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The purpose of this study was to investigate and evaluate the effectiveness of phytotherapy on a severe and complicated Immune Thrombocytopenia (ITP) patient who had failed with conventional treatments. A male patient presented with clinical symptoms of ITP and had been treated with Corticosteroids, Azathioprine, Eltrombopag, and platelet transfusions for over three years. The patient had an initial response but later developed severe complications, including hydrothorax, gastric pain, hematuria, and digestive hemorrhage, and no further response to treatment. The patient then received Phytotherapy for 17 months which significantly improved the clinical symptoms, platelet counts, and laboratory tests. Despite his active lifestyle, the patient was symptom-free with platelet counts ranging from 109 to 132×109/L. [ABSTRACT FROM AUTHOR]

Abstract: In the field of research for Severe Accidents in Nuclear Reactors, and more specifically In-Vessel Corium Retention, prediction of transient heat loads on the vessel wall is necessary, which involves a number of complex physical and chemical phenomena. In this framework, understanding of the interfacial conditions between the melt and the solid are relevant issues, which govern the heat flux distribution on the vessel wall. The LIVE experiment was launched at KIT to investigate the thermalhydraulics of a non-eutectic melt in a hemispherical shaped pool that is volumetrically heated and cooled on its lateral boundaries. The present work proposes an analysis of the experimental data obtained in LIVE L3A in order to describe the phenomenology at the interface for both hydraulic and chemical aspects, during transient as well as in steady state. In particular, a model is developed to describe analytically the melt temperature evolution and the crust thickness variation. Notably it is shown that the temperature at the pool-crust interface is close to the liquidus temperature corresponding to the initial concentration in the liquid pool. The characteristic parameters relative to the solidification rate and the thermal conditions determined in this work constitute the input needed to study more deeply the crust formation and notably to determine if a planar front is stable. [Copyright &y& Elsevier]

Abstract: The use of opioid medications for treating chronic noncancer pain is growing; however, there is a lack of good evidence regarding their long-term effectiveness, association with substance abuse, and proper prescribing guidelines. The current study directly compares for the first time in a randomized trial the effectiveness of a conservative, hold the line (Stable Dose) prescribing strategy for opioid medications with a more liberal dose escalation (Escalating Dose) approach. This 2-arm, parallel, randomized pragmatic clinical trial followed 135 patients referred to a specialty pain clinic at a Veterans Affairs Hospital for 12 months (94% male and 74% with musculoskeletal pain). Primary outcomes included monthly or quarterly evaluations of pain severity, pain relief from medications, pain-related functional disability, and opioid misuse behaviors. All subjects received identical pain treatment except for the application of treatment group specific strategies for opioid prescriptions. No group differences were found for primary outcomes of usual pain or functional disability although the Escalating Dose group did show a small but significantly larger increase in self-rated pain relief from medications. About 27% of patients were discharged over the course of the study due to opioid misuse/noncompliance, but there were no group differences in rate of opioid misuse. Perspective: The results of this study demonstrate that even in carefully selected patients there is a significant risk of problematic opioid misuse. Although in general there were no statistically significant differences in the primary outcomes between groups, the escalating dose strategy did lead to small improvements in self-reported acute relief from medications without an increase in opioid misuse, compared to the stable dose strategy. [Copyright &y& Elsevier]

Abstract: The function and development of cells rely heavily on the signaling interactions with the surrounding extracellular matrix (ECM). Therefore, a tissue engineering scaffold should mimic native ECM to recreate the in vivo environment. Previously, we have shown that an in vitro generated ECM secreted by cultured cells enhances the mineralized matrix deposition of marrow stromal cells (MSCs). In this study, MSC expression of 45 bone-related genes using real-time reverse transcriptase polymerase chain reaction (RT-PCR) was determined. Upregulation of osteoblastic markers such as collagen type I, matrix extracellular phosphoglycoprotein with ASARM motif, parathyroid hormone receptor, and osteocalcin, indicated that the MSCs on plain titanium scaffolds differentiated down the osteoblastic lineage and deposited a mineralized matrix on day 12. Significant mineralized matrix deposition was observed as early as day 4 on ECM-containing scaffolds and was associated with the enhancement in expression of a subset of osteoblast-specific genes that included a 2-fold increase in osteopontin expression at day 1 and a 6.5-fold increase in osteocalcin expression at day 4 as well as downregulation of chondrogenic gene markers. These results were attributed to the cellular interactions with growth factors and matrix molecules that are likely present in the in vitro generated ECM since the genes for insulin-like growth factor 1, insulin-like growth factor 2, vascular endothelial growth factor, dentin matrix protein, collagen type IV, cartilage oligomeric protein, and matrix metalloproteinase 13 were significantly upregulated during ECM construct generation. Overall, the data demonstrate that modulation of MSC differentiation occurs at the transcriptional level and gene expression of bone-related proteins is differentially regulated by the ECM. This study presents enormous implications for tissue engineering strategies, as it demonstrates that modification of a biomaterial with an in vitro generated ECM containing cell-generated bioactive signaling molecules can effectively direct gene expression and differentiation of seeded progenitor cell populations. [Copyright &y& Elsevier]

Abstract: This study aimed to determine if electromyographic (EMG) diagnostic evaluation can predict functional outcome in patients undergoing transforaminal lumbar spine epidural injections. In this retrospective study, functional outcome by Oswestry Disability Index (ODI) and verbal rating scale (VRS) for current pain severity was evaluated in 39 patients undergoing lumbar transforaminal epidural spinal injections (ESI). Subjects with low back pain (mean age, 60 ± 12.5 years) were evaluated for functional improvement post EMG and ESI. Of 39 patients tested with EMG before injection, 18 patients were positive for radiculopathy and 21 had a normal or negative examination. The patients were followed postinjection on average of 10.8 (SD ± 3.9) weeks. Pretreatment ODI scores were not significantly different between groups showing positive (72.3 SD ± 12.7) and negative (65.9 SD ± 18.6, P > .05) EMG findings. There was significantly greater improvement of ODI for EMG positive radiculopathy (7.11 SD ± 9.5) compared with negative EMG (3.2 SD ± 17.4, P < .05). Positive radiculopathy subjects complained of more pain by VRS before ESI than subjects with negative EMG findings, 8.1 SD ± 1.0 and 7.3 SD ± 0.8, respectively, which was not significant (P > .05). VRS mean improvement was not significantly different in the positive EMG group (1.8 SD ± 1.2) compared with a negative EMG (1.2 SD ± 1.2, P > .05). Perspective: The results appear to show that patients undergoing transforaminal ESI, who have a positive radiculopathy by EMG before injection, will have significant improvement in functional outcome by ODI but not with current pain intensity by VRS. This study suggests the importance and diagnostic value of ordering electromyography studies for lumbar radiculopathy evaluation, which may lead to prediction of outcome with lumbar transforaminal epidural spinal procedures. Furthermore, the current study highlights the difficulty of pain evaluation outcome by VRS. [Copyright &y& Elsevier]

• The paper establishes a predictability heterogeneity over US industries. • Stock returns are more predictable in sectors with a large average firm size while dividend growth is not. • Differences in dividend smoothness potentially drive cross-industry predictive patterns. This paper revisits the return predictability pattern in the stock market and investigates whether this pattern is valid across US industries. Using data over the last 91 years, I confirm that value-weighted stock returns are predictable. Moreover, my work establishes a predictability heterogeneity over US industries, in which stock returns are more predictable in sectors with a large average firm size. In light of the dividend-smoothing hypothesis, I show that differences in dividend smoothness potentially drive cross-industry predictive patterns. The findings further suggest that dividend yields are not good proxies for predicting returns in some small industries. [ABSTRACT FROM AUTHOR]

• To our knowledge, this is the first in-depth comparative inquiry between farming and fishing communities in South East Asia written in English. • Based on fieldwork in 26 villages we reveal differentiated trajectories of immiserizing growth, inequality, and coping. • In the Indonesian research areas inequality among fishers is lower than among farmers, while this is the opposite in Thailand and Vietnam. • Rural development theories and policies would benefit from taking into account interactions between fishing-based and farming based livelihoods. • We propose a reconceptualization of the middle-income trap and seek an effective integration of territorial, sectoral, and welfare policies. South East Asia is generally considered to be a relatively successful part of the Global South, yet wealth distribution remains socially and spatially skewed. This calls for a better understanding of how middle-income countries can improve the quality of economic growth. This article investigates rural inequality through the concepts of the multi-scalar middle-income trap and immiserizing growth. In addition to rural–urban differences there are stark disparities in rural and coastal villages. We compare processes of inequality and exclusion within and between fishing and farming communities in Indonesia, Thailand, and Vietnam. Our empirical inquiry focuses on livelihood challenges, inequality, and coping mechanisms based on 438 interviews in four coastal and four inland research sites covering 26 villages. We show that apart from the farming area in Vietnam, the personalized and spatial dimensions of the middle-income trap keep fishers and farmers in vulnerable settings and rural inequality is widening. This is particularly the case among farmers in Indonesia and fishers in Thailand and Vietnam. A chain of events can be identified from exclusion to immiserizing growth to in situ coping (Southern Thailand and Malang) and circular migration (Sukabumi and migrants from Central Vietnam). Our comparative investigation also reveals a substantial degree of resignation: villagers neither expect transformational change nor do they consider permanent outmigration. Based on these results we advocate for a reconceptualization of the middle-income trap and seek a more effective integration of territorial, sectoral, and welfare policies in South East Asia. [ABSTRACT FROM AUTHOR]

Abstract: We investigated the fabrication of highly porous scaffolds made of three different materials [poly(propylene fumarate) (PPF) polymer, an ultra-short single-walled carbon nanotube (US-tube) nanocomposite, and a dodecylated US-tube (F-US-tube) nanocomposite] in order to evaluate the effects of material composition and porosity on scaffold pore structure, mechanical properties, and marrow stromal cell culture. All scaffolds were produced by a thermal-crosslinking particulate-leaching technique at specific porogen contents of 75, 80, 85, and 90vol%. Scanning electron microcopy, microcomputed tomography, and mercury intrusion porosimetry were used to analyze the pore structures of scaffolds. The porogen content was found to dictate the porosity of scaffolds. There was no significant difference in porosity, pore size, and interconnectivity among the different materials for the same porogen fraction. Nearly 100% of the pore volume was interconnected through 20μm or larger connections for all scaffolds. While interconnectivity through larger connections improved with higher porosity, compressive mechanical properties of scaffolds declined at the same time. However, the compressive modulus, offset yield strength, and compressive strength of F-US-tube nanocomposites were higher than or similar to the corresponding properties for the PPF polymer and US-tube nanocomposites for all the porosities examined. As for in vitro osteoconductivity, marrow stromal cells demonstrated equally good cell attachment and proliferation on all scaffolds made of different materials at each porosity. These results indicate that functionalized ultra-short single-walled carbon nanotube nanocomposite scaffolds with tunable porosity and mechanical properties hold great promise for bone tissue engineering applications. [Copyright &y& Elsevier]

The increasing consumption of sugar-sweetened beverages in middle-income countries is having significant detrimental health effects. Beverage choices are influenced by consumers’ perceptions of products. Understanding the factors influencing perceptions is essential to reducing consumption of unhealthy beverages. To date little research has been conducted in this area, particularly outside of Western contexts. This study aimed to examine the health-related perceptions of non-alcoholic beverages and associated factors in five countries in the Asia Pacific region. A cross-sectional online survey was administered to middle-class household food providers in Melbourne, Shanghai, Vietnam, Indonesia and Singapore (n = 3951, 57% female). Participants rated the healthiness of common beverages and information on demographics, trust in sources of nutrition information and personal values was obtained. Data was analysed via principal components analysis and multiple linear regressions. Results demonstrated that both demographic and psychographic factors were associated with the perceived healthiness of beverages. Respondents perceived beverage healthiness in four types: sweetened, heavily marketed beverages, milk-based and children’s products, unsweetened, minimally processed beverages and waters. The perceived healthiness of sweetened, heavily marketed beverages and milk-based and children’s products was higher in Vietnam, Shanghai and Indonesia than in Singapore and Melbourne and positively associated with trust in industry sources of nutrition information and hedonist values. Perceiving unsweetened, minimally processed beverages as healthy was associated with trust in health authorities and equality-nature values. Reducing the perceived healthiness and consumption of unhealthy drinks requires nutrition education that responds to economic and cultural contexts and frames messages to appeal to prevailing personal values. [ABSTRACT FROM AUTHOR]

Alcaligenes faecalis D334 was determined in this study as a salt-tolerant bacterium isolated from mangrove sediment. In response to 6% (w/v) NaCl, strain D334 produced the highest ectoines of 14.14 wt%. To understand adaptive features to mangrove environment, strain D334 was sequenced using Pacific BioScience platform, resulting in a circular chromosome of 4.23 Mb. Of note, D334 genome harbored 81 salt-responsive genes, among which two membrane-associated genes ompc and eric were absent in 3 selected A. faecalis genomes. Apart from that, a complete pathway for ectoine and 5-hydroxyectoine synthesis was predicted. To resist 40 mM H 2 O 2 , 46 genetic determinants contributing to oxidative stress response were employed. Moreover, two operons involved in polyhydroxyalkanoate (PHA) production were identified in the D334 genome, resulting in maximum PHA content of 5.03 ± 0.04 wt% and PHA concentration of 0.13 ± 0.001 g/L. A large flagellar biosynthesis operon contributing to swimming motility was found to be conserved in D334 and 8 other A. faecalis genomes. These findings shed light for the first time on the high versatility of A. faecalis D334 genome to adapt to mangrove lifestyle and the possibility to develop D334 as an industrial platform for PHA and 5-hydroxyectoine production. [ABSTRACT FROM AUTHOR]

Abstract: The Prescription Drug Use Questionnaire (PDUQ) is one of several published tools developed to help clinicians better identify the presence of opioid abuse or dependence in patients with chronic pain. This paper introduces a patient version of the PDUQ (PDUQp), a 31-item questionnaire derived from the items of the original tool designed for self-administration, and describes evidence for its validity and reliability in a sample of patients with chronic nonmalignant pain and on opioid therapy. Further, this study examines instances of discontinuation from opioid medication treatment related to violation of the medication agreement in this population, and the relationship of these with problematic opioid misuse behaviors, PDUQ and PDUQp scores. A sample of 135 consecutive patients with chronic nonmalignant pain was recruited from a multidisciplinary Veterans Affairs chronic pain clinic, and prospectively followed over one year of opioid therapy. Using the PDUQ as a criterion measure, moderate to good concurrent and predictive validity data for the PDUQp are presented, as well as item-by-item comparison of the two formats. Reliability data indicate moderate test stability over time. Of those patients whose opioid treatment was discontinued due to medication agreement violation-related discontinuation (MAVRD) (n =38 or 28% of sample), 40% of these (n =11) were due to specific problematic opioid misuse behaviors. Based upon specificity and sensitivity analyses, a suggested cutoff PDUQp score for predicting MAVRD is provided. This study supports the PDUQp as a useful tool for assessing and predicting problematic opioid medication use in a chronic pain patient sample. [Copyright &y& Elsevier]

Abstract: This study introduces the Addiction Behaviors Checklist (ABC), which is a brief (20-item) instrument designed to track behaviors characteristic of addiction related to prescription opioid medications in chronic pain populations. Items are focused on observable behaviors noted both during and between clinic visits. One hundred thirty-six consecutive veterans in a multidisciplinary Veterans Affairs Chronic Pain Clinic who were receiving long-term opioid medication treatment were included in this study. This study represents one of the first to follow a sample of chronic pain patients on opioid therapy over time, using a structured assessment tool to evaluate and track behaviors suggestive of addiction. Interrater reliability and concurrent validity data are presented, as well as a cut-off score for use in determining inappropriate medication use. The psychometric findings support the ABC as a viable assessment tool that can increase a provider''s confidence in determinations of appropriate vs. inappropriate opioid use. [Copyright &y& Elsevier]