. RCP2.6, RCP6.0 and RCP8.5), future risk of mortalities were projected among the elderly for 2030–2039, 2060–2069 and 2090–2099, with a 30%, 40% and 50% expected increase in elderly population proportions, respectively. The baseline analysis from 2005 to 2018 identified that Taiwan's population is more vulnerable to cold effects than heat, with the highest cold-related mortality risk being attributed to circulatory diseases, followed by all-cause and respiratory diseases. However, future projections suggest a declining trend in cold-related mortalities and a significant rise in heat-related mortalities under different RCP scenarios. Heat-attributable mortalities under the RCP8.5 scenario by 2090–2099 would account for almost 170,360, 36,557 and 29,386 additional annual deaths among the elderly due to all-cause, circulatory and respiratory diseases, respectively. Heat-attributable all-cause mortalities among the elderly would increase by 3%, 11% and 30% under RCP2.6, RCP6.0 and RCP8.5, respectively, by 2090–2099. The findings of this study provide predictions on future temperature-related mortality among the elderly in a developed, ageing society with a hot and humid climate. The results from this study can guide public health interventions and policies for climate change and ageing society–associated health risks. [Display omitted] [ABSTRACT FROM AUTHOR]

Abstract: The objective was to develop a high-throughput method of identifying sex in both Coturnix chinensis and Gallus gallus, which would be useful for biomedical research and hatcheries. Because chromo-helicase-DNA binding protein (CHD)-based Griffiths P2/P8 primers do not produce polymerase chain reaction (PCR) products with distinguishable sex-specific curves in melting curve analysis (MCA), these primers are unsuitable for high throughput application in either species. Conserved regions were identified by basic local alignment search tool (BLAST) analyses of cloned CHD-Z and CHD-W genes of C. chinensis. Based on sequence alignment, a female-specific CHD-W primer (W-cot-F1) and a female/male (or CHD-W/CHD-Z)-common primer (ZW-cot-F1) were redesigned for use in combination with the Griffiths P2 primer for MCA-based PCR reaction. In C. chinensis and G. gallus, W-cot-F1/P2 and ZW-cot-F1/P2 had amplicon lengths of 315/318 and 114 base pairs and melting temperatures (Tm) of approximately 79.5 °C to 80 °C and approximately 78.5 °C to 79°C, respectively. Thus, MCA distinguished sex based on two distinct Tm peaks in females versus only one Tm peak in males. The MCA-based real-time PCR combined with the proposed primer redesign provided a high-throughput method of identifying sex in C. chinensis and G. gallus. [Copyright &y& Elsevier]

Abstract: Protonated polyaniline (PANI) is directly polymerized on Nafion 117 (N117), forming a composite membrane, to act as a methanol-blocking layer to reduce the methanol crossover in the direct methanol fuel cell (DMFC), which is beneficial for the DMFC operating at high methanol concentration. The PANI layer grown on the N117 with a thickness of 100nm has an electrical conductivity of 13.2Scm−1. The methanol permeability of the PANI/N117 membrane is reduced to 59% of that of the N117 alone, suggesting that the PANI/N117 can effectively reduce the methanol crossover in the DMFC. Comparison of membrane-electrode-assemblies (MEA) using the conventional N117 and the newly developed PANI/N117 composite shows that the PANI/N117-based MEA outputs higher power at high methanol concentration, while the output power of the N117-based MEA is reduced at high methanol concentration due to the methanol crossover. The maximum power density of the PANI/N117-based MEA at 60°C is 70mWcm−2 at 6M methanol solution, which is double the N117-based MEA at the same methanol concentration. The resistance of PANI/N117 composite membrane is reduced at elevated methanol concentration, due to the hydrogen bonding between methanol and PANI pushes the polymer chains apart. It is concluded that the PANI/N117-based MEA performs well at elevated methanol concentration, which is suitable for the long-term operation of the DMFC. [Copyright &y& Elsevier]

Abstract: To understand plastic changes in the dorsal horn related to neuropathic pain, we developed a model of decompression in rats with chronic constriction injury (CCI) and investigated corresponding changes in the dorsal horn. At postoperative week 4 (POW 4) of CCI, rats were divided into a decompression group, in which ligatures were removed, and a CCI group, in which ligatures remained. Spinal cords were immunostained for substance P (SP), the δ-opioid receptor (DOR), and calcitonin gene-related peptide (CGRP). Areas of immunoreactive nerve terminals in the dorsal horn were quantified and expressed as the dorsal horn index (immunoreactive areas of the operated side compared with those of the contralateral side). At POW 4, dorsal horn indexes of all of these molecules were significantly reduced in both groups to similar degrees (0.36∼0.43). At POW 8, neuropathic pain behaviors had completely disappeared in the decompression group with significant reversal of the dorsal horn indexes compared with the CCI group (0.81±0.02 vs. 0.58±0.09, P<0.001 for SP and 0.75±0.04 vs. 0.55±0.03, P<0.001 for DOR). In the CCI group, neuropathic pain behaviors became normalized at POW 12 with corresponding changes in dorsal horn indexes for both SP and DOR similar to those of the decompression group. In contrast, changes in the dorsal horn indexes of CGRP were similar in both the CCI and decompression groups throughout the experimental period. These findings suggest that CCI and decompression cause different patterns in peptidergic and DOR (+) nerve terminals in the dorsal horn. [Copyright &y& Elsevier]

Objective: The purpose of this study was to assess a cohort of patients who underwent a colpocleisis procedure more than I year post operation to determine: 1) the proportion of patients who regretted having the procedure, 2) patient satisfaction with the procedure, and 3) changes in symptom severity after surgery. Study design: Using the University of Alabama at Birmingham (UAB) Genitourinary Disorders Center database, a prospective analysis was performed on 54 patients who underwent colpocleisis between August 1996 and April 2003. From August to October of 2004, participants were contacted by an investigator not involved with the surgery and were asked 1) ‘do you regret having your surgery, and, if so, why?,’ 2) ‘how satisfied are you with your progress (completely, somewhat, or not)?,’ and 3) to repeat the short form Incontinence Impact Questionnaire/Urogenital Distress Inventory (IIQ-7/UDI-6). Results: Fifty-nine percent (32/54) of potential candidates participated in the study. Nine percent (3/32) of patients regretted having colpocleisis performed. Fifty-seven percent (16/28) were completely satisfied, 29% (8/28) somewhat satisfied, and 14% (4/28) not satisfied. Mean IIQ score improved significantly from 40.9 (±31.7) at baseline to 14.1 (±26.7) at last interview (P = .003). Mean UDI score improved significantly from 63.1 (±24.3) at baseline to 24.2 (±26.7) at last interview (P = .001). There was a negative correlation between change in UDI scores with time since procedure (r = -.397, P = .055) and age (r = -.435, P = .034). Conclusion: Few patients reported regret after partial colpocleisis. There was a high rate of patient satisfaction and significant symptom improvement more than a year post surgery. Stable but smaller improvements were reported with longer time from surgery and increasing age. [ABSTRACT FROM AUTHOR]

Background Liver type fatty acid binding protein (L-FABP) is abundant not only in the liver but also in the kidney and is excreted in urine. Its primary function is to facilitate intracellular long chain fatty acid transport and it might also act as an endogenous antioxidant molecular. The purpose of this study was to investigate whether plasma or urinary L-FABP levels were associated with graft function in renal transplant recipients. Patients and methods Sixty-seven renal transplant recipients with a mean age of 48.8 years were recruited. The mean duration of renal transplantation was 4131 days. Recipients were divided into 2 groups based on their estimated glomerular filtration rate (eGFR) values: moderate graft function (eGFR ≥60 mL/min/1.73 m 2 ) and low graft function (eGFR <60 mL/min/1.73 m 2 ). Fasting plasma and urinary L-FABP levels were measured. Results There was no significant difference in plasma L-FABP level between the 2 groups, although recipients in the low graft function group had significantly lower urinary L-FABP level when compared with recipients in the moderate graft function group. Plasma and urinary L-FABP levels were not associated with eGFR in the 67 recipients; however, urinary L-FABP level (β = −1.24, P = .037) and level adjusted by urinary creatinine (β = −0.75, P = .046) were significantly negatively associated with eGFR in recipients with low graft function after adjusting for potential confounders. Conclusion Increased urinary L-FABP level seems to be a significant indicator of decreased graft function in renal transplant recipients with loss of graft function. [ABSTRACT FROM AUTHOR]

Abstract We present a patient with positive donor-specific antibodies (DSA) and crossmatch of ABO-incompatible (ABOi) combined liver and kidney transplantation (CLKT). Antibody-mediated rejection did not occur and the graft had survived for over one year at the time of writing without infectious complications. A 56-year-old man with positive DSA and positive crossmatch underwent living donor CLKT. The preoperative protocol for ABOi consisted of a single dose of rituximab and total plasma exchange (TPE). The result of anti-B antibody titer for IgG was 1:32. The evaluations of complement-dependent cytotoxicity and flow cytometry cross-match revealed a change from T+/B+ to T-/B+. The patient required adult living donor CLKT. Acute rejection episodes were treated using antithymocyte globulin, and the kidney required 7 days' treatment to recover. No further rejection and infectious episodes have been observed in past 13 months since the transplant. DSA and crossmatches are important for antibody detection and analysis. In the rituximab era, TPE can be used to achieve a successful decrease in antibody titer. In countries with a severe shortage of cadaveric organ donors, it may be possible to select ABOi candidate donors with positive DSA and crossmatch. Highlights • Positive DSA and crossmatch in ABOi combined liver-kidney transplantation has not been previously reported. • A patient with ABO and crossmatch incompatibilities underwent a successful combined liver-kidney transplantation following preoperative intervention. • We demonstrate that DSA/crossmatch positive and ABO-incompatible individuals could still be organ donor candidates. [ABSTRACT FROM AUTHOR]

Phenoloxidases (POs) play key roles in various physiological functions in insects, e.g., cuticular sclerotization, wound healing, egg tanning, cuticle formation and melanotic encapsulaction of pathogens. Previously, we identified five POs, designated As-pro-PO I–V, from the mosquito Armigeres subalbatus and demonstrated that the functions of As-pro-PO I, II and III, were associated with filarial parasite melanization, blood feeding and cuticle formation, respectively. In the present study, we delineate the dual functions of As-pro-PO V. We found that the level of As-pro-PO V mRNA in mosquitoes was significantly increased after microfilaria challenge or blood feeding, and decreased to normal level after oviposition. Knockdown of As-pro-PO V by dsRNA resulted in significant decreases in the degree of microfilaria melanization, egg chronic melanization rates and egg hatching rates in Ar . subalbatus . Further transfection and electrophoretic mobility-shift assays verified the As-pro-PO V gene might regulated by both AP-1, a putative immune-related regulatory element and CdxA, a developmental regulatory element. The binding of AP-1 and CdxA motif with mosquito nuclear extracts was significantly enhanced after microfilaria challenge and blood-feeding in Ar . subalbatus , respectively. These results indicate that As-pro-PO V is a critical enzyme that is required for both an effective melanization immune response and egg chorion melanization in this mosquito. [ABSTRACT FROM AUTHOR]

Highlights: [•] Inverted pyramidal neurons can be targeted for in vitro electrophysiology. [•] Inverted neurons are different from neighboring upright neurons. [•] Inverted neurons in the mouse neocortex differ from those found in the rat. [ABSTRACT FROM AUTHOR]

Background Gabapentin is an anticonvulsant and adjuvant analgesic. It is effective in several pain studies. Neuropathic pain is the most difficult type of pain to treat. In this study, we examined if intrathecal gabapentin could prevent nerve injury-induced pain. Methods Under isoflurane anaesthesia, male Sprague–Dawley rats (200–250 g) underwent right L5/6 spinal nerve ligation and placement of an intrathecal catheter connected to an infusion pump. After surgery, intrathecal saline or gabapentin (20 µg h−1) was given for 7 days (n=8 per group). The right hind paw withdrawal threshold to von Frey filament stimuli and withdrawal latency to radiant heat were determined before (baseline) and once daily for 7 days after surgery. Haematoxylin and eosin and toluidine blue staining were used to evaluate the neurotoxicity of gabapentin (40 µg h−1). Results Seven days after nerve ligation, the affected paw withdrawal threshold and latency of saline-treated rats decreased from the baseline 11.7 (11.7–22.2) [median (inter-quartile range)] to 1.6 (0.9–3.2) g and 10.8 (10.5–11.2) to 4.3 (4.2–7) s, respectively. Rats receiving gabapentin (20 µg h−1) had higher withdrawal threshold [9.9 (9.9–19.3) g] and latency [11.5 (9.7–11.9) s] on day 7 after ligation. No obvious histopathological change or growth retardation was detected after intrathecal gabapentin (40 µg h−1) infusion. Conclusions We showed a preventative effect of intrathecal gabapentin on the development of nerve injury-induced mechanical allodynia and thermal hyperalgesia. Our data suggest that continuous intrathecal gabapentin may be considered as an alternative for the prevention of nerve injury-induced pain. [ABSTRACT FROM PUBLISHER]