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Background Bulla is a common cause of primary spontaneous pneumothorax. Video-assisted thoracoscopic surgery (VATS) through the lateral chest wall is a common surgical approach and an effective treatment for this condition, but postoperative incision scars affect the aesthetic outcome. VATS via axillary approach can hide the scar in the axilla, and the wound in its natural state is invisible; this greatly improves the cosmetic appearance. To our knowledge, this is the first report of VATS-based bullectomy via the axillary approach in a patient with spontaneous pneumothorax. Case presentation A 20-year-old female patient was admitted to the hospital with a 2-day history of chest tightness and chest pain. Plain chest computed tomography showed right spontaneous pneumothorax, lung compression of 75%, and right pulmonary bulla. After complete preoperative examination, VATS bullectomy via right axillary approach was performed. During the operation, a bulla measuring about 4 × 4 cm was found at the apex of the right lung and resected. The incision healed well, and the patient was discharged after surgery. Conclusions VATS bullectomy via axillary approach is safe and feasible, with the incision hidden in the axilla and not visible in the natural state. This method leaves no scar on the chest wall and has good cosmetic outcome.

Ovarian cancer is the most lethal gynecologic malignancy due to the late diagnoses at advanced stages, drug resistance and the high recurrence rate. Thus, there is an urgent need to develop new techniques to diagnose and monitor ovarian cancer patients. Fourier transform infrared (FTIR) spectroscopy has great potential in the diagnosis of this disease, as well as the real-time monitoring of cancer development and chemoresistance. As a noninvasive, simple and convenient technique, it can not only distinguish the molecular differences between normal and malignant tissues, but also be used to identify the characteristics of different types of ovarian cancer. FTIR spectroscopy is also widely used in monitoring cancer cells in response to antitumor drugs, distinguishing cells in different growth states, and identifying new synthetic drugs. In this paper, the applications of FTIR spectroscopy for ovarian cancer diagnosis and other works carried out so far are described in detail.

Purpose The incidence of nonsuicidal self-injury (NSSI) behavior among adolescents increases year by year. Patients with a history of both depression and NSSI behaviors tend to have greater risk of suicide. At present, the mechanism of adolescent depressive disorder patients with NSSI behaviors is not clear, epigenetic mechanism may be involved. Proopiomelanocortin (POMC) gene may be associated with depressive disorder. The purpose of this study was to investigate DNA methylation of POMC gene promoter region of adolescent depressive disorder patients with NSSI behaviors. Methods Bisulfite Sequencing PCR (BSP) was used to test the methylation level of POMC promoter of 15 adolescent depressive disorder patients with NSSI behaviors and 15 healthy controls (HC). Self-made questionnaires were used to collect clinical data of the case group and control group. Hamilton depression scale-24 (HAMD-24), Hamilton anxiety scale (HAMA), Symptom Checklist-90 (SCL-90) were used to evaluate the characteristics and severity of depressive, anxiety and psychotic symptoms. Adolescent self-injury questionnaire was used to assess NSSI behaviors and its severity. Results BSP analysis found that the POMC methylation level of cytosine-guanine dinucleotide 1 (CpG1) site was higher in the case group than that of HC (P

The application of microalgae biotechnology, which can recover nutrients from wastewater, improve water quality, and feed some aquatic animals, is becoming an emerging trend in the development of eco‐friendly aquaculture. Previous studies explored a variety of models to support the use of microalgae in aquaculture practice, verifying the feasibility and advantages of microalgae‐based aquaculture. However, a couple of bottlenecks and problems jeopardizing the application of microalgae biotechnology in aquaculture are discovered in the research and industrial practice. This work, hence, summarizes the research progress and the current opinions relating with the microalgae‐based aquaculture and proposes some critical thoughts about the bottlenecks challenging its industrial implementation. © 2020 Society of Chemical Industry (SCI)

Anthracyclines are a class of conventional and commonly used frontline chemotherapy drugs to treat breast cancer. However, the anthracycline-based regimens can only reduce breast cancer mortality by 20–30%. Furthermore, there is no appropriate biomarker for predicting responses to this kind of chemotherapy currently. Here we report our findings that may fill this gap by showing the AQP1 (Aquaporin1) protein as a potential response predictor in the anthracycline chemotherapy. We showed that breast cancer patients with a high level of AQP1 expression who underwent the anthracycline treatment had a better clinical outcome relative to those with a low level of AQP1 expression. In the exploration of the underlying mechanisms, we found that the AQP1 and glycogen synthase kinase-3β (GSK3β) competitively interacted with the 12 armadillo repeats of β-catenin, followed by the inhibition of the β-catenin degradation that led to β-catenin’s accumulation in the cytoplasm and nuclear translocation. The nuclear β-catenin interacted with TopoIIα and enhanced TopoIIα’s activity, which resulted in a high sensitivity of breast cancer cells to anthracyclines. We also found, the miR-320a-3p can attenuate the anthracycline’s chemosensitivity by inhibiting the AQP1 expression. Taken together, our findings suggest the efficacy of AQP1 as a response predictor in the anthracycline chemotherapy. The application of our study includes, but is not limited to, facilitating screening of the most appropriate breast cancer patients (who have a high AQP1 expression) for better anthracycline chemotherapy and improved prognosis purposes.

The aim of this study is to compare the recurrence rates with different modalities used as first-line treatment for first-episode primary spontaneous pneumothorax, and investigated the risk factors for recurrence. We retrospectively reviewed consecutive patients under 60 years of age who were treated for a first episode of primary spontaneous pneumothorax between May 1996 and May 2016 at our hospital. The patients were divided into 6 groups according to the treatment received. A total of 667 patients with 890 episodes of primary spontaneous pneumothorax were included in the analysis. The median follow-up period was 64.5 months. The recurrence rate in the 6 groups was as follows: observation, 52.5% (21/40); chest tube drainage, 32.6% (84/258); aspiration, 100% (42/42); axillary thoracotomy, 8.8% (9/102); 2-port video-assisted thoracoscopic surgery (VATS), 6.0% (7/117); and 3-port VATS, 10.6% (11/108). The recurrence rate was higher in non-surgery groups than in surgery groups (147/340 vs 27/327, P

When coupled online with mass spectrometry (MS), widely applied water-in-oil droplet-based microfluidics for single cell analysis met problems. For example, the oil phase rumpled the stability, efficiency, and accuracy of MS, the conventional interface between MS and the microfluidic chip suffered the low sample introduction efficiency, and the transportation rates sometimes unmatched the readout dwell times for transient signal acquisition. Considering cells are already "droplets" with hydrophilic surface and elastic hydrophobic membrane, we developed an oil-free passive microfluidic system (OFPMS) that consists of alternating straight-curved-straight microchannels and a direct infusion (dI) micronebulizer for inductively coupled plasma quadrupole-based mass spectrometry (ICP-qMS) of lined-up single-cell. OFPMS guarantees exact single cell isolation one by one just using a thermo-decomposable NH4HCO3 buffer, eliminating the use of any oil and incompatible polymer carriers. It is more flexible and facile to adapt to the dwell time of ICP-qMS owing to the adjustable throughput of 400 to 25000 cells/min and the controllable interval time of at least 20 ms between the lined-up adjacent single cells. Quantitative single-cell transportation and high detection efficiency of more than 70% was realized using OFPMS-dI-ICP-qMS exemplified here. Thus, cell-to-cell heterogeneity can be simply uncovered via the determination of metals in the individual cells.

Background: Women with breast cancer (BC) commonly experience physical and psychosocial symptoms after surgery. Web- and smartphone-based support can significantly improve women's symptoms and qual...

Background The study aim was to obtain epidemiological data on vitamin D levels for the pediatric population in Japan. We assessed the prevalence of vitamin D deficiency and insufficiency in 2-year-old Japanese children using data from a large ongoing birth cohort study. Methods Data for analysis was obtained from the Japan Environment and Children’s Study (JECS) and a Sub-Cohort Study (SCS) of JECS. We evaluated the children’s serum 25(OH) D levels by 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles, and the rates of vitamin D deficiency or insufficiency. We also presented a weighted prevalence rate for vitamin D deficiency or insufficiency among all children in JECS. Results After excluding children with missing 25(OH)D2 or 25(OH)D3 data, we analyzed 4655 remaining children, of whom 24.7% (95% CI, 23.5–26.0%) had vitamin D deficiency ( Conclusion We analyzed data on serum 25(OH) D levels from a birth cohort study and found that vitamin D deficiency and insufficiency are very common among 2-year-old Japanese children. Sex, season, and latitude affect serum 25(OH) D concentrations.

This article reflects on some radical changes made in mental health services in China which include the implementation of the initial triage system and the special isolation ward, the early screening and testing for both patients and staff, the smaller teams working on rotating shifts on-site, and the adequate provision of PPE. These measures would be of great value as a reference to the effective delivery of mental health services in other countries through this pandemic.

Objective: To determine whether there is added benefit for 3D mammography in the context of screening and diagnostic imaging, particularly relating to known prognostic characteristics, including histopathology, receptor status, and axillary lymph node involvement. Methods: An institutional review board–approved retrospective review was performed of our mammography and pathology databases from October 2012 to May 2015 to identify biopsy-proven invasive breast carcinoma detected on screening and diagnostic mammograms by 2D plus 3D (2D + 3D) imaging. Percentages of cancer detection by 2D and 3D were compared. Correlation with histopathology and lymph node status was analyzed. Results: Of 53 cancers diagnosed on 12 543 screening mammograms, 36 (67.9%) were better visualized on 3D (not visualized, equivocal, or only seen in retrospect on 2D). Of the 62 cancers diagnosed on 4090 diagnostic mammograms, 24 (38.7%) cancers were better detected on 3D. A statistically significant greater number of cancers were better detected on 3D in the screening compared to the diagnostic mammograms (67.9% vs 38.7%, P < .05). A significantly higher frequency of less aggressive tumors (grade I and grade II, positive estrogen/progesterone receptor, Her2 negative) was detected by 3D, with higher significance in the screening population. Additionally, there was a higher frequency of positive axillary lymph nodes in cancers detected by 3D in the screening group. Conclusion: Three-dimension increases invasive breast cancer detection, particularly pathologically less aggressive tumors, in both screening and diagnostic mammograms with more benefit for the screening population. Three-dimensional mammography detected more breast cancer associated with metastatic axillary lymph nodes in the screening population.

Aconiti Lateralis Radix Praeparata (Fuzi in Chinese), which are the lateral roots of Aconitum Carmichaelii Debx, is widely used in China to treat many neurological diseases. Fuzi, in its various forms, has many neuropharmacological effects. It can act as an analgesic and help with depression, epilepsy, and dementia. However, the neuropharmacological effects of Aconiti Lateralis Radix Praeparata are seldom comprehensively reviewed. In this review, the neuropharmacological activities of some components contained in Aconiti Lateralis Radix Praeparata are considered. These include aconitine, mesaconitine, hypaconitine, total alkaloid, polysaccharide-1, benzoylmesaconine, fuziline, songorine, and napelline. We also specifically discuss the antidepressant effects of total alkaloids and polysaccharide-1. This review may provide a theoretical basis for further utilization of Aconiti Lateralis Radix Praeparata for diseases that affect the central nervous system.

This study aimed to describe the distribution of pregnancies with medical and obstetric complications based on the Japan Environment and Children's Study (JECS). We evaluated the distribution of the history of obstetric/gynaecological diseases, the history of obstetric labour complications, pregnancy with medical and surgical complications, and obstetric labour complications in participants in the JECS. Of 100,818 pregnant women with medical record entries after delivery, 15,305 (15.2%) had medical and surgical complications in pregnancy and 46,756 (46.4%) experienced obstetric labour complications. The proportion of pregnancies with heart disease, kidney disease and hepatitis was 0.3%, 0.3% and 0.1%, respectively. Gestational diabetes was diagnosed in 2715 (2.7%) women. The proportion of women with mild and severe gestational hypertension was 2.3% and 1%, respectively. The JECS is the largest birth cohort in Japan. These data will provide useful, basic information for perinatal care in Japan.IMPACT STATEMENTWhat is already known on this subject? Epidemiological studies have suggested that pre-existing diseases and complications of pregnancy, such as heart disease in pregnancy, gestational hypertension and gestational diabetes, may have implications for pregnancy outcomes, as well as for children's health and development.What the results of this study add? We evaluated the distribution of the history of obstetric/gynaecological diseases, the history of obstetric labour complications, medical and surgical complications in pregnancy, and obstetric labour complications using data from the Japan Environment and Children's Study (JECS).What the implications are of these findings for clinical practice and/or further research? The JECS is the largest birth cohort in Japan. Our data will provide useful, basic information for perinatal care in Japan.

Background The aims of the present report were to estimate the prevalence of congenital anomalies (CAs) among infants in Japan using data from the Japan Environment and Children's Study (JECS) and to evaluate the validity of CA classification within JECS. Methods Data on CAs were collected at delivery and at age 1 month from the medical records of 101,825 infants at 15 regional centers. The analyses focused on 61 CAs, selected on the basis of reported associations with environmental exposure. Prevalence per 10,000 pregnancies (including miscarriages, stillbirths, and live births) was stratified according to four reporting patterns (at delivery, at age 1 month, at either, and at both). To evaluate the accuracy of observed CA prevalence, the medical records of 179 cases from a single JECS regional center underwent independent, retrospective re-evaluation. Results The prevalence of major CAs in four reporting patterns (at delivery, at age 1 month, at either, and at both) was 2.4, 2.6, 3.5, and 1.4 for myelomeningocele/spina bifida; 4.3, 4.2, 5.3, and 3.2 for cleft palate; 18.1, 17.4, 19.5, and 15.1 for cleft lip with or without cleft palate; 73.4, 100.3, 120.8, and 52.8 for congenital heart disease; and 10.5, 14.1, 15.0, and 9.6 for Down's syndrome, respectively. In the subsample re-evaluation, CA diagnoses were confirmed for 92.7%, 93.3%, 90.5%, and 97.8% of cases in the four reporting patterns (at delivery, at age 1 month, at either, and at both), respectively. Conclusions The present report generated reliable data concerning the prevalence of major CAs in JECS.

Aquaponics is considered as a possible method to produce aquatic animals and plants in an environmentally‐friendly way, but its commercialization is seriously hindered owing to some technical and economic problems. Recently, the integration of microbial community with aquaponics is on the way to becoming the next‐generation technology for the sustainable development and commercialization of the aquaponics industry. This article provides an authoritative discussion on the novel microbial community‐assisted aquaponics, which will be emerging from the research environment to industrial application in the coming future. Principles and key technologies of this novel aquaponics, as well as the potential challenges to its commercialization, are discussed. It is expected that the emerging technologies discussed in this work could address the existed technical problems and further promote the commercialization of aquaponics. © 2019 Society of Chemical Industry

BACKGROUND/OBJECTIVES The TOPICOP scale is an easy-to-use scale for assessing topical corticosteroid (TCS) phobia in atopic dermatitis (AD) patients and their caretakers. TCS phobia is a common problem among AD patients and their caretakers. The aim of this study was to examine the relationship between TCS phobia in caretakers of children with AD and the characteristics of patients using the TOPICOP scale. METHODS Caretakers of AD patients who visited the allergy clinic at the National Center for Child Health and Development in Tokyo between February 2014 and May 2014 were recruited. Caretakers of patients in follow-up had already attended an education session on treatment at the institution. All participants completed an anonymous questionnaire on the characteristics of the respondents and patients using the Patient-Oriented Eczema Measure (POEM) and the Japanese version of TOPICOP. RESULTS In total, 243 participants (88.9% female) completed the survey. The average TOPICOP score was 40.3 and the median POEM score was 4. The TOPICOP score was significantly higher for patients younger than 12 months old with moderate to very severe AD (POEM ≥ 8) whose caretaker had not attended an educational session (P

Modular multilevel converters (MMCs) have been widely used in voltage source converter HVdc, and the capacity of MMCs has reached 1000 MW. The accurate calculation and theoretical analysis of the loss has attracted more and more attention, especially in high-power applications. This paper presents a simplified analytical calculation model of average power loss for MMC based on the root mean square (RMS) and absolute values of the arm current. In this model, the analytical expressions of the conduction loss and the switching loss are derived in terms of the whole arm of MMC rather than a single submodule. It avoids the effect of the complexity of its switching pattern on the calculation accuracy of the model. The explicit expressions of the presented model show the relationship between the loss, the voltage balancing methods, and the main variables of MMC directly in comparison with the conventional loss evaluation methods. PSCAD/EMTDC simulation and experimental results of the ±350 kV/1000 MW MMC in the Luxi Back-to-Back DC Asynchronous Networking Project verify the correctness and the accuracy of the proposed simplified calculation model.

Background Although pregnancies conceived by assisted reproductive technology (ART) have a higher risk of maternal/perinatal complications, the overall risk of adverse outcomes necessitating advanced obstetric care has not been closely examined. The present study aimed to assess and compare the risk of maternal/perinatal complications and adverse outcomes in pregnancy and childbirth conceived by ART with those conceived naturally. Methods This study was conducted as a part of the Japan environment and children’s study (JECS), an ongoing nationwide birth cohort study in Japan. The risk of maternal/perinatal complications and adverse outcomes was assessed by mode of conception (natural conception, ovulation induction [OI] without ART, conventional in vitro fertilization and embryo transfer [IVF-ET], or intracytoplasmic sperm injection [ICSI]) using logistic regression and generalized estimating equations controlling for potential confounders. Results The final dataset included women who conceived naturally (N = 90,506), by OI without ART (N = 3939), by conventional IVF-ET (N = 1476), and by ICSI (N = 1671). Compared with women who conceived naturally, those who conceived by conventional IVF-ET were at higher risk of placenta previa (adjusted OR 2.90 [95% CI 1.94, 4.34]), morbidly adherent placenta (6.85 [3.88, 12.13]), and pregnancy-induced hypertension (1.40 [1.10, 1.78]) whereas those who conceived by ICSI had a higher risk of placental abruption (2.16 [1.20, 3.88]) as well as placenta previa (2.01 [1.29, 3.13]) and morbidly adherent placenta (7.81 [4.56, 13.38]). Women who conceived by ART had a higher risk of blood transfusion (conventional IVF-ET: 3.85 [2.52, 5.88]; ICSI: 3.76 [2.49, 5.66]) and ICU admission (conventional IVF-ET: 2.58 [1.11, 6.01]; ICSI: 3.45 [1.68, 7.06]) even after controlling for potential confounders. Neonates conceived by ART had a higher risk of preterm birth (conventional IVF-ET: 1.42 [1.13, 1.78]; ICSI: 1.31 [1.05, 1.64]). Conclusions Women who conceived by ART had a higher risk of maternal/perinatal complications necessitating advanced obstetric care. Obstetricians should be aware of the increased risk of adverse outcomes among this population.

Background: Schizophrenia is ranked among the top 25 leading causes of disability worldwide in 2013 which resulting in social and economic burden. By observing patients with schizophrenia one year before and after switching from oral antipsychotics (OAPs) to once-monthly paliperidone palmitate (PP1M), we can better understand the change of total costs in schizophrenic patients, including direct costs and indirect costs, after switching treatment patterns. Methods: A total of 100 schizophrenic (ICD-10) outpatient and inpatient patients from Shandong Mental Health Center were collected from December 2016 to June 2019. Treatment modalities, health care resource utilization and costs were compared before and after switching directly from oral antipsychotics to PP1M.Results: Of the 82 patients included in the main analyses, hospitalization costs decreased was partly offset by the increase of medical costs, which causing direct costs slightly increased (t=-1.81, P＞0.05). The reduction of productivity costs (t=2.06, P＜0.05) and caregiver care costs (t=1.99, P≤0.05) was seen at post-PP1M switch, therefore the indirect costs also obviously reduced (t=2.31, P＜0.05). Total costs slightly increased (t=-0.05, P＞0.05）compared to pre-PP1M period. For patients with ≥ 1 all-cause inpatient stay in the baseline period (n=32), compared with pre-PP1M, a fewer number of inpatient stays (t=1.73, P＜0.05) and hospitalizations (t=2.56, P≤0.01) were observed and a significant reduction in direct costs (t=2.20, P＜0.01) was observed post-transition to PP1M. Conclusions: Switching to PP1M from OAPs can improve adherence to therapy and not increase the costs of health care in the clinical. Patients with ≥1 recent all-cause inpatient stay had a significant reduction in direct costs after switching from oral antipsychotics to PP1M, suggesting that patients with ≥1 all-cause inpatient stay may benefit after switching to PP1M. Indirect costs decrease from OAPs to PP1M, suggesting that reduce the burden of the family labor after switch to PP1M.

We describe and release an open PE malware dataset called BODMAS to facilitate research efforts in machine learning based malware analysis. By closely examining existing open PE malware datasets, we identified two missing capabilities (i.e., recent/timestamped malware samples, and well-curated family information), which have limited researchers’ ability to study pressing issues such as concept drift and malware family evolution. For these reasons, we release a new dataset to fill in the gaps. The BODMAS dataset contains 57,293 malware samples and 77,142 benign samples collected from August 2019 to September 2020, with carefully curated family information (581 families). We also perform a preliminary analysis to illustrate the impact of concept drift and discuss how this dataset can help to facilitate existing and future research efforts.

Background Hypertensive disorders of pregnancy (HDP) are one of the most common medical conditions that women encounter during pregnancy. Whether or not hypertensive disorders of pregnancy (HDP) are associated with allergic conditions in the offspring is unclear. This study used data from a large Japanese birth cohort to investigate whether HDP contributes to the development of allergic conditions in the offspring at 3 years. We also assessed the effect of blood pressure at different pregnancy trimesters on children's allergies. Methods We obtained data from the Japan Environment and Children's Study (JECS), which included 104 062 fetal records. After data selection, we analyzed 77 505 mother–child pairs, using logistic regression models to examine the relationships between HDP or the mother's blood pressure and their children's allergic conditions. In addition, we also evaluated the effect of HDP during pregnancy on allergies with a propensity score matched dataset, using a logistic regression model that predicts the conditional probability of whether a mother belonged to the HDP or non-HDP group. Results Among the 77 505 mothers eligible for analysis, 2334 (3.0%) had HDP. Percentages of women with hypertension were 1.7% in early gestation, 1.0% in mid-gestation, and 1.6% in late gestation. After adjusting for multiple potential confounders, HDP contributed nothing to allergy development in offspring. Children born to women with hypertension were no more likely than those without to have allergic conditions at 3 years of age. The propensity score matched dataset showed similar findings. Conclusion HDP and high blood pressure during pregnancy are apparently not risk factors for developing allergy in offspring. This information may help clinicians in counseling women who suffered HDP during pregnancy.

Ebola virus (EBOV) is one of the most virulent pathogens that causes hemorrhagic fever and displays high mortality rates and low prognosis rates in both humans and nonhuman primates. The post-exposure antibody therapies to prevent EBOV infection are considered effective as of yet. However, owing to the poor thermal stability of mammalian antibodies, their application in the tropics has remained limited. Therefore, a thermostable therapeutic antibody against EBOV was developed modelled on the poultry(chicken) immunoglobulin Y (IgY). The IgY antibodies retaining their neutralising activity at 25°C for one year, displayed excellent thermal stability, opposed to conventional polyclonal antibodies (pAbs) or monoclonal antibodies (mAbs). Laying hens were immunised with a variety of EBOV vaccine candidates and it was confirmed that VSVΔG/EBOVGP encoding the EBOV glycoprotein could induce high titer neutralising antibodies against EBOV. The therapeutic efficacy of immune IgY antibodies in vivo was evaluated in the newborn Balb/c mice who have been challenged with the VSVΔG/EBOVGP model. Mice that have been challenged with a lethal dose of the pseudovirus were treated 2 or 24 h post-infection with different doses of anti-EBOV IgY. The group receiving a high dose of 106 NAU/kg (neutralising antibody units/kilogram) showed complete protection with no symptoms of a disease, while the low-dose group was only partially protected. Conversely, all mice receiving naive IgY died within 10 days. In conclusion, the anti-EBOV IgY exhibits excellent thermostability and protective efficacy. Anti-EBOV IgY shows a lot of promise in entering the realm of efficient Ebola virus treatment regimens., Author summary Despite the amount of efficient Ebola virus therapeutic antibodies reported in recent years, their application in tropical endemic areas has remained limited due to the low thermal stability of mammalian antibodies. A highly thermostable therapeutic polyclonal antibody against EBOV was developed based on chicken immunoglobulin Y (IgY). The EBOV specific IgY antibodies displayed excellent thermal stability, retaining their neutralising activity at 25°C for one year. The newborn mice receiving the passive transfer of IgY achieved complete protection against a lethal dose of virus challenge proving that the anti-EBOV IgY provides a promising recourse to solve some of the current clinical application hindrances of Ebola antibody-based treatments in Africa due to thermal stability.

Few epidemiologic studies have examined the role of maternal iron status in allergic diseases in offspring and findings have been inconsistent. We used a large birth cohort in Japan to explore the association of the markers for maternal iron status (maternal hemoglobin, hematocrit and dietary iron intake during pregnancy) with allergy development in offspring during early childhood. We analyzed information on children age 0–3 years from the Japan Environment and Children’s Study (JECS). We used logistic models and generalized estimating equation models to evaluate the effect of maternal hemoglobin and hematocrit levels and dietary iron intake on allergies in children. Models were also fitted with propensity score-matched datasets. Data were collected for a total of 91,247 mother–child pairs. The prevalence (95% confidence interval) of low hemoglobin and hematocrit was 14.0% (13.7–14.2%) and 12.5% (12.3–12.8%), respectively. After adjusting confounders, low hemoglobin and hematocrit during pregnancy were not associated with childhood allergic outcomes. Findings from models with propensity score-matched datasets also indicated that children born to mothers with low hemoglobin or hematocrit levels during pregnancy did not have a higher risk of developing allergic conditions at 3 years old. We found no meaningful associations between low energy adjusted maternal dietary iron intake and allergies in children. In conclusion, using birth cohort data, we found no evidence supporting an association of low maternal hemoglobin, hematocrit and low dietary iron intake with allergy symptoms during early childhood. Further studies with more suitable proxy markers for blood iron status are needed.

The association between maternal diet during pregnancy and allergy in offspring remains contentious. Here, we examined the association between maternal intake of vegetables and related nutrients during pregnancy and allergic diseases in offspring at one year of age. A cohort of 80,270 pregnant women enrolled in the Japan Environment and Children’s Study were asked to respond to a food frequency questionnaire during pregnancy and the International Study of Asthma and Allergies in Childhood questionnaire at one year postpartum. The women were categorized into quintiles according to the energy-adjusted maternal intake of vegetables and related nutrients. Using the categorizations as exposure variables, the adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were determined for the allergic outcomes, including asthma, wheeze, atopic dermatitis, eczema, and food allergy, in the offspring per quintile at one year of age. Of the 80,270 participants, 2,027 (2.5%), 15,617 (19.6%), 3,477 (4.3%), 14,929 (18.7%), 13,801 (17.2%), and 25,028 (31.3%) children experienced asthma, wheeze, atopic dermatitis, eczema, food allergy, and some form of allergic disease, respectively. The aORs of each quintile of maternal vegetable intake for all allergic outcomes were close to 1.0 compared to the lowest quintile. The lowest aOR was found in the association of maternal cruciferous vegetable intake with asthma (aOR: 0.82, 95% CI: 0.70–0.96) and highest was found in the association of maternal total vegetable intake with atopic dermatitis (aOR: 1.17, 95% CI: 1.04–1.31). The risk of allergic outcomes for the various nutrients related to vegetable consumption was close to 1.0. The maternal intake of vegetables and various related nutrients during pregnancy had little or no association with any of the allergic outcomes, including asthma, wheezing, atopic dermatitis, eczema, and food allergy, in offspring at one year.

Skin inflammation leads to altered cytokine/chemokine production and causes systemic inflammation. The systemic mechanism of atopic dermatitis (AD) is recognized to affect systemic metabolism. This study aimed to examine the relationship between early-onset persistent eczema and body weight, height, and body mass index (BMI), in addition to food allergy in a birth cohort among infants. This study design was a nationwide, multicenter, prospective birth cohort study—the Japan Environment and Children’s Study (JECS). Generalized linear models were fitted for z scores of weight, height, BMI, and food allergy to evaluate the relationship between eczema and these outcomes for infants at age1, 2, and 3 years. Persistent eczema was negatively associated with height at the age of 2 years (estimated coefficient, −0.127; 95% confidence interval [CI], −0.16 to −0.095) and 3 years (−0.177; 95% CI, −0.214 to −0.139). The same tendency was also observed with weight and BMI. Early disease onset at younger than 1 year and persistent eczema had the strongest association with development of food allergy at age 3 years (OR, 11.794; 95% CI, 10.721–12.975). One phenotype of eczema with early-onset and persistent disease creates a risk of both physical growth impairment and development of food allergy. Infants who present with the early-onset and persistent type of eczema should be carefully evaluated daily for impaired physical growth and development of food allergy.

Introduction: Previous studies have reported that maternal asthma increases the risk of preterm birth. We hypothesized that inflammatory reactions caused by allergic diseases might affect the uterine environment and, subsequently, perinatal outcomes. The objective of this study was to examine the associations between allergic features among mothers and preterm pregnancy outcomes in a nationwide birth cohort. Methods: We analyzed data from pregnant women obtained from the Japanese Environment and Children’s Study (JECS), a nationwide general birth cohort study. We used binomial and multinomial logistic regression models to examine the associations between maternal allergic features and preterm birth, threatened preterm labor (TPL), and preterm premature rupture of the membrane (PPROM). Results: A total of 97,683 pregnant women were included. Prevalence of preterm birth, TPL, and PPROM was 4.7, 19.6, and 1.2%, respectively. Maternal history of allergic diseases (asthma, allergic rhinitis, allergic conjunctivitis, food allergy, drug allergy, and contact dermatitis) increased the risk of TPL(adjusted odds ratio [aOR] = 1.11 [95% CI: 1.06–1.17], aOR = 1.12 [1.08–1.16], aOR = 1.10 [1.04–1.16], aOR = 1.17 [1.09–1.26], aOR = 1.35 [1.23–1.48], and aOR = 1.34 [1.20–1.49], respectively). Although some maternal allergic features showed a negative association with preterm birth, the variables affecting preterm birth differed according to the gestational age of the fetus (22–33 weeks vs. 34–36 weeks). There were no significant associations between maternal allergic features and PPROM. Conclusion: Maternal allergic disease, except atopic dermatitis, may increase the risk of TPL. Comorbidity of maternal allergic disorders and perinatal adverse outcomes require further investigation.

Background Capturing epidemiological signatures is essential to document burdens of disease and to design health care services, including prevention measures, clinical interventions, and policies. There are large geographical and ethnic variations in the epidemiology of allergic and immunological diseases. Various data are available from North America and Europe, but the epidemiology of allergic and immunological diseases in Asia is not well documented. Objective To characterize epidemiological signatures of allergic and immunological disease in young children in Japan. Methods This was a national, multicenter, prospective birth cohort study: Japan Environment and Children's Study (JECS). A general population of 103,060 women was enrolled during pregnancy. Allergic and immunological outcomes were assessed among young children using questionnaire data. Results The prevalence of caregiver-reported immediate food allergy was 7.6%, 6.7%, and 4.9% at age 1, 2, and 3 years, respectively. Hen egg allergy was most common (5.4% prevalence at age 1 year) followed by allergies to cow milk and wheat. Several patterns of allergic symptom clusters were identified. Physician diagnosed, as reported by the caregiver, non-IgE mediated gastrointestinal food allergy affected 0.5% of infants. By contrast, caregiver-reported gastrointestinal food allergies affected 1.4% of children. Kawasaki disease affected 0.3% and 0.4% children, respectively, at age 1 and 3 years. Primary immunodeficiency disorders affected 0.005% children at age 3 years. Conclusion These data provide important epidemiological signatures of allergy and immunology in young Japanese children including the age-specific prevalence of allergic disease, Kawasaki disease, and primary immune deficiency.

Background Adjuvants used in inactivated vaccines often upregulate type 2 immunity, which is dominant in allergic diseases. We hypothesised that cumulative adjuvant exposure in infancy may influence the development of allergies later in life by changing the balance of type 1/type 2 immunity. We examined the relationship between immunisation with different vaccine types and later allergic disease development. Methods We obtained information regarding vaccinations and allergic diseases through questionnaires that were used in The Japan Environment and Children’s Study (JECS), which is a nationwide, multicentre, prospective birth cohort study that included 103,099 pregnant women and their children. We examined potential associations between the initial vaccination before 6 months of age and symptoms related to allergies at 12 months of age. Results Our statistical analyses included 56,277 children. Physician-diagnosed asthma was associated with receiving three (aOR 1.395, 95% CI 1.028–1.893) or four to five different inactivated vaccines (aOR 1.544, 95% CI 1.149–2.075), compared with children who received only one inactivated vaccine. Similar results were found for two questionnaire-based symptoms, i.e. wheeze (aOR 1.238, 95% CI 1.094–1.401; three vaccines vs. a single vaccine) and eczema (aOR 1.144, 95% CI 1.007–1.299; four or five vaccines vs. a single vaccine). Conclusions Our results, which should be cautiously interpreted, suggest that the prevalence of asthma, wheeze and eczema among children at 12 months of age might be related to the amount of inactivated vaccine exposure before 6 months of age. Future work should assess if this association is due to cumulative adjuvant exposure. Despite this possible association, we strongly support the global vaccination strategy and recommend that immunisations continue. Trial registration UMIN000030786 .

Background Madelung’s disease (MD) is a rare disorder of fat metabolism, which is usually associated with diabetes, hyperuricemia, liver disease, nevertheless there is no report of a patient with MD and pulmonary aspergillosis (PA). This article aimed to enhance the awareness of this two diseases and discuss the possible mechanism of the combination of them preliminarily. Case presentation In this case, we described a 56-year-old male patient with cough, expectoration and dyspnea. His neck has a very peculiar appearance. Chest enhanced CT scan showed there were multiple nodules in both lungs, some of which had cavities and the mediastinal lymph nodes were swollen. Ultrasound scan of the neck showed diffuse hyperplasia of subcutaneous fat in neck and bilateral supraclavicular fossa. Fortunately, after performing pulmonary wedge resection aimed at pathological examination and giving relevant treatments, this patient was finally diagnosed as MD with PA, and his symptoms were significantly relieved. Conclusions MD is rare, the phenomenon that MD combined with PA is rarer. Immune disorder may be the possible mechanism.

Ebola virus (EBOV) is the most virulent pathogens that cause hemorrhagic fever with high mortality rates in humans and nonhuman primates. The postexposure antibody therapies to prevent EBOV infection are considered efficient. However, due to the poor thermal stability of mammalian antibody, their application in the tropics has been limited. Here, we developed a thermostable therapeutic antibody against EBOV based on chicken immunoglobulin Y (IgY). The IgY antibodies demonstrated excellent thermal stability, which retained their neutralizing activity at 25°C for one year, in contrast to conventional polyclonal or monoclonal antibodies (MAbs). We immunized laying hens with a variety of EBOV vaccine candidates and confirmed that VSV Δ G/EBOVGP encoding the EBOV glycoprotein could induce high titer neutralizing antibodies against EBOV. The therapeutic efficacy of immune IgY antibodies in vivo was evaluated in the newborn Balb/c mice model. Lethal dose of virus challenged mice were treated 2 or 24 h post-infection with different doses of anti-EBOV IgY. The group receiving a high dose of 106 NAU/kg (neutralizing antibody units/kilogram) achieved complete protection with no signs of disease, while the low-dose group was only partially protected. In contrast, all mice receiving naïve IgY died within 10 days. In conclusion, the anti-EBOV IgY exhibits excellent thermostability and protective efficacy, and it is very promising to be developed as alternative therapeutic entities.Author SummaryAlthough several Ebola virus therapeutic antibodies have been reported in recent years, however, due to the poor thermal stability of mammalian antibody, their application in tropical endemic areas has been limited. We developed a highly thermostable therapeutic antibody against EBOV based on chicken immunoglobulin Y (IgY). The IgY antibodies demonstrated excellent thermal stability, which retained their neutralizing activity at 25°C for one year. The newborn mice receiving passive transfer of IgY achieved complete protection against a lethal dose of virus challenge indicating that the anti-EBOV IgY provides a promising countermeasure to solve the current clinical application problems of Ebola antibody-based treatments in Africa.

The popularity of smart-home assistant systems such as Amazon Alexa and Google Home leads to a booming third-party application market (over 70,000 applications across the two stores). While existing works have revealed security issues in these systems, it is not well understood how to help application developers to enforce security requirements. In this paper, we perform a preliminary case study to examine the security vetting mechanisms adopted by Amazon Alexa and Google Home app stores. With a focus on the authentication mechanisms between Alexa/Google cloud and third-party application servers (i.e. endpoints), we show the current security vetting is insufficient as developers' mistakes cannot be effectively detected and notified. A weak authentication would allow attackers to spoof the cloud to insert/retrieve data into/from the application endpoints. We validate the attack through ethical proof-of-concept experiments. To confirm vulnerable applications have indeed passed the security vetting and entered the markets, we develop a heuristic-based searching method. We find 219 real-world Alexa endpoints that carry the vulnerability, many of which are related to critical applications that control smart home devices and electronic cars. We have notified Amazon and Google about our findings and offered our suggestions to mitigate the issue.

Background Exploring patterns of childhood wheeze may help to clarify the etiology and prognosis of respiratory diseases. The purpose of this study was to classify phenotypes of wheezing in children up to 9 years of age in Japan and to evaluate the individual and environmental risk factors for these phenotypes. Methods Wheeze was evaluated at approximately 1-year intervals based on the mothers' recollection of their child's wheezing or whistling in the chest during the preceding 12 months. The children were aged 1-9 years. In total, 1116 children who had at least five measures of wheezing at all nine time points were used for identifying trajectories. Trajectories were identified with group-based trajectory analysis. A multinomial logit model was built to evaluate the relationships between phenotypes and risk factors. Results Five typical trajectories were identified. The probability of group membership was 43.7%, 32.2%, 6.2%, 8.6%, and 9.2% for the never/infrequent wheeze, transient early wheeze, school-age-onset wheeze, early-childhood-onset remitting wheeze, and persistent wheeze trajectories, respectively. Infant tobacco exposure increased the odds of membership in the transient early wheeze trajectory compared to the never/infrequent wheeze trajectory. Conclusions Using the group-based trajectory modeling approach, we identified five trajectories of childhood wheeze development in a Japanese population. The trajectories shown here are based on formal statistical modeling rather than on subjective classification, and an assessment of its precision suggested that the model has high assignment accuracy.

Purpose Esophageal carcinoma (EC) is one of the most aggressive type cancers and dysregulation of retinoid X receptor α (RXRα) involves various tumors. However, the relationship of RXRα with the clinicopathological factors of EC, particularly prognostic characteristics, remains unclear. This present study was to evaluate the effect of RXRα expression in the development of EC. Methods The mRNA and protein expression level of RXRα in EC and normal esophageal tissues using reverse transcription-polymerase chain reaction (RT-PCR) and Western blot, respectively. The subcellular localization was detected by immunohistochemistry (IHC) analysis. The clinicopathological parameters were included age, sex, tumor size, differentiation, TNM stages and lymph node metastasis. Kaplan-Meier method and Cox's regression analyses were performed to evaluate the prognosis of 60 patients with EC. Results RXRα was elevated in EC tissues comparing with normal esophageal tissues at both mRNA and protein levels. The overexpression level of RXRα was closely associated to the tumor differentiation, TNM stage and lymph node metastasis of patients with EC. In addition, EC patients with RXRα high expression had significantly lower disease-free survival (DFS) and overall survival (OS). Multivariate analysis showed RXRα expression as an independent predictor for the DFS and OS rate of patients with EC. Conclusions Our results showed that overexpression of RXRα was correlated with unfavorable prognosis, suggesting that RXRα may serve as a potential targeted therapeutic marker in the treatment of EC.

Purpose: Basaloid squamous cell carcinoma (BSCC) is a rare, high-grade variant of squamous cell carcinoma (SCC). Most published studies based on population-based datasets focus on prognostic differences between SCC and BSCC. Competing risk analyses for this disease have not been performed. We used Surveillance Epidemiology and End Results (SEER) data to calculate and model the cumulative incidence of death for patients with head and neck BSCC (HNBSCC) with competing risk approaches, and built a model to predict probability of cause-specific death for these patients. Methods: We analyzed data on 1163 patients who were diagnosed with primary lip and oral cavity, oropharynx, or hypopharynx and larynx BSCC and registered in the SEER program between 2004 and 2013. We calculated crude cumulative incidence function (CIF) for mortality after diagnosis of HNBSCC. We built a Fine and Gray's proportional sub-distribution hazard model and nomogram to predict their probability of cause-specific death. We calculated concordance indexes (c-index) and plotted calibration curves to evaluate model performance. Results: Five-year cumulative incidence of cause-specific death after diagnosis of HNBSCC was 26.5% (95% CI: 23.4-29.8%); cumulative incidence of other causes of death was 11.8% (95% CI: 9.4-14.3%). Old age, large tumor size, hypopharynx and larynx sites, lymph node-positive, distant metastasis, and non-radiotherapy were significant factors for high probability of cause-specific death. The model was well calibrated. The bootstrap-corrected c-index for the model was 0.71. Conclusions: We built the first competing risk nomogram for HNBSCC. The model performance was found to be good. This individualized prognostic predictive tool will aid physicians in clinical counseling, and will assist patients in planning for their future lives.

Two types of wedge-shaped CsI(Tl) crystals were designed to be placed behind an annular double-sided silicon detector to identify light charged-particles with the Δ E − E method. The properties of the CsI(Tl) detectors with different shapes and sizes were investigated using an α source and a radioactive beam of 15C. The larger crystal was found to have better energy resolution, smaller light output non-uniformity, as well as better particle identification capability, and was finally adopted to form the Δ E - E telescope. The performance of the two types of CsI(Tl) crystals are interpreted based on Geant4 simulation results.

Vitamin D (VitD) may affect immune system modulation and result in the development of atopic dermatitis (AD). However, published findings have remained controversial. We investigated the association between early-life 25-hydroxyvitamin D (25(OH)D) levels and AD risk at childhood with a birth cohort. The data were obtained from “the Japan Environment and Children’s Study (JECS)” and “the Sub-Cohort study of JECS” performed with children aged 2 years. “Liquid chromatography-tandem mass spectrometry” was used to measure VitD. The information on AD was obtained from parents’ answers to a questionnaire when their children were aged 3 years. In order to explain the seasonal effects on VitD levels, a deseasonalized continuous variable was further calculated. The logistic regression models were fitted to evaluate the effect of VitD on childhood AD. The study included 4378 children with complete data on VitD and AD. The results from models indicated that low VitD at 2 years was not a risk factor for the development of AD at 3 years, after adjusting for potential confounders. Moreover, there was no U-shape relationship between deseasonalized VitD and childhood AD. Overall, early-life 25(OH)D levels were not link to the increased risk of developing childhood AD.

Defining biomarkers that predict therapeutic effects and adverse events is a crucial mandate to guide patient selection for personalized cancer treatments. DPD (dihydropyrimidine dehydrogenase, encoded by DPYD gene) is the initial and rate-limiting enzyme of metabolic pathway of fluoropyrimidines, and fluoropyrimidines are common used drug therapies for breast cancer. Previous studies on DPYD polymorphism were mainly focused on its association with fluoropyrimidines toxicity. In our present study, 5 DPYD single nucleotide polymorphisms status was detected from tumor tissues of 331 invasive breast cancer patients using standard techniques. We for the first time investigated the prognostic significance of DPYD polymorphisms in breast cancer. We demonstrated non-luminal breast cancer patients carrying DPYD c.1627A>G AG/GG treated with fluoropyrimidine-based regimen presented a shorter overall survival and progression-free survival than carriers treated with non-fluoropyrimidine regimen. However, non-luminal DPYD c.1627A>G AG/GG carriers treated with TE (taxane and anthracycline)-based regimen showed a better prognosis compared with carriers treated with non-TE regimen. Our results suggested TE-based chemotherapy was a suitable regimen for non-luminal patients with DPYD c.1627A>G AG/GG genotype and fluoropyrimidine-based regimen should not be recommended for those patients. Our findings provided a novel strategy, which will guide clinicians to choose more precise chemotherapy treatment for breast cancer patients.

Background Maxillary sinus carcinoma is an uncommon malignancy. Most reports on prognosis of this disease are from single institutions and include few patients. We used data from the United States National Cancer Institute's Surveillance Epidemiology and End Results (SEER) program to construct models and nomograms for predicting outcomes of patients with maxillary sinus carcinomas. Methods We used records from 668 patients with primary maxillary sinus carcinomas reported to the SEER program from 2004 to 2013 to build nomograms based on stratified multivariable Cox proportional hazard models for predicting 5-year overall survival (OS) and cause-specific survival (CSS). Model building was internally validated with the bootstrap approach. Results Five-year survival was 39.7% (95% confidence interval [CI], 35.5% to 44.5%) and 46.8% (42.3% to 51.8%) for OS and CSS, respectively. The final Cox model included the variables of age at diagnosis, tumor size, histologic type, TNM stage, and surgery. Radiotherapy was a stratification factor in the models. The models demonstrated good accuracy for predicting survival with a bootstrap-corrected Somers Dxy of 0.44 for both OS and CSS models. Calibration curves indicated acceptable model calibration. Conclusion We developed tools for predicting prognosis that incorporate TNM stage and other readily available variables for patients with maxillary sinus carcinomas. The model performance was validated as good. These models can help clinicians to offer improved patient counseling in terms of clinical outcomes and make optimal treatment plans.

The main objective of this study was to evaluate the cumulative incidence of cause-specific death and other causes of death for patients with head and neck adenoid cystic carcinoma (ACC). The secondary aim was to model the probability of cause-specific death and build a competing risk nomogram to predict cause-specific mortality for this disease. Data were extracted from the US National Cancer Institute’s Surveillance Epidemiology, and End Results (SEER)-18 dataset. The study cohort included patients with a diagnosis of primary head and neck ACC during the period 2004–2013. We calculated the cumulative incidence function (CIF) for cause-specific death and other causes of death, and constructed the Fine and Gray’s proportional subdistribution hazard model, as well as a competing-risk nomogram based on Fine and Gray’s model, to predict the probability of cause-specific death for patients with head and neck ACC. After data selection, 1435 cases were included for analysis. Five-year cumulative incidence of cause-specific death was 17.4% (95% confidence interval [CI] 15.1–19.8%) and cumulative incidence of other causes of death was 5.8% (95% CI 4.4–7.4%). Predictors of cause-specific death for head and neck ACC included age, tumor size, advanced T stage, positive lymph node, distant metastasis, and surgery. The nomogram was well-calibrated, and had good discriminative ability. The large sample allowed us to construct a reliable predictive model for rare malignancy. The model performance was good, with a concordance index of 0.79, and the nomogram can provide useful individualized predictive information for patients with head and neck ACC.

Background and Purpose: High mobility group box 1 (HMGB1) is a nuclear protein that is released on injury triggers inflammation. This study aims to elucidate the effects of salidroside on diabetes-induced liver inflammation. Experimental Approach: The levels of glucose, inflammatory cytokines and hepatic functional parameters in serum and liver of type 2 diabetic db/db mice were examined. Immunohistochemistry, immunofluorescence and western blot tests were performed to determine the mechanisms underlying the action. Palmitic acid (PA) or HMGB1–stimulated was adopted as an in vitro cell model. Key Results: Salidroside treatment improved glucose tolerance, lipid profiles while decreased the production of inflammatory cytokines. It also reduced the levels of serum biochemical markers. In addition, salidroside inhibited HMGB1 signaling pathway in db/db mice. In the salidroside treatment significantly inhibited PA or HMGB1 induced inflammatory signaling pathway, too. HMGB1 inhibitors and HMGB1 knockdown both hindered PA-induced HMGB1 signaling pathway, showing the same effect as salidroside. Conclusion: Salidroside treatment significantly alleviates insulin resistance, hyperglycemia and hepatic inflammation in db/db mice, and also showed beneficial to PA-stimulated. Salidroside proves to control hyperglycemia and hepatic inflammation via inhibiting HMGB1/RAGE/NF-κB and HMGB1/TLR4/NLRP3 signaling pathways. Funding Statement: This research was supported by National Natural Science Foundation of China (81400800). Declaration of Interests: The authors declare that they have no conflict of interest Ethics Approval Statement: All animal experiments were conducted in accordance with animal ethics of Zhengzhou University.

The National Land Cover Database (NLCD) 2016 provides a suite of data products, including land cover and land cover change of the conterminous United States from 2001 to 2016, at two- to three-year intervals. The development of this product is part of an effort to meet the growing demand for longer temporal duration and more frequent, accurate, and consistent land cover and change information. To accomplish this, we designed a new land cover strategy and developed comprehensive methods, models, and procedures for NLCD 2016 implementation. Major steps in the new procedures consist of data preparation, land cover change detection and classification, theme-based postprocessing, and final integration. Data preparation includes Landsat imagery selection, cloud detection, and cloud filling, as well as compilation and creation of more than 30 national-scale ancillary datasets. Land cover change detection includes single-date water and snow/ice detection algorithms and models, two-date multi-index integrated change detection models, and long-term multi-date change algorithms and models. The land cover classification includes seven-date training data creation and 14-run classifications. Pools of training data for change and no-change areas were created before classification based on integrated information from ancillary data, change-detection results, Landsat spectral and temporal information, and knowledge-based trajectory analysis. In postprocessing, comprehensive models for each land cover theme were developed in a hierarchical order to ensure the spatial and temporal coherence of land cover and land cover changes over 15 years. An initial accuracy assessment on four selected Landsat path/rows classified with this method indicates an overall accuracy of 82.0% at an Anderson Level II classification and 86.6% at the Anderson Level I classification after combining the primary and alternate reference labels. This methodology was used for the operational production of NLCD 2016 for the Conterminous United States, with final produced products available for free download.

Background Schizophrenia is a complex psychiatric disorder with unknown etiology. A number of recent studies have shown that the polymorphism of the neural precursor cell expressed developmentally down-regulated 4 (NEDD4) gene is associated with a variety of neuropsychiatric disorders, such as schizophrenia, and may also be associated with cognitive dysfunction in these diseases. Methods A case-control study was carried out, the alleles and genotypes distributions of five loci (rs3088077, rs2303579, rs7162435, rs11550869, rs62043855) of the NEDD4 gene from 296 schizophrenia patients and 320 healthy controls were detected by using Taqman single-nucleotide polymorphism (SNP) genotyping technology. The clinical data of case and control group members were collected by self-made questionnaire and the psychotic symptoms of case group members were assessed by the Positive and Negative Syndrome Scale (PANSS). The Matrics Consensus Cognitive Battery (MCCB) was used to test the cognitive function of case group members. Results The alleles and genotypes frequency of two loci (rs3088077, rs2303579) between case and control group showed significant differences (P P P P Conclusions Our study showed that in schizophrenia patients of Chinese Han population, the polymorphisms of rs3088077 and rs2303579 loci were related to the pathogenesis of schizophrenia, while the polymorphisms of rs2303579 and rs62043855 loci were associated with cognitive dysfunction.

Depression symptoms are closely related to inadequate sleep and are experienced by medical students at an increased rate. Bedtime procrastination is considered a new, important predictor of sleep deficiency. However, whether there is a correlation between bedtime procrastination and depression symptoms remains unclear. This study aimed to examine the impact of bedtime procrastination on depression symptoms among medical students. A total of 419 Chinese medical students were invited to participate in this study, and 401 participants (mean age, 19.48 years; range, 17–23 years) were included in the final statistical analysis. Depression symptoms and bedtime procrastination were assessed using the Beck Depression Inventory-II (BDI-II) and the Bedtime Procrastination Scale (BPS), respectively. The prevalence of depression symptoms in Chinese medical students was 26.9%. The mean BPS scores were significantly higher in the depressed group than in the non-depressed group. Binary logistic regression analysis identified that bedtime procrastination was an independent contributor to the prevalence of depression symptoms. Further correlation and multiple linear regression analyses demonstrated that the BDI scores were significantly and positively associated with the BPS scores in students without depression, while the BDI scores correlated with male students experiencing depression. Depression symptoms, which become more prevalent among Chinese medical students, are found to independently associate with bedtime procrastination. In particular, the severity of depression symptoms shows a positive correlation with increased bedtime procrastination before developing into depression, and it shows correlation with sex only in a state of depression.

Objective Although environmental lead exposure has decreased, several studies have shown that low-level lead exposure can result in adverse psychological symptoms. However, few studies have examined lead neurotoxicity in pregnant women. We investigated the association between lead exposure and psychological symptoms in pregnant women, and between socio-economic status and blood lead levels. Methods Blood lead levels were measured in 17,267 pregnant women in the Japan Environment and Children’s Study. Odds ratios (ORs) for high blood lead levels were calculated using multinomial logistic regression. Psychological symptoms were assessed using the Kessler Psychological Distress Scale (K6). ORs for depression (K6 ≥ 13 or ≥5) were calculated using logistic regression with adjustment for potential confounders. Results The geometric mean of whole blood lead levels was 0.58 μg/dl (range 0.14–6.75 μg/dl). Higher blood lead levels were associated with older age (OR 1.79, 9 5% confidence interval [CI] 1.46–2.19), unmarried status (OR 1.75, 95 % CI 1.31–2.33), lower household income (OR 1.76, 95 % CI 1.38–2.24), and lower educational attainment (OR 1.34, 95 % CI 1.20–1.48). The percentage of women with K6 scores ≥13 and ≥5 was 3 % and 28.2 %, respectively. There was no significant association between lead exposure and K6 score (K6 ≥ 13: OR 1.00, 95 % CI 0.76–1.32; K6 ≥ 5: OR 0.98, 95 % CI 0.88–1.09). Conclusion Our results indicate a small but significant association between higher blood lead levels and lower socio-economic status in a population with low blood lead levels, but no association between low-level lead exposure and psychological symptoms.

Background: Accumulating studies have focused on the clinicopathological and prognostic roles of large intergenic noncoding RNA regulator of reprogramming (lincRNA-ROR) in cancer patients. However, the results were controversial and unconvincing. Thus, we performed a meta-analysis to assess the associations between lincRNA-ROR expression and survival and clinicopathological characteristics of cancer patients. Methods: Hazard ratios for overall survival and disease-free survival with their 95% confidence intervals were used to evaluate the role of lincRNA-ROR expression in the prognosis of cancer patients. Risk ratios with their 95% confidence intervals were applied to assess the relationship between lincRNA-ROR expression and clinicopathological parameters. Results: A total of 18 articles with 1441 patients were enrolled. Our results indicated that high lincRNA-ROR expression was significant associated with tumor size, TNM stage, clinical stage, lymph metastasis, metastasis and vessel invasion of cancer patients. There were no correlations between high lincRNA-ROR expression and age, gender, infiltration depth, differentiation, serum CA19–9 and serum CEA of cancer patients. In addition, high lincRNA-ROR expression was associated with shorter Overall survival and disease-free survival on both univariate and multivariate analyses. Meanwhile, there were no obvious publication bias in our meta-analysis. Conclusions: LincRNA-ROR expression was associated with the clinicopathological features and outcome of cancer patients, which suggested that lincRNA-ROR might serve as a potential biomarker for cancer prognosis. Ethical approval: Since this study is on the basis of published articles, ethical approval and informed consent of patients are not required.

Astaxanthin, which is an important metabolite with anti-oxidative property, has been discovered in some fish, shrimp, and microorganisms. Owing to the great advantages of microalgae-based astaxanthin in the aspects of sustainability and safety, microalgal astaxanthin is emerging into the limelight. In the past years, researchers isolated a couple of microalgal species and explored the synthesis pathways of astaxanthin in algal cells. Also, specific culture conditions, such as nitrogen deficiency, high-intensity illumination, and supply of glucose, salt or trace elements, promoting the accumulation of astaxanthin in microalgal cells have been intensively studied. The main goal of this paper is to review the progresses in the production of microalgal astaxanthin and promote the wide use of microagal astaxanthin in aquaculture. In this regard, we summarized the studies on algal strains screening, synthetic mechanisms of microalgal astaxanthin, microalgae cultivation models, and fish-rearing with astaxanthin supplement. Based on the literature review, we discussed the challenges threatening the production and application of microalgal astaxanthin and pointed out the prospects of microalgal astaxanthin in the future. This work will provide a deep understanding of microalgal astaxanthin and its application in aquaculture.

Although recent studies suggest that eczema in early childhood is important in the development of food allergy, the importance of the timing of eczema onset has not been fully clarified.This study aim to identify an association between the timing of eczema onset and development of food allergy in a prospective birth cohort study.Data were obtained from the Tokyo Children's Health, Illness and Development (T-CHILD) study, which is a hospital-based birth cohort study currently in progress in Japan. A total of 1550 children were born to the recruited women. Outcome data for children were collected from questionnaires completed at 6 months, 1 and 3 years of age. Association between the timing of eczema onset and development of food allergy was estimated by logistic regression analyses. All analysis were performed using SPSS software with a two-sided 5% significance level.Eczema in the first year of life was a significant risk factor in multivariate analysis (aOR 3.90, 95% CI 2.34-6.52, p0.001). In each age (by month) stratum, infants with onset of eczema within the first 1-2 months after birth had the highest risk of food allergy at 3 years of age (aOR 6.61, 95% CI 3.27-13.34, p0.001).Infants with early eczema onset (especially within the first 1-4 months after birth) were found to have an increased risk of developing food allergy at 3 years of age. Our findings may contribute to a better understanding of the timing of eczema onset as a potentially modifiable risk factor and to defining those who may need to be on guard for food allergy.