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Background Clinical trials and spontaneous reporting systems have revealed rare but biologically plausible adverse events following varicella immunization. Few post-marketing controlled studies have been conducted to assess the relationship between the varicella vaccine and these outcomes. Objectives To evaluate the risk of pneumonia, idiopathic thrombocytopenic purpura (ITP), meningitis, encephalitis and ischemic stroke following varicella immunization. Materials and methods This nationwide observational study was based on Taiwan National Health Insurance data and National Immunization Information System from 2004 through 2014. Primary analysis included children aged 12–35 months who received the single varicella vaccine on the date of administration. The self-controlled risk interval design compared the incidence of pre-specified outcomes during a risk interval of 1–42 days post-vaccination and a control interval of 43–84 days. The outcomes of interest were defined as admitted pneumonia, ITP, meningitis, encephalitis, and ischemic stroke, as well as fracture as a negative control. Conditional Poisson regression was used to assess the incidence rate ratio (aIRR) with adjustments for age and seasonal effects. Results Among 1,194,189 children, who receiving the varicella vaccine, there was no observed increase in the risk for ITP (aIRR 1.00; 95% CI, 0.76–1.33), meningitis (aIRR 1.21; 95% CI, 0.49–2.95), encephalitis (aIRR 1.00; 95% CI, 0.62–1.60), or ischemic stroke (aIRR 1.24; 95% CI, 0.31–4.95). A clustering feature with pneumonia occurred during days 36–42 post-vaccination (aIRR 1.10; 95% CI, 1.02–1.18). An increase in the risk for ITP was observed in children receiving the varicella and MMR vaccines concomitantly (aIRR 1.70; 95% CI, 1.19–2.43), but not among those receiving the varicella vaccine only. Conclusions We detected a small risk of incidental pneumonia associated with varicella vaccine in the 6th week after immunization. There was no increase in the risk of other pre-specified adverse events.

To screen the optimal lactic acid bacteria (LAB) from nine strains LAB and culture media composition for spray‐drying microencapsulation in advance, the physicochemical and physiological properties of microencapsulation including cell permeability, viable cell count, and survival rate were analyzed. According to the primary results of the bacterial growth, pH determination, and quantification of organic acids, the optimal LAB of two from nine strains selected to be better promising LAB for spray drying was found to be Bifidobacterium adolescentis and Lactobacillus acidophilus. The viable cells count and survival rate were significantly higher for both B. adolescentis and L. acidophilus cultivated in MRS broth with glucose of carbon source containing 10% (w/w) green tea extract(p

Loss-of function mutations in Orai1 Ca2+ channels lead to a form of severe combined immunodeficiency, auto-immunity, muscle hypotonia and defects in dental enamel production and sweat gland function. Two single-nucleotide polymorphisms (SNPs) in Orai1 have been found and localize to the second extracellular loop. These polymorphisms associate with atopic dermatitis but how they affect Ca2+ signalling and cell function is unknown. Here, we find that Orai1–SNPs turnover considerably more slowly than wild type Orai1 and are more abundantly expressed in the plasma membrane. We show a central role for flotillin in the endocytotic recycling of Orai1 channels and that endocytosed wild type Orai1 is trafficked to Rab 7-positive late endosomes for lysosomal degradation. Orai1–SNPs escape the degradation pathway and instead enter Rab 11-positive recycling endosomes, where they are returned to the surface membrane through Arf6-dependent exocytosis. We find that Orai1–SNPs escape late endosomes through endosomal pH regulation of interaction between the channel and flotillin. We identify a pH-sensitive electrostatic interaction between positively charged arginine in extracellular loop 2 (K210) and a negatively charged aspartate (D112) in extracellular loop 1 that helps determine Orai1 turnover. The increase in membrane Orai1–SNP leads to a mis-match in Orai1–STIM stoichiometry, resulting in inhibition of Ca2+ entry and Ca2+-dependent gene expression. Our results identify new strategies for targeting atopic dermatitis.

Background : This study aimed to compare the predictors of suicides among psychiatric inpatients and recently discharged patients and to examine the association between the length of stay and suicides. Methods : Data from psychiatric inpatients were extracted from the National Health Insurance databank and merged with information from the Cause of Death data using unique identification numbers. Poisson regression analyses were used to estimate the incidence rate ratio for inpatient and post-discharge suicides, which included the variables of sex, age, psychiatric diagnosis, and number of admissions in the preceding year. The associations between length of stay and inpatient and post-discharge suicide were examined using multivariate Poisson regression analyses that were adjusted for these variables. Results : A diagnosis of affective disorders and a higher number of previous admissions increased both inpatient and post-discharge suicides. Patients older than 15–24 years had a significantly lower inpatient suicide risk but were more likely to die by suicide post-discharge. The risk of suicide both during the inpatient stay and post-discharge statistically significantly decreased when the length of stay was longer. Limitations : As there were variations in societal, environmental, and facility-level factors that might have influenced the association between length of stay and suicide, the generalization of our findings to different settings may be impeded. Conclusions : This study provides additional evidence that hospitalization helps to reduce the suicide risk. It suggests that medical professionals should be alert to inpatient suicide and that they should determine the optimal length of stay considering post-discharge suicide.

Background: Hepassocin is a liver-derived protein and its serum concentrations significantly increase in diabetes and fatty liver patients. Hepassocin is also a biomarker for diabetes and fatty liver, therefore, we aimed to investigate the impacts of different types of bariatric surgery on hepassocin plasma levels in obese patients with diabetes, and to determine if hepassocin could be a potential new marker for monitoring the effects of bariatric surgery and a treatment target. Methods: Overall, 12 patients undergoing gastric bypass (GB), 10 patients undergoing sleeve gastrectomy (SG) and 11 patients undergoing duodeno-jejunal bypass with sleeve gastrectomy (DJB-SG) were enrolled. Fasting hepassocin levels were measured at baseline, three, 12, and 24 months after surgery. Results: All the three groups significantly decreased their body mass index, waist-to-hip ratio, a body shape index (ABSI), triglycerides, fasting blood sugar, hemoglobin A1c, C-peptide levels and homeostasis model assessment of insulin resistance 24 months after surgery. There were no significant changes in hepassocin levels, even 24 months after the three surgeries. Hepassocin had a significant negative relationship with the ABSI (p&lt, 0.001) 24 months after the SG. Conclusions: Neither GB, SG, nor DJB-SG altered plasma hepassocin levels in diabetic patients up to 24 months after surgery. The use of hepassocin in clinical settings requires more investigation.

“The authors would like to withdraw the manuscript entitled “Do different bariatric surgery procedures impact hepassocin plasma levels in patients with type 2 diabetes mellitus?” due to unauthorized alteration of authors' affiliation by the Editorial Office of Liver Research. The Editorial Office of Liver Research takes the full responsibility and apologize to the authors for this oversight.” The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal

Objective Autonomic imbalance is considered a psychopathological mechanism underlying major depressive disorder (MDD). Heart rate variability (HRV) is an index for autonomic activation. Poor sleep quality is common among patients with MDD. HRV biofeedback (BF) has been used for regulating autonomic balance among patients with physical illness and mental disorders. The purpose of present study was to examine the effects of HRV-BF on depressive symptoms, sleep quality, pre-sleep arousal, and HRV indices, in patients with MDD and insomnia. Methods In this case-controlled study, patients with MDD and Pittsburgh Sleep Quality Index (PSQI) score higher than 6 were recruited. The HRV-BF group received weekly 60-minute protocol for 6 weeks, and the control group who have matched the age and sex received medical care only. All participants were assessed on Beck Depression Inventory-II, Back Anxiety Inventory, PSQI, and Pre-Sleep Arousal Scale. Breathing rates and electrocardiography were also performed under resting state at pre-testing, and post-testing conditions and for the HRV-BF group, also at 1-month follow-up. Results In the HRV-BF group, symptoms of depression and anxiety, sleep quality, and pre-sleep arousal were significantly improved, and increased HRV indices, compared with the control group. Moreover, in the HRV-BF group, significantly improved symptoms of depression and anxiety, decreased breathing rates, and increased HRV indices were detected at post-testing and at 1-month follow-up, compared with pre-testing values. Conclusion This study confirmed that HRV-BF is a useful psychosocial intervention for improving autonomic balance, baroreflex, and symptoms of depression and insomnia in MDD patients.

Background Systemic Inflammatory Response Syndrome (SIRS) criteria are often used to evaluate the risk of sepsis and to identify in-hospital mortality among patients with suspected infection. However, utilization of the SIRS criteria in mortality prediction among geriatric patients with influenza in the emergency department (ED) remains unclear. Therefore, we conducted a research to delineate this issue. Methods This is a retrospective case–control study including geriatric patients (age ≥ 65 years) with influenza, who presented to the ED of a medical center between January 1, 2010 and December 31, 2015. Vital signs, past history, subtype of influenza, demographic data, and outcomes were collected from all patients and analyzed. We calculated the accuracy for predicting 30-days mortality using the SIRS criteria. We also performed covariate adjustment of the area under the receiver operating characteristic curve (AUROC) via regression modeling. Results We recruited a total of 409 geriatric patients in the ED, with mean age 79.5 years and an equal sex ratio. The mean SIRS criteria score was 1.9±1.1. The result of a Hosmer–Lemeshow goodness-of-fit test was 0.34 for SIRS criteria. SIRS criteria score ≥ 3 showed better mortality prediction, with odds ratio (OR) 3.37 (95% confidence interval (CI), 1.05–10.73); SIRS score ≥ 2 showed no statistical significance, with p = 0.85 (OR, 1.15; 95% CI, 0.28–4.69). SIRS score ≥ 3 had acceptable 30-days mortality discrimination, with AUROC 0.77 (95% CI, 0.68–0.87) after adjustment. SIRS score ≥ 3 also had a notable negative predictive value of 0.97 (95% CI, 0.94–0.99). Conclusion The presence of a higher number of SIRS criteria (≥ 3) showed greater accuracy for predicting mortality among geriatric patients with influenza.

Background: Metoclopramide is used to relieve gastrointestinal symptoms, however, it could cause adverse reactions of motor disorders. The aim of this study was to investigate whether metoclopramide treatment has a duration–response or dose–response effect and to estimate the risk of developing Parkinsonism following different and specific durations of treatment. Methods: A cohort study of newly diagnosed type 2 diabetes mellitus in 45- to 79-year-old patients, between 1999 and 2008, was selected using the Longitudinal Health Insurance Database 2005. A nested case–control study was conducted in the diabetes cohort in which all incident cases of Parkinsonism were identified. We randomly matched each case with up to 10 controls from the risk set. Conditional logistic regression was utilized to estimate odds ratio of Parkinsonism associated with metoclopramide use. Results: A total of 34,685 patients with diabetes were assembled as the cohort, and 541 incident Parkinsonism cases were identified. There were duration–response and dose–response effects on the risk of developing Parkinsonism. Compared with never-use patients, the adjusted odds ratios (ORs) of continuing therapy for 0–1 month, 1–2 months, 2–3 months, 3–5 months, and more than 5 months were 1.17 [95% confidence interval (CI) 0.93–1.45], 1.44 (95% CI 1.04–2.00), 1.74 (95% CI 1.14–2.65), 1.90 (95% CI 1.23–2.93), and 2.17 (95% CI 1.50–3.12), respectively. Conclusions: With metoclopramide treatment, regardless of less or more than 3 months of use, the risk of developing Parkinsonism in patients with newly diagnosed diabetes escalated with the duration of therapy. Therefore, we recommend close monitoring for the development of Parkinsonism in patients treated with metoclopramide, particularly (but not limited to) those with prolonged exposure.

Water-soluble nitrogen-doped carbon quantum dots (C-dots) were fabricated by microwave-induced decomposition of the precursor materials citric acid and N,N'-bis(2-aminoethyl)-1,2-ethanediamine. The C-dots were placed on portable paper strips with novel origami designs to simplified user operations. The intensity of the blue fluorescence, best measured at excitation/emission wavelengths of 330/420 nm, depends on the pH value in the range from pH 2 to 12. The C-dots on the paper stripe are shown to be a sensitive fluorescent probe for chromium(VI) via an inner filter effect. Response is linear in the 0.08 to 1 mM concentration range, and the detection limit (at S/N = 3) is 0.14 mM. The test was applied to the determination of chromium(VI) in (spiked) environmental water samples. Graphical abstract Schematic presentation of the water-soluble nitrogen-doped carbon dots (C-dots) as a fluorescent probe for Cr

The quick Sepsis-Related Organ Failure Assessment (qSOFA) score was designed to predict mortality among sepsis patients. However, it has never been used to identify prolonged length of hospital stay (pLOS) in geriatric patients with influenza infection. We conducted this study to clarify this issue.We conducted a retrospective case-control study, including geriatric patients (aged ≥ 65 years) with influenza infection visiting the emergency department (ED) of a medical center between January 01, 2010 and December 31, 2015. The included patients were divided into two groups on the basis of their qSOFA score: qSOFA 2, and qSOFA ≥ 2. Data regarding demographics, vital signs, qSOFA score, underlying diseases, subtypes of influenza, and outcomes were included in the analysis. We investigated the association between qSOFA score ≥ 2 and pLOS (9 days) via logistic regression.Four hundred and nine geriatric patients were included in this study with a mean age of 79.5 (standard deviation [SD], 8.3) years. The median length of stay (LOS) was 7.0 (interquartile range [IQR], 4-12) days, while the rate of pLOS (9 days) was 32%. The median LOS in the qSOFA ≥ 2 group, 11.0 (7-15) days, was longer than the qSOFA 2 group, 6.0 (4-10) days (p-value0.01). Logistic regression showed that qSOFA ≥ 2 predicts pLOS with an odds ratio of 3.78 (95% confidence interval, 2.04-6.97).qSOFA score ≥ 2 is a prompt and simple tool to predict pLOS in geriatric patients with influenza infection.

Tyrosinase, chitosan, and reduced graphene oxide (rGO) are sequentially used to modify a screen-printed carbon electrode (SPCE) for the detection of dopamine (DA), without interference from uric acid (UA) or ascorbic acid (AA). The use of tyrosinase significantly improves the detection&rsquo, s specificity. Cyclic voltammetry (CV) measurements demonstrate the high sensitivity and selectivity of the proposed electrochemical sensors, with detection limits of 22 nM and broad linear ranges of 0.4&ndash, 8 &mu, M and 40&ndash, 500 &mu, M. The fabricated tyrosinase/chitosan/rGO/SPCE electrodes achieve satisfactory results when applied to human urine samples, thereby demonstrating their feasibility for analyzing DA in physiological samples.

Background H. pylori CagL-Y58/E59 increase gastric cancer risk by stronger binding with integrin to faciliate type IV secretory system (T4SS). H. pylori can secrete high temperature requirement A (HtrA) to mediate E-Cadherin cleavage for gastric epithelial junction disruption, so H. pylori CagL can adhere to integrin located on basolateral side of epithelium. The study test whether H. pylori HtrA amino acid polymorphisms can increase gastric cancer risk synergistically with CagL-Y58/E59. Methods One-hundred and sixty-four H. pylori-positive patients, including 71 with non-ulcer dyspepsia (NUD), 63 with peptic ulcers (PU), and 30 with gastric cancers (GC), were enrolled to receive upper gastrointestinal endoscopy to obtain gastric biopsies for H. pylori culture and histology by the updated Sydney system. Each isolate was screened for htrA & cagL genotype by polymerase chain reaction and HtrA & CagL-Y58/E59 amino acid sequence polymorphisms by sequencing. Results The prevalence rates of htrA & cagL gene were both 100%. The HtrA amino acid sequence polymorphisms were not different between NUD and PU. The H. pylori isolates of GC had higher rates of HtrA residue 171 as leucine than those of NUD (73.3% vs. 50.7%, P = 0.036, OR[95%CI] = 2.7[1.1–6.8]). The risk of the H. pylori-infected subjects to get gastric cancer was increased up to 15.4-fold, if the infected isolates had presence of both HtrA-L171 and CagL-Y58/E59 (P

Although the relationship between protein-bound uremic toxins (PBUTs) and cardiac structure and cardiac mortality in chronic kidney disease (CKD) has been studied in the past, the association between cardiac dysfunction and PBUTs has not yet been studied. We therefore evaluated the association between impaired peak cardiac performance and the serum free and total concentrations of potentially cardiotoxic PBUTs. In a cross-sectional study of 56 male CKD patients (stages 2⁻5 (pre-dialysis)) who were asymptomatic with no known cardiac diseases or diabetes we measured peak cardiac power (CPOmax), aerobic exercise capacity (VO2max), and echocardiographic parameters of cardiac morphology and evaluated their association with PBUTs. The serum total and free concentrations of indoxyl sulfate (IXS), p-cresyl sulfate (PCS), p-cresyl glucuronide, indole acetic acid, and hippuric acid showed significant negative correlation with CPOmax and VO2max. IXS and PCS were independently associated with CPOmax and VO2max even after controlling for eGFR. No correlation between left ventricular mass index (LVMI) and PBUTs was seen. The present study for the first time has demonstrated the association between subclinical cardiac dysfunction in CKD and serum levels of a panel of PBUTs. Further studies are required to evaluate the mechanism of cardiotoxicity of the individual uremic toxins.

Mercury and dioxin pollution associated with the China Petrochemical Development Corporation's An-shun plant is one of the most severe soil contamination incidents in Taiwan's history. Residents living nearby were exposed to heavy metals and dioxins that led to significant impacts on human health and safety. While many studies related to contamination in large-scale industrial areas have been conducted to evaluate the effects of occupational contaminant exposure, studies related to people who live near small-scale industry areas are less common. In this study, we use the system dynamics modeling to build a media flow pattern for mercury and dioxin in the vicinity of the An-shun plant, simulate the concentrations of the pollutants before and after remediation, and compare the simulated values with the measurements of actual conditions after remediation to evaluate the feasibility and accuracy of the model. This study also estimated the concentration of mercury and dioxin in each food medium to simulate the daily exposure of the human body to these contaminants. Finally, the reduction in mercury and dioxin levels in the study area was used to estimate the total health benefits to the local population. The objective of this study was to evaluate the application of this methodology to small-scale industrial areas as well as improve the decision-making process before, during, and after remediation of contaminated sites. The results of this study revealed the health benefits to residents living in the Annan District after remediation was completed at the An-shun plant were significant.

In this paper, we make the case that an argument for price-level targeting over inflation targeting need not to be based on some overly restrictive assumptions. We adopt a theoretical framework that deviates from the assumption of rational expectation, and that takes into account the cognitive limitations and a “trial and error” learning mechanism of the agents. The (im)perfect credibility of various monetary policies (e.g., a Taylor-type rule, strict domestic inflation targeting, strict consumer price index (CPI) inflation targeting, exchange rate peg, and domestic price-level and CPI-level targeting) may lead agents to react according to their expectation rules, and then create various degrees of booms and busts in output and inflation. Therefore, relaxing the rational expectation hypothesis has potential consequences for policy planning. We find that price-level targeting prevails over inflation targeting even under different expectation formation and even when the announced inflation target is not fully credible. The counterfactual analysis and sensitivity test confirm that CPI-level targeting is the most effective for improving social welfare and stability in an open economy. The business cycles induced by animal spirits are enhanced by strict inflation targeting.

The petrochemical industry produces many air pollutants during production, such as airborne particulate matters (PM10 and PM2.5), sulfur oxides, nitrogen oxides, volatile organic compounds, carbon oxides, etc. Petrochemical industrial accidents are more likely to cause major air pollution hazards in a short period. Therefore this study simulated diffusion and performed air pollution spatial risk analysis for potential air pollutants generated by the petrochemical industry using meteorological observation data from 2017 to 2019. The study targets were No. 6 Naphtha Cracker Complex Petrochemical Industrial Park (6NCC) of Formosa Petrochemical Corporation and Taichung Thermal Power Plant (TTPP) in central Taiwan. We used the industrial source complex model short term (ISCST3) air simulation model developed by the US Environmental Protection Agency to simulate pollutant diffusion under different weather conditions and seasons. Air pollution spatial risk was investigated for neighboring hospitals and schools for pollutant emission and diffusion to provide feedback to petrochemical related industry's risk management. Emission areas (6NCC and TTPP) were all in the southwest since the main air pollution accumulation and diffusion is to the northeast during monsoon season (October through March). Air pollution April through September each year is more evenly distributed, with pollutant concentrations low in all directions, approximately half the concentration in winter. Simulated air pollutant concentrations often overlapped with high risk population clusters (schools and hospitals). 6NCC posed little impact on nearby schools throughout the year; whereas TTPP posed relatively low risks to nearby schools and hospitals in summer, with slightly higher risk for Shenren Elementary School in Shengang township, Changhua County in winter. Overall 6NCC posed higher risk for Mailiao and Taixi townships in Yunlin County; whereas the TTPP posed higher risk on Longjing District of Taichung City, Shengang and Xianxi townships in Changhua County, particularly during winter. The results of this study will help the petrochemical industry and public health authority to wider manage air pollution risks.

Biodegradable starch-based plastics are formed by combining corn starch with biodegradable poly(butylene adipate-co-terephthalate) (PBAT). Starch reduces the production cost and improves the biodegradability. However, starch reduces the ductility and toughness of biodegradable plastics, limiting their application. In this study the low molecular weight poly(ethylene ether carbonate) (LPEEC) is synthesized by the ring-opening polymerization of ethylene carbonate produced from the greenhouse gas CO2. The extrusion combines starch-based plastic with LPEEC and provides plastics with increased tensile strength (by 3- to 4-fold) and elongation at break (by 4- to 5-fold), compared to that of plastics without LPEEC. The plastics with best mechanical properties are obtained using an LPEEC with the average molecular weights, molecular units of ethylene carbonate (Ec) and ethylene oxide (Eo) linkages of 3117 g/mol, 14, and 43, respectively. This is the first evidence of improving the properties of the starch-based polyester using LPEEC, which is suitable for biodegradable plastic.

This study aimed to determine the effectiveness of using noninvasive arterial pulse-wave and laser-Doppler flowmetry (LDF) measurements to discriminate between colorectal-cancer (CC) patients and healthy control subjects. Radial-artery blood pressure waveform (BPW), finger photoplethysmography (PPG), and skin-surface LDF signals were measured noninvasively in 12 CC patients and 25 control subjects. Beat-to-beat, spectral, and variability analyses were applied to 20-minute-long recorded signals. Significant intergroup differences were found. In BPW, [Formula: see text]–[Formula: see text] amplitude indices were significantly larger while [Formula: see text]–[Formula: see text] phase-angle indices were significantly smaller in the CC patients than in the controls. The PPG and LDF variability indices were significantly larger and smaller, respectively, in CC patients. The relative energy contributions of the endothelial-, neural-, and myogenic-related frequency bands in LDF were significantly smaller in CC patients. The present findings indicate that pulse and LDF waveform analysis can be used to evaluate the arterial pulse-wave transmission condition, the responses of the blood-flow perfusion, and its regulatory activities in CC patients. There could be some similarities and differences in the present indices for different types of cancer. These findings could be utilized in the development of a rapid, noninvasive, and objective technique for evaluating the CC-induced blood-flow responses.

Chun Yeh,1 Ching-Heng Ting,2 Ming-Luen Doong,3 Chin-Wen Chi,4,5 Shou-Dong Lee,1 Chih-Yen Chen6–8 1Division of Gastroenterology, Department of Internal Medicine, Cheng-Hsin General Hospital, 2Department of Pathology, Mackay Memorial Hospital, 3Institute of Physiology, 4Institute of Pharmacology, National Yang-Ming University School of Medicine, 5Department of Medical Research, Taipei Veterans General Hospital, 6Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, 7Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, 8Taiwan Association for the Study of Small Intestinal Diseases, Guishan, Taiwan Purpose: Urocortin 3 is a key neuromodulator in the regulation of stress, anxiety, food intake, gut motility, and energy homeostasis, while ghrelin elicits feeding behavior and enhances gastric emptying, adiposity, and positive energy balance. However, the interplays between urocortin 3 and ghrelin on food intake and gastric emptying remain uninvestigated.Methods: We examined the differential effects of central O-n-octanoylated ghrelin, des-Gln14-ghrelin, and urocortin 3 on food intake, as well as on charcoal nonnutrient semiliquid gastric emptying in conscious rats that were chronically implanted with intracerebroventricular (ICV) catheters. The functional importance of corticotropin-releasing factor (CRF) receptor 2 in urocortin 3-induced responses was examined by ICV injection of the selective CRF receptor 2 antagonist, astressin2-B.Results: ICV infusion of urocortin 3 opposed central acyl ghrelin-elicited hyperphagia via CRF receptor 2 in satiated rats. ICV injection of O-n-octanoylated ghrelin and des-Gln14-ghrelin were equally potent in accelerating gastric emptying in fasted rats, whereas ICV administration of urocortin 3 delayed gastric emptying. In addition, ICV infusion of urocortin 3 counteracted central acyl ghrelin-induced gastroprokinetic effects via CRF receptor 2 pathway.Conclusion: ICV-infused urocortin 3 counteracts central acyl ghrelin-induced hyperphagic and gastroprokinetic effects via CRF receptor 2 in rats. Our results clearly showed that enhancing ghrelin and blocking CRF receptor 2 signaling in the brain accelerated gastric emptying, which provided important clues for a new therapeutic avenue in ameliorating anorexia and gastric ileus found in various chronic wasting disorders. Keywords: corticotropin-releasing factor receptor, des-Gln14-ghrelin, food intake, gastric emptying, intracerebroventricular, urocortin 3&nbsp

Introduction: Alpha asymmetry of the left and right frontal hemisphere is a potential biomarker for major depressive disorder (MDD). Neurofeedback (NFB) is a clinical intervention program for regulating brain activity and decreasing alpha asymmetry. The purpose of this study was to explore the efficacy of NFB among patients with MDD. Methods: Fourteen patients with MDD were randomly assigned to a NFB group that received neurofeedback training 1 hr weekly for 6 weeks and to a control group that was treated without training. A 5-min resting baseline of electroencephalogram (EEG) was recorded at F3 (left) and F4 (right) before and after NFB, and the alpha power was analyzed as an asymmetry index (A1). Results: The A1 of the control group decreased from pre- to post-interventions while the A1 of the NFB group increased from pre- to post-interventions. Anxiety and depression scores of the responder group decreased from pre- to post-interventions, while the scores of the non-responder group increased from pre-to post-interventions. Conclusion: Patients who respond to the NFBtraining showed a decrease in anxiety and depression scores compared to those who do not. This study indicated that NFB could improve left frontal hypoarousal or right frontal hyperarousal among patients with MDD.

The present study utilizes a modified Poisson–Boltzmann (MPB) equation to take into account ion-size (steric) effect and then performs a series of simulations to investigate the ionic transport phenomenon within two nanofluidic devices, namely a nanoslit and a nanotube. The results show that at all electrolyte concentrations, the streaming conductance increases when the ion-size effect is taken into account, particularly under conditions of high surface charge density. The net charge density is amplified by the ion-size effect for both nanogeometries as well. The enhancement in the streaming conductance is particularly pronounced in the nanotube since the net charge density has higher value by the geometry effect of the nanotube. The maximum ratio of net charge density () is 1.55 near the surface of nanotube. In addition, it is shown that for both configurations, the contribution of electroosmotic flow to the electrical conductance increases when the finite ion size is taken into account.

We propose a method for detecting evolutionary forces underlying community assembly by quantifying the strength of community-environment relationships hierarchically along taxonomic ranks. This approach explores the potential role of phylogenetic conservatism on habitat preferences: wherein, phylogenetically related taxa are expected to exhibit similar environmental responses. Thus, when niches are conserved, broader taxonomic classification should not diminish the strength of community-environment relationships and may even yield stronger associations by summarizing occurrences and abundances of ecologically equivalent finely resolved taxa. In contrast, broader taxonomic classification should weaken community-environment relationships when niches are under great divergence (that is, by combining finer taxa with distinct environmental responses). Here, we quantified the strength of community-environment relationships using distance-based redundancy analysis, focusing on soil and seawater prokaryotic communities. We considered eight case studies (covering a variety of sampling scales and sequencing strategies) and found that the variation in community composition explained by environmental factors either increased or remained constant with broadening taxonomic resolution from species to order or even phylum level. These results support the niche conservatism hypothesis and indicate that broadening taxonomic resolution may strengthen niche-related signals by removing uncertainty in quantifying spatiotemporal distributions of finely resolved taxa, reinforcing the current notion of ecological coherence in deep prokaryotic branches.

Before 2007/08, the European Monetary Union (EMU) was expected to be enlarged on schedule, but the European sovereign debt problem, triggered by the exogenous US sub‐prime crisis, not only has revealed the EMU's fiscal coordination failure, but also has weakened regional financial integration. The stagnation of financial integration will therefore increase the cost of sustaining a monetary union, which in turn slows EMU enlargement and ruins the reputation of the euro. This paper aims to measure the damage to financial integration and to provide a more precise answer on real interest rate parity (RIP) convergence. Our estimation indicates that RIP between the EMU and some accession candidates is still valid after the interruptions of the financial crises. However, convergence of real interest rates cannot be achieved until 2030. This implies the EMU authority must strengthen regional financial integration to solidify the EMU and then be able to re‐start enlargement.

Backgrounds Patients with chronic kidney disease (CKD) more commonly experience cognitive impairment, but the etiologies are not clear. Uremic toxins such as p-cresyl sulfate (PCS) and indoxyl sulfate (IS) have been shown to increase the risks of cardiovascular diseases and mortality; however, no study has investigated the associations of PCS and IS with cognitive function in patients with CKD. Methods Patients with CKD aged ≥50 years and age- and sex-matched non-CKD comparison subjects were recruited. CKD stage was defined according to the National Kidney Foundation guidelines. Cognitive function was evaluated using comprehensive neuropsychological tests. The associations between uremic toxins and cognitive function domains were examined using multiple linear regression analysis. The interaction between uremic toxins and CKD stages on cognitive functions were also examined. Results In total, 199 patients with CKD and 84 comparison subjects completed the study. The patients with CKD had poorer cognitive function and higher serum PCS and IS levels. A higher serum IS level was associated with poor executive function (β = −0.31, P = 0.003) only in stage 3 CKD patients after adjustment for age, sex and educational level. Serum PCS level was not associated with cognitive function in patients with CKD. Conclusions Our study showed that a higher serum IS level was associated with poor executive function in the early stage of CKD. It would be worthwhile to investigate the effect of IS removal in early-stage CKD on the prevention of cognitive impairment in future studies.

Coloring a dense oxide layer is accomplished during plasma electrolytic oxidation (PEO) with an electrolyte mixed with dye emulsions. We demonstrate this coating technique using the aluminum disks of 6061 alloy and five synthetic dyes of red, yellow, orange, blue, and black color. The prepared dye emulsions are kinetically stable, containing negatively charged oil droplets of ~ 50 nm in size. To avoid color speckles, a barrier oxide layer must be first grown under the normal PEO conditions with an electrolyte without dye, followed by the growth of colored γ-alumina film with a stepwise increasing voltage of positive polarization in the electrolyte containing dye emulsion. Although the presence of surfactant in emulsion causes a large amount of bubbles that obscures the light of electric sparks, the spark sound can be heard clearly on site. These electric discharges can produce an uneven surface with many volcano craters of micrometer size which is the icon of PEO. Fortunately this typical unevenness can be smoothed out by synthetic dyes with proper voltage adjustment, resulting in a glossy surface.

In this study, a well-characterized carrier, osmotically-inducible protein Y (OsmY), was employed in conjunction with a newly discovered protein homolog of Cupriavidus metallidurans for use in protein secretion. Rmet_4872 and Rmet_3428 were identified as possible homologs of OsmY based on sequence/feature identities. RFP fluorescence and immunoblotting analyses were used to identify and quantify the secretion of fusion proteins. Two metal-binding proteins were used to demonstrate the applications of protein secretion in biogenic synthesis of metal nanoparticles. Our study highlights the potential of applying protein secretion to mediate the reduction of metal ions.

This study presents the design of novel dual-fed circularly polarized (CP) antenna. This antenna consists of a tapered slot, a backside metal plate and a microstrip-fed delay line phase shifter. Based on the analysis of the radiation mechanism of antenna ground plane, the edge shape is optimized as a half-circle type to enhance the bandwidth of antenna gain and CP purity. The proposed antenna possesses a wideband return loss better than 10 dB in the range of 4.18–7.57 GHz, covering the bandwidth of axial ratio lower than 3 dB from 4.25 to 6.75 GHz. The measured antenna gain is approximately 9–10.5 dBic and the radiation patterns are broadside and consistent within the CP operating bandwidth.

286 Background: Quality of life (QoL) is commonly assessed in oncology clinical trials. However, it is unclear if oncology healthcare providers (HCPs) perceive value in these metrics or if they impact clinical practice. We sought to assess the real-world utilization of QoL data and barriers to its adoption among US community oncology providers. Methods: Medical oncologists/hematologists, and advanced practice providers (APPs) participated in a survey to assess their perceptions and the utility of QoL data for routine practice during a live meeting in September 2019. Responses were captured via a web-based premeeting survey and an audience response system during the live meeting. Participant characteristics and responses were summarized using descriptive statistics. Results: A total of 71 HCPs (51 physicians and 20 APPs) participated. Regarding perceptions of QoL in oncology, 50% of physicians and 32% of APPs reported aligning with the sentence “It is important to have QoL, but efficacy is obviously the most critical endpoint.” HCPs reported that QoL may outweigh overall survival (OS) in certain clinical scenarios, such as in end-of-life (81%), frail patients (67%), or metastatic tumors (62%). When selecting between two agents with similar efficacy, safety was the most important factor (78%), followed by QoL (40%). 64% of physicians utilized aggregate QoL data from registrational trials or real-world studies to keep informed about QoL of different treatments, while 69% of APPs relied on their personal or practice experiences. 85% of physicians and 84% of APPs responded that it is important to perform formal QoL assessments during routine patient visits. 88% of HCPs expected that QoL/patient-reported outcomes (PRO) collection will increase their workload. Patient burden (58%) and provider resources (43%) were other barriers for QoL/PRO collection. HCPs were largely split regarding their understanding of QoL versus PRO, with 34% reporting that PRO was a subset of QoL and 28% reporting that QoL was a subset of PRO. Conclusions: Efficacy and safety are prioritized as clinical endpoints among oncology HCPs; however, there are certain clinical scenarios where QoL may provide more impactful data for HCPs in managing patients. Barriers remain to successful collection of QoL, and there is a need for further education among HCPs regarding PROs and QoL.

162 Background: There has been an increased emphasis on patient-reported outcomes (PROs) in recent oncology trials, and the benefits of incorporating PRO assessments during routine care have been established. The aim of the present study was to assess the perceptions, adoption and barriers to implementation of PROs in community practices during routine care. Methods: A live meeting in September 2019 surveyed US-based community oncology health care providers (HCPs), including medical oncologists/hematologists and advanced practice providers (APPs; defined as nurse practitioners and physician assistants) regarding their perceptions of PROs and their adoption of PROs during routine patient care. Participants completed both a web-based premeeting survey and live queries captured via audience response system. Data were summarized using descriptive statistics. Results: 71 HCPs (51 medical oncologists/hematologists and 20 APPs) participated. HCPs described their practices as: urban 50%, suburban 37%, and rural 13%. Over 80% reported having collected PRO data from their patients. Over 90% indicated that PROs are important to guide their treatment of patients, irrespective of the data sources (clinical studies or in real-world). Commonly collected PRO data included disease symptoms (66%), activities of daily living (62%), physical function (61%) and adverse events (59%). The NCCN Distress Thermometer (41%) was reported as the most common PRO instrument used during routine oncology care (Table). Despite understanding the importance of implementing PROs, 54% indicated that more resources (software and incentive systems) are needed, and 53% said that discussing PRO results with each patient is critical to facilitate the collection and utilization of PRO data. 84% were unaware of results of a seminal study which demonstrated that PROs improve quality of life and survival (Basch et al 2016, 2017). Conclusions: Most of the community oncology providers surveyed collected PRO data and acknowledged its value. However, more resources are needed to increase collection and use of PROs during routine care. Education directed towards community oncology providers is needed to highlight the value that PROs can add in cancer care. [Table: see text]

75 Background: In the value-based era, policymakers have begun incorporating quality of life (QoL) components into payment models, such as the Merit-based Incentive Payment System (MIPs), Oncology Care Model (OCM), and Accountable Care Organization (ACO), to increase accountability. This qualitative research study sought to understand how providers address their patients’ QoL issues in a value-based environment. Methods: A live meeting in September 2019 brought together community oncology healthcare providers (HCPs) from across the United States. Participants submitted their demographic information via a web-based pre-meeting survey and their responses pertaining to patient QoL via an audience response system during the live meeting. Participant responses and their practice demographics were analyzed using descriptive statistics. Results: 71 HCPs participated in this live market research program: 51 medical oncologists/hematologists (herein referred to as physicians) and 20 nurse practitioners or physician assistants (herein referred to as APPs). 50% of physicians and 25% of APPs were from privately owned community practices. Half of HCPs indicated that their practices are collecting and reporting QoL data through value-based programs: 28% of physicians and 60% of APPs were in OCM-participating practices. Regarding accountability, over 80% of HCPs strongly agreed that they have a role in improving patients’ QoL. However, 32% of physicians and 25% of APPs agreed that their payment should be tied to patients’ QoL improvement. According to HCPs, the top factor impacting patients’ QoL was symptom and symptom burden (83%). To address QoL in their patients, HCPs reported addressing patients’ psychosocial needs (78%), implementing survivorship care planning (76%), and using nurse navigators (69%). 70% of physicians and 95% of APPs were confident that their patients have reliable resources for managing their QoL issues. Conclusions: HCPs recognize their role in improving patients’ QoL, and their practices have made several transformations to improve patients’ QoL; they are confident that their patients have resources for managing QoL issues. However, many HCPs disagree with linking QoL improvements to their payment. Further studies are needed to understand QoL from patients’ perspectives in the value-based environment.

Date Presented 03/27/20 We explored the experiences of clients and their therapists using strategy training in outpatient settings in Taiwan with qualitative data to understand the benefits and challenges that they perceived during the intervention. Findings of this study support the use of strategy training in individuals with chronic stroke and brain injury and indicate potential challenges that OTs may encounter as delivering strategy training to clients in outpatient settings in Taiwan. Primary Author and Speaker: Feng-Hang Chang Additional Authors and Speakers: Chao-Yi Wu, Elizabeth Skidmore Contributing Authors: Wan-Chi Lin, Yi-Hsuan Wu, Pei-Chun Yeh, Yen-Nung Lin

Deep sequencing of T-cell receptor (TCR) genes is powerful at profiling immune repertoire. To prepare a TCR sequencing library, multiplex polymerase chain reaction (mPCR) is widely applied and is highly efficient. That is, most mPCR products contain the region critical for antigen recognition, which also indicates regular V(D)J recombination. Multiplex PCR, however, may suffer from primer bias. A promising alternative is 5’-RACE, which avoids primer bias by applying only one primer pair. In 5’-RACE data, however, non-regular V(D)J recombination (e.g., TCR sequences without a V gene segment) has been observed and the frequency varies (30–80%) between studies. This suggests that the cause of or how to reduce non-regular TCR sequences is not yet well known by the science community. Although it is possible to speculate the cause by comparing the 5’-RACE protocols, careful experimental confirmation is needed and such a systematic study is still not available. Here, we examined the 5’-RACE protocol of a commercial kit and demonstrated how a modification increased the fraction of regular TCR-β sequences to >85%. We also found a strong linear correlation between the fraction of short DNA fragments and the percentage of non-regular TCR-β sequences, indicating that the presence of short DNA fragments in the library was the main cause of non-regular TCR-β sequences. Therefore, thorough removal of short DNA fragments from a 5’-RACE library is the key to high data efficiency. We highly recommend conducting a fragment length analysis before sequencing, and the fraction of short DNA fragments can be used to estimate the percentage of non-regular TCR sequences. As deep sequencing of TCR genes is still relatively expensive, good quality control should be valuable.

Primary effusion lymphoma (PEL) is an aggressive neoplasm correlated with human herpesvirus 8 (HHV8). Metabolic reprogramming is a hallmark of cancers. The alterations in cellular metabolism are important to the survival of HHV8 latently infected cells. Pyruvate dehydrogenase (PDH) controls the flux of metabolites between glycolysis and the tricarboxylic acid cycle (TCA cycle) and is a key enzyme in cancer metabolic reprogramming. Glutaminolysis is required for the survival of PEL cells. Glutamate dehydrogenase 1 (GDH1) converts glutamate into α-ketoglutarate supplying the TCA cycle with intermediates to support anaplerosis. Previously we have observed that epigallocatechin-3-gallate (EGCG) can induce PEL cell death and N-acetyl cysteine (NAC) attenuates EGCG induced PEL cell death. In this study, results showed that EGCG upregulated the expression of glucose transporter GLUT3, and reduced the expression of pyruvate dehydrogenase E1-alpha (PDHA1), the major regulator of PDH, and GDH1. NAC could partially reverse the effects of EGCG in PEL cells. Overexpression of PDHA1 in PEL cells or supplement of α-ketoglutarate attenuated EGCG induced cell death. EGCG also reduced the levels of oncometabolite D-2-hydroxyglutarate (D2HG). These results suggest that EGCG may modulate the metabolism of PEL cells leading to cell death.

Background: Community-acquired Gram-Negative (GN) bacteremia caused more morbidity and mortality recently in children. The increasing drug resistance was also an important issue. However, published reference was few about children. Methods: We conducted a retrospective study to collect febrile patients with blood culture from a pediatric emergency department during 2007∼2013, and exclude cases ever admitted to hospital within 14 days. These blood cultures all showed single GN organism. The demographic characteristics of enrolled patients and the antibiogram of pathogens were recorded, and then were compared statistically to find out the immediate and appropriate antibiotics. Results: Total 143 sets of blood culture were GN bacilli and the median age of cases was 2 (IQR, 1-5) years old. Male gender was predominant. Non-fermenting Gram-negative bacilli group (NFGNB spp.), Salmonella spp. and Escherichia coli were first three common pathogens respectively. However, total 37 cases of NFGNB spp. other than Pseudomonas aeruginosa were the possible pathogens. By multiple logistic regression analysis, lower hemoglobin and higher alanine aminotransferase were significant difference between common pathogens and possible ones. Besides, the prevalent age regarding resistant strains of Escherichia coli and Pseudomonas aeruginosa were both focused on less than 1 year old. However, Salmonella spp. were prevalent in the age from 1 to 3 years old. Conclusions: For different age groups, Salmonella spp. and Escherchia coli were the most common pathogens of community-acquired GN bacteremia. For infants, Pseudomonas aeruginosa sepsis and resistant strain of Escherchia coli should be alert, and broader antibiotics should be considered. Key Words: community-acquired, bacteremia, gram-negative bacilli, infants

The carotid intimal-medial thickness (CIMT) is a strong predictor of future cardiovascular events. We assessed the mean CIMT and evaluated associated factors in head and neck cancer (HNC) patients.Between January 2016 and March 2018, 70 volunteers underwent automatic ultrasound measurement of the common carotid artery CIMT. A mean CIMT ≥ 1.0 mm was regarded as an elevated risk for cardiovascular disease (CVD). We aimed to investigate the risk factors for an increased mean CIMT.We recruited 20 HNC survivors and 50 noncancer control individuals. Multiple linear regression analysis showed that old age (β = 0.006, 95% confidence interval, CI 0.004-0.008), increased weight (β = 0.003, 95% CI 0.001-0.005), hypertension (β = 0.10, 95% CI 0.03-0.17), and prior irradiation (β = 0.13, 95% CI 0.08-0.19) were positively correlated with the mean CIMT. From logistic regression analysis, it was shown that patients who underwent radiotherapy (OR 13.5, 95% CI 1.48-122.8) and who had higher bodyweight (OR 1.09, 95% CI 1.01-1.18) had a significantly higher risk of developing CVD.Measurement of the mean CIMT using ultrasound could be useful for assessing CVD risk in HNC survivors after neck irradiation.

Background: Extensive studies have demonstrated that sleep is an important modulator of cardiovascular and metabolic diseases. However, its impact on renal function remains uncertain. Methods: A total of 26,249 adults aged ≥20 years were recruited through voluntary health examinations in Taiwan. Sleep duration was self-reported by questionnaire. Proteinuria was graded semi-quantitatively by dipstick urine test. The associations of sleep duration with proteinuria and estimated glomerular filtration rate (eGFR) were analyzed. Results: After an average follow-up period of 2.62 years, the crude hazard ratio (HR) for proteinuria progression were 1.92 (95% CI 1.22–3.03), 1.23 (95% CI 1.09–1.39), and 1.18 (95% CI 1.00–1.39) for those with sleep duration < 4, 4–6, and > 8 h compared to those with sleep duration of 6–8 h (the reference group), respectively. The HR remained significant for those with sleep duration < 4 h (adjusted HR 1.65 [95% CI 1.05–2.61]) and 4–6 h (adjusted HR 1.19 [95% CI 1.06–1.35]) after adjustment for age, sex, blood pressure, fasting glucose, body mass index, cholesterols, triglycerides, uric acids, physical activity, smoking, alcohol consumption, income/educational levels, and baseline eGFR. However, eGFR was not significantly different among different sleep duration groups. Discussion: This result indicates short sleep duration is independently associated with the progression of proteinuria.