Nomogram for preoperative differentiation of benign and malignant breast tumors using contrast-enhanced cone-beam breast CT (CE CB-BCT) quantitative imaging and assessment features.

PURPOSE: Breast cancer's impact necessitates refined diagnostic approaches. This study develops a nomogram using radiology quantitative features from contrast-enhanced cone-beam breast CT for accurate preoperative classification of benign and malignant breast tumors. MATERIAL AND METHODS: A retrospective study enrolled 234 females with breast tumors, split into training and test sets. Contrast-enhanced cone-beam breast CT-images were acquired using Koning Breast CT-1000. Quantitative assessment features were extracted via 3D-slicer software, identifying independent predictors. The nomogram was constructed to preoperative differentiation benign and malignant breast tumors. Calibration curve was used to assess whether the model showed favorable correspondence with pathological confirmation. Decision curve analysis confirmed the model's superiority. RESULTS: The study enrolled 234 female patients with a mean age of 50.2 years (SD ± 9.2). The training set had 164 patients (89 benign, 75 malignant), and the test set had 70 patients (29 benign, 41 malignant). The nomogram achieved excellent predictive performance in distinguishing benign and malignant breast lesions with an AUC of 0.940 (95% CI 0.900-0.940) in the training set and 0.970 (95% CI 0.940-0.970) in the test set. CONCLUSION: This study illustrates the effectiveness of quantitative radiology features derived from contrast-enhanced cone-beam breast CT in distinguishing between benign and malignant breast tumors. Incorporating these features into a nomogram-based diagnostic model allows for breast tumor diagnoses that are objective and possess good accuracy. The application of these insights could substantially increase reliability and efficacy in the management of breast tumors, offering enhanced diagnostic capability.

Identifying Fe as OER Active Sites and Ultralow-Cost Bifunctional Electrocatalysts for Overall Water Splitting.

Electrocatalysts based on Fe and other transition metals are regarded as most promising candidates for accelerating the oxygen evolution reaction (OER), whereas whether Fe is the catalytic active site for OER is still under debate. Here, unary Fe- and binary FeNi- based catalysts, FeOOH and FeNi(OH)x , are produced by self-reconstruction. The former is a dual-phased FeOOH, possessing abundant oxygen vacancies (VO ) and mixed-valence states, delivering the highest OER performance among all the unary iron oxides- and hydroxides- based powder catalysts reported to date, supporting Fe can be catalytically active for OER. As to binary catalyst, FeNi(OH)x is fabricated featuring 1) an equal molar content of Fe and Ni and 2) rich VO , both of which are found essential to enable abundant stabilized reactive centers (FeOOHNi) for high OER performance. Fe is found to be oxidized to 3.5+ during the *OOH process, thus, Fe is identified to be the active site in this new layered double hydroxide (LDH) structure with Fe:Ni = 1:1. Furthermore, the maximized catalytic centers enable FeNi(OH)x @NF (nickel foam) as low-cost bifunctional electrodes for overall water-splitting, delivering excellent performance comparable to commercial electrodes based on precious metals, which overcomes a major obstacle to the commercialization of bifunctional electrodes: prohibitive cost.

Effective photodegradation of rhodamine B and levofloxacin over CQDs modified BiOCl and BiOBr composite: Mechanism and toxicity assessment.

In this contribution, carbon quantum dots (CQDs) modified 3D-flower like BiOX (X = Cl, Br, I) photocatalyst were successfully prepared via a facile mechanical compounding method. The crystal structure, surface composition, morphologies, optical properties and photocatalytic activities were investigated in detail. The photocatalytic activity of the as-obtained photocatalyst were evaluated by degradation of rhodamine B (RhB) and Levofloxacin (LEV) under near IR-UV-vis light irradiation, the CQDs/BiOX composite displayed enhanced photocatalytic activity as compared with individual BiOX materials. The CQDs/BiOX composite had the outstanding light harvesting and electron transfer ability because of the ordered ultrathin nanosheet structure of the BiOX, the formation of metal Bi under photoinduction, and the synergistic effects between CQDs and pure BiOX. Antibacterial activity and effects on Rye seeds growth of the LEV degradation intermediate were also researched. Reactive-species-trapping experiments exhibited that h+ and O2- were the active reactive species during photodegradation process. This work provided an effective and simple strategy for designing QDs modified Bi-rich oxyhalides in organic pollutant containing wastewater treatment.

Enantioselective bioaccumulation, oxidative stress, and thyroid disruption assessment of cis-metconazole enantiomers in zebrafish (Danio rerio).

Chiral triazole pesticides may cause enantioselectively adverse effects to non-target organisms. In this work, we employed zebrafish as an aquatic organism model to explore stereoselective acute toxicity, bioaccumulation, oxidative stress, and thyroid disruption of cis-metconazole enantiomers. The median lethal concentration values of (1S, 5R)-metconazole, (1R, 5S)-metconazole, and the mixture of them against zebrafish were 4.01, 2.61 and 3.17 mg⋅L-1, respectively. (1R, 5S)-Metconazole was preferentially bioaccumulated in zebrafish than (1S, 5R)-metconazole, and the bioconcentration factor of (1R, 5S)-metconazole was 1.28-fold larger than that of (1S, 5R)-metconazole. Then, the activity order of catalase, superoxide dismutase, and glutathione-S transferase enzymes in zebrafish was expressed as (1S, 5R)-metconazole > the mixture > (1R, 5S)-metconazole, while the order of malondialdehyde content in zebrafish was (1R, 5S)-metconazole > the mixture > (1S, 5R)-metconazole. Moreover, cis-metconazole exhibited enantioselective regulation effects on the levels of triiodothyronine and thyroxine in zebrafish, and (1R, 5S)-metconazole possessed stronger thyroid disruption ability to zebrafish than the others. By virtue of molecular docking methodology, the binding affair and docking energy results supported that interactions between (1R, 5S)-metconazole and thyroid hormone receptors were much stronger than those between (1S, 5R)-metconazole and same receptors. This study of enantioselective evaluation of cis-metconazole in zebrafish can provide favorable information for risk assessments of chiral pesticides toward environment and health of aquatic organisms.

Risk Assessment of the Chiral Fungicide Triticonazole: Enantioselective Effects, Toxicity, and Fate.

The enantioselective toxicity of triticonazole (TRZ) to non-target organisms, the effect on wheat growth and quality, and the environmental fate of TRZ were investigated systematically in this study. The acute toxicity of S-TRZ to non-target aquatic and terrestrial organisms was greater than that of rac-TRZ and R-TRZ. The S-enantiomer significantly inhibited the growth and lodging resistance of wheat. S- and R-TRZ not only reduced the grain yield but also inhibited the activities of ADP-glucose pyrophosphorylase (AGPase) and starch synthase. The results of homology modeling and molecular docking further showed that the inhibition of AGPase activity by the two enantiomers hindered the accumulation of starch. By contrast, the racemate promoted the growth and development of wheat and improved grain quality. And the half-lives of the racemate in stems, grains, leaves, and soils were shorter than those of the enantiomers. The results of risk quotient (RQ) values showed that the application of TRZ enantiomers during wheat planting would bring a higher potential dietary risk to Chinese consumers. In comprehensive consideration of these results, the application of the racemate may be safer and more reasonable at the flowering stage of wheat.

Reinvestigating Tumor-Ventricle Relationship of Craniopharyngiomas With Predominantly Ventricular Involvement: An Endoscopic Endonasal Series Based on Histopathological Assessment.

OBJECTIVE: Craniopharyngiomas (CPs) predominantly involving the third ventricle were commonly termed "intraventricular" lesions. The aim of this study was to clarify the anatomical relationship between the tumor and the third ventricle by both surgical and histological investigation. METHODS: A retrospective review of primarily resected CPs by endoscopic endonasal surgery was performed. CPs with predominantly ventricular involvement were selected for study inclusion by preoperative imaging. The surgical procedure of each case was reviewed. The wholly removed tumor specimens were histologically analyzed, in all cases, to investigate the tumor-third ventricle relationship using hematoxylin and eosin, immunochemical, and immunofluorescence staining. RESULTS: Twenty-six primary CPs predominantly involving the third ventricle were selected from our series of 223 CPs treated by endoscopic endonasal surgery between January 2017 and March 2021. Gross-total resection was achieved in 24 (92.3%) of 26 patients, with achievement of near-total resection in the remaining patients. A circumferential layer of stretched third ventricle floor was identified surrounding the tumor capsule, which could be peeled off easily from the ventricle floor remnants at most areas of the plane of tumor attachment. Some portions of the tumor capsule tightly adhered to the third ventricle floor were removed together with the floor. A breach of various size was observed at the third ventricle floor after tumor removal in most cases, the floor remaining intact in only two cases (7.7%). Histological examination on marked portions of tumor capsule showed that the pia mater was frequently detected at most of the tumor-brain interface, except at the antero-frontal border of tumor contacting with the third ventricle floor. At this point, a layer of gliosis with various thickness was observed between the tumor and the neural tissue of the third ventricle floor. CONCLUSION: CPs with predominantly ventricular involvement should be considered as lesions with an extraventricular, epi-pia topography rather than "intraventricular" or "subpial" topography. Accurate understanding of the relationship between the third ventricle and such tumors would predict the circumferential cleavage plane of dissection, and remind neurosurgeons of performing dissection along the safe surgical plane to achieve total tumoral resection with minimizing hypothalamic damage.

Therapeutic assessment of fractions of Gastrodiae Rhizoma on chronic atrophic gastritis by 1H NMR-based metabolomics.

ETHNOPHARMACOLOGICAL RELEVANCE: Gastrodiae Rhizoma (GR), a well-known and commonly-used TCM (Traditional Chinese Medicine) for treating headache, dizziness, tetanus, epilepsy, and etc., has been proven to relieve chronic atrophic gastritis (CAG). Due to its complex ingredients, the active fractions responsible for the treatment of CAG remain largely unknown. AIM OF THE STUDY: To explore the underlying material and interpret its underlying mechanism, the therapeutic effect of extract from different polar parts of Gastrodiae Rhizoma on autoimmune CAG was studied based on the 1H NMR metabolomics. MATERIALS AND METHODS: The rat model of CAG was established by autoimmune method. The modeled CAG rats were then treated with 4 polar parts (T1-4 in descending polarity, corresponding to water, n-butanol, ethyl acetate and petroleum ether extracts, respectively) of Gastrodiae Rhizoma for 21 consecutive days. The stomach and serum samples were collected and then subjected to histopathology observation, biochemical measurement (MDA, SOD, GSH, NO, XOD and pepsin), 1H NMR metabolic profiling and multivariate/univariate statistical analysis. RESULTS: The results showed that T1 had the best therapeutic effect, T2 the second, and T3 and T4 the poorest with no obvious therapeutic effect, demonstrating that the effective components of Gastrodiae Rhizoma should be compounds of high polarity. T1 achieved good therapeutic effects due to the anti-inflammatory and anti-oxidant activities, and by rectifying the disturbed energy and amino acid metabolism in CAG model. CONCLUSION: This integrated metabolomics approach proved the validity of the therapeutic effect of extract from different polar parts of Gastrodiae Rhizoma on autoimmune CAG, providing new insights into the underlying mechanisms, and demonstrating the feasibility of metabolomics to evaluate efficacy of herbal drug, which is often difficult by traditional means.

Practice Variation in Anticoagulation Prescription and Outcomes After Device-Detected Atrial Fibrillation.

BACKGROUND: Device-detected atrial fibrillation (AF) is associated with increased risk of stroke; however, there are no clearly defined thresholds of AF burden at which to initiate oral anticoagulation (OAC). We sought to describe OAC prescription practice variation in response to new device-detected AF and the association with outcomes. METHODS: We performed a retrospective cohort study using data from the Veterans Health Administration linked to remote monitoring data that included day-level AF burden. We included patients with cardiac implantable electronic devices and remote monitoring from 2011 to 2014, CHA2DS2-VASc score ≥2, and no prior stroke or OAC receipt in the preceding 2 years. We determined the proportion of patients prescribed OAC within 90 days after new device-detected AF across a range of AF thresholds (≥6 minutes to >24 hours) and examined site variation in OAC prescription. We used multivariable Cox proportional hazards regressions to determine the association of OAC prescription with stroke by device-detected AF burden. RESULTS: Among 10 212 patients with cardiac implantable electronic devices, 4570 (45%), 3969 (39%), 3263 (32%), and 2469 (24%) had device-detected AF >6 minutes, >1 hour, >6 hours, and >24 hours, respectively. For device-detected AF >1 hour, 1712 patients met inclusion criteria (72±10 years; 1.5% female; CHA2DS2-VASc score 4.0±1.4; HAS-BLED score 2.6±1.1). The proportion receiving OAC varied based on device-detected AF burden (≥6 minutes: 272/2101 [13%]; >1 hour: 273/1712 [16%]; >6 hours: 263/1279 [21%]; >24 hours: 224/818 [27%]). Across 52 sites (N=1329 patients), there was substantial site-level variation in OAC prescription after device-detected AF >1 hour (median, 16%; range, 3%-67%; median odds ratio, 1.56 [95% credible interval, 1.49-1.71]). In adjusted models, OAC prescription after device-detected AF >24 hours was associated with reduced stroke risk (hazard ratio, 0.28; 95% CI, 0.10-0.81; P=0.02), although the propensity-adjusted model was significant when AF lasted at least 6 minutes. CONCLUSIONS: Among veterans with cardiac implantable electronic devices, device-detected AF is common. There is large practice variation in 90-day OAC initiation after new device-detected AF, with low rates of treatment overall, even for episodes that last >24 hours. The strongest association of OAC with reduction in stroke was observed after device-detected AF >24 hours. Randomized trials are needed to confirm these observational findings.

Changes in area and number of nature reserves in China.

Nature reserves (NR) are the cornerstone of biodiversity conservation. Over the past 60 years, the rapid expansion of NRs in China, one of the world's megadiverse countries, has played a critical role in slowing biodiversity loss. We examined the changes in the number and area of China's NRs from 1956 to 2014 and analyzed the effect of economic development on the expansion of China's NRs from 2005 to 2014 with linear models. Despite a continuing increase in the number of NRs, the total area of China's NRs decreased by 3% from 2007 to 2014. This loss resulted from downsizing and degazettement of existing NRs and a slowdown in the establishment of new ones. Nature reserves in regions with rapid economic development exhibited a greater decrease in area, suggesting that downsizing and degazettement of NRs are closely related to the intensifying competition between economic growth and conservation. For example, boundary adjustments to national NRs, the most strictly protected NRs, along the coast of China's Yellow Sea, a global biodiversity hotspot with a fast-growing economy, resulted in the loss of one-third of the total area. One of the most important ecosystems in these NRs, tidal wetlands, decreased by 27.8% because of boundary adjustments and by 25.2% because of land reclamation. Our results suggest conservation achievement, in terms of both area and quality, are declining at least in some regions in the Chinese NR estate. Although the designation of protected areas that are primarily managed for sustainable use has increased rapidly in recent years in China, we propose that NRs with biodiversity conservation as their main function should not be replaced or weakened.

Cambios en la Superficie y el Número de Reservas Naturales en China Resumen Las reservas naturales (RN) son la piedra angular de la conservación de la biodiversidad. Durante los últimos 60 años, la rápida expansión de las RN en China, uno de los países megadiversos, ha jugado un papel crítico en la reducción de la pérdida de biodiversidad. Examinamos los cambios en el número y superficie de las RN en China de 1956 a 2014 y analizamos el efecto del desarrollo económico en la expansión de las RN en China de 2005 a 2014 mediante modelos lineales. A pesar del incremento continuo en el número de RN, la superficie total de RN en China decreció en 3% de 2007 a 2014. Esta pérdida resultó de la reducción y cambio de registro de RN existentes y una desaceleración en el establecimiento de RN nuevas. Las reservas naturales en regiones con desarrollo económico rápido presentaron una mayor disminución en la superficie, lo que sugiere que la reducción y cambio de registro de RN están relacionados cercanamente con la intensificación de la competencia entre crecimiento económico y conservación. Por ejemplo, ajustes en los límites de RN nacionales, las RN más estrictamente protegidas, a lo largo de la costa del Mar Amarillo, un sitio de importancia para la biodiversidad global con una economía en rápido crecimiento, resultó en la pérdida de un tercio de la superficie total. Uno de los ecosistemas más importantes en estas RN, humedales mareales, decreció en 27.8% debido a ajustes en los límites y en 25.2% debido a la reclamación de tierras. Nuestros resultados sugieren que los logros de conservación, en términos tanto de área como de calidad, están declinando en las RN de China. Aunque la designación de áreas protegidas administradas primariamente para un uso sustentable ha incrementado rápidamente en años recientes en China, proponemos que las RN cuya principal función es la conservación de la biodiversidad no deben ser reemplazadas o debilitadas.

Illness Perceptions and Return to Work in Patients With Moderate to Severe Injuries.

AIM: Research indicates that injured patients' illness perceptions constitute a strong influence on their return to work (RTW). This study examined the relationships between illness perceptions and RTW in injured patients. DESIGN: A prospective cohort design was employed. METHODS: One hundred fifty-six patients were recruited from three hospitals, and 132 completed follow-up data at 3 months after injury. Three-month illness perceptions were measured using the Chinese Illness Perception Questionnaire Revised-Trauma. Return to work was defined as being able to return to a paying job covered by national work insurance. RESULTS: Non-RTW in injured patients tended to occur among patients who were older, less educated, more severely injured, and more likely to be admitted to intensive care units than patients who did RTW. Return to work patients also had more positive illness perceptions than non-RTW patients. Illness perceptions were associated with non-RTW, but the most important determinants of non-RTW were serious injury and older age. CONCLUSIONS: This study provides evidence to indicate that illness perceptions, personal data, and illness characteristics are associated with injured patients' RTW or non-RTW. The role of rehabilitation nurses may be extended accordingly based on findings from this study. IMPLICATIONS FOR PRACTICE: Case management with an interprofessional team may have positive impacts on RTW in injured patients. Rehabilitation nurses should identify patients' expectations of RTW and should work with an interdisciplinary team to develop interventions to reshape the patients' perceptions of returning to work, facilitating their transition back to work, if possible.

[Assessment of aquatic ecological security for mountainous rivers: A case study in the Taizi River Basin, Northeast China.] / æ²³æµå±±åŒºæ®µæ°´ç”Ÿæ€å®‰å ¨è¯„ä¼°­­ä»¥å¤ªå­æ²³ä¸ºä¾‹.

Watershed ecological security is strongly associated with the aquatic ecological status of the upper mountainous area. The present study aimed to assess the watershed ecological security status of the mountainous area under the PSFR (Pressure-State-Function-Response) assessment framework. An evaluation index system was established according to the watershed characteristics, which included four project hierarchical layers, i.e., aquatic ecological pressure, aquatic ecological state, ecological function, and social response, 11 component layers and 23 evaluation indexes. This index system was applied to evaluate the watershed ecological security status of the mountainous area (35 sub-watersheds) in the Taizi River Basin, Liaoning Province. Our results showed that the aquatic ecological status of the study area could be classified into three groups: insecure, general secure and secure, no very insecure and very secure status. Nine sub-watersheds were at the insecure ecological status, accounting for 25.7% of the total sub-watersheds, whereas 22 sub-watersheds were at the general secure state, representing 62.9% of the study area. In contrast, only four sub-watersheds were grouped at the secure status. Furthermore, agricultural activity was identified as the most significant factor responsible for the aquatic ecological security of mountainous area in the Taizi River Basin. Habitat degradation, including water quality deterioration and habitat loss, significantly reduced the ecological functions of the Taizi River Basin, and decreases in rare and peculiar species and biodiversity also posed a threat to the ecological integrity of the study region. Our results could be applied to diagnose the major factors affecting aquatic ecological security, and provide information for effective ecological restoration.

Association of Healthcare Plan with atrial fibrillation prescription patterns.

BACKGROUND: Atrial fibrillation (AF) is treated by many types of physician specialists, including primary care physicians (PCPs). Health plans have different policies for how patients encounter these providers, and these may affect selection of AF treatment strategy. HYPOTHESIS: We hypothesized that healthcare plans with PCP-gatekeeping to specialist access may be associated with different pharmacologic treatments for AF. METHODS: We performed a retrospective cohort study using a commercial pharmaceutical claims database. We utilized logistic regression models to compare odds of prescription of oral anticoagulant (OAC), non-vitamin K-dependent oral anticoagulant (NOAC), rate control, and rhythm control medications used to treat AF between patients with PCP-gated healthcare plans (eg, HMO, EPO, POS) and patients with non-PCP-gated healthcare plans (eg, PPO, CHDP, HDHP, comprehensive) between 2007 and 2012. We also calculated median time to receipt of therapy within 90 days of index AF diagnosis. RESULTS: We found similar odds of OAC prescription at 90 days following new AF diagnosis in patients with PCP-gated plans compared to those with non-PCP-gated plans (OR: OAC 1.01, P = 0.84; warfarin 1.05, P = 0.08). Relative odds were similar for rate control (1.17, P < 0.01) and rhythm control agents (0.93, P = 0.03). However, PCP-gated plan patients had slightly lower likelihood of being prescribed NOACs (0.82, P = 0.001) than non-gated plan patients. Elapsed time until receipt of medication was similar between PCP-gated and non-gated groups across drug classes. CONCLUSIONS: Pharmaceutical claims data do not suggest that PCP-gatekeeping by healthcare plans is a structural barrier to AF therapy, although it was associated with lower use of NOACs.

Patient and facility variation in costs of catheter ablation for atrial fibrillation.

BACKGROUND: Cost-effectiveness or value of cardiovascular therapies may be undermined by unwarranted cost variation, particularly for heterogeneous procedures such as catheter ablation for atrial fibrillation (AF). We sought to characterize cost variation of AF ablation in the US healthcare system and the relationship between cost and outcomes. METHODS AND RESULTS: We performed a retrospective cohort study using data from the MarketScan® commercial claims and Medicare supplemental databases including patients who received an AF ablation from 2007 to 2011. We aggregated encounter cost, reflecting total payments received for the encounter, to the facility level to calculate median facility cost. We classified procedures as outpatient or inpatient and assessed for association between cost and 30-day and 1-year outcomes. The analysis cohort included 9,415 AF ablations (59±11 years; 28% female; 52% outpatient) occurring at 327 facilities, with large cost variation across facilities (median: $25,100; 25th percentile: $18,900, 75th percentile: $35,600, 95th percentile: $57,800). Among outpatient procedures, there was reduced healthcare utilization in higher cost quintiles with reductions in rehospitalization at 30-days (Quintile 1: 16.1%, Quintile 5: 8.8%, P < 0.001) and 1-year (Quintile 1: 34.8%, Quintile 5: 25.6%, P < 0.001), which remained significant in multivariate analysis. CONCLUSIONS: Although median costs of AF ablation are below amounts used in prior cost-effectiveness studies that demonstrated good value, large facility variation in cost suggests opportunities for cost reduction. However, for outpatient encounters, association of cost to modestly improved outcomes suggests cost containment strategies could have variable effects.

Stereoselective quantification of triticonazole in vegetables by supercritical fluid chromatography.

A highly fast analytical method though supercritical fluid chromatography (SFC) has been developed to quantify triticonazole enantiomers in cucumbers and tomatoes. Effects of organic modifier type and concentration on chiral separation and quantification of standard solution as well as matrix-matched standard solutions have been studied in detail. Among three organic modifiers, better separation of triticonazole racemate was achieved with 20% ethanol (v/v). The run time in SFC (ca 3min) with CO2-ethanol (80:20, v/v) as the mobile phase was six-fold shorter than HPLC analysis (about 18min). Then, QuEChERS (quick, easy, cheap, effective, rugged and safe) extraction procedure was used for triticonazole in vegetables. The residue analysis method was validated. Good linearity (R2≥0.9988) and recoveries (81.62-106.21%, RSD≤7.30%) for the two enantiomers were achieved. This developed method described herein is convenient and reliable for enantioselective detection of triticonazole in vegetables, which might provide additional information for reliable risk assessment of chiral pesticides.

Assessment of the Fusion Tags on Increasing Soluble Production of the Active TEV Protease Variant and Other Target Proteins in E. coli.

In this study, five fusion tags affecting soluble production and cleavage activity of the tobacco etch virus (TEV) protease (TEVp) variant in Escherichia coli strains BL21 (DE3) and Rosetta™ (DE3) are investigated. Combination of the augmenting rare transfer RNAs (tRNAs) and the fused expressivity tag (N-terminal seven amino acid residues of E. coli translation initiation factor II) promotes the soluble TEVp partner expressed at relatively high level. Attachment of the maltose-binding protein (MBP) tag increases soluble expression of the protease released from the fusion protein in E. coli cells, but the incorporated TEVp recognition sequence slightly decreases expressivity of the fusion construct. Except for the green fluorescent protein, the attached expressivity tag shows less efficiency than the MBP tag in enhancing expression levels of the selected five target proteins in the Rosetta™ (DE3) cells under different induction conditions. Our results identified that high-level production of the functional target protein as the fusion partner in E. coli is combined with the intrinsic property of fusion tag, fusion protein stability, inherent folding of target protein, rare tRNA abundance, and the incorporated linker. Purified TEVp fusion constructs with the N-terminal expressivity tag, as well as the MBP partner, are the ideal alternatives for removing fusion tag.

A graphene oxide-based FRET sensor for rapid and specific detection of unfolded collagen fragments.

The unstructured collagen species plays a critical role in a variety of important biological processes as well as pathological conditions. In order to develop novel diagnosis and therapies for collagen-related diseases, it is essential to construct simple and efficient methods to detect unfolded collagen fragments. We therefore have designed a FITC-labeled collagen mimic triple helical peptide, whose adsorption on the surface of GO effectively quenches its fluorescence. The newly constructed GO/FITC-GPO complex specifically detects unstructured collagen fragments, but not fully folded triple helix species. The detection shows a clear preference for the collagen targets with complementary GPO-rich sequences. The conformation-sensitive, sequence-specific GO-based approach can be applied as an efficient biosensor for rapid detection of unfolded collagen fragments at nM level, and may have great potential in drug screening for inhibitors of unfolded collagen. It may provide a prototype to develop GO-based assays to detect other important unstructured proteins involved in diseases.

Amiodarone and risk of death in contemporary patients with atrial fibrillation: Findings from The Retrospective Evaluation and Assessment of Therapies in AF study.

BACKGROUND: There are limited data on mortality outcomes associated with use of amiodarone in atrial fibrillation and flutter (AF). METHODS: We evaluated the association of amiodarone use with mortality in patients with newly diagnosed AF using complete data from the Department of Veterans Affairs national health care system. We included patients seen in an outpatient setting within 90 days of a new diagnosis for nonvalvular AF between Veterans Affairs fiscal years 2004 and 2008. Multivariate analysis and propensity-matched Cox proportional hazards regression were used to evaluate the association of amiodarone use to death. RESULTS: Of 122,465 patients (353,168 person-years of follow-up, age 72.1 ± 10.3 years, 98.4% males), amiodarone was prescribed in 11,655 (9.5%). Cumulative, unadjusted mortality rates were higher for amiodarone recipients than for nonrecipients (87 vs 73 per 1,000 person-years, P < .001). However, in multivariate and propensity-matched survival analyses, there was no significant difference in mortality (multivariate hazard ratio 1.01, 95% CI 0.97-1.05, P = .51, and propensity-matched hazard ratio 1.02, 95% CI 0.97-1.07, P = .45). The hazard of death was not modified by age, sex, heart failure, kidney function, ß-blocker use, or warfarin use, but there was evidence of effect modification among patients diagnosed with AF as an inpatient versus outpatient. CONCLUSION: In a national health care system population of newly diagnosed AF, overall use of amiodarone as an early treatment strategy was not associated with mortality.

The relationship between geriatric depression and health-promoting behaviors among community-dwelling seniors.

BACKGROUND: People older than 65 years old account for about 10.9% of Taiwan's total population; it is also known that the older adults experience a higher incidence of depression. Public health nurses play an important role in promoting community health. Policymaking for community healthcare should reflect the relationship between health-promoting behavior and depression in community-dwelling seniors. Therefore, the encouragement of healthy aging requires strategic planning by those who provide health promotion services. OBJECTIVE: This study was designed to elicit the health-promoting behaviors of community seniors and investigate the relationship between geriatric depression and health-promoting behaviors among seniors who live in rural communities. METHODS: We used a cross-sectional, descriptive design and collected data using a demographic information datasheet, the Health Promotion for Seniors and Geriatric Depression Scale short forms. RESULTS: The study included 427 participants. Most were women; mean age was 75.8 years. Most were illiterate; roughly half engaged in a limited number of health-promoting activities. The Geriatric Depression Scale score was negatively associated with health-promoting behavior. Social participation, health responsibility, self-protection, active lifestyle, and total Health Promotion for Seniors score all reached statistical significance. Multivariate analysis indicated that geriatric depression and physical discomfort were independent predictors of health-promoting behavior after controlling the confounding factors. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Participants practiced less than the recommended level of health-promoting behaviors. We found a negative correlation between the geriatric depression score and health-promoting behavior. Results can be referenced to develop strategies to promote healthy aging in the community, especially with regard to promoting greater social participation and increased activity for community-dwelling older adults experiencing depression.

Development and preliminary testing of a brief screening measure of healthy lifestyle for diabetes patients.

OBJECTIVES: Improving diabetes control is a critical issue world-wide, because mortality rates and costs are increasing dramatically. Maintaining a healthy lifestyle is positively associated with diabetes control. However, the availability of practical screening tools suitable for determining and modifying healthy or unhealthy lifestyle choices is limited. The main aim of this study was to determine the appropriateness of the type 2 diabetes and health promotion scale (T2DHPS) for use in patients with type 2 diabetes. METHODS: This study examined the Cronbach's alpha, content validity, construct and concurrent validity of the Chinese language version of the T2DHPS for assessing lifestyle and disease control among patients with type 2 diabetes. The dimensions of the T2DHPS were generated from the Chinese version of adult health promotion and interviews with experts, and were corroborated by the literature. A total of 323 patients previously diagnosed with type 2 diabetes were recruited. A cross-sectional, descriptive design questionnaire was developed and tested at diabetes outpatient departments in three teaching hospitals between August 2010 and June 2011. Construct validity was established using factor analysis. The total and subscale scores of the T2DHPS were correlated with biomarkers of diabetes control for concurrent validity. RESULTS: Kaiser-Meyer-Olkin (KMO) and Bartlett's sphericity tests showed that the sample met the criteria required for factor analysis. A 28-item Likert-type scale of the T2DHPS was established, and explained 56.7% of the total variance. The simplified version of the T2DHPS was made up of six dimensions of behavior: physical activity, risk reduction, stress-management, enjoy life, health responsibility and a healthy diet. The reliability coefficient for the total scale was 0.89, and alpha coefficients for the subscales ranged from 0.63 to 0.86. Concurrent validity indicated that the T2DHPS is significantly positively associated with diabetes control. CONCLUSIONS: T2DHPS was shown to be a reliable and valid tool for assessing patients with type 2 diabetes, and can possibly predict diabetic control. This scale appears to be a useful screening tool for type 2 diabetic people in primary health care settings, to promote health status through modification of an unhealthy lifestyle.