A potential risk of overestimating apparent diffusion coefficient in parotid glands

Objectives: To investigate transient signal loss on diffusion weighted images (DWI) and overestimation of apparent diffusion coefficient (ADC) in parotid glands using single shot echoplanar DWI (EPDWI). Materials and Methods: This study enrolled 6 healthy subjects and 7 patients receiving radiotherapy. All participants received dynamic EPDWI with a total of 8 repetitions. Imaging quality of DWI was evaluated. Probability of severe overestimation of ADC (soADC), defined by an ADC ratio more than 1.2, was calculated. Error on T2WI, DWI, and ADC was computed. Statistical analysis included paired Student t testing and Mann-Whitney U test. A P value less than 0.05 was considered statistically significant. Results: Transient signal loss was visually detected on some excitations of DWI but not on T2WI or mean DWI. soADC occurred randomly among 8 excitations and 3 directions of diffusion encoding gradients. Probability of soADC was significantly higher in radiotherapy group (42.86%) than in healthy group (24.39%). The mean error percentage decreased as the number of excitations increased on all images, and, it was smallest on T2WI, followed by DWI and ADC in an increasing order. Conclusions: Transient signal loss on DWI was successfully detected by dynamic EPDWI. The signal loss on DWI and overestimation of ADC could be partially remedied by increasing the number of excitations. © 2015 Liu et al.published_or_final_versio

Time trends in service provision and survival outcomes for patients with renal cancer treated by nephrectomy in England 2000-2010.

OBJECTIVE: To describe the temporal trends in nephrectomy practice and outcomes for English patients with renal cell carcinoma (RCC). PATIENTS AND METHODS: Adult RCC nephrectomy patients treated between 2000 and 2010 were identified in the National Cancer Data Repository and Hospital Episode Statistics, and followed-up until date of death or 31 December 2015 (n = 30 763). We estimated the annual frequency for each nephrectomy type, the hospital and surgeon numbers and their case volumes. We analysed short-term surgical outcomes, as well as 1- and 5-year relative survivals. RESULTS: Annual RCC nephrectomy number increased by 66% during the study period. Hospital number decreased by 24%, whilst the median annual hospital volume increased from 10 to 23 (P < 0.01). Surgeon number increased by 27% (P < 0.01), doubling the median consultant number per hospital. The proportion of minimally invasive surgery (MIS) nephrectomies rose from 1% to 46%, whilst the proportion of nephron-sparing surgeries (NSS) increased from 5% to 16%, with 29% of all T1 disease treated with partial nephrectomy in 2010 (P < 0.01). The 30-day mortality rate halved from 2.4% to 1.1% and 90-day mortality decreased from 4.9% to 2.6% (P < 0.01). The 1-year relative survival rate increased from 86.9% to 93.4%, whilst the 5-year relative survival rate rose from 68.2% to 81.2% (P < 0.01). Improvements were most notable in patients aged ≥65 years and those with T3 and T4 disease. CONCLUSIONS: Surgical RCC management has changed considerably with nephrectomy centralisation and increased NSS and MIS. In parallel, we observed significant improvements in short- and long-term survival particularly for elderly patients and those with locally advanced disease

Infection with hepatitis B virus carrying novel pre-S/S gene mutations in female siblings vaccinated at birth: two case reports

<p>Abstract</p> <p>Introduction</p> <p>After the initiation of a mass hepatitis B vaccination program in Taiwan, the prevalence of hepatitis B virus infection has declined progressively. However, about 1 percent of the young generation, who received hepatitis B vaccination at birth, remain carriers. Infection with vaccine-escape hepatitis B virus mutants always occurs shortly after birth. Here, we report two female siblings in whom the infection occurred in their adolescence. This report raises the question of whether a booster for hepatitis B vaccination is needed.</p> <p>Case presentation</p> <p>Two 19 and 14-year-old Taiwanese female siblings were born to a mother infected with hepatitis B virus and received a complete course of hepatitis B vaccination at birth. They remained negative for serum hepatitis B surface antigen and positive for serum anti-hepatitis B surface antibody throughout their childhood. However, both were infected with the hepatitis B virus in their adolescence. Hepatitis B virus DNA was extracted from serum samples from the mother and two siblings. Hepatitis B virus pre-S/S sequence was amplified by polymerase chain reaction followed by nucleotide sequencing. When compared with the sequence obtained from the mother, multiple amino acid substitutions located near or in the major hydrophilic region of the surface antigen were identified in the elder sister. Four of these mutations (sL97S, sL98S, sG102R, and sA159P) were novel. A novel in-frame deletion (14 amino acids deleted, pre-S 127-140) was found in the hepatitis B virus pre-S2 region in the younger sister.</p> <p>Conclusions</p> <p>Despite having received hepatitis B vaccination at birth, hepatitis B virus infection can still occur in adolescence with the emergence of novel mutations in the pre-S/S gene. This is a rare event and, to the best of our knowledge, has not been previously reported.</p

Establishing consensus of position-specific predictors for elite youth soccer in England

Purpose: To construct a valid and reliable methodology for the development of position-specific predictors deemed appropriate for talent identification purposes within elite youth soccer in England. Method: N = 10 panel experts participated in a three-step modified e-Delphi poll to generate consensus on a series of generic youth player attributes. A follow-up electronic survey completed by coaches, scouts and recruitment staff (n = 99) ranked these attributes to specific player-positions. Results: A final list of 44 player attributes found consensus using the three-step modified e-Delphi poll. Findings indicated that player-positional attributes considered most important in the youth phase are more psychological and technical than physiological or anthropometric. Despite ‘hidden’ attributes (e.g., coachability, flair, versatility, and vision) finding consensus on the e-Delphi poll, there was no evidence to support these traits when associated with a specific playing position. Conclusion: For those practitioners responsible for talent recruitment, our findings may provide greater understanding of the multiple attributes required for some playing positions. However, further ecological research is required to assess the veracity of our claims

Characterization and Comparison of 2 Distinct Epidemic Community-Associated Methicillin-Resistant Staphylococcus aureus Clones of ST59 Lineage.

Sequence type (ST) 59 is an epidemic lineage of community-associated (CA) methicillin-resistant Staphylococcus aureus (MRSA) isolates. Taiwanese CA-MRSA isolates belong to ST59 and can be grouped into 2 distinct clones, a virulent Taiwan clone and a commensal Asian-Pacific clone. The Taiwan clone carries the Panton-Valentine leukocidin (PVL) genes and the staphylococcal chromosomal cassette mec (SCCmec) VT, and is frequently isolated from patients with severe disease. The Asian-Pacific clone is PVL-negative, carries SCCmec IV, and a frequent colonizer of healthy children. Isolates of both clones were characterized by their ability to adhere to respiratory A549 cells, cytotoxicity to human neutrophils, and nasal colonization of a murine and murine sepsis models. Genome variation was determined by polymerase chain reaction of selected virulence factors and by multi-strain whole genome microarray. Additionally, the expression of selected factors was compared between the 2 clones. The Taiwan clone showed a much higher cytotoxicity to the human neutrophils and caused more severe septic infections with a high mortality rate in the murine model. The clones were indistinguishable in their adhesion to A549 cells and persistence of murine nasal colonization. The microarray data revealed that the Taiwan clone had lost the ø3-prophage that integrates into the β-hemolysin gene and includes staphylokinase- and enterotoxin P-encoding genes, but had retained the genes for human immune evasion, scn and chps. Production of the virulence factors did not differ significantly in the 2 clonal groups, although more α-toxin was expressed in Taiwan clone isolates from pneumonia patients. In conclusion, the Taiwan CA-MRSA clone was distinguished by enhanced virulence in both humans and an animal infection model. The evolutionary acquisition of PVL, the higher expression of α-toxin, and possibly the loss of a large portion of the β-hemolysin-converting prophage likely contribute to its higher pathogenic potential than the Asian-Pacific clone

Efficient simulation of the spatial transmission dynamics of influenza

Early data from the 2009 H1N1 pandemic (H1N1pdm) suggest that previous studies over-estimated the within-country rate of spatial spread of pandemic influenza. As large spatially resolved data sets are constructed, the need for efficient simulation code with which to investigate the spatial patterns of the pandemic becomes clear. Here, we present a significant improvement to the efficiency of an individual based stochastic disease simulation framework commonly used in multiple previous studies. We quantify the efficiency of the revised algorithm and present an alternative parameterization of the model in terms of the basic reproductive number. We apply the model to the population of Taiwan and demonstrate how the location of the initial seed can influence spatial incidence profiles and the overall spread of the epidemic. Differences in incidence are driven by the relative connectivity of alternate seed locations. The ability to perform efficient simulation allows us to run a batch of simulations and take account of their average in real time. The averaged data are stable and can be used to differentiate spreading patterns that are not readily seen by only conducting a few runs. © 2010 Tsai et al.published_or_final_versio

Dialkyldithiophosphate Acids (HDDPs) as Effective Lubricants of Sol–Gel Titania Coatings in Technical Dry Friction Conditions

The goal of this study was the investigation of the effectiveness of dialkyldithiophosphate acids (HDDPs) films in improving the tribological properties of thin, sol– gel derived titania coatings. Amorphous, anatase, and rutile titania coatings were obtained using sol–gel dip–coating deposition after treatment at 100, 500, and 1,000 C, respectively. Titania coatings were then modified from the liquid phase by HDDPs acids having dodecyl-(C12), tetradecyl-(C14), and hexadecyl-(C16) alkyl chains deposited by dip–coating (DC) and Langmuir–Blodgett (LB) methods. The influence of the deposition procedure, the length of the HDDPs alkyl chain and the type of titania substrate on the surface morphology and tribological properties were studied. It was found, using wetting contact angle measurements, that these modifications of titania coatings decrease the surface free energy and increase its hydrophobicity. The surface topography imaged by Atomic force microscopy (AFM), exhibit island-like or agglomerate features for the DC deposition method, while smooth topographies were observed for LB depositions. Tribological tests were conducted by means of a microtribometer operating in the normal load range 30–100 mN. An enhancement of tribological properties was observed upon modification, as compared to unmodified titania

Electronic structure and bonding properties of Si-doped hydrogenated amorphous carbon films

[[abstract]]This work investigates the C K-edge x-ray absorption near-edge structure (XANES), valence-band photoelectron spectroscopy (PES), and Fourier transform infrared (FTIR) spectra of Si-doped hydrogenated amorphous carbon films. The C K-edge XANES and valence-band PES spectra indicate that the sp2/sp3 population ratio decreases as the amount of tetramethylsilane vapor precursor increases during deposition, which suggest that Si doping% enhances sp3 and reduces sp2-bonding configurations. FTIR spectra show the formation of a polymeric sp3 C–Hn structure and Si–Hn bonds, which causes the Young’s modulus and hardness of the films to decrease with the increase of the Si content.[[incitationindex]]SCI[[booktype]]紙

Deuterium fractionation across the infrared-dark cloud G034.77−00.55 interacting with the supernova remnant W44

Context. Supernova remnants (SNRs) may regulate star formation in galaxies. For example, SNR-driven shocks may form new molecular gas or compress pre-existing clouds and trigger the formation of new stars. / Aims. To test this scenario, we measured the deuteration of N2H+, DfracN2H+ – a well-studied tracer of pre-stellar cores – across the infrared-dark cloud (IRDC) G034.77-00.55, which is known to be experiencing a shock interaction with the SNR W44. / Methods. We use N2H+ and N2D+J = 1−0 single pointing observations obtained with the 30m antenna at the Instituto de Radioas-tronomia Millimetrica to infer DfracN2H+ towards five positions across the cloud, namely a massive core, different regions across the shock front, a dense clump, an+d ambient gas. / Results. We find DfracN2H+ in the range 0.03−0.1, which is several orders of magnitude larger than the cosmic D/H ratio (~10−5). The DfracN2H+ across the shock front is enhanced by more than a factor of 2 (DfracN2H+ ~ 0.05 - 0.07) with respect to the ambient gas (≤0.03) and simila+r to that measured generally in pre-stellar cores. Indeed, in the massive core and dense clump regions of this IRDC we measure DfracN2H+ ~ 0.01. / Conclusions. We find enhanced deuteration of N2H+ across the region of the shock, that is, at a level that is enhanced with respect to regions of unperturbed gas. It is possible that this has been induced by shock compression, which would then be indirect evidence that the shock is triggering conditions for future star formation. However, since unperturbed dense regions also show elevated levels of deuteration, further, higher-resolution studies are needed to better understand the structure and kinematics of the deuterated material in the shock region; for example, to decipher whether it is still in a relatively diffuse form or is already organised in a population of low-mass pre-stellar cores

The Reform of Employee Compensation in China’s Industrial Enterprises

Although employee compensation reform in Chinese industrial sector has been discussed in the literature, the real changes in compensation system and pay practices have received insufficient attention and warrant further examination. This paper briefly reviews the pre- and post-reform compensation system, and reports the results of a survey of pay practices in the four major types of industrial enterprises in China. The research findings indicate that the type of enterprise ownership has little influence on general compensation practices, adoption of profit-sharing plans, and subsidy and allowance packages. In general, pay is linked more to individual performance and has become an important incentive to Chinese employees. However, differences are found across the enterprise types with regard to performance-related pay. Current pay practices are positively correlated to overall effectiveness of the enterprise