Cognitive determinants of community functioning and quality of life in homeless adults with mental illness: 6-year follow-up from the At Home/Chez Soi Study Toronto site.

BACKGROUND: High rates of physical and mental health comorbidities are associated with functional impairment among persons who are homeless. Cognitive dysfunction is common, but how it contributes to various functional outcomes in this population has not been well investigated. This study examines how cognition covaries with community functioning and subjective quality of life over a 6-year period while accounting for the effects of risk and protective factors. METHODS: Participants were 349 homeless adults (mean age = 39.8) recruited from the Toronto site of the At Home/Chez Soi study, a large Canadian randomized control trial of Housing First. Participants completed up to four clinical evaluations over 6 years. Factor scores were created to index verbal learning and memory (vLM) and processing speed-cognitive flexibility (PSCF). The primary outcomes were community functioning and subjective quality of life. Risk factors included lifetime homelessness, mental health diagnoses, medical comorbidity, and childhood adversity. Linear mixed-effects models were conducted to examine cognition-functional outcome associations over time, with resilience as a moderator. RESULTS: Better vLM (b = 0.787, p = 0.010) and PSCF (b = 1.66, p < 0.001) were associated with better community functioning, but not with quality of life. Resilience conferred a protective effect on subjective quality of life (b = 1.45, p = 0.011) but did not moderate outcomes. CONCLUSIONS: Our findings suggest a need to consider the unique determinants of community functioning and quality of life among homeless adults. Cognition should be prioritized as a key intervention target within existing service delivery models to optimize long-term functional outcomes.

Long-term clinical outcomes of endoscopic submucosal dissection for colorectal neoplasia with or without the hybrid technique.

AIM: The main aim of this study was to compare the long-term outcome of a conventional colorectal endoscopic submucosal dissection (ESD) in which submucosal dissection was continued throughout until the completion of resection (ESD-T) to hybrid endoscopic submucosal dissection (ESD-H) in the colorectum. METHOD: Medical records of 836 colorectal neoplasia patients treated by ESD-T or ESD-H were reviewed. ESD-H was defined as colorectal ESD with additional snaring in the final stage of the procedure. Primary outcomes were the overall and metastatic recurrence rates. Secondary outcomes were short-term outcomes such as the en bloc resection rate, procedure time and adverse events. RESULTS: The overall recurrence rate was higher in the ESD-H than in the ESD-T group (5.7% vs 0.7%, P = 0.001). The metastatic recurrence rate showed no significant difference between these groups (1.4% vs 1.4%, P = 1.000). Multivariate analysis revealed that a failed en bloc resection (hazard ratio 24.097; 95% CI 5.446-106.237; P < 0.001) and larger tumour size (hazard ratio 1.042; 95% CI 1.014-1.070; P = 0.003) were independently associated with overall recurrence. The ESD-H group showed a lower en bloc resection rate (56.8% vs 96.5%, P < 0.001), shorter procedure time (45.6 vs 54.3 min, P < 0.001) and higher perforation rate (10.3% vs 6.0%, P = 0.029). CONCLUSION: Although long-term outcomes in terms of overall recurrence are inferior following ESD-H, a failed en bloc resection and large tumour size are the only independent risk factors for recurrence. Further investigations are warranted to improve the long-term outcomes of ESD-H.

Synthesis and Characterization of Mimosa Pudica Leaves Shaped α-Iron Oxide Nanostructures for Ethanol Chemical Sensor Applications.

Herein, the synthesis of mimosa pudica leaves shaped a-iron oxide (α-Fe2O3) nanostructures is reported through simple and facile hydrothermal process. The prepared α-Fe2O3 nanostructures were characterized in terms of their morphological, structural, compositional and optical properties through a variety of characterization techniques such as FESEM, EDS, XRD, FTIR and Raman spectroscopy. The detailed characterizations revealed the well-crystallinity and dense growth of mimosa pudica leaf shaped α-Fe2O3 nanostructures. Further, the prepared nanomaterials were used as efficient electron mediator to fabricate sensitive ethanol chemical sensor. The fabricated sensor exhibited a high sensitivity of -30.37 µAmM(-1) cm(-2) and low detection limit of -0.62 µM. The observed linear dynamic range (LDR) was in the range from 10 µM-0.625 µM.

Differential association of proinflammatory cytokines with left ventricular diastolic dysfunction in subjects with and without continuous ambulatory peritoneal dialysis.

BACKGROUND AND AIMS: The association between inflammation and left ventricular (LV) diastolic dysfunction in continuous ambulatory peritoneal dialysis (CAPD) and non-CAPD patients is not established. The objective of this study was to test the above association and whether inflammation interacts with CAPD to increase LV diastolic dysfunction risks. METHODS AND RESULTS: 120 subjects with normal creatinine levels and 101 CAPD patients were recruited. Echocardiographic parameters were assessed in all patients. The participants were classified as having LV diastolic dysfunction by echocardiographic findings including mitral inflow E/A ratio < 1, deceleration time > 220 cm/s, or decreased peak annular early diastolic velocity in tissue Doppler imaging. Blood was sampled at the baseline for measurement of inflammation markers, including tissue necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6). Subjects with LV diastolic dysfunction had higher proinflammation cytokines levels in both groups. Inflamed markers correlated significantly with echocardiography parameters for LV diastolic dysfunction in patients receiving CAPD. In a multivariate regression analysis adjusting for all the factors associated with LV diastolic dysfunction, inflammation is still significantly associated with left ventricular diastolic dysfunction (TNF-alpha, OR: 2.6, 95% CI: 2.0-3.35, p < 0.001; IL-6, OR: 1.26, 95% CI: 1.25-1.26, p = 0.01). In addition, the interaction of CAPD and inflammation significantly contributed to the development of LV diastolic dysfunction (CAPD∗ TNF-α: OR: 1.45, 95% CI: 1.13-1.79, P = 0.004). CONCLUSION: We found inflammation plays a vital role for LV diastolic dysfunction especially in CAPD patients. A synergistic effect between CAPD and inflammation, especially TNF-α, would further aggravate LV diastolic dysfunction.

High-yield synthesis of well-crystalline alpha-Fe2O3 nanoparticles: structural, optical and photocatalytic properties.

In this paper, the high-yield facile synthesis, detailed characterization and photocatalytic application of alpha-Fe2O3 nanoparticles are reported. The synthesis was done via simple hydrothermal process by using aqueous mixtures of iron chloride, hexamethylenediamine and NH3 x H2O at 110 degrees C. The morphologies of the synthesized products were examined by using field emission scanning electron microscopy (FESEM) and transmission electron microscopy (TEM) which confirmed that the synthesized structures are almost spherical shaped nanoparticles with the average diameters of -35 +/- 5 nm, and are grown in high yield. The detailed structural characterizations and composition of the as-synthesized nanoparticles were investigated by using X-ray diffraction (XRD), high-resolution TEM (HRTEM), energy dispersive spectroscopy (EDS) attached with FESEM and Fourier transform infrared spectroscopy (FTIR) which substantiated that the as-synthesized nanoparticles are well crystalline and pure alpha-Fe2O3. The UV-Vis absorption spectrum of the synthesized nanoparticles demonstrated the existence of two optical band gaps which correspond to direct and indirect transitions, respectively. The as-synthesized alpha-Fe2O3 nanoparticles exhibit good photocatalytic properties on photocatalytic degradation of methylene blue.

Well-crystalline ZnO nanowire based field effect transistors (FETs).

Well-crystalline ZnO nanowires were grown on Si(100) via non-catalytic thermal evaporation process using metallic zinc powder in presence of oxygen. The detailed morphological characterizations by field emission scanning electron microscopy (FESEM) and transmission electron microscopy (TEM) confirmed that the synthesized products are nanowires with the typical diameter and lengths of approximately 55 +/- 5 nm and several micrometers, respectively and are grown in high density over the silicon substrate. The detailed structural characterizations by high-resolution TEM and X-ray diffraction confirmed that the synthesized nanowires are well-crystalline and possessing wurtzite hexagonal phase. The presence of Raman-active optical-phonon E2(high) mode at 437 cm(-1) in the Raman-scattering spectrum confirms good crystal quality for the as-grown ZnO nanowires. The electrical transport properties of the as-grown nanowires were explored by fabricating single nanowire based field effect transistors (FETs). The fabricated single ZnO nanowire based FET exhibits carrier concentration and electron mobility of approximately 7.49 x 10(17) cm(-3) and approximately 8.42 cm2V(-1)s(-1), respectively.

Utilization of ZnO nanocones for the photocatalytic degradation of acridine orange.

A facile aqueous solution process was used to synthesize well-crystalline ZnO nanocones at 60 degrees C by using zinc nitrate hexahydrate and sodium hydroxide. The morphological, structural and optical properties of the synthesized ZnO nanocones were investigated by using field emission scanning electron microscopy (FESEM) attached with energy dispersive spectroscopy (EDS), transmission electron microscopy (TEM) equipped with high-resolution (HRTEM), X-ray diffraction (XRD) pattern, Fourier transform infrared (FTIR) spectroscopy and UV-Vis. spectroscopy measurements. The structural and optical properties of the as-synthesized nanocones confirmed a pure and well crystalline product possessing wurtzite hexagonal phase. The as-synthesized ZnO nanocones were used as photocatalyst for the efficient photocatalytic degradation of acridine orange. The acridine orange was almost completely degraded within 105 minutes. This research demonstrates that the simply synthesized ZnO nanostructures could be efficient photocatalyst for the photocatalytic degradation of various organic dyes and chemicals.

Fabrication and radio frequency characterization of carbon nanotube field effect transistor: evidence of quantum capacitance.

We fabricated an radio frequency (RF) carbon nanotube field effect transistor (CNTFET) whose electrode shapes were standard RF designed ground-signal-ground (GSG)-type pads. The S-parameters measured from our RF CNTFET in the frequency range up to 6 GHz were fitted with an RF equivalent circuit, and the extracted gate capacitance was shown to be the capacitance value of the series combination of the electrostatic capacitance and the quantum capacitance. The effect of the channel resistance and the kinetic inductance was also discussed.

The effects of hidden female smokers on the association between smoking and chronic obstructive pulmonary disease in Korean adults.

OBJECTIVE: Smoking is an important causative factor of chronic obstructive pulmonary disease (COPD), and females are considered more susceptible to the effects of smoking than males. However, in previous Korean studies, the effects of sex differences on the association between smoking and COPD have been controversial. In this study, the effects of sex differences on the association between smoking and COPD and the effects of female hidden smokers on that association in Korean adults were investigated. METHODS: Data were acquired from the Korea National Health and Nutrition Examination Surveys (KNHANES). RESULTS: The multivariate logistic regression analysis showed that self-reported smoking status for ex-smoker and current smoker correlated with COPD (odds ratio, OR: 1.67 and OR: 2.41, respectively). Self-reported smoking status for ex-smoker and current smoker correlated with COPD in men (OR: 1.61, OR: 2.43, respectively). Female self-reported current smoking status correlated with COPD (OR: 2.52), but female ex-smoker status was not significantly correlated with COPD. The ratios of cotinine-verified to self-reported smoking rates were 1.95 for women and 1.07 for men. CONCLUSION: The results of this study were that sex differences might affect the association between COPD and smoking and that female hidden smoking might affect the association between smoking and COPD in Korean adults.

Phase II study with oxaliplatin and S-1 for patients with metastatic colorectal cancer.

BACKGROUND: To evaluate the efficacy and safety of the combination of oxaliplatin and S-1 (OS) in treating metastatic colorectal cancer. PATIENTS AND METHODS: Eligible patients were those with measurable lesions, no previous history of chemotherapy (except adjuvant chemotherapy), an age of 18-70 years, and an Eastern Cooperative Oncology Group performance status of zero to two. Oxaliplatin 130 mg/m(2) was administered i.v. on day 1, and S-1 40 mg/m(2) b.i.d. was administered orally on days 1-14, every 3 weeks. RESULTS: Forty-eight patients (median age, 56 years) were enrolled: 23 had colon cancer, seven rectosigmoid colon cancer; and 18 rectal cancer. Of the 48 patients, 31 were diagnosed with metastatic cancer and 17 had relapsed cancer after surgery, with adjuvant chemotherapy or chemoradiotherapy. In total, 413 cycles were administered (median 6 per patient; range 2-24). Toxicity was evaluated in 48 patient and response in 46. Major toxic effects were grade 3/4 thrombocytopenia (13%) and neutropenia (10%). The overall response rate was 54% [95% confidence interval (CI) 40% to 68%]. The median time to progression and median survival time were 8.5 (95% CI 6.2-10.9) months and 27.2 (95% CI 20.3-34.0) months, respectively. CONCLUSIONS: These data indicate that the OS regimen is effective and well tolerated in patients with advanced colorectal cancer.

A high-resolution anorectal manometry parameter based on integrated pressurized volume: A study based on 204 male patients with constipation and 26 controls.

BACKGROUND: Conventional anorectal manometric parameters based on linear waves cannot properly predict balloon expulsion (BE) time. We aimed to determine the correlation between integrated pressurized volume (IPV) parameters during simulated evacuation (SE) and BE time in healthy individuals and constipated patients and to assess the correlation between each parameter and symptoms. METHODS: A total of 230 male participants (including 26 healthy volunteers and 204 chronically constipated patients) underwent high-resolution anorectal manometry (HRAM) and BE tests. The IPV was calculated by multiplying the amplitude, distance, and time from the HRAM profile. Receiver operating characteristic curve (ROC) analysis and partial least square regression (PLSR) were performed. KEY RESULTS: ROC analysis indicated that the IPV ratio between the upper 1 cm and lower 4 cm of the anal canal was more effective for predicting BE time (area under the curve [AUC]: 0.74, 95% confidence interval [CI]: 0.67-0.80, P < .01) than the conventional anorectal parameters, including defecation index and rectoanal gradient (AUC: 0.60, 95% CI: 0.52-0.67, P = .01). PLSR analysis of a linear combination of IPV parameters yielded an AUC of 0.79. Moreover, the IPV ratio showed a greater clinical correlation with patient symptoms than conventional parameters. CONCLUSIONS AND INFERENCES: The IPV parameters and the combination of IPV parameters via PLSR were more significantly correlated with BE time than the conventional parameters. Thus, this study presents a useful diagnostic tool for the evaluation of pathophysiologic abnormalities in dyssynergic defecation using IPV and BE time.

Intracellular ATP increases capsaicin-activated channel activity by interacting with nucleotide-binding domains.

Capsaicin (CAP)-activated ion channel plays a key role in generating nociceptive neural signals in sensory neurons. Here we present evidence that intracellular ATP upregulates the activity of capsaicin receptor channel. In inside-out membrane patches isolated from sensory neurons, application of CAP activated a nonselective cation channel (i(cap)). Further addition of ATP to the bath caused a significant increase in i(cap), with a K(1/2) of 3.3 mm. Nonhydrolyzable analogs of ATP, adenylimidodiphosphate and adenosine 5'-O-(3-thio)-triphosphate, also increased i(cap). Neither Mg(2+)-free medium nor inhibitors of various kinases blocked the increase in i(cap) induced by ATP. The enhancing effect of ATP was also observed in inside-out patches of oocytes expressing vanilloid receptor 1, a cloned capsaicin receptor. Single point mutations (D178N, K735R) within the putative Walker type nucleotide-binding domains abolished the effect of ATP. These results show that ATP increases i(cap) in sensory neurons by direct interaction with the CAP channel without involvement of phosphorylation.

D-arabinose dehydrogenase and biosynthesis of erythroascorbic acid in Candida albicans.

D-Arabinose dehydrogenase was purified 2750-fold from the cytosolic fraction of Candida albicans to apparent homogeneity, with an overall yield of 3%, by a purification procedure consisting of ammonium sulfate precipitation and DEAE-Sepharose A-50, Sephacryl S-200, Cibacron blue and phenyl-Sepharose CL-4B chromatographies. Gel-filtration chromatography gave an apparent molecular mass of 41 kDa and SDS-PAGE showed only one protein band corresponding to a molecular mass of 42 kDa, indicating that the enzyme is a single polypeptide. The enzyme was optimally active at pH 8.0 and the pI value of the enzyme was 5.0. The enzyme was relatively stable from pH 4.5 to 7.5. The optimal temperature for the enzyme activity was 30 degrees C. The activity of the enzyme was inhibited by Hg2+, Fe2+, Zn2+, Cu2+, Mg2+, Mn2+, N-ethylmaleimide and p-chloromercuribenzoic acid. The enzyme catalysed the oxidation of D-arabinose, L-fucose, L-xylose and L-galactose, which have the same configurations of hydroxyl groups at C2- and C3-positions, with apparent K(m) values of 29.2, 28.9, 37.1 and 91.3 mM at pH 8.0, respectively, with 50 microM NADP+. The enzyme used NADP+ as a coenzyme. Apparent K(m) value at 60 mM D-arabinose for NADP+ was 44.6 microM. NADPH inhibited the enzyme activity competitively with respect to NADP+ (Ki = 78.6 microM). The amino-terminal sequence of the enzyme was Met-Lys-Leu-Ala-Thr-Glu-Ile-Asp-Phe-X-Leu-Asn-Asn-Gly-. The reaction product was D-arabinono-1,4-lactone, judged from gas-liquid chromatography/mass spectrometry. In C. albicans, D-erythroascorbic acid was formed from D-arabinose by D-arabinose dehydrogenase and D-arabinono-1,4-lactone oxidase.

Risk factors for death in homeless adults in Boston.

BACKGROUND: Homeless individuals experience high mortality rates. Males, whites, and substance abusers are more likely to die, but other high-risk characteristics are unknown. OBJECTIVE: To identify demographic and clinical factors associated with an increased risk of death in homeless individuals. METHODS: We conducted a case-control study of 558 adults who were seen by a health care program for the homeless in Boston, Mass, and who died in 1988 to 1993. Age-matched paired controls were selected from among individuals seen by the program who were alive at the end of 1993. Predictive data were obtained by blinded review of medical records. Odds ratios (ORs) for death were calculated using logistic regression analysis models. RESULTS: In a multivariate analysis, the strongest risk factors for death were acquired immunodeficiency syndrome (OR, 55.8), symptomatic human immunodeficiency virus infection (OR, 17.7), asymptomatic human immunodeficiency virus infection (OR, 4.1), renal disease (OR, 18.4), a history of cold-related injury (OR, 8.0), liver disease (OR, 3.8), and arrhythmia (OR, 3.3). A history of substance abuse involving injection drugs (OR, 1.6) or alcohol (OR, 1.5) also increased the risk of mortality. Nonfluency in English was associated with a decreased risk of death (OR, 0.4). CONCLUSIONS: In a group of adults seen by a health care program for the homeless, specific medical illnesses were associated with the greatest risk of death. Substance abuse alone was less strongly associated with death. Interventions to reduce mortality among the homeless should focus on individuals with high-risk characteristics.

Fabrication and Characterization of Field Effect Transistor Based on High-Aspect Ratio Sulfur-Doped ZnO Nanowires.

Well-crystalline sulfur (S) doped ZnO nanowires have been grown via a simple thermal evaporation process on Si substrate using high purity zinc and sulfur powders in presence of oxygen. The as-grown S:ZnO nanowires were characterized in terms of their morphological structural, compositional and optical properties using several techniques such as FESEM, TEM, XRD, EDS and PL. The morphological characterizations revealed that the as-grown nanowires had diameters in the range of 60-100 nm with lengths 5-15 µm. The details structural properties confirmed the well-crystallinity and wurtzite hexagonal phase for the prepared nanowires. Room temperature photoluminescence (PL) spectrum showed a strong green band with a suppressed UV emission. The electrical properties of single S:ZnO nanowire was examined by fabricating single nanowire based field effect transistors (FETs). The detailed electrical transport results showed that S:ZnO nanowires possess n-type semiconducting behavior and exhibited an electron mobility of -67.7 cm2 V(-1) s(-1) and a carrier concentration of 2 x 10(17) cm(-3), respectively.

A capsaicin-receptor antagonist, capsazepine, reduces inflammation-induced hyperalgesic responses in the rat: evidence for an endogenous capsaicin-like substance.

In the present study, the presence of an endogenous capsaicin-like substance and the role of capsaicin receptors in nociception during inflammation were assessed using Fos immunohistochemistry and the paw-withdrawal test in rats. Intradermal injection of carrageenan in the hind-paw produced inflammation in the foot pad, increased the number of cells exhibiting Fos-like immunoreactivity in the dorsal horn of the spinal cord, and decreased the paw-withdrawal latency. Intradermal injection of capsazepine, a capsaicin-receptor antagonist, significantly reduced the number of cells exhibiting Fos-like immunoreactivity, significantly increased the paw-withdrawal latency, but did not decrease inflammation induced by carrageenan injection. Intradermal injection of capsaicin or formalin also increased Fos-positive neurons. Capsaicin- or formalin-induced Fos expression was reduced in both cases by pretreatment of capsazepine, but to a much lesser extent for formalin. The capsazepine inhibition of carrageenan inflammation-induced hyperalgesic responses strongly suggests that an endogenous capsaicin-like substance is released in inflamed tissues and produces nociceptive neural impulses by acting on capsaicin receptors present on sensory neurons. Furthermore, our results indicate that capsaicin receptors take part only in generating nociceptive signals in sensory neurons, but not in activating the inflammation-promoting cells.

A novel method for simultaneous anterograde and retrograde labeling of spinal cord motor tracts in the same animal.

Examination of repaired spinal cord tracts has usually required separate groups of animals for anterograde and retrograde tracing owing to the incompatibility of techniques such as tissue fixation. However, anterograde and retrograde labeling of different animals subjected to the same repair may not allow accurate examination of that repair strategy because widely variable results can occur in animals subjected to the same strategy. We have developed a reliable method of labeling spinal cord motor tracts bidirectionally in the same animal using DiI, a lipophilic dye, to anterogradely label the corticospinal tract and Fluoro-Gold (FG) to retrogradely label cortical and brainstem neurons of several spinal cord motor tracts in normal and injured adult rats. Other tracer combinations (lipophilic dyes or fluorescent dextrans) were also investigated but were less effective. We also developed methods to minimize autofluorescence with the DiI/FG technique, and found that the DiI/FG technique is compatible with decalcification and immunohistochemistry for several markers relevant for studies of spinal cord regeneration. Thus, the use of anterograde DiI and retrograde FG is a novel technique for bidirectional labeling of the motor tracts of the adult spinal cord with fluorescent tracers and should be useful for demonstrating neurite regeneration in studies of spinal cord repair.(J Histochem Cytochem 49:1111-1122, 2001)

Aortic root abscess with fistula formation.

Aortic root abscess is a common complication of aortic valve endocarditis. However, aortic root abscess and formation of a fistula from the aortic root to the right ventricular outflow tract in the setting of a native aortic valve and previous repair of an aortic dissection with a Dacron graft is an uncommon event. Transesophageal echocardiography is superior to transthoracic echocardiography for the diagnosis of aortic root abscess. To our knowledge, no studies have compared the diagnostic value of cardiac MRI with transesophageal echocardiography for this condition.