Prenatal exposure to nickel and atopic dermatitis at age 3 years: a birth cohort study with cytokine profiles

BACKGROUND

Nickel, the fifth most common element on Earth, is the leading inducer of contact allergies in humans, with potent immunological effects. Nickel-induced contact allergies predominantly affect females. Maternal exposure to nickel has been associated with several developmental abnormalities. However, how a maternal nickel exposure affects the development of atopic diathesis and immune abnormalities in children has never been addressed.

OBJECTIVES

We aimed to determine whether maternal Ni exposure affects the development of atopic dermatitis and immune abnormalities in their children.

METHODS

Using a birth cohort study, we analysed 140 mother-child pairs recruited in 2012-2015 from central Taiwan. Maternal exposure to nickel was estimated using urinary nickel levels measured by inductively coupled plasma mass spectrometry (ICP-MS). The serum levels of 65 analytes and IgE in 3-year-old children were profiled with a multiplex ELISA. The correlation between the maternal urinary nickel concentration and serum analyte levels was assessed using Spearmen's correlation. Multivariant regression analysis was performed to evaluate the association between maternal urinary nickel levels and serum analyte concentrations in their children.

RESULTS

The geometric means of the maternal urinary nickel and the children's serum IgE levels were 2.27 μg/L and 69.71 IU/ml, respectively. The maternal nickel exposure was associated with increased serum levels of IL-1β, IL-2, TNF-α, and leukaemia inhibitory factor (LIF) but with decreased serum levels of matrix metalloproteinase-1 (MMP-1), IL-2R, and eotaxin-1 in the children. In addition, the development of childhood atopic dermatitis at 3 years old was significantly associated with the child's serum levels of IgE and IL-2R, but it was negatively associated with the maternal nickel exposure.

CONCLUSIONS

This is the first study showing the potential immunological effects of maternal nickel exposure in their children at an early developmental stage.

P–570 Embryos originating from oocytes with smooth endoplasmic reticulum clusters have a lower euploidy rate via PGT-A testing using next-generation sequencing

Study question

Does the presence of smooth endoplasmic reticulum clusters (sERCs) in oocytes affect the human embryo ploidy?

Summary answer

The euploidy rate of embryos originating from sERCs + oocytes is lower

What is known already

While an expert panel strongly recommended that sERCs+ oocytes should not be inseminated, some normal healthy babies derived from sERCs+ oocytes have been reported. In previous studies have shown that declined fertilization rate and lower proportions of good quality embryos are found in oocytes showing sERCs. The updating findings of the molecular status of sERC+ oocytes elucidated the sERCs+ oocytes may have impaired chromosomal segregation ability. However, no study reveals the relation between sERCs and embryo ploidy.

Study design, size, duration

A retrospective study enrolled 129 preimplantation genetic testing (PGT) cycles from January 2017 to March 2020 at Chang Gung Memorial Hospital, Lonkou.

Participants/materials, setting, methods

ICSI fertilization rate, Day5 usable blastocyst rate (D5UBR), total usable blastocyst rate (TUBR), euploidy rate, mosaic rate, and aneuploidy rate are investigated between embryo originating from sERCs+ and sERCs- oocytes.

Main results and the role of chance

Although higher TBUR in blastocyst derived from sERCs+ oocytes than sERCs- group (73.7% vs. 62.5%) but accompanied lower euploidy rate (7% vs. 29%) and higher aneuploid rate (79% vs. 54%).

Limitations, reasons for caution

Limited sample size, need a large-scale study to confirm the conclusion. The live-birth rate per embryo transfer cycle was not included for analysis. As we did not perform polar body analysis, we cannot state for sure that embryonic aneuploidy was related to the oocyte.

Wider implications of the findings: This study demonstrates that embryos originating from sERCs+ oocytes have a lower euploidy rate.

Trial registration number

CMRPG3H0751

Magnesium oxide and hip fracture in the elderly: a population-based retrospective cohort analysis

Using national insurance claims of Taiwan, we found that magnesium oxide (MgO) use is associated with an increased risk of hip fracture in the elderly. Further studies are warranted to explore the mechanisms associated with MgO use that lead to hip fracture.

PURPOSE

The purpose of this study was to investigate the association between MgO use and hip fracture risk in the elderly (age > 65 years).

METHODS

This nationwide population-based retrospective study was conducted from 1996 to 2013. Individuals with (n = 26,069) and without (n = 26,069) MgO use were enrolled after propensity score matching. Primary outcome was a hip fracture. After adjusting for age, sex, comorbidities, and medications, multivariate Cox proportional hazards regression models were used to calculate incidences and risk of hip fracture [hazard ratio (HR)].

RESULTS

During the mean follow-up duration of 4.8 years in the MgO cohort and 5.7 years in the non-MgO cohort, respectively 1547 and 1107 cases developed a hip fracture. MgO use was identified as a risk factor for hip fracture in both univariate [crude HR, 1.68; 95% confidence interval (CI), 1.55-1.81; p < 0.001] and multivariate [adjusted HR (aHR), 1.66; 95% CI, 1.54-1.80; p < 0.001] Cox proportional hazards regression models. The cumulative incidence of hip fracture was significantly higher in the MgO cohort than in the non-MgO cohort (1.23 per 100 person-years vs. 0.74 per 100 person-years, logrank test, p < 0.001).

CONCLUSION

MgO use is an independent risk factor for hip fracture in the elderly.

Broadband, millimeter-wave antireflection coatings for large-format, cryogenic aluminum oxide optics

We present two prescriptions for broadband ($ {\sim} 77 - 252\;{\rm GHz} $), millimeter-wave antireflection coatings for cryogenic, sintered polycrystalline aluminum oxide optics: one for large-format (700 mm diameter) planar and plano-convex elements, the other for densely packed arrays of quasi-optical elements-in our case, 5 mm diameter half-spheres (called "lenslets"). The coatings comprise three layers of commercially available, polytetrafluoroethylene-based, dielectric sheet material. The lenslet coating is molded to fit the 150 mm diameter arrays directly, while the large-diameter lenses are coated using a tiled approach. We review the fabrication processes for both prescriptions, then discuss laboratory measurements of their transmittance and reflectance. In addition, we present the inferred refractive indices and loss tangents for the coating materials and the aluminum oxide substrate. We find that at 150 GHz and 300 K the large-format coating sample achieves $ (97 \pm 2)\% $ transmittance, and the lenslet coating sample achieves $ (94 \pm 3)\% $ transmittance.

Detection of CMB-Cluster Lensing using Polarization Data from SPTpol

We report the first detection of gravitational lensing due to galaxy clusters using only the polarization of the cosmic microwave background (CMB). The lensing signal is obtained using a new estimator that extracts the lensing dipole signature from stacked images formed by rotating the cluster-centered Stokes QU map cutouts along the direction of the locally measured background CMB polarization gradient. Using data from the SPTpol 500  deg^{2} survey at the locations of roughly 18 000 clusters with richness λ≥10 from the Dark Energy Survey (DES) Year-3 full galaxy cluster catalog, we detect lensing at 4.8σ. The mean stacked mass of the selected sample is found to be (1.43±0.40)×10^{14}M_{⊙} which is in good agreement with optical weak lensing based estimates using DES data and CMB-lensing based estimates using SPTpol temperature data. This measurement is a key first step for cluster cosmology with future low-noise CMB surveys, like CMB-S4, for which CMB polarization will be the primary channel for cluster lensing measurements.

Extensively drug-resistant tuberculosis in Myanmar: burden and mutations causing second-line drug resistance

SETTING

Two tuberculosis (TB) reference laboratories in Myanmar.

OBJECTIVES

To determine the proportion of extensively drug-resistant TB (XDR-TB) cases among multidrug-resistant TB (MDR-TB) cases and the mutations that cause resistance to second-line drugs in Myanmar.

DESIGN

This was a cross-sectional, retrospective study. Multidrug-resistant Mycobacterium tuberculosis isolates were collected during 2015-2016. Phenotypic drug susceptibility testing (DST) was performed and drug-resistant mutations identified by sequencing. Genotypes were determined to explain relationships between drug resistance patterns and genotypes.

RESULTS

Of 89 MDR-TB isolates, 12 were XDR-TB and 24 were pre-XDR-TB, with 21 resistant to fluoroquinolones (FQs) and 3 to second-line injectable agents (SLIDs). High rates of cross-resistance among second-line drugs were observed. Correlations between phenotypic and molecular DST against FQs and SLIDs were 91% in both cases. The most frequent mutation in FQ-resistant isolates was D94G (8/21) in gyrA and A1401G (11/15) in rrs in those resistant to SLIDs. The dominant genotype was the Beijing type (76/89).

CONCLUSION

There were high proportions of XDR-TB and pre-XDR-TB among MDR-TB cases; cross-resistance among second-line drugs was high, with various types of genetic mutations. These data suggest that resistance to second-line anti-tuberculosis drugs should be monitored intensively, and molecular DST should be employed.

HLA-A*33:74N, a novel HLA-A*33 variant, identified by sequence-based typing in a Taiwanese individual

A one nucleotide replacement in codon 803 of HLA-A*33:03:01 results in a novel allele, HLA-A*33:74N.

HLA-B*40:247, a novel HLA-B*40 variant, identified by sequence-based typing in a Taiwanese individual

A one nucleotide replacement in codon 261 of HLA-B*40:01:01 results in a novel allele, HLA-B*40:247.

HLA-A*11:134, a novel HLA-A*11 variant, identified by sequence-based typing in a Taiwanese individual

A one nucleotide replacement in codon 31 of HLA-A*11:01:01 results in a novel allele, HLA-A*11:134.

Ethnicity as an independent predictive factor for the results of computed tomography pulmonary angiography and ultrasonography of the lower limbs

BACKGROUND

Asians, Pacific Islanders and Maori have significantly lower rates of venous thromboembolism (VTE) compared to Europeans, but its clinic implication regarding diagnosis and prevention is unclear.

AIMS

To investigate if ethnicity affects the yield of computed tomography pulmonary angiography (CTPA) and ultrasonography of the lower limbs.

METHODS

Data previously collected for 523 patients from another study were used to analyse the effect of ethnicity on the results of CTPA; 1587 consecutive ultrasonography of lower limbs was retrospectively analysed according to ethnicity. The Wells score was retrospectively calculated to determine the pretest probability of VTE.

RESULTS

The positive rates of CTPA were 23.3% for European patients and 9.3% for non-European patients. The rate ratio was 2.50 (confidence interval [CI] 1.27-4.95). European patients were 2.5 times more likely to have a positive scan result than non-Europeans, given same pretest probability. There was a larger difference among patients with low and moderate pretest probability with a rate ratio of 4.27 (CI 1.62-11.3). The positive rates of ultrasound scans (USS) among European patients were 16.6 and 9.0% for non-European patients. Rate ratio was 1.85 (CI 1.27-4.95). The difference was also more significant amongst patients with low and moderate pretest probability. The rate ratio was 2.31 (CI 1.38-3.86) for European patients compared to non-European patients.

CONCLUSION

Given the same pretest probability according to the Wells score, European patients had significantly higher positive rates of CTPA and ultrasonography of the lower limbs than non-European patients. Further prospective studies are required to confirm our findings and establish an appropriate pretest assessment tool for non-European patients.

A novel allele, HLA-B*15:259, was identified in a Taiwanese individual by sequence-based typing

A one nucleotide replacement in codon 24 of HLA-B*15:54 results in a novel allele, HLA-B*15:259.

Applying the Back-Propagation Neural Network model and fuzzy classification to evaluate the trophic status of a reservoir system

The trophic state index, and in particular, the Carlson Trophic State Index (CTSI), is critical for evaluating reservoir water quality. Despite its common use in evaluating static water quality, the reliability of the CTSI may decrease when water turbidity is high. Therefore, this study examines the reliability of the CTSI and uses the Back-Propagation Neural Network (BPNN) model to create a new trophic state index. Fuzzy theory, rather than binary logic, is implemented to classify the trophic status into its three grades. The results show that compared to the CTSI with traditional classification, the new index with fuzzy classification can improve trophic status evaluation with high water turbidity. A reliable trophic state index can correctly describe reservoir water quality and allow relevant agencies to address proper water quality management strategies for a reservoir system.

Cardiac dysfunction and N-terminal pro-B-type natriuretic peptide in exacerbations of chronic obstructive pulmonary disease

Elevated levels of B-type natriuretic peptides among patients with exacerbations of chronic obstructive pulmonary disease (COPD) are associated with higher mortality. The pathophysiology is unclear. To establish if elevated levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) are due to right or left heart dysfunction, we performed echocardiograms in 18 patients admitted to hospital with COPD. Elevated levels of NT-proBNP were associated with both right and left heart dysfunction and indicate that these patients have biventricular dysfunction rather than isolated right ventricular compromise.

Detection of B-mode polarization in the cosmic microwave background with data from the South Pole Telescope

Gravitational lensing of the cosmic microwave background generates a curl pattern in the observed polarization. This "B-mode" signal provides a measure of the projected mass distribution over the entire observable Universe and also acts as a contaminant for the measurement of primordial gravity-wave signals. In this Letter we present the first detection of gravitational lensing B modes, using first-season data from the polarization-sensitive receiver on the South Pole Telescope (SPTpol). We construct a template for the lensing B-mode signal by combining E-mode polarization measured by SPTpol with estimates of the lensing potential from a Herschel-SPIRE map of the cosmic infrared background. We compare this template to the B modes measured directly by SPTpol, finding a nonzero correlation at 7.7σ significance. The correlation has an amplitude and scale dependence consistent with theoretical expectations, is robust with respect to analysis choices, and constitutes the first measurement of a powerful cosmological observable.

Detection and identification of occult HBV in blood donors in Taiwan using a commercial, multiplex, multi-dye nucleic acid amplification technology screening test

BACKGROUND

The ability of a new generation commercial, multiplex, multi-dye test from Roche, the cobas TaqScreen MPX test, version 2.0, to detect and identify occult HBV infections was evaluated using routine donor samples from Kaohsiung Blood Bank, Taiwan.

STUDY DESIGN AND METHODS

A total of 5973 samples were tested by nucleic acid amplification technology (NAT); 5898 in pools of six, 66 in pools of less than six and nine samples individually. NAT-reactive samples were retested with alternative NAT tests, and follow-up samples from the donors were tested individually by NAT and for all the HBV serological markers.

RESULTS

Eight NAT-only-reactive donors were identified, and follow-up samples were obtained from six of the donors. The results indicated that all eight donors had an occult HBV infection with viral loads <12 IU/ml.

CONCLUSION

The cobas(®) TaqScreen MPX test, version 2.0, has an advantage over the current Roche blood screening test, the cobas TaqScreen MPX test, for screening donations in countries with a high prevalence of occult HBV infections since the uncertainty associated with identifying samples with very low viremia is removed by the ability of the test to identify the viral target in samples that are reactive with the cobas TaqScreen MPX test, version 2.0.

Frequency multiplexed superconducting quantum interference device readout of large bolometer arrays for cosmic microwave background measurements

A technological milestone for experiments employing transition edge sensor bolometers operating at sub-Kelvin temperature is the deployment of detector arrays with 100s-1000s of bolometers. One key technology for such arrays is readout multiplexing: the ability to read out many sensors simultaneously on the same set of wires. This paper describes a frequency-domain multiplexed readout system which has been developed for and deployed on the APEX-SZ and South Pole Telescope millimeter wavelength receivers. In this system, the detector array is divided into modules of seven detectors, and each bolometer within the module is biased with a unique ∼MHz sinusoidal carrier such that the individual bolometer signals are well separated in frequency space. The currents from all bolometers in a module are summed together and pre-amplified with superconducting quantum interference devices operating at 4 K. Room temperature electronics demodulate the carriers to recover the bolometer signals, which are digitized separately and stored to disk. This readout system contributes little noise relative to the detectors themselves, is remarkably insensitive to unwanted microphonic excitations, and provides a technology pathway to multiplexing larger numbers of sensors.

Larval dietary wheat germ oil influences age-specific protein expression in adults of the oriental fruit fly

Changes in essential dietary components alter global gene expression patterns in animals. We reported on a proteomics study designed to identify molecular markers of deficiencies in culture media developed for the oriental fruit fly, Bactrocera dorsalis. In that study, we found significant changes in expression of 70 proteins in adults of larvae reared on media lacking wheat germ oil (WGO), compared to media supplemented with WGO. Of these, a gene encoding an insect chitin-binding protein was expressed at about 120-fold higher levels in adult males reared on media supplemented with WGO. We inferred it may be feasible to develop the gene as a molecular marker of dietary lipid deficiency. The work was focused, however, on analysis of 11 day old adults. We have no information on expression of the chitin-binding protein, nor on any other proteins at other adult ages. In this paper we address the idea that the whole animal proteome changes dynamically with age. We reared separate groups of fruit fly larvae on media with and without WGO supplementation and analyzed protein expression in adult males and females age 0, 4, 8 and 12 days old using 2D electrophoresis. Gel densitometry revealed significant increases (by >2-fold) and decreases (by >50%) in expression levels of 29 proteins in females and 10 in males. We identified these proteins by mass spectrometry on MALDI TOF/TOF and bioinformatic analyses of the protein sequences. Two proteins, peroxiredoxin (26-fold increase) and vitellogenin 1 (15-fold increase) increased in expression in day 8 females. The key finding is that most changes in protein expression occurred in day 8 females. We infer that the fruit fly proteome changes with adult age. The natural changes in proteome with adult age is a crucial aspect of developing these and other proteins into molecular markers of lipid deficiency in fruit flies and possibly other insect species.

Seasonal variation and health risk assessment of polycyclic aromatic hydrocarbons in Miaoli city, Taiwan

The ambient PAHs levels in the downtown area of a traditional small city were analyzed for winter and summer seasons. A total of 16 PAHs in gaseous and particulate phase were quantified. The average gaseous PAHs were 2,189 ± 1,194 and 623.8 ± 545.1 ng/m(3) in winter and summer seasons, respectively. For the PAHs in particulate phase, they were 40.32 ± 12.15 and 11.99 ± 5.63 ng/m(3) in winter and summer seasons, respectively. These values were comparable to those reported for large cities or even higher. The estimated BaPeq was 12.32 ± 6.34 ng/m(3). As low-molecular-weight PAHs primarily existed in gaseous phase, high-molecular-weight PAHs in particulate phase became a significant fraction of total particulate phase PAHs. Particulate phase PAHs was significantly inversely associated with the ambient temperature for each individual PAHs species. However, this relationship did not exist for high-molecular-weight PAHs in gaseous phase. The results indicated the photo-degradation of high-molecular-weight PAHs should warrant a further thoughtfully investigation.

Association between the interleukin-18 promoter polymorphism and pulmonary tuberculosis in a Korean population

OBJECTIVE

To examine the role of the -667G/T, -618A/C and -148G/C single nucleotide polymorphisms in the promoter region of the human interleukin (IL) 18 gene in the development of pulmonary tuberculosis (PTB), and its radiographic characteristics and severity.

DESIGN

Differences in the allele and genotype distributions of the -667G/T, -618A/C, and -148G/C polymorphisms between 251 patients with PTB and 225 healthy controls, between patients with single- and multilobe involvement, and between patients with and without cavities were explored. Serum IL-18 levels were measured using an enzyme-linked immunosorbent assay.

RESULTS

The -148G/G genotype was more common in patients with cavities than in those without (82.8% vs. 70.9%, P = 0.04), but an analogous trend was not observed for the -667G/T and -618A/C genotypes. However, there were no significant differences in allele and genotype distributions between patients with PTB and healthy controls, or between patients with single- and multilobe involvement (P > 0.05). Serum IL-18 levels were higher in patients with cavities (P = 0.01) and in patients with the -148G/G genotype (P = 0.02).

CONCLUSION

Considering serum IL-18 levels, the -148G/G genotype is associated with a cavitary formation of PTB rather than its development.

X-Ray spectra and electronic correlations of FeSe(1-x)Te(x)

Critical issues concerning emerging Fe-based superconductors include the degree of electron correlation and the origin of the superconductivity. X-Ray absorption spectra (XAS) and resonant inelastic X-ray scattering spectra (RIXS) of FeSe(1-x)Te(x) (x = 0-1) single crystals were obtained to study their electronic properties that relate to electron correlation and superconductivity. The linewidth of Fe L(2,3)-edges XAS of FeSe(1-x)Te(x) is narrower than that of Fe-pnictides, revealing the difference between their hybridization effects and localization character and those of other Fe-pnictides. While no significant differences exist between the Fe L-edge XAS and RIXS of FeSe(1-x)Te(x) and those of Fe-pnictides, Se K-edge and Te K-edge XAS exhibit substantial edge shift, suggesting that the superconductivity in an Fe-Se superconductor is strongly associated with the ligand states. A comparison of the Se K-edge and Te K-edge spectra reveals that the charge transfer may occur between Se and Te. Given the Coulomb interaction and the bandwidth, the spectral results indicate that FeSe(1-x)Te(x) is unlikely to be a weakly correlated system unlike the Fe-pnictides of the "1111" and "122" families. The spectral results further demonstrate that superconductivity in this class of Fe-based compounds is strongly associated with the ligand 4p hole state.

Dark-recovery experiences, coping strategies, and needs of adult heart transplant recipients in Taiwan

AIMS

The aim of this project was to identify the dark-recovery experiences (DRE) that adult heart transplant recipients (AHTRs) perceived as causing the most suffering after heart transplantation (HT). In artition, we sought to explore the stage-specific difficulties, coping strategies, and helpers for transplant recipients DRE in Taiwan.

METHODS

A qualitative design was employed using a sample group of patients with DRE. Retrospective data collected by face-to-face in-depth interviews were subjected to content analysis.

RESULTS

A total of 20 AHTRs (16 men, 4 women) participated in this research. Their ages ranged from 32-70 years (mean, 46.95 years). Their post-HT timeframe ranged from 3 months-2.10 years. The subjects reported DRE the across preoperative intensive care unit (ICU), postoperative floor unit, and even after the hospital discharge stages. Four major difficulties during DRE were reported: (1) becoming a burden for families (all stages); (2) unfamiliar with medical protocols, environment, and policy (ICU stage); (3) mental and physical discomforts caused by the invasive examinations and unstable health condition (post-ICU to postdischarge stages); and (4) sense of uncertainty about health progression and quality of life in the future (post-ICU to postdischarge stages). Four coping strategies were used for DRE: (1) asking religious support (all stages); (2) changing mindsets and taking positive attitudes to live with difficulties (ICU to postdischarge stages); (3) setting goals for health maintenance and recovery (post-ICU to postdischarge stages); and (4) planning to look for an appropriate job in the future (postdischarge stages). Families and religious persons were cited as helpers (all stages), as well as health professionals (ICU to postdischarge stages), other AHTRs (post-ICU to postdischarge stages), and the social welfare systems (postdischarge stages).

CONCLUSION

DRE, coping strategies, and related helpers in Taiwan were systematically explored in this project. With this information, the transplantation team will be empowered to provide better care for AHTRs during their most vulnerable time.

Optimal strategies for best management practice placement in a synthetic watershed

It is significant to arrange suitable design and placement of best management practices (BMPs) for reaching the aim that can not only satisfy environmental quality standards, but also decrease the total cost of BMPs. This study applied WinVAST model to predict watershed responses. The objective of this work was to discuss both the economic costs and benefits of BMPs and the control efficiency of discharge and pollutant exports, and to create some suitable standards for the optimal BMPs placement strategies. It is significant to find an optimal number and location of BMPs. In the case study herein, the number of BMPs including a detention pond and a grassy swale would be better to be given by four. The number of BMPs should also be determined by the environmental standards. Moreover, the result shows that the optimal location of BMPs placement is in the downstream area near the outlet and on the mainstream of the catchment. When the BMPs are set in these regions, it cannot only reduce the peak flow and peak pollutant exports, but also have slow time to peak watershed responses.

Single aperiodically poled lithium niobate for simultaneous laser Q switching and second-harmonic generation in a 1342 nm Nd:YVO4 laser

We report the design and experimental demonstration of an electro-optically Q-switched intracavity second-harmonic generator (ISHG) based on a single aperiodically poled lithium niobate (APLN) in a 1,342 nm Nd:YVO(4) laser. This intracavity APLN, designed using the aperiodic optical superlattice technique, can perform simultaneously as a laser Q switch and a second-harmonic generator. At approximately 200 VQ-switching voltage and a 5 kHz switching rate, we measured a pulse energy of approximately 5.7 microJ and a peak power of approximately 700 W at 671 nm from the constructed ISHG with a 5.2 W diode power based on 51% fundamental energy depletion.

Cardio-selective and non-selective beta-blockers in chronic obstructive pulmonary disease: effects on bronchodilator response and exercise

BACKGROUND

Patients with chronic obstructive pulmonary disease (COPD) often have co-existing cardiovascular disease and may require beta-blocker treatment. There are limited data on the effects of beta-blockers on the response to inhaled beta2-agonists and exercise capacity in patients with COPD.

OBJECTIVE

To determine the effects of different doses of cardio-selective and non-selective beta-blockers on the acute bronchodilator response to beta-agonists in COPD, and to assess their effects on exercise capacity.

METHODS

A double-blind, randomized, three-way cross-over (metoprolol 95 mg, propranolol 80 mg, placebo) study with a final open-label high-dose arm (metoprolol 190 mg). After 1 week of each treatment, the bronchodilator response to salbutamol was measured after first inducing bronchoconstriction using methacholine. Exercise capacity was assessed using the incremental shuttle walk test.

RESULTS

Eleven patients with moderate COPD were recruited. Treatments were well-tolerated although two did not participate in the high-dose metoprolol phase. The area under the salbutamol-response curve was lower after propranolol compared with placebo (P=0.0006). The area under the curve also tended to be lower after high-dose metoprolol (P=0.076). The per cent recovery of the methacholine-induced fall was also lower after high-dose metoprolol (P=0.0018). Low-dose metoprolol did not alter the bronchodilator response. Oxygen saturation at peak exercise was lower with all beta-blocker treatments (P=0.046).

CONCLUSION

Non-selective beta-blockers and high doses of cardio-selective beta-blockers may inhibit the bronchodilator response to beta2-agonists in patients with COPD. Beta-blockers were also associated with lower oxygen saturation during exercise. The clinical significance of these adverse effects is uncertain in view of the benefits of beta-blocker treatment for cardiovascular disease.

The impact of watershed delineation on hydrology and water quality simulation

Flood routing is a significant calculation for predicting watershed responses, involving discharge and pollutant exports. The computation of flow routing is highly relative to the relationship between downstream and upstream subbasins. A watershed could always be divided into several subbasins based on its topography and stream distribution. How detailed of the delineation of the stream distribution in a watershed would influence the modeling accuracy of flow routing and the prediction of watershed responses. The objective of this work was to discuss the effect of watershed delineation on runoff and pollutant transport predictions. When the number of divided subbasins increases, the stream distribution could be delineated more clearly. The case area was usually regarded as two subbasins only. In the present study, the case area was divided into 43, 25, 15 and 9 subbasins respectively. If the modeling result under 43 subdivisions is assumed to be the actual situation, the relative error of runoff simulation due to the simplified delineation of stream distribution is only around 25% in two subdivisions. However, the relative error of suspended solids (SS), total nitrogen (TN) and orthophosphate (Orth-P) simulation can reach 85%, 71 and 70% in two subdivisions respectively. The uncertainties or errors induced by too much simplification of watershed delineation could be carried over and amplified to the pollutant transport process and the modeling results of pollutant exports.

Relationship between landscape characteristics and surface water quality

The effects of landscape characteristics on surface water quality were evaluated in terms of land-use condition, soil type and slope. The case area, the Chichiawan stream in the Wulin catchment in Taiwan, is Formosan landlocked salmon's natural habitat. Due to the agriculture behavior and mankind's activities, the water and environmental quality has gradually worsened. This study applied WinVAST model to predict hydrological responses and non-point source pollution (NPSP) exports in the Wulin catchment. The land-use condition and the slope of land surface in a catchment are major effect factors for watershed responses, including flows and pollutant exports. This work discussed the possible variation of watershed responses induced by the change of land-use condition, soil type and slope, etc. The results show that hydrological responses are highly relative to the value of Curve Number (CN); Pollutant exports have large relation to the average slope of the land surface in the Wulin catchment.

Monolithically integrated multi-wavelength filter and second harmonic generator in aperiodically poled lithium niobate

We report on the design and experimental characterization of aperiodically poled lithium niobate (APLN) crystals for use in monolithically integrated dual nonlinear-optical devices. A cascade and a single aperiodic-domain-structure designs based on simulated annealing method were constructed in LiNbO(3) to simultaneously perform as 4-channel electro-optically active (EOA) filters and 4-channel frequency doublers in the telecom band. We found that we could obtain a 2.44-fold enhancement in second-harmonic-generation conversion efficiency and a 2.4-time reduction in filter transmission bandwidth with the single APLN device over the cascade one when the same device length of 2 cm and the EOA field of 1027 V/mm were used.

South Pole Telescope optics

The South Pole Telescope is a 10 m diameter, wide-field, offset Gregorian telescope with a 966-pixel, millimeter-wave, bolometer array receiver. The telescope has an unusual optical system with a cold stop around the secondary. The design emphasizes low scattering and low background loading. All the optical components except the primary are cold, and the entire beam from prime focus to the detectors is surrounded by cold absorber.

Evaluation of an acid-fast bacilli autostainer for concentrated sputum smears

SETTING

An automatic acid-fast bacilli (AFB) stainer was developed to improve laboratory workflow and protect laboratory workers.

OBJECTIVE

To determine the usefulness of the 7720 Aerospray AFB slide stainer for liquefied and concentrated respiratory specimens.

DESIGN

With 24 smear-positive specimens submitted for AFB stain and culture in a tertiary care hospital, the autostainer was evaluated to determine whether smears would be sloughed from slides during the staining process by loading distilled water instead of staining reagents. With 109 more specimens, the performance of the 7720 Aerospray was compared with manual florescence staining as a gold standard. The tested smears were prepared with Mycohold treatment.

RESULTS

In most cases, the slides exposed to the autostainer containing distilled water showed lower grades of AFB than those slides not exposed to the autostainer (14/24 in Mycohold-treated slides). Almost half (54/109, 49.5%) of the Mycohold-treated autostained smears had a lower grade than the same smears stained manually. Among 62 Mycohold-treated autostained smear-negative specimens, respectively eight (12.9%) and 19 (30.6%) were high and low false-negatives.

CONCLUSION

The 7720 Aerospray showed poor performance in AFB staining of concentrated sputum specimens.

Effect of spatial variability of storm on the optimal placement of best management practices (BMPs)

It is significant to design best management practices (BMPs) and determine the proper BMPs placement for the purpose that can not only satisfy the water quantity and water quality standard, but also lower the total cost of BMPs. The spatial rainfall variability can have much effect on its relative runoff and non-point source pollution (NPSP). Meantime, the optimal design and placement of BMPs would be different as well. The objective of this study was to discuss the relationship between the spatial variability of rainfall and the optimal BMPs placements. Three synthetic rainfall storms with varied spatial distributions, including uniform rainfall, downstream rainfall and upstream rainfall, were designed. WinVAST model was applied to predict runoff and NPSP. Additionally, detention pond and swale were selected for being structural BMPs. Scatter search was applied to find the optimal BMPs placement. The results show that mostly the total cost of BMPs is higher in downstream rainfall than in upstream rainfall or uniform rainfall. Moreover, the cost of detention pond is much higher than swale. Thus, even though detention pond has larger efficiency for lowering peak flow and pollutant exports, it is not always the determined set in each subbasin.

Electronic structure of phospho-olivines Li(x)FePO4 (x = 0, 1) from soft-x-ray-absorption and -emission spectroscopies

The electronic structure of the phospho-olivine Li(x)FePO4 was studied using soft-x-ray-absorption (XAS) and emission spectroscopies. Characteristic changes in the valence and conduction bands are observed upon delithation of LiFePO4 into FePO4. In LiFePO4, the Fe-3d states are localized with little overlap with the O-2p states. Delithiation of LiFePO4 gives stronger hybridization between Fe-3d states and O-2p states leading to delocalization of the O-2p states. The Fe L-edge absorption spectra yield "fingerprints" of the different valence states of Fe in LiFePO4 and FePO4. Resonant soft-x-ray-emission spectroscopy at the Fe L edge shows strong contributions from resonant inelastic soft x-ray scattering (RIXS), which is described using an ionic picture of the Fe-3d states. Together the Fe L-edge XAS and RIXS study reveals a bonding character of the Fe 3d-O2p orbitals in FePO4 in contrast to a nonbonding character in LiFePO4.

Electro-optic narrowband multi-wavelength filter in aperiodically poled lithium niobate

We report on an iterative design scheme for and the first experimental demonstration of active narrowband multi-wavelength filters based on aperiodically poled lithium niobate crystals. A simultaneous transmission of 8 wavelengths, each with a ~0.45-nm linewidth and nearly 100% peak transmittance, was achieved in such a device. The transmission spectrum of this device can be tuned by temperature at a rate of ~0.65 nm/ degrees C.

Autofluorescence lifetime measurement on oral carcinogenesis

Normal and cancerous tissues have distinct autofluorescence lifetime because of their biophysical and biochemical differences. Protoporphyrin IX (PplX) is a useful fluorophore, which generally accumulates more in cancerous cells than in normal cells due to heme synthesis pathway, is often employed in photodynamic detection and therapy. Under 410nm excitation, the main emission peak of PplX is at 630nm. Autofluorescence lifetime at 630nm emission would be elongated if PplX gathered more in cells. In this study, we tried to find if there exist significant differences of autofluorescence lifetime at 630nm (under 410nm excitation) between normal and cancerous tissues for in vivo measurement. The result shows that normal tissues in general have shorter lifetime (about 2.8 approximately 3.5 ns) than that of abnormal tissues. The measured data suggest that lifetime would get longer in accordance with the degree of carcinogenesis. For cancer tissues, the average autofluorescence lifetime was extended to be about 10ns. Furthermore, the efficiency of treatment could also be defined refer to the time-series of lifetime decline.

Feasibility study for the administration of remifentanil based on the difference between response entropy and state entropy †

BACKGROUND

Facial electromyography (FEMG) may have utility in the assessment of nociception during surgery. The difference between state entropy (SE) and response entropy (RE) is an indirect measure of FEMG. This study assesses an automated algorithm for remifentanil administration that is based on maintaining an entropy difference (ED) that is less than an upper boundary condition and greater than a lower boundary condition.

METHODS

The algorithm was constructed with a development set (n = 40), and then automated and studied with a validation set (n = 20) of patients undergoing anterior cruciate ligament repair. The percentage of time that the ED was maintained between the two boundary conditions was determined. Remifentanil and propofol predicted effect-site concentrations (Ce) were determined at surgical milestones and, after drug discontinuation, the time to response to verbal stimulation and orientation was measured.

RESULTS

The median (25th-75th percentile) per cent of time that the ED was recorded between the boundary conditions was 99.3% (98.1-99.8%). Predicted propofol (microg ml(-1)) and remifentanil (ng ml(-1)) Ce (sd), respectively, were 3.5 and 4.0 at induction, 1.9 (0.8) and 7.2 (3.7) at the end of surgery, and 1.1 (0.5) and 3.2 (2.2) at eye opening. The median time to eye opening and orientation was 3.8 and 6.8 min, respectively.

CONCLUSION

This feasibility study supports the concept that remifentanil may be delivered using an algorithm that maintains the difference between SE and RE between the upper and lower boundary condition.

Trend of anti-tuberculosis drug resistance in Korea, 1994-2004

SETTING

The 245 health centres through which the National Tuberculosis Programme (NTP) is implemented in Korea and the TB Laboratory Network of the Korean National Tuberculosis Association.

OBJECTIVE

To observe the trend of anti-tuberculosis drug resistance in Korea from 1994 to 2004 and possible related factors.

DESIGN

All tuberculosis (TB) patients registered for treatment at the health centres for a given period were assessed.

RESULTS

Of 2636 new smear-positive patients from the 2004 survey, 338 cases (12.8%, 95% confidence interval [CI] 11.5-14.1) showed resistance to any of the first-line drugs: 261 with isoniazid (INH) resistance (9.9%, 95%CI 8.8-11.0) and 71 with multidrug resistance (MDR) (2.7%, 95%CI 2.1-3.3). Compared with previous surveys, a statistically significant increase in MDR (P=0.00675), any drug resistance (P=0.03779), any INH resistance (P=0.00313) and any rifampicin resistance (P = 0.00176) has been observed among new cases since 1994. Any resistance to second-line drugs ranged from 0.1% (capreomycin) to 1.1% (para-aminosalicylic acid) among new cases and from 1.1% to 3.6% among retreatment cases. Resistance to kanamycin and ofloxacin was found in 1.4% and 2.6%, respectively, of new and previously treated MDR-TB cases.

CONCLUSION

A statistically significant increase in drug resistance was noticed among new cases.

X-ray spectroscopic study of the charge state and local ordering of room-temperature ferromagnetic Mn-doped ZnO

The charge state and local ordering of Mn doped into a pulsed laser deposited single-phase thin film of ZnO are investigated by using x-ray absorption spectroscopy at the O K-edge, Mn K-edge and L-edge, and x-ray emission spectroscopy at the O K-edge and Mn L-edge. This film is ferromagnetic at room temperature. EXAFS measurement shows that Mn(2+) replaces the Zn site in tetrahedral symmetry, and there is no evidence for either metallic Mn or MnO in the film. Upon Mn doping, the top of O 2p valence band extends into the bandgap, indicating additional charge carriers being created.

Audit of acute admissions of chronic obstructive pulmonary disease: inpatient management and outcome

BACKGROUND

Despite the publication of several management guidelines for exacerbations of chronic obstructive pulmonary disease (COPD), there is little information on standards of care in clinical practice. The aim of this audit was to examine the assessment, management and outcome of COPD admissions to a secondary and tertiary referring New Zealand hospital during two different seasons. Compliance to current recommendations was examined and compared with the available international published work.

METHODS

All COPD-related admissions to Waikato Hospital during the months of May and October 2004 were reviewed. Ninety-four cases (from 84 patients) were audited.

RESULTS

General characteristics, clinical features and lung function tests were similar to that of other cohorts. Twenty-three per cent of the admissions were Maori and the mean age of Maori admissions were significantly less than that of the non-Maori admissions (57 and 72 years, respectively; P = 0.0001). The geometric mean length of stay was 3.4 days, which is significantly less than most other reported hospital lengths of stays related to exacerbations of COPD. Fifty-five per cent of the cohort was admitted more than once to the hospital for COPD in the 12 months before the index admission. Thirteen per cent of all admissions received assisted ventilation. Overall 30-day mortality was 8% and the 12-month mortality was 31%. Decreased body mass index was a risk factor for death as was an increased CURB-65 (confusion, urea, respiratory rate, blood pressure age) score--a simple bedside assessment score, which has previously been used to predict mortality in patients with community-acquired pneumonia.

CONCLUSION

This audit documented the general characteristics, assessment, management and outcome of the COPD admissions to a secondary New Zealand hospital. Further investigations into factors contributing to shorter length of stay and predictors of mortality are needed.

Prevalence of non-tuberculous mycobacteria in a hospital environment

In recent years, non-tuberculous mycobacteria (NTM) have emerged as an important cause of opportunistic nosocomial infections but there is little known about the isolation and identification of NTM in Korea. The aim of this study was to assess the prevalence of NTM in the hospital environment and identify the species. A total of 150 samples were collected from different parts of the hospital. NTM were isolated and identified by restriction fragment length polymorphism analysis of the gene encoding rpoB and partial sequencing analysis of hsp65 and rpoB. In this study, 60 strains of NTM were isolated from 50 of the 150 samples. Half of the tap water samples (50 of 100) were positive for mycobacteria. An estimated 73.3% of the isolates were saprophytic, 21.7% were potentially pathogenic and 5% were unidentified. The presence of NTM in hospital tap water is not uncommon. Such water isolates might cause true nosocomial infection in immunocompromised patients, in addition to the risk of false-positive culture results.

Insulin sensitivity and resistin expression in nitric oxide-deficient rats

AIMS/HYPOTHESIS

The aim of this study was to investigate changes in insulin sensitivity and expression of the gene encoding resistin (Retn) in adipocytes from long-term nitric oxide (NO)-deficient rats.

METHODS

Male Sprague-Dawley rats received [Formula: see text]-nitro-L: -arginine methyl ester (L-NAME 0.5 mg/ml) in their drinking water for 4 weeks, while control rats received plain drinking water. During the experimental period, changes in plasma glucose, insulin and C-peptide levels were measured. After administration of L-NAME for 4 weeks, insulin sensitivity was evaluated in vivo and in vitro. An insulin binding assay was also performed to determine the number and binding affinity of insulin receptors in adipocytes. Adipocyte Retn mRNA levels were examined using northern blotting.

RESULTS

Successful induction of NO deficiency was demonstrated by an increase in systemic blood pressure. No difference in plasma glucose levels was found between the two groups. Compared with the control rats, plasma insulin and C-peptide levels were significantly decreased in the NO-deficient rats, and insulin sensitivity was significantly increased. Insulin-stimulated glucose uptake and insulin binding capacity, but not binding affinity, were significantly increased in adipocytes isolated from NO-deficient rats. In addition, adipocyte Retn mRNA levels, but not plasma resistin levels, were significantly decreased in NO-deficient rats, and the Retn mRNA levels were negatively correlated with insulin sensitivity.

CONCLUSIONS/INTERPRETATION

Insulin sensitivity was increased in NO-deficient rats and this was associated with insulin binding capacity and downregulated Retn expression. These findings suggest that NO plays a regulatory role in metabolism. Dysregulation of NO production may result in the development of metabolic disorders.

Development and evaluation of triplex PCR for direct detection of mycobacteria in respiratory specimens

AIMS

To develop a method for the simultaneous detection of Mycobacterium tuberculosis, Mycobacterium avium-intracellularecomplex (MAC), and other mycobacteria in clinical specimens using triplex PCR.

METHODS AND RESULTS

The target of amplification was the internal transcribed spacer region between the l6S and 23S rDNA genes. Twenty-two mycobacterial type strains, 118 M. tuberculosis, 87 other mycobacteria, 75 nonmycobacterial pathogens, 115 respiratory specimens from confirmed cases of tuberculous or other mycobacterial diseases, and sputa from 50 patients with nonmycobacterial respiratory diseases were tested. In M. tuberculosis, 322 bp pan-mycobacterial and 133 bp species-specific bands were observed. In MAC, the respective bands were 322 and 84 bp. The other mycobacteria showed single pan-mycobacterial bands of approx. 300-350 bp. Nonspecific amplicons were not found in any of the nonmycobacterial pathogens. In the tuberculosis specimens, 96.4% of smear-positive specimens and 70.2% of smear-negative specimens showed positive reactions. Specimens from two patients with MAC infection were MAC positive. Only 1 of 50 specimens from nonmycobacterial diseases was positive (2.0%).

CONCLUSION, SIGNIFICANCE AND IMPACT OF THE STUDY

Triplex PCR enables accurate and rapid diagnosis of tuberculosis and probably is useful for the detection of MAC and other mycobacteria in respiratory specimens.

Evaluation of a modified antimycobacterial susceptibility test using Middlebrook 7H10 agar containing 2,3-diphenyl-5-thienyl-(2)-tetrazolium chloride

A rapid and accurate antimycobacterial susceptibility test is essential for effective treatment of tuberculosis. The aim of this study was to evaluate a modified method applying 2,3-diphenyl-5-thienyl-(2)-tetrazolium chloride (STC) to the Clinical and Laboratory Standards Institute (CLSI) guideline for susceptibility testing of Mycobacterium tuberculosis. A total of 132 clinical isolates of M. tuberculosis, forty-eight isolates showing resistance to one or more of the first-line antituberculosis drugs, and eighty-four fully susceptible isolates were collected from hospitals of a nationwide distribution from June to September 2004. The modified procedure was conducted basically according to the agar-proportion method described in the CLSI Guideline both with STC 50 mug/mL. The amount of growth in each well was recorded and graded at 2nd and 3rd weeks after inoculation. After 3 weeks of incubation, the diagnostic sensitivity and specificity for the detection of drug-resistant strains of STC-containing agar proportion methods were 100%, except ethambutol-low level resistance, of which the diagnostic sensitivity was 93.4%. After two weeks of incubation in STC-containing agar proportion methods, one hundred of the 107 strain-drug combinations have shown drug resistance, indicating the sensitivity of 93.5%. Especially, all 41 isoniazid-resistant strains and 19 of 21 rifampin-resistant strains (90.5%) could be detected after two weeks of incubation. A modification of the agar proportion method using STC resulted in a reliable and more easily interpretable data, and detected most of resistant strains a week earlier than conventional method.

Limits on spin-independent interactions of weakly interacting massive particles with nucleons from the two-tower run of the cryogenic dark matter search

We report new results from the Cryogenic Dark Matter Search (CDMS II) at the Soudan Underground Laboratory. Two towers, each consisting of six detectors, were operated for 74.5 live days, giving spectrum-weighted exposures of 34 (12) kg d for the Ge (Si) targets after cuts, averaged over recoil energies 10-100 keV for a weakly interacting massive particle (WIMP) mass of 60 GeV/c2. A blind analysis was conducted, incorporating improved techniques for rejecting surface events. No WIMP signal exceeding expected backgrounds was observed. When combined with our previous results from Soudan, the 90% C.L. upper limit on the spin-independent WIMP-nucleon cross section is 1.6 x 10(-43) cm2 from Ge and 3 x 10(-42) cm2 from Si, for a WIMP mass of 60 GeV/c2. The combined limit from Ge (Si) is a factor of 2.5 (10) lower than our previous results and constrains predictions of supersymmetric models.

Prevalence of Antibody to Hepatitis E Virus among Haemodialysis Patients in Taiwan: Possible Infection by Blood Transfusion

BACKGROUND/AIMS

A higher prevalence of anti-hepatitis E virus (HEV) in non-endemic viral hepatitis such as in Germany has been reported in our previous study. The aim of this study was to assess the seroepidemiology of HEV among haemodialysis (HD) patients in Shin-Kong Hospital, Taiwan, and to evaluate whether there was an increased risk of infection and exposure to HEV even in an area of endemic viral hepatitis.

METHODS

Serum samples obtained from 400 Taiwanese patients on chronic HD (group 1), 400 sex- and age-matched healthy subjects (group 2) and hospital patients (group 3) were tested for the IgG anti-HEV.

RESULTS

The prevalence of anti-HEV among the HD patients and the healthy controls were 31 and 8.9%, respectively. The difference (22%) was statistically significant (p < 0.01). In comparison, the anti-HEV in hospital patients was 16%.

CONCLUSION

The study indicated a significantly higher risk of HEV infection among patients on chronic HD in endemic regions of viral hepatitis such as Taiwan. Mostly because of anaemia, HD patients usually received packed transfusion (red blood cells) if their haemoglobin was low. It is possible that HEV infection may be transmitted through blood transfusions in an endemic area. In such areas, appropriate strategies should be adopted to prevent the risk of HEV among HD patients.

First results from the Cryogenic Dark Matter Search in the Soudan Underground Laboratory

We report the first results from a search for weakly interacting massive particles (WIMPs) in the Cryogenic Dark Matter Search experiment at the Soudan Underground Laboratory. Four Ge and two Si detectors were operated for 52.6 live days, providing 19.4 kg d of Ge net exposure after cuts for recoil energies between 10 and 100 keV. A blind analysis was performed using only calibration data to define the energy threshold and selection criteria for nuclear-recoil candidates. Using the standard dark-matter halo and nuclear-physics WIMP model, these data set the world's lowest exclusion limits on the coherent WIMP-nucleon scalar cross section for all WIMP masses above 15 GeV/c2, ruling out a significant range of neutralino supersymmetric models. The minimum of this limit curve at the 90% C.L. is 4 x 10(-43) cm2 at a WIMP mass of 60 GeV/c2.