Development and Validation of Interpretable Machine Learning Models for Clinically Significant Prostate Cancer Diagnosis in Patients With Lesions of PI-RADS v2.1 Score ≥3.

BACKGROUND: For patients with PI-RADS v2.1 ≥ 3, prostate biopsy is strongly recommended. Due to the unsatisfactory positive rate of biopsy, improvements in clinically significant prostate cancer (csPCa) risk assessments are required. PURPOSE: To develop and validate machine learning (ML) models based on clinical and imaging parameters for csPCa detection in patients with PI-RADS v2.1 ≥ 3. STUDY TYPE: Retrospective. SUBJECTS: One thousand eighty-three patients with PI-RADS v2.1 ≥ 3, randomly split into training (70%, N = 759) and validation (30%, N = 324) datasets, and 147 patients enrolled prospectively for testing. FIELD STRENGTH/SEQUENCE: 3.0 T scanners/T2-weighted fast spin echo sequence and DWI with diffusion-weighted single-shot gradient echo planar imaging sequence. ASSESSMENT: The factors evaluated for csPCa detection were age, prostate specific antigen, prostate volume, and the diameter and location of the index lesion, PI-RADSv2.1. Five ML models for csPCa detection were developed: logistic regression (LR), extreme gradient boosting, random forest (RF), decision tree, and support vector machines. The csPCa was defined as Gleason grade ≥2. STATISTICAL TESTS: Univariable and multivariable LR analyses to identify parameters associated with csPCa. Area under the receiver operating characteristic curve (AUC), Brier score, and DeLong test were used to assess and compare the csPCa diagnostic performance with the LR model. The significance level was defined as 0.05. RESULTS: The RF model exhibited the highest AUC (0.880-0.904) and lowest Brier score (0.125-0.133) among the ML models in the validation and testing cohorts, however, there was no difference when compared to the LR model (P = 0.453 and 0.548). The sensitivity and negative predictive values in the validation and testing cohorts were 93.8%-97.6% and 82.7%-95.1%, respectively, at a threshold of 0.450 (99% sensitivity of the RF model). DATA CONCLUSION: The RF model might help for assessing the risk of csPCa and preventing overdiagnosis and unnecessary biopsy for men with PI-RADSv2.1 ≥ 3. EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 2.

Insights into urinary incontinence after robot-assisted radical prostatectomy: urgent urinary incontinence or stress urinary incontinence.

PURPOSE: Urinary incontinence is a common complication following robot-assisted radical prostatectomy (RARP). Few studies have explored the relationships and differences between stress urinary incontinence (SUI) and urgent urinary incontinence (UUI) after RARP. This study aimed to investigate the occurrence rates and risk factors of UUI and SUI in short term after RARP. METHODS: We prospectively included prostate cancer patients who underwent RARP by a single surgeon. Demographics, lower urinary tract function, oncology, and follow-ups were recorded. Occurrence rates and risk factors of UUI and SUI within 3 months after catheter withdrawal were calculated. RESULTS: The study cohort included 363 subjects with a mean age of 66.05 years. The median preoperative International Prostate Symptom Score (IPSS) was 14 (range 0-35), and the median Overactive Bladder Symptom Score (OABSS) was 3 (range 0-14). The occurrence rate of UUI and SUI at 3 months after catheter withdrawal was 8.5% (31/363) and 15.2% (55/363). Nearly all patients with UUI also had SUI. Diabetes history and high OABSS before RARP were independent risk factors for UUI, especially within 1 month after catheter withdrawal. The Gleason Score was an independent risk factor for SUI at 3 months after catheter withdrawal. Additionally, UUI but not SUI might be an influencing factor for decision-making regarding postoperative radiotherapy. CONCLUSION: The occurrence rate of SUI after RARP was persistently higher than that of UUI. Nearly all of the patients with UUI simultaneously had SUI. The risk factors of UUI and SUI after RARP were absolutely different.

Global impact of atmospheric arsenic on health risk: 2005 to 2015.

Arsenic is a toxic pollutant commonly found in the environment. Most of the previous studies on arsenic pollution have primarily focused on arsenic contamination in groundwater. In this study, we examine the impact on human health from atmospheric arsenic on the global scale. We first develop an improved global atmospheric arsenic emission inventory and connect it to a global model (Goddard Earth Observing System [GEOS]-Chem). Model evaluation using observational data from a variety of sources shows the model successfully reproduces the spatial distribution of atmospheric arsenic around the world. We found that for 2005, the highest airborne arsenic concentrations were found over Chile and eastern China, with mean values of 8.34 and 5.63 ng/m3, respectively. By 2015, the average atmospheric arsenic concentration in India (4.57 ng/m3) surpassed that in eastern China (4.38 ng/m3) due to the fast increase in coal burning in India. Our calculation shows that China has the largest population affected by cancer risk due to atmospheric arsenic inhalation in 2005, which is again surpassed by India in 2015. Based on potential exceedance of health-based limits, we find that the combined effect by including both atmospheric and groundwater arsenic may significantly enhance the risks, due to carcinogenic and noncarcinogenic effects. Therefore, this study clearly implies the necessity in accounting for both atmospheric and groundwater arsenic in future management.

Use of Facebook by Academic Medical Centers in Taiwan During the COVID-19 Pandemic: Observational Study.

BACKGROUND: The battle against COVID-19 remains ongoing, and social media has played an important role during the crisis for both communication and health promotion, particularly for health care organizations. Taiwan's success during the COVID-19 outbreak is well known and the use of social media is one of the key contributing factors to that success. OBJECTIVE: This nationwide observational study in Taiwan aimed to explore the use of Facebook by academic medical centers during the COVID-19 pandemic. METHODS: We conducted a nationwide observational study of all Facebook fan page posts culled from the official accounts of all medical centers in Taiwan from December 2019 to April 2020. All Facebook posts were categorized into either COVID-19-related posts or non-COVID-19-related posts. COVID-19-related posts were split into 4 categories: policy of Taiwan's Center for Disease Control (TCDC), gratitude notes, news and regulations from hospitals, and education. Data from each post was also recorded as follows: date of post, headline, number of "likes," number of messages left, number of shares, video or non-video post, and date of search. RESULTS: The Facebook fan pages of 13 academic medical centers, with a total of 1816 posts, were analyzed. From January 2020, the percentage of COVID-19 posts increased rapidly, from 21% (January 2020) to 56.3% (April 2020). The trends of cumulative COVID-19 posts and reported confirmed cases were significantly related (Pearson correlation coefficient=0.93, P<.001). Pages from private hospitals had more COVID-19 posts (362 versus 289), as well as more video posts (72 posts, 19.9% versus 36 posts, 12.5%, P=.011), when compared to public hospitals. However, Facebook pages from public hospitals had significantly more "likes," comments, and shares per post (314, 5, 14, respectively, P<.001). Additionally, medical centers from different regions displayed different strategies for using video posts on Facebook. CONCLUSIONS: Social media has been a useful tool for communication during the COVID-19 pandemic. This nationwide observational study has helped demonstrate the value of Facebook for academic medical centers in Taiwan, along with its engagement efficacy. We believe that the experience of Taiwan and the knowledge it can share will be helpful to health care organizations worldwide during our global battle against COVID-19.

The decade long achievements of China's marine ecological civilization construction (2006-2016).

China needs to balance between current population pressures and a vulnerable marine environment, creating a national, political outline or management strategy dubbed an ecological civilization construction. The nation's effort to protect and maintain a sustainable ocean and address the relevant economic, resource and environmental issues relies on Marine Ecological Civilization (MEC) construction. The quantification of MEC progress is essential to track the management performance and guide the subsequent development and implementation. This study evaluates the performance of China's MEC from 2006 to 2016 based on a comprehensive index system. Our findings are as follows: During 2006-2016, the overall MEC performance score increased from 0.3426 to 0.4850 nationwide. Large space-time variations exist among the eleven coastal regions. The Shandong and Guangdong regions showed relatively good performances, whereas the Jiangsu, Guangxi and Shanghai regions had low scores. A decade long change in MEC scores showed that Hebei achieved the largest increase ratio. Marine management was improved by implementing various conservation strategies by China's government. Marine education and human talent introduction deserve more attention in less developed areas such as Hainan and Guangxi, and poor marine environmental quality was an urgent issue of the Yangtze river estuary economic zone. More accessible marine monitoring dataset are needed to track future space-time progress dynamics towards MEC construction. Our results provide a decade long retrospect of China's MEC achievements, and the quantified evaluation for each coastal region can provide valuable insight to policy-makers.

Osteopontin as a multifaceted driver of bone metastasis and drug resistance.

Metastasis to bone frequently occurs in majority of patients with advanced breast cancer and prostate cancer, leading to devastating skeletal-related events and substantially reducing the survival of patients. Currently, the crosstalk between tumor cells and the bone stromal compartment was widely investigated for bone metastasis and the resistance to many conventional therapeutic methods. Osteopontin (OPN), also known as SPP1 (secreted phosphoprotein 1), a secreted and chemokine-like glyco-phosphoprotein is involved in tumor progression such as cell proliferation, angiogenesis, and metastasis. The expression of OPN in tumor tissue and plasma has been clinically proved to be correlated to poor prognosis and shortened survival in patients with breast cancer and prostate cancer. This review summarizes the multifaceted roles that OPN plays in bone microenvironment and drug resistance, with emphasis on breast and prostate cancers, via binding to αvß3 integrin and CD44 receptor and inducing signaling cascades. We further discuss the promising therapeutic strategy for OPN targeting, mainly inhibiting OPN at transcriptional or protein level or blocking it binding to receptor or its downstream signaling pathways. The comprehending of the function of OPN in bone microenvironment is crucial for the development of novel biomarker and potential therapeutic target for the diagnosis and treatment of bone metastasis and against the emergence of drug resistance in advanced cancers.

Mercury Pollution in the Arctic from Wildfires: Source Attribution for the 2000s.

Atmospheric mercury (Hg) is a global environmental pollutant, with wildfire emissions being an important source. There have been growing concerns on Hg contamination in the Arctic region, which is largely attributed to long-range transport from lower latitude regions. In this work, we estimate the contributions of wildfire emissions from various source regions to Hg pollution in the Arctic (66° N to 90° N) using a newly developed global Hg wildfire emissions inventory and an atmospheric chemical transport model (GEOS-Chem). Our results show that global wildfires contribute to about 10% (15 Mg year-1) of the total annual Hg deposition to the Arctic, with the most important source region being Eurasia, which contribute to 5.3% of the total annual Hg deposition followed by Africa (2.5%) and North America (1%). The substantial contributions from the Eurasia region are driven by the strong wildfire activity in the boreal forests. The total wildfire-induced Hg deposition to the Arctic amounts to about one-third of the deposition caused by present-day anthropogenic emissions. We also find that wildfires result in significant Hg deposition to the Arctic across all seasons (winter: 8.3%, spring: 7%, summer: 11%, and fall: 14.6%) with the largest deposition occurring during the boreal fire season. These findings indicate that wildfire is a significant source for Arctic Hg contamination and also demonstrate the importance of boreal forest in the global and regional Hg cycle through the mobilization of sequestered Hg reservoir.

Expression of programmed death ligand-1 on bladder tissues is detected in a clinically and histologically well-defined interstitial cystitis cohort.

OBJECTIVE: To investigate the expression of programmed death ligand-1 (PD-L1) in interstitial cystitis (IC). METHODS: We reviewed the data of IC patients underwent hydrodistension plus bladder biopsy. Follow-ups were performed. We assessed the degree of inflammation of the bladder wall on slides stained with hematoxylin and eosin (H&E). We performed immunohistochemistry for PD-L1 expression detection and for counting T lymphocytes and B lymphocytes. RESULTS: The present study included eight men and 32 women. With H&E staining, we detected 13, 15, and 12 patients with mild, moderate, and severe inflammation. The degree of inflammation was negatively correlated with disease course (P = 0.018) and positively correlated with bladder pain (P < 0.001). Hydrodistension was found effective at postoperative 3-month for 19 patients. Overall, 17, 15, 7, and 1 subject had no, mild, moderate, and high PD-L1 expression, that correlated positively with the degree of inflammation. Compared with patients with no and mild PD-L1 expression, patients with moderate and high PD-L1 expression tended to have more effective hydrodistension outcomes (12 of 32 vs 7 of 8; P = 0.017). In the subset of 12 patients with severe inflammation, there were five of six patients (83.3%) with moderate or high PD-L1 expression and one of six patients (16.7%) with no and mild PD-L1 expression with an effective hydrodistension outcome. CONCLUSIONS: Expression of PD-L1 on bladder is detected in a cohort of IC patients presented with diffuse global glomerulation or Hunner ulcer. PD-L1 expression is more common in IC patients with severe bladder inflammation.

Urodynamic characteristics of pelvic lipomatosis with glandular cystitis patients correlate with morphologic alterations of the urinary system and disease severity.

AIMS: To explore urodynamic characteristics and their clinical value in pelvic lipomatosis (PL) patients. METHODS: We reviewed the clinical information of 84 PL patients. A voiding pressure-flow study was used to classify patients into nonoutlet obstruction (NOO), latter-half-section obstruction (LHSO), or whole-section bladder outlet obstruction (BOO) groups. Urinary morphologic features were measured by imaging examination and cystoscopy. RESULTS: A unique LHSO that presented as sudden increasing detrusor pressure (Pdet) and decreasing flow rate in the latter half of voiding was observed for 52.4% (44 of 84) patients. Overall, 27.4% (23 of 84 patients) were diagnosed with BOO with whole-section increasing Pdet and decreasing flow rate. According to the morphologic feature analyses, the NOO patients had the largest angle of anteroposterior vesical walls (P < 0.001) and the least severe thickened bladder trigone (P = 0.015). The external compression at the bladder neck and thickened bladder trigone caused a prolonged and strictured bladder outlet tract (see the Supplementary video). There were 0, 5, and 4 urinary diversions performed in the NOO, LHSO, and BOO groups at diagnosis (P = 0.055). No patients in the NOO group, seven in the LHSO group, and two patients in the BOO group had disease progression at follow-up. Two LHSO patients and one BOO patients without hydronephrosis at diagnosis developed to hydronephrosis during follow-up. CONCLUSIONS: Morphologic alterations of the urinary system of PL patients lead to unique LHSO or BOO on UDS. The presences of LHSO and BOO are associated with disease severity and progression.

Nonlinear response of nitric oxide fluxes to fertilizer inputs and the impacts of agricultural intensification on tropospheric ozone pollution in Kenya.

Crop yields in sub-Saharan Africa remain stagnant at 1 ton ha-1 , and 260 million people lack access to adequate food resources. Order-of-magnitude increases in fertilizer use are seen as a critical step in attaining food security. This increase represents an unprecedented input of nitrogen (N) to African ecosystems and will likely be accompanied by increased soil emissions of nitric oxide (NO). NO is a precursor to tropospheric ozone, an air pollutant and greenhouse gas. Emissions of NO from soils occur primarily during denitrification and nitrification, and N input rates are a key determinant of emission rates. We established experimental maize plots in western Kenya to allow us to quantify the response function relating NO flux to N input rate during the main 2011 and 2012 growing seasons. NO emissions followed a sigmoid response to fertilizer inputs and have emission factors under 1% for the roughly two-month measurement period in each year, although linear and step relationships could not be excluded in 2011. At fertilization rates above 100 kg N ha-1 , NO emissions increased without a concomitant increase in yields. We used the geos-chem chemical transport model to evaluate local impacts of increased NO emissions on tropospheric ozone concentrations. Mean 4-hour afternoon tropospheric ozone concentrations in Western Kenya increased by up to roughly 2.63 ppbv under fertilization rates of 150 kg N ha-1 or higher. Using AOT40, a metric for assessing crop damage from ozone, we find that the increased ozone concentrations result in an increase in AOT40 exposure of approximately 110 ppbh for inputs of 150 kg N ha-1 during the March-April-May crop growing season, compared with unfertilized simulations, with negligible impacts on crop productivity. Our results suggest that it may be possible to manage Kenyan agricultural systems for high yields while avoiding substantial impacts on air quality.

Results of a randomized, double-blind, active-controlled clinical trial with propiverine extended release 30 mg in patients with overactive bladder.

OBJECTIVE: To compare the efficacy and safety of the 30 mg extended release (ER) formulation of propiverine hydrochloride with the 4 mg ER formulation of tolterodine tartrate in patients with overactive bladder (OAB) in a non-inferiority trial. PATIENTS AND METHODS: Eligible patients, aged 18-75 years and with symptoms of OAB, were enrolled in this multicentre, randomized, double-blind, parallel-group, active-controlled study. After a 2-week screening period, patients were randomized at a 1:1 ratio to receive either propiverine ER 30 mg or tolterodine ER 4 mg daily during the 8-week treatment period. Efficacy was assessed using a 3-day voiding diary and patient's self-reported assessment of treatment effect. Safety assessment included recording of adverse events, laboratory test results, measurement of post-void residual urine and electrocardiograms. RESULTS: A total of 324 patients (244 female and 80 male) were included in the study. Both active treatments improved the variables included in the voiding diary and in the patient's self-reported assessment. The change from baseline in the number of voidings per 24 h was significantly greater in the propiverine ER 30 mg group compared with the tolterodine ER 4 mg group after 8 weeks of treatment (full analysis set [FAS] -4.6 ± 4.1 vs -3.8 ± 5.1; P = 0.005). Significant improvements were also observed for the change of urgency incontinence episodes after 2 weeks (P = 0.026) and 8 weeks (P = 0.028) of treatment when comparing propiverine ER 30 mg with tolterodine ER 4 mg. Both treatments were well tolerated, with a similar frequency of adverse drug reactions in both the propiverine ER 30 mg and tolterodine ER 4 mg groups (FAS 40.7 vs 39.5%; P = 0.8). More patients treated with tolterodine ER 4 mg discontinued the treatment because of adverse drug reactions compared with propiverine ER 30 mg (7.4 vs 3.1%). CONCLUSIONS: Propiverine ER 30 mg was confirmed to be an effective and well-tolerated treatment option for patients with OAB symptoms. This first head-to-head study showed non-inferiority of propiverine ER 30 mg compared with tolterodine ER 4 mg.

Anthropogenic Cycles of Arsenic in Mainland China: 1990-2010.

Arsenic (As) is a trace element in the global environment with toxicity to both humans and ecosystem. This study characterizes China's historical anthropogenic arsenic cycles (AACs) from 1990 to 2010. Key findings include the following: (1) the scale of China's AACs grew significantly during the studied period, making China the biggest miner, producer, and user of arsenic today; (2) the majority of arsenic flows into China's anthroposphere are the impurity of domestically mined nonferrous metal ores, which far exceeds domestic intentional demands; (3) China has been a net exporter of arsenic trioxide and arsenic metalloid, thus suffering from the environmental burdens of producing arsenic products for other economies; (4) the growth of arsenic use in China is driven by simultaneous increases in many applications including glass making, wood preservatives, batteries, semiconductors, and alloys, implying the challenge for regulating arsenic uses in multiple applications/industries at the same time; (5) the dissipative arsenic emissions resulting from intentional applications are at the same order of magnitude as atmospheric emissions from coal combustion, and their threats to human and ecosystem health can spread widely and last years to decades. Our results demonstrate that the characterization of AACs is indispensable for developing a complete arsenic emission inventory.

Global Atmospheric Transport and Source-Receptor Relationships for Arsenic.

Arsenic and many of its compounds are toxic pollutants in the global environment. They can be transported long distances in the atmosphere before depositing to the surface, but the global source-receptor relationships between various regions have not yet been assessed. We develop the first global model for atmospheric arsenic to better understand and quantify its intercontinental transport. Our model reproduces the observed arsenic concentrations in surface air over various sites around the world. Arsenic emissions from Asia and South America are found to be the dominant sources for atmospheric arsenic in the Northern and Southern Hemispheres, respectively. Asian emissions are found to contribute 39% and 38% of the total arsenic deposition over the Arctic and Northern America, respectively. Another 14% of the arsenic deposition to the Arctic region is attributed to European emissions. Our results indicate that the reduction of anthropogenic arsenic emissions in Asia and South America can significantly reduce arsenic pollution not only locally but also globally.

Repair of complex vesicovaginal fistulas by combining a rotational bladder flap and full thick vascular peritoneal interposition.

PURPOSE: To present the experience of repairing iatrogenic vesicovaginal fistulas (VVFs) using a rotational bladder flap and peritoneal interposition technique. METHODS: Between January 2009 and June 2014, a total of 18 patients (mean age, 44.0 years; age range, 29-51 years) with VVFs were treated using a transperitoneal approach. All VVFs were complications of gynecologic procedures. Twelve patients experienced recurrent VVFs and one patient had a concomitant rectovaginal fistula after radiotherapy. The fistula was approached transabdominally. The peritoneum covering the bladder was isolated to expose the bladder and prepare for the interposition. The bladder was opened along the sagittal plane to the fistula and a bladder flap was rotated downward to fill the fistula defect. The vaginal defect was closed, then a flap using the isolated peritoneum was interposed and fixed between the vagina and bladder. A ureteral re-implantation was performed in one patient. All VVF procedures were performed by one urologist (SW). Repair of the rectovaginal fistula was performed by a general surgeon at the same time. RESULTS: Seventeen patients (success rate = 94% [100% for primary cases and 92% for recurrent cases]) had no evidence of recurrent VVF at a mean follow-up of 20 months (range, 6-36 months). The only patient who had previously undergone a repair procedure failed. CONCLUSIONS: A transperitoneal approach with the use of a rotational bladder flap and peritoneal interposition might be a feasible and reliable procedure for surgical management of iatrogenic VVFs, especially in complicated cases. Neurourol. Urodynam. 35:934-938, 2016. © 2015 Wiley Periodicals, Inc.

Impact of preoperative urodynamic testing for urinary incontinence and pelvic organ prolapse on clinical management in Chinese women.

AIM: To assess the impact of preoperative urodynamic testing on the clinical management of urinary incontinence and pelvic organ prolapse. METHODS: Urodynamic testing was performed prior to surgery in 307 patients with pelvic organ prolapse or urinary incontinence. The resulting changes to planned treatment were recorded and retrospectively assessed. RESULTS: Results of urodynamic testing prompted changes to the treatment plan in 136 cases (44.2%), including 86 cases of no or slight-stress urinary incontinence, 28 cases of bladder outlet obstruction, 12 cases of occult stress urinary incontinence and 10 cases of detrusor overactivity and urge urinary incontinence. Urodynamic testing excluded disadvantageous factors in 69 cases (22.4%), including 46 cases of overactive bladder and 23 cases of voiding dysfunction. The information provided to patients when seeking informed consent was augmented by the results of urodynamic testing in 63 cases (20.5%). Urodynamic testing was of no value in 39 cases (12.7%). CONCLUSIONS: Preoperative urodynamic testing for urinary incontinence and pelvic organ prolapse can result in changes to treatment plans, exclusion of disadvantageous factors, and augmentation of information provided to patients when seeking informed consent.

[Effects of Compound Aconitum Polysaccharide on Glycosylation of Tumor Cells].

Objective To observe inducing or inhibiting effects of Chinese medicine (CM) poly- saccharides on glycoprotein chain synthetized different glycosyltransferases, thus disclosing targets of CM polysaccharides and its mechanisms. Methods In vivo anti-tumor effects of CM polysaccharides were observed using the inhibiting rate of tumor growth by dividing different Aconitum containing groups. Effects of CM polysaccharides on liver cancer cell SK-HEP-1 glycosyltransferase and tumor related gene expressions were observed. Meanwhile, changes of polylactosamine expression were detected using flow cytometry (FCM) with polylactosamine specific biotin labeling lectin. Results Compared with the model group, the average tumor weight was significantly lower in each medication group (P <0. 01). Compared with the adriamycin group, no significant difference in average tumor weight of the three compound groups (P>0. 05). The expression level of polylactosamine was reduced after adding Aconitum polysac- charide; and CM compound polysaccharides respectively. Conclusions Polysaccharide compound showed similar anti-tumor effect as that of adriamycin. Besides, polylactosamine expression level was reduced in the three compound groups along with increased prepared Aconitum polysaccharide, with more obvious anti-tumor effects shown.

[Risk factors for interstitial cystitis/painful bladder syndrome in patients with lower urinary tract symptoms presenting for urologic care].

OBJECTIVE: To identify the risk factors in interstitial cystitis/painful bladder syndrome (IC/PBS) patients with lower urinary tract symptoms (LUTS) without urinary tract infection or benign prostate hyperplasia in China. METHODS: A total of 954 outpatients with LUTS presenting for care to urology clinics at 8 hospitals throughout China from November 20, 2008 to August 24, 2012 were surveyed with a standardized questionnaire and validated outcome measures. The definitions for IC/PBS based on the O'Leary-Sant interstitial cystitis symptom and problem indices were used. The possible risk factors was analyzed with the Fisher's exact and Pearson chi-square tests. And multivariate predictive models were developed with binary Logistic regression methods. RESULTS: There were 491 females and 463 males. And 44.7% (427/954) met the criteria for IC/PBS. There was significant gender difference (51.7% (254/491) vs 37.4% (173/463), P < 0.05) . After adjusting for confounding factors, bladder pain was significantly associated with stimulatory foods (OR: 81.16, 95%CI: 11.50-590.00, P = 0.001) and anorectal disease (OR: 54.90, 95%CI: 9.52-401.00, P = 0.001) in females. Caffeine beverage intake (OR: 4.29, 95%CI: 1.86-9.86, P = 0.001) was the only modifiable association according to multivariate analysis of males. CONCLUSIONS: Stimulatory foods, anorectal disease and caffeine beverages are potential risk factors for IC/PBS.Further studies are necessary to determine their roles in the pathogenesis of this disorder.

Effects of cell surface α2-3 sialic acid on osteogenesis.

A cell culture model of osteoblast differentiation was applied in our study of the effect of sialic acid on the osteogenesis by using the pre-osteoblast of MC3T3-E1 subclone 14 cells. Following the treatment of different concentrations of α2,3-neuraminidase, which specifically removed the α2-3 sialic acid from cell surface, a significant decrease of α2-3 sialic acid was detected with fluorescein isothiocyanate (FITC)-labeled Maackia amurensis lectin (MAL-II) by flow cytometry analysis. von Kossa staining showed that the bone mineralization decreased in MC3T3-E1 subclone 14 cells after the treatment of α2,3-neuraminidase for 2 weeks. However α2,3-neuraminidase did not affect the formation of osteoblasts in MC3T3-E1 subclone 14 cells, which was demonstrated by positive alkaline phosphatase (ALP)-staining. Characteristic biological markers and osteoblast-like cell-related factors of osteoblastic cells were also examined. Both RT-PCR and Western blot analysis demonstrated that the expression of bone sialoprotein (BSP), osteoprotegerin (OPG), and vitamin D receptor (VDR) were significantly decreased when α2-3 sialic acid expression decreased on the cell surface, while the expression of osteocalcin (OC) and osteopontin (OPN) remained unchanged. We propose a hypothesis that α2-3 sialic acid affects bone mineralization but not osteogenic differentiation.

Modeling acute respiratory illness during the 2007 San Diego wildland fires using a coupled emissions-transport system and generalized additive modeling.

BACKGROUND: A study of the impacts on respiratory health of the 2007 wildland fires in and around San Diego County, California is presented. This study helps to address the impact of fire emissions on human health by modeling the exposure potential of proximate populations to atmospheric particulate matter (PM) from vegetation fires. Currently, there is no standard methodology to model and forecast the potential respiratory health effects of PM plumes from wildland fires, and in part this is due to a lack of methodology for rigorously relating the two. The contribution in this research specifically targets that absence by modeling explicitly the emission, transmission, and distribution of PM following a wildland fire in both space and time. METHODS: Coupled empirical and deterministic models describing particulate matter (PM) emissions and atmospheric dispersion were linked to spatially explicit syndromic surveillance health data records collected through the San Diego Aberration Detection and Incident Characterization (SDADIC) system using a Generalized Additive Modeling (GAM) statistical approach. Two levels of geographic aggregation were modeled, a county-wide regional level and division of the county into six sub regions. Selected health syndromes within SDADIC from 16 emergency departments within San Diego County relevant for respiratory health were identified for inclusion in the model. RESULTS: The model captured the variability in emergency department visits due to several factors by including nine ancillary variables in addition to wildfire PM concentration. The model coefficients and nonlinear function plots indicate that at peak fire PM concentrations the odds of a person seeking emergency care is increased by approximately 50% compared to non-fire conditions (40% for the regional case, 70% for a geographically specific case). The sub-regional analyses show that demographic variables also influence respiratory health outcomes from smoke. CONCLUSIONS: The model developed in this study allows a quantitative assessment and prediction of respiratory health outcomes as it relates to the location and timing of wildland fire emissions relevant for application to future wildfire scenarios. An important aspect of the resulting model is its generality thus allowing its ready use for geospatial assessments of respiratory health impacts under possible future wildfire conditions in the San Diego region. The coupled statistical and process-based modeling demonstrates an end-to-end methodology for generating reasonable estimates of wildland fire PM concentrations and health effects at resolutions compatible with syndromic surveillance data.

Kudzu (Pueraria montana) invasion doubles emissions of nitric oxide and increases ozone pollution.

The nitrogen-fixing legume kudzu (Pueraria montana) is a widespread invasive plant in the southeastern United States with physiological traits that may lead to important impacts on ecosystems and the atmosphere. Its spread has the potential to raise ozone levels in the region by increasing nitric oxide (NO) emissions from soils as a consequence of increasing nitrogen (N) inputs and cycling in soils. We studied the effects of kudzu invasions on soils and trace N gas emissions at three sites in Madison County, Georgia in 2007 and used the results to model the effects of kudzu invasion on regional air quality. We found that rates of net N mineralization increased by up to 1,000%, and net nitrification increased by up to 500% in invaded soils in Georgia. Nitric oxide emissions from invaded soils were more than 100% higher (2.81 vs. 1.24 ng NO-N cm(-2) h(-1)). We used the GEOS-Chem chemical transport model to evaluate the potential impact of kudzu invasion on regional atmospheric chemistry and air quality. In an extreme scenario, extensive kudzu invasion leads directly to an increase in the number of high ozone events (above 70 ppb) of up to 7 days each summer in some areas, up from 10 to 20 days in a control scenario with no kudzu invasion. These results establish a quantitative link between a biological invasion and ozone formation and suggest that in this extreme scenario, kudzu invasion can overcome some of the air quality benefits of legislative control.