Transcriptome-wide subtyping of pediatric and adult T cell acute lymphoblastic leukemia in an international study of 707 cases.

T cell acute lymphoblastic leukemia (T-ALL) is an aggressive hematological malignancy of T cell progenitors, known to be a heterogeneous disease in pediatric and adult patients. Here we attempted to better understand the disease at the molecular level based on the transcriptomic landscape of 707 T-ALL patients (510 pediatric, 190 adult patients, and 7 with unknown age; 599 from published cohorts and 108 newly investigated). Leveraging the information of gene expression enabled us to identify 10 subtypes (G1­G10), including the previously undescribed one characterized by GATA3 mutations, with GATA3R276Q capable of affecting lymphocyte development in zebrafish. Through associating with T cell differentiation stages, we found that high expression of LYL1/LMO2/SPI1/HOXA (G1­G6) might represent the early T cell progenitor, pro/precortical/cortical stage with a relatively high age of disease onset, and lymphoblasts with TLX3/TLX1 high expression (G7­G8) could be blocked at the cortical/postcortical stage, while those with high expression of NKX2-1/TAL1/LMO1 (G9­G10) might correspond to cortical/postcortical/mature stages of T cell development. Notably, adult patients harbored more cooperative mutations among epigenetic regulators, and genes involved in JAK-STAT and RAS signaling pathways, with 44% of patients aged 40 y or above in G1 bearing DNMT3A/IDH2 mutations usually seen in acute myeloid leukemia, suggesting the nature of mixed phenotype acute leukemia.

Validity of evaluation scales for post-stroke depression: a systematic review and meta-analysis.

BACKGROUND: Post-stroke depression (PSD) is closely associated with poor stroke prognosis. However, there are some challenges in identifying and assessing PSD. This study aimed to identify scales for PSD diagnosis, assessment, and follow-up that are straightforward, accurate, efficient, and reproducible. METHODS: A systematic literature search was conducted in 7 electronic databases from January 1985 to December 2023. RESULTS: Thirty-two studies were included, the Patient Health Questionnaire-9 (PHQ-9) and Hamilton Depression Scale (HDRS) had higher diagnostic accuracy for PSD. The sensitivity, specificity, and diagnostic odds ratio of PHQ-9 or diagnosing any depression were 0.82, 0.87, and 29 respectively. And for HDRS, used for diagnosing major depression, the scores were 0.92, 0.89, and 94. Furthermore, these two scales also had higher diagnostic accuracy in assessing depressive symptoms during both the acute and chronic phases of stroke. In patients with post-stroke aphasia and cognitive impairment, highly diagnostic scales have not been identified for assessing depressive symptoms yet. CONCLUSIONS: The PHQ-9 and HDRS scales are recommended to assess PSD. HDRS, which demonstrates high diagnostic performance, can replace structured interviews based on diagnostic criteria.

Alteration of Glycerophospholipid Metabolism in Hippocampus of Post-stroke Depression Rats.

Post-stroke depression (PSD) is the most common mental disorder in stroke survivors. However, its specific pathophysiology remains largely unknown. Previous studies suggested a role of hippocampus in PSD. Therefore, we conducted this study to investigate the lipid metabolic signatures in hippocampus of PSD rats. Here, the liquid chromatography mass spectrometry was used to identify the lipid metabolic signatures in the hippocampus of PSD, control and stroke rats. Then, correlations between behavior indices and differential lipid metabolites in PSD rats were explored. Pathway and enrichment analysis were further conducted to uncover the crucial metabolic pathways related to PSD. Finally, we found that the lipid metabolic phenotype in hippocampus of PSD rats was substantially different from that in control and stroke rats, and identified 50 key lipid metabolites that were significantly decreased in PSD rats. These differential metabolites were mainly involved in glycerophospholipid metabolism. Meanwhile, the sucrose preference and immobility time were found to be significantly positively and negatively, respectively, correlated with glycerophospholipid metabolites. The pathway and enrichment analysis showed that the glycerophospholipid metabolism, especially cardiolipin metabolism, was significantly disturbed in PSD rats. These results suggested that the down-regulated glycerophospholipids in hippocampus, especially cardiolipin, might participate in the pathophysiology of PSD. Our findings would be helpful for future exploring the pathophysiology of PSD.

Membrane recruitment of Atg8 by Hfl1 facilitates turnover of vacuolar membrane proteins in yeast cells approaching stationary phase.

BACKGROUND: The vacuole/lysosome is the final destination of autophagic pathways, but can also itself be degraded in whole or in part by selective macroautophagic or microautophagic processes. Diverse molecular mechanisms are involved in these processes, the characterization of which has lagged behind those of ATG-dependent macroautophagy and ESCRT-dependent endosomal multivesicular body pathways. RESULTS: Here we show that as yeast cells gradually exhaust available nutrients and approach stationary phase, multiple vacuolar integral membrane proteins with unrelated functions are degraded in the vacuolar lumen. This degradation depends on the ESCRT machinery, but does not strictly require ubiquitination of cargos or trafficking of cargos out of the vacuole. It is also temporally and mechanistically distinct from NPC-dependent microlipophagy. The turnover is facilitated by Atg8, an exception among autophagy proteins, and an Atg8-interacting vacuolar membrane protein, Hfl1. Lack of Atg8 or Hfl1 led to the accumulation of enlarged lumenal membrane structures in the vacuole. We further show that a key function of Hfl1 is the membrane recruitment of Atg8. In the presence of Hfl1, lipidation of Atg8 is not required for efficient cargo turnover. The need for Hfl1 can be partially bypassed by blocking Atg8 delipidation. CONCLUSIONS: Our data reveal a vacuolar membrane protein degradation process with a unique dependence on vacuole-associated Atg8 downstream of ESCRTs, and we identify a specific role of Hfl1, a protein conserved from yeast to plants and animals, in membrane targeting of Atg8.

Trajectory Design for Multi-UAV-Aided Wireless Power Transfer toward Future Wireless Systems.

In this paper, we investigate an unmanned aerial vehicle (UAV)-assisted wireless power transfer (WPT) system, in which a set of UAV-mounted mobile energy transmitters (ETs) are dispatched to broadcast wireless energy to an energy receiver (ER) on the ground. In particular, we aim to maximize the amount of energy transferred to the ER during a finite UAV's flight period, subject to the UAV's maximum speed and collision avoidance constraints. First, the basic one/two-UAV scenarios are researched in detail, which show that UAVs should hover at fixed locations during the whole charging period. Specifically, the Lagrange multiplier method is employed to solve the proposed optimization problem for the case of two UAV situation. Specifically, the general conclusions based on the theoretical analysis of one/two-UAV scenarios are drawn contribute to deducing the trajectory design of UAVs when the number of UAVs increases from three to seven. The obtained trajectory solution implies that UAVs should be evenly distributed on the circumference with point (0,0,H) as the center and UAVs' safe distance as the radius. Finally, numerical results are provided to validate the trajectory design algorithm for the multiple UAVs-enabled single-user WPT system.

[Quantitative analysis methods of white matter microstructure based on diffusion tensor imaging and its application in chronic pain research].

As the two essential components, the white matter and gray matter compose the central nervous system of the brain. Widely known that axons of neurons mainly form the white matter, and these formed nerve fibers are responsible for transmitting information among various brain regions to achieve the coordinated operation of the entire brain. Early research on the white matter could only be done by dissecting living animals or human cadavers, until Basser et al. proposed diffusion tensor imaging (DTI) technology in 1994, which could detect the diffusion characteristics of water in the brain in vivo noninvasively. Accordingly, this technology could be applied to investigate the diffusion movement of water in white matter to obtain the information of direction and micro-anatomy of white matter fiber bundles. With the advancement on the display and analysis of the anatomical structure of white matter fiber bundles, the exploration of microscopic pathological changes, and the assistance of clinical diagnosis and neurophysiological research, DTI technology has become one of the most popular topics in brain science research. Chronic pain refers to pain lasting more than three months, which not only seriously affects the patient's physical and social functions, but also dramatically reduces the quality of life. It was reported that long-term pain stimulation might cause pathological remodeling of the central nervous system, and abnormalities in white matter were found in imaging examinations of patients with chronic pain. This review introduces the quantitative analysis methods of white matter fiber bundle microstructure based on DTI and its application in chronic pain, and further discusses the application value of DTI technology on clinical research of chronic pain.

[Effect of Shanhaidan Granules combined with tadalafil on erectile dysfunction: A multi-center clinical trial].

OBJECTIVE: To observe the clinical effect and safety of Shanhaidan Granules (SHDG) combined with tadalafil tablets (TT) in the treatment of ED. METHODS: In this open multi-center case-control clinical trial, we enrolled 247 ED patients according to the designed criteria, and treated them orally with SHDG at 10 g per time tid (n = 74), TT at 5 mg per time bid (n = 52), or SHDG + TT at the above doses (n = 121), all for 8 weeks. Before and after medication, we recorded the IIEF-6, erection hardness scores (EHS), traditional Chinese medicine syndromes (TCMS) scores, penile cavernous blood flow parameters and adverse reactions, and compared them between the 3 groups of patients. RESULTS: After 8 weeks of treatment, all the patients showed significantly increased IIEF-6, EHS and TCMS scores in comparison with the baseline (P < 0.05). The total effectiveness rates in the SHDG, TT and SHDG + TT groups were 60.8%, 67.3% and 69.4% respectively based on the IIEF-6 scores, remarkably higher in the TT and SHDG + TT groups than in the SHDG group (P < 0.05), and 40.5%, 32.7% and 63.6% respectively according to the TCMS scores, markedly higher in the SHDG and SHDG + TT groups than in the TT group (P < 0.05). Single-center data manifested significantly increased peak systolic velocity (PSV) of the penile artery in the SHDG + TT and TT groups (P < 0.05). The improvement values of relevant parameters were remarkably higher in the SHDG + TT group than in the TT and SHDG groups, so were IIEF-6 scores in the TT than in the SHDG group, and TCM syndromes in the SHDG than in the TT group. No medication-related adverse events were found in any of patients after treatment, except for some mild side effects including muscle soreness and gastrointestinal reactions in a few cases, all soon relieved, none with abnormalities in blood and urine routine tests or hepatic and renal function indicators. CONCLUSIONS: Shanhaidan Granules combined with tadalafil can significantly improve the erectile function and reduce TCM syndromes in ED patients, and therefore can be applied effectively and safely in clinical practice./.

Performance, kinetics characteristics and enhancement mechanisms in anammox process under Fe(II) enhanced conditions.

In order to explore the performance, kinetics characteristics and enhancement mechanisms in anammox process under ferrous iron enhanced conditions, a laboratory-scale UASB anammox reactor has been built up and operated for 534 days. Experimental results showed that the Anammox process was successfully started up in a short operation period and the TNRE reached 83.34 ± 2.96% with a maximum total nitrogen removal rate of 14.4 kg m-3 d-1 after long-term operated under influent Fe(II) concentration of 5.3 mg L-1. Simulation results using different kinetic models showed that the Stover-Kincannon model and the Grau second-order model were useful for describing the anammox performance under Fe(II) enhanced conditions. Extracellular polymeric substance (EPS) act a pivotal part in the granulation of Anammox sludge and the improvement of anammox activity. Iron improved the hydrophobicity of the sludge by reducing the PN/PS ratios, and also increased the Anammox granular diameter. The granular diameter of higher than 2.00 accounted for 58.3% of the total sludge. At the same time, the presence of iron decreased EPS levels, and also decreased the iron adsorption ability to sludge. More iron was transported into Anammox, which improved the nitrogen removal ability in the Anammox reactor.

Variation in microbial populations and antibiotic resistance genes in mariculture sediments in the present of the seaweed Ulva fasciata and under selective pressure of oxytetracycline.

The widely distributed seaweed Ulva fasciata has nutrient absorption abilities and can be used in the bioremediation of polluted maricultural environments. This study explored microbial community and antibiotic resistance gene (ARG) variation in mariculture sediments in response to different trace levels (10, 100, and 500 µg L-1) of oxytetracycline (OTC) and the presence of Ulva fasciata. The increase in OTC level promoted nutrient (NO3_-N and PO43--P) removal mainly due to Ulva fasciata adsorption. The abundances of the Euryarchaeota and Planctomycetes phyla in sediments were positively related to the increase in OTC stress, while a negative correlation occurred for the Proteobacteria phylum via metagenomic analysis. Compared with the control system, the increase rates of total ARGs were 3.90%, 7.36% and 13.42% at the OTC levels of 10, 100 and 500 µg L-1, respectively. OTC stress mainly favoured the collateral enrichment of non-corresponding polypeptide and MLS ARGs, mainly due to the enrichment of the phyla Planctomycetes and Euryarchaeota by the synergistic effect of OTC and nutrients. The results of quantitative PCR with tetracycline resistance genes (TRGs) (tetO, tetT, tetPB, tetW and otrA) and a horizontal transfer gene (intl1) demonstrated that all of genes had much higher gene numbers in sediments after 3 months of OTC stress than in those without OTC stress, which was strongly related to the variation in the phyla Bacteroidetes, Gemmatimonadetes and Acidobacteria. The significant correlation between intl1 and the target TRGs is indicative of the important role of the horizontal transfer of integron-resistant genes in the spread of TRGs.

Effect of low-intensity extracorporeal shockwave therapy on nocturnal penile tumescence and rigidity and penile haemodynamics.

The study aims to evaluate the effect of low-intensity extracorporeal shockwave therapy (Li-ESWT) on nocturnal erection and penile haemodynamics. Patients with erectile dysfunction (ED) were enrolled from January 2018 to March 2019. Self-reported erectile symptoms, the International Index of Erectile Function-5 (IIEF-5) and Erection Hardness Scores (EHS), nocturnal penile tumescence and rigidity (NPTR) and cavernous duplex Doppler ultrasound (CDDU) were evaluated. NPTR and CDDU were evaluated by Rigiscan and vascular ultrasound system respectively. Comparisons of NPTR and CDDU parameters were performed before and after Li-ESWT (Renova, once a week, 4 weeks in total). A total of 35 cases (mean age 36.51 ± 11.47 years) were enrolled for analysis. The IIEF-5 (10.60 ± 5.99 vs. 15.13 ± 6.22, p = .003), EHS (p = .016) and self-reported erectile hardness (p = .014) were significantly improved after 1-month treatment. Nocturnal erection frequency (p = .010), duration of total erection (p = .017), duration of erectile rigidity ≥60% at penile tip and base (p = .014 and p = .002) and the best erectile rigidity at penile tip and base (p = .012 and p = .005) improved significantly after treatment. However, no CDDU parameters improved after Li-ESWT (all p > .05). Li-ESWT can effectively improve subjective erectile function and nocturnal erection in ED patients. Large sample and well-designed studies need to be developed for supporting the current findings.

Stem cells and vascular dementia: from basic science to the clinic.

Vascular dementia (VD) is the second most common cause of dementia following Alzheimer's disease (AD). The major symptoms of VD including memory loss, language deficits and impairment of executive functions. Its specific etiology and pathogenesis remain unknown. Currently, treatment options of VD are still limited. The therapeutic strategies aim to control the vascular risk factors and improve the cognitive function. In recent years, cell therapy for neurodegenerative diseases has attracted a great deal of attention. Evidence suggested that stem cell transplantation could improve the symptoms of cerebral infarction and AD. Therefore, it may serve as a potential therapy for VD. We summarized the latest research results both in vitro and in vivo. Further, the clinical trial of stem cell transplantation in VD patients was also reviewed. Finally, the limitations and future directions of cell therapy in VD treatment were discussed.

[Updated cytokine therapy of erectile dysfunction].

Four types of cytokines are found to be related to the pathogenesis and treatment of ED. The cytokines capable of promoting angiogenesis can improve vascular endothelial function, promote endothelial regeneration and thus improve erectile function, those capable of promoting nerve regeneration can improve erectile function by protecting cavernous nerves, those capable of protecting the smooth muscle function can improve erectile function by promoting the smooth muscle expression and inhibiting penile fibrosis, and those inflammation-related cytokines can induce penile erection by acting on the corresponding receptor relaxing smooth muscle. Compared with PDE-5 inhibitors, cytokines are more targeted for the treatment of ED. However, current studies are mostly dependent on rat models and lack of large sample sizes, which has restricted further clinical application of cytokines. Although VEGF, IGF-1, BDNF and NGF can significantly improve the erectile function of ED rats, experiments with larger samples and larger animals are needed to further confirm their efficacy and safety.

Low- Versus High-Risk Rectal Cancer Based on MRI Features: Outcomes in Patients Treated Without Neoadjuvant Chemoradiotherapy.

OBJECTIVE: The objective of this study was to compare the prognoses of patients with low- and high-risk rectal cancer detected by MRI who were treated without neoadjuvant chemoradiotherapy (NCRT) and to determine independent risk factors. MATERIALS AND METHODS: This retrospective study included 185 patients with pathologically proven rectal adenocarcinoma who were treated without NCRT. Cancer was defined as high risk if one or more of the following factors were present: extramural depth of tumor invasion greater than 5 mm or stage T4a or T4b for tumor in the mid or high rectum; involvement of intersphincteric space, levators, or adjacent organs for tumor in the low rectum; extramural venous invasion (EMVI); or circumferential resection margin (CRM) involvement. Patients without any of those risk factors were placed in the low-risk group. The Kaplan-Meier method and Cox proportional hazards regression model were used to compare the survival outcomes between the two groups and to investigate the univariate and multivariate influences of the risk factors. RESULTS: Cancer was deemed to be low risk in 65 (35.1%) patients and high risk in 120 (64.9%) patients. The two patient groups had statistically significant differences in 3-year actuarial overall survival (OS; 100% vs 88.3%, p = 0.0044), disease-free survival (DFS; 92.3% vs 60.0%, p < 0.0001), and local recurrence (LR; 1.5% vs 10.0%, p = 0.0297). CRM involvement was identified as an independent risk factor for OS (hazard ratio [HR], 4.78; 95% CI, 1.24-18.45), DFS (HR, 2.44; 95% CI, 1.24-4.81), and LR (HR, 3.92; 95% CI, 1.07-14.41). Moreover, EMVI was identified as an independent risk factor for DFS (HR, 2.46; 95% CI, 1.28-4.74). CONCLUSION: The LR and long-term survival of patients in the low-risk group were more favorable than those of patients in the high-risk group. EMVI and CRM status were independent risk factors.

Correction to: Ponticoccus alexandrii sp. nov., a novel bacterium isolated from the marine toxigenic dinoflagellate Alexandrium minutum.

Subsequent to the publication of this article, it was noted that one of the culture collection numbers given for the type strain was given in error. Consequently, in the abstract "The type strain is AT2-AT (CCTCC AB 2016296T = KCTC 52626T)." should read "The type strain is AT2-AT (CCTCC AB 2016296T = KCTC 62340T)." Likewise, in the protologue section, "The type strain is AT2-AT (= CCTCC AB 201696T = KCTC 52626T), which is a algal-associated bacterium isolated from the culture of a toxigenic marine dinoflagellate, Alexandrium minutum (Amtk-4) collected from southern Taiwan." should read "The type strain is AT2-AT (= CCTCC AB 201696T = KCTC 62340T), which is an algal-associated bacterium isolated from the culture of a toxigenic marine dinoflagellate, Alexandrium minutum (Amtk-4), collected from southern Taiwan."

Ponticoccus alexandrii sp. nov., a novel bacterium isolated from the marine toxigenic dinoflagellate Alexandrium minutum.

During an investigation of the biodiversity of the cultivable bacterial community associated with paralytic shellfish poisoning toxin-producing marine dinoflagellate, Alexandrium minutum a novel algal-associated bacterium, designated strain AT2-AT was isolated. 16S rRNA gene sequence similarity analysis showed that the strain is a member of the genus Ponticoccus, with high sequence similarity to Ponticoccus litoralis DSM 18986T (97.9%) and Ponticoccus lacteus JCM 30379T (96.0%). However, based on the data obtained for the physiological and biochemical characteristics, and low level of DNA-DNA relatedness analysis, the strain could be genotypically and phenotypically differentiated from two type strains of the genus Ponticoccus. Therefore, this algal-associated bacterial strain is concluded to represent a novel species of the genus Ponticoccus, for which the name Ponticoccus alexandrii sp. nov. is proposed. The type strain is AT2-AT (CCTCC AB 2016296T = KCTC 62340T) [corrected].

Hoeflea prorocentri sp. nov., isolated from a culture of the marine dinoflagellate Prorocentrum mexicanum PM01.

A Gram-stain negative, aerobic, rod-shaped, non-motile, yellow-pigmented and non-spore-forming bacterial strain, designated PM5-8T, was isolated from a culture of a marine toxigenic dinoflagellate Prorocentrum mexicanum PM01. Strain PM5-8T grew at 15-35 °C (optimum, 25-30 °C) and pH 6-11 (optimum, 7.5-8). Cells required at least 1.5% (w/v) NaCl for growth, and can tolerate up to 7.0% with the optimum of 4%. Phylogenetic analysis based on 16S rRNA gene sequence revealed that the strain PM5-8T is closely related to members of the genus Hoeflea, with high sequence similarities with Hoeflea halophila JG120-1T (97.06%) and Hoeflea alexandrii AM1V30T (97.01%). DNA-DNA hybridization values between the isolate and other type strains of recognized species of the genus Hoeflea were between 11.8 and 25.2%, which is far below the value of 70% threshold for species delineation. The DNA G + C content was 50.3 mol%. The predominant cellular fatty acids of the strain were identified as summed feature 8 (C16:1 ω7c and/or C16:1 ω6c; 51.5%), C18:1 ω7c 11-methyl (20.7%), C16:0 (17.2%) and C18:0 (5.7%). The major respiratory quinone was Q-10. Polar lipids profiles contained phosphatidylcholine, phosphatidylglycerol, sulfoquinovosyl diacylglycerol, phosphatidylmono- methylethanolamine, phosphatidylethanolamine and four unidentified lipids. On the basis of the polyphasic taxonomic data presented, strain PM5-8T (= CCTCC AB 2016294T = KCTC 62490T) represents a novel species of the genus Hoeflea, for which the name Hoeflea prorocentri sp. nov. is proposed.

Evaluation of attitudes and knowledge toward mental disorders in a sample of the Chinese population using a web-based approach.

BACKGROUND: People with mental disorders often encounter stigmatizing attitudes related to their conditions. Stigma often represents one of the critical obstacles that stand in the way of delivering mental health care. The main aim of the study was to assess the knowledge and attitudes toward mental disorders in a sample of the Chinese population; furthermore, we also aimed to identify and explore the socio-demographic characteristics associated with specific knowledge and attitudes towards psychiatric disorders. METHODS: A cross-sectional survey was created and delivered through an Internet chat application over the period June-December 2017. The Mental Health Knowledge Questionnaire and the Perceived Devaluation and Discrimination Scale were used to evaluate the participants' mental health knowledge and attitudes toward mental disorders. RESULTS: A total of 1087 participants were recruited in for our survey. The mean score of the MHKQ and PDD were (15.89 ± 2.69) and (33.77 ± 6.66), respectively. Univariate analyses showed that young people and rural residents tended to show more positive attitudes toward mental disorders with respect to older people and urban residents (P < 0.05). People with higher education levels, those who had contact with people with mental disorders, and those who learned about mental disorders by personal encounter resulted to have had higher MHKQ scores (P < 0.05). CONCLUSIONS: In our sample of the Chinese population, negative attitudes toward mental disorders were often reported. General education programs may not be an effective way to decrease stigma, while anti-stigma campaigns targeted for specific groups, such as urban residents and the older people, should be carried out in the future in China.

Tooth loss as a risk factor for dementia: systematic review and meta-analysis of 21 observational studies.

BACKGROUND: Tooth loss is suggested to be associated with an increased risk of dementia in many studies. But the relationship between tooth loss and dementia is not yet fully understood. This systematic review and meta-analysis aimed to determine the relative effect of tooth loss on dementia risk. METHODS: An electronic search of PubMed, Scopus, Embase, and Web of Knowledge was conducted in March 2018 to identify relevant observational studies with the English language restriction. Studies were included if they assessed the relationship between tooth loss and risk of dementia. Study quality was detected by the modified Downs and Black scale. Odds risks (ORs) were pooled using a random-effects model in the crude model. RESULTS: The literature search initially yielded 1574 articles, and 21 observational studies published between 1994 and 2017 were finally included for the analyses. The crude results with random-effects model showed that patients with multiple tooth loss had higher incidence of dementia (OR 2.62, 95% CI 1.90-3.61, P < 0.001, I2 = 90.40%). The association remained noted when only adjusted results were pooled from 18 studies (OR 1.55, 95% CI 1.41-1.70, P = 0.13, I2 = 28.00%). Meta-regression analysis showed that study design explained about 16.52% of heterogeneity in the crude model. The overall quality rating scores of studies ranged from 11 to 16. CONCLUSIONS: Findings from this review evidenced that tooth loss is positively associated with an increased risk of dementia in adults. Future well-designed longitudinal researches examining the direct and indirect relationship between tooth loss and dementia risk are encouraged.

Underestimated effects of sediments on enhanced startup performance of biofilm systems for polluted source water pretreatment.

In order to evaluate the enhancement mechanisms of enhanced startup performance in biofilm systems for polluted source water pretreatment, three lab-scale reactors with elastic stereo media (ESM) were operated under different enhanced sediment and hydraulic agitation conditions. It is interesting to found the previously underestimated or overlooked effects of sediment on the enhancement of pollutants removal performance and enrichment of functional bacteria in biofilm systems. The maximum NH4+-N removal rate of 0.35 mg L-1 h-1 in sediment enhanced condition was 2.19 times of that in control reactor. Sediment contributed to 42.0-56.5% of NH4+-N removal and 15.4-41.2% of total nitrogen removal in different reactors under different operation conditions. The enhanced hydraulic agitation with sediment further improved the operation performance and accumulation of functional bacteria. Generally, Proteobacteria (48.9-52.1%), Bacteroidetes (18.9-20.8%) and Actinobacteria (15.7-18.5%) were dominant in both sediment and ESM bioiflm at  phylum level. The potentially functional bacteria found in sediment and ESM biofilm samples with some functional bacteria mainly presented in sediment samples only (e.g., Genera Bacillus and Lactococcus of Firmicutes phylum) may commonly contribute to the removal of nitrogen and organics.

Efficacy of Vitamin B Supplementation on Cognition in Elderly Patients With Cognitive-Related Diseases.

Increase in serum homocysteine is shown to be a potential risk factor for cognitive impairment. Evidence suggests that vitamin B supplementation may reduce cognitive decline by lowering the homocysteine levels. The current meta-analysis evaluated the efficacy of folic acid along with vitamin B12 and/or B6 in lowering homocysteine, thereby attenuating cognitive decline in elderly patients with Alzheimer disease or dementia. Randomized controlled trials (RCTs) comparing the efficacy of folate and B vitamin supplementation in patients with cognitive decline secondary to Alzheimer disease or dementia were identified using the keywords, "homocysteine, hyper-homocysteinemia, B vitamin, vitamin B6, B12, folic acid, cognitive, Alzheimer's disease, and dementia." The outcome measures analyzed were the Mini-Mental State Examination (MMSE) score and serum homocysteine. Of the 77 studies identified, 4 RCTs were included in the current meta-analysis. The baseline characteristics, age, and gender distribution of patients among the 2 groups (supplement vs placebo) were comparable. The results reveal that the intervention group achieved significantly greater reduction in homocysteine levels than the control (pooled difference in means = -3.625, 95% confidence interval [CI] = -5.642 to -1.608, P < .001). However, no significant difference in MMSE (pooled difference in means = 0.027, 95% CI = -0.518 to 0.573, P = 0.921) was observed between the groups. Taken together, vitamin B supplementation was effective in reducing serum homocysteine levels. However, it did not translate into cognitive improvement, indicating that the existing data on vitamin B-induced improvement in cognition by lowering homocysteine levels are conflicting.