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Objective This study investigated the impact of COVID‐19 home confinement on autism spectrum disorder (ASD) symptoms and irritability in children and adolescents with ASD. Method The study participants included 46 drug‐naive children aged 4‐17 years diagnosed with ASD. Parents of the participants completed the Autism Behaviour Checklist (AuBC) and Affective Reactivity Index (ARI) scales for both normal conditions and COVID‐19 home confinement. Results All subscale scores for AuBC (sensory, relating, body and object use, language, and social and self‐help) and ARI scores significantly increased during the COVID‐19 home confinement period (P

Background Clinical symptoms of adults and paediatric inpatients with COVID‐19 disease are conflicting. This meta‐analysis was conducted to assess the effect of age of COVID‐19 inpatient on the severity of the disease. Methods A systematic literature search up to January 2021 was performed and 5 studies included 910 inpatients with COVID‐19 disease at the baseline of the study; 773 of them were adult inpatients, and 137 of them were paediatric inpatients. They reported a comparison between adults and children with COVID‐19 in the level of symptomatic severity, clinical features, computed tomography (CT) results and laboratory results. Odds ratio (OR) with 95% confidence intervals (CIs) were calculated assessing the effect of age of COVID‐19 inpatient on the severity of the disease using the dichotomous method with a random or fixed‐effect model. Results Adults with COVID‐19 disease had significantly lower number of mild cases (OR, 0.18; 95% CI, 0.04‐0.77, P = .02); higher number severe cases (OR, 4.90; 95% CI, 2.03‐11.83, P

Objective Coronavirus disease 2019 (COVID‐19) is an emerging, fast‐spreading, highly mortal and worldwide infectious disease. The pulmonary system was defined as the main target of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), but the mortality concept of this disease presented with more severe and systemic disease. The present study investigated the relationship between the patient characteristics at the initial hospital administration and fatality in COVID‐19 patients. Methods In this retrospective and comparative cohort study, all the 767 hospitalised COVID‐19 patients, treated between 18 March and 15 May 2020 in the Covid Clinics of Gulhane Training and Research Hospital in Ankara, Turkey, were evaluated. Results The fatality rate was significantly increased in patients with any comorbid disease except asthma. The initial laboratory test results indicated highly significant differences according to the patient's outcome. A multifactor logistic regression analysis was performed to calculate the adjusted odds ratios for predicting patient outcomes. Being older than 60 years increased the death risk with an adjusted OR of 7.2 (95% CI: 2.23‐23.51; P = .001). The presence of a cancer and the extended duration of intensive care unit treatment were other significant risk factors for nonsurvival. Azithromycin treatment was determined as significantly reduced the death ratio in these patients (P = .002). Conclusion It was revealed that being older than 60 years, presence of a cancer and extended duration of ICU treatment were the major risk factors for predicting fatality rate in hospitalised COVID‐19 patients.

Aim The frequency of vaccine refusal and hesitation, which is associated with many factors, is increasing worldwide. The purpose of this study is to estimate the frequency of vaccine refusal against COVID‐19 vaccines and to identify the underlying factors for refusal or hesitation. Materials and Methods This is a cross‐sectional study carried out in a district of Istanbul from 25 to 30 December 2020. A sample of people from the ages of 20 to 85 in the district was selected, and a total of 384 people were enrolled. A questionnaire about the COVID‐19 vaccine was administered to the participants by phone. The questionnaire consisted of questions about the sociodemographic characteristics of participants and their thoughts about possible COVID‐19 vaccines. Results 45.3% of the participants were hesitant about getting the COVID‐19 vaccine, which was declared appropriate by the Ministry of Health. The rate of those who think that the COVID‐19 vaccine will be effective in preventing and controlling the disease was 51.6%. 89.6% of the participants were hesitant about getting their children vaccinated. Those who do not consider COVID‐19 disease as a risk to their health were 22.9%, and 32.8% thought that they would be protected from the disease by natural and traditional ways. The median score of the participants' risk perception was 7 (IQR: 6‐8; Mean: 6.8; SD: 1.7). The median value of risk perception score of those who accept the vaccine was 6 (IQR: 4‐6), while the median value for those who did not accept the vaccine was 4 (IQR: 4‐6) (P

Background The outbreak of coronavirus disease 2019 (COVID‐19) rapidly spread across worldwide, posing a significant challenge to public health. Several shortcomings in the existing infectious disease management system were exposed during the pandemic, which hindered the control of the disease globally. To cope with this issue, we propose a window‐period framework to reveal the general rule of the progression of management of infectious diseases and to help with decision making at the early stage of epidemics with a focus on healthcare provisions. Methods The framework has two significant periods (dark‐window period and bright‐window period). Outbreak of COVID‐19 in China was used as an example for the application of the framework. Results The framework could reflect the progression of the epidemic objectively. The spread increased slowly in the dark‐window period, but rocketed up in the bright‐window period. The beginning of the bright‐window period was the time when healthcare personnel were exposed to a substantially high risk of nosocomial infection. Additionally, proper and prompt preventive actions during the dark‐window and bright‐window periods were substantially important to reduce the future spreading of the disease. Conclusions It was recommended that when possible healthcare provisions should upgrade to the highest level of alert for the control of an unknown epidemic in the dark‐window period, while countermeasures in the bright‐window period could be accordingly adjusted with full exploration and considerations. The framework may provide some insights into how to accelerate the control of future epidemics promptly and effectively.

Aims It is aimed to investigate the disease processes and drug combinations in patients who received favipiravir treatment. Methods This cross‐sectional, analytical and retrospective study included all patients aged ≥18 years (n = 502) who were hospitalised in Samsun, Turkey, for COVID‐19 and were given favipiravir from the date between 25 March 2020 and 3 June 2020. Results In total, 58.6% (n = 294) of the patients were male and 24.5% (n = 123) were between the ages of 71 and 80 years. During the first case process, the mortality rate was 19.9%, whereas the rate of those who were discharged as is/followed up at home for 14 days was 37.3%. During the second case process, the mortality rate was 6.2%, and the rate of those who was discharged as is/followed up at home for 14 days was 65.6%. The mean length of hospital stay was 10.61 ± 8.17 days for the first and 7.97 ± 4.16 days for the second hospitalisation; this difference was significant. Mortality risk of those who used Tocilizumab or vitamin C beside Favipiravir was higher than those who did not. The length of hospital stay was higher in patients using tocilizumab than in those who did not (P

Objectives Coronavirus‐19 is a rapidly progressing disease that can result in mortality. We aimed to evaluate the efficacy of the delta neutrophil index in predicting mortality in intensive care patients diagnosed with Coronavirus‐19. Materials and methods Patients with a positive polymerase chain reaction test and/or computed tomography findings compatible with the disease were included in the study. The demographic characteristics of the patients, polymerase chain reaction test results, chest computed tomography findings, blood parameters at the time of presentation, 30‐day mortality, and the number of days in the intensive care unit were assessed. Results Of the 388 patients receiving intensive care, 220 (56.7%) were men and 168 (43.3%) were women. The mean age was 70 ± 15 years. The evaluation of mortality, 264 (68%) of the patients survived and 124 (32%) died. The delta neutrophil index, neutrophil lymphocyte ratio, lactate, interleukin‐6 and C‐reactive protein values were statistically significantly higher and the lymphocyte value was significantly lower in the mortality group (P = .003, .034, .000, .002, .000 and .024, respectively). In the receiver operating characteristic curve analysis, the area under the curve values of the delta neutrophil index, lymphocyte, neutrophil lymphocyte ratio, lactate, interleukin‐6 and C‐reactive protein levels in predicting mortality were 0.718, 0.416, 0.628, 0.585, 0.701 and 0.684, respectively. Conclusion We consider that the delta neutrophil index can be used as an effective prognostic parameter to show intensive care mortality in patients with Coronavirus‐19.

Aims This study aims to analyse the novel Coronavirus disease- (COVID-19) related testicular pain in hospitalised patients because of COVID-19 and to review as an aetiological factor for epididymitis, orchitis or both. Methods A total of 91 patients were included in the study. A questionnaire was formed for the questioning of testicular pain or epididymo-orchitis in patients with COVID-19. Demographics and past medical history was also recorded. Patients' neutrophil and lymphocyte counts, neutrophil-lymphocyte ratios (NLR), C-reactive protein (CRP) levels and D-dimer values were recorded. Patients with COVID-19 were divided into two groups according to absence or presence of testicular pain or epididymo-orchitis as group 1 and group 2. All results were compared for both groups. Results The median age of patients was similar in both groups. Testicular pain was occurred in 10.98% of the patients. Clinical presentation of epididymo-orchitis was diagnosed in only one patient. No statistically significant difference was reported in terms of patients' age, levels of CRP and D-Dimer or NLR and results of questionnaire form queries between the two groups (P > .05). Conclusion Testicular pain was observed more frequently in hospitalised COVID-19 cases. While no inflammation marker which is related to predict of testicular pain or epididymo-orchitis was found in patients with COVID-19.

A novel coronavirus (severe acute respiratory syndrome corononavirus-2; SARS-CoV-2) has affected millions of people across the world. The coronavirus disease (COVID-19) resulting from SARS-CoV-2 manifests in variable clinical severity, featuring both respiratory and extra-respiratory symptoms. Dermatological manifestations of COVID-19 are sparsely reported. To study the various dermatological findings in SARS-CoV-2 positive patients in Indian population. Institutional ethical committee permission was sought and102 SARS-CoV-2 positive patients were included in the study. A thorough clinical examination was done to determine the nature and frequency of various dermatological manifestations in these patients. Out of the 102 positive cases, 95 were males. The mean age of the group was 39.30 years. Thirteen patients (12.7%) were found to have dermatological manifestations. Three (2.9%) had maculopapular rash, two (1.9%) had urticarial lesions and eight (7.8%) patients had itching without any specific cutaneous signs. Trunk was the most frequently affected area, followed by the extremities. No mucosal signs and symptoms were detected. Dermatological manifestations were seen in a small group of COVID-19 patients. The presentation may vary in different population groups and based on severity of disease.

Coronavirus disease, first emerged in Wuhan, rapidly spread all over the world since December 2019. There are concerns about elective dermatology appointments and its results. Herein, we aimed to find out which type of dermatologic patients attended to dermatology outpatient clinic. The patients visiting the clinics for elective dermatologic diseases between March 11 and 18, 2020, were included in this study. Their age, sex, diagnosis of disease, requirement for emergent intervention, and their medical records about COVID‐19 were obtained. There were 390 patients attending to the dermatology outpatient clinic in this period. The most common disease was acne (N: 94, 24%), only 19% of patients need emergent interventions or dose adjustment. There were 40 (10%) patients over the age of 65. After their visits, five patients were diagnosed as COVID‐19 in 2weeks. Dermatologic examinations may be a vector for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) transmission since being closed to the patient. Five of our patients were diagnosed as COVID‐19 after their elective visit to hospital. Since the asymptomatic course of some young patients, most of our patients were not screened for COVID‐19. Our findings support the concerns of elective physician examinations.

Summary Background Older subjects with type 2 diabetes mellitus (T2DM) have differential characteristics compared with middle-aged or younger populations, and require tailored management of the disease. Aims To evaluate how clinical characteristics, degree of control of glycaemia and cardiovascular risk factors, presence of chronic complications and treatments differ between older T2DM patients and younger adults. Methods Cross-sectional study using data from a population-based electronic database. We retrieved data from 318,020 patients ≥ 30 years diagnosed with T2DM, attended during 2011 in primary care centres in Catalonia, Spain. We performed descriptive and comparative analyses stratified by gender and age subgroups: ≤ 65, 66–75, 76–85 and >85 years. Results Both men and women across older age subgroups (> 65 years) had longer diabetes duration than younger adults (8.0 vs. 5.6 in men and 8.4 vs. 6.9 years in women; p < 0.001), but better glycaemic control (mean glycated haemoglobin 7.1 vs. 7.7 in men and 7.1 vs. 7.4 in women; p < 0.001), and better combined control of different cardiovascular risk factors (p < 0.001). Moreover, older patients were more likely to achieve glycaemic targets irrespective of having cardiovascular disease. The use of oral antidiabetics decreased with increasing age, and insulin in monotherapy was more frequently prescribed among patients in the older age subgroups. Diabetes-related complications were more frequent in men of all group ages. In the older age subgroups, patients of both sexes had a longer duration of T2DM but better glycaemic control. In this context, the prevalence of diabetic retinopathy decreased unexpectedly with increasing age. Conclusion Control of glycaemia and cardiovascular risk factors was better among older T2DM patients. There is a need for prospective studies to quantify the weight of risk factors in each complication to adapt the therapeutic and care approaches in elderly people.

SUMMARY Background: Response to treatment among primary care patients with gastrooesophageal disease (GERD) is variable. Aim: The GERD Management Project (GMP) evaluated the effectiveness of a structured management approach to GERD vs. standard treatment (usual care). Methods: Data from five cluster-randomised clinical trials in adult primary care patients with symptoms of GERD were pooled. The structured pathway was based on the self-administered GERD Questionnaire (GerdQ) and was compared with standard treatment. Results: 1734 patients were enrolled (structured treatment, n = 834; standard treatment, n = 900). The difference in the mean GerdQ score change from baseline favoured the structured pathway ()0.61; 95% CI: )0.88, )0.34; p < 0.001). The odds ratio for an indication for treatment revision at the end of follow-up (structured vs. standard treatment) was 0.39 (95% CI: 0.29, 0.52; p = 0.001). Conclusions: Management of primary care patients with GERD can be improved by systematic stratification of patients using a patient management tool such as the GerdQ. What’s known • The treatment response among primary care patients with gastro-oesophageal reflux disease (GERD) is variable and many patients who receive medical attention for GERD still continue to experience persistent symptoms. • An unmet need therefore exists for improved management of GERD in primary care, including a means to identify patients who may benefit from further assessment and more effective therapies.

Morbihan's disease is characterized by chronic persistent facial edema of the upper half of the face, absence of typical diagnostic findings, and refractoriness to treatment. A 44‐year‐old man was diagnosed with Morbihan's disease based on clinical signs and histopathology, which showed dermal edema in upper dermis, discrete lymphocytic infiltrate without granulomatous reaction, and mast cell infiltration. After long‐term therapy with intralesional triamcinolone a remarkable objective and subjective clinical response was observed. Reported cases of Morbihan's disease are reviewed, with respect to their treatment and histopathological findings. Mast cell infiltration has been observed on histopathology in most patients who responded to intralesional triamcinolone, suggesting a possible marker of response. The long‐lasting response seen in our case indicates the efficacy of intralesional triamcinolone in this rare condition.

SummaryEpilepsy is now recognized as the second most common neurological disease in China. To determine the genetic cause of epileptic encephalopathy, we performed a multiomics study using mouse models of controls, anticonvulsant mice treated with five drugs and epileptic mice. Based on genome-wide profiling analysis, we discovered four genes in the epileptic mouse group with differentially-expressed mRNA. After isobaric tags for relative and absolute quantification (iTRAQ) validation, only one gene, SNCA, remained, which was associated with apoptotic response of neuronal cells, and regulation of dopamine release and transport. We also identified three miRNAs targeting SNCA, out of which mmu-miR-21a-3p demonstrated a seven-fold change in expression between control and epileptic mice.

SummaryAim Real-world data on treatment patterns/outcomes in patients with advanced melanoma, while scarce, are useful for health technology assessments that govern patient access in many countries. We collected retrospective data on treatment patterns among patients in France, Germany and the UK with Stage IIIB/IIIC melanoma with macroscopic lymph node involvement, whose primary melanoma and regional lymph node metastases had been completely resected. Methods Patients ≥18 years were diagnosed between 1 January 2009 and 31 December 2011. Data were obtained from patients’ medical records and a patient survey. Results Forty-nine centres provided data on 558 patients: 53.6% had Stage IIIB disease; 58.2% were of working age (

Parkinson’s disease is a common chronic disease that affects a large number of people. In the real world, however, Parkinson’s disease can result in a loss of physical performance, which is classified as a movement disorder by clinicians. Parkinson’s disease is currently diagnosed primarily through clinical symptoms, which are highly dependent on clinician experience. As a result, there is a need for effective early detection methods. Traditional machine learning algorithms filter out many inherently relevant features in the process of dimensionality reduction and feature classification, lowering the classification model’s performance. To solve this problem and ensure high correlation between features while reducing dimensionality to achieve the goal of improving classification performance, this paper proposes a recurrent neural network classification model based on self attention and motion perception. Using a combination of self-attention mechanism and recurrent neural network, as well as wearable inertial sensors, the model classifies and trains the five brain area features extracted from MRI and DTI images (cerebral gray matter, white matter, cerebrospinal fluid density, and so on). Clinical and exercise data can be combined to produce characteristic parameters that can be used to describe movement sluggishness. The experimental results show that the model proposed in this paper improves the recognition performance of Parkinson’s disease, which is better than the compared methods by 2.45% to 12.07%.

In order to improve the effect of intensive care, this paper proposes a lean nursing intervention method and evaluates the lean nursing intervention through a controlled experiment. According to the actual situation of intensive care, this paper starts with the research from several aspects of patients’ ICU nursing time, patients’ satisfaction, patients’ pathological knowledge familiarity, patients’ autonomous nursing, and enthusiasm of patients and their families. Moreover, this paper collects and displays experimental results through mathematical statistics, gives patients lean management concepts and methods based on routine care, and finds that it has good management effects. Thus, lean management concepts and methods can effectively improve the anxiety state of critically ill patients, improve the patient’s knowledge of disease, and reduce adverse nursing events to improve patient nursing satisfaction, which is worthy of further promotion in the clinic.

Recently, many researchers have designed various automated diagnosis models using various supervised learning models. An early diagnosis of disease may control the death rate due to these diseases. In this paper, an efficient automated disease diagnosis model is designed using the machine learning models. In this paper, we have selected three critical diseases such as coronavirus, heart disease, and diabetes. In the proposed model, the data are entered into an android app, the analysis is then performed in a real-time database using a pretrained machine learning model which was trained on the same dataset and deployed in firebase, and finally, the disease detection result is shown in the android app. Logistic regression is used to carry out computation for prediction. Early detection can help in identifying the risk of coronavirus, heart disease, and diabetes. Comparative analysis indicates that the proposed model can help doctors to give timely medications for treatment.

Pneumonia is an infamous life-threatening lung bacterial or viral infection. The latest viral infection endangering the lives of many people worldwide is the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19. This paper is aimed at detecting and differentiating viral pneumonia and COVID-19 disease using digital X-ray images. The current practices include tedious conventional processes that solely rely on the radiologist or medical consultant’s technical expertise that are limited, time-consuming, inefficient, and outdated. The implementation is easily prone to human errors of being misdiagnosed. The development of deep learning and technology improvement allows medical scientists and researchers to venture into various neural networks and algorithms to develop applications, tools, and instruments that can further support medical radiologists. This paper presents an overview of deep learning techniques made in the chest radiography on COVID-19 and pneumonia cases.

Aims. Sickle cell disease (SCD) is an upcoming global health problem with rapid progress in therapy especially since 2017. However, systematic reviews found no clinical trials on the dental treatment of sickle cell disease (SCD). This article aims to outline the oral features of the sickle disease and discuss oral management strategies that can serve as guidelines for dental professionals. Material and Methods. A comprehensive literature review was conducted using PubMed, Google Scholar, and Web of Science. The search strategies were developed to cover publications from January 2010 to March 2020. With the help of keywords, multiple abstracts were identified. These abstracts were further reviewed, which included the information about the SCD manifestation, particularly about the oral health features. Based on all these articles and clinical experience, a narrative review was constructed, which summarizes all the aspects of the oral manifestation in people with SCD. Results. The results of this study demonstrate that there is distinct evidence available, indicating the developmental enamel defect leading to hypoplasia and increasing susceptibility to dental caries. Another important result of this review found that people with SCD have a vaso-occlusive crisis in the microcirculation in the dental pulp leading to symptomatic and asymptomatic pulpal necrosis without any signs of odontogenic pathology in an apparently healthy tooth. The study also found that early detection, intervention, and prevention are crucial for improving oral health care, and involving a multidisciplinary approach plays an important role in managing people with SCD. Conclusion. Patients with sickle cell disease have chronic overall health problems. The hematological disorder becomes their main concern and impaired oral health becomes secondary, increasing the risk for dental caries at the most. This paper broadly describes the oral manifestations of SCD, additionally; this paper also provides recommendations for better dental management of patients with SCD. Patients with SCD are often misjudged and, due to lack of knowledge and guidelines, dental providers are not able to provide adequate care. This paper attempts to highlight the essential measures to provide better dental care.

Purpose. The study explored the clinical influence, effectiveness, limitations, and human comparison outcomes of machine learning in diagnosing (1) dental diseases, (2) periodontal diseases, (3) trauma and neuralgias, (4) cysts and tumors, (5) glandular disorders, and (6) bone and temporomandibular joint as possible causes of dental and orofacial pain. Method. Scopus, PubMed, and Web of Science (all databases) were searched by 2 reviewers until 29th October 2020. Articles were screened and narratively synthesized according to PRISMA-DTA guidelines based on predefined eligibility criteria. Articles that made direct reference test comparisons to human clinicians were evaluated using the MI-CLAIM checklist. The risk of bias was assessed by JBI-DTA critical appraisal, and certainty of the evidence was evaluated using the GRADE approach. Information regarding the quantification method of dental pain and disease, the conditional characteristics of both training and test data cohort in the machine learning, diagnostic outcomes, and diagnostic test comparisons with clinicians, where applicable, were extracted. Results. 34 eligible articles were found for data synthesis, of which 8 articles made direct reference comparisons to human clinicians. 7 papers scored over 13 (out of the evaluated 15 points) in the MI-CLAIM approach with all papers scoring 5+ (out of 7) in JBI-DTA appraisals. GRADE approach revealed serious risks of bias and inconsistencies with most studies containing more positive cases than their true prevalence in order to facilitate machine learning. Patient-perceived symptoms and clinical history were generally found to be less reliable than radiographs or histology for training accurate machine learning models. A low agreement level between clinicians training the models was suggested to have a negative impact on the prediction accuracy. Reference comparisons found nonspecialized clinicians with less than 3 years of experience to be disadvantaged against trained models. Conclusion. Machine learning in dental and orofacial healthcare has shown respectable results in diagnosing diseases with symptomatic pain and with improved future iterations and can be used as a diagnostic aid in the clinics. The current review did not internally analyze the machine learning models and their respective algorithms, nor consider the confounding variables and factors responsible for shaping the orofacial disorders responsible for eliciting pain.

Today, with the development of medical technology, stomach cancer remains to be one of the most common causes of death associated with cancer. Studies show that the incidence of stomach cancer varies in different areas but is more common in China. Most patients were diagnosed late with local or remote metastasis. The data show that the survival rate within five years is less than 10%. Therefore, it is very important to study the gastric cancer cells systematically, explore the factors that lead to the change of the number of gastric cancer cells, and put forward practical suggestions for the prevention and control of the disease. This paper analyzes the disease-related information of several patients with gastric cancer in a hospital, discusses the growth of gastric cancer cells and season-related factors, and analyzes the single factor of gastric cancer patients and season-related possible factors. In this paper, we choose to observe gastric cancer cells in different seasons under the microscopic environment to further explore the influence of seasons on gastric cancer cells. The results showed that gastric cancer cells grew faster under microscope in spring and summer. We found that the incidence rate of gastric cancer in spring and summer was higher than that in autumn and winter. Diabetic patients and diabetes history are important risk factors of gastric cancer in spring and summer. Therefore, we advocate healthy lifestyle, pay attention to their poor performance in life, and actively help them to correct, which is of positive significance for the prevention and control of gastric cancer.

Lung cancer is a lethal disease, and early diagnosis with the aid of biomarkers such as HSP90α protein can certainly assist the doctors to start treatment of patient at the earliest and can save their lives. To analyse the diagnostic value of HSP90α expression in lung cancer patients by collecting data of patients through IoT devices to avoid delay in treatments, a study has been presented in this paper where the significance of HSP90α biomarker is highlighted in early diagnosis of patients suffering from lung cancer. The second objective of the research study is to examine the correlation between the appearance level of HSP90α biomarker and the clinicopathological features of lung cancer. It is also evaluated whether the changes in HSP90α index are indicative or noteworthy before and after surgery of lung cancer patients. An observatory study of 78 patients with lung cancer in Qinhuangdao Hospital is presented in this paper where the samples were collected from June 2018 to March 2020. Their data were collected through IoT devices used in the latest healthcare facilities of the hospital. The ELISA method was utilized to identify the level of plasma HSP90 and to analyse HSP90 levels between the lung cancer group and healthy group of people. The relationship between HSP90 and the clinical pathological features of 78 patients suffering from lung cancer was analysed. An electrochemical luminescence method was used to detect CEA, NSE, SCC, and CYFRA21-1 levels. ROC curve and box plots were used to determine the analytic value of HSP90 and other biomarkers used in lung cancer diagnosis. Forty-two patients with moderate to early stage lung cancer with surgical correction were selected, and paired sample T test was used to analyse HSP90 levels before and after surgery. The plasma HSP90 level of lung cancer patients was quite higher as compared to the group of healthy people as per the values depicted in the research study. Second, HSP90 levels are substantially higher in pathologic type, differentiation degree, stage, and the existence of the lung, liver, and bone metastases ( P P > 0.05). The ROC value for HSP90 was 0.599, while the area under the curve of HSP90 combined with other four tumour markers was 0.915 in the presented case study, indicating the presence of lung cancer. Patients with lung cancer had statistically significant differences in HSP90 expression levels before and after surgery ( P

ADHD is a common disease in children, and the pathogenesis is still unclear. Attention deficit is the main manifestation of ADHD, which has a serious impact on children’s learning and growth. The treatment of ADHD is mainly western medicine, supplemented by psychotherapy. More and more studies have shown that ADHD has similar characteristics to psychological diseases, and dopamine beta hydroxylase gene abnormality is the common feature of most mental diseases. In view of the potential relationship between ADHD and dopamine β hydroxylase gene, this paper will study the polymorphism of dopamine β hydroxylase gene in children with ADHD under the nursing intervention mode. This paper is divided into three parts. The first part is theoretical research. In this part, we deeply analyze ADHD. We think that the pathogenesis of ADHD mainly comes from four factors: heredity, environment, nutrition, and behavior. In order to further test the relationship between ADHD and dopamine beta hydroxylase gene, the corresponding experimental model was established in the second part of this paper. All the samples in the experiment are from real cases. The experimental principle and specific operation steps are given in detail. In order to facilitate comparison, the same number of control groups was established in addition to the real disease. The third part is the experimental results and analysis. After a number of comparative experiments, through the analysis of experimental data, we believe that ADHD is closely related to the gene of dopamine beta hydroxylase. Among them, the A2 gene in the patient group was significantly more than that in the normal group, which further verified that ADHD has the characteristics of common psychological diseases.

The aim is to summarize current knowledge on both QoL and depressive/anxious symptoms in patients with UM, including studies on the effect on QoL and psychological status of genetic testing related to the risk of metastatic disease. A review from the last 25 years by using the databases “PsycInfo,” “Medline,” and “Science Direct” was performed. As a total result, eighteen papers were retrieved. Eight studies (44.4%) used a prospective design methodology: two were retrospective observations (11.1%), three were cross-sectional observational studies (16.6%), and three (16.6%) were naturalistic follow-up studies. One trial was conducted with a case-control design (5.5%), and one was a methodological paper (5.5%). The number of subjects included in the studies ranged widely, between 7 and 842 (mean: 152.1 ± 201.3), for a total of 2587 patients, 1306 males (50.5%) and 1281 females (49.5%). The mean age of subject enrolled was 61.3 ± 4.1 years. Twenty-six different scales, questionnaires, or interviews were utilized. No significant differences in QoL between radiotherapy and enucleation emerged. Genetic testing did not significantly affect QoL or psychological status.

Objective. To evaluate the effect of Lycium barbarum polysaccharides in the treatment and/or prevention of diseases of different etiologies and systems. Methods. We performed an Entrez PubMed literature search using keywords “lycium”, “barbarum”, “polysaccharides”, “anti-fibrotic”, “anti-apoptotic”, “anti-oxidizing”, “anti-aging”, “neuroprotection”, “metabolism”, “diabetes”, “hyperlipidemia”, “neuroprotection”, and “immunomodulation” on the 14th of August 2018, resulting in 207 papers, of which 20 were chosen after filtering for ‘English language’ and ‘published within 10 years’ as well as curation for relevance by the authors. Results. The 20 selected papers included 2 randomized control trials (1 double-blinded RCT and 1 double-blinded placebo-controlled RCT), 11 in vivo studies, 5 in vitro studies, 1 study with both in vivo and in vitro results, and 1 chemical study. There is good evidence from existing studies on the antifibrotic, antioxidizing, neuroprotective, anticancer, and anti-inflammatory effects of Lycium barbarum polysaccharides. However, there is a need for further studies in the form of large-scale clinical trials to support its use in humans. There is also significant potential for LBP as a safe and effective topical treatment in ocular surface diseases, owing to promising in vitro results and a lack of demonstrated toxic effects to corneal epithelial cells. Conclusion. Results from existing studies suggest that LBP is a promising therapeutic agent, particularly in the management of liver disease, hyperlipidemia, and diabetes. One major limitation of current research is a lack of standardization and quality control for the LBP used. The availability of research-grade LBP will inevitably promote future research in this field worldwide.

The Global Foot-and-mouth disease (FMD) Research Alliance periodically reviews the state of FMD research to assess progress and to identify new priorities. In this supplement we provide an update of global FMD research, comprising (i) this overview paper, which includes background information with key findings, and papers covering (ii) epidemiology, wildlife and economics, (iii) vaccines, (iv) diagnostics, (v) biotherapeutics and disinfectants, (vi) immunology and (vii) pathogenesis and molecular biology. FMD research publications were reviewed (2011-2015) and activity updates were obtained from 33 FMD research institutes from around the world. Although a continual threat, FMD has been effectively controlled in much of the world using existing tools. However, control remains a challenge in most developing countries, where little has been done to understand the ongoing burden of FMD. More research is needed to support control in endemically infected countries, particularly robust field studies. Traditional FMD vaccines have several limitations including short duration and spectrum of protection, cold chain requirements, and the costs and biosecurity risks associated with vaccine production. Significant progress has been made in the development of novel vaccine candidates, particularly in the use of recombinant vaccines and virus-like particles as an alternative to traditional inactivated whole virus vaccines. Continued investment is needed to turn these developments into improved vaccines produced at scale. Increased knowledge of cellular and mucosal immunity would benefit vaccine development, as would further advances in our ability to enhance vaccine capsid stability. Developments in molecular biology and phylogenetics underlie many of the recent advances in FMD research, including improved vaccines and diagnostics, and improved understanding of FMD epidemiology. Tools for genetic analyses continue to become both more powerful and more affordable enabling them to be used to address an ever-expanding range of questions. This rapidly advancing field potentiates many areas of FMD research and should be prioritized.

Alzheimer’s disease (AD) is a neurodegenerative disorder that accounts for nearly 70% of the more than 46 million dementia cases estimated worldwide. Although there is no cure for AD, early diagnosis and an accurate characterization of the disease progression can improve the quality of life of AD patients and their caregivers. Currently, AD diagnosis is carried out using standardized mental status examinations, which are commonly assisted by expensive neuroimaging scans and invasive laboratory tests, thus rendering the diagnosis time consuming and costly. Notwithstanding, over the last decade, electroencephalography (EEG) has emerged as a noninvasive alternative technique for the study of AD, competing with more expensive neuroimaging tools, such as MRI and PET. This paper reports on the results of a systematic review on the utilization of resting-state EEG signals for AD diagnosis and progression assessment. Recent journal articles obtained from four major bibliographic databases were analyzed. A total of 112 journal articles published from January 2010 to February 2018 were meticulously reviewed, and relevant aspects of these papers were compared across articles to provide a general overview of the research on this noninvasive AD diagnosis technique. Finally, recommendations for future studies with resting-state EEG were presented to improve and facilitate the knowledge transfer among research groups.

The global burden of obesity and psychiatric disorders poses some of the greatest challenges to healthcare systems worldwide. These pathological conditions result from a combination of genetic and environmental factors. For instance, obesity and depression have a heritability of approximately 50% and are negatively affected by chronic stress, neuroendocrine and metabolic disorders, sedentary lifestyle, poor-quality diet, and excessive consumption of alcohol and other drugs of abuse [1, 2]. Interestingly, there is evidence suggesting a bidirectional negative interaction between these two pathological conditions [3, 4]. Recent evidence suggests that obesity and psychiatric disorders can reshape the brain. Whereas the hippocampus is a major brain area associated with mood and memory, the hypothalamus is the essential neuroendocrine region that controls food intake and energy expenditure. Previous research has shown that depressive behavior decreases adult hippocampal neurogenesis and antidepressant use prevents this effect [5]. Also, the adult hypothalamus can undergo neurogenesis and neurodegeneration [6]. There are common neuroinflammatory processes and cellular mechanisms occurring within different areas of the brain during obesity and psychiatric disorders [7]. Thus, the brain plasticity changes associated with obesity or psychiatric conditions could potentially expand the knowledge of both fields. The review article entitled “Obesity Reduces Cognitive and Motor Functions across the Lifespan” by C. Wang et al. highlights the negative impact of obesity on cognition and motor control. The authors discuss the deleterious effects obesity-related brain plasticity and the central actions of leptin, BDNF, and IGF-1. Their review also addresses the impact of exercise on counteracting obesity and obesity-related deficits altering cognition and motor control. Thus, their contribution dwells into different possible interrelationships among obesity, diabetes, and central nervous system pathways and how environmental factors such as physical exercise could promote favorable outcomes. In the review article entitled “The Effects of Leptin Replacement on Neural Plasticity,” G. Paz-Filho discusses the metabolic and neurocognitive effects of leptin replacement therapy. This field is currently gaining momentum since metreleptin, a leptin analogue, is currently being used to treat leptin-deficient individuals and also patients undergoing lipodystrophy and hypothalamic amenorrhea. This comprehensive review also describes leptin roles in neural plasticity and microglial function in leptin-deficient and leptin-sufficient individuals. The most relevant challenges to this treatment and its side effects are also described. There is an ongoing bias in the scientific literature that frequently does not acknowledge sex differences in study designs and analyses. Since sex-dependent variance underlying obesity, metabolic syndromes, and neural plasticity is not an exception to this rule, E. Underwood and L. T. Thompson report novel data addressing some of these issues in rodents. In their manuscript entitled “A High-fat Diet Causes Impairment in Hippocampal Memory and Sex-Dependent Alterations in Peripheral Metabolism,” they show for the first time sex-dependent metabolic regulation occurring along with sex-independent cognitive behavioral performance. Because current therapeutic strategies to treat obesity have failed in decreasing its global prevalence and incidence, novel approaches are much needed. In the review article entitled “Deep Brain Stimulation for Obesity: From a Theoretical Framework to Practical Application” R. K. Nangunoori et al. describe the central feeding and reward brain circuitries. The authors also postulate novel potential uses of deep brain stimulation to target the reward circuitry alone or in conjunction with hypothalamic areas modulating feeding behavior. However, further research in this area is needed to establish the putative use of this therapeutic approach. Alzheimer's disease is a neurodegenerative disease that has been estimated to affect up to 35 million people worldwide and predicted to affect 1 in 85 individuals by 2050. In the paper entitled “A Mutation in DAOA Modifies the Age of Onset in PSEN1 E280A Alzheimer's Disease,” J. Velez et al. provide novel data identifying new genes that could regulate the age of onset of Alzheimer's disease. Their study is based on the largest pedigree segregating a unique form of Alzheimer's disease. The pedigrees have been ascertained from a genetic isolate in Colombia that the authors have been studying for over 30 years [8, 9]. This original paper complements the results of other recently published reports by the same team that describe a novel gene network regulating the age of onset of Alzheimer's disease in the same genetic isolate [10]. Neuropsychiatric conditions such as major depression have been associated with altered levels of central excitatory neurotransmitters and/or their receptors. L.-C. Lee et al. expanded the field of knowledge in this area by showing novel associations between major depression and disruptive behaviors and single-nucleotide polymorphisms (SNPs) located within the genes encoding NMDA receptors (NMDAr). Their results are reported in the paper entitled “Influence of Genetic Variants of the N-Methyl-D-Aspartate Receptor on Emotion and Social Behavior in Adolescents.” The authors recruited 832 adolescents to evaluate their emotional and social impairments and to investigate their possible association with 59 SNPs harbored in NMDAr genes. The long-term effects of adverse early-life experiences have been frequently modelled in rodent paradigms of maternal separation. In the original article entitled “Repeated Three-Hour Maternal Separation Induces Depression-Like Behavior and Affects the Expression of Hippocampal Plasticity-Related Proteins in C57BL/6N Mice,” Y. Bian et al. report novel results using the maternal separation paradigm. The authors investigated the effect of maternal separation stress on hippocampal neuroplasticity during the early phase of young-adulthood development and found that mice had reduced levels of plasticity-related proteins and developed depressive-like behavior before reaching adulthood. Finally, in the original article entitled “History of Illicit Stimulant Use Is Not Associated with Long-Lasting Changes in Learning of Fine Motor Skills in Humans,” G. Todd et al. studied the possible long-lasting effects of illicit stimulant use in putative changes in learning of fine motor skills. The authors assessed motor learning with a three-minute visuomotor tracking task in three groups of individuals: abstinent stimulant users and two control groups comprising non-drug users and cannabis users. Their results show that the ability of learning of a new fine visuomotor skill remains unchanged in individuals with a history of illicit stimulant use. We hope that this special issue will provide new insights into important aspects of neural plasticity associated with obesity, stress, and drug abuse. We believe that the different research perspectives presented in this special issue will encourage efforts towards the development of novel scientific approaches to tackle obesity and psychiatric disorders such as major depression and addictive behavior. These chronic pathological conditions are responsible for one of the greatest global health and financial burdens of all times.

Tuberculosis is still a major health hazard in the developing world, while its incidence has recently started to escalate after decreasing for many years. It is a chronic granulomatous disease that can affect any part of the body, including the oral cavity. Oral lesions of tuberculosis, though uncommon, are seen in both the primary and secondary stages of the disease. This paper presents a case of tuberculosis of the submasseteric space, manifesting as a persistent swelling at ramus and angle of mandible. The diagnosis was confirmed based on histopathology after an open incisional biopsy. Patient underwent antituberculosis therapy and his extraoral swelling completely resolved after 4 months of the therapy. The purpose of this paper is to emphasize the importance of early and definitive diagnosis of orofacial tuberculosis, to recognize it based on signs and symptoms, and to refer the patients suspected of active tuberculous infection for appropriate medical treatment.

An increasing number of experiments have been designed to detect intracellular and intercellular molecular interactions. Based on these molecular interactions (especially protein interactions), molecular networks have been built for using in several typical applications, such as the discovery of new disease genes and the identification of drug targets and molecular complexes. Because the data are incomplete and a considerable number of false-positive interactions exist, protein interactions from different sources are commonly integrated in network analyses to build a stable molecular network. Although various types of integration strategies are being applied in current studies, the topological properties of the networks from these different integration strategies, especially typical applications based on these network integration strategies, have not been rigorously evaluated. In this paper, systematic analyses were performed to evaluate 11 frequently used methods using two types of integration strategies: empirical and machine learning methods. The topological properties of the networks of these different integration strategies were found to significantly differ. Moreover, these networks were found to dramatically affect the outcomes of typical applications, such as disease gene predictions, drug target detections, and molecular complex identifications. The analysis presented in this paper could provide an important basis for future network-based biological researches.

Biology has become the land of the “-omics,” including genomics [1], transcriptomics [2, 3], epigenomics [4], proteomics [5], lipidomics [6, 7], and metabolomics [8]. Each of these “-omics” generates a huge amount of high-throughput data, and it is a challenge both to analyze these data and to further investigate the function of specific molecules. Though more genomes have been completed due to the rapid development of sequencing technology [9], we cannot understand the information contained within a genome until we mine out its implicated functions including downstream transcription, translation, epigenetics modulation, and metabolic pathways. In this special issue, we mainly focus on functional “-omics” and bioinformatics. The Peer-reviewed papers are collected in the special issue. They are approximately divided into three areas: bioinformatics, functional genomics, and functional genetics. The majority of the papers are purely bioinformatics related papers. We define bioinformatics papers as those using computational tools or developing methods to analyze functional “-omics” data without using wet labs. Two papers fell into the category of functional genomics, which is focused on using whole genome level wet-lab technology to find important molecules and investigate their potential functions. Five papers are considered as functional genetics papers. Functional genetics is a broad concept here and these papers are concentrated on studying the molecular functions and mechanisms of individual molecules using wet-lab experimental approaches. Bioinformatics. In the bioinformatics papers, four papers deal with transcriptomics data. F. Wang et al. developed a novel approach for coexpression analysis of E2F1-3 and MYC target genes in chronic myelogenous leukemia (CML); they found a significant difference in the coexpression patterns of those candidate target genes between the normal and the CML groups. It is challenging to analyze the quantity of image data on gene expression. A. Shlemov et al. developed a method called 2D singular spectrum analysis (2D-SSA) for application to 2D and 3D datasets of embryo images related to gene expression; it turned out to work pretty well. J. Li et al. characterized putative cis-regulatory elements (CREs) associated with male meiocyte-expressed genes using in silico tools. They found that the upstream regions (1 kb) of the top 50 genes preferentially expressed in Arabidopsis meiocytes possessed conserved motifs, which were potential binding sites of transcription factors. NAGNAG alternative splicing plays an important role in biological processes and represents a highly adaptable system for posttranslational regulation of gene function. Interestingly, X. Sun et al. identified about 31 NAGNAG alternative splicing sites that were identified in human large intergenic noncoding RNAs (lincRNAs). Three papers are focused on the deification of new gene family members and gene evolution. Conotoxins are small disulfide-rich neurotoxic peptides, which can bind to ion channels with very high specificity and regulate their activities. H. Ding et al. developed a novel method called iCTX-Type, which is a sequence-based predictor that can be used to identify the types of conotoxins in targeting ion channels. A user-friendly web tool is also available. Y.-Z. Zhou et al. analyzed the evolution pattern and function diversity of PPAR gene family members based on 63 homology sequences of PPAR genes from 31 species. They found that gene duplication events, selection pressures on HOLI domain, and the variants on promoter and 3′UTR are critical for PPARs evolution and acquiring diversity functions. There has recently been considerable focus on its two human pathogenic species N. meningitidis and N. gonorrhoeae, which belong to Neisseria, a genus of gram-negative bacteria. D. Yu et al. selected 18 Neisseria genomes, preformed a comparative genome analysis, and identified 635 genes with recombination signals and 10 genes that showed significant evidence of positive selection. Further functional analyses revealed that no functional bias was found in the recombined genes. The data help us to understand the adaptive evolution in Neisseria. One paper tried to solve the key algorithm issue called the all-pairs suffix-prefix matching problem, which is crucial for de novo genome assembly. M. H. Rachid et al. developed a space-economical solution to the problem using the generalized Sadakane compressed suffix tree. One paper conducted a comparative genomics analysis. R. Cecagno et al. found that the versatile gene repertoire in the genome of rhizosphere bacterium Azospirillum amazonense could have been acquired from distantly related bacteria from horizontal transfer. They also demonstrated that the coding sequence related to production of phytohormones, such as flavin monooxygenase and aldehyde oxidase, is likely to represent the tryptophan-dependent TAM pathway for auxin production in this bacterium. They conclude that the genomic structure of the bacteria has evolved to meet the requirement for adaptation to the rhizosphere and interaction with host plants. One article conducted a meta-analysis. H. Ye et al. have demonstrated that rs2228671 is a protective factor of CHD in Europeans. One paper is concentrated on the microorganism bioinformatics. Y. Ding et al. recognized the roles of the synonymous codon usage in the formation of nsp1α structure of porcine reproductive and respiratory syndrome virus PRRSV. Functional Genomics. There are two papers that conducted gene association studies based on genome wide data. J. Li et al. found that the presence of ATTe4haplotype was associated with an increased risk of mental retardation (MR) in children but did not find any significant association between single loci of the four common ApoE polymorphisms (−491A/T, −427T/C, −219T/G, and e2/3/4) and MR or borderline MR. J. Zhou et al. did not find an association between rs7529229 and chronic heart disease (CHD) in Han Chinese. However, their meta-analyses indicated that rs7529229 was associated with the CHD risk in Europeans. Functional Genetics. There are 5 articles that investigate the individual gene function in different areas. Two papers are related to neural diseases. G.-M. Chang et al. found that activating NF-κB signaling pathway can protect intestinal epithelial cell No. 6 against fission neutron irradiation. X.-S. Liu et al. demonstrated that hepatocyte growth factor (HGF) could promote the regeneration of damaged Parkinson's disease (PD) cells at higher efficacy than the supernatant from hUC-MSCs alone. Thus, the combination of hUC-MSC with HGF could potentially be a new biological treatment for PD. One paper is focused on cancer. N. Ji et al. found that celastrol had antiprostate cancer effects partially through the downregulation of the expression level of hERG channel in DU145 cells, suggesting that celastrol may be a potential agent against prostate cancer with a mechanism of blocking the hERG channel. One paper is studying heart disease. Z. Lu et al. reported that the levels of NT-proBNP and CCR were closely related to the occurrence of HF and were independent risk factors for heart failure (HF). Meanwhile, there was a significant negative correlation between the levels of NT-proBNP and CCR. One interesting paper is trying to understand the function of Japanese encephalitis virus (JEV), and they have demonstrated that RNA recombination in JEV occurs unequally in different cell types. They conclude that the adjustment of viral RNA to an appropriately lower level in mosquito cells prevents overgrowth of the virus and is beneficial for cells to survive the infection. In summary, this special issue presents a broad range of topics from functional genomics, genetics, and bioinformatics. It covers a variety of diseases such as cancer, heart, and neural and infectious diseases. The study organisms include human, mouse, plant, and microorganisms. We hope that the readers will find interesting knowledge and methods in the issue. Youping Deng Hongwei Wang Ryuji Hamamoto David Schaffer Shiwei Duan

I congratulate Prokopieva et al. for their review “Use of Carnosine for Oxidative Stress Reduction in Different Pathologies” [1]. The authors overview properties and biological effects of the antioxidant carnosine (Cn). Data on the use of Cn in various conditions are discussed. Special attention is given to the use of carnosine in neurologic, mental diseases and alcoholism. I have read the paper with a great interest. However, a comment seems to be necessary to formulate a praxis-relevant and evidence-based conclusion. Cn or β-alanyl-L-histidine, an endogenously synthesized dipeptide, was reported to possess antioxidant properties [1, 2]. Cn enters blood being absorbed in the small intestine upon ingestion [2]. Cn is also synthesized in the human body; carnosine synthase is present in skeletal and heart muscle and certain brain regions and in other tissues. The synthesis rate of Cn appears to be predominantly rate-limited by the availability of β-alanine. Another precursor, L-histidine, is normally present in blood in sufficient concentrations [3]. The supply of β-alanine is dependent both on the hepatic synthesis from uracil and on the diet [2]. Cn penetrates through blood-brain barrier and is generally characterized by high bioavailability [1]. To decide whether supplementation of a substance is indicated, the question should be answered whether there can be a deficiency of that substance and if yes, whether it can be compensated for by a diet modification. Such deficiency appears to be improbable for Cn, which is abundant in muscles and can be synthesized in the body. Tissue Cn concentrations are influenced by the diet and are lower in vegetarians than in the general population [2, 4]. In vegetarians, muscle Cn content is limited by hepatic synthesis of β-alanine, whereas in omnivores there is additional dietary supply [5]. Cn was reported to be of importance for the antioxidant lens protection and preservation of its transparency, for prevention of certain neurologic and mental diseases. These potencies have been ascribed to the antioxidant properties of Cn [1, 2, 6, 7]. Among other potential applications, Cn eye drops have been recommended for cataracts [1, 6, 7]. However, if Cn concentration in body fluids is of importance, the incidence of corresponding conditions in vegetarians or population groups consuming less meat would be higher than average, which, to the best of our knowledge, has never been reported. Antioxidants affecting reactive oxygen species may have both harmful and beneficial effects [8]. The same is true particularly for Cn [9]. Generation of reactive oxygen species is a normal phenomenon in the course of aerobic metabolism [8]. Free radicals are not invariably toxic; some of them are necessary for the proper physiological functioning [10]. The redox status is maintained in equilibrium under the influence of many factors [11, 12]. The artificial support of the antioxidant status is considered to be not necessarily beneficial [11]. The topic of antioxidants is further complicated by conflicts of interest. Some antioxidants are propagated as dietary supplements or inexpensive substitutes for evidence-based medications. There are many examples of marketed substances without satisfactorily proven effectiveness beyond the placebo effect [13–17]. Publications of questionable reliability are sometimes used for advertising of drugs and dietary supplements, for their official registration, and for obtaining permissions for practical use. As a result, substances with unproven effects can be offered to the patients misinformed not only by advertising but also by some publications supposed to be scientific. The Cn eye drops sold in Russia are relatively expensive; they are prescribed to aged patients. In theory, Cn eye drops could be replaced by adequately prepared meat extract. Analogous suggestions have been made, for example, for osteoarthritis, to recommend for patients with low incomes to replace glycosaminoglycan-containing chondroprotectors with natural glycosaminoglycans that are abundant, for example, in animal cartilages and chicken wings [17]. To support the placebo effect, patients may be advised that the natural products can supply their organism with Cn similarly to drugs or dietary supplements. However, considering uncertainties about practical usefulness of antioxidants, discussed above, we would rather abstain from such recommendations. Even more precarious, because of complication risks [18], are recommendations of peribulbar injections of carcinine (an analog of Cn) as an antioxidant for prophylactic purposes [19]. Until recently, peribulbar injections of amino acid taurine (one of the most abundant amino acids in mammalian tissues [20, 21]) were used in the former SU as a preparation named Taufon in elderly patients for prophylactic purposes as well as for the treatment of macular dystrophy associated with atherosclerosis [22], while hematomas were observed as complications. Taufon has also been used as eye drops [23]. In conclusion, a stereotype that can be observed in some papers on normal metabolites such as Cn or taurine is as follows: metabolic importance of a substance is pointed out, which is true for many normal metabolites. In the second part of the paper, practical applications are discussed, although it remains unproven whether a deficiency of the substance ever occurs, and if it does, whether it can be compensated for by a diet, or a supplementation by drugs is really necessary. Note that drugs or dietary supplements might be more expensive for patients than a diet modification, for example, consumption of more meat products as a natural source of Cn or taurine. In any case, considering reported efficiency of Cn in chronic discirculatory encephalopathy, dementia, alcoholism, some mental disorders, and diabetes [1, 24, 25], an increase in consumption of meat products should be recommended for inhabitants of homes for the aged and psychiatric facilities. This seems to be the most important conclusion that can be derived from the article [1]. Benefits from the intake of Cn, other peptides, or amino acids in such patients may be seen as circumstantial evidence of malnutrition.

Unscheduled care (UC) refers to non-routine face-to-face care, such as accident and emergency care, out-of-hours care, or walk-in centres. Current health service policy aims to reduce its use. Unscheduled care is common in people with long-term conditions such as diabetes, asthma, chronic obstructive pulmonary disease and coronary heart disease. By reviewing qualitative research literature, we aimed to understand the breadth of psychosocial and other influences on UC use in people with long-term conditions. Few qualitative papers specifically address UC in patients in these disease groups. Therefore, our literature search also included qualitative research that explored factors potentially relevant to UC use, including attitudes to healthcare use in general. By searching Medline, Embase, Psycinfo and Cinahl from inception to 2011, we identified 42 papers, published since 1984, describing relevant original research and took a meta-ethnographic approach in reviewing them. The review was conducted between Spring 2009 and April 2011, with a further search in December 2011. Most papers reported on asthma (n = 13) or on multiple or unspecified conditions (n = 12). The most common methods reported were interviews (n = 33) and focus groups (n = 13), and analyses were generally descriptive. Theoretical and ethical background was rarely explicit, but the implicit starting point was generally the ‘problem’ of UC, and health-care, use in general, decontextualised from the lives of the patients using it. Patients’ use of UC emerged as understandable, rational responses to pressing clinical need in situations in which patients thought it the only option. This belief reflected the value that they had learned to attach to UC versus routine care through previous experiences. For socially or economically marginalised patients, UC offered access to clinical or social care that was otherwise unavailable to them.

The metabolic syndrome is a complex of clinical features leading to an increased risk for cardiovascular disease and type 2 diabetes mellitus in both sexes. Visceral obesity and insulin resistance are considered the main features determining the negative cardiovascular profile in metabolic syndrome. The aim of this paper is to highlight the central role of obesity in the development of a chronic low-grade inflammatory state that leads to insulin resistance, endothelial and microvascular dysfunctions. It is thought that the starting signal of this inflammation is overfeeding and the pathway origins in all the metabolic cells; the subsequent increase in cytokine production recruits immune cells in the extracellular environment inducing an overall systemic inflammation. This paper focuses on the molecular and cellular inflammatory mechanisms studied until now.

Visual and visuospatial dysfunction is prevalent in Parkinson’s disease (PD). To promote assessment of these often overlooked symptoms, we adapted the PD Vision Questionnaire for Internet administration. The questionnaire evaluates visual and visuospatial symptoms, impairments in activities of daily living (ADLs), and motor symptoms. PD participants of mild to moderate motor severity (n=24) and healthy control participants (HC,n=23) completed the questionnaire in paper and web-based formats. Reliability was assessed by comparing responses across formats. Construct validity was evaluated by reference to performance on measures of vision, visuospatial cognition, ADLs, and motor symptoms. The web-based format showed excellent reliability with respect to the paper format for both groups (allP′s<0.001; HC completing the visual and visuospatial section only). Demonstrating the construct validity of the web-based questionnaire, self-rated ADL and visual and visuospatial functioning were significantly associated with performance on objective measures of these abilities (allP′s<0.01). The findings indicate that web-based administration may be a reliable and valid method of assessing visual and visuospatial and ADL functioning in PD.

Despite diagnostic advances, breast cancer remains the most prevalent cancer among women in the United States. The armamentarium of treatment options for metastatic disease is limited and mostly ineffective with regards to eradicating cancer. However, there have been novel findings in the recent literature that substantiate the function of the microenvironment in breast cancer progression and the support of metastasis to tertiary sites such as bone marrow. The uncovered significance of the microenvironment in the pathophysiology of breast cancer metastasis has served to challenge previously widespread theories and introduce new perspectives for the future research to eradicate breast cancer. This paper delineates the current understanding of the molecular mechanisms involved in the interactions between breast cancer cells and the microenvironment in progression, metastasis, and dormancy. The information, in addition to other mechanisms described in bone marrow, is discussed in the paper.

This paper reviews the therapeutically beneficial effects of progressive resistance exercise (PRE) on Parkinson's disease (PD). First, this paper discusses the rationale for PRE in PD. Within the first section, the review discusses the central mechanisms that underlie bradykinesia and muscle weakness, highlights findings related to the central changes that accompany PRE in healthy individuals, and extends these findings to individuals with PD. It then illustrates the hypothesized positive effects of PRE on nigro-striatal-thalamo-cortical activation and connectivity. Second, it reviews recent findings of the use of PRE in individuals with PD. Finally, knowledge gaps of using PRE on individuals with PD are discussed along with suggestions for future research.

The prevalence and severity of tooth wear is increasing in industrialised nations. Yet, there is no high-level evidence to support or refute any therapeutic intervention. In the absence of such evidence, many currently prevailing management strategies for tooth wear may be failing in their duty of care to first and foremost improve the oral health of patients with this disease. This paper promotes biologically sound approaches to the management of tooth wear on the basis of current best evidence of the aetiology and clinical features of this disease. The relative risks and benefits of the varying approaches to managing tooth wear are discussed with reference to long-term follow-up studies. Using reference to ethical standards such as “The Daughter Test”, this paper presents case reports of patients with moderate-to-severe levels of tooth wear managed in line with these biologically sound principles.