The clinical significance of monitoring the expression of the SIL-TAL1 fusion gene in T-cell acute lymphoblastic leukemia after allogeneic hematopoietic stem cell transplantation

INTRODUCTION

SIL-TAL1 rearrangement is common in T-cell acute lymphoblastic leukemia (T-ALL). However, whether this fusion gene might be used as a reliable marker of minimal residual disease (MRD) following allogeneic stem cell transplantation (allo-HSCT) remains unknown METHODS: The clinical data of consecutive 29 patients with T-ALL who received allo-HSCT were collected. Their MRD were evaluated by SIL-TAL1, Wilms' tumor 1 (WT1) expression, and the leukemia-associated immunophenotype (LAIP) .

RESULTS

The median follow-up was 354 days (71-2111 days). Of the enrolled patients, 14 (87.5%) patients died of leukemia relapse. A total of 15 (51.7%) patients experienced relapse at a median of 90 days (60-540 days) after transplantation. The SIL-TAL1 expression of 16 patients converted from negative prior to transplantation to positive at 77 days (30-281 days) following transplantation; furthermore, 15 (93.8%) of them eventually experienced relapse. In the 15 relapsed patients, 13 (86.7%) had increased SIL-TAL1 expression levels 30 days (11-220 days) earlier than the hematological relapse and the detection of abnormal WT1 and LAIP.

CONCLUSION

We are the first to demonstrate the reliability of the SIL-TAL1 fusion gene as a good MRD marker for patients with T-ALL after allo-HSCT.

Evolution of the Reactor Antineutrino Flux and Spectrum at Daya Bay

The Daya Bay experiment has observed correlations between reactor core fuel evolution and changes in the reactor antineutrino flux and energy spectrum. Four antineutrino detectors in two experimental halls were used to identify 2.2 million inverse beta decays (IBDs) over 1230 days spanning multiple fuel cycles for each of six 2.9 GW_{th} reactor cores at the Daya Bay and Ling Ao nuclear power plants. Using detector data spanning effective ^{239}Pu fission fractions F_{239} from 0.25 to 0.35, Daya Bay measures an average IBD yield σ[over ¯]_{f} of (5.90±0.13)×10^{-43}  cm^{2}/fission and a fuel-dependent variation in the IBD yield, dσ_{f}/dF_{239}, of (-1.86±0.18)×10^{-43}  cm^{2}/fission. This observation rejects the hypothesis of a constant antineutrino flux as a function of the ^{239}Pu fission fraction at 10 standard deviations. The variation in IBD yield is found to be energy dependent, rejecting the hypothesis of a constant antineutrino energy spectrum at 5.1 standard deviations. While measurements of the evolution in the IBD spectrum show general agreement with predictions from recent reactor models, the measured evolution in total IBD yield disagrees with recent predictions at 3.1σ. This discrepancy indicates that an overall deficit in the measured flux with respect to predictions does not result from equal fractional deficits from the primary fission isotopes ^{235}U, ^{239}Pu, ^{238}U, and ^{241}Pu. Based on measured IBD yield variations, yields of (6.17±0.17) and (4.27±0.26)×10^{-43}  cm^{2}/fission have been determined for the two dominant fission parent isotopes ^{235}U and ^{239}Pu. A 7.8% discrepancy between the observed and predicted ^{235}U yields suggests that this isotope may be the primary contributor to the reactor antineutrino anomaly.

Human β-defensin-3 induces IL-8 release and apoptosis in airway smooth muscle cells

BACKGROUND

Human airway smooth muscle cells (ASMCs) may have a pro-inflammatory role through the release of inflammatory mediators. Increasing evidence indicates that human β-defensins (HBDs) are related to pathogenesis of asthma.

OBJECTIVES

To examine the plasma level of HBD-1, HBD-2 and HBD-3 in asthmatic patients and the expression of their mouse orthologues in the lung tissue of a mouse model of chronic severe asthma. Further to investigate the effect of HBD-3 on the release of the pro-inflammatory cytokine IL-8 and to explore the mechanisms.

METHODS

The plasma levels of HBD-1, HBD-2 and HBD-3 from 34 healthy controls and 25 asthmatic patients were determined by ELISA. The expression of mouse β-defensins MBD-1, MBD-3 and MBD-14 in the lung tissue of asthmatic mice was detected by Western blot. The ASMCs were cultured with HBD-3 for 24 hour, and then the supernatant level of IL-8 was evaluated by ELISA and the cell viability was examined by WST-1 assay. The signalling pathway was investigated with blocking antibodies or pharmacological inhibitors.

RESULTS

The plasma levels of HBD-1 and HBD-3 were elevated in asthmatic patients, and the expression of MBD-14, the mouse orthologue for HBD-3, was increased in asthmatic mice. HBD-3-induced IL-8 production in a CCR6 receptor-specific manner and was dependent on multiple signalling pathways. Moreover, HBD-3-induced cell apoptosis concurrently, which was dependent on the ERK1/2 MAPK pathway. Mitochondrial ROS regulated both HBD-3-induced IL-8 production and cell apoptosis.

CONCLUSIONS AND CLINICAL RELEVANCE

These observations provide clear evidence of an important new mechanism for the promotion of airway inflammation and tissue remodelling with potential relevance for the treatment of asthma.

Tunable PEGylation of branch-type PEI/DNA polyplexes with a compromise of low cytotoxicity and high transgene expression: in vitro and in vivo gene delivery

Although PEGylated polyplexes for gene delivery are widespread, there is a need for an in-depth investigation of the role of the PEGylation degree on the delivery efficiency of the systems. For this, a low-toxicity series of polymers for gene delivery were designed via Michael addition of poly(ethylene glycol)methyl ether methacrylate (PEGMA) onto branched polyethylenimine PEI. The goal was to finely tune the PEGylation degree in order to determine the system offering the best compromise between low cytotoxicity and high transfection efficiency under both in vitro and in vivo conditions. From dynamic light scattering tests, zeta potential measurements and gel retardation assay, it was found that nanoparticle assembly of PEI-g-PEGMA and DNA exhibited stable complex formation when the PEGylation degree was below 2.9%. In addition, complexes formed from polymers with a PEGylation degree of at least 1.67% (from PEI-g-PEGMA-6 to PEI-g-PEGMA-18) all showed very low hemolysis activity. Transfection efficiencies of the prepared complexes were determined using the pEGFP-C3 vector and β-galactosidase. Complexes made of PEI-g-PEGMA-6 and PEI-g-PEGMA-10 at a polymer nitrogen/DNA phosphorus weight ratio (W_n/W_p) of 5 led to the best transfection efficiencies. Moreover, PEGylation ensured low cytotoxicity of the complexes in particular at high W_n/W_p ratios. In vivo tests in a mouse model confirmed the in vitro results obtained for PEI-g-PEGMA-6-based complexes, at all W_n/W_p ratios tested, but also showed that a high PEGylation degree (5.2% for PEI-g-PEGMA-18), though inefficient in vitro could still lead to successful delivery in vivo, due to a prolonged contact time between the complex and the cells, and to the change in the biological environment. Overall, provided a fine tuning of the grafting density of PEGMA onto PEI and the polymer nitrogen/DNA phosphorus weight ratio, our results prove that PEI-g-PEGMA polymers constitute an efficient platform for successful in vitro and in vivo gene delivery, and ensure low cytotoxicity and prolonged cell viability.

The Effects of Lentivirus-mediated shRNA Interference Targeting Mcl-1 on Growth of NK/T-cell Lymphoma

Myeloid leukemia-1 (Mcl-1) gene has been reported as an important factor in various types of cancer, but little research was processed on natural killer (NK)/T-cell lymphoma, a kind of a highly aggressive disease with a poor prognosis. Here we investigated the expression of Mcl-1 in seven lymphoma cell lines and its potential role as a molecular drug target for NK/T-cell lymphoma therapy by using lentivirus-mediated shRNA interference targeting Mcl-1 (lenti-shMcl-1). In our study, the expression of Mcl-1 in different lymphoma cell lines were evaluated firstly, after that lenti-shMcl-1 was constructed and transduced into NK/T-cell lymphoma cell line SNK-6 which had a high level expression of Mcl-1. Methylthiazolete-Trazolium (MTT) assay and flow cytometry (FCA) were employed to detect the status of proliferation and apoptosis after infection. Lastly we investigated the effects of chemotherapy agent vincristine (VCR) combination with lenti-shMcl-1 by MTT and FCA assay. The results showed that Mcl-1 gene expressed in all seven lymphoma cell lines at different levels. Recombinant lentiviruses could infect SNK-6 cells effectively. Mcl-1 expression level was remarkably down-regulated after infection with lenti-shMcl-1. The growth of SNK-6 cells was inhibited significantly through apoptosis pathway. Otherwise, lenti-shMcl-1 also revealed a significant chemosensitizing effect in combination with vincristine. In a word, we demonstrated that lenti-shMcl-1 had a significant anti-NK/T cell lymphoma effect and targeting Mcl-1 therapy could be a promising novel approach in treatment of lymphoma.

Relationship between enhanced dewaterability and structural properties of hydrothermal sludge after hydrothermal treatment of excess sludge

Hydrothermal treatment is an effective method to enhance the deep dewaterability of excess sludge with low energy consumption. In this study, an insight into the relationship between enhanced dewaterability and structural properties of the produced hydrothermal sludge was presented, aiming at better understanding the effect of hydrothermal process on excess sludge dewatering performance. The results indicated that hydrothermal effect induced the transformation of surface water to interstitial and free water by lowering the binding strength between adjacent water and solid particles and that free water became the main form for moisture existence in hydrothermal sludge as temperature was higher than 180 °C. Increase in temperature of hydrothermal treatment generated a significant size reduction of sludge flocs but treated sludge with a higher rigidity, which not only strengthened the network of hydrothermal sludge but also destroyed the binding of EPS with water. Hydrothermal process caused crevice and pore structures of excess sludge to disappear gradually, which was a main driving force of water removal as temperature was below 150 °C. With the temperature of hydrothermal treatment exceeding 180 °C, the morphology of hydrothermal sludge became rough which linked closely to the solid precipitation of condensation polymerization, and further became smooth at higher temperature (210 °C) due to the coal-like structures with higher aromaticities, indicating that hydrothermal reaction pathways began to play a main role in enhanced dewaterability. Hydrothermal treatment led to more alkyl and aromatic carbon, but lower O-alkyl, carboxyl and carbonyl carbon.

Hepatitis B infection is associated with an increased incidence of thrombocytopenia in healthy adults without cirrhosis

The association between HBV infection and incident thrombocytopenia among subjects without cirrhosis or splenomegaly is unknown. Therefore, we sought to elucidate the association between HBV infection and the development of thrombocytopenia in a large cohort of apparently healthy men and women. A cohort study was performed in 122 200 participants without liver cirrhosis or splenomegaly who underwent comprehensive health examinations and were followed until December 2014. HBV infection was defined by the presence of hepatitis B surface antigen (HBsAg) at baseline. Thrombocytopenia was defined as a platelet count <150 000/μL. Cox proportional hazard models were used to estimate adjusted hazard ratios with 95% confidence intervals (CIs) for incident thrombocytopenia. HBsAg was positive in 4857 of 122 200 subjects (4.0%) at baseline. During 883 983 person-years of follow-up, 2037 incident cases of thrombocytopenia were identified (incident rate 2.3 per 1000 person-years). HBsAg-positive subjects had a higher incidence of thrombocytopenia than did healthy controls (11.2 vs 1.9 per 1000 person-years, respectively). The multivariate-adjusted hazard ratio (95% CI) for incident thrombocytopenia comparing HBsAg-positive to HBsAg-negative subjects was 5.71 (5.10-6.38). Strong associations between HBsAg positivity and thrombocytopenia were consistently observed across prespecified subgroups. In this large cohort study of an apparently healthy population, HBsAg positivity was strongly and independently associated with incident thrombocytopenia, indicating that mechanisms of thrombocytopenia other than portal hypertension may exist in healthy HBV carriers.

Factors affecting the quality of life among Chinese rural general residents: a cross-sectional study

OBJECTIVES

The brief version of the World Health Organization's Quality of Life Instrument (WHOQOL-BREF) is widely used for evaluating the personal subjective quality of life (QOL) of patients and particular populations. However, in the absence of sufficient studies among the general population, normative data for WHOQOL-BREF remain scarce. To fill this gap, the present study explored more sociodemographic and health-related factors affecting the QOL.

STUDY DESIGN

In total, 11,351 participants aged ≥35 years in rural areas of Liaoning Province were screened with a stratified cluster multistage sampling scheme in 2012-2013. Anthropometric measurements, laboratory examinations, and self-reported information on disease history were collected by trained personnel. Depression symptoms were assessed using the Patient Health Questionnaire-9.

METHODS

Stepwise multiple linear regression was used to explore the association between multiple factors and QOL.

RESULTS

Females and single/widowed subjects had lower QOL scores than males and married/cohabiting subjects, respectively. Total QOL scores and scores for each domain decreased as age increased, but a positive correlation was found between age and the environmental domain score. Participants with higher annual incomes, education levels, and activity levels had higher QOL scores. In the regression model, the coefficient for stroke was -2.17 (95% confidence interval [CI] -2.64, -1.71) for the total QOL score. For a one-level increase in depression level, the total QOL score decreased by 5.62 (95% CI -5.83 to -5.42), physical domain score decreased by 1.63 (95% CI -1.69 to -1.58), and psychological domain score decreased by 1.81 (95% CI -1.87 to -1.75).

CONCLUSIONS

Socio-economic status including marital status is highly related to QOL. Regarding chronic diseases, stroke is an important factor of QOL and depressive symptoms have a strong negative relationship with QOL.

The cell division control protein 42-Src family kinase-neural Wiskott-Aldrich syndrome protein pathway regulates human proplatelet formation

Essentials The role of the cytoskeleton during megakaryocyte differentiation was examined. Human megakaryocytes are derived from in vitro cultured CD34+ cells. Cell division control protein 42 (CDC42) positively regulates proplatelet formation (PPF). Neural Wiskott-Aldrich syndrome protein, the main effector of CDC42 with Src positively regulates PPF.

SUMMARY

Background Cytoskeletal rearrangements are essential for platelet release. The RHO small GTPase family, as regulators of the actin cytoskeleton, play an important role in proplatelet formation (PPF). In the neuronal system, CDC42 is involved in axon formation, a process that combines elongation and branching as for PPF. Objective To analyze the role of CDC42 and its effectors of the Wiskott-Aldrich syndrome protein (WASP) family in PPF. Methods Human megakaryocytes (MKs) were obtained from CD34+ cells. Inhibition of CDC42 in MKs was performed with the chemical inhibitor CASIN or with an active or a dominant-negative form of CDC42. The knock-down of N-WASP was obtained with a small hairpin RNA strategy Results Herein, we show that CDC42 activity increased during MK differentiation. The use of the chemical inhibitor CASIN or of an active or a dominant-negative form of CDC42 demonstrated that CDC42 positively regulated PPF in vitro. We determined that N-WASP, but not WASP, regulated PPF. We found that N-WASP knockdown led to a marked decrease in PPF, owing to a defect in the demarcation membrane system (DMS). This was associated with RHOA activation, and a concomitant augmentation in the phosphorylation of mysosin light chain 2. Phosphorylation of N-WASP, creating a primed form of N-WASP, increased during MK differentiation. Phosphorylation inhibition by two Src family kinase inhibitors decreased PPF. Conclusions We conclude that N-WASP positively regulates DMS development and PPF, and that the Src family kinases in association with CDC42 regulate PPF through N-WASP.

Chronic kidney disease and high eGFR according to body composition phenotype in adults with normal BMI

BACKGROUND AND AIMS

Body composition contributes to the risk of chronic kidney disease (CKD) and glomerular hyperfiltration. In adults with normal body mass index (BMI), the relationships of body composition with CKD and high estimated glomerular filtration rate (eGFR) are largely unknown.

METHODS AND RESULTS

We analyzed 10,734 adults from the Korean National Health and Nutrition Examination Survey (KNHANES), whose body mass index (BMI) was within the normal range (18.5-24.9 kg/m²). Body composition was categorized into four phenotypes (normal, sarcopenia alone, obesity alone, and sarcopenic obesity) based on appendicular lean mass index (ALMI) and total body fat percentage (TBF%) measured by dual-energy X-ray absorptiometry (DXA). We examined the relationship of CKD and high eGFR (eGFR ≥ 120 ml/min per 1.73 m²) with body composition phenotypes. Sarcopenia alone (14.3%), obesity alone (16.0%), and sarcopenic obesity (10.7%) were prevalent. The association between sarcopenia alone and eGFR was J-shaped, while that between sarcopenic obesity and eGFR was U-shaped. In multivariate logistic regression analysis compared with the normal phenotype, sarcopenic obesity had an elevated odds ratio (OR) for CKD (OR: 1.59, 95% CI: 1.16-2.19). Sarcopenia alone (OR: 1.87; 95% CI: 1.41-2.47) and sarcopenic obesity (OR: 2.37, 95% CI: 1.68-3.36) had elevated OR for high eGFR.

CONCLUSION

These findings suggest that decreased muscle mass and coexistence with excess adiposity show associations with CKD and high eGFR even in adults with normal BMI. Body composition measured by DXA could provide information on the relationship of body composition with CKD and high eGFR.

Insulin resistance increases loss of antibody to hepatitis B surface antigen in nondiabetic healthy adults

The aim of this study was to evaluate the impact of insulin resistance on the persistence of a protective level of anti-HBs (hepatitis B surface antigen) in a nondiabetic general population. A cohort study was designed comprising of 38 473 Korean men and women with anti-HBs at concentrations ≥10 mIU/mL, who underwent a health examination. Insulin resistance was assessed with a homoeostasis model assessment of insulin resistance (HOMA-IR). A decline in anti-HBs to <10 mIU/L during the follow-up was considered to be a loss of protective anti-HBs. Cox-proportional hazard models were used to estimate the adjusted hazard ratios and 95% confidence intervals for anti-HBs loss across quintiles of HOMA-IR and insulin. We identified 20 826 incidents of loss of anti-HBs antibody during 180 522 person-years of follow-up (incident rate 11.5 per 100 person-years). Increasing HOMA-IR was positively associated with incident loss of anti-HBs. The multivariable-adjusted hazard ratios (95% confidence intervals) for incident loss of anti-HBs comparing quintiles 2-5 vs quintile 1 of HOMA-IR were 1.09 (1.04-1.14), 1.14 (1.09-1.19), 1.14 (1.09-1.19) and 1.21 (1.16-1.27), respectively. These associations were stronger in younger individuals under the age of 35 than in people 35 years of age or older (P for interaction = 0.004). The association was also more evident in subjects with higher titres (≥100 mIU/mL) of anti-HBs than in those with low titres (P for interaction < 0.001). Insulin resistance was associated with an increased risk for loss of vaccine-acquired anti-HBs in a large sample of a nondiabetic, general population, indicating a possible role of insulin resistance in vaccine-induced immunity.

Using graphical representations to enhance the quality-of-care for colorectal cancer patients

The study was to enhance adherence to quality-of-care guidelines for colorectal cancer (CRC) patients through plotting graphical representations. Rasch analysis was performed to examine the unidimensional measurement of the 13 core indicators. An author-made Excel module was applied to plot the so-called Wright map and KIDMAP in education field to report physicians' adherence to the quality-of-life guidelines. We found that the scale of the quality-of-care guidelines for patients with colon cancer is unidimensional. A total of 15 (3.8%) and 14 (3.5%) persons' response patterns (i.e., Outfit MNSQs >2.0 and 4.0, respectively) are aberrantly dispersed from the majority of sample according to their estimated parameters of persons and indicators. It can be used for investigating the root cause of the 1ow measures and/or the most unexpected aberrant pattern of responses using Rasch analysis once any one indicator of unexpectedly aberrant treatment (p < .05) presents. The Rasch model can deal with these binary and/or missing data frequently seen in clinical settings. We confirm this computer module can contribute to ensuring that hospitals adhere to the treatment guidelines for patients with colon cancer.

Limits on Active to Sterile Neutrino Oscillations from Disappearance Searches in the MINOS, Daya Bay, and Bugey-3 Experiments

Searches for a light sterile neutrino have been performed independently by the MINOS and the Daya Bay experiments using the muon (anti)neutrino and electron antineutrino disappearance channels, respectively. In this Letter, results from both experiments are combined with those from the Bugey-3 reactor neutrino experiment to constrain oscillations into light sterile neutrinos. The three experiments are sensitive to complementary regions of parameter space, enabling the combined analysis to probe regions allowed by the Liquid Scintillator Neutrino Detector (LSND) and MiniBooNE experiments in a minimally extended four-neutrino flavor framework. Stringent limits on sin^{2}2θ_{μe} are set over 6 orders of magnitude in the sterile mass-squared splitting Δm_{41}^{2}. The sterile-neutrino mixing phase space allowed by the LSND and MiniBooNE experiments is excluded for Δm_{41}^{2}<0.8  eV^{2} at 95%  CL_{s}.

Improved Search for a Light Sterile Neutrino with the Full Configuration of the Daya Bay Experiment

This Letter reports an improved search for light sterile neutrino mixing in the electron antineutrino disappearance channel with the full configuration of the Daya Bay Reactor Neutrino Experiment. With an additional 404 days of data collected in eight antineutrino detectors, this search benefits from 3.6 times the statistics available to the previous publication, as well as from improvements in energy calibration and background reduction. A relative comparison of the rate and energy spectrum of reactor antineutrinos in the three experimental halls yields no evidence of sterile neutrino mixing in the 2×10^{-4}≲|Δm_{41}^{2}|≲0.3  eV^{2} mass range. The resulting limits on sin^{2}2θ_{14} are improved by approx imately a factor of 2 over previous results and constitute the most stringent constraints to date in the |Δm_{41}^{2}|≲0.2  eV^{2} region.

Characterization of residual tumours at the primary site in patients with a near pathological complete response after neoadjuvant chemoradiotherapy for oesophageal cancer

BACKGROUND

A 'surgery as needed' strategy has been proposed for patients with oesophageal cancer who truly achieve a pathological complete response (pCR) following neoadjuvant chemoradiotherapy (nCRT). However, the ability to detect residual disease remains problematic. This study investigated the anatomical locations and pathological characteristics of residual cancer in patients with oesophageal squamous cell carcinoma (SCC) who achieved a near pCR following nCRT.

METHODS

Patients with oesophageal SCC who achieved a near pCR after nCRT were eligible. Near pCR was defined as residual cancer in the resection specimen representing less than 10 per cent of the apparent original tumour area.

RESULTS

Detailed histopathological reassessment of 76 consecutive patients (mean age 54·4 years) with a near pCR was undertaken. Some 32 patients (42 per cent) with a near pCR had no detectable mucosal lesions. Residual tumour was identified most frequently in the submucosal layer (54, 71 per cent), followed by the mucosa (44, 58 per cent), muscle layer (36, 47 per cent) and adventitia (22, 29 per cent) (P < 0·001). Among patients without ypT1a disease, increasing depth of tumour invasion correlated negatively with the likelihood of mucosal involvement. Of patients with ypT3 disease, 16 of 22 had no detectable cancer located in the mucosa, compared with six of 29 with ypT1b disease (P < 0·001).

CONCLUSION

Better tools for predicting pCR are required before considering a 'surgery as needed' approach in the management of oesophageal cancer.

Health Status in Allergic Rhinitis

Although valid and reliable instruments exist to measure the quality of life of allergic rhinitis patients, a statistically sensitive and clinically meaningful way to evaluate patients undergoing immunotherapy has not been reported. A 21-site prospective, observational study was performed in a population of consecutive patients with allergic rhinitis. Baseline general health measures revealed significant ( P > 0.05) decrements from reported normative levels in 8 domains for patients choosing to undergo immunotherapy and 5 domains for patients choosing not to undergo immunotherapy. The General Health Survey was less sensitive in detecting change than the Nasal Health Survey (Chronic Sinusitis Survey) and allergy-specific (Rhinoconjunctivitis Quality of Life Questionnaire and Allergy Outcome Survey) surveys. Severity of symptoms was associated with both the likelihood to choose immunotherapy and the likelihood for early improvement. We conclude that general and condition-specific measures can be used to observe patients after immunotherapy; however, obtaining baseline data and controlling for seasonality are important considerations.

The Effect of Moderate Dietary Protein and Phosphate Restriction on Calcium-Phosphate Homeostasis in Healthy Older Cats

Background

Dietary phosphate and protein restriction decreases plasma PTH and FGF‐23 concentrations and improves survival time in azotemic cats, but has not been examined in cats that are not azotemic.

Hypothesis

Feeding a moderately protein‐ and phosphate‐restricted diet decreases PTH and FGF‐23 in healthy older cats and thereby slows progression to azotemic CKD.

Animals

A total of 54 healthy, client‐owned cats (≥ 9 years).

Methods

Prospective double‐blinded randomized placebo‐controlled trial. Cats were assigned to test diet (protein 76 g/Mcal and phosphate 1.6 g/Mcal) or control diet (protein 86 g/Mcal and phosphate 2.6 g/Mcal) and monitored for 18 months. Changes in variables over time and effect of diet were assessed by linear mixed models.

Results

A total of 26 cats ate test diet and 28 cats ate control diet. There was a significant effect of diet on urinary fractional excretion of phosphate (P = 0.045), plasma PTH (P = 0.005), and ionized calcium concentrations (P = 0.018), but not plasma phosphate, FGF‐23, or creatinine concentrations. Plasma PTH concentrations did not significantly change in cats fed the test diet (P = 0.62) but increased over time in cats fed the control diet (P = 0.001). There was no significant treatment effect of the test diet on development of azotemic CKD (3 of 26 (12%) test versus 3 of 28 (11%) control, odds ratio 1.09 (95% CI 0.13–8.94), P = 0.92).

Conclusions and Clinical Importance

Feeding a moderately protein‐ and phosphate‐restricted diet has effects on calcium‐phosphate homeostasis in healthy older cats and is well tolerated. This might have an impact on renal function and could be useful in early chronic kidney disease.

Active fiber-based retroreflector providing phase-retracing anti-parallel laser beams for precision spectroscopy

We present an active fiber-based retroreflector providing high quality phase-retracing anti-parallel Gaussian laser beams for precision spectroscopy of Doppler sensitive transitions. Our design is well-suited for a number of applications where implementing optical cavities is technically challenging and corner cubes fail to match the demanded requirements, most importantly retracing wavefronts and preservation of the laser polarization. To illustrate the performance of the system, we use it for spectroscopy of the 2S-4P transition in atomic hydrogen and demonstrate an average suppression of the first order Doppler shift to 4 parts in 10⁶ of the full collinear shift. This high degree of cancellation combined with our cryogenic source of hydrogen atoms in the metastable 2S state is sufficient to enable determinations of the Rydberg constant and the proton charge radius with competitive uncertainties. Advantages over the usual Doppler cancellation based on corner cube type retroreflectors are discussed as well as an alternative method using a high finesse cavity.

LAPTM4B: an oncogene in various solid tumors and its functions

The oncogene Lysosome-associated protein transmembrane-4β (LAPTM4B) gene was identified, and the polymorphism region in the 5′-UTR of this gene was certified to be associated with tumor susceptibility. LAPTM4B-35 protein was found to be highly expressed in various solid tumors and could be a poor prognosis marker. The functions of LAPTM4B in solid tumors were also explored. It is suggested that LAPTM4B could promote the proliferation of tumor cells, boost invasion and metastasis, resist apoptosis, initiate autophagy and assist drug resistance.

Trauma team utilization of universal precautions: if you see something, say something

PURPOSE

The risks deriving from the lack of compliance with universal safety precautions (USPs) are unequivocal. However, the adoption of these prophylactic precautions by healthcare providers remains unacceptably low. We hypothesized that trauma teams are not routinely adhering to USPs and that a brief educational intervention, followed by real-time peer feedback, would substantially improve compliance rates.

METHODS

This before-and-after interventional study took place in the resuscitation bay of a Level I Trauma Center during trauma team activations. Six USPs were examined: hand washing (before and after patient contact), use of gloves, gowns, eye protection, and masks. Surgery and Emergency Medicine attending physicians, residents, and nurses, who had direct patient contact, were included. Following 162 baseline observations, an educational intervention in the form of brief lectures was conducted, emphasizing the danger to self from dereliction of USPs. Subsequently, 167 post-intervention observations were made after a one-month period of knowledge decay. Finally, real-time feedback was provided by trauma team leaders and study staff. Adherence to prophylactic measures was recorded again.

RESULTS

Baseline compliance rates were dismal. Only hand washing prior to patient interaction, the use of eye protection, and the use of masks improved significantly (p < 0.05) after the educational initiative. However, compliance rates remained suboptimal. No difference was noted regarding the three other USPs. Impressively, following real-time behavioral corrections, compliance improved to nearly 90 % for all USPs (p < 0.05).

CONCLUSIONS

Compliance with OSHA-required USPs during trauma team activations is unacceptably low, but can be dramatically improved through simple educational interventions, combined with real-time peer feedback.

Effect of dendritic cell vaccine therapy on lymphocyte subpopulation in refractory primary brain tumor

BACKGROUND

Dendritic cell (DC)-based immunotherapy has the potential to induce an antitumor response within the immunologically privileged brain.

AIMS

The aim of this study was to evaluate the short-term effect of DC vaccine therapy on lymphocyte subsets in patients with refractory primary brain tumor.

MATERIALS AND METHODS

Eighteen cases with refractory primary brain tumor who refused any treatment against tumor within 6 months of the therapy, were referred to one medicine center, from January 2011 to October 2012. All patients received 1 × 10(7) tumor lysate-pulsed DC vaccinations both intradermal injection and intravenous infusion 3 times/week.

RESULTS

There were increases of lymphocytes CD8+ (P = 0.002) and CD56+ (P = 4.207E-10), but no change of lymphocytes CD3+ (P = 0.651). Six patients were positive response of delayed-type hypersensitivity. There were improving of appetite in 14 cases and increasing of physical strength 17 cases.

CONCLUSIONS

DC vaccine has the potential for inducing an immune cytotoxic effect directed toward tumor cells.

[Stress distribution and deformation of uterosacral ligament and cardinal ligament under different working conditions simulated by the finite element model]

OBJECTIVE

To establish the finite element model of uterosacral ligament (USL) and cardinal ligament (CL) and analyze the stress distribution and deformation with USL and CL under different working conditions.

METHODS

Patients with stage Ⅲ-Ⅳ pelvic organ prolapse (POP) and healthy female volunteers were selected for research subject, and divided into anterior uterus group and posterior uterus group. Two POP patients and two volunteers were selectd into the anterior uterus group and posterior uterine group respectively. Pelvic MRI scan was performed in two groups. Based on the original MRI data sets, the finite element model of USL and CL was constructed by using the software such as the Mimics, and the stress distribution and deformation of USL and CL were simulated.

RESULTS

Under the premise of the elastic modulus fixed and three different working conditions such as 60 cmH2O, 99 cmH2O and 168 cmH2O (1 cmH2O=0.098 kPa) with abdominal pressure generated by maximum Valsalva maneuver, according to the present conditions and the simulation, the trend was analyzed: the stress and deformation of the uterus, anterior vaginal wall, USL and CL in two groups were mainly distributed in the middle and lower part of the anterior vaginal wall or the ligament and the cervix-vagina junction, the maximum stress and the maximum displacement were mainly concentrated in the lower region of the anterior vaginal wall. With increasing of abdominal pressure generated by the maximum Valsalva maneuver, the maximum stress values of the POP patient in anterior uterus group under three different working conditions were: 0.027 9, 0.046 0, 0.078 0 MPa, and the maximum displacement values were: 9.145 5, 15.090 0, 25.607 0 mm. The maximum stress values of the volunteer in anterior uterus group under three different working conditions were: 0.012 6, 0.020 8, 0.035 3 MPa, and the maximum displacement values were: 1.816 7, 2.997 5, 5.086 7 mm. The maximum stress values of the POP patient in posterior uterine group under three different conditions were: 0.069 4, 0.114 6, 0.194 5 MPa, and the maximum displacement values were: 11.658 0, 19.236 0, 32.643 0 mm. The maximum stress values of the volunteer in posterior uterus group under three different working conditions were: 0.009 1, 0.015 1, 0.025 6 MPa, and the maximum displacement values were: 2.581 6, 4.259 6, 7.228 4 mm. The maximum stress values and the maximum displacement values were all increased with increasing of abdominal pressure in the two groups. The maximum stress values and the maximum displacement values of the POP patients were greater than those of volunteers. Under different working conditions, the maximum stress values and maximum displacement values of the posterior uterus POP patient were all greater than those of the anterior uterus POP patient.

CONCLUSIONS

The finite element model of USL and CL is completely based on the MRI technology and the model is real and reliable. The increase of abdominal pressure will produce a larger stress and deformation of USL and CL, which is one of the reasons causing the injury of the ligament.

Measurement of the Reactor Antineutrino Flux and Spectrum at Daya Bay

This Letter reports a measurement of the flux and energy spectrum of electron antineutrinos from six 2.9 GWth nuclear reactors with six detectors deployed in two near (effective baselines 512 and 561 m) and one far (1579 m) underground experimental halls in the Daya Bay experiment. Using 217 days of data, 296 721 and 41 589 inverse β decay (IBD) candidates were detected in the near and far halls, respectively. The measured IBD yield is (1.55±0.04) ×10(-18)  cm(2) GW(-1) day(-1) or (5.92±0.14) ×10(-43)  cm(2) fission(-1). This flux measurement is consistent with previous short-baseline reactor antineutrino experiments and is 0.946±0.022 (0.991±0.023) relative to the flux predicted with the Huber-Mueller (ILL-Vogel) fissile antineutrino model. The measured IBD positron energy spectrum deviates from both spectral predictions by more than 2σ over the full energy range with a local significance of up to ∼4σ between 4-6 MeV. A reactor antineutrino spectrum of IBD reactions is extracted from the measured positron energy spectrum for model-independent predictions.

Dose-associated pulmonary complication rates after fresh frozen plasma administration for warfarin reversal

ESSENTIALS: Fresh frozen plasma (FFP) may be associated with a dose-based risk of pulmonary complications. Patients received FFP for warfarin reversal at a large academic hospital over a 3-year period. Almost 20% developed pulmonary complications, and the risk was highest after > 3 units of FFP. The risk of pulmonary complications remained significant in multivariable analysis.

BACKGROUND

Fresh frozen plasma (FFP) is often administered to reverse warfarin anticoagulation. Administration has been associated with pulmonary complications, but it is unclear whether this risk is dose-related. Aims We sought to characterize the incidence and dose relationship of pulmonary complications, including transfusion-associated circulatory overload (TACO) and transfusion-related acute lung injury (TRALI), after FFP administration for warfarin reversal.

METHODS

We performed a structured retrospective review of patients who received FFP for warfarin reversal in the emergency department (ED) of an academic tertiary-care hospital over a 3-year period. Logistic regression was used to explore the relationship between FFP dose and risk of pulmonary events.

RESULTS

Two hundred and fifty-one patients met the inclusion criteria. Overall, 49 patients (20%) developed pulmonary complications, including 30 (12%) with TACO, two (1%) with TRALI, and 17 (7%) with pulmonary edema not meeting the criteria for TACO. Pulmonary complications were significantly more frequent in those who received > 3 units of FFP (34.0% versus 15.6%, 95% confidence interval for risk difference 7.9%-8.9%). After stratification by subtype of complication, only the risk of TACO was statistically significant (28.3% versus 7.6%, 95% confidence interval for risk difference 8.2%-16.6%). In multivariable analysis controlling for age, sex, initial systolic blood pressure, and intravenous fluids given in the ED, > 3 units of FFP remained a significant risk factor for pulmonary complications (odds ratio 2.49, 95% confidence interval 1.21-5.13).

CONCLUSIONS

Almost 20% of patients who received FFP for warfarin reversal developed pulmonary complications, primarily TACO, and this risk increased with > 3 units of FFP. Clinicians should be aware of and prepared to manage these complications.

Tuning the conductivity type in a room temperature magnetic oxide: Ni-doped Ga0.6Fe1.4O3 thin films

The mechanism responsible for conduction in pulsed laser deposited thin films of room temperature ferrimagnetic Ga_0.6Fe_1.4O₃ is fully elucidated. The conduction type can be tuned from n to p through doping with bivalent Ni ions.

Selective removal of copper with polystyrene–1,3-diaminourea chelating resin: synthesis and adsorption studies

In this study, green chloromethylated polystyrene bead–1,3-diaminourea (PS–DU) which was intended to adsorb copper ions was synthesized from chloromethylated polystyrene (PS-Cl) and 1,3-diaminourea (DU).

Akirin2 expression in response to vaccine-induced immunity in chicken

Akirin2 is a nuclear factor that plays an important role in the development and regulation of innate immune response. In this study, akirin2 gene expression in several primary immune organs (liver, thymus, and bursa) of Hi-Line Brown chicken administered with the LoSota vaccine was analyzed during the various stages of increase in Newcastle disease virus antibody titer. The results revealed that akirin2 expression was significantly higher in the liver (P < 0.01) and bursa (P < 0.05) of vaccinated chicken 7 and 14 days post-immunization, respectively. These results could serve as a foundation for further studies on the functions of akirin2 in immune response.