Benefits of tropical peatland rewetting for subsidence reduction and forest regrowth: results from a large-scale restoration trial.

Drainage and deforestation of tropical peat swamp forests (PSF) in Southeast Asia cause carbon emissions and biodiversity loss of global concern. Restoration efforts to mitigate these impacts usually involve peatland rewetting by blocking canals. However, there have been no studies to date of the optimal rewetting approach that will reduce carbon emission whilst also promoting PSF regeneration. Here we present results of a large-scale restoration trial in Sumatra (Indonesia), monitored for 7.5 years. Water levels in a former plantation were raised over an area of 4800 ha by constructing 257 compacted peat dams in canals. We find peat surface subsidence rates in the rewetted restoration area and adjoining PSF to be halved where water tables were raised from ~ - 0.6 m to ~ - 0.3 m, demonstrating the success of rewetting in reducing carbon emission. A total of 57 native PSF tree species were found to spontaneously grow in the most rewetted conditions and in high densities, indicating that forest regrowth is underway. Based on our findings we propose that an effective PSF restoration strategy should follow stepwise rewetting to achieve substantial carbon emission reduction alongside unassisted regrowth of PSF, thereby enabling the peat, forest and canal vegetation to establish a new nature-based ecosystem balance.

The iMHere 2.0 System for Family Caregivers of Older Adults: A Focus Group.

Background: Family caregivers with continuous caregiving responsibilities are at increased risk for adverse physical and mental health outcomes. In response to the challenges of caregiving, a mobile health system (iMHere 2.0) was developed to support caregivers. The study's objective was to gather feedback from family caregivers of older adults on the current features of iMHere 2.0 and to formulate design criteria for future iterations of the system. Methods: An exploratory qualitative study with thematic analyses of focus group feedback. Findings: A total of 10 caregivers of older adults participated in a focus group. Five themes emerged: (1) Monitoring health data, (2) Setting up customized reminders, (3) Supporting care coordination, (4) Balancing security and multiple user access, and (5) Disseminating iMHere 2.0 into the community, along with some potential barriers to implementation. Conclusions: Design criteria were developed to provide a framework for iterative design and development of the iMHere system to support caregivers of older adults.

Pilot RCT examining feasibility and disability outcomes of a mobile health platform for strategy training in inpatient stroke rehabilitation (iADAPT).

BACKGROUND: Strategy training is an intervention that may reduce disability when delivered in inpatient rehabilitation following stroke. However, shorter lengths of stay and challenges with continuity of care following discharge results in difficulties in achieving adequate intervention dosage and carryover of training. OBJECTIVE: We examined whether strategy training using a mobile health platform (iADAPT) is feasible during inpatient stroke rehabilitation and following discharge. METHODS: In this RCT, participants were randomized to receive strategy training using either the iADAPT application (n = 16) or a workbook (n = 15). Participants in both groups received 7 in-person sessions during inpatient rehabilitation and 3 remote sessions following discharge. We calculated descriptive statistics to examine acceptance, attendance, and adherence, and within-group effect sizes on satisfaction and disability. RESULTS: Participants in the iADAPT group attended fewer total intervention sessions (n = 5.5, workbook n = 9.0) but attempted a similar number of goals (n = 7.6, workbook n = 8.2). Both groups reported similar satisfaction with in-person intervention (Treatment Expectancy: iADAPT d = 0.60, workbook d = 0.47; Patient Provider Connection: iADAPT d = 0.18, workbook d = 0.31), but the mobile health group reported greater satisfaction with remote intervention (Treatment Expectancy: iADAPT d = -0.91, workbook d = -0.97; Patient Provider Connection: iADAPT d = 0.85, workbook d = -1.80). . CONCLUSIONS: Considering these promising feasibility metrics and the benefits of mobile health, it is worth continuing to explore the efficacy of strategy training using a mobile health platform.

Mobile Health to Support Community-Integration of Individuals With Disabilities Using iMHere 2.0: Focus Group Study.

BACKGROUND: Mobile health (mHealth) systems that support self-management can improve medical, functional, and psychosocial outcomes for individuals with disabilities and chronic conditions. The mHealth systems can potentially be expanded to support community integration. OBJECTIVE: The purposes of this study were to (1) partner with a community-based organization that supports community integration of individuals with disabilities; (2) identify software requirements needed to support community participation; and (3) iteratively refine an existing mHealth application to include new requirements. METHODS: Community Living and Support Services (CLASS), a nonprofit organization that serves individuals with disabilities in Pittsburgh, Pennsylvania, was identified as the focus group for this study. Key stakeholders within the Community Partners Program at CLASS proposed design requirements for an existing mHealth application, Interactive Mobile Health and Rehabilitation (iMHere) 2.0, that has been used to support self-management. RESULTS: We gathered qualitative data from a focus group composed of CLASS members to develop and iteratively revise iMHere 2.0 to include new modules and features to support community integration. A caregiver app was also developed. The new system contains features to support finance, transportation, client and caregiver communication, calendar and checklist management, upcoming medical and nonmedical appointments, social engagement, pain management, and access to a personal profile. Modifications were made to the following existing modules: education, mood, personal health record, goals, medications, and nutrition. CONCLUSIONS: A successful partnership with a community-based organization that supports individuals with disabilities resulted in a newly designed mHealth system with features to support community integration.

Using Harris hawk optimization towards support vector regression to ozone prediction.

As an area experiencing air pollution, especially ozone concentrations that often exceed the threshold or are unhealthy, JABODETABEK (Jakarta, Bogor, Depok, Tangerang, and Bekasi) seeks to prevent and control pollution as well as restore air quality. Therefore, this study aims to build a predictive model of ozone concentration using Harris hawks optimization-support vector regression (HHO-SVR) in 14 sub-districts in JABODETABEK. This goal is achieved by collecting data on ozone concentration as a response variable and meteorological factors as predictor variables from the website that provides the data. Other predictor variables such as time and significant lag detected with partial autocorrelation function of ozone concentration were also used. Then the variables will be selected using the recursive feature elimination-support vector regression (RFE-SVR) to obtain a significant predictor variable that affects the ozone concentration. After that, the prediction model will be built using the HHO-SVR method, support vector regression (SVR) whose parameter values are optimized with the Harris hawks optimization (HHO) algorithm. When the model has been formed, several evaluation metrics used to determine the best model include mean absolute error (MAE), root mean square error (RMSE), mean absolute percentage error (MAPE), Coefficient of Determination (R2), Variance Ratio (VR), and Diebold-Mariano test. The results of this study indicate that lag 1, lag 2, air temperature, humidity, and UV index are significant predictor variables of the RFE-SVR results for most sub-districts. In general, the HHO process takes longer than other metaheuristic algorithms. On average, 7 of the 14 sub-districts using the HHO-SVR model yielded the best predictions with MAE below 10, RMSE and MAPE below 20, R2 around 0.97, and VR around 0.98. Then, the results of the Diebold-Mariano test also show that the accuracy of the prediction results and the stability of the performance of the HHO-SVR model is better, especially for the Ciputat and South Bekasi sub-districts. This shows that the two sub-districts are very suitable to use HHO-SVR in predicting ozone concentrations.

Making Self-Management Mobile Health Apps Accessible to People With Disabilities: Qualitative Single-Subject Study.

BACKGROUND: Over the past decade, a large number of mobile health (mHealth) apps have been created to help individuals to better manage their own health. However, very few of these mHealth apps were specifically designed for people with disabilities, and only a few of them have been assessed for accessibility for people with disabilities. As a result, people with disabilities have difficulties using many of these mHealth apps. OBJECTIVE: The objective of this study was to identify an approach that can be generally applied to improve the accessibility of mHealth apps. METHODS: We recruited 5 study participants with a primary diagnosis of cerebral palsy or spinal cord injury. All the participants had fine motor impairment or lack of dexterity, and hence, they had difficulties using some mHealth apps. These 5 study participants were first asked to use multiple modules in the client app of a novel mHealth system (iMHere 2.0), during which their performance was observed. Interviews were conducted post use to collect study participants' desired accessibility features. These accessibility features were then implemented into the iMHere 2.0 client app as customizable options. The 5 participants were asked to use the same modules in the app again, and their performance was compared with that in the first round. A brief interview and a questionnaire were then performed at the end of the study to collect the 5 participants' comments and impression of the iMHere 2.0 app in general and of the customizable accessibility features. RESULTS: Study results indicate that the study participants on their first use of the iMHere 2.0 client app experienced various levels of difficulty consistent with the severity of their lack of dexterity. Their performance was improved after their desired accessibility features were added into the app, and they liked the customizable accessibility features. These participants also expressed an interest in using this mHealth system for their health self-management tasks. CONCLUSIONS: The accessibility features identified in this study improved the accessibility of the mHealth app for people with dexterity issues. Our approach for improving mHealth app accessibility may also be applied to other mHealth apps to make those apps accessible to people with disabilities.

Recombinant platelet-derived growth factor-BB and hyaluronic acid stimulates knee cartilage regeneration by forming higher chondrocytes count and lower YKL-40 level in rats model.

OBJECTIVE: Osteoarthritis is caused by cartilage degeneration arising from cartilage degradation of type II collagen which synthesis also deteriorated. Nowadays, osteoarthritis is still difficult to handle because of the irreversibility and progressivity of the disease. Regenerative therapy offers a great challenge and better result for osteoarthritis treatment. This study aims to prove that the administration of recombinant platelet-derived growth factor-BB (rrPDGF-BB) with hyaluronic acid (HA) can stimulate the higher forms of chondrocyte and lower the YKL-40 levels as a specific marker of cartilage degradation in mouse knee osteoarthritis model. METHOD: This was an experimental study, post-test only control group design using white Wistar rats as subjects that were induced by monosodium iodoacetate (MIA) to create osteoarthritis (OA). The treatment group was given treatment group was given rrPDGF-BB and HA, while no such treatment was given to the control group. The chondrocyte cell count was examined with routine histopathology, and YKL-40 levels were calculated by ELISA. RESULT: Statistical analysis using independent t-test showed that the mean difference in the number of cell counts of chondrocytes was significantly higher than the control group. While the mean difference of YKL-40 level in the treatment group was significantly lower compared to the control group with. CONCLUSION: We conclude that the administration of rrPDGF-BB and HA in mouse knee joint osteoarthritis model have a regenerative effect on knee joint cartilage characterized by a higher number of chondrocytes and lower YKL-40 levels.

Feasibility of an iterative rehabilitation intervention for stroke delivered remotely using mobile health technology.

Background: Telehealth affords rehabilitation professionals opportunities to expand access to intervention for people in rural areas. Complex interventions have not been adapted for remote delivery using mobile health technologies. Strategy training is a complex intervention that teaches clients skills for identifying barriers and solutions to engagement in meaningful activities. Our goal was to adapt the delivery of strategy training for remote delivery using mobile health technology.Methods: We conducted a sequential descriptive case series study (n = 5) in which community-dwelling participants with chronic stroke and prior exposure to strategy training used the iADAPTS mobile health application for 5 weeks. Expert practitioners advised revisions to the intervention process. Safety was assessed via monitoring occurrence of adverse events and risk for adverse events. Acceptability was assessed via the Client Satisfaction Questionnaire-8 (CSQ-8) and the Patient-Provider Connection Short Form of the Healing Encounters and Attitudes Lists (HEAL PPC).Results: Revisions to the intervention process supported the delivery of strategy training using mobile health technology after stroke. No adverse events occurred and risk for adverse events was managed through the intervention process. Acceptability was high (CSQ-8, 25 to 32; HEAL PPC, 59.9 to 72.5).Conclusions: Strategy training can be adapted for delivery using mobile health technology, with careful consideration to methods for training participants on new technology and the intervention delivery. Future research should establish the efficacy and effectiveness of integrating mobile health in delivery of interventions that promote engagement in client-selected activities and community participation.Implications for rehabilitationTranslating the strategy training intervention from face-to-face to remote delivery required thoughtful adaptation of the intervention protocol.Strategies for training clients to use mobile health technology during intervention may be important when designing remotely delivered mHealth intervention protocols.Client safety should be considered within the design of the intervention protocol for a complex intervention designed to be delivered remotely.Future studies should examine the efficacy of complex rehabilitation interventions such as strategy training on clinical outcomes (e.g., community participation).

The Effect of the Interactive Mobile Health and Rehabilitation System on Health and Psychosocial Outcomes in Spinal Cord Injury: Randomized Controlled Trial.

BACKGROUND: Individuals with spinal cord injury (SCI) are at risk for secondary medical complications, such as urinary tract infections (UTIs) and pressure injuries, that could potentially be mitigated through improved self-management techniques. The Interactive Mobile Health and Rehabilitation (iMHere) mobile health (mHealth) system was developed to support self-management for individuals with disabilities. OBJECTIVE: The main objective of this study was to determine if the use of iMHere would be associated with improved health outcomes over a 9-month period. A secondary objective was to determine if the use of iMHere would be associated with improved psychosocial outcomes. Phone usage, app usage, and training time data were also collected to analyze trends in iMHere use. METHODS: Overall, 38 participants with SCI were randomized into either the intervention group who used the iMHere system and received standard care or the control group who received standard care without any technology intervention. Health outcomes were recorded for the year before entry into the study and during the 9 months of the study. Participants completed surveys at baseline and every 3 months to measure psychosocial outcomes. RESULTS: The intervention group had a statistically significant reduction in UTIs (0.47 events per person; P=.03; number needed to treat=2.11). Although no psychosocial outcomes changed significantly, there was a nonsignificant trend toward a reduction in mood symptoms in the intervention group compared with the control group meeting the threshold for clinical significance. Approximately 34 min per participant per month were needed on average to manage the system and provide technical support through this mHealth system. CONCLUSIONS: The use of the iMHere mHealth system may be a valuable tool in the prevention of UTIs or reductions in depressive symptoms. Given these findings, iMHere has potential scalability for larger populations. TRIAL REGISTRATION: ClinicalTrials.gov NCT02592291; https://clinicaltrials.gov/ct2/show/NCT02592291.

The mHealth App Usability Questionnaire (MAUQ): Development and Validation Study.

BACKGROUND: After a mobile health (mHealth) app is created, an important step is to evaluate the usability of the app before it is released to the public. There are multiple ways of conducting a usability study, one of which is collecting target users' feedback with a usability questionnaire. Different groups have used different questionnaires for mHealth app usability evaluation: The commonly used questionnaires are the System Usability Scale (SUS) and Post-Study System Usability Questionnaire (PSSUQ). However, the SUS and PSSUQ were not designed to evaluate the usability of mHealth apps. Self-written questionnaires are also commonly used for evaluation of mHealth app usability but they have not been validated. OBJECTIVE: The goal of this project was to develop and validate a new mHealth app usability questionnaire. METHODS: An mHealth app usability questionnaire (MAUQ) was designed by the research team based on a number of existing questionnaires used in previous mobile app usability studies, especially the well-validated questionnaires. MAUQ, SUS, and PSSUQ were then used to evaluate the usability of two mHealth apps: an interactive mHealth app and a standalone mHealth app. The reliability and validity of the new questionnaire were evaluated. The correlation coefficients among MAUQ, SUS, and PSSUQ were calculated. RESULTS: In this study, 128 study participants provided responses to the questionnaire statements. Psychometric analysis indicated that the MAUQ has three subscales and their internal consistency reliability is high. The relevant subscales correlated well with the subscales of the PSSUQ. The overall scale also strongly correlated with the PSSUQ and SUS. Four versions of the MAUQ were created in relation to the type of app (interactive or standalone) and target user of the app (patient or provider). A website has been created to make it convenient for mHealth app developers to use this new questionnaire in order to assess the usability of their mHealth apps. CONCLUSIONS: The newly created mHealth app usability questionnaire-MAUQ-has the reliability and validity required to assess mHealth app usability.

An Adaptive Mobile Health System to Support Self-Management for Persons With Chronic Conditions and Disabilities: Usability and Feasibility Studies.

BACKGROUND: Persons with chronic conditions and disabilities (PwCCDs) are vulnerable to secondary complications. Many of these secondary complications are preventable with proactive self-management and proper support. To enhance PwCCDs' self-management skills and conveniently receive desired support, we have developed a mobile health (mHealth) system called iMHere. In 2 previous clinical trials, iMHere was successfully used to improve health outcomes of adult participants with spina bifida and spinal cord injury. To further expand use of iMHere among people with various types of disabilities and chronic diseases, the system needs to be more adaptive to address 3 unique challenges: 1) PwCCDs have very diverse needs with regards to self-management support, 2) PwCCDs' self-management needs may change over time, and 3) it is a challenge to keep PwCCDs engaged and interested in long-term self-management. OBJECTIVE: The aim of this study was to develop an adaptive mHealth system capable of supporting long-term self-management and adapting to the various needs and conditions of PwCCDs. METHODS: A scalable and adaptive architecture was designed and implemented for the new version, iMHere 2.0. In this scalable architecture, a set of mobile app modules was created to provide various types of self-management support to PwCCDs with the ability to add more as needed. The adaptive architecture empowers PwCCDs with personally relevant app modules and allows clinicians to adapt these modules in response to PwCCDs' evolving needs and conditions over time. Persuasive technologies, social support, and personalization features were integrated into iMHere 2.0 to engage and motivate PwCCDs and support long-term usage. Two initial studies were performed to evaluate the usability and feasibility of the iMHere 2.0 system. RESULTS: The iMHere 2.0 system consists of cross-platform client and caregiver apps, a Web-based clinician portal, and a secure 2-way communication protocol for providing interactions among these 3 front-end components, all supported by a back-end server. The client and caregiver apps have 12 adaptive app modules to support various types of self-management tasks. The adaptive architecture makes it possible for PwCCDs to receive personalized app modules relevant to their conditions with or without support from various types of caregivers. The personalization and persuasive technologies in the architecture can be used to engage PwCCDs for long-term usage of the iMHere 2.0 system. Participants of the usability study were satisfied with the iMHere 2.0 client app. The feasibility evaluation revealed several practical issues to consider when implementing the system on a large scale. CONCLUSIONS: We developed an adaptive mHealth system as a novel method to support diverse needs in self-management for PwCCDs that can dynamically change over time. The usability of the client app is high, and it was feasible for PwCCDs to use in supporting personalized and evolving self-care needs.

Recombinant platelet derived growth factor-BB and hyaluronic acid effect in rat osteoarthritis models.

Osteoarthritis (OA) arises from imbalance of cartilage metabolism between the synthesis and degradation of type II collagen by the chondrocyte. Collagen type II degradation is characterized by increase in the biomarker of C-telopeptide fragment of type II collagen (CTX-II), while the anabolic process of cartilage is characterized by an increase in the biosynthesis of procollagen amino terminal N-propeptide type IIA (PIIANP). Platelet derived growth factor (PDGF) with Hyaluronic Acid (HA) as a potent growth factor can be used to stimulate the higher formation of chondrocyte and PIIANP levels and lower CTX-II levels in mouse knee osteoarthritis model.

Development of "My Wheelchair Guide" app: a qualitative study.

Background: The smartphone app "My Wheelchair Guide" is designed to provide essential information about wheelchair use and service delivery for new wheelchair users. It aims to empower wheelchair users in taking ownership in acquiring appropriate wheelchairs, and guiding them to use their wheelchairs in a safe and effective manner.Objective: This paper describes the development of the "My Wheelchair Guide" app and the usability evaluation of one of the app sections "Use a Wheelchair".Method: Ten manual wheelchair users and four seating/mobility professionals completed a survey on the ease of use and perceived usefulness of the app, and a semi-structured interview. Wheelchair users used checklists in the app to self-assess their wheelchairs' fit and set-up, and their wheelchair skills. Two investigators independently conducted content analysis of the interview transcripts and identified salient themes.Results: All participants perceived the app to be easy to use. Both wheelchair users and wheelchair seating professionals recognized that the "Use a Wheelchair" section would be very beneficial for new wheelchair users. Self-assessment checklists facilitated participants to review their wheelchair set-up and skills. Participants also provided several suggestions and recommendations to revise and refine the app section.Conclusion: The app section was perceived to be a useful and easy-to-use educational tool by most of the study participants. Participants' feedback will be used to guide the app revision for a better user experience. Further studies could be conducted to assess the app effectiveness on improving wheelchair users' knowledge and facilitating self-advocacy for appropriate wheelchairs.Implications for rehabilitationSmartphone apps designed to support patient education and self-management regarding wheelchair use are perceived beneficial by both wheelchair users and clinical professionals.Smartphone apps support multimedia information presentation and user interaction, and can potentially create an effective learning environment for wheelchair users and their families to learn about their everyday devices.Users of educational apps prefer reduced text-based content and care about app aesthetics.

Elevated High-Sensitivity C-Reactive Protein And Interleukin-6 Plasma As Risk Factors For Symptomatic Lumbar Osteoarthritis In Postmenopausal Women.

AIM: To determine whether elevated high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and erythrocyte sedimentation rate (ESR), as risk factors of symptomatic lumbar osteoarthritis (OA) in estrogen deficiency postmenopausal women. METHODS: A case-control study was conducted between January and June 2017. The inclusion criteria include post-menopausal women with estrogen deficiency with low back pain. Exclusion criteria were: patients with a history of undergoing bilateral oophorectomy, taking hormonal replacement therapy or corticosteroid, malignancies, and lumbosacral spine trauma. The blood examinations were taken to measure IL-6 level by ELISA, hs-CRP level by spectrophotometry and ESR by modified Westergren method. RESULTS: A group of 44 pairs of subjects were divided equally into case and control groups showed that in estrogen deficiency postmenopausal women, an increased level of hs-CRP increased the risk for symptomatic lumbar OA (OR = 2.83, CI95% = 1.065-8.776, p = 0.034). Also, a high level of IL-6 increased the risk of symptomatic lumbar OA (OR = 2.7, CI95% = 0.991-8.320, p = 0.033). No such significant findings were found for an increased ESR level. CONCLUSION: Elevated level of plasma hs-CRP and IL-6 were concluded as risk factors for symptomatic lumbar OA in post-menopausal women.

A Successful Tracheal Resection and Anastomosis in Papillary Thyroid Carcinoma with Tracheal Invasion.

BACKGROUND: Well-differentiated thyroid carcinoma (DTC) can be locally aggressive, invading aerodigestive tract. The rationale for aggressive surgical resection in this clinical setting is supported by a long-term local control with a positive impact on survival. CASE REPORT: A 60-year-old male patient was consulted by a digestive surgeon of unaware thyroid enlargement. Physical and imaging examination showed a suspect of thyroid malignancy. During surgery, we found that a tumour had invaded the anterior side of the trachea. Resection of three tracheal rings was performed, with end-to-end anastomosis. Surgical outcome regarding nervous preservation and parathyroid glands was good as well as cosmetic aspect. During one-year follow-up, no indication of tumour recurrence was found. The management of locally invasive DTC has been controversial yielding the palliative surgery modalities. Advances in surgical technique have given a new perspective of resection in a difficult case. This case report was managed by sleeve resection with end-to-end anastomosis which showed a satisfactory outcome functionally and cosmetically. CONCLUSION: Sleeve resection with primary reconstruction of the trachea is a simple one-stage procedure which can adequately address the problem of tracheal invasion by thyroid cancer.

Hernia mesh prevent dislocation after wide excision and reconstruction of giant cell tumor distal radius.

Giant cell tumor (GCT) remains as major health problem. GCT which located at the lower end of the radius tends to be more aggressive. Wide excision and reconstruction of the wrist in stage 3 of distal radius GCT lesion is an optimal modality to prevent tumor recurrence. However, dislocation often occurs as its complication. We are reporting patient with GCT of distal radius treated with wide excision and reconstruction using nonvascularized fibular graft and the addition of hernia mesh. Circumferential non-absorbable polypropylene hernia mesh was applied, covered radioulnar joint and volar aspect of radius, and served as additional support to prevent dislocation. During five years and two months of follow-up, we found no dislocation in our patient. Furthermore, good functional outcome was obtained. Our finding suggests that the addition of hernia mesh after wide excision and reconstruction with nonvascularized fibular graft may benefit to prevent dislocation and provides an excellent functional outcome.

Outcome of bone recycling using liquid nitrogen as bone reconstruction procedure in malignant and recurrent benign aggressive bone tumour of distal tibia: A report of four cases.

Amputation still considered as primary choice of malignancy treatment in distal tibia. Bone recycling with liquid nitrogen for reconstruction following resection of malignant bone tumours offers many advantages. We presented four patients with osteosarcoma, Ewing sarcoma, adamantinoma and recurrent giant cell tumour over distal tibia. All of the patients underwent wide excision and bone recycling using liquid nitrogen as bone reconstruction. The mean functional Musculoskeletal Tumor Society (MSTS) score was 75% with no infection and local recurrent. The reconstruction provides good local control and functional outcome.

Case Report of the positive exostosin-1 without B-cell lymphoma-2 gene expression of giant cell tumor lesion in hereditary multiple exostosis.

INTRODUCTION: The giant cell tumor, in which BCL-2 gene was expressed only in its malignant transformation, is a benign, primary skeletal neoplasm with variable biologic aggressiveness. The is of the giant cell tumor. A coexistence with hereditary multiple exostosis with expression of EXT-1 is very rare. The correlation between giant cell tumor in hereditary multiple exostosis is still not clearly determined. PRESENTATION OF CASE: A 31-years-old female presented with pain and lump on her left wrist and a coexistence of non tender multiple lump in the right and left knee. A wide excision of the tumor and reconstruction using non vascularized fibular graft was performed, followed by histopathology and immunohistochemistry of EXT-1 and BCL-2. DISCUSSION: In this case, the tumor showed negative BCL-2 and positive EXT-1 gene expression. Giant cell tumor and hereditary multiple exostosis also demonstrated associations of chromosomes 11 with a different pathological process. CONCLUSION: Giant cell tumor in hereditary multiple exostosis revealed positive EXT-1 without BCL-2 expression. It still need more investigation to confirm the relationship between these tumors.

The organization of STI/HIV risk-taking among long-line fishermen in Bali, Indonesia.

We report on selected findings of a qualitative social network study investigating STI/HIV-related risk among migrant fishermen based at one of Indonesia's major fishing ports in Bali. Their activities between fishing trips include drinking parties, watching pornographic videos, and visiting brothels, while condom use is rare. While on board, they plan and anticipate these activities and many insert penile implants. These fishermen run a high personal risk of contracting STI/HIV, and, with their circular migration patterns among Indonesian and foreign ports such as Thailand and South Africa, and with visits back to their rural hometowns and wives or girlfriends in Java, there is a serious risk of disease transmission to the general population. This paper argues that the role that social interactions play in HIV/AIDS-related risks should be considered as important as (if not more important than) individual knowledge, attitudes, and practices in the design of effective STI/HIV prevention programs.

Na+ transport by the neural glutamine transporter ATA1.

Transfer of glutamine between astrocytes and neurons is an essential part of the glutamate-glutamine cycle in the brain. Here we have investigated how the neural glutamine transporter (rATA1/GlnT) works. Rat ATA1 was expressed in Xenopus laevis oocytes and examined using two-electrode voltage-clamp recordings, ion-sensitive microelectrodes and tracer flux experiments. Glutamine transport via rATA1 was electrogenic and caused inward currents that did not reverse at positive holding potentials. Currents were induced by a variety of neutral amino acids in the following relative order Ala>Ser/Gln/Asn/His/Cys/Met >MeAIB/Gly>Thr/Pro/Tyr/Val, where MeAIB is the amino acid analogue N-methylaminoisobutyric acid. The uptake of glutamine and the corresponding currents depended on Na+ and pH. Hill-coefficient and flux studies with 22NaCl indicated a cotransport stoichiometry 1 Na+ per transport cycle. The transporter also showed uncoupled Na+ transport, particularly when alanine was used as the substrate. Although substrate uptake increased strongly with increasing pH, no change of intracellular pH was observed during transport. A decrease of the intracellular pH similarly inhibited glutamine transport via ATA1, suggesting that the pH dependence was an allosteric effect on the transporter.