Navigation programs, are they helpful for perioperative care with thyroid cancer patients?

The purpose of this study was to develop and evaluate a navigation program for patients with thyroid cancer. The navigation program was developed following an analysis of the unmet needs of patients who underwent surgery for thyroid cancer. Ninety-nine patients in the control group received usual care, and 95 in the navigation group were managed with a navigation program during the perioperative period. The effectiveness of the navigation program was assessed by administering a questionnaire to both groups. Overall satisfaction scores were significantly higher in the navigation than in the control group (p = .025), as were satisfaction scores on the continuity of information (p < .001), the continuity of management (p = .002), the continuity of relationships with healthcare providers (p<.001), and patient empowerment (p < .001). The newly developed navigation program for patients with thyroid cancer was effective in raising satisfaction levels and in actively managing the disease during the perioperative period.

Accuracy of Xpert(®) MTB/RIF assay compared with AdvanSure™ TB/NTM real-time PCR using bronchoscopy specimens

BACKGROUND

The performance of Xpert(®) MTB/RIF assay, an automated nucleic acid amplification test (NAAT) that was developed for the detection of tuberculosis (TB), has been evaluated in various clinical settings. However, few studies have compared Xpert with other NAATs, especially its performance using lower respiratory tract specimens (LRTS).

OBJECTIVE

To compare the practical diagnostic performance of the Xpert assay with that of the AdvanSure™ TB/NTM RT-PCR kit in the detection of pulmonary TB (PTB), using LRTS obtained through bronchoscopy.

RESULTS

Of 249 patients included, 105 had culture-confirmed PTB. Using culture as reference, the overall sensitivity of Xpert and AdvanSure was respectively 92.4% and 83.8%. When acid-fast bacilli smear results were taken into consideration, the sensitivity of Xpert for smear-positive and smear-negative LRTS was respectively 100% and 88.9%, while that of the AdvanSure was 100% and 76.4%. Xpert showed better results than AdvanSure in terms of sensitivity in smear-negative LRTS (P = 0.012), but no difference in smear-positive LRTS.

CONCLUSIONS

Xpert may be advantageous in the detection of PTB using LRTS, particularly in low microbiological burden settings.

Effect of Nicardipine on Haemodynamic and Bispectral Index Changes following Endotracheal Intubation

We investigated the effect of IV nicardipine on haemodynamic and bispectral index responses to the induction of general anaesthesia and intubation. Forty patients were randomly allocated to two groups of 20 to receive normal saline or nicardipine 15 μg/kg IV 30 s after induction. Ninety seconds later, tracheal intubation was performed. Systolic blood pressure, heart rate and bispectral index were measured at baseline, 1 min after induction, pre-intubation, and every minute until 5 min after endotracheal intubation. Rate–pressure product values were calculated. In the nicardipine group, systolic blood pressure decreased compared with the control group, and heart rate increased compared with the control group. Bispectral index and rate–pressure product showed no differences between the two groups. In conclusion, the administration of 15 μg/kg nicardipine IV does not affect anaesthetic depth in response to the induction of general anaesthesia and intubation.

Effect of Administration of Ketorolac and Local Anaesthetic Infiltration for Pain Relief after Laparoscopic-assisted Vaginal Hysterectomy

The efficacy of local anaesthetic infiltration and/or non-steroidal anti-inflammatory drugs for post-operative analgesia following laparoscopic-assisted vaginal hysterectomy (LAVH) was investigated in 83 patients, randomized into four groups in this double-blind, placebo-controlled study: group BK, local infiltration with bupivacaine and pre-incisional intramuscular (IM) ketorolac; group NN, saline local infiltration IM; group BN, local infiltration with bupivacaine and saline IM; group NK, local infiltration with saline and ketorolac IM. Post-operative pain scores were assessed at 1 h, 3 h, 6 h, 12 h and 24 h using a visual analogue scale (VAS). The major pain site, first analgesic request time and incidence of analgesic requests were also recorded. At 1 h, 3 h and 6 h after surgery, group BK patients had significantly lower VAS pain scores than group NN patients. The first analgesic request time was significantly longer in group BK than in groups NN, BN and NK. Pre-incisional treatment with ketorolac IM and local infiltration with bupivacaine reduced post-operative pain after LAVH.

Mutational spectrum of Korean patients with corneal dystrophy

Corneal dystrophy typically refers to a group of rare hereditary disorders with a heterogeneous genetic background. A comprehensive molecular genetic analysis was performed to characterize the genetic spectrum of corneal dystrophies in Korean patients. Patients with various corneal dystrophies underwent thorough ophthalmic examination, histopathologic examination, and Sanger sequencing. A total of 120 probands were included, with a mean age of 50 years (SD = 18 years) and 70% were female. A total of 26 mutations in five genes (14 clearly pathogenic and 12 likely pathogenic) were identified in 49 probands (41%). Epithelial-stromal TGFBI dystrophies, macular corneal dystrophy and Schnyder corneal dystrophy (SCD) showed 100% mutation detection rates, while endothelial corneal dystrophies showed lower detection rates of 3%. Twenty six non-duplicate mutations including eight novel mutations were identified and mutations associated with SCD were identified genetically for the first time in this population. This study provides a comprehensive characterization of the genetic aberrations in Korean patients and also highlights the diagnostic value of molecular genetic analysis in corneal dystrophies.

Effects of Temperature and Pore Structure on High Surface Area-Activated Carbon Obtained from Peanut Shells

Activated carbon was synthesized from peanut shells by treating with H3PO4 with an intention to enhance the surface area and to find its electrochemical performance in EDLC as electrode material. The powdered peanut shells were pyrolyzed at three different temperatures namely 300 degrees C, 600 degrees C and 800 degrees C respectively. The structural and surface properties of the pyrolyzed carbon materials were studied using N2 adsorption/desorption, Raman, TEM and SEM analysis. There has been remarkable increase in the surface area of the carbon pyrolyzed at 600 degrees C due to the effect of pore generations. The surface area of the 600 degrees C pyrolyzed sample was found to be 1629 m2/g. The electrochemical properties of all the samples were evaluated by cyclic voltammetry, impedance spectroscopy, and galvanostatic charge-discharge tests. The system showed excellent cycleability and a maximum specific capacitance of 291 Fg(-1) was obtained in a 0.1 M H2SO4 electrolyte solution. The effects of the various properties of the activated carbon on the EDLC performance are discussed.

Changes in lung function according to disease extent before and after pulmonary tuberculosis

OBJECTIVE

To evaluate changes in lung function in individuals before and after treatment for pulmonary tuberculosis (PTB) in relation to extent of disease.

DESIGN

Using a retrospective cohort design, changes in and predictors of lung function were evaluated.

RESULTS

A total of 41 patients were included in the final analysis. The median decline in annualised forced expiratory volume in 1 sec (FEV1) was 180.0 ml/year (95%CI 118.9-356.1) in advanced PTB and 94.7 ml/year (95%CI 33.4-147.3) in localised PTB (ΔFEV1% predicted/year 9.4%, 95%CI 4.4-14.0 vs. 3.8%, 95%CI 1.8-6.2). The median decline in annualised forced vital capacity (FVC) was 309.6 ml/year (95%CI 137.0-359.0) in advanced PTB and 101.1 ml/year (95%CI 30.3-219.6) in localised PTB (ΔFVC % predicted/year 7.3%, 95%CI 5.3-12.3 vs. 2.9%, 95%CI 0.9-6.5).

CONCLUSIONS

As the sample size of our study was small, the conclusions could be biased. Nevertheless, our findings show that PTB causes a significant decline in lung function even in localised PTB, whereas advanced PTB was associated with excessive or even higher decline. This study suggests that early diagnosis and treatment of PTB is needed to preserve lung function.

New method: Are tumor markers in vaginal-washing fluid significant in the diagnosis of primary ovarian carcinoma?

OBJECTIVE

Ovarian cancer is the seventh most common cancer in women worldwide, with nearly a quarter of a million women diagnosed every year. The serum tumor markers cancer antigens CA 125, CA 19-9, and carcinoembryonic antigen (CEA) are potentially of clinical value for the diagnosis of ovarian cancer. A diagnostic tool that is noninvasive, simple to perform, and specific is needed to predict primary ovarian cancer. The purpose of this study was to evaluate the diagnostic sensivitity and specificity of vaginal-washing tumor markers CA 125, CA 19-9, and CEA for diagnosis of primary ovarian cancer.

MATERIALS AND METHODS

In the current prospective study, 30 patients with advanced primary ovarian cancer and 30 patients with benign ovarian cysts were enrolled. The vaginal-washing fluid samples were obtained the day before surgery and were immediately centrifuged and stored at -80 degrees C until analysis. Measurements of CA 125, CA 19-9, and CEA were determined using fully-automated chemiluminescent microparticle immunoassays.

RESULTS

The vaginal fluid concentrations of CA 125, CA 19-9, and CEA in patients with primary ovarian carcinoma were significantly higher (p < 0.001) compared to those in patients with benign adnexal masses (p < 0.001). In the ROC curve analysis, the optimal cut-off values for the detection of primary ovarian cancer were >295 for CA 125 (p < 0.001), > 101 for CA 19-9 (p < 0.001), and >135 for CEA (p < 0.001).

CONCLUSION

Vaginal-washing tumor markers CA 125, CA 19-9, and CEA are simple, noninvasive, and reliable diagnostic tests for the detection of primary ovarian cancer.

Smaller size of high metabolic rate organs explains lower resting energy expenditure in Asian-Indian Than Chinese men

BACKGROUND

In Singapore, the obesity prevalence is disproportionately higher in the Asian-Indians and Malays than the Chinese. Lower resting energy expenditure (REE) may be a contributory factor.

OBJECTIVE

We explored the association between ethnicity and REE in Chinese, Asian-Indian and Malay men living in Singapore and determined the influence of body composition, mass/volume of high metabolic rate organs, represented by brain volume and trunk fat-free mass (FFM), and physical activity on ethnic differences.

DESIGN

Two hundred and forty-four men from Singapore (n=100 Chinese, 70 Asian-Indians and 74 Malays), aged 21-40 years and body mass index of 18.5-30.0 kg m(-2), were recruited in this cross-sectional study. REE was assessed by indirect calorimetry and body composition by dual-energy X-ray absorptiometry. Brain volume was measured by magnetic resonance imaging. Physical activity was assessed by the Singapore Prospective Study Program Physical Activity Questionnaire.

RESULTS

REE was significantly lower in Asian-Indians compared with that in Chinese after adjusting for body weight. FFM (total, trunk and limb) and total fat mass were important predictors of REE across all ethnic groups. Brain volume was positively associated with REE only in Malays. Moderate and vigorous physical activity was positively associated with REE only in Asian-Indians and Malays. The difference in REE between Asian-Indians and Chinese was attenuated but remained statistically significant after adjustment for total FFM (59±20 kcal per day), fat mass (67±20 kcal per day) and brain volume (54±22 kcal per day). The association between REE and ethnicity was no longer statistically significant after total FFM was replaced by trunk FFM (which includes heart, liver, kidney and spleen) but not when it was replaced by limb FFM (skeletal muscle).

CONCLUSIONS

We have demonstrated a lower REE in Asian-Indians compared with Chinese who may contribute to the higher rates of obesity in the former. This difference could be accounted for by differences in metabolically active organs.

Application of sequential expanded granular sludge bed reactors for biodegradation of acetate, benzoate, terephtalate and p-toluate in purified terephtalic acid production wastewater

The anaerobic degradation of four major constituents from purified terephtalic acid production wastewater in sequential two expanded granular sludge bed (EGSB) reactors was studied. The performance of the system was evaluated in terms of chemical oxygen demand (COD) removal efficiencies, methane production, stability, granular sludge adaptability as well as reversion of bacterial inhibition. With volumetric loading rates of 1.9-25 kg-COD m(-3) d(-1) and terephtalate and p-toluate of 584-821 mg L(-1), average removal efficiencies of 97.6% and 75.2% were achieved in the EGSB reactors, respectively. In these conditions, gas production reached a total methane production rate of 0.33 L g-COD(-1) in the two-stage EGSB reactor system. The disturbance of the EGSB reactors was observed at a feed concentration above around 6.9 g-COD L(-1) because of higher influent COD concentration compared to other experiments.

Topological Magnon Bands in a Kagome Lattice Ferromagnet

There is great interest in finding materials possessing quasiparticles with topological properties. Such materials may have novel excitations that exist on their boundaries which are protected against disorder. We report experimental evidence that magnons in an insulating kagome ferromagnet can have a topological band structure. Our neutron scattering measurements further reveal that one of the bands is flat due to the unique geometry of the kagome lattice. Spin wave calculations show that the measured band structure follows from a simple Heisenberg Hamiltonian with a Dzyaloshinkii-Moriya interaction. This serves as the first realization of an effectively two-dimensional topological magnon insulator--a new class of magnetic material that should display both a magnon Hall effect and protected chiral edge modes.

Optical Characterization on Perovskite Zirconate Nanocrystals

We performed an optical study on the electronic properties of perovskite zirconate AZrO3 (A = Ca and Ba) nanocrystals (NCs), which depend strongly on the size of A ion as well as the post-annealing process. The zirconate NCs were synthesized in the combustion method, which was found to be quite effective for synthesizing highly orthorhombic CaZrO3 NCs in the sense that their grain sizes are relatively larger and as-synthesized NCs do not include any raw material phase in the XRD pattern, compared with the cubic BaZrO3 NCs. The room-temperature visible emission is commonly quite strong in both NCs. Interestingly, the dominance of the green-yellow emission over the violet-blue emission with increasing the post-annealing temperature (Tanneal) appears to be in agreement with the formation of the mid-gap state identified in the absorption spectra. While the optical bandgaps of NCs increased with increasing Tanneal, a systematic trend that the optical bandgap in the AZrO3 NCs decreased with the increasingly larger size of the A ion occurred. We discuss our findings in relation to the oxygen vacancy formation, lattice distortion, and size effect.

Ethnic differences in insulin sensitivity and beta-cell function among Asian men

BACKGROUND AND OBJECTIVES

Lean Asian Indians are less insulin sensitive compared with Chinese and Malays, but the pancreatic beta-cell function among these ethnic groups has yet to be studied in depth. We aimed to study beta-cell function in relation to insulin sensitivity among individuals of Chinese, Malay and Asian-Indian ethnicity living in Singapore.

SUBJECTS AND METHODS

This is a sub-group analysis of 59 normoglycemic lean (body mass index (BMI) <23 kg m(-)(2)) adult males (14 Chinese, 21 Malays and 24 Asian Indians) from the Singapore Adults Metabolism Study. Insulin sensitivity was determined using fasting state indices (homeostatic model assessment-insulin resistance), the euglycemic-hyperinsulinemic clamp (ISI-clamp) and a liquid mixed-meal tolerance test (LMMTT) (Matsuda insulin sensitivity index (ISI-Mat)). Beta-cell function was assessed using fasting state indices (homeostatic model assessment-beta-cell function) and from the LMMTT (insulinogenic index and insulin secretion index). The oral disposition index (DI), a measure of beta-cell function relative to insulin sensitivity during the LMMTT, was calculated as a product of ISI-Mat and insulin secretion index.

RESULTS

Asian Indians had higher waist circumference and percent body fat than Chinese and Malays despite similar BMI. Overall, Asian Indians were the least insulin sensitive whereas the Chinese were most insulin sensitive. Asian Indians had higher beta-cell function compared with Chinese or Malays but these were not statistically different. Malays had the highest incremental area under the curve for glucose during LMMTT compared with Asian Indians and Chinese. However, there were no significant ethnic differences in the incremental insulin area under the curve. The oral DI was the lowest in Malays, followed by Asian Indians and Chinese.

CONCLUSION

Among lean Asians, Chinese are the most insulin sensitive whereas Asian Indians are the least insulin sensitive. However, Malays demonstrate higher postprandial glucose excursion with lower beta-cell response compare with Chinese or Asian Indians. The paths leading to type 2 diabetes mellitus might differ between these Asian ethnic groups.

PCDHB14- and GABRB1-like nervous system developmental genes are altered during early neuronal differentiation of NCCIT cells treated with ethanol

Ethanol (EtOH) exposure during embryonic development causes dysfunction of the central nervous system (CNS). Here, we examined the effects of chronic EtOH on gene expression during early stages of neuronal differentiation. Human embryonic carcinoma (NCCIT) cells were differentiated into neuronal precursors/lineages in the presence or absence of EtOH and folic acid. Gene expression profiling and pathway analysis demonstrated that EtOH deregulates many genes and pathways that are involved in early brain development. EtOH exposure downregulated several important genes, such as PCDHB14, GABRB1, CTNND2, NAV3, RALDH1, and OPN5, which are involved in CNS development, synapse assembly, synaptic transmission, and neurotransmitter receptor activity. GeneGo pathway analysis revealed that the deregulated genes mapped to disease pathways that were relevant to fetal alcohol spectrum disorders (FASD, such as neurotic disorders, epilepsy, and alcohol-related disorders). In conclusion, these findings suggest that the impairment of the neurological system or suboptimal synapse formation resulting from EtOH exposure could underlie the neurodevelopmental disorders in individuals with FASD.

Electrochemical Performance of Electrophoretically Deposited Nanostructured LiMnPO4-Sucrose Derived Carbon Composite Electrodes for Lithium Ion Batteries

The present study reports an approach by which thin films of sucrose added olivine type LiMnPO4-Ccomposite and pristine LiMnPO4 is made by a technique of electrophoretic co-deposition in which pristine and composite samples were synthesized by a sol-gel route. These thin films with enhanced surface area is used to fabricate cathodes for rechargeable Li ion batteries. XRD confirms phase pure single crystalline orthorhombic structure. Transmission Electron Microscopy (TEM) images shows the carbon coating over LiMnPO4 and the particle size restricted in the nano regime. The presence of sp2 hybridized carbon on LiMnPO4 particles is confirmed by X-ray Photon spectroscopy (XPS). To explore the electrochemical behavior, cyclic voltammetry (CV) and cycling studies were performed. The specific capacity for LiMnPO4-C is found to be increased by 43% in comparison to the pristine LiMnPO4. It also exhibited 86% retention in capacity compared to the pristine LiMnPO4 (52%). The result indicates that a proper carbon coating can significantly improve the electronic conductivity and hence the specific capacity.

Electrochemical Performance of PbO2 and PbO2-CNT Composite Electrodes for Energy Storage Devices

In this work we report the electrochemical performance comparison of two new hybrid supercapacitors one based on graphene as negative electrode and lead dioxide thin film as positive electrode and the other with graphene as negative electrode and lead dioxide-carbon nanotube composite as positive electrode in 0.1 M KOH electrolyte. In the present work, PbO2 was synthesized using sol-gel method which is one of the promising materials for hybrid supercapacitors. The XRD confirmed the single phase of the PbO2 and the grain size is 39 nm which has been determined using Scherrer's formula. Thin films of PbO2, PbO2-CNT composite and graphene were coated on the titanium substrate by electrophoretic deposition. Further material characterisation has been carried out using SEM, TEM, XPS and electrochemical characterisation using CV, charge/discharge and electrochemical impedance spectroscopy (EIS) for obtaining energy density and power density, cyclic stability and internal resistance respectively. The present results revealed that PbO2-CNT composite/graphene asymmetric hybrid supercapacitor exhibits large specific capacitance and energy density over PbO2/graphene based system. The PbO2-CNT composite/graphene asymmetric hybrid supercapacitor exhibited maximum power density and energy density of 1200 W/Kg and 65 Wh/Kg respectively at a current density of 2 A/g. The PbO2-CNT composite/graphene asymmetric hybrid system exhibited excellent cycling stability with the capacitance retained 85% of its maximum value up to 3000 cycles.

A polymorphism in the porcine miR-208b is associated with microRNA biogenesis and expressions of SOX-6 and MYH7 with effects on muscle fibre characteristics and meat quality

MicroRNAs (miRNAs) encoded by the myosin heavy chain (MHC) genes are muscle-specific miRNAs (myomiRs) and regulate the expression of MHC isoforms in skeletal muscle. These miRNAs have been implicated in muscle fibre types and their characteristics by affecting the heterogeneity of myosin. In pigs, miR-208b and miR-499 are embedded in introns of MYH7 and MYH7b respectively. Here, we identified a novel single nucleotide polymorphism (SNP) in intron 30 of MYH7 by which porcine miR-208b is encoded. Based on the association study using a total of 487 pigs including Berkshire (n = 164), Landrace (n = 121) and Yorkshire (n = 202), the miR-208b SNP (g.17104G>A) had significant effects on the proportions of types I and IIb fibre numbers (P < 0.010) among muscle fibre characteristics and on drip loss (P = 0.012) in meat quality traits. Moreover, the SNP affected the processing of primary miR-208b into precursor miR-208b with a marginal trend towards significance (P = 0.053), thereby leading to significant changes in the levels of mature miR-208b (P = 0.009). These SNP-dependent changes in mature miR-208b levels were negatively correlated with the expression levels of its target gene, SOX-6 (P = 0.038), and positively associated with the expression levels of its host gene, MYH7 (P = 0.046). Taken together, our data suggest that the porcine miR-208b SNP differentially represses the expression of SOX-6 by regulating miRNA biogenesis, thereby affecting the expression of MYH7 and the traits of muscle fibre characteristics and meat quality.

Outcome of excision of oral erythroplakia

Oral erythroplakia is a precancerous lesion with high malignant potential, and resection is the recommended treatment. We designed a retrospective study to analyse the outcome of treatment in patients who had operations for oral erythroplakia. A total of 84 patients (74 men and 10 women, mean (SD) age 54 (12) years, range 29-83) were enrolled. Histopathologically the diagnoses were invasive carcinoma (n=3), dysplasia/carcinoma in situ (n=61), and squamous hyperplasia (n=20), and all patients were treated by carbon dioxide laser excision. There was no postoperative malignant transformation, but invasive carcinoma found after initial excision (n=3) was treated by further radical excision. The mean (SD) follow-up period was 46 (29) months (range 1-124), The postoperative recurrent rate was 14/84 (16.7%). The area of oral erythroplakia was the only factor associated with postoperative recurrence on univariate analysis, and was also the only independent factor that predicted postoperative recurrence in multivariate logistic regression analysis. An area exceeding 80 mm2 had the best predictive value (sensitivity=0.71, specificity=0.67) with a 5.1 times increased risk (odds ratio=5.1, CI 95% 1.45 to 18.05, p=0.01) of recurrence. Laser excision is effective for oral erythroplakia that is still confined to dysplasia of any degree, with low morbidity. The area of oral erythroplakia is a predictive factor for postoperative recurrence.

Metal oxide coated lithium cobalt fluorophosphate cathode materials for lithium secondary batteries--effect of aging and temperature

Lithium cobalt fluorophosphate (Li2CoPO4F) is a promising 5 V class cathode material for lithium secondary batteries. In this study, surface coating with ZrO2 improved the electrochemical activity of Li2CoPO4F with a maximum discharge capacity of 144 mA h g(-1). The effectiveness of ZrO2 coating was evaluated using aging analysis with a commercial electrolyte, i.e., 1 M LiPF6 in EC:DMC (1:1, v/v). The metal ion dissolution was reduced to 1/8th of that observed in the non-coated Li2CoPO4F. It was found that the thin coating layer had less or no contribution to the additional resistance for the cell, both at an open circuit potential and at a fully charged state; hence, the capacity of the cell was retained over cycling. Elevated temperature aging did not affect the intrinsic property of the coated Li2CoPO4F, as observed from the complete anodic and cathodic peaks from cyclic voltammetry studies after 30 days of storage at 50 degrees C. An increase in impedance was observed for aged cells, which could be due to the thick SEI layer formed during storage. The ZrO2 coating over Li2CoPO4F was crucial for the improved performance of electrode active material at higher operating potentials of up to 5.2 V.

Preparation and characterization of chlorine doped Li3V2(PO4)3 as high rate cathode active material for lithium secondary batteries

Monoclinic Li3V2(PO4)2.99Cl0.01 was synthesized using the conventional solid state method and the X-ray diffraction pattern was indexed based on P2(1)/n space group. The sharp cyclic voltammetric curves clearly revealed three lithium extraction/insertion processes at approximately 3.64, 3.72, 4.13, and 4.58 V during the anodic scan and 3.96, 3.58, and 3.48 V during the cathodic scan. Charge/discharge studies showed reduced electrolyte decomposition contribution in the case of the chlorine doped Li3V2(PO4)2.99Cl0.01 sample with an initial capacity of 176 mA h g(-1) at a 0.1 C current rate. The chlorine doped Li3V2(PO4)3 sample showed an increased capacity retention with an increase in current rate, even at a very high C-rate (20 C), than the pristine and carbon coated samples. The pristine and carbon coated Li3V2(PO4)3 samples showed a lower capacity retention of 71% and 84%, respectively, at a current rate of 0.1 C. In contrast, the chlorine doped Li3V,(PO4)3 sample retained 87% of the initial capacity (176 mA h g(-1)) at the same current rate but with a higher coulombic efficiency of 91%. The enhanced capacity retention for the chlorine doped Li3V2(PO4)3 was attributed to the reduction in polarization and decreased charge transfer resistance of the electrode.

Paperless reporting and electronically verifying clinical investigations

PURPOSE

The purpose of this paper is to outline considerations and steps taken to introduce electronic reporting and verification from systems design and multidisciplinary collaborations to gap analysis and devising solutions. It also evaluates carefully placed forcing functions' impact on verification rates.

DESIGN/METHODOLOGY/APPROACH

A multidisciplinary workgroup was formed to stop print and establish electronic reporting. The electronic verification's success was assessed by weekly activity analysis.

FINDINGS

Introducing a verification forcing function markedly improved verification activity. Thereafter, non-verified results stabilized at 7 percent up to 75 weeks post-implementation.

PRACTICAL IMPLICATIONS

This paper illustrates how results reporting and verification could be implemented in a tertiary hospital using a mixed electronic and paper record. Factors that were critical to success include stakeholder engagement and applying systems design that focussed on patient safety as a key priority. The electronic reporting system was augmented by strategically inserted forcing functions, clear clinical-responsibility lines and ancillary alert systems.

ORIGINALITY/VALUE

The systems design method's value in managing non-critical but abnormal results appears to have been under-appreciated. This paper describes how systems design could be used to improve health information delivery and management.

Aluminum based sulfide solid lithium ionic conductors for all solid state batteries

The present work focuses on the synthesis of lithium ionic conductors based on a Li2S-Al2S3-GeS-P2S5 system due to the high ionic conductivity exhibited by the constituents of this system. Mechanical milling for a short duration and a single step heat treatment at a moderate temperature of 550 °C resulted in crystalline powders with high lithium ionic conductivity at room temperature that are comparable to the organic liquid electrolytes. The effect of various aluminum to germanium ratios was studied. Among the samples containing Al : Ge, the ratio of 30 : 70 was found to show high ionic conductivities of 1.7 × 10(-3) S cm(-1) at 25 °C and ∼ 6 × 10(-3) S cm(-1) at 100 °C equivalent. The activation energy of this material was significantly less (Ea = 17 kJ mol(-1)), which can be considered to be the best value among solid electrolytes. The electrochemical stability was analyzed using cyclic voltammetry between -0.3 and 5.0 V and it was found that the voltammetric profile was smooth without any additional current response, due to electrolyte decomposition, or any other side reaction, except a pair of lithium deposition and stripping peaks.

Visfatin and its genetic variants are associated with obesity-related morbidities and cardiometabolic risk in severely obese children

BACKGROUND

Visfatin is an adipokine, associated with obesity and possibly glucose regulation.

OBJECTIVE

The aim of this study was to examine the association of visfatin and its genetic variants with adiposity, cardiometabolic risk factors and obesity-related morbidities in obese children.

METHODS

Anthropometric measurements, dual energy X-ray absorptiometry scan, fasting blood samples and oral glucose tolerance tests were performed for 243 obese children. We screened the visfatin gene of 24 obese subjects and then performed genotyping of identified genetic variants in other 219 obese children through direct DNA sequencing.

RESULTS

Fasting serum visfatin correlated with measures of obesity and liver enzymes and was elevated in obese children with abnormal glucose tolerance and non-alcoholic fatty liver disease. The two upstream single nucleotide polymorphisms, -3187G>A (rs11977021) and -1537C>T (rs61330082), were at complete linkage disequilibrium. The AA genotype of -3187G>A was associated with higher serum visfatin (6.17 ± 0.76 ng mL(-1) vs. 3.92 ± 0.44 ng mL(-1)) and higher triglyceride (1.39 ± 0.08 mmol L(-1) vs. 1.19 ± 0.07 mmol L(-1)) as compared with the GG genotype. There was also a significant linear increase in serum visfatin across GG to GA to AA genotype of -3187G>A, indicating possible additive effect of A allele. The dominant GA + AA genotype model of +21426G>A (rs2302559) was associated with lower serum visfatin (3.83 ± 0.56 ng mL(-1) vs. 5.13 ± 0.34 ng mL(-1)) and lower plasma glucose (4.37 ± 0.08 mmol L(-1) vs. 4.77 ± 0.12 mmol L(-1)) as compared with the GG genotype.

CONCLUSION

Visfatin and its genetic variants were associated with adiposity, obesity-related morbidities and adverse cardiometabolic parameters. This supported our hypothesis that visfatin plays a significant role in the development of obesity-related morbidities and cardiometabolic risk.

Associations between ethnicity, body composition, and bone mineral density in a Southeast Asian population

CONTEXT AND OBJECTIVE

Chinese men in Singapore have a higher incidence of hip fractures than Malay and Indian men. We investigated whether there were corresponding ethnic differences in peak bone mineral density (BMD) in young men and whether differences in body composition influenced peak BMD.

DESIGN AND SETTING

This was a cross-sectional study of healthy volunteers in a tertiary medical center.

PARTICIPANTS

A total of 100 Chinese, 82 Malay, and 80 Indian men aged 21 to 40 years, with body mass index between 18 and 30 kg/m(2) underwent dual-energy x-ray absorptiometry to assess BMD, lean mass (LM) and fat mass (FM), and magnetic resonance imaging to quantify abdominal subcutaneous and visceral adipose tissue. Multiple linear regression models, with adjustment for age and height (as a proxy for skeletal size), were used.

RESULTS

Malay and Indian men had significantly higher BMD than Chinese men at the lumbar spine (Malay: B, 0.06 ± 0.02, P = .001; Indian: B, 0.03 ± 0.02, P = .049), femoral neck (Malay: B 0.04 ± 0.02, P = .034; Indian: B, 0.04 ± 0.02, P = .041), hip (Malay: B, 0.05 ± 0.02, P = .016; Indian: B, 0.06 ± 0.02, P = .001), and ultradistal radius (Malay: B, 0.03 ± 0.01, P < .001; Indian: B, 0.02 ± 0.01, P = .029), and this difference was retained after adjustment for LM and FM, except in Malay men at the femoral neck and in Indian men at the ultradistal radius. LM was an important independent determinant of BMD at all sites, whereas FM, subcutaneous adipose tissue, and visceral adipose tissue were not significantly associated with BMD at any site.

CONCLUSIONS

Lower peak BMD in Chinese men may partly explain the higher fracture incidence in this ethnic group. Further studies are needed to elucidate the reasons for these ethnic differences in bone accumulation.

Afamin stimulates osteoclastogenesis and bone resorption via Gi-coupled receptor and Ca2+/calmodulin-dependent protein kinase (CaMK) pathways

BACKGROUND

Afamin was recently identified as a novel osteoclast-derived coupling factor that can stimulate the in vitro and in vivo migration of preosteoblasts.

AIM

In order to understand in more detail the biological roles of afamin in bone metabolism, we investigated its effects on osteoclastic differentiation and bone resorption.

METHODS

Osteoclasts were differentiated from mouse bone marrow cells. Tartrate-resistant acid phosphatase (TRAP)-positive multinucleated cells were considered as osteoclasts, and the resorption area was determined by incubating the cells on dentine discs. The intracellular cAMP level was determined using a direct enzyme immunoassay. Signaling pathways were investigated using western blot and RT-PCR. Recombinant afamin was administered exogenously to bone cell cultures.

RESULTS

Afamin stimulated both osteoclastogenesis and in vitro bone resorption. Consistently, the expressions of osteoclast differentiation markers were significantly increased by afamin. Although afamin mainly affected the late-differentiation stages of osteoclastogenesis, the expression levels of receptor activator of nuclear factor-κB ligand (RANKL)-dependent signals were not changed. Afamin markedly decreased the levels of intracellular cAMP with reversal by pretreatment with pertussis toxin (PTX), a specific inhibitor of Gi-coupled receptor signaling. In addition, PTX almost completely blocked afamin-stimulated osteoclastogenesis. Furthermore, pretreatment with KN93 and STO609 - Ca2+/cal - mo dulin-dependent protein kinase (CaMK) and CaMK kinase inhibitors, respectively - significantly prevented decreases in the intracellular cAMP level by afamin while attenuating afamin-stimulated osteoclastogenesis.

CONCLUSION

Afamin enhances osteoclastogenesis by decreasing intracellular cAMP levels via Gi-coupled receptor and CaMK pathways.

Development of microsatellite markers for a hard-shelled mussel, Mytilus coruscus, and cross-species transfer

The Korean mussel Mytilus coruscus, an endemic marine bivalve mollusk, is economically important. Its population is currently decreasing due to overexploitation and invasion of a more competitive species, Mytilus galloprovincialis. In this study, microsatellite markers for M. coruscus were developed using a cost-effective pyrosequencing technique. Among the 33,859 dinucleotide microsatellite sequences identified, 176 loci that contained more than 8 CA, CT, or AT repeats were selected for primer synthesis. Sixty-four (36.4%) primer sets were produced from the 100- to 200-bp polymerase chain reaction products obtained from 2 M. coruscus individuals. Twenty of these were chosen to amplify DNA from 82 M. coruscus individuals, and 18 polymorphic loci and 2 monomorphic loci were selected as microsatellite markers. The number of alleles and the allele richness of the polymorphic loci ranged from 2 to 22 and from 2.0 to 19.7 with means of 10.8 and 10.1, respectively. Null alleles were detected for all but three loci, which resulted in an observed heterozygosity lower than the expected heterozygosity and therefore an excess of homozygotes. In a cross-species transfer analysis of these markers using 7 Mytilidae species, the locus Mc65 was amplified from all species tested and was found to be polymorphic in all of them. Among the species, M. galloprovincialis, Lithophaga curta, and Hormomya mutabilis showed the same transferability of 25%, but the five amplified loci were polymorphic only in M. galloprovincialis and H. mutabilis. These microsatellite markers may be useful for future resource management and artificial production of juveniles for aquaculture.

Spin-induced optical conductivity in the spin-liquid candidate herbertsmithite

We report a direct measurement of the low-frequency optical conductivity of large-area single-crystal herbertsmithite, a promising spin-liquid candidate material, by means of terahertz time-domain spectroscopy. In the spectral range below 1.4 THz, we observe a contribution to the real part of the in-plane conductivity σ(ab)(ω) from the spin degree of freedom. This spin-induced conductivity exhibits a power-law dependence on frequency σ(ab)(ω) ~ ω(β) with β ≈ 1.4. Our observation is consistent with the theoretically predicted low-frequency conductivity arising from an emergent gauge field of a gapless U(1) Dirac spin liquid.

A high performance hybrid capacitor with Li2CoPO4F cathode and activated carbon anode

For the first time, we report the possibility of utilizing Li2CoPO4F as a novel cathode material for hybrid capacitor applications. Li2CoPO4F powders were prepared by a conventional two-step solid state method. A hybrid cell was fabricated using Li2CoPO4F as the cathode along with activated carbon (AC) as the anode in 1 M LiPF6 dissolved in 1 : 1 EC/DMC electrolyte and its electrochemical properties were examined by cyclic voltammetry (CV), electrochemical impedance spectroscopy (EIS) and constant current charge-discharge (C-D) techniques. The Li2CoPO4F/AC cell is capable of delivering a discharge capacitance of 42 F g(-1) at 150 mA g(-1) current density within 0-3 V region having excellent coulombic efficiency of over 99% even after 1000 cycles. Furthermore, the Li2CoPO4F/AC cell exhibited excellent rate performance with an energy density of ~24 W h kg(-1) at 1100 mA g(-1) current and maintained about 92% of its initial value even after 30,000 C-D cycles. Electrochemical impedance spectroscopy was conducted to corroborate the results that were obtained and described.

Association of a single nucleotide polymorphism in the akirin 2 gene with economically important traits in Korean native cattle

The akirin 2 gene, located on chromosome 9 in cattle, was previously reported to be associated with nuclear factor-kappa B (NF-κB), involved in immune reactions and marbling of meat. To determine whether a single nucleotide polymorphism (SNP) in akirin 2 is associated with economically important traits of Korean native cattle, the c.*188G>A SNP DNA marker in the 3'-UTR region of akirin 2 was analyzed for its association with carcass weight, longissimus muscle area and marbling. The c.*188G>A SNP was genotyped by polymerase chain reaction restriction fragment length polymorphism, and the frequency of the AA, AG, and GG genotypes were 6.82%, 71.29% and 21.88% respectively. This SNP was significantly associated with longissimus muscle area (Bonferroni corrected P < 0.05), and marbling score (Bonferroni corrected P < 0.01). These results suggest that the c.*188G>A SNP of akirin 2 might be useful as a DNA marker for longissimus muscle area and marbling scores in Korean native cattle.

Antinociceptive curcuminoid, KMS4034, effects on inflammatory and neuropathic pain likely via modulating TRPV1 in mice

BACKGROUND

Curcumin, the active ingredient of turmeric (Curcuma longa), has a wide range of beneficial effects including anti-inflammation and analgesia. However, poor bioavailability of curcumin hinders its clinical application. To overcome this limitation, we modified the structure of curcumin and synthesized new derivatives with favourable pharmacokinetic profiles. Recently, curcumin has been shown to have an antagonizing effect on transient receptor potential vanilloid type 1 (TRPV1) ion channels. We investigated the antinociceptive activity of KMS4034 which had the most favourable pharmacokinetics among the tested curcumin derivatives.

METHODS

To evaluate the mechanism of the antinociceptive effects of KMS4034, capsaicin (I(CAP))- and heat (I(heat))-induced currents in TRPV1 expressing HEK293 cells were observed after the application of KMS4034. Nociceptive behavioural measurement using the hot-plate test, formalin test, and chronic constriction injury (CCI) model were evaluated in mice. Also, calcitonin gene-related peptide (CGRP) was stained immunohistochemically in the L4/5 dorsal horns in mice with neuropathic pain.

RESULTS

I(CAP) (P<0.01) and I(heat) (P<0.05) of TRPV1 were significantly blocked by 10 μM KMS4034. Behaviourally, noticeable antinociceptive effects after 10 mg kg(-1) of KMS4034 treatment were observed in the first (P<0.05) and second phases (P<0.05) of the formalin and hot-plate tests. The mechanical threshold of CCI mice treated with 10 mg kg(-1) KMS4034 was significantly increased compared with control. Immunohistochemical CGRP expression was decreased in the lamina I-II of the lumbar dorsal horns in KMS4034-treated CCI mice compared with the control (P<0.05).

CONCLUSIONS

KMS4034 may be an effective analgesic for various pain conditions.

Homocysteine induces COX-2 expression in macrophages through ROS generated by NMDA receptor-calcium signaling pathways

Homocysteine (Hcy) at elevated levels is a putative risk factor for many cardiovascular disorders including atherosclerosis. In the present study, we investigated the effect of Hcy on the expression of cyclooxygenase (COX)-2 in murine macrophages and the mechanisms involved. Hcy increased the expression of COX-2 mRNA and protein in dose- and time-dependent manners, but did not affect COX-1 expression. Hcy-induced COX-2 expression was attenuated not only by the calcium chelators, EGTA and BAPTA-AM, but also by an antioxidant, N-acetylcysteine. Calcium chelators also attenuated Hcy-induced reactive oxygen species (ROS) production in macrophages, indicating that Hcy-induced COX-2 expression might be mediated through ROS generated by calcium-dependent signaling pathways. In another series of experiments, Hcy increased the intracellular concentration of calcium in a dose-dependent manner, which was attenuated by MK-801, an N-methyl-D-aspartate (NMDA) receptor inhibitor, but not by bicuculline, a gamma-aminobutyric acid receptor inhibitor. Molecular inhibition of NMDA receptor using small interfering RNA also attenuated Hcy-induced increases in intracellular calcium. Furthermore, both ROS production and Hcy-induced COX-2 expression were also inhibited by MK-801 as well as by molecular inhibition of NMDA receptor. Taken together, these findings suggest that Hcy enhances COX-2 expression in murine macrophages by ROS generated via NMDA receptor-mediated calcium signaling pathways.

Body fat in Singaporean infants: development of body fat prediction equations in Asian newborns

BACKGROUND/OBJECTIVES

Prediction equations are commonly used to estimate body fat from anthropometric measurements, but are population specific. We aimed to establish and validate a body composition prediction formula for Asian newborns, and compared the performance of this formula with that of a published equation.

SUBJECTS/METHODS

Among 262 neonates (174 from day 0, 88 from days 1-3 post delivery) from a prospective cohort study, body composition was measured using air-displacement plethysmography (PEA POD), with standard anthropometric measurements, including triceps and subscapular skinfolds. Using fat mass measurement by PEA POD as a reference, stepwise linear regression was utilized to develop a prediction equation in a randomly selected subgroup of 62 infants measured on days 1-3, which was then validated in another subgroup of 200 infants measured on days 0-3.

RESULTS

Regression analyses revealed subscapular skinfolds, weight, gender and gestational age were significant predictors of neonatal fat mass, explaining 81.1% of the variance, but not triceps skinfold or ethnicity. By Bland-Altman analyses, our prediction equation revealed a non-significant bias with limits of agreement (LOA) similar to those of a published equation for infants measured on days 1-3 (95% LOA: (-0.25, 0.26) kg vs (-0.23, 0.21) kg) and on day 0 (95% LOA: (-0.19, 0.17) kg vs (-0.17, 0.18) kg). The published equation, however, exhibited a systematic bias in our sample.

CONCLUSIONS

Our equation requires only one skinfold site measurement, which can significantly reduce time and effort. It does not require the input of ethnicity and, thus, aid its application to other Asian neonatal populations.

A new antiallergic agent that binds to dimerized translationally controlled tumor protein and inhibits allergic symptoms is nontoxic

Dimerized translationally controlled tumor protein (dTCTP) plays a role in allergic diseases. A 7-mer peptide, dimerized translationally binding protein 2 (dTBP2), binds to dTCTP and inhibits dTCTP, suggesting that the 7-mer peptide may have therapeutic potential. We assessed the safety of dTBP2 by examining its cytotoxicity to both human bronchial epithelial cells and mice. dTBP2 did not cause cytotoxicity to the epithelial cells in concentrations up to 100 μg/ml. Also, dTBP2 caused no adverse effects upon repeated administration of 50 mg/kg over 24 h to mice. Hence, we conclude that dTBP2 is a safe candidate drug for use in the therapy of allergic diseases.

Electronic structure of Zn doped Fe3O4 thin films

We investigated the effect of Zn doping on the electronic property of magnetite by using optical spectroscopy. The (Zn(x)Fe(1-x))Fe2O4 (ZFFO) (x = 0, 0.2, 0.4, and 0.5) samples were prepared by PLD technique. The XRD measurement revealed that all the samples have an inverse spinel-type of crystalline structure. The M-H curves indicate that the saturation magnetization reduces with the increasing x. From the spectroscopic ellipsometry and infrared spectroscopy, we found that the doping of nonmagnetic Zn2+ ions leads to the dramatic change in the electronic structure of the ZFFO films. We discuss the correlation of our spectra with the electric and magnetic properties of the ZFFO films.

Synthesis and optical characterization of SrHfO3 nano-crystals synthesized by using the combustion method

We synthesized SrHfO3 nano-crystals (NCs) by using the combustion method, and investigated their emission property using 325 nm photo-excitation. The as-grown SrHfO3 NCs were annealed at different temperatures from 700 degrees C to 1450 degrees C. The X-ray diffraction analysis revealed that all the samples are of a single phase, and the grain size increases with the higher temperature annealing. Interestingly, it is found that in contrast to the bulk case, the SrHfO3 NCs show a strong blue emission even at room temperature. The strong dependence of the visible emission on annealing temperatures and grain sizes indicated that the effects of grain size and oxygen vacancies may play a role in forming the observed visible emission band for SrHfO3 NCs. We also compare our findings with the case of similar material, SrZrO3.

The impact of total antioxidant capacity on pulmonary function in asthma patients

BACKGROUND

Oxidative stress, mediated by an imbalance between oxidants and antioxidants, contributes significantly to the pathogenesis of asthma.

OBJECTIVE

To evaluate the impact of serum total antioxidant capacity (TAC) on the pulmonary function of Korean asthma patients.

METHOD

A total of 104 adult asthma patients enrolled from the COREA (Cohort for Reality and Evolution of Adult Asthma in Korea) programme participated in the study. Baseline clinical parameters at enrolment, and the results of pulmonary function tests at baseline and 1 and 2 years after enrolment were collected. TAC at baseline was measured using a Trolox-equivalent antioxidant capacity assay. Patients were divided into two groups based on TAC levels, and various clinical parameters were compared.

RESULT

Serum TAC levels correlated with forced expiratory volume in 1 second (FEV(1)) at baseline (r = 0.22, P = 0.03). The group with higher baseline TAC levels maintained greater mean FEV(1) both 1 and 2 years after enrolment, even after adjusting for sex, age, height, weight, body mass index and smoking status.

CONCLUSION

These results suggest an important link between serum TAC levels and pulmonary function, indicating that higher TAC levels may be a biomarker for favourable prognosis in asthma patients.

The correlation between expression of synuclein-gamma, glucose transporter-1, and survival outcomes in endometrioid endometrial carcinoma

PURPOSE

To evaluate the correlation between immunohistochemical expression of synuclein-gamma, glucose transporter-1, and survival outcomes in endometrioid endometrial carcinoma.

MATERIALS AND METHODS

A tissue microarray was constructed using formalinfixed, paraffin-embedded tissue that included 23 early and 18 advanced cases. The intensity and area of the immunohistochemical reactions were evaluated using the semi-quantitative scoring system.

RESULTS

Synuclein-y expression was higher in the advanced stage, although it was not statistically significant (p = 0.51). Glucose transporter-1 was overexpressed in the advanced stage (p = 0.01). Synuclein-gamma (score = 0 vs > 0) and glucose transporter-1 (score < or = 7 vs > 7) did not show any differences in overall survival (p = 0.54, p = 0.48) and disease-free survival (p = 0.61, p = 0.14).

CONCLUSION

In this study the expression of synuclein-y and glucose transporter-1 were not considered to be a prognostic factor and were not related with survival outcomes in endometrioid endometrial carcinoma.