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
Summary
Background
Indigo naturalis and its refined formulation, Lindioil, are effective in treating psoriatic symptoms topically. Indirubin is the active ingredient in indigo naturalis.
Objectives
...To determine the efficacy and safety of different concentrations of indirubin in Lindioil ointment for treating psoriasis.
Methods
In this randomized, double‐blind trial, adult patients presenting with chronic plaque psoriasis for > 1 year and with < 20% of the body surface area (BSA) affected were randomized to apply Lindioil ointment containing 200, 100, 50 or 10 μg g−1 of indirubin twice daily for 8 weeks followed by an additional 12‐week safety/extension period. The primary end point was the mean percentage change in Psoriasis Area and Severity Index (PASI) score along with the proportion of participants achieving 75% and 90% reductions in PASI scores (PASI 75 and PASI 90, respectively) from baseline to week 8.
Results
The results from week 8 revealed that the 200 μg g−1 group had the greatest reduction in PASI score 69·2%, 95% confidence interval (CI) 55·5–82·8, followed by the 100 μg g−1 group (63·1%, 95% CI 52·8–73·5), the 10 μg g−1 group (53·4%, 95% CI 42·8–64·0) and the 50 μg g−1 group (50·3%, 95% CI 37·4–63·2), with a between‐group comparison of P = 0·0445. The group with the highest proportion of the patients achieving PASI 75 (57%, P = 0·0474) and PASI 90 (30%, P = 0·0098) was the 200 μg g−1 group. No severe treatment‐related adverse events were reported during the 20‐week evaluation.
Conclusions
An amount of 200 μg g−1 of indirubin in Lindioil ointment is the most effective concentration studied so far for treating psoriasis topically, and is safe.
What's already known about this topic?
As a result of safety concerns about the long‐term use of corticosteroids and other standard treatments, there is a growing demand for herbal treatments for psoriasis.
Indigo naturalis, a herb used in Chinese medicine, is effective for the topical treatment of psoriasis when used as a crude ointment or in its refined form, Lindioil.
What does this study add?
Indirubin is the active ingredient in indigo naturalis, and different concentrations of indirubin in indigo naturalis ointment yield different results in treating psoriasis.
This study provides evidence that 200 μg g−1 of indirubin, the highest concentration studied so far, is the most effective concentration and is safe.
Linked Comment: Sekhon and Koo. Br J Dermatol 2018; 178:21.
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Background and purpose
To assess the efficacy of various antiepileptic drugs (AEDs) for controlling post‐stroke epilepsy.
Methods
This nationwide cohort study was conducted by using data from 2004 to ...2008 on new occurrence of post‐stroke epilepsy obtained from the National Health Insurance Research Database of Taiwan. The examined AEDs were phenytoin (PHT), valproic acid (VPA), carbamazepine (CBZ) and new AEDs. Recurrent seizures requiring either emergency room (ER) visits or hospitalization were used to measure the efficacy of seizure control. The Kaplan−Meier failure curve and Cox proportional hazard regression analyses were used to compare the risk of seizure recurrence in patients taking various AEDs.
Results
In all, 3622 late‐onset post‐stroke epilepsy patients were selected. Overall, 1.05 and 0.70 recurrent seizure incidences occurred per 100 person‐months based on ER visits 95% confidence interval (CI) 0.95–1.15 and hospitalizations (95% CI 0.62–0.78), respectively. The incidences of ER visits for patients using different AEDs were 1.26, 0.70, 0.43 and 0.38 per 100 person‐months for PHT, VPA, CBZ and new AEDs, respectively. Compared with patients using PHT, the adjusted hazard ratios for ER visits were 0.56 (95% CI 0.42–0.74; P < 0.001), 0.37 (95% CI 0.18–0.75; P = 0.006) and 0.28 (95% CI 0.15–0.52; P < 0.001) for patients using VPA, CBZ and new AEDs, respectively. The adjusted hazard ratios of hospitalizations for seizure recurrence yielded similar results.
Conclusions
This large nationwide, population‐based study demonstrated that late‐onset post‐stroke epilepsy patients using VPA and new AEDs have better seizure control than those using PHT as demonstrated by lower risks of ER visits and hospitalization.
Noninvasive and real‐time cuffless blood pressure (BP) measurement realizes the idea of unobtrusive and continuous BP monitoring which is essential for diagnosis and prevention of cardiovascular ...diseases associated with hypertension. In this paper, a wearable sensor patch system that integrates flexible piezoresistive sensor (FPS) and epidermal electrocardiogram (ECG) sensors for cuffless BP measurement is presented. By developing parametric models on the FPS sensing mechanism and optimizing operational conditions, a highly stable epidermal pulse monitoring method is established and beat‐to‐beat BP measurement from the ECG and epidermal pulse signals is demonstrated. In particular, this study highlights the compromise between sensor sensitivity and signal stability. As compared with the current optical‐based cuffless BP measurement devices, the sensing patch requires much lower power consumption (3 nW) and is capable of detecting subtle physiological signal variations, e.g., pre and postexercises, thus providing a promising solution for low‐power, real‐time, and home‐based BP monitoring.
A wearable sensor patch that integrates a flexible piezoresistive sensor and epidermal electrocardiogram sensors is demonstrated for extracting real‐time beat‐to‐beat blood pressure (BP) through a pulse transit time method. This sensing patch requires ultralow power consumption (3 nW) and is capable of detecting subtle physiological signal variations, e.g., pre‐ and post‐exercises, thus providing a promising solution for real‐time and home‐based BP monitoring.
MicroRNAs (miRNAs) are thought to control tumor metastasis through direct interactions with target genes. Thyroid hormone (T3) and its receptor (TR) are involved in cell growth and cancer ...progression. However, the issue of whether miRNAs participate in T3/TR-mediated tumor migration is yet to be established. In the current study, we demonstrated that T3/TR negatively regulates mature miR-17 transcript expression, both in vitro and in vivo. Luciferase reporter and chromatin immunoprecipitation (ChIP) assays localized the regions responding to TR-mediated repression to positions -2234/-2000 of the miR-17 promoter sequence. Overexpression of miR-17 markedly inhibited cell migration and invasion in vitro and in vivo, mediated via suppression of matrix metalloproteinases (MMP)-3. Moreover, p-AKT expression was increased in miR-17-knockdown cells that led to enhanced cell invasion, which was blocked by LY294002. Notably, low miR-17 expression was evident in highly metastatic cells. The cell migration ability was increased by T3, but partially reduced upon miR-17 overexpression. Notably, TRα1 was frequently upregulated in hepatocellular carcinoma (HCC) samples and associated with low overall survival (P=0.023). miR-17 expression was significantly negatively associated with TRα1 (P=0.033) and MMP3 (P=0.043) in HCC specimens. Data from our study suggest that T3/TR, miR-17, p-AKT and MMP3 activities are interlinked in the regulation of cancer cell metastasis.
Endovascular repair (EVAR) of mycotic aortic aneurysm (MAA) has become an alternative treatment for high risk patients. The aim of this study was to evaluate long-term survival and outcomes.
...Retrospective analysis of 40 consecutive patients with MAAs undergoing EVAR and subsequent intravenous antibiotic treatment between September 2009 and April 2015. Follow-up was truncated on 30 April 2015. Uni- and multivariate logistic regression were used to assess risk factors of adverse outcomes. Cumulative survival was calculated using the Kaplan–Meier method.
Median age at repair was 73 years (range 48–88 years) and 31 (77%) were men. Eleven (27%) patients were infected with Salmonella, 12 (30%) with non-Salmonella species, and 17 (42%) had negative cultures. Anatomical locations included the aortic arch/thoracic area in 10 (25%), the paravisceral area in seven (17%), and the infrarenal area in 23 (57%). Ten (25%) patients presented with aneurysm rupture and underwent emergency repair. Median follow-up was 25 months (range 1–69 months). Cumulative 1 and 5 year survival rates were 71% and 53%, respectively. Persistent or recurrent infection occurred in 20% (n = 8). Patients with persistent infection were treated with long-term medical therapy, but all died (75%; n = 6) within 6 months of repair. No survival difference was found between patients with or without Salmonella infections. However, there was a trend toward better survival in culture negative patients.
EVAR of MAA is an acceptable alternative treatment of MAA. However, persistent infection after endovascular treatment does occur and is often fatal without surgical treatment.
Infection by hepatitis B virus (HBV) accounts for 50-80% of hepatocellular carcinoma (HCC) development worldwide, in which the HBV-encoded X protein (HBx) has critical role in the induction of ...carcinogenesis. Several studies have shown that thyroid hormone (TH) suppresses HCC development and protects hepatocytes from HBx-induced damage, thus it is of interest to examine whether TH can protect hepatocytes from HBx-induced carcinogenesis. By treating HBx- transgenic mice with or without TH, we confirmed the protective effects of TH on HBx-induced hepatocarcinogenesis, which was achieved via reduction of reactive oxygen species (ROS) inflicted DNA damage. We further found that TH induced biogenesis of mitochondria (MITO) and autophagy of HBx-targeted MITO simultaneously, consequently leading to suppression of HBx-promoted ROS and carcinogenesis. Using microarray data analysis, this protective effect of TH was found to be mediated via activation of PTEN-induced kinase 1 (PINK1) in hepatocytes. PINK1, in turn, activated and recruited Parkin, an E3 ligase, to ubiquitinate MITO-associated HBx protein and trigger selective mitophagy. The pathological significance of the TH/PINK1 pathway in liver protection was confirmed by the concomitant decrease in expression of both TR and PINK1 in matched HCC tumor tissues and negatively correlated with aggressive progression of cancer and poor prognosis. Our data indicate that TH/PINK1/Parkin pathway has a critical role in protecting hepatocytes from HBx-induced carcinogenesis. Notably, several liver-targeting therapeutic derivatives of TH facilitating prevention or therapy of steatosis have been identified. Furthermore, our proof-of-concept experiments suggest that application of T
constitutes an effective novel therapeutic or preventive option for HCC. Thus, the utilization of the agonists of TRs could be the meaningful strategy in liver relative diseases, ranging from simple hepatic steatosis to HCC.
To investigate the global incidence of prostate cancer with special attention to the changing age structures. Data regarding the cancer incidence and population statistics were retrieved from the ...International Agency for Research on Cancer in World Health Organization. Eight developing and developed jurisdictions in Asia and the Western countries were selected for global comparison. Time series were constructed based on the cancer incidence rates from 1988 to 2007. The incidence rate of the population aged ≥ 65 was adjusted by the increasing proportion of elderly population, and was defined as the "aging-adjusted incidence rate". Cancer incidence and population were then projected to 2030. The aging-adjusted incidence rates of prostate cancer in Asia (Hong Kong, Japan and China) and the developing Western countries (Costa Rica and Croatia) had increased progressively with time. In the developed Western countries (the United States, the United Kingdom and Sweden), we observed initial increases in the aging-adjusted incidence rates of prostate cancer, which then gradually plateaued and even decreased with time. Projections showed that the aging-adjusted incidence rates of prostate cancer in Asia and the developing Western countries were expected to increase in much larger extents than the developed Western countries.
Fecal microbiota transplant (FMT) has emerged as a potential treatment for severe colitis associated with graft-versus-host disease (GvHD) following hematopoietic stem cell transplant. Bacterial ...engraftment from FMT donor to recipient has been reported, however the fate of fungi and viruses after FMT remains unclear. Here we report longitudinal dynamics of the gut bacteriome, mycobiome and virome in a teenager with GvHD after receiving four doses of FMT at weekly interval. After serial FMTs, the gut bacteriome, mycobiome and virome of the patient differ from compositions before FMT with variable temporal dynamics. Diversity of the gut bacterial community increases after each FMT. Gut fungal community initially shows expansion of several species followed by a decrease in diversity after multiple FMTs. In contrast, gut virome community varies substantially over time with a stable rise in diversity. The bacterium, Corynebacterium jeikeium, and Torque teno viruses, decrease after FMTs in parallel with an increase in the relative abundance of Caudovirales bacteriophages. Collectively, FMT may simultaneously impact on the various components of the gut microbiome with distinct effects.