Better position for the wearable sensor to monitor badminton sport training loads

This study purposed to identify the better accelerometer location for monitoring badminton sports training load by investigating the correlation between internal (HR, training impulse [TRIMP]) training load and external (acceleration, player load [PL]) training loads measured from 5 different body locations. Twelve college-level badminton athletes wore a HR transmitter belt and five accelerometers fixed on both hands, legs, and lower back while performing continuous three-minute training of four badminton skills including backhand serve (BS), net shot (NS), footwork training (FT), and jump smash (JS). Results showed PL at the five locations were significantly related to TRIMP (r = 0.570-0.843, p < 0.05), in which PL at lower back has highest Pearson (r = 0.843) and partial (r = 0.366) correlated to TRIMP (p < 0.05). Base on the stepwise multiple regression, PL at lower back and racket hand explained 88% of the variance of TRIMP (R2 = 0.879). In conclusion, lower back is an idea location for accelerometer to monitor overall external training load in badminton if considering one accelerometer location, while combining PL at the lower back and racket hand can predict 88% of the variation of the internal training load.

Reliability of a method to assess corticomotor excitability of lower limb muscles using a normalized EMG motor thresholding procedure

Given the importance of determining intervention-induced neuroplastic changes with lower extremity functional tasks, a reliable transcranial magnetic stimulation (TMS) methodology for proximal lower extremity muscles is needed. A pre-set fixed voltage value is typically used as the criterion for identifying a motor evoked potential (MEP) during the motor thresholding procedure. However, the fixed voltage value becomes problematic when the procedure is applied to proximal lower extremity muscles where active contractions are required. We sought to establish the reliability of a method measuring corticomotor excitability of gluteus maximus and vastus lateralis using normalized electromyography (EMG) as the criterion for identifying MEPs during the motor thresholding procedure. The active motor threshold for each muscle was determined using the lowest stimulator intensity required to elicit 5 MEPs that exceeded 20% maximal voluntary isometric contraction from 10 stimulations. TMS data were obtained from 10 participants on 2 separate days and compared using random-effect intra-class correlation coefficients (ICCs). Slopes from two input-output curve fitting methods as well as the maximum MEP of gluteus maximus and vastus lateralis were found to exhibit good to excellent reliability (ICCs ranging from 0.75 to 0.99). The described TMS method using EMG-normalized criteria for motor thresholding produced reliable results utilizing a relatively low number of TMS pulses.

Lower Extremity Support Moment and Distribution of Joint Moments during Sloped Running

The existing literature often exhibits inconsistent findings regarding lower extremity kinetics during sloped running, likely due to high variability of typical individual joint moments between and within runners. A better understanding of the kinetic effects of sloped running may be achieved by comparing the support moment and joint contributions among level, upslope, and downslope running. Twenty recreational runners (10 females) ran on three different conditions (level, 6° upslope and 6° downslope). Total support moment and joint contributions of the hip, knee, and ankle joints were compared among the three slope conditions using a one-way ANOVA with repeated measures and post-hoc pairwise comparisons. Our results showed that peak total support moment was highest during upslope running and was lowest during downslope running. The joint contribution to total support moment was similar in upslope and level running where the ankle joint has highest contribution followed by the knee and hip joints. During downslope running, highest knee joint contribution but least ankle and hip joint contributions were found when compared to level and upslope running.

Corticomotor excitability of gluteus maximus and hip extensor strength: The influence of sex

PURPOSE

To compare hip extensor strength and corticomotor excitability (CME) of gluteus maximus (GM) between males and females. A secondary purpose was to determine if CME of GM is predictive of hip extensor strength.

METHOD

Thirty-two healthy individuals participated (15 males and 17 females). CME of GM was assessed using the input-output curve (IOC) procedure acquired from transcranial magnetic stimulation (average slope). Hip extensor strength was measured by a dynamometer during a maximal voluntary isometric contraction. Independent t-tests were used to compare CME of GM and peak hip extensor torque between males and females. Linear regression analysis was used to determine whether peak hip extensor torque was predicted by CME of GM.

RESULT

Compared to males, females demonstrate lower peak hip extensor torque (4.42 ± 1.11 vs. 6.15 ± 1.72 Nm/kg/m2, p < 0.01) and lower CME of GM (1.36 ± 1.07 vs. 2.67 ± 1.30, p < 0.01). CME of GM was a significant predictor of peak hip extensor torque for males and females combined (r² = 0.36, p < 0.001).

CONCLUSION

Our findings support the premise that corticomotor excitability plays a role in the ability of a muscle to generate torque.

Corticomotor Excitability of Gluteus Maximus Is Associated with Hip Biomechanics During a Single-Leg Drop-Jump

The purpose of this study was to determine the association between corticomotor excitability (CME) of gluteus maximus (GM) and hip biomechanics during a single-leg drop-jump task. Thirty-two healthy individuals participated. The slope of the input-output curve (IOC) obtained from transcranial magnetic stimulation was used to assess CME of GM. The average hip extensor moment and peak hip flexion angle during the stance phase of the drop jump task was calculated. The slope of the IOC of GM was found to be a predictor of the average hip extensor moment (r² = 0.18, p = 0.016) and peak hip flexion angle (r² = 0.20, p = 0.01). Our results demonstrate that greater functional use of the hip was associated with enhanced descending neural drive of GM.

Optimal shear cushion stiffness at different gait speeds

The present study quantified the effects of different shear cushion stiffness on the time to peak posterior shear force (TPPSF), peak posterior shear force (PPSF), average posterior loading rate (APLR), and maximum posterior loading rate (MPLR) at different locomotion speeds using a custom-made sliding platform, as well as to identify the optimal stiffness of shear cushion. Twelve male collegiate students (heel-strikers) performed walking at 1.5 m/s, jogging at 2.5 m/s, and running at 3.5 m/s. A custom-made sliding platform was used to provide the different shear cushion conditions. The shear cushion conditions were fixed (a fixed platform; control group), stiff (K = 2746 N/m), medium stiff (K = 2256 N/m), medium soft (K = 1667 N/m), and soft (K = 1079 N/m). The results showed that all cushion conditions produced sliding displacement and delayed the TPPSF during walking, jogging, and running compared with fixed condition. The APLR and MPLR were lowest under medium soft condition during walking, while the PPSF was similar between medium soft and soft conditions. For jogging and running, the PPSF as well as APLR and MPLR were the lowest under medium stiff condition except the maximum PLR was similar among stiff, medium stiff, and medium soft conditions during running. In conclusion, shear cushion produces appropriate sliding displacement and effectively delays the TPPSF to provide the musculoskeletal system additional time to absorb the impact and reduce loading. The present study demonstrates optimal stiffness of shear cushion at different traveling speeds and suggests that a shear cushion system can be applied in future designs of cushion structures.

Combination of arginine, glutamine, and omega-3 fatty acid supplements for perioperative enteral nutrition in surgical patients with gastric adenocarcinoma or gastrointestinal stromal tumor (GIST): A prospective, randomized, double-blind study

Background

Perioperative enteral nutrition (EN) enriched with immune-modulating substrates is preferable for patients undergoing major abdominal cancer surgery. In this study, perioperative EN enriched with immune-modulating nutrients such as arginine, glutamine, and omega-3 fatty acids was evaluated for its anti-inflammatory efficacy in patients with gastric adenocarcinoma or gastrointestinal stromal tumor (GIST) receiving curative surgery.

Materials and Methods

This prospective, randomized, double-blind study recruited 34 patients with gastric adenocarcinoma or gastric GIST undergoing elective curative surgery. These patients were randomly assigned to the study group, receiving immune-modulating nutrient-enriched EN, or the control group, receiving standard EN from 3 days before surgery (preoperative day 3) to up to postoperative day 14 or discharge. Laboratory and inflammatory parameters were assessed on preoperative day 3 and postoperative day 14 or at discharge. Adverse events (AEs) and clinical outcomes were documented daily and compared between groups.

Results

No significant differences were observed between the two groups in selected laboratory and inflammatory parameters, or in their net change, before and after treatment. AEs and clinical outcomes, including infectious complications, overall complications, time to first bowel action, and length of hospital stay after surgery, were comparable between treatment groups (all P > 0.05).

Conclusion

Immune-modulating nutrient-enriched EN had no prominent immunomodulation effect compared with that of standard EN.

Walking beyond preferred transition speed increases muscle activations with a shift from inverted pendulum to spring mass model in lower extremity

BACKGROUND

The triggers for the transition of gait from walking to running during increasing speed locomotion have been attributed to an energy conservation strategy or a relief of excessive muscle activation. Walking beyond the preferred transition speed (PTS) has been proposed as an exercise protocol for boosting energy consumption. However, the biomechanical factors involved while this protocol is used have not been investigated. Thus, this study investigated the difference between walking and running below, during, and beyond the PTS from a biomechanical perspective.

METHODS

Sixteen healthy male participants were recruited. After determination of their PTS, five speeds of walking and running were defined. Kinematic data, including center-of-mass (COM) displacement, COM acceleration, and electromyography (EMG) data of rectus femoris (RF), biceps femoris, gastrocnemius (GAS), and tibialis anterior were collected at the five speeds for both walking and running.

RESULT

The vertical COM displacement and acceleration in running were significantly larger than those in walking at all five speeds (p<0.05). EMG signals of the two antigravity muscles, RF and GAS, demonstrated a significant higher activation in walking than that in running at the speed beyond PTS (p<0.05).

CONCLUSION

The larger energy consumption in walking than that in running beyond the PTS may be attributed to the high activation of lower-extremity muscles. The smaller vertical COM displacements and accelerations exhibited when participants walked beyond the PTS rather than ran did not indicate adverse effects of using walking beyond the PTS as an exercise prescription for boosting energy consumption.

The force output of handle and pedal in different bicycle-riding postures

The purpose of this study was to analyse the force output of handle and pedal as well as the electromyography (EMG) of lower extremity in different cycling postures. Bilateral pedalling asymmetry indices of force and EMG were also determined in this study. Twelve healthy cyclists were recruited for this study and tested for force output and EMG during steady state cycling adopting different pedalling and handle bar postures. The standing posture increased the maximal stepping torque (posture 1: 204.2 ± 47.0 Nm; posture 2: 212.5 ± 46.1 Nm; posture 3: 561.5 ± 143.0 Nm; posture 4: 585.5 ± 139.1 Nm), stepping work (posture 1: 655.2 ± 134.6 Nm; posture 2: 673.2 ± 116.3 Nm; posture 3: 1852.3 ± 394.4 Nm; posture 4: 1911.3 ± 432.9 Nm), and handle force (posture 1: 16.6 ± 3.6 N; posture 2: 16.4 ± 3.6 N; posture 3: 26.5 ± 8.2 N; posture 4: 41.4 ± 11.1 N), as well as muscle activation (posture 1: 13.6-25.1%; posture 2: 13.0-23.9%; posture 3: 23.6-61.8%; posture 4: 22.5-65.8%) in the erector spine, rectus femoris, tibialis anterior, and soleus. However, neither a sitting nor a standing riding posture affected the hamstring. The riding asymmetry was detected between the right and left legs only in sitting conditions. When a cyclist changes posture from sitting to standing, the upper and lower extremities are forced to produce more force output because of the shift in body weight. These findings suggest that cyclists can switch between sitting and standing postures during competition to increase cycling efficiency in different situations. Furthermore, coaches and trainers can modify sitting and standing durations to moderate cycling intensity, without concerning unbalanced muscle development.

Has racial difference in cause-specific death improved in older patients with late-stage breast cancer?

BACKGROUND

Research on temporal mortality trends for stage IV breast cancer is limited, especially among older patients by race. We evaluated factors associated with overall, breast cancer-specific and other-cause mortalities using contemporary population data.

PATIENTS AND METHODS

Using the Surveillance, Epidemiology, and End Results-Medicare linked data, we identified older women (≥ 66 years) with stage IV breast cancer diagnosed in 2002-2009. Overall mortality was estimated by the Kaplan-Meier method, compared by log-rank tests, and modeled by Cox models. Competing risk analysis was used to evaluate breast cancer-specific and other-cause mortalities.

RESULTS

The median overall survival time for non-Hispanic blacks improved from 8.6 months in 2002-2003 to 9.9 months in 2007-2009, whereas that for non-Hispanic whites improved from 12.1 to 14.8 months. In the multivariate model, the risk of breast cancer-specific death for patients diagnosed in 2007-2009 was significantly lower (P = 0.02), whereas the risk of other-cause mortality changed little (P = 0.88) compared with those risks for patients diagnosed in 2002-2003. Non-Hispanic blacks had the higher risk of both mortality types compared with non-Hispanic whites; a diagnosis time-race interaction term was not statistically significant for either cause of death.

CONCLUSION

Breast cancer-specific mortality among older women modestly improved from 2002 to 2009 across all races, but not other-cause mortality. Racial disparity in mortality persisted, but did not widen in this period. Efforts should be devoted to improving other-cause mortality for all women, with special attention toward decreasing breast cancer mortality for non-Hispanic black women.

Assessment of walking, running, and jumping movement features by using the inertial measurement unit

PURPOSE

To observe various modes of lower limb locomotion, an inertial measurement unit (IMU) was used. Digital signals were used to identify signal characteristics that help to distinguish among locomotion modes and intensity levels.

METHODS

A wireless IMU was installed on the outside of shoes and three forms of locomotion (walking, running, and jumping) were assessed at two intensity levels (low and high) to observe the acceleration, foot angular velocity variations, and characteristics of the curve variations in the anteroposterior, mediolateral, and superior-inferior directions.

RESULTS

Most interactions between intensity and locomotion were statistically significant, except for the acceleration in the anteroposterior direction and on the horizontal plane. In addition, as the intensity increased, the values of all the parameters increased. Thus, both the acceleration values and range of angular velocity variation can be used to distinguish the intensity levels. Moreover, the results indicated that the angular velocity in the frontal axis, which is the sequence of the plantar/dorsiflexion movements, can also be used to identify different locomotion.

CONCLUSIONS

Uniaxial acceleration or the range of angular velocity variation could be used to identify locomotion intensities, whereas the characteristics of the uniaxial angular velocity curve could be used to identify the locomotion modes.

Shear cushions reduce the impact loading rate during walking and running

In addition to vertical ground reaction force (GRF), anterior-posterior GRF with a greater external moment arm may be another repetitive impact force that contributes to overuse running injuries. In this study, a shear cushion device was placed between the sole of a shoe and the ground to reduce not only the vertical loading, but also the anterior-posterior loading while walking and running. For this study, 15 healthy male runners classified as heel strikers (height: 173.2 +/- 4.7 cm, mass: 68.5 +/- 5.6 kg) were recruited. Participants were required to walk (2.5 m/s), jog (3.5 m/s), and run (4.2 m/s) while wearing shoes with three different sole groove designs (conventional, straight groove, and 45 degrees groove). Both the straight and 45 degrees groove soles provided significant shear shift during walking, jogging, and running, as well as delayed the time to first peak anterior-posterior GRF during walking. The straight groove sole reduced the vertical loading rate during jogging (p = 0.010) and running (p = 0.010), and delayed the time to first peak vertical GRF in all gait conditions. These findings suggest that the vertical loading rate and the time to the first peak anterior-posterior GRF can be changed by the sole groove design under various gait conditions.

Is the foot striking pattern more important than barefoot or shod conditions in running?

People have advocated barefoot running, claiming that it is better suited to human nature. Humans usually run barefoot using a forefoot strike and run shod using a heel strike. The striking pattern was thought to be a key factor that contributes to the benefit of barefoot running. The purpose of this study is to use scientific data to prove that the striking pattern is more important than barefoot or shod conditions for runners on running injuries prevention. Twelve habitually male shod runners were recruited to run under four varying conditions: barefoot running with a forefoot strike, barefoot running with a heel strike, shod running with a forefoot strike, and shod running with a heel strike. Kinetic and kinematic data and electromyography signals were recorded during the experiments. The results showed that the lower extremity can gain more compliance when running with a forefoot strike. Habitually shod runners can gain more shock absorption by changing the striking pattern to a forefoot strike when running with shoes and barefoot conditions. Habitually shod runners may be subject to injuries more easily when they run barefoot while maintaining their heel strike pattern. Higher muscle activity in the gastrocnemius was observed when running with a forefoot strike, which may imply a greater training load on the muscle and a tendency for injury.

Determination of codeine in urine and drug formulations using a clay-modified screen-printed carbon electrode

Both flow-injection analysis and square-wave stripping voltammetry were evaluated for the determination of codeine in pharmaceutical formulations using a nontronite clay-modified screen-printed carbon electrode. Compared with a bare screen-printed carbon electrode, the nontronite clay-modified screen-printed carbon electrode exhibited a marked enhancement of the current response of codeine. A linear calibration plot was obtained over the 2.5-45 microM range (correlation coefficient=0.999) in pH 6.0 phosphate buffer solution with a detection limit of 20 nM (S/N=3) by square-wave voltammetry (SWV). While, in flow-injection analysis, the linearity was over 5-120 ng range with a detection limit of 1 ng in 20 microl loop. The nontronite clay-modified screen-printed carbon electrode can be either disposable or reused since the renewal gave a good reproducible surface. Quantitative analysis was performed by the standard addition method for codeine content in both urine and commercially available drugs.

Two-photon diffraction and quantum lithography

We report a proof-of-principle experimental demonstration of quantum lithography. Utilizing the entangled nature of a two-photon state, the experimental results have beaten the classical diffraction limit by a factor of 2. This is a quantum mechanical two-photon phenomenon but not a violation of the uncertainty principle.

Simultaneous determination of magnesium L-ascorbyl-2-phosphate and kojic acid in cosmetic bleaching products by using a microbore column and ion-pair liquid chromatography

A rapid, sensitive, and reliable method was developed for the simultaneous determination of magnesium L-ascorbyl-2-phosphate (AS-PM) and kojic acid (KA), commonly using bleaching agents in cosmetic products. The method uses a prepacked C18 microbore column for ion-pair liquid chromatography with photodiode array detection. The eluant is 0.5mM tetrabutylammonium bromide and 0.05M phosphate buffer, pH 5, containing 5% methanol, at a flow rate of 70 microL/min. The determinations of AS-PM and KA were linear in the range of 0.5-1,000 and 0.25-500 ng, respectively. The precision of the assay ranged from 0.31 to 2.19%, and the detection limits (signal-to-noise ratio = 3) were 0.04 and 0.02 ng for AS-PM and KA, respectively.

Quantum teleportation of a polarization state with a complete bell state measurement

We report a quantum teleportation experiment in which nonlinear interactions are used for the Bell state measurements. The experimental results demonstrate the working principle of irreversibly teleporting an unknown arbitrary polarization state from one system to another distant system by disassembling into and then later reconstructing from purely classical information and nonclassical EPR correlations. The distinct feature of this experiment is that all four Bell states can be distinguished in the Bell state measurement. Teleportation of a polarization state can thus occur with certainty in principle.

Determination of sunscreen agents in cosmetic products using microwave-assisted extraction and liquid chromatography

Microwave-assisted extraction (MAE), was used to extract sunscreen agents from cosmetic products. The extracts were analyzed by liquid chromatography (LC). The present method allows the determination of three sunscreen agents, Eusolex 2292, 4360 and 6300. The precision of the assay at 40 microg/ml of sunscreen agents ranged from 1.5 to 2.2%, and the detection limits were 2.0-4.0 ng/ml.

Delayed "Choice" quantum eraser

We report a delayed "choice" quantum eraser experiment of the type proposed by Scully and Druhl (where the "choice" is made randomly by a photon at a beam splitter). The experimental results demonstrate the possibility of delayed determination of particlelike or wavelike behavior via quantum entanglement. The which-path or both-path information of a quantum can be marked or erased by its entangled twin even after the registration of the quantum.

Voltammetric determination of caffeine in beverages using a chemically modified electrode

A Nafion-ruthenium oxide pyrochlore chemically modified electrode is used for the determination of caffeine in beverages by square-wave voltammetry. Compared to a bare glassy carbon electrode, the chemically modified electrode exhibits a marked enhancement of the current response. A linear calibration curve is obtained over the 5-200 microns range in 0.05 M HCIO4 solution with a detection limit (3 delta) of 2 micron. The results of 15 successive repetitive measurement-regeneration cycles showed a relative standard deviation of 2.7% for 10 micron caffeine. Thus, the electrode renewal gives a good reproducible surface. Quantitative analysis was performed by the standard addition method for caffeine content in tea, coffee, decaffeinated coffee, and cola beverages.

New dual electrochemical detector for microbore liquid chromatography. Determination of dopamine and serotonin in rat striatum dialysates

A new type of liquid chromatographic (LC) dual thin-layer amperometric detector for the simultaneous measurement of trace levels of dopamine and serotonin in microdialysates is described. The concentrations of these analytes in rat dialysates are usually in the sub-nanomolar concentration range (typically, 0.10-5.00 pg in 5-microl dialysates). With this dual electrode, a glass-lined microbore column provides excellent sensitivity, selectivity, and separation. In addition, a three- to five-fold improvement in anodic current or cathodic responses over conventional dual electrodes in microbore LC can be achieved. Due to the irreversible electrochemical properties of some interference peaks, this dual electrode provides reliable measurement of dopamine based on the cathodic signal. The detection limit (signal-to-noise ratio = 3) of this assay is 0.02 pg per injection for dopamine or serotonin. This new dual electrode allows the simultaneous measurements of basal dopamine and serotonin in rat striatum dialysates without the use of re-uptake inhibitors in perfusion medium.

Rapid and reliable high-performance liquid chromatographic method for analysing human plasma serotonin, 5-hydroxyindoleacetic acid, homovanillic acid and 3,4-dihydroxyphenylacetic acid

The simultaneous measurement of homovanillic acid, 3,4-dihydroxyphenylacetic acid, serotonin and 5-hydroxyindoleacetic acid in human plasma by an ultrafiltration and microbore high-performance liquid chromatography-electrochemical detection technique is established. Conventional preparation of blood is very tedious and time-consuming, but isocratic separation of the analytes in plasma ultrafiltrates using a microbore column could be achieved within 10 min. Hence, theoretically, over 140 analyses can be performed in a working day. The detection limit (signal-to-noise ratio = 3) of this method is about 0.1-0.5 pg per injection for all analytes. The required volume of plasma samples can be less than 100 microliters. Hence, blood loss is minimal, especially in repeated blood sampling. This rapid, simple and sensitive method can, therefore, be used as a routine clinical tool in the simultaneous measurement of plasma homovanillic acid, 3,4-dihydroxyphenylacetic acid, serotonin and 5-hydroxyindoleacetic acid.

Simultaneous measurement of serotonin, catecholamines and their metabolites in mouse brain homogenates by high-performance liquid chromatography with a microbore column and dual electrochemical detection

A dual electrochemical detector with two working electrodes (anode and cathode) suitable for high-performance liquid chromatography with a microbore octadecylsilica column was applied for the simultaneous measurement of norepinephrine, epinephrine, dopamine, 3,4-dihydroxyphenylacetic acid, homovanillic acid, 5-hydroxyindoleacetic acid, 3-methoxytyramine and 5-hydroxytryptamine (serotonin) in mouse brain homogenates. Microbore high-performance liquid chromatography provides very good resolution of these analytes and offers selective detection of biogenic amines and their metabolites on the basis of their retention behaviour and electrochemical reversibility. The large early-eluting peak of brain homogenates was eliminated on cathodic detection, thereby providing reliable measurements of early eluates. The detection limit of this method was ca. 0.2-0.5 pg per injection for all components, at a signal-to-noise ratio of 3. Owing to the high sensitivity, the brain tissue samples could be kept very small (less than 10 mg). Isocratic separation of these analytes was achieved within 15 min; hence over 90 analyses could be performed in a single working day. This simple, efficient and sensitive method can be used as a basic research tool for the assaying of biogenic amines and their metabolites in brain homogenates.

Suppression and transient induction of lymphokines in cancer patients after administration of polyethylene glycolated interleukin-2

Polyethylene glycolated (pegylated) interleukin-2 (PEG IL-2) was administered as a weekly i.v. bolus to patients with metastatic cancer in a phase-I trial. Efficacy, toxicity and pharmacokinetics have been described previously. To explore mechanism of IL-2 action and discover predictors of efficacy, the levels of several lymphokines were measured in pharmacokinetic serum samples. IL-1 beta and IL-6 were elevated in many patients before PEG IL-2 administration, forming a continuous, log-normal distribution among patients. The levels of the two lymphokines were strongly correlated. However, no significant correlation could be found between these levels, clinical chemistry, or tumor regression seen after PEG IL-2 administration. Three hours after PEG IL-2 administration, IL-1 beta and IL-6 levels, if elevated, fell to normal. In all patients, independent of initial levels, IL-6 and IFN-gamma, but not IL-1 beta, increased 4 to 6 h after the injection and then fell rapidly, even though PEG IL-2 levels were high and often changed only slightly during this period. This suggests an active shut down of lymphokine synthesis, or an increase in elimination rate. After the fourth administration of PEG IL-2, the peak level of IFN-gamma was 2 to 20 times higher than after the first, while the peak level of IL-6 did not change in a consistent direction. Responding patients had typical peak levels of IL-6 and IFN-gamma. Low levels of TNF and IL-4 were occasionally seen before and after PEG IL-2 administration, but no consistent pattern was evident.

Botulism in China

During the period 1958-1983, 986 outbreaks of botulism occurred in China, affecting 4,377 individuals and resulting in 548 deaths. The initial cases of botulism were found in Xinjiang province, where the incidence was highest. Outbreaks have occurred in all of the northern provinces and in some of the southern provinces of China. The toxin found most frequently in the northwest region of China was type A; in north China, type B; and in the northeast, type E. The most frequently offending food was home-made strong-smelling preserved bean curd, which was implicated in 74% of the outbreaks. The complex clinical manifestations of botulism can be grouped into those affecting the eyes, the mouth, the pharynx, and the skeletal muscles. Following the institution of effective methods of prevention and treatment, epidemics of botulism in China have been controlled and the mortality rate reduced from 41% (1950s) to 7.6% (1983).