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Background: Acute diarrhea with fever can potentially represent a more severe form of the disease compared to non-febrile diarrhea. This study was to investigate the epidemiological characteristics and enteric pathogen composition of febrile-diarrheal patients, and to explore factors including pathogens associated with fever by age group. Methods: A nationwide surveillance study of acute diarrheal patients of all ages was conducted in 217 sentinel hospitals from 31 provinces (autonomous regions or municipalities) in China between 2011 and 2020. Seventeen diarrhea-related pathogens, including seven viruses and ten bacteria, were investigated and their association with occurrence of fever symptoms was assessed using multivariate logistic analysis. Results: A total of 146,296 patients with acute diarrhea (18.6% with fever) were tested. Th diarrheal children below 5 years had the highest frequency of fever (24.2%), and related to significantly higher prevalence of viral enteropathogens (40.2%) as compared with other age groups (P < 0.001). Within each age group, the febrile-diarrheal patients were associated with a significantly higher prevalence of bacterial pathogens than afebrile-diarrheal patients (all P < 0.01). There was discrepancy when each pathogen was compared, i.e., nontyphoidal Salmonella (NTS) was overrepresented in febrile vs non-febrile patients of all age groups, while the febrile vs non-febrile difference for diarrheagenic Escherichia coli (DEC) was only significant for adult groups. The multivariate analysis revealed significant association between fever and infection with rotavirus A among children [odds ratio (OR) = 1.60], for DEC in adult groups (OR = 1.64), for NTS in both children (OR = 2.95) and adults (OR = 3.59). Conclusions: There are significant discrepancy of the infected enteric pathogens in patients with acute diarrhea with fever between age groups, and it is valuable for priority detection of NTS and rotavirus A in patients with children < 5 years old and NTS and DEC in adult patients. The results may be useful in identifying dominant pathogen candidates for the application of diagnostic assays and prevention control. [ABSTRACT FROM AUTHOR]

Submuscular plating and osteotomy using power saw have shown the benefits in certain situations of limb lengthening. However, no previous studies combining both procedures have been conducted for acute tibial deformity correction and limb lengthening. Nineteen cases were enrolled in this study. Ten patients received tibial lengthening with acute knee angular deformity correction using high-energy osteotomy (Group 1), and nine patients received tibial lengthening only with osteotomy using multiple drills and osteotome (Group 2). Radiographic parameters retrieved before and after the operation included leg-length discrepancy, tibial length, length gained, mechanical lateral distal femoral angle (mLDFA), medial proximal tibial angle (MPTA), and mechanical axis deviation (MAD). There were significant differences between groups in terms of external fixator index (EFI) (p = 0.013) and healing index (HI) (p = 0.014), but no significance in the length gained (p = 0.356). The latest postoperative mLDFA (p = 0.315), MPTA (p = 0.497), and MAD (p = 0.211) of Group 1 were not distinguishable from Group 2. The functional outcomes were excellent, and there were no permanent complications. Despite showing a longer healing time, this alternative lengthening procedure which combines fixator-assisted plate lengthening in the tibia with simultaneous surgical intervention of acute tibial deformity correction using an oscillating saw is appropriate for patients with leg-length discrepancy and angular deformity of the tibia. [ABSTRACT FROM AUTHOR]

Background: Identifying patients with stage I non‐small cell lung cancer (NSCLC) at increased risk of tumor recurrence following surgery remains a major challenge. The current study aimed to compare disease‐free survival (DFS) rates after surgery between patients with clinically node‐positive (cN+) and ‐negative (cN0) stage I NSCLC. Methods: Patients with pathological stage I resected NSCLC were identified from the lung cancer database of Changhua Christian Hospital in Taiwan. Patients with clinical N status 1 or 2 and pathological N status 0 were identified as the cN+/pN0 cohort, whereas others were identified as the cN0/pN0 cohort. Propensity score matching (PSM) was used to balance the baseline characteristics between both cohorts. Kaplan–Meier method and Cox proportional hazards model were used to evaluate DFS. Results: From January 2010 to July 2019, 754 eligible patients were enrolled into the study, among whom 41 (5.4%) were cN+/pN0. The median follow‐up time was 43.4 months. Before PSM, the 5‐year DFS rate was 79.0% and 90.3% in cN+/pN0 and cN0/pN0 cohorts (log‐rank test, p = 0.009), respectively. After a 1:4 PSM, multivariate analysis showed that the cN+/pN0 cohort still had a poorer DFS compared to the cN0/pN0 cohort in (hazard ratio, 3.17; p = 0.040). Conclusion: Among patients with stage I resected NSCLC, cN+ patients had a worse DFS compared to cN0 patients. Surgeons should therefore consider more aggressive adjuvant therapy or frequent follow‐up in patients with surgically resected stage I NSCLC with cN+ status. [ABSTRACT FROM AUTHOR]

Background To combat the coronavirus disease 2019 (COVID-19) pandemic, nonpharmaceutical interventions (NPIs) were implemented worldwide, which impacted a broad spectrum of acute respiratory infections (ARIs). Methods Etiologically diagnostic data from 142 559 cases with ARIs, who were tested for 8 viral pathogens (influenza virus [IFV], respiratory syncytial virus [RSV], human parainfluenza virus [HPIV], human adenovirus [HAdV], human metapneumovirus [HMPV], human coronavirus [HCoV], human bocavirus [HBoV], and human rhinovirus [HRV]) between 2012 and 2021, were analyzed to assess the changes in respiratory infections in China during the first COVID-19 pandemic year compared with pre-pandemic years. Results Test-positive rates of all respiratory viruses decreased during 2020, compared to the average levels during 2012–2019, with changes ranging from −17.2% for RSV to −87.6% for IFV. Sharp decreases mostly occurred between February and August when massive NPIs remained active, although HRV rebounded to the historical level during the summer. While IFV and HMPV were consistently suppressed year-round, RSV, HPIV, HCoV, HRV, and HBoV resurged and went beyond historical levels during September 2020–January 2021, after NPIs were largely relaxed and schools reopened. Resurgence was more prominent among children <18 years and in northern China. These observations remain valid after accounting for seasonality and long-term trend of each virus. Conclusions Activities of respiratory viral infections were reduced substantially in the early phases of the COVID-19 pandemic, and massive NPIs were likely the main driver. Lifting of NPIs can lead to resurgence of viral infections, particularly in children. [ABSTRACT FROM AUTHOR]

Characterizing the mechanistic interactions between exposures and diseases is one of the most critical issues in epidemiologic studies. Previous studies have proposed a stochastic sufficient component cause framework, under which each sufficient cause is treated as a stochastic process instead of a time-invariant random variable. However, different types of mechanistic interactions such as synergism and agonism cannot be further identified. In this study, we proposed a stochastic marginal sufficient component cause model to conceptualize and identify agonism and synergism by exploiting the additional information. We further provided six approaches to identify and estimate agonism and synergism based on an additive hazard model and a complementary log model. Researchers can easily adjust confounding factors by including appropriate covariates into a regression model. Simulations have proven that approaches under three models are all valid tests. The power of an additive hazard model increases as the total follow-up time increases and is higher than that of the other two models. We applied this method to a Taiwanese cohort data set to investigate the mechanistic interaction among hepatitis B and C viruses on the incidence of hepatocellular carcinoma. The hazard of people with agonistic interaction is 1.28×10-5 (95% CI: 6.97×10-6 , 1.87×10-5 ), and the cumulative hazard of those people is 7.41×10-2 (95% CI: 4.09×10-2 , 1.07×10-1 ), which is approximately 3.5 times stronger than that of synergistic interaction. The proposed method makes it possible to quantify different types of mechanistic interactions in longitudinal studies with censored data. [ABSTRACT FROM AUTHOR]

Chronic obstructive pulmonary disease (COPD) has significant contributions to morbidity and mortality world-wide. Early symptoms of COPD are not readily distinguishable, resulting in a low rate of diagnosis and intervention. Different guidelines and recommendatations for the diagnosis and treatment of COPD exist globally. The first edition of clinical practice guidelines for COPD was published in 2016 by the Ministry of Health and Welfare in Taiwan in collaboration with the Taiwan evidence-based medicine association and Cochrane Taiwan, and was revised in 2019 in order to update recent diagnostic and therapeutic modalities for COPD and its acute exacerbation. This revised guideline covered a range of topics highlighted in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) report, including strategies for the diagnosis, assessment, monitoring, and management of stable COPD and exacerbations, with particular focus on evidence from Taiwan. The recommendations included in the revised guideline were formed based on a comprehensive systematic review or meta-analysis of specific clinical issues identified by an expert panel that surveyed relevant scientific evidence in the literature and guidelines published by the clinical communities and organizations nationally and internationally. The guidelines and recommendations are applicable to the clinical settings in Taiwan. We expect this revised guideline to facilitate the diagnosis, treatment and management of patients with COPD by physicians and health care professionals in Taiwan. Adaptations of the materials included herein for educational and training purposes is encouraged. [ABSTRACT FROM AUTHOR]

Backgroud: The objectives of this study were to try to identify the key dimension in satisfaction from the combination of satisfaction clusters, and its effect on the change of OHRQoL(Oral Health-related Quality of Life) of elderly denture users. Methods: This follow-up study was conducted in subjects aged 65 years and over. All participants (n = 2128) completed questionnaires before and approximately 6 months after receiving complete denture. Information obtained by questionnaire included demographic characteristics, patients' self-satisfaction rate and OHRQoL. The 6 satisfaction dimensions (including speaking, stability, esthetic, chewing, doctor and general dimensions) were classified as 5 cluster groups, which is the group of not at all satisfied in all dimensions (NAS); only satisfied with doctor and general dimensions(SDG); moderate satisfaction group(MS); quite satisfied group(QS); the highly satisfied group(HS) by an analysis of PCA (Principle component analysis) and CA (cluster analysis). Multiple linear regression was adapted to estimate the association between satisfaction and the responsiveness of OHIP-7T (Oral Health Impact Profile). Results: When compared to the cluster "NAS", the greatest improvement of OHRQoL after treatment was found in the group "HS" (β = 7.31(6.26–8.36), followed by group "QS" (β = 4.71(3.54–5.87)), group "MS" (β = 4.33(2.92–5.74)) and group "SDG" (β = 3.25(2.10–4.41)). An increasing trend was detected in patient-rating satisfaction and OHRQoL. The satisfaction cluster group is an important factor of OHRQoL after adjusting for other confounders. Conclusion: Psychological-related aspects is the greatest impacting dimension on OHRQoL among denture wearers in Taiwan elderly. Better communication from the dental professional team with denture patients would improve their OHRQoL. [ABSTRACT FROM AUTHOR]

Background: Antiplatelet use on the risk of intracerebral hemorrhage (ICH) in patients with Alzheimer's disease (AD) has not yet been completely elucidated.Objective: This large epidemiologic study aims to estimate the risk of ICH in AD patients treated with antiplatelet therapy (APT).Methods: Using data from Taiwan's National Health Insurance Research Database, ICH risk in APT-treated AD patients with a validated diagnosis (N = 824) was determined. AD without APT and non-AD with and without APT comparison cohorts were selected. To adjust for confounders and competing risk of death, inverse probability of treatment weighting using propensity scores and competing risks regression (CRR) were applied. Cox proportional hazards regression analysis estimated ICH risk in all cohorts comparing with non-AD without APT.Results: Among the 824 AD patients with APT, 79.6% were prescribed aspirin. ICH incidence rates in the AD (with/without APT) and non-AD (with/without APT) cohorts were 2.88/2.70 and 2.24/1.20 per 1,000 person-years, respectively. Overall, AD with (adjusted hazards ratio (aHR), 2.29; 95% CI, 1.19-4.38) and without (aHR, 1.97; 95% CI, 1.08-3.61) APT and non-AD with APT (aHR, 1.80; 95% CI, 1.34-2.42) were at a higher risk and had elevated subdistribution HR obtained from CRR than non-AD without APT controls. However, the risk was comparable between the AD cohorts with and without APT (HR, 1.16; 95% CI, 0.51-2.66).Conclusions: Our study indicated both the APT and non-APT users in AD population yielded higher ICH risks. However, whether APT use potentiate the risk of ICH in AD patients may warrant further evaluation. [ABSTRACT FROM AUTHOR]

Background Little is known about the association between weight changes and adverse health outcomes among Chinese adults. Methods A total of 1715 Chinese adults, 45–60 years of age, have been recruited to participate in the Hefei Nutrition and Health Study started in 2012. Multivariate logistic regression analysis was performed to determine the association of weight changes since age 20 (loss ≥5.0 kg; maintain [±4.9 kg]; gain 5.0–9.9 kg; gain ≥10.0 kg) with cardiovascular risk factors. Results Men who gained 10.0 kg or more had increased risks of hypertension (odds ratios (OR) = 3.07; 95% CI: 1.98–4.76), impaired fasting glucose (OR = 1.74; 95% CI: 1.02–2.97), reduced high-density lipoprotein (HDL) cholesterol levels (OR = 2.77; 95% CI: 1.42–5.40) and elevated triglyceride levels (OR = 5.72; 95% CI: 2.94–11.12). Women who gained 10.0 kg or more had increased risks of hypertension, elevated low-density lipoprotein (LDL) cholesterol levels and elevated triglycerides levels of 2.01(95% CI: 1.18–3.42), 3.40 (95% CI: 1.18–9.82) and 5.60 (95% CI: 1.59–19.61), respectively. Conclusion Weight gain during adulthood was associated with increased risks of high triglycerides, hypertension, impaired fasting glucose and risk of reduced HDL cholesterol in men. Furthermore, weight gain was a predictor of high-risk triglycerides, hypertension and elevated LDL cholesterol in women. [ABSTRACT FROM AUTHOR]

Parkinson's disease (PD) is a neurodegenerative disease of the central nervous system that results from the degeneration of dopaminergic neurons in the substantia nigra. Abnormal gait begins in the early stage and becomes severe as the disease progresses; therefore, the assessment of gait becomes an important issue in evaluating the progression of PD and the effectiveness of treatment. To provide a clinically useful gait assessment in environments with budget and space limitations, such as a small clinic or home, we propose and develop a portable method utilizing the monocular image sequences of walking to track and analyze a Parkinsonian gait pattern. In addition, a centroid tracking algorithm is developed and used here to enhance the method of quantifying kinematic gait parameters of PD in different states. Twelve healthy subjects and twelve mild patients with PD participate in this study. This method requires one digital video camera and subjects with two joint markers attached on the fibula head and the lateral malleolus of the leg. All subjects walk with a natural pace in front of a video camera during the trials. Results of our study demonstrate the stride length and walking velocity significantly decrease in PD without drug compared to PD with drug in both proposed method and simultaneous gait assessment performed by GAITRite(®) system. In gait initiation, step length and swing velocity also decrease in PD without drug compared to both PD with drug and controls. Our results showed high correlation in gait parameters between the two methods and prove the reliability of the proposed method. With the proposed method, quantitative measurement and analysis of Parkinsonian gait could be inexpensive to implement, portable within a small clinic or home, easy to administer, and simple to interpret. Although this study is assessed Parkinsonian gait, the proposed method has the potential to help clinicians and researchers assess the gait of patients with other neuromuscular diseases, such as traumatic brain injury and stroke patients. [ABSTRACT FROM AUTHOR]

Background/purpose: The time required to reach oxygenation equilibrium after positive end-expiratory pressure (PEEP) adjustments in mechanically ventilated patients with acute respiratory distress syndrome (ARDS) is unclear. We used electrical impedance tomography to elucidate gas distribution and factors related to oxygenation status following PEEP in patients with ARDS. Methods: Nineteen mechanically ventilated ARDS patients were placed on baseline PEEP (PEEPB) for 1 hour, PEEPB - 4 cmH2O PEEP (PEEPL) for 30 minutes, and PEEPB + 4 cmH2O PEEP (PEEPH) for 1 hour. Tidal volume and respiratory rate were similar. Impedance changes, respiratory parameters, and arterial blood gases were measured at baseline, 5 minutes, and 30 minutes after PEEPL, and 5 minutes, 15 minutes, 30 minutes, and 1 hour after PEEPH. Results: PaO2/fraction of inspired oxygen (P/F ratio) decreased quickly from PEEPB to PEEPL, and stabilized 5 minutes after PEEPL. However the P/F ratio progressively increased from PEEPL to PEEPH, and a significantly higher P/F ratio and end-expiratory lung impedance were found at 60 minutes compared to 5 minutes after PEEPH. The end-expiratory lung impedance level significantly correlated with P/F ratio (p < 0.001). With increasing PEEP, dorsal ventilation significantly increased; however, regional ventilation did not change over time with PEEP level. Conclusion: Late improvements in oxygenation following PEEP escalation are probably due to slow recruitment in ventilated ARDS patients. Electrical impedance tomography may be an appropriate tool to assess recruitment and oxygenation status in patients with changes in PEEP. [ABSTRACT FROM AUTHOR]

Aim: The present meta-nalysis investigates the prognostic value of osteopontin. (OPN) expression in patients with non-small-cell lung cancer. (NSCLC).Materials and Methods: The Web of Science (1945 ~ 2013), the Cochrane Library Database (Issue 12, 2013), PubMed (1966 ~ 2013), EMBASE (1980 ~ 2013), CINAHL (1982 ~ 2013), and the Chinese Biomedical Database (CBM) (1982 ~ 2013) were searched, without language restrictions, to retrieve studies related to OPN and NSCLC. We compiled carefully selected data and a meta-analysis was conducted using STATA software (Version 12.0, Stata Corporation, and College Station, Texas USA). Hazard ratios (HR) with corresponding 95% confidence interval (95%CI) were calculated.Results: Ten clinical cohort studies were selected for statistical analysis, representing a total of 1,133 NSCLC patients. The main findings of our meta-analysis are that patients who were OPN-positive had significantly shorter overall survival than OPN-negative patients. (HR = 1.47, 95%CI = 1.15. ~ 1.79,P< 0.001). Ethnicity.stratified analysis revealed a significant correlation between expression levels of OPN and poor prognosis of NSCLC patients among both Caucasians and Asians. (Asians: HR = 1.53, 95%CI = 0.95. ~ 2.11, P < 0.001; Caucasians: HR = 1.56, 95%CI = 1.08. ~ 2.03, P < 0.001; respectively).Conclusions: The present meta-analysis is consistent with the hypothesis that increased expression of OPN protein may be significantly associated with poor prognosis in patients with NSCLC. [ABSTRACT FROM AUTHOR]

Background/Purpose Subthalamic nucleus deep brain stimulation (STN-DBS) has been shown to produce long-term symptom improvement in Parkinson's disease. The aim of this study was to identify the target symptoms that show the most improvement at 1 year and at 5 years after STN-DBS. Methods This was a 5-year cohort study of 41 consecutive patients treated with bilateral STN-DBS. Clinical evaluations were performed 1 month prior to surgery and 1 year and 5 years after surgery. The outcome measurements at 1 year and 5 years were the changes compared with the baseline in Unified Parkinson's Disease Rating Scale (UPDRS) parts I, II, III, and IV scores, the Hoehn and Yahr stage, and Schwab and England Activities of Daily Living (SEADL) scores in the conditions of off-medication/on-stimulation and off-medication/off-stimulation. Further analysis included changes in the levodopa equivalent daily dose. Results When compared to the preoperative baseline off-medication condition, significant improvements were observed in the UPDRS parts I, II, III, and IV and SEADL ( p < 0.001) scores in the off-medication/on-stimulation condition 1 year after STN-DBS. Five years after STN-DBS, improvements in UPDRS scores were observed only for parts II, III, and IV ( p < 0.001). In the off-medication/off-stimulation condition, no significant improvement was observed. At 5 years, significant deteriorations were observed in scores for the UPDRS part III axial subitem ( p = 0.005), UPDRS part I ( p = 0.005), UPDRS part II ( p < 0.001), and SEADL ( p = 0.001). Conclusion The long-term effect of STN-DBS on motor function is promising, although the magnitude of its effectiveness varied over the 5-year period. [ABSTRACT FROM AUTHOR]

Tea infusions were prepared from cold or hot brewed-parched or steamed green tea at 2, 6 and 10% and their color properties; several components and sensory scores were measured. Tea infusions from both green tea were comparable in contents of soluble solids, sugars, free amino acids, caffeine and antioxidant components, and had different pH values, profiles of various catechins, colors and sensory results. Higher ratios (tea leaves/water) resulted in higher soluble component contents in tea infusions but lower sensory results. Cold brewing of lower extraction efficacy resulted in lighter, less colored and higher sensory-rated tea infusions with less astringent and bitter taste. Five of 12 different tea infusions were highly rated and were in the descending order of 2%-cold, 2%-hot, 6%-cold brewed infusions from parched green tea, and 2%-cold and 2%-hot brewed infusions from steamed green tea. Overall, cold brewed tea infusions from parched green tea would be a new alternative. Practical Application Green tea includes the Japanese style steamed tea and the Chinese style parched (fired) tea with the difference in blanching. This research disclosed herein were the information about the influence of different brewing temperatures (cold or hot water) on the quality of tea infusions brewed from different green tea (parched or steamed) at different concentrations (2, 6 or 10%). Tea infusions from parched and steamed green tea were comparable in contents of soluble solids, sugars, free amino acids, caffeine and antioxidant components, and had different pH values, profiles of various catechins, colors, and sensory results. Cold brewing of lower extraction efficacy resulted in lighter, less colored and higher sensory-rated tea infusions. Cold brewed tea infusions contained lower contents of caffeine, epigallocatechin gallate and epigallocatechin, and were less astringent and bitter. Overall, cold brewed tea infusions from parched green tea would be a new alternative to the public. [ABSTRACT FROM AUTHOR]

OBJECTIVES:To compare the efficacy of hepatocellular carcinoma (HCC) surveillance at 4- and 12-month intervals in a community for patients with chronic viral hepatitis and thrombocytopenia.METHODS:In 10 townships, adults (≥40 years) with platelet ≤150 (×109)/l, positive hepatitis B surface antigen, or antibody to hepatitis C virus were invited to this study. These townships were randomized into 4- (group A) and 12-month (group B) interval surveillance groups. Seven hundred and eighty-five and 796 residents met the study criteria in groups A and B. Ultrasonography (US) was the surveillance method.RESULTS:A total of 744 residents (group A: 387; group B: 357) were enrolled. In the study period, HCC was diagnosed in 39 residents (group A: 24; group B: 15). There was no difference in cumulative 3-year HCC incidence between the two groups. The tumors were smaller in group A than in group B, though group A had more patients with tumor ≤2 cm (P=0.003) who were in Barcelona Clinic Liver Cancer (BCLC) very-early stage (P=0.017) and had undergone curative treatments (P=0.049). Male gender, cirrhosis, and platelet ≤100 (×109)/l were associated factors of HCC occurrence. There was no difference in 4-year overall survival between the two groups. Patients undergoing recommended treatments had better 4-year survival rates.CONCLUSIONS:Compared with 12-month interval, US surveillance at 4-month interval detected more patients with HCC≤ 2 cm who were in BCLC very-early stage and were fit for curative treatments. Up to 4-year follow-up, however, the overall survival was not different. [ABSTRACT FROM AUTHOR]

Abstract: Aligning a laser scanned three-dimensional (3D) surface is considered a critical step in object recognition, shape analysis, and automatic visual inspection. Two major concerns for the alignment task are execution time and alignment accuracy. Recently, neural network-based methods have become very popular due to their high efficiency. However, such methods experience difficulty in reaching high accuracy because the use of principal component analysis (PCA) to perform coarse alignment causes a large alignment error. Thus, a TSK-type neural-fuzzy network (TNFN)-based coarse-to-fine 3D surface alignment scheme is proposed in the current paper. Compared with traditional neural network-based approaches, the proposed method provides a coarse-to-fine alignment approach to ensure the accurate pose estimated by TNFN in the coarse phase, as well the high alignment speed provided by TNFN-based surface modeling in the fine phase. Experimental results demonstrate the superior performance of the proposed 3D surface alignment system over existing systems. [Copyright &y& Elsevier]

Present paper provides information on comparing the spectral characteristics of leaf-scale wheat aphids using simultaneously the imaging Pushbroom Imaging Spectrometer (PIS) and non-imaging ASD (Analytical Spectral Devices) Fieldspec-FR2500 field spectrometer. Comparative results indicated that the PIS proved superior to the ASD in spectral resolution and sampling interval, but it was inferior in spectral range and field of view (FOV). Moreover, corresponding spectral properties were fairly similar including reflectance, spectral difference and change rate and the sensitive bands and spectral ranges. Spectral curves from both devices showed the typical reflectance properties of green vegetation: green peak at 550 nm, red valley at 680 nm and high near-infrared reflectance at 780 nm. However, the specific reflectance values appeared different for four damage levels (Normal, Light, Moderate & Serious). The maximum and minimum reflectance values were respectively 41.18% and 2.36% for the PIS, while they were 40.32% and 1.51% for the ASD, respectively. Specifically, in the wavelength range of 400- 900 nm, they were similar in the spectral difference and change rate. The maximum values were respectively 14.8% and 14.0 % for the PIS, and they were 8.7% and 20.3% for the ASD, respectively. Additionally, continuum removal was used to compare the selection of sensitive bands and ranges, which were 500 nm and 663 nm, 430-530 nm and 550-690 nm for the ASD, while they were 504 nm and 681 nm, 430-530 nm and 550-730 nm for the PIS, respectively. Finally, using the high spatial resolution PIS image, environment for visualizing images (ENVI-EX) was also used to extract aphids. Overall accuracy attained was thus 97%. This study can explore further investigations in precision agriculture using near-ground imaging spectrometers. [ABSTRACT FROM AUTHOR]

A novel medical image quality index using grey relational coefficient calculation is proposed in this study. Three medical modalities, DR, CT and MRI, using 30 or 60 images with a total of 120 images used for experimentation. These images were first compressed at ten different compression ratios (10 ∼ 100) using a medical image compression algorithm named JJ2000. Following that, the quality of the reconstructed images was evaluated using the grey relational coefficient calculation. The results were shown consistent with popular objective quality metrics. The impact of different image aspects on four grey relational coefficient methods were further tested. The results showed that these grey relational coefficients have different slopes but very high consistency for various image areas. Nagai's grey relational coefficient was chosen in this study because of higher calculation speed and sensitivity. A comparison was also made between this method and other windows-based objective metrics for various window sizes. Studies found that the grey relational coefficient results are less sensitive to window size changes. The performance of this index is better than some windows-based objective metrics and can be used as an image quality index. [ABSTRACT FROM AUTHOR]

Abstract: Hospital-associated invasive pneumococcal disease (HA-IPD) is infrequently reported. A retrospective surveillance of IPD in a medical centre in Taiwan was conducted from 2000 to 2008 to compare the clinical and microbiological characteristics of HA-IPD and community-associated IPD (CA-IPD). HA-IPD was identified in 37 patients, comprising 12.3% of the 302 hospitalised patients with IPD. Patients with HA-IPD were more likely to have solid-organ cancer (40.5% vs. 16.6%; P =0.001) or to have received immunosuppressive therapy (56.8% vs. 26.8%; P <0.001). The 30-day mortality rate of HA-IPD was significantly higher than that of CA-IPD (40.5% vs. 16.2%; P =0.001). Age ≥65 years [odds ratio (OR)=2.10; P =0.033], HA-IPD (OR=2.90; P =0.009) and liver cirrhosis (OR=3.19; P =0.009) were independent predictors of 30-day mortality. No significant differences in serotype distribution or in susceptible rates to penicillin (18.2% vs. 32.6%; P =0.14) and cefotaxime (60.6% vs. 67.8%; P =0.53) were found between HA-IPD and CA-IPD isolates. Similar prevalences of the serotypes included in the pneumococcal vaccines were found in isolates from patients with HA-IPD and CA-IPD. Among patients with HA-IPD and CA-IPD, 26 (78.8%) and 172 (73.2%) (P =0.45) had isolates of serotypes included in the 7-valent pneumococcal conjugate vaccine, and 30 (90.9%) and 224 (95.3%) (P =0.96) had isolates of serotypes included in the 23-valent pneumococcal polysaccharide vaccine, respectively. In summary, this study found that HA-IPD and CA-IPD were not significantly different with regard to serotype distribution and antimicrobial susceptibility in Taiwan. Patients with HA-IPD have a higher mortality rate, and pneumococcal vaccination for patients at increased risk for HA-IPD should be encouraged. [Copyright &y& Elsevier]

JunB is a component of the activator protein 1 transcription factors and has been identified to be important in hematopoiesis. Transgenic mice lacking JunB expression develop myeloproliferative disease resembling human chronic myeloid leukemia (CML). JunB expression was significantly decreased in CML patients. We used real-time quantitative reverse transcription-polymerase chain reaction analysis to monitor both JunB and BCR-ABL expression during imatinib therapy. Nineteen patients were evaluated every 2 to 4 weeks, and their levels of JunB expression before therapy were significantly decreased compared with those of healthy individuals. After imatinib therapy, an increase in JunB expression was found in 5 patients, all of whom achieved a complete cytogenetic response (CCR) and molecular response (MR), with a decrease in BCR-ABL expression. JunB expression decreased to a very low level in 2 patients, both of whom showed progression to blast crisis. Variable JunB expression was found in the other 12 patients, and their outcomes were mostly driven by BCR-ABL levels. The patients with an increase in JunB expression were statistically more likely to achieve a major cytogenetic response (P = .045), CCR (P = .033), and MR (P = .033) than the group with no increase in JunB expression, and a durable response was observed. This study revealed that an increase in JunB expression is a good prognostic marker for predicting clinical response in CML patients treated with imatinib when such data are combined with an evaluation of BCR-ABL expression. [ABSTRACT FROM AUTHOR]

The effect of 1-alkanols upon the main phase-transition temperature of phospholipid vesicle membranes between gel and liquid-crystalline phases was not a simple monotonic function of alkanol concentration. For instance, 1-decanol decreased the transition temperature at low concentrations, but increased it at high concentrations, displaying a minimal temperature. This concentration-induced biphasic effect cannot be explained by the van't Hoff model on the effect of impurities upon the freezing point. To explain this nonlinear response, a theory is presented which treats the effect of 1-alkanols (or any additives) on the transition temperature of phospholipid membranes in a three-component mixture. By fitting the experimental data to the theory, the enthalpy of the phase transition delta H* and the interaction energy, epsilon*AB between the additive and phospholipid molecules may be estimated. The theory predicts that when epsilon*AB greater than 2 (where epsilon*AB = epsilon AB/RT0, T0 being the transition temperature of phospholipid), both minimum and maximum transition temperatures should exist. When epsilon*AB = 2, only one inflection point exists. When epsilon*AB less than 2, neither maximum nor minimum exists. The alkanol concentration at which the transition temperature is minimum (Xmin) depends on the epsilon*AB value: the larger the epsilon*AB values, the smaller the Xmin. When epsilon*AB is large enough, Xmin values become so small that the plot delta T vs. X shows positive delta T in almost all alkanol concentrations. The interaction energy between 1-alkanols and phospholipid molecules increased with the increase in the carbon chain-length of 1-alkanols. In the case of the dipalmitoylphosphatidylcholine vesicle membrane, the carbon chain-length of 1-alkanols that caused predominantly positive delta T was about 12. [ABSTRACT FROM AUTHOR]

Rotavirus vaccination reduces the incidence and severity of acute gastroenteritis due to rotavirus infection. However, because of a lack of understanding and private payment for the rotavirus vaccine, the rotavirus vaccination rate is still low in some countries. We intended to assess the impact of shared decision-making (SDM) with the assistance of patient decision aids (PDAs) on the rotavirus vaccination rate, and the knowledge, confidence, and congruence of value among baby's parents when decision-making. The study was a two-group, outcome assessor-blind, randomized, controlled trial. The families of 1-month-old infants for routine vaccination were enrolled; they were divided randomly into non-SDM and SDM groups. The influence of SDM on the acceptance of rotavirus vaccination was assessed when their infants were 2 months old. Outcome measures were decisional conflict, decision-making difficulties, and rotavirus vaccine knowledge, and the overall rotavirus vaccination rate. The study enrolled 180 participants. SDM, parents' education level, and rotavirus vaccination of a previous child were variables that influenced acceptance of rotavirus vaccination. The SDM group scored significantly higher for understanding the information on the oral rotavirus vaccine than the non-SDM group, which helped them to decide whether to vaccinate the baby against rotavirus. The rotavirus vaccination rate was 16.7% higher in the SDM group than the non-SDM group. SDM assisted with PDAs gives more information and helps infants' families understand what they need, reduces their decision conflict, and increases their baby's vaccination against rotavirus, which promotes public health. The clinical trial is registered at ClinicalTrials.gov (NCT03804489). [ABSTRACT FROM AUTHOR]

Study Design: A retrospective case-control study.Objective: To compare postoperative blood loss, amount of allogeneic blood transfusion, removal time of drainage tube, length of hospital stay, and complications associated with tranexamic acid (TXA).Summary Of Background Data: Spinal fusion surgery can be associated with significant blood loss. To the best of our knowledge, very few published studies exist reporting the effect of topical use of tranexamic acid (tTXA) on decreasing the blood loss in patients undergoing posterior lumbar spinal fusions.Methods: We conducted a retrospective nonrandomized case-control study of 100 adults undergoing posterior lumbar spinal fusion surgery. In the tTXA group (n = 50), wound surface was soaked with TXA (1 g in 100 mL saline solution) for 5 minutes before wound closure. In the control group (n = 50), wound surface was soaked with the same volume of normal saline. The postoperative blood loss, removal time of drainage tube, amount of allogeneic blood transfusion, and length of hospital stay were compared between the two groups. And the complications of TXA were also collected.Results: In the tTXA group, the postoperative blood loss, removal time of drainage tube, postoperative length of hospital stay were significantly lower than those in the control group (155.2 ± 104.3 mL vs. 278.6 ± 124.1 mL, 2.0 ± 0.6 d vs. 2.4 ± 0.5 d, 4.7 ± 1.4 d vs. 5.6 ± 2.3 d, P < 0.05, respectively). There was no significant difference in blood transfusion between two groups. No significant changes were noticed in terms of coagulation function, and no complications associated with TXA were observed.Conclusion: tTXA can significantly reduce postoperative blood loss, accelerate removal of drainage tube, shorten the duration of hospital stay, while not increasing the complication incidence in patients undergoing posterior lumbar spinal fusion surgery.Level Of Evidence: 3. [ABSTRACT FROM AUTHOR]

Objective: To explore whether the presence of azoospermia factor c (AZFc) microdeletions adversely affects intracytoplasmic sperm injection (ICSI) outcome.Design: Retrospective cohort.Setting: University hospital.Patient(s): A total of 293 patients with azoospermia or severe oligozoospermia AZFc deletions underwent 345 ICSI cycles, and 363 idiopathic patients with normal Y chromosome underwent 462 ICSI cycles.Intervention(s): Testicular sperm aspiration, microdissection testicular sperm extraction.Main Outcome Measure(s): The main clinical outcome parameters were cumulative clinical pregnancy rate, cumulative live birth delivery rate, and no embryo suitable for transfer cycle rate.Result(s): Compared with the control group, the AZFc deletion group exhibited poorer ICSI outcome, with significant differences between the 2 groups for cumulative clinical pregnancy rate (45.39% vs. 67.49%; odds ratio [OR], 2.843; 95% confidence interval [CI]), cumulative live birth delivery rate (35.15% vs. 53.44%; OR, 2.234; 95% CI), no embryo suitable for transfer cycle rate (15.07% vs. 8.23%; OR, 0.565; 95% CI), fertilization rate (46.80% vs. 53.37%; adjusted β, -0.074; 95% CI), implantation rate (28.63% vs. 31.26%; adjusted β, -0.075; 95% CI) separately. The poor ICSI outcome of the AZFc deletion group was related to AZFc microdeletions by linear and logistic regression analyses.Conclusion(s): AZFc microdeletions adversely affect ICSI outcome; patients with AZFc deletion should be informed that they have reduced opportunities to be biological fathers. [ABSTRACT FROM AUTHOR]

Nursing home-associated pneumonia (NHAP) is a common type of infection among long-term care residents. Moreover, the mortality of NHAP is also higher than community-acquired pneumonia (CAP). In traditional Chinese medicine (TCM), the decoctions of Banxia Houpo Tang (BHT) and Ding Chuan Tang (DCT) are two formulas supporting the lungs' natural defense systems, helps to expel mucus and promote detoxification. We designed a concentrated Chinese herbal extract formula called BDT1, that combines the compounds of BHT and DCT. In this study, we evaluated the safety and efficacy of BDT1 for NHAP prevention in high-risk older residents in the nursing home. In this randomized, double-blind, placebo-controlled trial, 160 participants aged over 65 years old living in the nursing home were randomly assigned 1:1 to the BDT1 and placebo group. Besides regular medicine, participants received either BDT1 or a placebo for 12 consecutive weeks. The primary outcome was the hospitalization rate for pneumonia in the intervention period and half-year follow-up. The microscopic examination of Gram-stained sputum was also evaluated before and after the trial. Data were analyzed by using the Chi-square test and Wilcoxon Signed Ranks Test with SPSS. A total of 160 participants were enrolled into two study groups in this study, which was completed with 143 participants analyzed, including 70 subjects in the BDT1 group and 73 subjects in the placebo group. After the 12-week medical treatment, the hospitalization rate for pneumonia was 10.0% and 34.2% in the BDT1 and placebo group respectively. The risk of pneumonia in half a year was lower in the BDT1 group (adjusted hazard ratio = 0.422, 95% CI = 0.226–0.791). Compared to the placebo group, the level of Gram-negative bacilli in the BDT1 group is significantly declined in sputum samples (p < 0.05). In conclusion, the cumulative incidence of pneumonia and related-hospitalization rates declined significantly after 12-weeks of BDT1 treatment. Besides, Chinese herbal medicine BDT1 is a safe therapy without hepatotoxicity or nephrotoxicity. [Display omitted] [ABSTRACT FROM AUTHOR]

Membrane protrusion and adhesion to the extracellular matrix, which involves the extension of actin filaments and formation of adhesion complexes, are the fundamental processes for cell migration, tumor invasion, and metastasis. How cancer cells efficiently coordinate these processes remains unclear. Here, we showed that membrane-targeted chloride intracellular channel 1 (CLIC1) spatiotemporally regulates the formation of cell-matrix adhesions and membrane protrusions through the recruitment of PIP5Ks to the plasma membrane. Comparative proteomics identified CLIC1 upregulated in human hepatocellular carcinoma (HCC) and associated with tumor invasiveness, metastasis, and poor prognosis. In response to migration-related stimuli, CLIC1 recruited PIP5K1A and PIP5K1C from the cytoplasm to the leading edge of the plasma membrane, where PIP5Ks generate a phosphatidylinositol 4,5-bisphosphate-rich (PIP2-rich) microdomain to induce the formation of integrin-mediated cell-matrix adhesions and the signaling for cytoskeleon extension. CLIC1 silencing inhibited the attachment of tumor cells to culture plates and the adherence and extravasation in the lung alveoli, resulting in suppressed lung metastasis in mice. This study reveals what we believe is an unrecognized mechanism that spatiotemporally coordinates the formation of both lamellipodium/invadopodia and nascent cell-matrix adhesions for directional migration and tumor invasion/metastasis. The unique traits of upregulation and membrane targeting of CLIC1 in cancer cells make it an excellent therapeutic target for tumor metastasis. [ABSTRACT FROM AUTHOR]

Background: A vegetarian diet may be a risk factor for depression, but this relationship was unclear in the elderly Chinese population.Methods: Self-report data were gathered from 1051 elderly persons using the Cohort of Elderly Health and Environment Controllable Factors, which was created in West Anhui, China. The depressive symptoms were set as binary, ordinal, and continuous outcomes, respectively, whereas the dietary structures were computed as an ordinal variable and a dummy variable. Multiple logistic regression, ordinal regression, and linear regression were used to assess the relationship by adjusting the potential confounding variables with p-values of <0.1 in univariate analysis.Results: The elderly participants who had a vegetable-based diet had the highest GDS scores of 8.78 ± 6.894 (p = 0.001) and the highest rate of depression (32.9%, p = 0.003). After adjustment for the potential confounders, elderly men who had a vegetable-based diet had a higher rate of depression (OR[95%CI]: 1.62[1.07-2.46], 4.71[1.38-16.03]), more severe symptoms of depression (OR[95%CI]: 8.85[2.94-34.12]), and higher GDS scores (β[95%CI]: 1.46[0.70-2.22], 2.97[1.28-4.67]) than male participants who had a meat-based diet, but this was not the case in women.Limitations: All data were self-reported. The study lacked quantitatively evaluated dietary intake. The duration of the current dietary structures and comorbidities were not reported. The cross-sectional study made the causal role uncertain.Conclusions: Vegetarian diets may pose a greater risk of depressive symptoms among the elderly Chinese population, especially elderly men. Given the cross-sectional nature of this study, the causal role was uncertain. Further prospective studies, in particular among elderly women, are needed. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to determine whether stereotactic computed tomographic (CT) images fused with magnetic resonance images (MRI) is superior to stereotactic MRI alone in accuracy for targeting the subthalamic nucleus (STN) in deep brain stimulation (DBS). Methods: During 2006 to 2007, 21 consecutive patients with Parkinson''s disease were enrolled in this retrospective cohort study. CT Fusion group included 10 patients who underwent 20 procedures of STN-DBS under MRI-directed targeting in which the MRIs were fused to stereotactic CT images for surgical coordinates. MRI group included 11 patients who underwent 20 procedures under MRI-directed targeting alone. Results: After DBS surgery, in comparison to baseline levodopa (L-dopa) OFF, Unified Parkinson Disease Rating Scale, Part III scores improved by 43.6% ± 20.3% and 39.0% ± 15.6% (P = 0.60) in CT Fusion group and MRI group, respectively (L-dopa OFF/DBS ON). The mean decrease in L-dopa equivalent daily dose was 38.9% ± 26.3% and 36.7% ± 30.5% (P = 0.87), respectively. Single microelectrode recording (MER) trajectory procedure was experienced in 65% of patients in the CT Fusion group (13/20) and 45% of patients in the MRI group (9/20). The mean recorded STN length from initial to final MER trajectory in the CT Fusion and MRI groups was 4.3 mm (standard deviation [SD] = 1.8 mm)/5.1 mm (SD = 0.5 mm) and 3.6 mm (SD = 1.7 mm) (P = 0.214)/4.5 mm (SD = 0.7 mm) (P = 0.006), respectively. The final recorded STN length was significantly longer in the CT Fusion group. Conclusions: In-frame–based stereotactic STN targeting, an image fusion technique between stereotactic CT and MRI, can record a significantly longer STN length through limited MER compared with MRI alone. Whether this could translate into better clinical outcome and less morbidity still need a large and randomized trial. [Copyright &y& Elsevier]