Contemporary prevalence of carotid stenosis in patients presenting with ischaemic stroke.

BACKGROUND: Carotid stenosis is a common cause of ischaemic stroke and transient ischaemic attack (TIA). Despite rising recognition and centralization of stroke services there has been a decline in interventions for carotid stenosis in recent years. The aim of this study was to determine the current prevalence and management of carotid stenosis in the UK. METHODS: This was a 1-year prospective observational study of consecutive patients presenting with ischaemic stroke, TIA or ischaemic retinal artery occlusion to a central London hyperacute stroke unit. Patients with significant carotid stenosis, defined as atherosclerotic narrowing of 50 per cent or greater, underwent multidisciplinary team (MDT) discussion to determine the cause of stroke/TIA and classify carotid stenosis as symptomatic or incidental. RESULTS: In total, 2707 patients were seen; half had an ischaemic event and the majority had carotid imaging (1252 of 1444). Carotid stenosis of at least 50 per cent was seen in 238 (prevalence 19·0 (95 per cent c.i. 16·6 to 21·4) per cent). Patients with significant carotid stenosis were more likely to have hypertension, hypercholesterolaemia, diabetes and ischaemic heart disease. Carotid stenosis was deemed symptomatic in 99 patients (7·9 (6·3 to 9·5) per cent); of these, 17 had carotid occlusion, 17 were unfit for surgery and 58 patients were referred for carotid intervention. Among 139 patients with asymptomatic stenosis, 75 had carotid stenosis ipsilateral to the stroke but, after MDT discussion, the cause was deemed to be atrial fibrillation (32), small-vessel disease (15), another determined cause (5), or not determined owing to atypical imaging or clinical presentation. CONCLUSION: Carotid stenosis is common, affecting one in five patients presenting with stroke or TIA. Careful MDT discussion may avoid unnecessary intervention and should be the standard of care.

Indoor air quality in hairdressing salons in Taipei.

To improve indoor air quality and to protect public health, Taiwan has enacted the "Indoor Air Quality Act (IAQ Act)" in 2012. For the general public, the indoor air quality in hair salons is important because it is a popular location that people will often visit for hair treatments. However, only a few exposure assessments regarding air pollutants have previously been performed in hair salons. To assess the air quality of hairdressing environments in Taipei, ten hairdressing salons were included for a walk-through survey in this study. In addition, the airborne concentrations of formaldehyde, volatile organic compounds (VOCs), CO2 , and phthalate esters were also determined in 5 salons. Charcoal, XAD-2, and OVS-Tenax tubes were used for the air sampling, while the samples were analyzed with gas chromatography/mass spectrometer. It was found that the products used in hair salons contained various chemicals. In fact, from the walk-through survey, a total of 387 different ingredients were found on 129 hair product labels. The hair salons were not well ventilated, with CO2 levels of 600 to 3576 ppm. The formaldehyde concentrations determined in this study ranged from 12.40 to 1.04 × 103  µg m-3 , and the maximum level was above the permissible exposure limit (PEL) of US Occupational Safety and Health Administration (US OSHA). Additionally, 83% of the samples were with levels higher than the standard regulated by Taiwan's IAQ Act. The concentrations of VOCs and phthalate esters were below the occupational exposure limits (OELs), but higher than what was found in general residential environments. The hair products were considered as the major source of air pollutants because significantly higher concentrations were found around the working areas. The number of perming treatments, the number of workers, and the frequency of using formaldehyde releasing products, were found to be associated with the levels of formaldehyde. This study indicates that efforts are needed to improve the indoor air quality in hairdressing salons in Taipei.

Transcranial Doppler Ultrasound Detection of Microemboli as a Predictor of Cerebral Events in Patients with Symptomatic and Asymptomatic Carotid Disease: A Systematic Review and Meta-Analysis.

OBJECTIVE: Identification of patients who will benefit from carotid endarterectomy is not entirely effective, primarily utilising degree of carotid stenosis. This study aimed at determining if microembolic signals (MES) detected by transcranial Doppler ultrasound (TCD) can provide clinically useful information regarding stroke risk in patients with carotid atherosclerosis. METHODS: A meta-analysis of prospective studies was performed. Three analyses were proposed investigating MES detection as a predictor of: stroke or TIA, stroke alone, and stroke or TIA but with an increased positivity threshold. Subgroup analysis was used to compare pre-operative (symptomatic or asymptomatic) patients and peri- or post-operative patients. RESULTS: Twenty-eight studies reported data regarding both MES status and neurological outcome. Of these, 22 papers reported data on stroke and TIA as an outcome, 19 on stroke alone, and eight on stroke and TIA with increased positivity threshold. At the median pre-test probability of 3.0%, the post-test probabilities of a stroke after a positive and negative TCD were 7.1% (95% CI 5-10.1) and 1.2% (95% CI 0.6-2.5), respectively. In addition, the sensitivities and specificities of each outcome showed that increasing the threshold for positivity to 10 MES per hour would make TCD a more clinically useful tool in peri- and post-operative patients. CONCLUSION: TCD provides clinically useful information about stroke risk for patients with carotid disease and is technically feasible in most patients. However, the generally weak level of evidence constituting this review means definitive recommendations cannot be made.

Underlayer Effect on Perpendicular Magnetic Anisotropy in Co20Fe60B20\MgO Films.

Perpendicular Magnetic Tunneling Junctions (pMTJs) with Ta\CoFeB\MgO have been extensively studied in recent years. However, the effects of the underlayer on the formation of the CoFeB perpendicular magnetic anisotropy (PMA) are still not well understood. Here we report the results of our systematic use of a wide range of elements (Ti, V, Cr, Zr, Nb, Mo, Ru, Rh, Pd, Ag, Hf, Ta, W, Re, Os, Ir, Pt and Au) encompassed by columns IVA, VA, VIA, VIIA and VIIIA of the periodic table as the underlayer in a underlayer\Co20Fe60B20\MgO stack. Our goals were to survey more elements which could conceivably create a PMA in CoFeB and thereby to explore the mechanisms enabling these underlayers to enhance or create the PMA. We found underlayer elements having both an outer shell of 4d electrons (Zr, Nb Mo, and Pd) and 5d electrons (Hf, Ta, W, Re, Ir, and Pt) resulted in the development of a PMA in the MgO-capped Co20Fe60B20. Hybridization between the 3d electrons of the Fe or Co (in the Co20Fe60B20) at the interface with the 4d or 5d electrons of the underlayer is thought to be the cause of the PMA development.

Characterization of T cell receptor gamma chain expression in a subset of murine thymocytes.

While much information exists about the structure and function of the clonally distributed T cell receptor (TCR) alpha beta heterodimer, little is known about the gamma protein, the product of a third rearranging TCR gene. An antiserum to a carboxyl-terminal peptide common to several of the murine gamma chain constant regions and a monoclonal antibody to the murine T3 complex were used to identify products of this TCR gene family in a subpopulation of Lyt2-, L3T4- thymocytes. This subpopulation does not express TCR alpha or full-length TCR beta messenger RNA. The gamma chain is a 35-kilodalton (kD) protein that is disulfide-bonded to a 45-kD partner and is associated with the T3 complex. Analysis of the glycosylation pattern of this thymic gamma chain revealed that the major variable region gamma (V gamma) gene transcribed in activated peripheral T cells is absent from this subpopulation. The cells that bear this second T cell receptor may therefore represent a distinct lineage differentiating within the thymus.

Size dependence in tunneling spectra of PbSe quantum-dot arrays.

Interdot Coulomb interactions and collective Coulomb blockade were theoretically argued to be a newly important topic, and experimentally identified in semiconductor quantum dots, formed in the gate confined two-dimensional electron gas system. Developments of cluster science and colloidal synthesis accelerated the studies of electron transport in colloidal nanocrystal or quantum-dot solids. To study the interdot coupling, various sizes of two-dimensional arrays of colloidal PbSe quantum dots are self-assembled on flat gold surfaces for scanning tunneling microscopy and scanning tunneling spectroscopy measurements at both room and liquid-nitrogen temperatures. The tip-to-array, array-to-substrate, and interdot capacitances are evaluated and the tunneling spectra of quantum-dot arrays are analyzed by the theory of collective Coulomb blockade. The current-voltage of PbSe quantum-dot arrays conforms properly to a scaling power law function. In this study, the dependence of tunneling spectra on the sizes (numbers of quantum dots) of arrays is reported and the capacitive coupling between quantum dots in the arrays is explored.

Carotid artery stenosis, an underestimated cause of stroke recurrence in patients with ischaemic monocular visual loss.

INTRODUCTION: Isolated monocular ischaemic events are thought to be low risk for stroke recurrence. In the presence of carotid stenosis however, the risks should not be treated similarly and surgical intervention should be considered at an early stage. The aim of this study was to determine the vascular risk profile and stroke recurrence in patients with ischaemic monocular visual loss. METHODS AND METHODS: Consecutive records for all patients with monocular ischaemia were reviewed from January 2014 to October 2016. Stroke, transient ischaemic attack or monocular ischaemia recurrence within 90 days were recorded. Carotid stenosis was assessed with duplex ultrasound, computed tomography or magnetic resonance angiography. RESULTS: In total, 400 patients presented with monocular ischaemia; 391 had carotid imaging (97.8%). Causality was symptomatic carotid stenosis ≥ 50% in 53 (13.6%), including carotid stenosis ≥ 70% in 31 (7.9%). Patients with permanent visual loss (n = 131) were more likely to have significant stenosis compared with patients with transient visual loss (n = 260), 19.8% compared with 10.4% (P = 0.012). Recurrent stroke, transient ischaemic attack or monocular ischaemia within 90 days after presentation occurred in three patients (5.7%) in the carotid stenosis group, compared to three (0.9%) who did not have stenosis (P = 0.035). Age, male sex and hypertension were associated with carotid stenosis but hypercholesterolaemia, diabetes and smoking were not. CONCLUSIONS: Carotid stenosis ≥ 50% is present in patients with ocular ischaemia in approximately 20% of those with persistent visual loss and in 10% with transient visual loss. Those with carotid stenosis have a higher risk of stroke recurrence and should be considered urgent surgical intervention as other forms of stroke.

Field protection effectiveness of chemical protective suits and gloves evaluated by biomonitoring.

OBJECTIVES: To determine the effectiveness of protective suits and gloves by biomonitoring. METHODS: Fifteen male spray painters at a ship coating factory were studied for two weeks. Workers wore no protective clothing during the first week and wore protective suits and gloves during the second week. Sampling was conducted on four consecutive working days each week. Ethyl benzene and xylene in the air were collected by using 3M 3500 organic vapour monitors. Urine was collected before and after each work shift. RESULTS: Urinary mandelic acid (MA) and methyl hippuric acid (MHA) levels were divided by the personal exposure concentrations of ethyl benzene and xylene, respectively. Mean (SE) corrected MA and MHA concentrations in the first week were 1.07 (0.18) and 2.66 (0.68) (mg/g creatinine)/(mg/m3), and concentrations in the second week were 0.50 (0.12) and 1.76 (0.35) (mg/g creatinine)/(mg/m3) in the second week, respectively. Both MA and MHA concentrations in the second week (when spray painters wore protective suits and gloves) were lower than in the first week, respectively (p<0.001, p = 0.011). Mean decrease in MA and MHA biomarkers were 69% and 49%, respectively. CONCLUSION: This study successfully evaluated the effectiveness of chemical protective suits and gloves by using biomarkers as urinary MA and MHA. This method is feasible for determining the performance of workers wearing personal protective equipment. Moreover, the experimental results suggest that dermal exposure may be the major contributor to total body burden of solvents in spray painters without protective suits and gloves.

Particle separation to enhance the efficiency of soil acid washing--case study on the removal of cadmium from contaminated soil in southwestern Taiwan.

The current trend in remediating contaminated soil by acid washing is to separate the soil mass by their particles sizes prior to washing. However, there is little information about the cost-effectiveness of this practice in literature. In this research, a cadmium-contaminated agricultural field has been selected for conducting a comparative study on cadmium removal by applying the acid washing method to soil samples with and without prior particle separation. The study provides valuable information for the advancement of this method to remediate contaminated soil. The results indicate that sand particles constitute about 70% of the total soil mass but only 24% of the total cadmium. After acid washing once, less than 2% of cadmium remains; multiple washing of the sand portion is thus not cost-effective. Furthermore, after particle separation, the soil mass that needs to be washed is greatly reduced to 35%; the total cost is reduced by about one third due to the savings in the acid solution utilization and the treatment of used acid solution.

Study of different methods for enhancing the nitrate removal efficiency of a zero-valent metal process.

This study explores the effect of several enhancing methods, namely acid wash pretreatment, ultrasound treatment and addition of nickel catalyst on the nitrate removal efficiency of three zero-valent metals--iron, aluminium and zinc. It is hoped that by learning about the major reaction pathways of nitrate removal with zero-valent metals and the main factors influencing the reactivity of those zero-valent metals, optimum process conditions may be identified. The study results show that direct transfer of electrons is the major reaction pathway. Thus increasing a clean, fresh metal surface and decreasing the thickness of the diffusion layer to accelerate mass transfer are the main determinants of reaction rate. In the absence of a clean, fresh metal surface, the catalytic reaction of nickel becomes the primary removal pathway.

A helix initiation motif, XLLRA, is stabilized by hydrogen bond, hydrophobic and van der Waals interactions.

Five partially overlapping synthetic peptides containing the N-terminal portion of the leucine zipper (LZ)-like domain of human immunodeficiency virus envelope glycoprotein gp41 were used to deduce the helix initiation site. Circular dichroism (CD) data suggested a strong helix-inducing motif, LLRA. The coupling constant and nuclear Overhauser effect (NOE) results obtained from nuclear magnetic resonance experiments in 20% trifluoroethanol aqueous solution at 280 K for the four decapeptides under study suggested that the motif XLLRA, where X is a group or an amino acid residue capable of forming hydrogen bond to arginine, constitutes a helix nucleation core. A similar conclusion was reached for a pentadecapeptide in water, suggesting that the result was not dependent on both chain length and the helix promoting medium. Detailed analysis of NOE and CD data from the four decapeptides indicated that the acetyl group and asparagine had a strong tendency to be helix N-capping, in confirmation of previous studies. Molecular modeling using restraints derived from NOE data showed that van der Waals, hydrophobic interactions and hydrogen bonds contribute synergetically to the stability of the core structure. The concept of nucleation core consisting of a few amino acids may be generally applied in proton design and folding studies.

miR-155 and miR-146b negatively regulates IL6 in Helicobacter pylori (cagA+) infected gastroduodenal ulcer.

OBJECTIVE: Helicobacter pylori (H. pylori) infection is the main cause of gastroduodenal ulcer. The molecular mechanisms that underlying this progress are still not very clear. MicroRNAs (miRNAs) are small noncoding RNAs that function as negative regulator of numerous target genes at posttranscriptional level. miRNAs plays important roles in the development of many infection related diseases. The roles of miRNAs in the development of H. pylori-infected gastroduodenal ulcer haven't been well studied yet. MATERIALS AND METHODS: The miRNA and mRNA profiles in normal gastroduodenal biopsy, H. pylori-infected gastroduodenal biopsy and H. pylori-infected gastroduodenal ulcer biopsy samples were compared and analyzed to identify potential related miRNAs and their target genes. The differential expression of the identified miRNAs and their target gene were validated in an independent set of H. pylori positive gastroduodenal ulcer biopsy samples by immunohistochemistry staining and RT-PCR. Then microRNA mimics were transfected to gastric epithelial cells infected with H. pylori 26695 (cagA+). RT-PCR and Western blotting were performed to confirm the target gene of the identified microRNAs. RESULTS: The integrative analysis and immunohistochemistry staining validation indicated that miR-155 and miR-146b, as well as their predicted target gene IL6, are up-regulated in H. pylori positive gastroduodenal ulcer. Further experiments in gastric epithelial cells revealed that H. pylori 26695 (cagA+) infection induces IL6 overexpression. But the overexpression of IL6 is weaken due to negative regulation by miR-155 and miR-146b. CONCLUSIONS: This study indicated that the up-regulation of miR-155 and miR-146b decreases H. pylori (cagA+)-introduced IL6 overexpression, which might weaken the cleanup of H. pylori (cagA+) and contributes to ulcer.

On the importance of van der Waals interaction in the groove binding of DNA with ligands: restrained molecular dynamics study.

Comparison of interaction energy between an oligonucleotide and a DNA-binding ligand in the minor and major groove modes was made by use of restrained molecular dynamics. Distortion in DNA was found for the major groove mode whereas less significant changes for both ligand and DNA were detected for the minor groove binding after molecular dynamics simulation. The conformation of the ligand obtained from the major groove modes resembles that computed with the ligand soaked in water. The van der Waals contact energy was found to be as significant as electrostatic energy and more important for difference in binding energy between these two binding modes. The importance of van der Waals force in groove binding was supported by computations on the complex formed by the repressor peptide fragment from the bacteriophage 434 and its operator oligonucleotide.

The enhancement methods for the degradation of TCE by zero-valent metals.

Batch tests were performed to compare the degradation rates of TCE on Fe0 and Zn0. Our results indicated that the degradating capability of Zn0 to TCE was nearly 10 times higher than that of Fe0. On the other hand, the degradation rates of Fe0 or Zn0 in conjunction with other metals for reduction of TCE was investigated. The selected metals were nickel (Ni0) and palladium (Pd0) both of which have a strong enhancement effect. The reduction rates of Zn0/Pd0 and Zn0/Ni0 for TCE were the fastest. Fe0 that had lost its surface activity could be activated again by the addition of Pd0 or Ni0.

Feasibility of using metals to remediate water containing TCE.

The feasibility of treating underground water contaminated by a chlorinated organic compound with bimetallics Fe/ Ni, Zn/Ni and Zn single metal was studied. Column tests to simulate a reactive permeable wall in a funnel-and-gate system were used. Research results indicated that bimetallic Fe0/Ni0 and Zn0/Ni0 all had a very strong degraded power to trichloroethylene (TCE) at concentration up to 25 mg/l under different flow rates (27 cm/day-20 m/day). Furthermore, the concentrations of TCE and various ions in the treated effluent were nearly lower than the values specified in related standards for drinking water in Taiwan. These results showed that this technique could be effectively and safely used as an underground water remediation process.

[Effect of an extract from the cauline of Piper kadsura ohwi on endotoxin-induced hypotension and lung injury in rats].

Arterial hypotension and high-permeability pulmonary edema were induced by intravenous injection of platelet activating factor (PAF) or endotoxin in rats. Pre-treatment with extract from the Cauline of Piper kadsura attenuated endotoxin-induced hypotension and lung injury, which may result from the PAF antagonistic effect of Piper kadsura.

Biological properties of sodium alkyl methyl ester sulfonate/alkyltrimethylammonium bromide surfactant mixtures.

Quaternary ammonium compounds (QACs) are commonly used as disinfectant in medical care, food industry, detergents and glue industries. This is due to a small concentration of QACs is sufficient to inhibit the growth of various bacteria strains. In this work, the inhibitive power of cationic surfactants, alkyltrimethylammonium bromide (C(n)TAB) in the presence of anionic surfactants, sodium alkyl methyl ester α-sulfonate (C(n)MES) was studied. The growth inhibition test with gram-positive (Staphylococcus aureus) and gram-negative (Escherichia coli and Pseudomonas aeruginosa) bacteria were used to determine the toxicity of single and mixed surfactants. Results from this work showed that certain mixed surfactants have lower minimum inhibition concentration (MIC) as compared to the single C(n)TAB surfactants. Besides that, it was also found that alkyl chain length and the mixing ratios of the surfactants play a significant role in determining the mixture inhibitive power.