Characterization of buried interfaces using Ga Kα hard X-ray photoelectron spectroscopy (HAXPES).

The extension of X-ray photoelectron spectroscopy (XPS) to measure layers and interfaces below the uppermost surface requires higher X-ray energies and electron energy analysers capable of measuring higher electron kinetic energies. This has been enabled at synchrotron radiation facilities and by using lab-based instruments which are now available with sufficient sensitivity for measurements to be performed on reasonable timescales. Here, we detail measurements on buried interfaces using a Ga Kα (9.25 keV) metal jet X-ray source and an EW4000 energy analyser (ScientaOmicron GmbH) in the Henry Royce Institute at the University of Manchester. Development of the technique has required the calculation of relative sensitivity factors (RSFs) to enable quantification analogous to Al Kα XPS, and here we provide further substantiation of the Ga Kα RSF library. Examples of buried interfaces include layers of memory and energy materials below top electrode layers, semiconductor heterostructures, ions implanted in graphite, oxide layers at metallic surfaces, and core-shell nanoparticles. The use of an angle-resolved mode enables depth profiling from the surface into the bulk, and is complemented with surface-sensitive XPS. Inelastic background modelling allows the extraction of information about buried layers at depths up to 20 times the photoelectron inelastic mean free path.

Viscous placebo and carbohydrate breakfasts similarly decrease appetite and increase resistance exercise performance compared with a control breakfast in trained males.

Given the common view that pre-exercise nutrition/breakfast is important for performance, the present study investigated whether breakfast influences resistance exercise performance via a physiological or psychological effect. Twenty-two resistance-trained, breakfast-consuming men completed three experimental trials, consuming water-only (WAT), or semi-solid breakfasts containing 0 g/kg (PLA) or 1·5 g/kg (CHO) maltodextrin. PLA and CHO meals contained xanthan gum and low-energy flavouring (approximately 122 kJ), and subjects were told both 'contained energy'. At 2 h post-meal, subjects completed four sets of back squat and bench press to failure at 90 % ten repetition maximum. Blood samples were taken pre-meal, 45 min and 105 min post-meal to measure serum/plasma glucose, insulin, ghrelin, glucagon-like peptide-1 and peptide tyrosine-tyrosine concentrations. Subjective hunger/fullness was also measured. Total back squat repetitions were greater in CHO (44 (sd 10) repetitions) and PLA (43 (sd 10) repetitions) than WAT (38 (sd 10) repetitions; P < 0·001). Total bench press repetitions were similar between trials (WAT 37 (sd 7) repetitions; CHO 39 (sd 7) repetitions; PLA 38 (sd 7) repetitions; P = 0·130). Performance was similar between CHO and PLA trials. Hunger was suppressed and fullness increased similarly in PLA and CHO, relative to WAT (P < 0·001). During CHO, plasma glucose was elevated at 45 min (P < 0·05), whilst serum insulin was elevated (P < 0·05) and plasma ghrelin suppressed at 45 and 105 min (P < 0·05). These results suggest that breakfast/pre-exercise nutrition enhances resistance exercise performance via a psychological effect, although a potential mediating role of hunger cannot be discounted.

Carcinoma ex pleomorphic adenoma: case report and options for systemic therapy.

The most common benign salivary tumour is a pleomorphic adenoma. Transformation to malignancy, carcinoma ex pleomorphic adenoma (cxpa), occurs in 6% of cases. Management focuses on surgical resection and radiotherapy; however, rare cases require systemic management. We present the case of a 60-year-old woman with a cxpa of the left parotid gland who required systemic therapy for locally recurrent disease. Treatment options were guided by the literature concerning malignant salivary gland tumour and by whole-genome and transcriptome sequencing of the tumour. The patient received multiple systemic agents during the course of her disease, with cyclophosphamide-doxorubicin-cisplatin providing the best control (partial response). Genomeand transcriptome-directed therapy, including sorafenib and vismodegib, were utilized with limited clinical benefit. Malignant transformation in cxpa is a complex process, and therapy directed at a single tumour pathway might not be sufficient to control disease.

Parents have different perceptions of bed-wetting than children from six to 15 years of age.

AIM: Enuresis is a common childhood disorder that negatively affects children's social and psychological well-being. This study investigated the psychological and emotional problems of children in Taiwan who wet the bed between the ages of six and 15 by comparing feedback from the children, their parents and a control group. METHODS: This case study featured 93 children with primary nocturnal enuresis from enuresis clinics, and their parents, and 98 nonenuretic controls and parents from the local community. All the parents completed the Behavioural and Emotional Rating Scale (BERS) and all the children completed the Teenage Self-Concept Scale (TSCS). T-scores were used for statistical comparisons and high scores related to higher self-concept. RESULTS: The parents and their children displayed different perceptions of enuresis, with more behavioural and emotional problems in enuretic children. Older children and children with more severe enuresis reported more difficulties, and low maternal education was also a risk factor. CONCLUSION: Parental attitudes and perceptions towards bed-wetting were different from their children's. The children's age, enuresis severity and their mothers' educational level were potential risk factors that affected well-being. Health practitioners need to facilitate communication between enuretic children and their parents in addition to monitoring their psychological well-being.

An orbitocortical-thalamic circuit suppresses binge alcohol-drinking.

Alcohol consumption remains a significant global health challenge, causing millions of direct and indirect deaths annually. Intriguingly, recent work has highlighted the prefrontal cortex, a major brain area that regulates inhibitory control of behaviors, whose activity becomes dysregulated upon alcohol abuse. However, whether an endogenous mechanism exists within this brain area that limits alcohol consumption is unknown. Here we identify a discrete GABAergic neuronal ensemble in the medial orbitofrontal cortex (mOFC) that is selectively recruited during binge alcohol-drinking and intoxication. Upon alcohol intoxication, this neuronal ensemble suppresses binge drinking behavior. Optogenetically silencing of this population, or its ablation, results in uncontrolled binge alcohol consumption. We find that this neuronal ensemble is specific to alcohol and is not recruited by other rewarding substances. We further show, using brain-wide analysis, that this neuronal ensemble projects widely, and that its projections specifically to the mediodorsal thalamus are responsible for regulating binge alcohol drinking. Together, these results identify a brain circuit in the mOFC that serves to protect against binge drinking by halting alcohol intake. These results provide valuable insights into the complex nature of alcohol abuse and offers potential avenues for the development of mOFC neuronal ensemble-targeted interventions.

Repeatable and deterministic all electrical switching in a mixed phase artificial multiferroic.

We demonstrate a repeatable all-electric magnetic switching behaviour in a PMN-PT/FeRh thin film artificial multiferroic. The magnitude of the effect is significantly smaller than expected from conventional thermomagnetic switching of FeRh thin films and we explore properties of the PMN-PT/FeRh system in order to understand the origin of this reduction. The data demonstrate the importance of the crystallographic phase of PMN-PT and show how a phase transition at ~ 100 °C modifies the magneto-electric coupling. We demonstrate a large strain remanence effect in the PMN-PT substrate, which limits the magnetoelectric coupling on successive cycling of the applied electric field.

Contrasting Effects of Local Environmental and Biogeographic Factors on the Composition and Structure of Bacterial Communities in Arid Monospecific Mangrove Soils.

Mangrove forests are important biotic sinks of atmospheric CO2 and play an integral role in nutrient-cycling and decontamination of coastal waters, thereby mitigating climatic and anthropogenic stressors. These services are primarily regulated by the activity of the soil microbiome. To understand how environmental changes may affect this vital part of the ecosystem, it is key to understand the patterns that drive microbial community assembly in mangrove forest soils. High-throughput amplicon sequencing (16S rRNA) was applied on samples from arid Avicennia marina forests across different spatial scales from local to regional. Alongside conventional analyses of community ecology, microbial co-occurrence networks were assessed to investigate differences in composition and structure of the bacterial community. The bacterial community composition varied more strongly along an intertidal gradient within each mangrove forest, than between forests in different geographic regions (Australia/Saudi Arabia). In contrast, co-occurrence networks differed primarily between geographic regions, illustrating that the structure of the bacterial community is not necessarily linked to its composition. The local diversity in mangrove forest soils may have important implications for the quantification of biogeochemical processes and is important to consider when planning restoration activities. IMPORTANCE Mangrove ecosystems are increasingly being recognized for their potential to sequester atmospheric carbon, thereby mitigating the effects of anthropogenically driven greenhouse gas emissions. The bacterial community in the soils plays an important role in the breakdown and recycling of carbon and other nutrients. To assess and predict changes in carbon storage, it is important to understand how the bacterial community is shaped by its environment. Here, we compared the bacterial communities of mangrove forests on different spatial scales, from local within-forest to biogeographic comparisons. The bacterial community composition differed more between distinct intertidal zones of the same forest than between forests in distant geographic regions. The calculated network structure of theoretically interacting bacteria, however, differed most between the geographic regions. Our findings highlight the importance of local environmental factors in shaping the microbial soil community in mangroves and highlight a disconnect between community composition and structure in microbial soil assemblages.

Highly sensitive molecular diagnosis of prostate cancer using surplus material washed off from biopsy needles.

INTRODUCTION: Currently, final diagnosis of prostate cancer (PCa) is based on histopathological analysis of needle biopsies, but this process often bears uncertainties due to small sample size, tumour focality and pathologist's subjective assessment. METHODS: Prostate cancer diagnostic signatures were generated by applying linear discriminant analysis to microarray and real-time RT-PCR (qRT-PCR) data from normal and tumoural prostate tissue samples. Additionally, after removal of biopsy tissues, material washed off from transrectal biopsy needles was used for molecular profiling and discriminant analysis. RESULTS: Linear discriminant analysis applied to microarray data for a set of 318 genes differentially expressed between non-tumoural and tumoural prostate samples produced 26 gene signatures, which classified the 84 samples used with 100% accuracy. To identify signatures potentially useful for the diagnosis of prostate biopsies, surplus material washed off from routine biopsy needles from 53 patients was used to generate qRT-PCR data for a subset of 11 genes. This analysis identified a six-gene signature that correctly assigned the biopsies as benign or tumoural in 92.6% of the cases, with 88.8% sensitivity and 96.1% specificity. CONCLUSION: Surplus material from prostate needle biopsies can be used for minimal-size gene signature analysis for sensitive and accurate discrimination between non-tumoural and tumoural prostates, without interference with current diagnostic procedures. This approach could be a useful adjunct to current procedures in PCa diagnosis.

The Importance of Understanding Parental Perception When Treating Primary Nocturnal Enuresis: A Topic Review and an Institutional Experience.

Primary nocturnal enuresis (PNE) is a common childhood disorder that adversely affects a child's mental well-being and social life. Our clinical experience showed parents and their child often have significantly different perspective of enuresis, and these differences can affect family dynamics, treatment approaches, and treatment success. Parents' perception of PNE also influences the likelihood of seeking medical treatment, and we found parents of children with enuresis have markedly different beliefs regarding bedwetting than those of physicians. Because achieving remission for PNE requires parents and their child to actively participate in treatment, assessing their expectancy of success and their beliefs will allow clinicians to adjust treatment goals as necessary. When treating PNE, guidelines consistently recommend incorporating bed alarms as part of the therapy. However, through interviewing parents and treating their children, we found parents preferred medications or other behavioral strategies, such as limiting water intake, because of their convenience. Many parents would complain bed alarms woke them up instead of their child, and they would soon give up on bed alarms. Part of assessing their beliefs includes assessing their confidence in their child being able to wake up to alarms and to persist with treatment. Understanding how they manage and approach setbacks will also determine the treatment modality suited for their child. In this review paper, we detailed our experiences interviewing parents and treating their child with NE with urodynamics and medications at the Changhua Christian Hospital in Taiwan.

Surface antigens of melanoma and melanocytes. Specificity of induction of Ia antigens by human gamma-interferon.

IFN-gamma is known to induce expression of Ia antigens on a variety of cell types. In the present study, this activity of IFN-gamma has been analyzed with a panel of 36 melanoma cell lines, normal melanocytes, and 97 cell lines representing a range of other differentiation lineages. 55% of the melanoma cell lines express Ia antigens in a constitutive manner without IFN-gamma induction. Of the 16 Ia-melanoma lines, 13 could be induced to express Ia antigens by IFN-gamma, whereas three were noninducible. Melanocytes, which do not normally express Ia antigens, are converted to Ia expression by IFN-gamma. Ia antigens expressed constitutively or after IFN-gamma induction were identified with antibodies detecting monomorphic and allomorphic products of DR and DC loci. IFN-gamma appeared to be unique in its ability to induce Ia expression on melanoma and melanocytes; 14 other agents (including IFN-alpha and IFN-beta) known to influence growth or differentiation did not have Ia-inducing activity. Equally striking is the restriction of antigenic changes following IFN-gamma induction to HLA-associated products; of the 38 systems of cell surface antigens examined, only HLA-A,B,C, beta 2m, and Ia antigens were affected. A variety of other Ia- cell types were shown to be Ia-inducible by IFN-gamma; these included established lines of breast, colon, pancreas, bladder, kidney, ovary, and brain cancers, and cultures of normal fibroblasts, kidney epithelia, and epidermal keratinocytes. In contrast, three tumor types, teratocarcinoma, choriocarcinoma, and neuroblastoma, were not inducible for Ia expression, even though IFN-gamma could induce expression of HLA-A,B,C products. The broad representation of Ia antigens on most somatic cell types expressed either constitutively or after IFN-gamma can be viewed in an immunological context (antigen presentation/immune regulatory signals) or could indicate that Ia products have functions other than those related to immune reactions.

Topography dependence of the metamagnetic phase transition in FeRh thin films.

The equiatomic alloy FeRh is of great scientific and technological interest due its highly unusual first-order antiferromagnetic (AF) to ferromagnetic (FM) phase transition. Here we report an exploration of the interplay between topography and phase evolution with a comprehensive magnetic force microscopy study of nominal 50 nm thick FeRh thin films and subtractively patterned wires of width 0.2 µm-2 µm. In continuous films where the surface morphology had not been optimised for smoothness, the topographical variation was observed to dominate the distribution of the magnetic transition temperatures and dictates the nucleation and growth of the magnetic phases. This observation was repeated for patterned elements, where the effects of surface morphology were more significant than those of spatial confinement. These results have clear implications for future studies of low-dimensional FeRh films, as surface topography must be considered when analysing and comparing the transition behaviour of FeRh thin films.

Movement patterns of players in the Australian Women's Rugby League team during international competition.

OBJECTIVES: To describe the movement patterns of the Australian Women's Rugby League team during international competition. DESIGN: Retrospective observational study. METHODS: Global Positioning Systems technology recorded the movements of players from the Australian Women's Rugby League team (n=31) during seven international rugby league matches. A subgroup of players (n=18) that played at least 80min in a match were categorized into three positional groups: forwards (n=7), backs (n=7) and halves (n=4), and analysed for external outputs that were classified into multiple speed zones. Mean speed (mmin-1) and mean speed when travelling >12kmh-1 (MS12; mmin-1) were calculated for each 10% interval of playing time of both groups to assess changes in match intensity. RESULTS: Total distance travelled was greater in the first half (3332.9m compared to 3249.0m), along with distances travelled at speeds >15kmh-1 (p<0.05), whereas players travelled further at speeds <6kmh-1 in the second half (p=0.005). Backs travelled further at speeds <6kmh-1 (p=0.002) and >15kmh-1 (p=0.007) compared to forwards. Mean speed significantly reduced across the first and second halves (p<0.05), while MS12 reduced by ∼40% in the first half of the match (i.e. first ∼5min compared to the last ∼5min). CONCLUSION: These results provide coaches with sport-specific activity profiles of female rugby league players that can be used to individualise training prescription. Given that match-intensity deteriorated across the first and second halves, programs may be targeted at improving endurance and supramaximal exercise tolerance in order for female players to withstand high match-demands of international competition.

Experience Of Medical Treatment With Desmopressin And Imipramine In Children With Severe Primary Nocturnal Enuresis In Taiwan.

PURPOSE: The aim of this study was to compare the efficacy and safety of desmopressin and imipramine in the treatment of severe primary nocturnal enuresis (NE) in Taiwan. PATIENTS AND METHODS: This study was a retrospective chart review study conducted on children with primary monosymptomatic nocturnal enuresis (PMNE) or non-monosymptomatic nocturnal enuresis (PNMNE), referred to and treated by senior physicians in a Changhua medical center in Taiwan. After being screened, these children were treated with either desmopressin (n = 125) or imipramine (n = 71). All participants were treated for at least 3 months and followed afterward for at least 3 more months. The response and relapse rates were measured. Side effects were monitored. Age, gender, and severity of NE were recorded. RESULTS: After 3 months of treatment, 97 children treated with desmopressin were responsive (77.6%) while 58 children treated with imipramine were responsive (81.7%). Sixty-one children treated with desmopressin (48.8%) and 26 treated with imipramine (36.6%) relapsed during the 3-month post-treatment monitoring. The differences in responsive and relapse rates were not statistically significant. Four children treated with imipramine (5.6%) reported side effects while none was reported for children treated with desmopressin (P < 0.05). Age, gender, and the presence or absence of daytime enuresis did not influence the response rate to either drug (P < 0.05). CONCLUSION: Currently, desmopressin is preferred over imipramine for treating NE due to the latter's side effects. Our results demonstrated similar response rates for both drugs, with imipramine demonstrating minimal side effects. While health practitioners should pay attention to its side effects, concerns regarding imipramine toxicity in NE treatment are often overblown. Since imipramine is much cheaper than desmopressin, using imipramine to manage NE can allow health practitioners, especially in Taiwan, to treat the greatest number of children with NE.

Coral reef degradation affects the potential for reef recovery after disturbance.

The loss of coral cover is often accompanied by an increase of benthic algae, a decline in biodiversity and habitat complexity. However, it remains unclear how surrounding communities influence the trajectories of re-colonization between pulse disturbance events. Over a 12-month field experiment in the central Red Sea, we examined how healthy (hard-coral dominated) and degraded (algae-dominated) reef areas influence recruitment and succession patterns of benthic reef foundation communities on bare substrates. Crustose coralline algae and other calcifiers were important colonizers in the healthy reef area, promoting the accumulation of inorganic carbon. Contrary, substrates in the degraded area were predominantly colonized by turf algae, lowering the accumulation of inorganic carbon by 178%. While coral larvae settlement similarly occurred in both habitats, degraded areas showed 50% fewer recruits. Our findings suggest that in degraded reefs the replenishment of adult coral populations is reduced due to recruitment inhibition through limited habitat complexity and grazing pressure, thereby restraining reef recovery.

Oncogene N-ras mediates selective inhibition of c-fos induction by nerve growth factor and basic fibroblast growth factor in a PC12 cell line.

A cell line was generated from U7 cells (a subline of PC12 rat pheochromocytoma cells) that contains a stably integrated transforming mouse N-ras (Lys-61) gene under the control of the long terminal repeat from mouse mammary tumor virus. Such cells, designated UR61, undergo neuronal differentiation upon exposure to nanomolar concentrations of dexamethasone, as a consequence of expression of the activated N-ras gene (I. Guerrero, A. Pellicer, and D.E. Burstein, Biochem, Biophys. Res. Commun. 150:1185-1192, 1988). Exposure of UR61 cells to either nerve growth factor (NGF) or basic fibroblast growth factor (bFGF) results in a marked induction of c-fos RNA, with kinetics paralleling those of NGF- or bFGF-induced expression of c-fos RNA in PC12 cells. Dexamethasone-induced expression of activated N-ras p21 results in blocking of c-fos RNA induction by NGF or bFGF in a time-dependent manner. Activated N-ras p21-mediated inhibition of c-fos RNA induction in UR61 cells is selective for NGF and bFGF and is not due to selective degradation of c-fos RNA. Normal and transforming N-ras can trans activate the chloramphenicol acetyltransferase gene linked to mouse c-fos regulatory sequences when transient expression assays are performed. Our observations suggest that N-ras p21 selectively interacts with pathways involved in induction of c-fos expression which initiate at the receptors for NGF and bFGF.

Regulation of protein kinase C activity in neuronal differentiation induced by the N-ras oncogene in PC-12 cells.

Expression of the N-ras oncogene under the control of the glucocorticoid-responsive promoter in the pheochromocytoma cell line UR61, a subline of PC-12 cells, has been used to investigate the differentiation process to neuronal cells triggered by ras oncogenes (I. Guerrero, A. Pellicer, and D. E. Burstein, Biochem. Biophys. Res. Commun. 150:1185-1192, 1988). Using ras-inducible cell lines, we observed that expression of the oncogenic N-ras p21 protein interferes with the ability of phorbol esters to induce downregulation of protein kinase C. This effect was associated with the appearance of immunologically detectable protein kinase C as well as the activity of the enzyme as analyzed either by binding of [3H]phorbol-12,13-dibutyrate in intact cells or by in vitro kinase activity. These results indicate a relationship between ras p21 and protein kinase C in neuronal differentiation in this model system. Comparison to the murine fibroblast system suggests that this relationship may be functional.

Role of UEV-1, an inactive variant of the E2 ubiquitin-conjugating enzymes, in in vitro differentiation and cell cycle behavior of HT-29-M6 intestinal mucosecretory cells.

By means of differential RNA display, we have isolated a cDNA corresponding to transcripts that are down-regulated upon differentiation of the goblet cell-like HT-29-M6 human colon carcinoma cell line. These transcripts encode proteins originally identified as CROC-1 on the basis of their capacity to activate transcription of c-fos. We show that these proteins are similar in sequence, and in predicted secondary and tertiary structure, to the ubiquitin-conjugating enzymes, also known as E2. Despite the similarities, these proteins lack a critical cysteine residue essential for the catalytic activity of E2 enzymes and, in vitro, they do not conjugate or transfer ubiquitin to protein substrates. These proteins constitute a distinct subfamily within the E2 protein family and are highly conserved in phylogeny from yeasts to mammals. Therefore, we have designated them UEV (ubiquitin-conjugating E2 enzyme variant) proteins, defined as proteins similar in sequence and structure to the E2 ubiquitin-conjugating enzymes but lacking their enzymatic activity (HW/GDB-approved gene symbol, UBE2V). At least two human genes code for UEV proteins, and one of them, located on chromosome 20q13.2, is expressed as at least four isoforms, generated by alternative splicing. All human cell types analyzed expressed at least one of these isoforms. Constitutive expression of exogenous human UEV in HT-29-M6 cells inhibited their capacity to differentiate upon confluence and caused both the entry of a larger proportion of cells in the division cycle and an accumulation in G2-M. This was accompanied with a profound inhibition of the mitotic kinase, cdk1. These results suggest that UEV proteins are involved in the control of differentiation and could exert their effects by altering cell cycle distribution.

Updated recommendations from the Canadian National Consensus Meeting on HER2/neu testing in breast cancer.

Testing for HER2/neu in breast cancer at the time of primary diagnosis is now the standard of care. Accurate and standardized testing methods are of prime importance to ensure the proper classification of the patient's HER2/neu status. A meeting of pathologists from across Canada was convened to update the Canadian HER2/neu testing guidelines. This National HER2/neu Testing Committee reviewed the recently published American Society of Clinical Oncology/ College of American Pathologists (ASCO/CAP) guidelines for HER2/neu testing in breast cancer. The updated Canadian HER2/neu testing guidelines are based primarily on the ASCO/CAP guidelines, with some modifications. It is anticipated that widespread adoption of these guidelines will further improve the accuracy of HER2/neu testing in Canada.

Substrate Induced Strain Field in FeRh Epilayers Grown on Single Crystal MgO (001) Substrates.

Equi-atomic FeRh is highly unusual in that it undergoes a first order meta-magnetic phase transition from an antiferromagnet to a ferromagnet above room temperature (Tr ≈ 370 K). This behavior opens new possibilities for creating multifunctional magnetic and spintronic devices which can utilise both thermal and applied field energy to change state and functionalise composites. A key requirement in realising multifunctional devices is the need to understand and control the properties of FeRh in the extreme thin film limit (tFeRh < 10 nm) where interfaces are crucial. Here we determine the properties of FeRh films in the thickness range 2.5-10 nm grown directly on MgO substrates. Our magnetometry and structural measurements show that a perpendicular strain field exists in these thin films which results in an increase in the phase transition temperature as thickness is reduced. Modelling using a spin dynamics approach supports the experimental observations demonstrating the critical role of the atomic layers close to the MgO interface.

Factors associated with remission of primary nocturnal enuresis and changes of parental perception towards management strategies: A follow-up study.

OBJECTIVE: To understand the remission rates, shifts in treatment methods used by parents, and parents' attitudes towards their children with primary nocturnal enuresis (NE). STUDY DESIGN: A total of 408 children aged 6-12 years and diagnosed with primary nocturnal enuresis from a 2004 epidemiological study in Taiwan were enrolled. After a 5.5-year follow-up period, the remission rates of the children of each age group were evaluated, and the corresponding treatment methods were employed daily. Furthermore, the major risk factors that influenced the remission rates in these children were investigated. RESULTS: The overall remission rate was 93.1% among all age groups, and the median age of remission was 9.9 years (95% CI 9.5-10.2 years). Comparing the previous and after results of this study, the treatment methods utilized by the parents in response to enuresis were significantly different. More parents chose combination therapy and sought medical attention as the children grew older, particularly the parents of children with severe NE. Few parents still continued to use punishment method. A Cox proportional hazards regression model revealed that girls, young children, those with low enuresis frequency, and light sleepers had higher remission rates than did their counterparts. CONCLUSION: Parents' attitudes towards enuresis influence their choice of therapy for their children. In most cases, parents chose a combination of therapies, particularly combining limited fluid intake and regular voiding. Only 37 (9.1%) children received medicine. The older the enuretic child, the more likely the parents were to seek medical treatment for their children. Enuresis might disappear spontaneously but not always. A small proportion of children will continue to wet till adulthood. The treatment of NE at this age would be challenging. Children who were deep sleepers or affected by severe enuresis had a low probability of achieving dryness. However, girls and young children had a higher probability of achieving remission than did their counterparts.