Structural analysis of the dual agonism at GLP-1R and GCGR

Glucagon-like peptide-1 receptor (GLP-1R) and glucagon receptor (GCGR), two members of class B1 G protein-coupled receptors, play important roles in glucose homeostasis and energy metabolism. They share a high degree of sequence homology but have different functionalities. Unimolecular dual agonists of both receptors developed recently displayed better clinical efficacies than that of monotherapy. To study the underlying molecular mechanisms, we determined high-resolution cryo-electron microscopy structures of GLP-1R or GCGR in complex with heterotrimeric Gs protein and three GLP-1R/GCGR dual agonists including peptide 15, MEDI0382 (cotadutide) and SAR425899 with variable activating profiles at GLP-1R versus GCGR. Compared with related structures reported previously and supported by our published pharmacological data, key residues responsible for ligand recognition and dual agonism were identified. Analyses of peptide conformational features revealed a difference in side chain orientations within the first three residues, indicating that distinct engagements in the deep binding pocket are required to achieve receptor selectivity. The middle region recognizes extracellular loop 1 (ECL1), ECL2, and the top of transmembrane helix 1 (TM1) resulting in specific conformational changes of both ligand and receptor, especially the dual agonists reshaped ECL1 conformation of GLP-1R relative to that of GCGR, suggesting an important role of ECL1 interaction in executing dual agonism. Structural investigation of lipid modification showed a better interaction between lipid moiety of MEDI0382 and TM1-TM2 cleft, in line with its increased potency at GCGR than SAR425899. Together, the results provide insightful information for the design and development of improved therapeutics targeting these two receptors simultaneously.

Erratum: Momentum-Resolved Observation of Thermal and Quantum Depletion in a Bose Gas [Phys. Rev. Lett. 117, 235303 (2016)]

This corrects the article DOI: 10.1103/PhysRevLett.117.235303.

[Reproducibility evaluation of air-charged catheter for rest urethral pressure profilometry]

We retrospectively included 53 (9 males, 44 females) patients who underwent rest urethral pressure profilometry (RUPP) due to lower urinary tract symptoms (LUTS) in Beijing Chaoyang Hospital from May 2021 to March 2022. The age of patients was (55±16) (25-76) years old. The clinical diagnoses of the included patients with lower urinary tract symptoms were classified as: benign prostatic hyperplasia in 9 cases, interstitial cystitis in 1 case, stress urinary incontinence in 11 cases and non-obstructive dysuria in 32 cases. The full set of urodynamic examination was composed of bladder pressure measurement during the filling period, pressure flow study (PFS) and RUPP. All the urodynamic examination was performed by air-charged catheter (ACC) and corresponding equipment. All patients underwent RUPP measurements twice. The vesical pressure (Pves) values were (35.30±6.15), (35.81±5.91) cmH₂O (1 cmH₂O=0.098 kPa); the Pura@max were (141.91±36.53), (145.02±38.85) cmH₂O; functional urethral length were (41.70±16.34), (42.55±16.40) mm; the maximum urethral closure pressure for the two RUPP measurements were (106.57±36.44), (109.41±39.27) cmH₂O. There was no statistical difference between the two RUPP measurements (P>0.05). The reproducibility of the RUPP measurements obtained by ACC is good and deserves further study.

Identification and expression pattern analysis of PtCarA and PtCarB genes in Populus trichocarpa under different nitrogen treatments

Carbamoyl phosphate synthetase (CPS) catalyses the synthesis of ammonia carbamoyl phosphate (CP), which plays a key role in the biosynthesis of arginine and pyrimidine nucleotides. There are two subunits of the CPS enzyme in Populus trichocarpa, CarA (small subunit) and CarB (large subunit). Only when they coexist can CPS catalyse synthesis of CP. However, it is not clear how CPS responds to nitrogen (N) to affect arginine and pyrimidine nucleotide biosynthesis. In this study, bioinformatics methods were used to analyse the expression patterns of genes encoding CarA and CarB, and qRT-PCR and RNA-seq were used to investigate their molecular responses under different N concentrations. Phylogenetic analysis revealed that the phylogenetic trees of CarA and CarB had similar topologies. qRT-PCR showed that the PtCarA and PtCarB genes were regulated by N, while their N-regulated patterns differed in different tissues. The expression patterns of PtCarA and PtCarB show a significant positive correlation according to qRT-PCR and RNA-seq. The analysis of promoter cis-acting elements showed that the promoter regions of PtCarA1, PtCarA2 and PtCarB contained some identical cis-acting elements. According to analysis of the phylogenetic tree, expression patterns and promoter elements, we speculate that there might be coevolution among PtCarA1, PtCarA2 and PtCarB. This study provides valuable information for further understanding the function of CPS in poplar, especially for N response, and provides new ideas for studying the evolution of gene families related to heteromultimers.

Risk of stroke with antivenom usage after venomous snakebite in Taiwan: a population-based cohort study

BACKGROUND AND PURPOSE

Stroke is a rare complication of snakebites, but may lead to serious sequelae. We aimed to explore the relationship between venomous snakebite and the risk for acute stroke, in a nationwide population-based cohort study.

METHODS

This retrospective cohort study used claims data between 1 January 2000 and 31 December 2012, from the Taiwan National Health Insurance Research Database. The study included data of patients aged 18 years or older with venomous snakebite (n = 535), matched for propensity score with controls without venomous snakebite (n = 2140). The follow-up period was the duration from the initial diagnosis of venomous snakebite and administration of antivenom to the date of an acute stroke, or until 31 December 2013. The competing risk model was used to estimate the hazard ratio (HR) and 95% confidence intervals (CIs) of stroke, ischemic stroke and hemorrhagic stroke, after adjusting for demographic and other possible stroke risk factors.

RESULTS

The adjusted HR for the venomous snakebite group compared with the control group was 2.68 for hemorrhagic stroke (95% CI = 1.35-5.33). Stratified analysis showed that the older age group (>65 years old) had a higher risk of hemorrhagic stroke. A 2.72-fold significant increase in the risk for hemorrhagic stroke was observed following venomous snakebite with antivenom usage (95% CI = 1.41-5.26).

CONCLUSION

Venomous snakebite is associated with an increased risk of hemorrhagic stroke after the use of antivenom. Further study of the underlying mechanism is warranted.

Ophiostomatoid fungi including a new species associated with Asian larch bark beetle Ips subelongatus, in Heilongjiang (Northeast China)

Ips subelongatus (Coleoptera, Scolytinae) is an important bark beetle species that infests Larix spp. in Asia. Individuals of this beetle are vectors of ophiostomatoid fungi, on their exoskeletons, that are transmitted to infested trees. In this study, the symbiotic assemblage of ophiostomatoid fungi associated with I. subelongatus in Northeast China was studied. Fungal isolates were identified based on their morphological characters and sequences of ITS, beta-tubulin, elongation factor 1-alpha and calmodulin gene regions. In total, 48 isolates were collected and identified, residing in six taxa. These included a novel species, described here as Ophiostoma gmelinii sp. nov.

Melanodevriesia, a new genus of endolichenic oleaginous black yeast recovered from the Inner Mongolia Region of China

Black yeasts are a phylogenetically diverse group of ascomycetous fungi that may exist in both unicellular and mycelial morphs. This group of fungi contains numerous commercially significant species as well as others whose precise roles are unknown, such as endolichenic species. There is currently a paucity of data about endolichenic black yeast species. To bridge this gap, we surveyed China’s Inner Mongolia Autonomous Region in July 2019. Several fungal species associated with diverse lichens were isolated during this survey. Among these were two isolates of a previously unknown species of oleaginous black yeast from Mycosphaerellales. Analyses of morphological and molecular data revealed that these two isolates were closely related to Xenodevriesia strelitziicola (Xenodevriesiaceae), although with significant differences. As a result, we established the genus Melanodevriesiagen. nov. to describe this previously unknown species, Melanodevriesia melanelixiaesp. nov. In addition, we used Transmission Electron Microscopy to visualise the intracellular oil bodies metabolised by this fungus in its unicellular state. The black yeast species identified in this study may have a wide range of commercial applications. More research is needed to determine the chemical composition of the microbial oil synthesized by this fungus and whether it has commercial value.

Citation: Chang R, Cao W, Wang Y, Li S, Li X, Bose T, Si HL (2022). Melanodevriesia, a new genus of endolichenic oleaginous black yeast recovered from the Inner Mongolia Region of China. Fungal Systematics and Evolution9: 1–9. doi: 10.3114/fuse.2022.09.01

Mobilizing COVID-19 Testing: Impact and Challenges

Introduction/Objective

In response to the rapidly evolving COVID-19 pandemic, Sanford Health developed a mobile diagnostic testing program capable of reaching geographically dispersed sites and communities. These mobile laboratories provided on-site testing and sensitive detection of SARS-CoV-2 by leveraging Cepheid’s GeneXpert platform, enabling rapid reporting of results directly to the patient and physician. Aggregation of these results allowed monitoring population infection rates and public health reporting.

Methods/Case Report

Within 3 weeks of conception, the first mobile unit was designed, engineered and deployed. Key requirements for successful implementation included mobile lab licensure, CLIA certification, COLA enrollment, Quality and Risk assessments, inventory management, lab maintenance and ongoing monitoring. Testing was performed using the Xpert Xpress SARS-CoV-2 test and the population tested were primarily asymptomatic individuals.

Results (if a Case Study enter NA)

Between May 3rd, 2020 and June 23rd, 2021, a total of 31,148 Xpert Xpress SARS-CoV-2 tests were run across 3 mobile laboratories, with an average of 600 tests performed per week. The percent positivity ranged from 0% to 5.8%, reaching highest positivity in week beginning May 10th, 2020. The average turnaround time from sample collection to result verification was 2.0 hours, and the average time from sample receipt to result verification was under 1 hour.

Conclusion

Sanford Health’s mobile testing program brings SARS-CoV-2 PCR testing to the community and dramatically reduces the time from sample collection to result reporting compared with traditional testing labs, enabling rapid intervention following a positive result. The flexibility of the GeneXpert platform, including the instrument’s robustness, the independently functioning analyzers, and the wide range of tests available, makes it particularly well suited to mobile laboratories. This program demonstrates the impact of on-site testing and highlights the challenges that were overcome for successful implementation, providing a blueprint to support the development of other mobile laboratories in the US.

Synergistic Effect between Modified Graphene Oxide and Ammonium Polyphosphate on Combustion Performance, Thermal Stability and Mechanical Properties of Polylactic Acid

To improve the thermal stability, ZF-GO (graphene oxide (GO) modified by zinc ferrite (ZF)) is prepared. In view of the anti-dripping function of ZF-GO and flame retardant effect of ammonium polyphosphate (APP), the influence of ZF-GO, APP, mixture of ZF-GO and APP on combustion performance, thermal stability and mechanical properties of polylactic acid (PLA) is investigated. Results show that the modification of GO by ZF significantly improves the residue of ZFGO by 34.7%. The char-forming capability and unique network structure of ZF-GO prevent the melt dripping of PLA. Although APP can increase the limiting oxygen index of PLA, there is still melt dripping. The combination of ZF-GO and APP improves the residual yield of 94PLA/3ZF-GO/3APP by 4.3 times relative to pure PLA, and the UL-94 level reaches V-0. The two additives show synergistic char-forming effect, and there is both physical carbonization and chemical carbonization. The incorporated fillers can decrease the total heat release (THR) of PLA composites. Specifically, the THR and peak value of heat release rate of 94PLA/3ZF-GO/3APP decrease by 21.2% and 53.9%, respectively. For the PLA/ZF-GO/APP system, plenty of residues and the anti-dripping network structure are key factors to get good flame retardancy. Addition of ZFGO and APP reduces the tensile strength, but the tensile elongation of the modified PLA composites is improved. 94PLA/ 3ZF-GO/3APP shows good integrated performance.

Management and cleanup of legacy radium-contaminated sites in the United States

The hazards associated with radium-containing materials were largely unknown when they were first introduced into household and other products over a century ago. Radium was also originally thought to have beneficial health properties, leading to confusion amongst the public about the safety of radium in household products and food items. When the adverse health effects associated with radium were discovered and became well known, radium products became unpopular and were prohibited in some countries. In the United States, after the hazards associated with radium became known, radium was first regulated by individual states in the late 1920s and early 1930s. Later, the US Nuclear Regulatory Commission (NRC) was given a role in the regulation of discrete sources of radium with the passage of the Energy Policy Act of 2005. After passage of the Act, the NRC began to systematically identify sites around the country where radium was used and reached out to site owners to determine whether existing radium contamination could pose a risk to public health and safety and the environment. The NRC devised a graded approach in response to its new regulatory responsibilities to address potential public health and safety issues at legacy radium sites. By September 2019, the NRC had dispositioned all the sites that were identified as having potential contamination from historical radium within its regulatory purview in non-Agreement States. The staff worked with site owners and federal, state and local officials, as needed, to properly disposition the sites to ensure that each site either meets the applicable criteria for unrestricted use or has controls in place to limit access during remediation so that no site poses an unacceptable risk to public health and safety and the environment.

Figs S1-S4

Fig. S1. Phylogram obtained from ML analyses of the partial BT and EF gene sequences of the O. clavatum species complex. Sequences obtained in this study are printed in bold type. Maximum-likelihood bootstrap support values (1 000 replicates) above 70 % are indicated at the nodes. Bayesian inference posterior probabilities (above 0.9) are indicated by bold lines at the relevant branches. T = ex-type cultures. Fig. S2. Phylogram obtained from ML analyses of the ITS region and the partial BT gene of the O. ips species complex. Sequences obtained in this study are printed in bold type. Maximum-likelihood bootstrap support values (1 000 replicates) above 70 % are indicated at the nodes. The Bayesian inference posterior probabilities (above 0.9) are indicated by bold lines at the relevant branches. T = ex-type cultures. Fig. S3. Phylogram obtained from ML analyses of the ITS region, and the partial BT and CAL gene sequences of the Sporothrix gossypina species complex. Sequences obtained in this study are printed in bold type. Maximum-likelihood bootstrap support values (1 000 replicates) above 70 % are indicated at the nodes. Bayesian inference posterior probabilities (above 0.9) are indicated by bold lines at the relevant branches. T = ex-type cultures. Fig. S4. Phylogram obtained from ML analyses of the ITS region, and the partial BT and EF gene sequences of Endoconidiophra. Sequences obtained in this study are printed in bold type. Maximum-likelihood bootstrap support values (1 000 replicates) above 70 % are indicated at the nodes. Bayesian inference posterior probabilities (above 0.9) are indicated by bold lines at the relevant branches. T = ex-type cultures.

Challenges in Evaluating Interactive Visual Machine Learning Systems

In interactive visual machine learning (IVML), humans and machine learning algorithms collaborate to achieve tasks mediated by interactive visual interfaces. This human-in-the-loop approach to machine learning brings forth not only numerous intelligibility, trust, and usability issues, but also many open questions with respect to the evaluation of the IVML system, both as separate components, and as a holistic entity that includes both human and machine intelligence. This article describes the challenges and research gaps identified in an IEEE VIS workshop on the evaluation of IVML systems.

Cryo-electron microscopy structure of the glucagon receptor with a dual-agonist peptide

Unimolecular dual agonists of the glucagon (GCG) receptor (GCGR) and glucagon-like peptide-1 receptor (GLP-1R) are a new class of drugs that are potentially superior to GLP-1R-specific agonists for the management of metabolic disease. The dual-agonist, peptide 15 (P15), is a glutamic acid 16 analog of GCG with GLP-1 peptide substitutions between amino acids 17 and 24 that has potency equivalent to those of the cognate peptide agonists at the GCGR and GLP-1R. Here, we have used cryo-EM to solve the structure of an active P15-GCGR-G_s complex and compared this structure to our recently published structure of the GCGR-G_s complex bound to GCG. This comparison revealed that P15 has a reduced interaction with the first extracellular loop (ECL1) and the top of transmembrane segment 1 (TM1) such that there is increased mobility of the GCGR extracellular domain and at the C terminus of the peptide compared with the GCG-bound receptor. We also observed a distinct conformation of ECL3 and could infer increased mobility of the far N-terminal His-1 residue in the P15-bound structure. These regions of conformational variance in the two peptide-bound GCGR structures were also regions that were distinct between GCGR structures and previously published peptide-bound structures of the GLP-1R, suggesting that greater conformational dynamics may contribute to the increased efficacy of P15 in activation of the GLP-1R compared with GCG. The variable domains in this receptor have previously been implicated in biased agonism at the GLP-1R and could result in altered signaling of P15 at the GCGR compared with GCG.

Lexical analysis of emotional responses to "real-world" experiences in individuals with schizophrenia

Abnormalities in emotion perception, expression, and experience are considered a core component of schizophrenia. Previous laboratory studies have demonstrated that while individuals with schizophrenia report levels of positive emotions comparable to healthy individuals in response to positive stimuli, they also report co-occurring negative emotions in response to such stimuli. However, it is unknown whether this response pattern extends to "real world" naturalistic environments. To examine this question, we employed an experience sampling method (ESM) approach using mobile electronic devices to collect information up to 10 times/day over a two-day period from 53 individuals with schizophrenia and 19 non-clinical controls. As part of each experience sample, participants completed brief open-ended responses and answered questions about their emotional responses to three recent events (neutral, positive, and negative). Additionally, participants completed diagnostic and clinical measures. Lexical analyses were used to analyze ESM-based word production and characterize emotion word use. Compared to non-clinical controls, individuals with schizophrenia reported similar levels of positive emotion, but significantly higher negative emotion, which was associated with increased negative symptoms. The schizophrenia group used more anxiety words in response to negative and neutral events, and more anger words in response to positive events. Increased use of anger words was linked with elevations in positive symptoms as well as symptoms of depression, while use of sadness words was linked with anhedonia. Our findings support the co-activation of negative emotion hypothesis documented in laboratory settings and provide evidence of its ecological validity. Implications for functioning and future directions are discussed.

SAT-222 Hormone Responses Associated with Letrozole Ovulation Induction in Anovulatory Women with PCOS

Abstract: The aromatase inhibitor (AI) letrozole has been shown to be the most effective oral medication for ovulation induction in anovulatory women with PCOS. It has been established that AIs block the conversion of androgens to estrogen, leading to reduction of serum estrogen levels. However, the mechanism by which letrozole induces ovulation is unknown. It has been suggested that the mechanism of AIs in ovulation induction may involve increased FSH secretion in response to reduced estrogen levels. To examine the mechanism by which AIs induce ovulation, we performed a pilot interventional study. Ten anovulatory women with PCOS, aged 24-34 years were enrolled. Each subject underwent baseline serum hormone assessment and transvaginal ultrasound. Women were excluded if they had hypogonadotropic hypogonadism, or ultrasound evidence of a dominant follicle or corpus luteum. Each subject underwent ovulation induction with letrozole 2.5 mg/day for 5 days. Repeat transvaginal ultrasound was done three days after completing letrozole. Ovulation was defined by (1) presence of >=1 ovarian follicle >=16 mm on follow up ultrasound and (2) positive home ovulation predictor test. Serum hormone levels were assessed in all subjects at baseline and at two, four, and seven days after letrozole initiation. Mean serum hormone levels were compared using paired Student’s t test with statistical significance set at p<0.05. Three of 10 subjects ovulated after completing letrozole. In all subjects, the baseline levels (mean ± SD) of serum FSH, LH, estradiol, and androstenedione were 5.4 ± 2.2 mIU/mL, 12.1 mIU/mL, 86.2 ± 32.1pg/mL, and 3.2 ± 1.5 ng/mL, respectively. A significant reduction in serum estradiol was noted on day two compared to baseline (-35.2 pg/mL). There was a significant increase in mean serum FSH (+1.8 mIU/mL) and LH (+4.7 mIU/mL) on day two after starting letrozole. Significant increases in serum androstenedione were observed on day two (+0.8 ng/mL) and day four (+1.5 ng/mL) relative to baseline values. The study was not sufficiently powered to detect differences in serum hormone levels between women that did and did not ovulate in response to letrozole administration. These data suggest that the mechanism of ovulation induction by AI may involve a transient increase in serum gonadotropins resulting from interrupted estrogen negative feedback. Sources of Research Support: NIH Grants T32 HD007203, K12 HD001259, and P50 HD012303.Key Words: Polycystic Ovary Syndrome; Infertility; Anovulation

Enhancing Flame Retardancy, Thermal Stability, Physical and Mechanical Properties of Polyethylene Foam with Polyphosphate Modified Expandable Graphite and Ammonium Polyphosphate

The method of preparing polyolefin foam with good flame retardancy, thermal stability, and physical and mechanical properties was investigated. Foaming condition of linear low density polyethylene (LLDPE) was investigated with triphenyl phosphate (TPP) as plasticizer, NaHCO3 as foaming agent. The influence of modified expandable graphite (EGP) and ammonium polyphosphate (II) on foam density, compression strength, combustion characteristics and thermal stability was explored. Results verified that EGP presented better dilatability and flame retardancy than the normal expandable graphite. Addition of EGp improved the limiting oxygen index (LOI) of 15NaHCO3/100 LLDPETPP/30EGp foam from 18.8% to 24.6%. Furthermore, the combination of EGp and ammonium polyphosphate (II) (APP) at the mass ratio of 2:1 improved the LOI of 15NaHCO3/100 LLDPETPP/20EGp/10APP sample to 27.9%, and the vertical burning UL-94 level reached V-0, indicating that this material was flame retardant. Although these additives made 15NaHCO3/100 LLDPETPP/20EGp/10APP composite exhibit a high density of 142.5 kg m−3, which was increased by 12.3 wt% relative to the 15NaHCO3/100 LLDPETPP foam, it could improve the compressive strength to 0.4747 MPa, which was about 2.7 times that of the matrix. The thermal stability of the material was also enhanced.

[Effect of interleukin-7 on the anti-tumor function of CD8(+) T cells in patients with non-small cell lung cancer]

Objective: To investigate the effect of interleukin (IL)-7 on anti-tumor activity of CD8(+) T cells in non-small cell lung cancer (NSCLC) patients. Methods: Twenty-seven NSCLC patients and ten healthy controls were included from Zhengzhou Central Hospital between January 2017 and July 2017. Plasma, peripheral blood mononuclear cells (PBMCs), and bronchial alveolar lavage fluid (BALF) (both tumor site and non-tumor site) were collect from NSCLC patients, while plasma and PBMCs were also collected from healthy controls. IL-7 level and IL-7 receptor α (CD127) mRNA relative expression was measured. Purified CD8(+) T cells and primary NSCLC cells were stimulated with recombinant IL-7. Cellular proliferation, cytokines secretion, and protein expression in IL-7 signaling pathway were investigated. Direct/indirect contact coculture system of CD8(+) T cells and primary NSCLC cells was also used to assess the cytolytic and noncytolytic activity after IL-7 stimulation. Results: Plasma IL-7 level was significantly reduced in NSCLC patients compared with normal controls[1 731 (1 364, 2 536) vs 2 686 (1 692, 4 786) ng/L, P=0.023). IL-7 level in BALF isolated from tumor site was also remarkably down-regulated compared with non-tumor site in NSCLC patients[1 045 (562, 1 550) vs 1 599 (1 166, 2 107) ng/L, P=0.006 9). There was no statistical difference of CD127 mRNA between the two groups. Recombinant IL-7 stimulation did not affect cellular proliferation and cytokines production in primary NSCLC cells, however, remarkably increased cellular proliferation, interferon (IFN)-γ/tumor necrosis factor (TNF)-α secretion, and signal transducers and activators of transcription 5 (STAT5) phosphorylation and suppressor of cytokine signaling 3 (SOCS3) expression of CD8(+) T cells from NSCLC patients. IL-7 stimulation also significantly enhanced the cytolytic and noncytolytic function of CD8(+) T cells on primary NSCLC cells. Conclusion: IL-7 enhances anti-tumor activity of CD8(+) T cells in NSCLC patients.

Delayed enhancement of the peritumoural cortex in clear cell renal cell carcinoma: correlation with Fuhrman grade

AIM

To assess the delayed enhancement of the peritumoural cortex (DEC) sign in clear cell renal cell carcinoma (ccRCC), and investigate a possible correlation among DEC and Fuhrman grade.

MATERIALS AND METHODS

This retrospective study included 506 patients with 511 histopathologically proven ccRCCs evaluated by computed tomography (CT) angiography. DEC was detected and compared in groups divided by Fuhrman grades (low grade: 1 and 2, high grade: 3 and 4) using univariate and multivariate analyses.

RESULTS

DEC was detected in 89 of 511 (17.4%) ccRCCs (grade 1: 5.7%, 2/35; grade 2: 16.2%, 70/433; grade 3: 31.4%, 11/35; grade 4: 75%, 6/8; p<0.001). The incidence was higher in high-grade ccRCCs (39.5%, 17/43) than in low-grade ccRCCs (15.4%, 72/468; p<0.001). In multivariate analysis, tumour size >5.4 cm (p<0.001, odds ratio [OR]=3.57, 95% confidence interval [CI]: 1.76-7.23) and detection of DEC (p=0.021, OR=2.33, 95% CI: 1.13-4.80) were independent predictors of high-grade ccRCC. For all ccRCCs, the area under the receiver operating characteristic (ROC) curve (AUC) of DEC in predicting high-grade ccRCC was 0.62 (95% CI: 0.53-0.72) with 39.5% sensitivity and 84.6% specificity, while for ccRCCs of >5.4 cm diameter, the AUC was 0.66 (95% CI: 0.52-0.80) with 68.4% sensitivity and 62.7% specificity.

CONCLUSIONS

The DEC sign may predict aggressive biological behaviour of ccRCC, irrespective of tumour size.

Influence of Titanium Dioxide Modified Expandable Graphite and Ammonium Polyphosphate on Combustion Behavior and Physicomechanical Properties of Rigid Polyurethane Foam

In this research, the individual influence and synergistic behavior between titanium dioxide modified expendable graphite and ammonium polyphosphate on combustion behavior and physicomechanical properties of rigid polyurethane foam (RPUF) were investigated. Combustion behavior was evaluated by limiting oxygen index, and vertical-combustion tests. Thermal stability was studied via thermogravimetric/differential thermal gravimetric (TG/DTG) analysis. Results showed that the modified expendable graphite presented better thermal stability and flame retardancy for RPUF than the normal expandable graphite. Furthermore, the combination of the modified expendable graphite and ammonium polyphosphate with the mass ratio of 1 : 1 caused the RPUF to exhibit better flame retardancy, compression strength and high temperature thermal stability. Especially, the compression strength of this polymer composite sharply increased by 52.4 % over RPUF.

Tumor-induced osteomalacia in association with PTEN-negative Cowden syndrome

Tumor-induced osteomalacia (TIO) is a rare paraneoplastic condition in which phosphaturic mesenchymal tumors (PMTs) secrete high levels of fibroblast growth factor 23 (FGF23) into the circulation. This results in renal phosphate wasting, hypophosphatemia, muscle weakness, bone pain, and pathological fractures. Recent studies suggest that fibronectin-fibroblast growth factor receptor 1 (FN1-FGFR1) translocations may be a driver of tumorigenesis. We present a patient with TIO who also exhibited clinical findings suggestive of Cowden syndrome (CS), a rare autosomal dominant disorder characterized by numerous benign hamartomas, as well as an increased risk for multiple malignancies, such as thyroid cancer. While CS is a clinical diagnosis, most, but not all, harbor a mutation in the tumor suppressor gene PTEN. Genetic testing revealed a somatic FN1-FGFR1 translocation in the FGF23-producing tumor causing TIO; however, a germline PTEN mutation was not identified. To our knowledge, this is the first reported case of concurrent TIO and CS.

The Effects of Policy-Driven Air Quality Improvements on Children's Respiratory Health

INTRODUCTION

Ambient air pollution causes substantial morbidity and mortality in the United States and worldwide. To reduce this burden of adverse health effects, a broad array of strategies to reduce ambient air pollution has been developed and applied over past decades to achieve substantial reductions in ambient air pollution levels. This has been especially true in California, where the improvement of air quality has been a major focus for more than 50 years. Direct links between regulatory policies, changes in ambient pollutant concentrations, and improvements in public health have not been extensively documented. Data from the Children's Health Study (CHS), a multiyear study of children's respiratory health development, offered a unique opportunity to evaluate the effects of long-term reductions in air pollution on children's health.

METHODS

We assessed whether changes in ambient air quality and emissions were reflected in three important indices of children's respiratory health: lung-function growth, lung-function level, and bronchitic symptoms. To make the best use of available data, these analyses were performed across the longest chronological period and largest CHS population available for the respective lung-function or bronchitic symptoms data sets. During field study operations over the course of the CHS, children's health status was documented annually by testing lung-function performance and the completion of standardized questionnaires covering a broad range of respiratory symptoms. Air quality data for the periods of interest were obtained from community monitoring stations, which operated in collaboration with regional air monitoring networks over the 20-year study time frame. Over the 20-year sampling period, common protocols were applied to collect data across the three cohorts of children. Each cohort's data set was assessed to investigate the relationship between temporal changes in lung-function development, prevalence of bronchitic symptoms, and ambient air pollution concentrations during a similar, vulnerable adolescent growth period (age 11 to 15 years). Analyses were performed separately for particulate matter ≤10 µm in aerodynamic diameter (PM₁₀), particulate matter ≤2.5 µm in aerodynamic diameter (PM₂.₅), ozone (O₃), and nitrogen dioxide (NO₂). Emissions data and regulatory policies were collected from the staff of state and regional regulatory agencies, modeling estimates, and archived reports.

RESULTS

Emissions in the regions of California studied during the 20-year period decreased by 54% for oxides of nitrogen (NOₓ), 65% for reactive organic gases (ROG), 21% for PM₂.₅, and 15% for PM₁₀. These reductions occurred despite a concurrent 22% increase in population and a 38% increase in motor vehicle miles driven during that time frame. Air quality improved over the same time frame, with reductions in NO₂ and PM₂.₅ in virtually all of the CHS communities. Annual average NO₂ decreased by about 53% (from ~41 to 19 ppb) in the highest NO₂-reporting community (Upland) and by about 28% (from ~10 to 7 ppb) in one of the lowest NO₂-reporting communities (Santa Maria). Reductions in annual average PM₂.₅ concentrations ranged from 54% (~33 to 15 µg/m³) in the community with the highest concentration (Mira Loma) to 13% (~9 to 8 µg/m³) in a community with one of the lowest concentrations (Santa Maria). Improvements in PM₁₀ and O₃ (measured during eight daytime hours, 10 AM to 6 PM) were most evident in the CHS communities that initially had the highest levels of PM and O₃. Trends in annual average NO₂, PM₂.₅, and PM₁₀ ambient air concentrations in the communities with higher-pollution levels were generally consistent with observed trends in NOₓ, ROG, PM₂.₅, and PM₁₀ emissions.

Significant improvements in lung-function growth in progressive cohorts were observed as air quality improved over the study period. Improvements in four-year growth of both forced expiratory volume in the first second of exhalation (FEV1) and forced vital capacity (FVC) were associated with declining levels of NO₂ (P < 0.0001), PM₂.₅ (P < 0.01), and PM₁₀ (P < 0.001). These associations persisted after adjustment for important potential confounders. Further, significant improvements in lung-function growth were observed in both boys and girls and among asthmatic and non-asthmatic children. Within-community decreases in O₃ exposure were not significantly associated with lung-function growth. The proportion of children with clinically low FEV1 (defined as <80% predicted) at age 15 declined significantly, from 7.9% to 3.6% across the study periods, respectively, as the air quality improved (P < 0.005). We found little evidence to suggest that improvements in lung-function development were attributable to temporal confounding.

Reductions in outdoor levels of NO₂, O₃, PM₁₀, and PM₂.₅ across the cohort years of participation were associated with significant reductions in the prevalence of bronchitic symptoms regardless of asthma status, but observed improvements were larger in children with asthma. Among asthmatic children, the reductions in prevalence of bronchitic symptoms at age 10 were 21% (P < 0.01) for NO₂, 34% (P < 0.01) for O₃, 39% (P < 0.01) for PM₁₀, and 32% (P < 0.01) for PM₂.₅ for reductions of 4.9 ppb, 3.6 ppb, 5.8 µg/m³, and 6.8 µg/m³, respectively. Similar reductions in prevalence of bronchitic symptoms were observed at age 15 among these same asthmatic children. As in the lung-function analyses, we found little evidence that temporal confounding accounted for the observed associations of symptoms reduction with air quality improvement.

The large number and breadth of regulatory activities, as well as the prolonged phase-in periods of several policy approaches to reduce emissions, precluded the close temporal linkage of specific policies with specific changes in health status. However, the combination of policies addressing motor vehicle emissions - from on-board diagnostics to emission controls, from low-sulfur fuels to vehicle smog-check recertification, and from re-formulated gasoline to the various strategies contained within the San Pedro Bay Ports Clean Air Plan (especially the Clean Truck Program) - all contributed to an impressive and substantial reduction in emissions. These reductions collectively improved local and regional air quality, and improvements in local and regional air quality were associated with improvements in respiratory health.

CONCLUSIONS

This study provides evidence that multiyear improvements in air quality and emissions, primarily driven through a broad array of science-based regulatory policy initiatives, have resulted in improved public health outcomes. Our study demonstrates that improvements in air quality, brought about by science-based regulatory actions, are associated with improved respiratory health in children. These respiratory health metrics include reductions in respiratory symptoms and improvements in lung-function development in a population widely accepted to be at risk and highly vulnerable to the effects of air pollution. Our research findings underscore the importance of sustained air regulatory efforts as an effective means of achieving improved respiratory health in communities and regions affected by airborne pollution.

Momentum-Resolved Observation of Thermal and Quantum Depletion in a Bose Gas

We report on the single-atom-resolved measurement of the distribution of momenta ℏk in a weakly interacting Bose gas after a 330 ms time of flight. We investigate it for various temperatures and clearly separate two contributions to the depletion of the condensate by their k dependence. The first one is the thermal depletion. The second contribution falls off as k^{-4}, and its magnitude increases with the in-trap condensate density as predicted by the Bogoliubov theory at zero temperature. These observations suggest associating it with the quantum depletion. How this contribution can survive the expansion of the released interacting condensate is an intriguing open question.

[Association between genetic polymorphisms of HIF-2α gene and high altitude pulmonary hypertension in Han population]

Objective: To test the hypothesis that the single nucleotide polymorphisms (SNPs) in HIF-2α gene were associated with the susceptibility of high altitude pulmonary hypertension (HAPH) in Han population in China. Methods: Those Han population who emigrated to plateau (average altitude 3 300 m) and have been lived here for more than 20 years were included as the research subjects, the method of cluster random sampling was used to enroll 49 HAPH patients as the case group (HAPH group) and 39 free of HAPH people as the control group. The Sanger chain termination method was used to detect the SNPs of rs1562453, rs1867785, rs4953361, rs7598371 and rs11125068 in HIF-2α gene. Results: The genotype and frequencies of rs1562453 were CC (49.0%), CT (46.9%) and TT (4.1%) in the HAPH group, and the locus's genotype and frequencies were CC (76.9%), CT (17.9%) and TT (5.1%) in the control group. The alleles and frequencies of rs1562453 were C (72.4%) and T (27.6%) in the HAPH group, and the locus's alleles and frequencies were C (85.9%) and T (14.1%) in the control group. Their genotypes and alleles frequencies were of significant difference between the two groups (genotypes P=0.017; allele P=0.031). Meanwhile, The genotype and frequencies of rs1867785 were AA (46.9%), AG (46.9%) and GG (6.1%) in the HAPH group, and the locus's genotype and frequencies were AA (74.4%), AG (25.6%) and GG (0.0%) in the control group. The alleles and frequencies of rs1867785 were A (70.4%) and G (29.6%) in the HAPH group, and the locus's alleles and frequencies were A (87.2%) and G (12.8%) in the control group. Their genotypes and alleles frequencies were of significant difference between the two groups (genotypes P=0.020; allele P=0.008). Genotypes frequencies of the rs1562453 and rs1867785 were analyzed by Logistic Regression which showed that the genotypes frequencies of rs1562453 were also of significant difference between two groups (Wald=9.561, P=0.008), CT vs CC (β=1.720, OR=5.580, P=0.011). Conclusion: The SNPs of rs1562453 in HIF-2α gene may be associated with the development of HAPH among Chinese Han population, and individuals with the genotype CT may be more vulnerable to HAPH than those who carry genotype CC, and allele T may be a risk factor for HAPH.

Two methods for setting child-focused tuberculosis care targets

OBJECTIVE

To allocate resources for household contact investigations, tuberculosis (TB) programs need estimates of the numbers of child contacts requiring care.

DESIGN

We developed two methods to estimate annual numbers of child contacts aged 0-14 years requiring evaluation and treatment. Method 1 combines local data using simple formulas. Using publicly available data, Method 2 uses a linear regression model based on Demographic and Health Survey and World Bank data to estimate the number of children per household, then combines these results with case notifications and risk estimates of disease and infection.

RESULTS

Applying Method 1 to data from Malawi indicated that every year ~21 000 child contacts require evaluation and ~1900 should be diagnosed with TB. Applying Method 2 to all countries suggested that, globally, 2.41 million (95% uncertainty interval [UI] 2.36-2.46) children aged <5 years, and 5.07 million (95%UI 4.81-5.34) children aged 5-14 years live in households of adult patients with known TB. Of these, 239 014 (95%UI 118 649-478581) and 419 816 (95%UI 140600-1 268805), respectively, will have TB. An additional 848 453 (95%UI 705838-1 017551) and 2660 885 (95%UI 2080517-3 413 189), respectively, will be infected.

CONCLUSION

It is feasible to use available data to set programmatic evaluation and treatment targets to improve care for child contacts of patients with TB.

Characterization of a detector chain using a FPGA-based time-to-digital converter to reconstruct the three-dimensional coordinates of single particles at high flux

We report on the development of a novel FPGA-based time-to-digital converter and its implementation in a detection chain that records the coordinates of single particles along three dimensions. The detector is composed of micro-channel plates mounted on top of a cross delay line and connected to fast electronics. We demonstrate continuous recording of the timing signals from the cross delay line at rates up to 4.1 × 10(6) s(-1) and three-dimensional reconstruction of the coordinates up to 3.2 × 10(6) particles per second. From the imaging of a calibrated structure we measure the in-plane resolution of the detector to be 140(20) μm at a flux of 3 × 10(5) particles per second. In addition, we analyze a method to estimate the resolution without placing any structure under vacuum, a significant practical improvement. While we use UV photons here, the results of this work apply to the detection of other kinds of particles.

A high pressure x-ray photoelectron spectroscopy study of CO oxidation over Rh(100)

We have studied the oxidation of CO over Rh(100) using high pressure x-ray photoelectron spectroscopy under CO and O2 pressures ranging from 0.01 to 1 mbar. The results show a very low or no conversion for the CO covered surface found at low temperatures, while the activity rises slightly when the temperature is high enough for some CO to desorb, exposing surface sites for dissociative O2 adsorption. As the temperature is increased further, more CO desorbs and oxygen replaces CO as the dominating species at the surface. At the same time we find a sudden increase in the reactivity, such that all CO that reaches the surface is instantly transformed into CO2. We find that the O coverage in the active state is highly dependent on the total pressure and, although we do not detect any presence of a surface oxide as in previous surface x-ray diffraction studies, the highest O coverage indicates that the surface is close to being oxidized.

Virtual airway simulation to improve dexterity among novices performing fibreoptic intubation

We developed a virtual reality software application (iLarynx) using built-in accelerometer properties of the iPhone(®) or iPad(®) (Apple Inc., Cupertino, CA, USA) that mimics hand movements for the performance of fibreoptic skills. Twenty novice medical students were randomly assigned to virtual airway training with the iLarynx software or no additional training. Eight out of the 10 subjects in the standard training group had at least one failed (> 120 s) attempt compared with two out of the 10 participants in the iLarynx group (p = 0.01). There were a total of 24 failed attempts in the standard training group and four in the iLarynx group (p < 0.005). Cusum analysis demonstrated continued group improvement in the iLarynx, but not in the standard training group. Virtual airway simulation using freely available software on a smartphone/tablet device improves dexterity among novices performing upper airway endoscopy.

In situ x-ray photoelectron spectroscopy of model catalysts: at the edge of the gap

We present high-pressure x-ray photoelectron spectroscopy (HP-XPS) and first-principles kinetic Monte Carlo study addressing the nature of the active surface in CO oxidation over Pd(100). Simultaneously measuring the chemical composition at the surface and in the near-surface gas phase, we reveal both O-covered pristine Pd(100) and a surface oxide as stable, highly active phases in the near-ambient regime accessible to HP-XPS. Surprisingly, no adsorbed CO can be detected during high CO(2) production rates, which can be explained by a combination of a remarkably short residence time of the CO molecule on the surface and mass-transfer limitations in the present setup.

[Clinical analysis of 2261 cases of Yunnan Tin miners with lung cancer]

BACKGROUND

To find out the clinical features and the regular patterns of lung cancer among Yunnan Tin miners and get ready for the further clinical practices.

METHODS

From 1975 to 1998 the clinical data in 2261 patients with primary lung cancer from Yunnan Tin Corporation were retrospectively analyzed.

RESULTS

The male patients were obviously more than female (male to female was 97.3:1). The ratio of age ranging from 50 to 69 years old was 74.3%. Of the whole group, 60.4% was squamous cell carcinoma and 71.4%was in stage III or IV. The 5-year survival rates of the three groups, which were respectively treated with surgical resection, non-surgical therapy and palliatively supporting therapy, were 43.4%, 7.5% and 1.2% respectively (P<0.01).

CONCLUSIONS

There are some features in patients with lung cancer from Yunnan Tin Corporation. Early diagnosis for lung cancer and healthy quality education will be still important for our future work.

An Affordance-Based Framework for Human Computation and Human-Computer Collaboration

Visual Analytics is "the science of analytical reasoning facilitated by visual interactive interfaces". The goal of this field is to develop tools and methodologies for approaching problems whose size and complexity render them intractable without the close coupling of both human and machine analysis. Researchers have explored this coupling in many venues: VAST, Vis, InfoVis, CHI, KDD, IUI, and more. While there have been myriad promising examples of human-computer collaboration, there exists no common language for comparing systems or describing the benefits afforded by designing for such collaboration. We argue that this area would benefit significantly from consensus about the design attributes that define and distinguish existing techniques. In this work, we have reviewed 1,271 papers from many of the top-ranking conferences in visual analytics, human-computer interaction, and visualization. From these, we have identified 49 papers that are representative of the study of human-computer collaborative problem-solving, and provide a thorough overview of the current state-of-the-art. Our analysis has uncovered key patterns of design hinging on human and machine-intelligence affordances, and also indicates unexplored avenues in the study of this area. The results of this analysis provide a common framework for understanding these seemingly disparate branches of inquiry, which we hope will motivate future work in the field.

Systemic metoclopramide to prevent postoperative nausea and vomiting: a meta-analysis without Fujii's studies

Previous evidence suggested that 10 mg systemic metoclopramide is not effective to prevent postoperative nausea and/or vomiting (PONV) in patients receiving general anaesthesia. However, the evidence included data with questioned validity by the author Yoshitaka Fujii. The objective of the current study was to examine the effect of a systemic dose of 10 mg metoclopramide to prevent PONV. This quantitative systematic review was performed according to the PRISMA guidelines. A wide search was performed to identify randomized clinical trials that evaluated systemic 10 mg metoclopramide as a prophylactic agent to reduce PONV. Meta-analysis was performed using a random-effect model. Thirty trials evaluating the effect of 10 mg systemic metoclopramide in 3328 subjects on PONV outcomes were included. Metoclopramide reduced the incidence of 24 h PONV compared with control, odds ratio (OR) [95% confidence interval (CI)] of 0.58 (0.43-0.78), number needed to treat (NNT)=7.8. When evaluated as separate outcomes, metoclopramide also decreased the incidence of nausea over 24 h, OR (95% CI) of 0.51 (0.38-0.68), NNT=7.1, and vomiting over 24 h, OR (95% CI) of 0.51 (0.40-0.66), NNT=8.3. A post hoc analysis examining three studies with questioned validity performed by the author Yoshitaka Fujii that would meet criteria for inclusion in the current study did not demonstrate a significant benefit of metoclopramide compared with control on the incidence of 24 h PONV. Our findings suggest that metoclopramide 10 mg i.v. is effective to prevent PONV in patients having surgical procedures under general anaesthesia. Metoclopramide seems to be a reasonable agent to prevent PONV.

Pearson syndrome: unique endocrine manifestations including neonatal diabetes and adrenal insufficiency

PURPOSE

Pearson syndrome is a very rare metabolic disorder that is usually present in infancy with transfusion dependent macrocytic anemia and multiorgan involvement including exocrine pancreas, liver and renal tubular defects. The disease is secondary to a mitochondrial DNA deletion that is variable in size and location. Endocrine abnormalities can develop, but are usually not part of the initial presentation. We report two patients who presented with unusual endocrine manifestations, neonatal diabetes and adrenal insufficiency, who were both later diagnosed with Pearson syndrome.

METHODS

Medical records were reviewed. Confirmatory testing included: mitochondrial DNA deletion testing and sequencing of the breakpoints, muscle biopsy, and bone marrow studies.

RESULTS

Case 1 presented with hyperglycemia requiring insulin at birth. She had several episodes of ketoacidosis triggered by stress and labile blood glucose control. Workup for genetic causes of neonatal diabetes was negative. She had transfusion dependent anemia and died at 24 months due to multisystem organ failure. Case 2 presented with adrenal insufficiency and anemia during inturcurrent illness, requiring steroid replacement since 37 months of age. He is currently 4 years old and has mild anemia. Mitochondrial DNA studies confirmed a 4.9 kb deletion in patient 1 and a 5.1 kb deletion in patient 2.

CONCLUSION

The patients reported highlight the importance of considering mitochondrial DNA disorders in patients with early onset endocrine dysfunction, and expand the knowledge about this rare mitochondrial disease.