Suicidality Among People Living With HIV From 2010 to 2021: A Systematic Review and a Meta-regression.

OBJECTIVE: The association between human immunodeficiency virus (HIV)/AIDS and suicidality is not well understood, partly because of variability in results. This meta-analysis aimed to investigate the predictive value of HIV/acquired immune deficiency syndrome for incident suicidality. METHODS: A literature review was conducted of articles published between January 1, 2010, and October 31, 2021. The following databases were searched: Embase, MEDLINE, CINAHL, Web of Science, and Scopus. The search terms included human immunodeficiency virus (HIV), suicidal behavior, auto mutilation, and self-injurious behavior. Observational studies were screened following a registered protocol, and eligible ones were meta-analyzed and followed by meta-regression. RESULTS: A total of 43 studies were included in this systematic review, and a meta-regression included 170,234 participants. The pooled prevalence estimates of suicidal ideation, attempted suicide, and deaths by suicide were 22.3%, 9.6%, and 1.7%, respectively. The following significant risk factors for suicide ideation were found: substance use, depression, low quality of life, low social support, without HIV status disclosure, living alone, low level of memory problems, family history of suicide, and stage III of HIV. Risk factors for suicide attempts were depression and family history of suicide. An elevated risk for suicide-related death was found for people living with HIV (PLHIV) who had a psychiatric disorder and in studies conducted in hospital-based settings (versus national database studies or HIV clinic settings). CONCLUSIONS: The risk of suicidality is high among PLHIV within all six World Health Organization regions during the modern antiretroviral therapy era. Assessment of socioeconomic and psychological factors is recommended for further management to prevent suicide among PLHIV. The present findings are useful for design of intervention protocols and development of clinical practice guidelines intended to manage the well-being of PLHIV worldwide.

A universal strategy for the fabrication of single-photon and multiphoton NIR nanoparticles by loading organic dyes into water-soluble polymer nanosponges.

The development of optical organic nanoparticles (NPs) is desirable and widely studied. However, most organic dyes are water-insoluble such that the derivatization and modification of these dyes are difficult. Herein, we demonstrated a simple platform for the fabrication of organic NPs designed with emissive properties by loading ten different organic dyes (molar masses of 479.1-1081.7 g/mol) into water-soluble polymer nanosponges composed of poly(styrene-alt-maleic acid) (PSMA). The result showed a substantial improvement over the loading of commercial dyes (3.7-50% loading) while preventing their spontaneous aggregation in aqueous solutions. This packaging strategy includes our newly synthesized organic dyes (> 85% loading) designed for OPVs (242), DSSCs (YI-1, YI-3, YI-8), and OLEDs (ADF-1-3, and DTDPTID) applications. These low-cytotoxicity organic NPs exhibited tunable fluorescence from visible to near-infrared (NIR) emission for cellular imaging and biological tracking in vivo. Moreover, PSMA NPs loaded with designed NIR-dyes were fabricated, and photodynamic therapy with these dye-loaded PSMA NPs for the photolysis of cancer cells was achieved when coupled with 808 nm laser excitation. Indeed, our work demonstrates a facile approach for increasing the biocompatibility and stability of organic dyes by loading them into water-soluble polymer-based carriers, providing a new perspective of organic optoelectronic materials in biomedical theranostic applications.

Is nurse-led case management effective in improving treatment outcomes for cancer patients? A systematic review and meta-analysis.

AIMS: To identify and synthesize the outcomes of nurse-led case management interventions for improving cancer treatment. DESIGN: Systematic review with meta-analysis. DATA SOURCES: PubMed, MEDLINE, CINAHL, EMBASE, Cochrane Library and CEPS were searched for articles published from inception till June 2019, and search was finalized in January 2020. REVIEW METHODS: The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. The quality of evidence was assessed using Joanna Briggs Institute Critical Appraisal Tools. Outcomes were analysed by using a pool of data of 95% confidence intervals (CIs), p value and fitting model based on heterogeneity of test results. RESULTS: Eleven articles were included in the meta-analysis. When compared with the regular care group, the nurse-led case management group had: 1) shorter time from diagnosis to treatment by 9.07 days, 2) an improved treatment completion rates (OR = 2.45) and 3) more number of patients received hormone therapy. CONCLUSION: The synthesized results presented that nurse-led case management is more effective than regular care in improving treatment timeliness, treatment completion rates and hormone therapy rates.

[Improving the Follow-Up Completion Rate of Community-Dwelling Individuals Who Screened Positive for Colorectal Cancer].

BACKGROUND & PROBLEMS: Early screening and early treatment of colorectal cancer increases the 5-year-survival rate of early stage cancer by 90%. However, a lack of knowledge regarding screening opportunities among community residents affects their willingness to seek medical help and delays treatment. The World Health Organization estimated that deaths from colorectal cancer in the next 20 years will increase from 8.2 million people to 13 million people annually. However, systemic screening and follow-up services will promote early detection and treatment and should effectively decrease colorectal cancer-related mortality. PURPOSE: The aim of this study is to increase the follow-up completion rate of community participants who tested positive during a screening for colorectal cancer. RESOLUTIONS: The resolution measure produced stool occult blood screening education leaflets, promoted health lectures on the topic of cancer screening, planned a training course for cancer-prevention education, constructed a participant tracking and notification system in the outpatient information system for positive participants, set up a procedure for positive participant follow-up, and designed a cooperative model for community health promotion. RESULTS: The follow-up completion rate of participants who tested positive during colorectal cancer screen tests increased to 74.1%, and the accuracy rate of colorectal screening knowledge rose to 93.9%. CONCLUSIONS: Implementation of the project increased the follow-up effectiveness of participants who tested positive during the screening. We hope that medical facilities cooperate with communities in order to facilitate health promotion and increase the number of residents with correct cancer-prevention concepts.

The impact of sleep disturbances on suicide risk among people living HIV: An eleven-year national cohort.

OBJECTIVES: The suicide rate among individuals who experience sleep disturbances is five times higher than in the general population. Up to 70 % of people living with HIV (PLHIV) experience sleep disturbances. This study's purpose was to determine whether this population has higher rates of suicide compared to those without sleep disorders. Possible risk factors were also explored. METHODS: A secondary analysis of nationwide data on all males and females over 15 years old with HIV living in Taiwan was conducted from January 1, 2005, to December 31, 2016. Sleep disturbances were identified through recorded diagnoses and medical treatments. Cox proportional hazard models and hazard ratios (HRs) and mediation analysis were employed to estimate the association between sleep disturbances and suicide risk during the follow-up period. RESULTS: Of the 5680 PLHIV, 72 suicide events were reported. The suicide incidence rate among PLHIV suffering from sleep disturbances was 769 per 100,000 person-years. Sleep disturbances were associated with a significantly increased risk of suicide (AHR = 1.75, 95 % CI 1.02-3.02, p = 0.0429). A premium-based monthly salary of <24,000 (NT $) was also associated with an increased hazard of suicide (AHR = 4.14, 95 % CI 1.60-10.75, p = 0.0035). The pathway effect analysis using potential outcomes showed that depression did not mediate the effect of sleep disturbance on suicide. CONCLUSIONS: Sleep disturbances were associated with higher suicide rates, even after adjusting for pre-existing depression. These findings suggest that paying attention to suicidal ideation among PLHIV suffering from sleep disturbances is necessary.

Global overview of suicidal behavior and associated risk factors among people living with human immunodeficiency virus: A scoping review.

Death by suicide is a major public health problem. People living with human immunodeficiency virus (PLHIV) have higher risk of suicidal behavior than the general population. The aim of this review is to summarize suicidal behavior, associated risk factors, and risk populations among PLHIV. Research studies in six databases from January 1, 1988, to July 8, 2021, were searched using keywords that included "HIV," "suicide," and "risk factors." The study design, suicide measurement techniques, risk factors, and study findings were extracted. A total of 193 studies were included. We found that the Americas, Europe, and Asia have the highest rates of suicidal behavior. Suicide risk factors include demographic factors, mental illness, and physiological, psychological, and social support. Depression is the most common risk factor for PLHIV, with suicidal ideation and attempt risk. Drug overdosage is the main cause of suicide death. In conclusion, the current study found that PLHIV had experienced a high level of suicidal status. This review provides an overview of suicidal behavior and its risk factors in PLHIV with the goal of better managing these factors and thus preventing death due to suicide.

Dynamic changes in quality of life, psychological status, and body image in women who underwent a mastectomy as compared with breast reconstruction: an 8-year follow up.

BACKGROUND: Surgical decisions and methods of surgery highly influence long term QoL for breast cancer (BC) survivors. This study is aimed towards an exploration of the dynamic changes in quality of life (QoL), anxiety/depression status, and body image (BI) among women with BC who received a mastectomy compared with those receiving breast reconstruction (BR) within an 8-year follow-up period. METHODS: Women with major BC surgeries were invited to complete the World Health Organization Quality of Life-Brief (WHOQOL-BREF), the European quality of life five dimensions questionnaire (EQ-5D), and a body image scale within 8 years of surgery. Kernel smoothing methods were applied to describe dynamic changes in QoL, anxiety/depression, and BI at different time points. Linear mixed effects models were constructed to identify the interaction between time, different types of surgery, and the determinants of QoL in these patients. RESULTS: After 1:10 propensity score matching, a total of 741 women who had undergone a BR and mastectomy were included. The BR group exhibited a high WHOQOL QoL score one to five years after surgery with some fluctuations. The mastectomy group had comparatively stable QoL scores on WHOQOL items and were less depressed/anxious. The BR group generally showed fluctuating, higher BI scores two years after surgery, but they exhibited more anxiety/depression during follow up for 8 years. Medical comorbidities, the status of anxiety/depression, and BI were the major factors influencing all domains and items of the WHOQOL BREF among women with BC. CONCLUSION: The mastectomy group showed a decreased trend toward depression in patients with BC. The BR group showed a significant improvement in QoL in the first 5 years with massive fluctuations. These findings should be considered and discussed in patient participatory decision-making and promotion of QoL for breast cancer survivors.

Novel metal peroxide nanoboxes restrain Clostridioides difficile infection beyond the bactericidal and sporicidal activity.

Clostridioides difficile spores are considered as the major source responsible for the development of C. difficile infection (CDI), which is associated with an increased risk of death in patients and has become an important issue in infection control of nosocomial infections. Current treatment against CDI still relies on antibiotics, which also damage normal flora and increase the risk of CDI recurrence. Therefore, alternative therapies that are more effective against C. difficile bacteria and spores are urgently needed. Here, we designed an oxidation process using H2O2 containing PBS solution to generate Cl- and peroxide molecules that further process Ag and Au ions to form nanoboxes with Ag-Au peroxide coat covering Au shell and AgCl core (AgAu-based nanoboxes). The AgAu-based nanoboxes efficiently disrupted the membrane structure of bacteria/spores of C. difficile after 30-45 min exposure to the highly reactive Ag/Au peroxide surface of the nano structures. The Au-enclosed AgCl provided sustained suppression of the growth of 2 × 107 pathogenic Escherichia coli for up to 19 days. In a fecal bench ex vivo test and in vivo CDI murine model, biocompatibility and therapeutic efficacy of the AuAg nanoboxes to attenuate CDI was demonstrated by restoring the gut microbiota and colon mucosal structure. The treatment successfully rescued the CDI mice from death and prevented their recurrence mediated by vancomycin treatment. The significant outcomes indicated that the new peroxide-derived AgAu-based nanoboxes possess great potential for future translation into clinical application as a new alternative therapeutic strategy against CDI.

Higher Risk of Acute Respiratory Distress Syndrome and Risk Factors among Patients with COVID-19: A Systematic Review, Meta-Analysis and Meta-Regression.

OBJECTIVE: To estimate the global risk and risk factors associated with acute respiratory distress syndrome (ARDS) among patients with COVID-19: Design: A systematic review, meta-analysis and meta-regression. SETTING AND PARTICIPANTS: Hospitals or nursing homes and patients with acute respiratory distress syndrome after COVID-19. METHODS: The literature review was systematically conducted on Embase, MEDLINE, CINAHL, and Web of Science, in addition to manual searches and reference list checking from 1 January 2019 to 2 March 2022. The search terms included coronavirus, acute respiratory syndrome, acute respiratory distress syndrome and observational studies. Three reviewers independently appraised the quality of the studies and extracted the relevant data using the Joanna Briggs Institute abstraction form and critical appraisal tools. A study protocol was registered in PROSPERO (CRD42022311957). Eligible studies were meta-analyzed and underwent meta-regression. RESULTS: A total of 12 studies were included, with 148,080 participants. The risk ratio (RR) of ARDS was 23%. Risk factors were age ≥ 41-64 years old (RR = 15.3%, 95% CI =0.14-2.92, p = 0.03); fever (RR = 10.3%, 95% CI = 0.03-2.03, p = 0.04); multilobe involvement of the chest (RR = 33.5%, 95% CI = 0.35-6.36, p = 0.02); lymphopenia (RR = 25.9%, 95% CI = 1.11-4.08, p = 0.01); mechanical ventilation with oxygen therapy (RR = 31.7%, 95% CI = 1.10-5.25, p = 0.002); European region (RR = 16.3%, 95% CI = 0.09-3.17, p = 0.03); sample size ≤ 500 (RR = 18.0%, 95% CI = 0.70-2.89, p = 0.001). CONCLUSIONS AND IMPLICATIONS: One in four patients experienced ARDS after having COVID-19. The age group 41-64 years old and the European region were high-risk groups. These findings can be used by policymakers to allocate resources for respiratory care facilities and can also provide scientific evidence in the design of protocols to manage COVID-19 worldwide.

Higher Risk of Depression After Total Mastectomy Versus Breast Reconstruction Among Adult Women With Breast Cancer: A Systematic Review and Metaregression.

This systematic review with a meta-regression was conducted to determine the risk of depression after mastectomy compared to breast reconstruction among women with breast cancer 1 year after surgery. A literature search was conducted according to PRISMA guidelines using 4 databases: Medline (Ovid), Embase, Cinahl, and the Cochrane Library for the period January 2000 to March 2019. Studies that measured the status of depression within 1 year and immediately after surgery were included. Outcomes related to depression were analyzed by using a pool of event rates and a risk ratio of 95% confidence interval (CI), P value, and a fitting model based on the results of a heterogeneity test of mastectomy and BR. The statistical analysis was conducted using Comprehensive Meta-analysis 3.0 software. Nine studies met the inclusion criteria. There were 865 cases of mastectomy only, with a 22.2% risk of depression (95% CI, 12.4-36.2). In 869 women who underwent BR, the risk of depression was 15.7% (95% CI, 8.8-26.2). The depression risk ratio for mastectomy compared to BR was 1.36 (95% CI, 1.11-1.65). Patients with delayed reconstruction exhibited lower levels of depression (risk ratio 0.96, 95% CI 0.57-1.01). The Beck Depression Inventory (BDI) scale showed high sensitivity, and the Hospital Anxiety Depression Scale (HADS) with a cutoff of > 7 could measure even low to moderate depressive symptoms. One in 4 women with breast cancer had symptoms of depression after mastectomy; both surgeries were associated with depression in women 1 year after surgery. Our results will permit the development of proactive treatment plans before and after surgery to mitigate risk and prevent depression through the use of sensitive depression scales like BDI.

Incidence of Herpes Zoster in HIV-Infected Patients Undergoing Antiretroviral Therapy: A Systematic Review and Meta-analysis.

The incidence of herpes zoster (HZ) in patients infected with HIV is higher than that of the general population. However, the incidence of HZ in HIV patients receiving antiretroviral therapy (ART) remains unclear. This meta-analysis aimed to estimate the pooled incidence rate and risk factors for HZ in the post-ART era. We identified studies assessing the incidence of HZ in the post-ART era between 1 January 2000 and 28 February 2021, from four databases. Pooled risk ratios were calculated from 11 articles using a random-effects model. The heterogeneity of the included trials was evaluated by visually inspecting funnel plots, performing random-effects meta-regression and using I2 statistics. Of the 2111 studies screened, we identified 11 studies that were eligible for final inclusion in the systematic review and 8 studies that were eligible for a meta-analysis. The pooled incidence of HZ in the post-ART era (after the introduction of ART in 1997) was 2.30 (95% confidence interval (CI): 1.56-3.05) per 100 person years (PYs). The risks of incidence of HZ among people living with HIV included male sex (AOR: 4.35 (95% CI: 054-2.41)), men who have sex with men (AOR: 1.21 (95% CI: -0.76-1.13)), CD4 count < 200 cells/µL (AOR: 11.59 (95% CI: 0.53-4.38)) and not receiving ART (AOR: 2.89 (95% CI: -0.44-2.56)). The incidence of HZ is substantially lower among HIV infected patients receiving ART than those not receiving ART. Initiating ART immediately after diagnosis to treat all HIV-positive individuals is crucial to minimize the disease burden of HZ.

Foodborne Klebsiella pneumoniae: Virulence Potential, Antibiotic Resistance, and Risks to Food Safety.

ABSTRACT: Gastrointestinal carriage of Klebsiella pneumoniae is a predisposing factor for liver abscess in several Asian countries. To determine whether hypervirulent K. pneumoniae in the gut may be transmitted through food, we screened a range of raw and ready-to-eat retail food by culture and recovered K. pneumoniae in 21% (147 of 698) of samples tested. Based on PCR, no K. pneumoniae isolates carried the rmpA gene linked to community-acquired pyogenic liver abscess, providing no evidence of a link between food and liver disease. However, phenotypic resistance to multiple antibiotic classes was seen through disk diffusion tests, and carriage of genetic elements (wcaG and capsule types K1, K2, and K54) associated with increased virulence (8%, 11 of 147) was observed by PCR. Multidrug-resistant isolates were from raw vegetables, chicken or pork liver, and a ready-to-eat poultry dish; one multidrug-resistant K. pneumoniae isolate from raw bean sprouts was resistant to a third-generation cephalosporin (ceftriaxone). Although K. pneumoniae may be present in food without causing harm, we found isolates belonging to the K1 capsular serotype coexisting with the wcaG gene, one also conferring multidrug resistance. K. pneumoniae that carry antibiotic resistance genes, regardless of pathogenicity, may increase the available genetic pool of resistance along the food chain. Hygienic food handling practices are necessary to lower risks of acquiring K. pneumoniae and other opportunistic pathogens. .

Identification of the genetic determinants of Salmonella enterica serotype Typhimurium that may regulate the expression of the type 1 fimbriae in response to solid agar and static broth culture conditions.

BACKGROUND: Type 1 fimbriae are the most commonly found fimbrial appendages on the outer membrane of Salmonella enterica serotype Typhimurium. Previous investigations indicate that static broth culture favours S. Typhimurium to produce type 1 fimbriae, while non-fimbriate bacteria are obtained by growth on solid agar media. The phenotypic expression of type 1 fimbriae in S. Typhimurium is the result of the interaction and cooperation of several genes in the fim gene cluster. Other gene products that may also participate in the regulation of type 1 fimbrial expression remain uncharacterized. RESULTS: In the present study, transposon insertion mutagenesis was performed on S. Typhimurium to generate a library to screen for those mutants that would exhibit different type 1 fimbrial phenotypes than the parental strain. Eight-two mutants were obtained from 7,239 clones screened using the yeast agglutination test. Forty-four mutants produced type 1 fimbriae on both solid agar and static broth media, while none of the other 38 mutants formed type 1 fimbriae in either culture condition. The flanking sequences of the transposons from 54 mutants were cloned and sequenced. These mutants can be classified according to the functions or putative functions of the open reading frames disrupted by the transposon. Our current results indicate that the genetic determinants such as those involved in the fimbrial biogenesis and regulation, global regulators, transporter proteins, prophage-derived proteins, and enzymes of different functions, to name a few, may play a role in the regulation of type 1 fimbrial expression in response to solid agar and static broth culture conditions. A complementation test revealed that transforming a recombinant plasmid possessing the coding sequence of a NAD(P)H-flavin reductase gene ubiB restored an ubiB mutant to exhibit the type 1 fimbrial phenotype as its parental strain. CONCLUSION: Genetic determinants other than the fim genes may involve in the regulation of type 1 fimbrial expression in S. Typhimurium. How each gene product may influence type 1 fimbrial expression is an interesting research topic which warrants further investigation.

Corrigendum to "Time-Shift Correlation Algorithm for P300 Event Related Potential Brain-Computer Interface Implementation".

[This corrects the article DOI: 10.1155/2016/3039454.].

Incidence of Neurological Disorders Among HIV-Infected Individuals With Universal Health Care in Taiwan From 2000 to 2010.

OBJECTIVE: To determine the incidence of and factors associated with neurological disorders in a large Taiwanese cohort of HIV-infected persons with free access to highly active antiretroviral therapy (HAART). DESIGN: A retrospective population-based cohort study was conducted using the National Health Insurance Research Database for the years 2000-2010. METHODS: We identified 13,316 HIV-positive persons from 2000 through 2010. We used direct standardization to calculate age-adjusted and sex-adjusted incidence rates based on the 2000 World Health Organization world standard population. Factors associated with neurological disorders were analyzed using a Cox proportional hazards model. RESULTS: The standardized incidence of neurological disorders among HIV-infected persons increased from 22.16 per 1000 person-years in 2000 to 25.23 per 1000 person-years in 2010. Cognitive disorders increased significantly from 0.36 per 1000 person-years in 2001 to 7.44 per 1000 person-years in 2010 (trend P < 0.001). The rate of neurological disorders increased with age ≥55 years [adjusted hazard ratios (AHRs) 2.54, 95% confidence interval (CI): 1.89 to 3.40], hypertension (AHR 1.41, 95% CI: 1.12 to 1.76), substance abuse (AHR 1.65, 95% CI: 1.36 to 2.02), opportunistic infection (AHR 1.76, 95% CI: 1.47 to 2.11), syphilis (AHR 1.27, 95% CI: 1.10 to 1.47), and emergency department visits >5 (AHR 2.41, 95% CI: 1.96 to 2.97). The incidence of neurological disorders was negatively associated with adherence to HAART (adherence ≥85% AHR: 0.79, 95% CI: 0.64 to 0.97). CONCLUSIONS: The rising incidence of cognitive disorders among HIV-positive persons highlights the need to provide routine neurological evaluations at clinical visits. Receiving HAART with adherence ≥85% contributes to a reduced risk of neurological disorders.

Serotype occurrence and antimicrobial susceptibility of Salmonella isolates recovered from pork carcasses in Taiwan (2000 through 2003).

One hundred fifty-eight Salmonella strains isolated from pork carcasses in a nationwide screening program in Taiwan from 2000 through 2003 were analyzed for serotype distribution and antimicrobial susceptibility. Twenty Salmonella serotypes were obtained, among which Derby, Anatum, Typhimurium, and Schwarzengrund were the most frequently isolated, accounting for 76% of the strains. Antimicrobial susceptibility tests with the microdilution method were performed on these serotypes to determine the MIC. All strains tested were sensitive to ceftriaxone, with an MIC90 (minimum concentration inhibiting 90% of isolates tested) of 0.25 to 8 microg/ml. More than 60% of the strains were resistant to ampicillin, chloramphenicol, tetracycline, nalidixic acid, and sulfamethoxazole, with MIC90 values of 128 to >512 microg/ml. More than 80% of the Salmonella Schwarzengrund strains were resistant to ciprofloxacin (MIC90 = 8 microg/ml) and enrofloxacin (MIC90 = 16 microg/ml). The Salmonella Typhimurium strains exhibited 17 and 23% resistance to ciprofloxacin and enrofloxacin, respectively, with an MIC90 of 8 microg/ ml, and these two antibiotics also were active against Salmonella Derby and Salmonella Anatum. Cephalothin, gentamicin, and trimethoprim had limited activity against Salmonella Anatum and Salmonella Schwarzengrund, with MIC90 values of 256 to >512 microg/ml. Cephalothin and gentamicin were moderately active against Salmonella Derby and Salmonella Typhimurium, but 30 to 40% of these strains were resistant to trimethoprim. The Salmonella strains isolated from pork carcasses in Taiwan were relatively resistant to the antimicrobial agents tested, with the exception of ceftriaxone. Although a variety of MIC values were obtained, generally these values were high.

Time-Shift Correlation Algorithm for P300 Event Related Potential Brain-Computer Interface Implementation.

A high efficient time-shift correlation algorithm was proposed to deal with the peak time uncertainty of P300 evoked potential for a P300-based brain-computer interface (BCI). The time-shift correlation series data were collected as the input nodes of an artificial neural network (ANN), and the classification of four LED visual stimuli was selected as the output node. Two operating modes, including fast-recognition mode (FM) and accuracy-recognition mode (AM), were realized. The proposed BCI system was implemented on an embedded system for commanding an adult-size humanoid robot to evaluate the performance from investigating the ground truth trajectories of the humanoid robot. When the humanoid robot walked in a spacious area, the FM was used to control the robot with a higher information transfer rate (ITR). When the robot walked in a crowded area, the AM was used for high accuracy of recognition to reduce the risk of collision. The experimental results showed that, in 100 trials, the accuracy rate of FM was 87.8% and the average ITR was 52.73 bits/min. In addition, the accuracy rate was improved to 92% for the AM, and the average ITR decreased to 31.27 bits/min. due to strict recognition constraints.

Early expression of heme oxygenase-1 in leukocytes correlates negatively with oxidative stress and predicts hepatic and renal dysfunction at late stage of sepsis.

Oxidative stress triggered by septic insult may be the major cause of multiple organ dysfunction syndrome (MODS) in intensive unit care patients. The inducible form of heme oxygenase-1 (HO-1) can be induced by cytokines, lipopolysaccharide, and reactive oxygen species during sepsis. These facts raise the question of whether the expression of HO-1 in leukocytes can indicate the level of oxidative stress of multiple organs in sepsis. Clinical peritonitis was simulated in an animal model by cecal ligation and puncture (CLP). The level of oxidative stress was examined by plasma lipid peroxidation (LPO). Liver function was analyzed by plasma aspartate aminotransferase, alanine aminotransferase, total bilirubin, and direct bilirubin. Lung function was evaluated by severity of edema. Renal function was measured by blood urea nitrogen and creatinine. The correlation between early HO-1 induction and LPO level or organ functional indicators of the same rat at late sepsis was analyzed by linear regression. The results showed that the protein content of HO-1 increased at 9 h after CLP, whereas expression of HO-1 mRNA in leukocytes was significantly increased (P < 0.01) at 6 h after CLP. Plasma level of LPO and the indices of hepatic, pulmonary, and renal function were significantly increased at 18 h after CLP. Moreover, highly negative correlations were observed between HO-1 mRNA expression at 6 h after CLP and level of LPO or severity of hepatic/renal dysfunction at 18 h after CLP. These results suggest that early HO-1 mRNA expression in leukocytes may represent oxidative stress and may predict the severity of liver and renal dysfunction during sepsis.

Eyelid tumors in southern Taiwan: a 5-year survey from a medical university.

This retrospective case analysis investigated the epidemiology of eyelid tumors in a subtropical area. The study assessed the proportion of all eyelid tumors that were malignancies, the accuracy of diagnosis, and surgical results. We retrospectively collected all cases of eyelid tumors in the Department of Ophthalmology, Kaohsiung Medical University, Taiwan, between January 1994 and December 1998. Among the 144 cases collected, about half of the tumors were located in the upper eyelids and the other half in the lower eyelids. Nearly 50% of cases underwent tumor resection with eyelid reconstruction. When followed up to April 1999, 97% of patients were satisfied with the surgical results. There were 18 cases (12.5%) of malignant tumors, including 14 basal cell carcinomas, three sebaceous carcinomas, and one squamous cell carcinoma. Before surgery, two malignancies were presumed to be benign tumors while another two were thought to be different malignant tumors. The benign tumors included 38 nevi, 15 squamous papillomas, 13 cysts, 11 verrucae, 10 seborrheic keratoses, four hemangiomas, and others. All tumors that were thought to be malignancies were treated using complete resection with margin monitoring by frozen section. At the end of follow-up, no recurrence was noted. More than 10% of cases of eyelid tumors in this subtropical teaching hospital were malignant. All surgeons should be alert to this phenomenon when they operate on an eyelid tumor. The best policy is to send all specimens for pathologic examination.

Heme oxygenase-1 suppresses the infiltration of neutrophils in rat liver during sepsis through inactivation of p38 MAPK.

To investigate the molecular mechanism underlying heme oxygenase-1 (HO-1)-modulated infiltration of neutrophils, the sepsis model of cecal ligation and puncture in Sprague-Dawley rats was used. In vivo induction and suppression of HO-1 were performed by pretreatment with cobalt protoporphyrin IX (CoPP) and zinc protoporphyrin IX, respectively. Tricarbonyldichlororuthenium(II) dimer, [Ru(CO)3Cl2]2 (a carbon monoxide [CO] releaser), and hemoglobin (a CO scavenger) were used to examine the participation of HO-1/CO in the effect of CoPP pretreatment on formylated peptide (fMLP)-induced p38 mitogen-activated protein kinase (MAPK) phosphorylation. Anisomycin (a p38 MAPK activator) and SB203580 (a p38 MAPK inhibitor) were used to examine p38 MAPK mediation in the attenuation of fMLP-attracted migration by HO-1. The results demonstrated that zinc protoporphyrin IX and CoPP pretreatment conferred enhancing and inhibitory effects, respectively, on hepatic neutrophil infiltration. Pretreatment with CoPP inhibited fMLP-induced migration and p38 MAPK phosphorylation in neutrophils ex vivo. The [Ru(CO)3Cl2]2 stimulated whereas hemoglobin diminished the suppression of fMLP-induced p38 MAPK phosphorylation by CoPP. Moreover, anisomycin diminished the suppressive effects of CoPP pretreatment on fMLP-induced migration, actin polymerization, polarization, and migration speed of neutrophils. These results suggest that HO-1 in neutrophil attenuates its infiltration during sepsis via the inactivation of p38 MAPK. Understanding the mechanism that diminishes neutrophil infiltration by HO-1 may help prevent hepatic failure during sepsis.