Timely and accurate forecasts of tropical cyclones (TCs, i.e., hurricanes and typhoons) are of great importance for risk mitigation. Although in the past two decades there has been steady improvement ...in track prediction, improvement on intensity prediction is still highly challenging. Cooling of the upper ocean by TC‐induced mixing is an important process that impacts TC intensity. Based on detail in situ air‐deployed ocean and atmospheric measurement pairs collected during the Impact of Typhoons on the Ocean in the Pacific (ITOP) field campaign, we modify the widely used Sea Surface Temperature Potential Intensity (SST_PI) index by including information from the subsurface ocean temperature profile to form a new Ocean coupling Potential Intensity (OC_PI) index. Using OC_PI as a TC maximum intensity predictor and applied to a 14 year (1998–2011) western North Pacific TC archive, OC_PI reduces SST_PI‐based overestimation of archived maximum intensity by more than 50% and increases the correlation of maximum intensity estimation from r2 = 0.08 to 0.31. For slow‐moving TCs that cause the greatest cooling, r2 increases to 0.56 and the root‐mean square error in maximum intensity is 11 m s−1. As OC_PI can more realistically characterize the ocean contribution to TC intensity, it thus serves as an effective new index to improve estimation and prediction of TC maximum intensity.
Key Points
Current potential intensity index considers only ocean's surface contribution
Inclusion of ocean's subsurface information to improve estimation
Based on a valuable in situ data set from the ITOP field campaign
This prospective study assessed the effectiveness of screening older long-term care residents (LTCRs) for fracture risk and osteoporosis in Taiwan. Fracture risk screening was done using the Fracture ...Risk Assessment Tool (FRAX), and those with high or moderate risk were offered osteoporosis workup and treatment at the hospital. Among 785 LTCRs screened, 338 men (mean age 75.6) and 447 women (mean age 81.2) were included. Only 5.2% of women and no men were using anti-osteoporosis medication. Based on the Bone Health and Osteoporosis Foundation (BHOF) recommendations, 69.2% of men and 92.6% of women were classified as high fracture risk. In 110 participants willing to receive bone mineral density examination, osteoporosis was diagnosed in 86.2% of women and half of men. FRAX could effectively differentiate fracture risk in 648 LTCRs who completed 2-year follow-ups; no fracture occurred in the low-risk group. The study emphasizes the importance of fracture risk screening to enhance osteoporosis diagnosis and treatment among LTCRs.
Background Amoxicillin‐resistant Helicobacter pylori with minimal inhibitory concentration (MIC) ≥ 256 mg L−1 was isolated from a gastritis patient. The aims were to investigate the mechanism of ...high‐level amoxicillin resistance in H. pylori.
Materials and methods The β‐lactamase production was determined by means of nitrocefin sticks and the presence of gene encoding the β‐lactam antibiotic resistance enzyme TEM β‐lactamase was analysed by polymerase chain reaction (PCR), sequencing and dot‐blot hybridization. Sequencing analysis of pbp1A gene was performed and amoxicillin‐susceptible isolate was transformed with pbp1A PCR products from the resistant isolate. The expression of hefC efflux system was analysed using real‐time quantitative PCR.
Results Activity of β‐lactamase was detected. Sequence analysis showed that the PCR product derived from H. pylori 3778 was identical to the blaTEM‐1 (GenBank accession EU726527). Dot‐blot hybridization confirmed the presence of β‐lactamase gene blaTEM‐1. By transformation of PCR product of mutated pbp1A gene from H. pylori 3778 into amoxicillin‐susceptible strain showed that substitutions in Thr556→Ser, Lys648→Gln, Arg649→Lys and Arg656→Pro contribute to low‐level amoxicillin resistance. The MIC of amoxicillin for the transformants was 0·75 mg L−1. Over‐expression of hefC was not found.
Conclusions High‐level amoxicillin resistance is associated with β‐lactamase production in H. pylori. Low‐level amoxicillin resistance is linked to a point mutation on pbp1A. Because H. pylori can exchange DNA through natural transformation, spreading of blaTEM‐1 amoxicillin resistance gene among H. pylori is a potential threat when treating H. pylori infection.
Liver kinase B1 (LKB1) loss in lung adenocarcinoma is commonly caused by genetic mutations, but these mutations rarely occur in Asian patients. We recently reported wild-type LKB1 loss via the ...alteration of NKX2-1/p53-axis-promoted tumor aggressiveness and predicted poor outcomes in cases of lung adenocarcinoma. The mechanistic action of wild-type LKB1 loss within tumor progression remains unknown. The suppression of MYC by LKB1 controls epithelial organization; therefore, we hypothesize that MYC expression can be increased via wild-type LKB1 loss and promotes tumor progression. Here, MYC transcription is upregulated by LKB1-loss-mediated MZF1 expression. The wild-type LKB1-loss-mediated MZF1/MYC axis is responsible for soft-agar growth, migration and invasion in lung adenocarcinoma cells. Moreover, wild-type LKB1 loss-induced cell invasiveness was markedly suppressed by MYC inhibitors (10058-F4 and JQ1). Patients with low-LKB1/high-MZF1 or low-LKB1/high-MYC tumors have shorter overall survival and relapse-free-survival periods than patients with high-LKB1/low-MZF1 or high-LKB1/low-MYC tumors. In summary, MZF1-mediated MYC expression may promote tumor progression, resulting in poor outcomes in cases of lung adenocarcinoma with low-wild-type-LKB1 tumors.
The epidemiology of candidaemia varies between hospitals and geographic regions. Although there are many studies from Asia, a large-scale cross-sectional study across Asia has not been performed. We ...conducted a 12-month, laboratory-based surveillance of candidaemia at 25 hospitals from China, Hong Kong, India, Singapore, Taiwan and Thailand. The incidence and species distribution of candidaemia were determined. There were 1601 episodes of candidaemia among 1.2 million discharges. The overall incidence was 1.22 episodes per 1000 discharges and varied among the hospitals (range 0.16–4.53 per 1000 discharges) and countries (range 0.25–2.93 per 1000 discharges). The number of Candida blood isolates and the total number of fungal isolates were highly correlated among the six countries (R² = 0.87) and 25 hospitals (R² = 0.77). There was a moderate correlation between incidence of candidaemia and the intensive care unit (ICU)/total bed ratio (R² = 0.47), although ICUs contributed to only 23% of candidaemia cases. Of 1910 blood isolates evaluated, Candida albicans was most frequently isolated (41.3%), followed by Candida tropicalis (25.4%), Candida glabrata (13.9%) and Candida parapsilosis (12.1%). The proportion of C. tropicalis among blood isolates was higher in haemato-oncology wards than others wards (33.7% versus 24.5%, p 0.0058) and was more likely to be isolated from tropical countries than other Asian countries (46.2% versus 18.9%, p 0.04). In conclusion, the ICU settings contribute, at least in part, to the incidence variation among hospitals. The species distribution is different from Western countries. Both geographic and healthcare factors contribute to the variation of species distribution.
Natural deep eutectic solvents (NADESs) are efficient in extracting natural products. However, traditional organic solvents are toxic in the extraction of anthraquinones from
Rheum palmatum
L. To ...solve this problem, we applied natural deep eutectic solvent ultrasound-assisted extraction in this study for the extraction of total anthraquinones from
R. palmatum
L. Principal component analysis revealed that the selected NADES which consisted of lactic acid, glucose and water (LGH), was highly efficient in extracting anthraquinones from
R. palmatum
L. The ratio of lactic acid/glucose and the addition of water in LGH were investigated
via
a single-factor experiment. With a lactic acid/glucose ratio of 5 : 1 (mol/mol), and 10% of water (v/v), LGH had a high extraction yield to anthraquinones. Optimized by response surface methodology (RSM), the optimized extraction conditions of extraction time, extraction temperature and solvent-to-solid ratio of 1.5 h, 82 °C and 26 mL g
−1
, respectively. Under optimum conditions, the extraction yields of aloe-emodin, rhein, emodin, chrysophanol, physcion and total anthraquinones were 2.60 ± 0.01, 5.78 ± 0.02, 2.21 ± 0.02, 5.87 ± 0.02, 8.81 ± 0.01 and 25.27 ± 0.07 mg g
−1
, respectively. The enrichment and separation of five anthraquinones in LGH extraction solution were efficiently achieved using DM130 macroporous resin, with purities of 90.98%, 96.67%, 92.37%, 95.80% and 91.61% as indicated by HPLC, and recovery yields of 84.08%, 79.51%, 84.96%, 81.83% and 78.35%, respectively. LGH was environmentally friendly and highly efficient in extracting anthraquinones from
R. palmatum
L., and NADESs showed potential for the extraction of effective components from natural products.
Natural deep eutectic solvents ultrasound-assisted extraction (NADES-UAE) was applied to extract total anthraquinones from
Rheum palmatum
L.
Background
Patterns of recurrence after surgery with postoperative chemoradiotherapy (S‐CCRT) or surgery alone in patients with oesophageal squamous cell carcinoma (SCC) may differ. This might ...influence the nature and timing of subsequent management strategies.
Methods
Patients with SCC who had undergone R0 resection were included. Propensity score matching was used to select matched groups. Survival and recurrence were compared by Kaplan–Meier analysis. Univariable and multivariable Cox regression analyses were used to identify prognostic factors for overall and disease‐free survival.
Results
A total of 1390 patients were included, of whom 1000 had surgery alone and 390 underwent S‐CCRT. Propensity score matching yielded 213 well balanced pairs. The 3‐year overall survival rate and median survival time in the S‐CCRT group were 0·50 and 36·5 (95 per cent c.i. 25·1 to 52·6) months respectively, compared with 0·38 and 22·8 (18·2 to 29·0) months in the surgery‐alone group (P = 0·006). The 3‐year disease‐free survival rate and median disease‐free survival time in the S‐CCRT group were 0·46 and 30·6 (22·2 to 39·3) months respectively, compared with 0·36 and 17·6 (11·3 to 23·9) months in the surgery‐alone group (P = 0·006). The 2‐year freedom from locoregional recurrence rate was 0·87 and 0·77 in the S‐CCRT and surgery‐alone groups respectively (P = 0·003). In multivariable analysis, independent prognostic factors for disease‐free survival included age over 56 years, pT3–4 category, pN category, poor differentiation, tumour length exceeding 4·0 cm, and receiving postoperative chemoradiotherapy (hazard ratio 0·62, 95 per cent c.i. 0·47 to 0·81; P < 0·001).
Conclusion
Oesophagectomy with postoperative chemoradiotherapy was associated with longer survival and lower recurrence rates, especially at a locoregional level, compared with surgery alone.
Longer survival and less recurrence with multimodal treatment
Anti-interferon- γ (IFN-γ) autoantibodies (anti-IFN-γ Abs) have been increasingly recognized as an important cause of disseminated nontuberculous mycobacterial (DNTM) infection, and identification of ...this immunodeficiency impacts clinical management. However, the protean disease manifestations and inaccessibility to diagnostic tests in clinical settings hamper its early diagnosis. Here, we sought to determine whether QuantiFERON-TB Gold In-tube (QFT-GIT), a commercialized IFN-γ release assay, could be used to screen for neutralizing anti-IFN-γ Abs among previously healthy adults with DNTM infection.
Non-HIV patients with DNTM infection were prospectively enrolled for the QFT-GIT assays. We measured their plasma concentration of anti-IFN-γ Abs and their neutralizing capacity through enzyme-linked immunosorbent assay and flow cytometry. We then analysed the correlation between QFT-GIT results and the presence of neutralizing anti-IFN-γ Abs among patients with and without previously recognized immunosuppression, respectively.
Irrespective of the autoantibody concentration or disease activity, all patients with neutralizing anti-IFN-γ Abs (100%, 30/30) had indeterminate QFT-GIT results because of extremely low or undetectable IFN-γ levels in the mitogen tubes. None of the four DNTM patients who were previously healthy and tested negative of anti-IFN-γ Abs had an indeterminate QFT-GIT result, and their IFN-γ levels in the mitogen tube were significantly higher than those of the patients with anti-IFN-γ Abs (8.28 IU/mL vs. 0.05 IU/mL, p 0.001).
An indeterminate QFT-GIT result because of undetectable or extremely low IFN-γ level in the mitogen tube suggests the presence of neutralizing anti-IFN-γ Abs in a previously healthy patient with DNTM infection.
Malignant pleural effusions (MPEs) are often observed in lung cancer, especially adenocarcinoma. Epidermal growth factor receptor (EGFR) gene mutations are usually detected in lung adenocarcinoma. ...The purpose of the present study was to investigate the EGFR mutation rate in MPEs of lung adenocarcinoma. Between June 2005 and December 2006, 136 MPEs from lung adenocarcinoma were collected for EGFR mutation detection. In addition, between April 2001 and November 2004, 91 surgically resected specimens of lung adenocarcinoma from patients without MPEs were assessed for EGFR mutation. The EGFR mutation rate was significantly higher in the patients with MPEs than in the patients without (68.4% versus 50.5%). The EGFR mutation rate in patients with MPEs was not associated with sex, smoking history, age or cancer stage. By multivariate analysis, an age of <65 yrs, never smoking, Eastern Cooperative Oncology Group performance status 0-1, and EGFR mutation were significantly associated with a longer overall survival for lung adenocarcinoma patients with MPEs. The patients with malignant pleural effusions related to lung adenocarcinoma had a higher epidermal growth factor receptor gene mutation rate than the patients from whom surgically resected specimens were taken. Epidermal growth factor receptor tyrosine kinase inhibitors may be the treatment of choice for lung adenocarcinoma with malignant pleural effusions in east Asia.
Abstract Background and aims Abdominal aortic calcification (AC) has been reported to be associated with cardiovascular disease (CVD) in hemodialysis patients but is rarely discussed in peritoneal ...dialysis (PD) patients. We examined the independent predictors and predictive power for survival of AC in prevalent PD patients. Methods and Results AC was detected by computed tomography (CT) and represented as the percentage of the total aortic cross-section area affected by AC (%AC). The predictors of %AC ≥15 were examined by multiple logistic regression analysis. Cox proportional hazard analysis was used to determine the hazard ratios associated with high %AC. A total of 183 PD patients were recruited to receive CT scans and divided into group 1 (%AC < 15, n = 97), group 2 (%AC ≥ 15, n = 41), and group 3 (diabetic patients, n = 45). Group 1 patients had lower osteoprotegerin (OPG) levels than group 2 patients (798 ± 378 vs. 1308 ± 1350 pg/mL, p < 0.05). The independent predictors for %AC ≥ 15 included the atherogenic index, OPG, and C-reactive protein (CRP). The age-adjusted hazard ratios associated with %AC ≥15 were 3.46 ( p = 0.043) for mortality and 1.90 ( p = 0.007) for hospitalization. Conclusions %AC can predict mortality and morbidity in non-diabetic PD patients, and 15% is a good cut-off value for such predictions. There are complex associations among mineral metabolism, inflammation, and dyslipidemia in the pathogenesis of AC.
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