Feasibility of tuberculosis treatment monitoring by video directly observed therapy: a binational pilot study

BACKGROUND

Although directly observed therapy (DOT) is recommended worldwide for monitoring anti-tuberculosis treatment, transportation and personnel requirements limit its use.

OBJECTIVE

To evaluate the feasibility and acceptability of 'video DOT' (VDOT), which allows patients to record and transmit medication ingestion via videos watched remotely by health care providers to document adherence.

METHODS

We conducted a single-arm trial among tuberculosis (TB) patients in San Diego, California, USA, (n = 43) and Tijuana, Mexico (n = 9) to represent high- and low-resource settings. Pre-/post-treatment interviews assessed participant characteristics and experiences. Adherence was defined as the proportion of observed doses to expected doses.

RESULTS

The mean age was 37 years (range 18-86), 50% were male, and 88% were non-Caucasian. The mean duration of VDOT use was 5.5 months (range 1-11). Adherence was similar in San Diego (93%) and Tijuana (96%). Compared to time on in-person DOT, 92% preferred VDOT, 81% thought VDOT was more confidential, 89% never/rarely had problems recording videos, and 100% would recommend VDOT to others. Seven (13%) participants were returned to in-person DOT and six (12%) additional participants had their phones lost, broken or stolen.

CONCLUSIONS

VDOT was feasible and acceptable, with high adherence in both high- and low-resource settings. Efficacy and cost-effectiveness studies are needed.

Serum levels and clinical significance of IFN-γ and IL-10 in patients with coronary heart disease

OBJECTIVE

The present study aims to investigate the relationship of IFN-γ and IL-10 with the pathogenesis of coronary heart disease (CHD).

PATIENTS AND METHODS

A total of 128 patients with angiographically confirmed CHD were included in CHD group, while 106 patients with no angiographically confirmed coronary artery stenosis were included in the control group. The age and body mass index of patients were documented. Concentrations of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were measured. Moreover, serum levels of IFN-γ and IL-10 were determined by ELISA and mRNA levels of these two factors were measured by quantitative RT-PCR.

RESULTS

Compared to those of controls, concentrations of TG and LDL-C were significantly higher (p < 0.01) whereas HDL-C concentrations were significantly lower in CHD patients (p < 0.001). Correlation analysis revealed that serum IFN-γ level was significantly positively correlated with TG concentration in CHD patients (r = 0.560, p < 0.05), while the IL-10 level was negatively correlated with TG concentration (r = -0.411, p < 0.05). Both protein level and mRNA level of IFN-γ were higher in the serum of CHD patients than in controls. However, the protein level and mRNA level of IL-10 were significantly lower in CHD patients than in controls (p < 0.001).

CONCLUSIONS

IFN-γ and IL-10 are involved in the development of atherosclerosis of coronary artery and IL-10 may inhibit atherogenesis.

Frequency Comparison of Two (40)Ca(+) Optical Clocks with an Uncertainty at the 10(-17) Level

Based upon an over-one-month frequency comparison of two (40)Ca(+) optical clocks, the frequency difference between the two clocks is measured to be 3.2×10(-17) with a measurement uncertainty of 5.5×10(-17), considering both the statistic (1.9×10(-17)) and the systematic (5.1×10(-17)) uncertainties. This is the first performance of a (40)Ca(+) clock better than that of Cs fountains. A fractional stability of 7×10(-17) in 20,000 s of averaging time is achieved. The evaluation of the two clocks shows that the shift caused by the micromotion in one of the two clocks limits the uncertainty of the comparison. By carefully compensating the micromotion, the absolute frequency of the clock transition is measured to be 411 042 129 776 401.7(1.1) Hz.

High accuracy measurement of the ground-state hyperfine splitting in a ¹¹³Cd⁺ microwave clock

A microwave frequency standard based on laser-cooled (113)Cd(+) ions has been developed in recent years, and the short-term frequency instability is measured to be 6.1×10(-13)/√τ. By comparing the Cd(+) clock to a superior frequency reference, the ground-state hyperfine splitting of (113)Cd(+) is measured precisely to be 15199862855.0192(10) Hz with a fractional precision of 6.6×10(-14). This result is consistent with previous results, and the measurement precision is improved by nearly one order more than the best result reported before.

Whole-genome analysis revealed the positively selected genes during the differentiation of indica and temperate japonica rice

To investigate the selective pressures acting on the protein-coding genes during the differentiation of indica and japonica, all of the possible orthologous genes between the Nipponbare and 93–11 genomes were identified and compared with each other. Among these genes, 8,530 pairs had identical sequences, and 27,384 pairs shared more than 90% sequence identity. Only 2,678 pairs of genes displaying a Ka/Ks ratio significantly greater than one were revealed, and most of these genes contained only nonsynonymous sites. The genes without synonymous site were further analyzed with the SNP data of 1529 O. sativa and O. rufipogon accessions, and 1068 genes were identified to be under positive selection during the differentiation of indica and temperate japonica. The positively selected genes (PSGs) are unevenly distributed on 12 chromosomes, and the proteins encoded by the PSGs are dominant with binding, transferase and hydrolase activities, and especially enriched in the plant responses to stimuli, biological regulations, and transport processes. Meanwhile, the most PSGs of the known function and/or expression were involved in the regulation of biotic/abiotic stresses. The evidence of pervasive positive selection suggested that many factors drove the differentiation of indica and japonica, which has already started in wild rice but is much lower than in cultivated rice. Lower differentiation and less PSGs revealed between the Or-It and Or-IIIt wild rice groups implied that artificial selection provides greater contribution on the differentiation than natural selection. In addition, the phylogenetic tree constructed with positively selected sites showed that the japonica varieties exhibited more diversity than indica on differentiation, and Or-III of O. rufipogon exhibited more than Or-I.

Early third trimester maternal response to glucose challenge and pregnancy outcome in Chinese women-relationship between upper distribution level and recommended diagnostic criteria

BACKGROUND/OBJECTIVES

The objective of this study was to examine the relationship between upper distribution levels of glucose values in the 75-g oral glucose tolerance test (OGTT) and recommended diagnostic criteria for gestational diabetes mellitus (GDM) and adverse pregnancy outcomes.

SUBJECTS/METHODS

The distribution of the OGTT 2-h values of 13,501 pregnant women, which were below the World Health Organization (WHO) threshold for overt diabetes mellitus (DM), and managed in one teaching hospital in China, was reviewed and related to maternal characteristics and pregnancy outcomes.

RESULTS

For the entire group, the 90th and 95th percentile values of the OGTT 2-h glucose level, respectively, were close to the diagnostic cutoff values of the WHO and International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. For adverse maternal outcomes, glucose level above the 90th percentile value was associated with increased hypertensive disorders, whereas no difference was seen with cutoff using the 95th percentile value. For perinatal outcomes, the 90th percentile was associated with increased neonatal intensive care unit admission and hypoglycemia, whereas the 95th percentile showed in addition association with phototherapy for jaundice and 5th-minute Apgar score <7. Although no differences in the incidence of adverse pregnancy outcomes were found using the different cutoffs, the >95th percentile cutoff value would have missed out 33.3-56.7% of the cases of adverse outcomes that would otherwise have been attributed to GDM.

CONCLUSIONS

Further studies are warranted to clarify which diagnostic criterion is most appropriate universally to identify adverse pregnancy outcomes attributed to GDM, and which could be mitigated with treatment specific for GDM.

Ontogenesis of the collapsed layer during haustorium development in the root hemi-parasite Santalum album Linn

The structure and development of collapsed layers of the haustorium were studied in Santalum album Linn. Through light and transmission electron microscopy, it was shown that the collapsed layers originated from starch-containing cells when the haustorium developed an internal gland, thickened gradually and ultimately developed into the mantle, which, combined with the sucker, buckled the host root. We report on the presence of inter-collapsed layers for the first time. These layers develop after penetration into the host and are located between the intrusive tissues and the vascular meristematic region, gradually linking the collapsed layers and remains around the sucker. The proliferation of cells in the meristematic region and the 'host tropism' of cortical layers contribute to pressure within the haustorium and result in development of the collapsed layers. Besides, starch-containing cells that turn into collapsed layers are vulnerable to pressure as they lack a large vacuole, have uneven cell wall thickness and a loose cell arrangement. We proposed that the functions of collapsed layers are to efficiently assure that cell inclusion and energy concentrate at the inner meristematic region and are recycled to affect penetration, reinforce the physical connection between the sandalwood haustorium and host root, and supply space for haustorial development.

Mapping of quantitative trait loci underlying cold tolerance in rice seedlings via high-throughput sequencing of pooled extremes

Low temperature is a major limiting factor in rice growth and development. Mapping of quantitative trait loci (QTLs) controlling cold tolerance is important for rice breeding. Recent studies have suggested that bulked segregant analysis (BSA) combined with next-generation sequencing (NGS) can be an efficient and cost-effective way for QTL mapping. In this study, we employed NGS-assisted BSA to map QTLs conferring cold tolerance at the seedling stage in rice. By deep sequencing of a pair of large DNA pools acquired from a very large F3 population (10,800 individuals), we obtained ∼450,000 single nucleotide polymorphisms (SNPs) after strict screening. We employed two statistical methods for QTL analysis based on these SNPs, which yielded consistent results. Six QTLs were mapped on chromosomes 1, 2, 5, 8 and 10. The three most significant QTLs on chromosomes 1, 2 and 8 were validated by comparison with previous studies. Two QTLs on chromosomes 2 and 5 were also identified previously, but at the booting stage rather than the seedling stage, suggesting that some QTLs may function at different developmental stages, which would be useful for cold tolerance breeding in rice. Compared with previously reported QTL mapping studies for cold tolerance in rice based on the traditional approaches, the results of this study demonstrated the advantages of NGS-assisted BSA in both efficiency and statistical power.

Scaphoid nonunion reconstructed with vascularized bone-grafting pedicled on 1,2 intercompartmental supraretinacular artery and external fixation

BACKGROUND

Vascularized bone-grafting pedicled on 1,2 intercompartmental supraretinacular artery (1,2 ICSRA) has been recommended as a treatment alternative for established scaphoid nonunion complicated with proximal pole avascular necrosis (AVN). Previous reports focused the studies on the union rate and the revascularization of the transferred graft. However, the postoperative wrist stiffness still a challenging problem and remaining to be solved. The purpose of our study was to determine whether the combination of vascularized bone-grafting pedicled on 1,2 ICSRA and wrist external fixator immobilization provides a more effective strategy for treating established scaphoid nonunion complicated with AVN and improving postoperative range of motion (ROM) of the injured wrist.

PATIENTS AND METHODS

We retrospectively reviewed a consecutive series of 11 patients who had cases of established scaphoid nonunion involving AVN of the proximal pole were treated with vascularized bone-grafting pedicled on 1,2 1,2 ICSRA, internal fixation, and wrist external fixator immobilization. Procedure of wrist arthrolysis was performed before vascularized bone graft transferring. Preoperative and postoperative evaluation included measurement of clinical (wrist ROM and grip strength), radiographic (intrascaphoid angle, scapholunate angle) and functional (Mayo wrist score) parameters.

RESULTS

Osseous union was achieved in all of the 11 cases within an average period of 11.4 weeks. On an average 6.1 years follow-up, there were three excellent, six good and two fair results. Significant improvements were found for Mayo wrist score, wrist ROM, and grip strength (p < 0.01). Intrascaphoid angle and scapholunate angle were significantly improved postoperatively, and there was no significant difference between the postoperative values and the values at the last follow-up. Early functional rehabilitation of the injured wrist under the protection of the fixator did not result in displacement of the transferred graft.

CONCLUSIONS

The results of the present investigation support the use of the vascularized bone graft pedicled on 1,2 ICSRA in the treatment of scaphoid nonunion complicated with proximal pole AVN. Procedures of wrist arthrolysis and early institution of wrist functional rehabilitation under the protection of the external fixator play important role in the restoration of range of motion of the injured wrist.  

A comparison of the thresholding strategies of micro-CT for periodontal bone loss: a pilot study

OBJECTIVES

Micro-CT provides three-dimensional details and has been widely used for biomedical assessments. This study aimed to determine the most appropriate threshold method for quantitatively assessing the dynamics of periodontal destruction.

METHODS

Inflammation was induced by submerging a silk ligature in the sulcus of the maxillary second molars of rats, and the animals were killed prior to ligature placement and after 7 and 21 days. The maxillae were examined for the bone resorptive activities by micro-CT, histology and tartrate-resistant acid phosphatase staining. The imaging threshold was determined by CT phantom, global and local algorithms. A bone fraction measurement from each threshold-determining technique was compared with histomorphometry. The reliability and reproducibility were examined by the intraclass correlation coefficient (ICC) and the coefficient of variation.

RESULTS

Significant reduction of inflammatory infiltration (p < 0.01) and active osteoclastic resorption (p < 0.05) from Day 7 to Day 21 were noted. High inter- and intraexaminer agreement were demonstrated in both histomorphometric and micro-CT assessments (ICC > 0.98). The algorithm-based technique demonstrated stronger correlation to histomorphometry than phantom-based thresholds, and the highest agreement was presented by the local algorithm (ICC > 0.96). This, however, was considerably computationally expensive.

CONCLUSIONS

The local threshold-determining algorithm is suggested for examining inflammation-induced bone loss. Further investigation will be aimed at enhancing computational efficiency.

The diagnostic value of a multivariate logistic regression analysis model with transvaginal power Doppler ultrasonography for the prediction of ectopic pregnancy

OBJECTIVE

A multivariate logistic regression analysis model for predicting ectopic pregnancy in women with pregnancy of unknown location was designed and evaluated clinically.

METHODS

Endometrial thickness, symmetry, resonance, pattern of echogenicity, helicine artery blood flow and blood flow resistance index (RI) in 129 patients with suspected early ectopic pregnancy were assessed by transvaginal power Doppler ultrasonography. Variables significant in univariate logistic regression analysis were included in a multivariate predictive logistic regression analysis model.

RESULTS

The final predictive model included three factors: endometrial thickness≤9 mm; a multilayered endometrial echogenicity pattern with prominent outer and midline hyperechogenic lines and an inner hypoechogenic region; and visible endometrial arterial blood flow. The area under the receiver operating characteristic curve of the model was 0.980. When RI was >0.65 and the predictive probability>0.50, diagnostic accuracy was high. The model correctly diagnosed 52/55 (94.5%) clinically confirmed ectopic pregnancy cases.

CONCLUSION

This multivariate predictive logistic regression analysis model has clinical value for the differential diagnosis of early ectopic pregnancy when the pregnancy location is unknown.

Traumatic forequarter amputation associated acute lung injury (ALI): report of one case

One case of traumatic forequarter amputation associated acute lung injury (ALI) was presented. A discussion reviewing the treatment guidelines for this devastating injury, and pointing out the importance of supporting the lung and preventing the development of acute respiratory distress syndrome (ARDS) was included.

Optimal ultrasonic array focusing in attenuative media

This paper presents a parametric study on the efficiency of ultrasound focusing in an attenuative medium, using phased arrays. Specifically, an analytical model of ultrasound wave focusing in a homogeneous, isotropic and attenuative fluid with point sources is presented. Calculations based on the model have shown that in an attenuative medium, an optimum frequency exists for the best focusing performance for a particular size of aperture and focal distance. The effect of different f numbers on the focusing performance in the attenuative medium is further investigated. The information obtained from the analytical model provides insights into the design and installation of a phased transducer array for energy efficient wave focusing.

Prospective assessment of C4d deposits on circulating cells and renal tissues in lupus nephritis: a pilot study

Complement activation plays a key role in the pathogenesis of lupus nephritis (LN), a severe complication of systemic lupus erythematosus (SLE). We prospectively evaluated 15 LN subjects and two control groups: 13 non-SLE renal subjects (control A) and 239 SLE subjects without LN (control B). All had C4d levels on circulating erythrocytes (E-C4d), reticulocytes (R-C4d) and platelets (P-C4d) measured by flow cytometry, while C4d deposition in renal tissue was semiquantitatively assessed in LN subjects and control A using immunoperoxidase staining. Compared with control A, LN biopsies had higher glomerular-C4d scores (p = 0.003), which were associated with more frequent granular glomerular immunofluorescence staining and electron dense deposits (p < 0.001). Compared with control A and B groups, LN subjects had higher E-C4d (p = 0.002 and p = 0.005) and R-C4d levels (p = 0.002 and p = 0.008), respectively. LN subjects were more likely to have P-C4d compared with control A (p = 0.016). In LN, only E-C4d correlated with National Institutes of Health (NIH) activity index (r = 0.55, p = 0.04). In conclusion, LN biopsies showed frequent glomerular-C4d staining associated with immune complex deposits. LN subjects had higher E-C4d and R-C4d levels compared with both control groups. E-C4d levels also correlated with NIH activity index. These findings suggest a potential role of C4d on circulating cells as a biomarker for lupus nephritis.

[Allelopathic potential and physiological mechanism of Oryza sativa L. under phosphorus deficiency stress]

In this paper, allelopathic rice PI312777 (PI) and non-allelopahtic rice Lemont (Le) were grown in the nutrient solution with two levels of phosphorus (P) supply, and their allelopathic effects on Echinochloa crus-galli L. were studied. The results showed that under phosphorous deficiency stress, the inhibitory effect of PI on E. crus-galli root growth had an obvious increase. After growing in the nutrient solution with low P supply (0.5 mg x L(-1)) for 5, 10 and 15 days, the inhibitory rate of PI on E. crus-galli root dry matter increased by 5.64%, 3.89% and 12.13%, respectively, while that of Le did not show the same trend, compared with normal P supply. With low P supply for 5, 10 and 15 days, PI allelopathic effect on the leaf POD activity of E. crus-galli increased by 20.19%, 15.47% and 6.68%, IAAoase activity increased by 18.08%, 17.71% and 12.50%, while NR activity increased by 13.89%, 18.60% and 2.10%, respectively, suggesting that under P deficiency, PI enhanced its allelopathic potential through two pathways, i.e., to increase the weed POD and IAAoase activities to slow down its growth rate, and to decrease the weed NR activity to affect its N uptake.

Enhancement of antitumor activity of the anti-EGF receptor monoclonal antibody cetuximab/C225 by perifosine in PTEN-deficient cancer cells

Mutational inactivation or deletion of the phosphatase and tensin homologue deleted on chromosome 10 (PTEN)/MMAC1/TEP gene in human cancer cells leads to a constitutively active status of the phosphatidylinositol 3-kinase/Akt pathway in the cells and has been linked to the lack of responses of the cells to the epidermal growth factor (EGF) receptor-targeted therapeutics. Akt is strongly inhibited by perifosine, an orally active alkyl-lysophospholipid currently being evaluated as an anti-cancer agent in phase 1 and 2 clinical trials. To determine whether perifosine may enhance the antitumor activity of the anti-EGF receptor monoclonal antibody cetuximab/C225 in PTEN-deficient cancer cells, we exposed MDA468 breast cancer cells (which contain mutated PTEN gene) and PC3 prostate cancer cells (in which the PTEN gene is deleted) to perifosine and cetuximab, alone and in combination. Treatment of the cells with perifosine reduced baseline levels of phosphorylated Akt, phosphorylated p44/42 mitogen-activated protein kinase (MAPK) and p38MAPK, and increased baseline levels of phosphorylated stress-activated protein kinase (SAPK)/c-jun NH(2)-terminal kinase (JNK). A 72-h exposure of the MDA468 and PC3 cells to perifosine alone resulted in cell death in a dose-dependent manner, which was enhanced by cetuximab. Addition of subtoxic doses of perifosine to cetuximab treatment also enhanced the cetuximab-induced growth inhibition. The combination treatment enhanced the inhibition of phosphorylation of Akt, p44/42MAPK and p38MAPK, but offset the phosphorylation of SAPK/JNK that was activated by perifosine treatment alone. Taken together, the data showed that perifosine enhances the antitumor activity of cetuximab in PTEN-deficient cancer cells. Further evaluation of the combination treatment in preclinical and clinical studies is warranted.

Palm print image recovery and de-noising via multi-channel wavelet filter bank

In this paper, a 3-channel wavelet transform method is introduced to recover palm print images following serious deformation. The deformation processing is actually a kind of digital re-sampling. A filter bank consisting of three filters is implemented for wavelet decomposition of the palm print image, and then a procedure of binary interpolation is performed after the image is reconstructed by another filter bank consisting of another three filters. The design of multi-channel wavelet filter bank is based on the Quadrature Mirror Filter (QMF) method. Because the noise is caused by the Morie stripe, the images are further de-noised after the geometry deformation is addressed. Acceptable results have been obtained.

[Changes of key enzyme activities in rice cultivars with different photooxidation-tolerance during grain-filling stage in early and late seasons]

Four rice cultivars with different photooxidation-tolerance characteristics during grain-filling stage in early and late seasons were selected to uncover the physiological and biochemical mechanisms of the correlation between rice photooxidation-tolerance and grain quality. The results showed that the parameters mean grain-filling rate (Gmean), time arrived to maximum grain-filling rate (T(max. G)), and 100-grain weight at the maximum grain-filling rate (T(max. G)) were relatively stable for the varieties adaptable to high light intensity, while on the contrary for those sensitive to photooxidation. The ADP glucose pyrophosphorylase and starch synthase activities of the varieties adaptable to high light intensity after grain-filling peaks had a less difference between early and late seasons than those sensitive to photooxidation, and the relative enzyme activities in the varieties adaptable to high light intensity changed coequally in early and late seasons.