Advance Directive and End-of-Life Care Preferences Among Nursing Home Residents in Wuhan, China: A Cross-Sectional Study

© 2014 AMDA - The Society for Post-Acute and Long-Term Care Medicine. Objectives: To describe Chinese nursing home residents' knowledge of advance directive (AD) and end-of-life care preferences and to explore the predictors of their preference for AD. Design: Population-based cross-sectional survey. Settings: Nursing homes (n= 31) in Wuhan, Mainland Southern China. Participants: Cognitively intact nursing home residents (n= 467) older than 60 years. Measures: Face-to-face questionnaire interviews were used to collect information on demographics, chronic diseases, life-sustaining treatment, AD, and other end-of-life care preferences. Results: Most (95.3%) had never heard of AD, and fewer than one-third (31.5%) preferred to make an AD. More than half (52.5%) would receive life-sustaining treatment if they sustained a life-threatening condition. Fewer than one-half (43.3%) chose doctors as the surrogate decision maker about life-sustaining treatment, whereas most (78.8%) nominated their eldest son or daughter as their proxy. More than half (58.2%) wanted to live and die in their present nursing homes. The significant independent predictors of AD preference included having heard of AD before (odds ratio [OR] 9.323), having definite answers of receiving (OR 3.433) or rejecting (OR 2.530) life-sustaining treatment, and higher Cumulative Illness Rating Scale score (OR 1.098). Conclusions: Most nursing home residents did not know about AD, and nearly one-third showed positive attitudes toward it. AD should be promoted in mainland China. Education of residents, the proxy decision maker, and nursing home staff on AD is very important. Necessary policy support, legislation, or practice guidelines about AD should be made with flexibility to respect nursing home residents' rights in mainland China

Allelopathy of root exudates from different resistant eggplants to Verticillium dahliae and the identification of allelochemicals

Three eggplant cultivars were inoculated with Verticillium dahliae Kleb. to assess their resistance to Verticillium wilt. Solanum tor was resistant, “Liyuanziqie” was tolerant, and “Xi’anlvqie” susceptible. The disease incidence and disease index of Verticillium wilt and the amount of V. dahliae in rhizospheric soil, variation of microbial composition, the allelopathy of root exudates to mycelium growth of V. dahliae and the chemical substances of root exudates from eggplant cultivars with different resistance to Verticillium wilt were investigated in this experiment. The results showed that the root exudates of resistant type could not only affect the growth and development of V. dahliae, but also influence V. dahliae indirectly through regulating soil microbial community composition. This may be one of the reasons for the increase of disease resistance. However, the susceptible type exhibited an opposite trend. It was inferred that the resistant type contained some particular components, such as  acohd, amide, pyranoid, fluorene, while the susceptible one comprised more types of components, that is, ketone, phenol, ester and phenolic acid.Key words: Allelopathy, allelochemical, root exudates, eggplant, Verticillium dahliae, Verticillium wilt, microbial composition

Physical origins of ruled surfaces on the reduced density matrices geometry

© 2016, Science China Press and Springer-Verlag Berlin Heidelberg. The reduced density matrices (RDMs) of many-body quantum states form a convex set. The boundary of low dimensional projections of this convex set may exhibit nontrivial geometry such as ruled surfaces. In this paper, we study the physical origins of these ruled surfaces for bosonic systems. The emergence of ruled surfaces was recently proposed as signatures of symmetry-breaking phase. We show that, apart from being signatures of symmetry-breaking, ruled surfaces can also be the consequence of gapless quantum systems by demonstrating an explicit example in terms of a two-mode Ising model. Our analysis was largely simplified by the quantum de Finetti’s theorem—in the limit of large system size, these RDMs are the convex set of all the symmetric separable states. To distinguish ruled surfaces originated from gapless systems from those caused by symmetry-breaking, we propose to use the finite size scaling method for the corresponding geometry. This method is then applied to the two-mode XY model, successfully identifying a ruled surface as the consequence of gapless systems

Stochastic separated flow models with applications in numerical computations of supersonic particle-laden turbulent flows

In this article, three stochastic separated flow models were applied to predict the dispersion of inertial fuel particles in the supersonic turbulent flows. The flow field of continuous phase was simulated by means of Reynolds-averaged Navier–Stokes method with a two-equation turbulence model. Clift’s expression was used to modify the drag force on the particle considering the compressibility effects. The particle-phase statistics were obtained by a secondary-order time-weighed Eulerian method. The ability of those stochastic separated flow models was then compared for predicting the mean particle velocity and the particle dispersion. For obtaining a statistically stationary solution, the stochastic separated flow model required the largest number of computational particles, whereas the improved stochastic separated flow model was found to need the least. The time-series stochastic separation flow model lay in-between. Compared with the other two models, the particle dispersion was over-predicted by the stochastic separated flow model in the supersonic particle-laden boundary layer flow, while the improved stochastic separated flow model was less predictable for the particle spatial distribution in the particle-laden strut-injection flow. Three models could well predict the mean velocities of the particle phase. This study is valuable for selecting a validated model used for predicting the particle dispersion in supersonic turbulent flows

Genetic diversity among Toxoplasma gondii isolates from different hosts and geographical locations revealed by analysis of ROP13 gene sequences

Toxoplasma gondii can infect almost all the warm-blooded animals and human beings, causing serious public health problems and economic losses worldwide. Rhoptry protein 13 (ROP13) plays some roles in the invasion process of T. gondii. In this study, sequence variation in ROP13 gene among 14 T. gondii isolates from different geographical locations and hosts was examined. The ROP13 gene was amplified from individual isolates and sequenced. Results show that the length of the ROP13 sequences was 1203 bp. In total, there were 44 variable nucleotide positions in the ROP13 sequences, and sequence variations were 0.1 to 2.0% among the 14 examined T. gondii isolates, representing higher rate in transversion than in transition. Intra-specific nucleotide variations were mainly at the second codon positions. Phylogenetic analysis of the 14 examined T. gondii isolates indicate that the ROP13 sequence was not a suitable genetic marker to differentiate T. gondii isolates of different genotypes from different hosts and geographical regions. Low variation in ROP13 gene sequence may suggest that ROP13 gene could represent a good vaccine candidate against toxoplasmosis.Key words: Toxoplasma gondii, toxoplasmosis, rhpotry protein 13 (ROP13), sequence variation, phylogenetic analysis

Alisertib, an Aurora kinase A inhibitor, induces apoptosis and autophagy but inhibits epithelial to mesenchymal transition in human epithelial ovarian cancer cells.

Ovarian cancer is a leading killer of women, and no cure for advanced ovarian cancer is available. Alisertib (ALS), a selective Aurora kinase A (AURKA) inhibitor, has shown potent anticancer effects, and is under clinical investigation for the treatment of advanced solid tumor and hematologic malignancies. However, the role of ALS in the treatment of ovarian cancer remains unclear. This study investigated the effects of ALS on cell growth, apoptosis, autophagy, and epithelial to mesenchymal transition (EMT), and the underlying mechanisms in human epithelial ovarian cancer SKOV3 and OVCAR4 cells. Our docking study showed that ALS, MLN8054, and VX-680 preferentially bound to AURKA over AURKB via hydrogen bond formation, charge interaction, and π-π stacking. ALS had potent growth-inhibitory, proapoptotic, proautophagic, and EMT-inhibitory effects on SKOV3 and OVCAR4 cells. ALS arrested SKOV3 and OVCAR4 cells in G2/M phase and induced mitochondria-mediated apoptosis and autophagy in both SKOV3 and OVCAR4 cell lines in a concentration-dependent manner. ALS suppressed phosphatidylinositol 3-kinase/protein kinase B (Akt)/mammalian target of rapamycin (mTOR) and p38 mitogen-activated protein kinase pathways but activated 5\u27-AMP-dependent kinase, as indicated by their altered phosphorylation, contributing to the proautophagic activity of ALS. Modulation of autophagy altered basal and ALS-induced apoptosis in SKOV3 and OVCAR4 cells. Further, ALS suppressed the EMT-like phenotype in both cell lines by restoring the balance between E-cadherin and N-cadherin. ALS downregulated sirtuin 1 and pre-B cell colony enhancing factor (PBEF/visfatin) expression levels and inhibited phosphorylation of AURKA in both cell lines. These findings indicate that ALS blocks the cell cycle by G2/M phase arrest and promotes cellular apoptosis and autophagy, but inhibits EMT via phosphatidylinositol 3-kinase/Akt/mTOR-mediated and sirtuin 1-mediated pathways in human epithelial ovarian cancer cells. Further studies are warranted to validate the efficacy and safety of ALS in the treatment of ovarian cancer

Pretreatment CT texture features for prognostication in patient with Stage III Non-Small Cell Lung Cancer

Purpose: To determine whether CT texture features can yield prognostic information in addition to conventional prognostic factors in stage III non-small cell lung cancer (NSCLC).Methods: We conducted a retrospective review of 91 patients with stage III NSCLC treated with definitive chemoradiation. All patients received a four-dimensional (4D) CT simulation, where we utilized the average image (average-CT) and an expiratory image (T50-CT), and a diagnostic contrast enhanced CT image (CE-CT). A penalized cox regression model was used for covariate selection and model development. Models incorporating texture features from the 3 image types and clinical factors were compared to models incorporating clinical factors alone for overall survival (OS), local-regional control (LRC), and freedom from distant metastases (FFDM). Predictive Kaplan-Meier curves were generated using leave-one-out cross-validation. Stratification into low-risk and high-risk groups was based on a patient’s predicted outcome being greater or less than the median. Reproducibility of texture features was evaluated using test-retest scans from independent patients. The concordance correlation coefficient (CCC) was used to assess texture feature reproducibility and classification accuracy was used to assess reproducibility of texture features within the context of our models.         Results: Models incorporating both texture and clinical features demonstrated a significant improvement in stratification compared to models using clinical features alone in cross-validated Kaplan-Meier curves in terms of OS (p = 0.046), LRC (p = 0.01), and FFDM (p = 0.005). The average CCC was 0.89, 0.91, and 0.67 for texture features extracted from the average-CT, T50-CT, and CE-CT, respectively. Incorporating reproducibility uncertainties within our model yielded 80.4 (SD = 3.7), 78.3 (SD = 4.0), and 78.8 (SD = 3.9) percent classification accuracy for OS, LRC, and FFDM, respectively.    Conclusion: Pretreatment tumor texture may provide prognostic information in additional to routinely obtained clinical features. Reproducibility of CE-CT appears inferior to average-CT and T50-CT; however model classification accuracy rates of ~80% were still achieved.----------------------Cite this article as: Fried DV, Tucker SL, Zhou S, Liao ZX, Ibbott GS, Court LE.   Pretreatment CT texture features for prognostication in patient with Stage III Non-Small Cell Lung Cancer. Int J Cancer Ther Oncol 2014; 2(2):020223. DOI: 10.14319/ijcto.0202.2

Cellular and Hormonal Disruption of Fetal Testis Development in Sheep Reared on Pasture Treated with Sewage Sludge

The purpose of this study was to evaluate whether experimental exposure of pregnant sheep to a mixture of environmental chemicals added to pasture as sewage sludge (n = 9 treated animals) exerted effects on fetal testis development or function; application of sewage sludge was undertaken so as to maximize exposure of the ewes to its contents. Control ewes (n = 9) were reared on pasture treated with an equivalent amount of inorganic nitrogenous fertilizer. Treatment had no effect on body weight of ewes, but it reduced body weight by 12–15% in male (n = 12) and female (n = 8) fetuses on gestation day 110. In treated male fetuses (n = 11), testis weight was significantly reduced (32%), as were the numbers of Sertoli cells (34% reduction), Leydig cells (37% reduction), and gonocytes (44% reduction), compared with control fetuses (n = 8). Fetal blood levels of testosterone and inhibin A were also reduced (36% and 38%, respectively) in treated compared with control fetuses, whereas blood levels of luteinizing hormone and follicle-stimulating hormone were unchanged. Based on immunoexpression of anti-Müllerian hormone, cytochrome P450 side chain cleavage enzyme, and Leydig cell cytoplasmic volume, we conclude that the hormone changes in treated male fetuses probably result from the reduction in somatic cell numbers. This reduction could result from fetal growth restriction in male fetuses and/or from the lowered testosterone action; reduced immunoexpression of α-smooth muscle actin in peritubular cells and of androgen receptor in testes of treated animals supports the latter possibility. These findings indicate that exposure of the developing male sheep fetus to real-world mixtures of environmental chemicals can result in major attenuation of testicular development and hormonal function, which may have consequences in adulthood

Evidence for Anthropogenic Surface Loading as Trigger Mechanism of the 2008 Wenchuan Earthquake

Two and a half years prior to China's M7.9 Wenchuan earthquake of May 2008, at least 300 million metric tons of water accumulated with additional seasonal water level changes in the Minjiang River Valley at the eastern margin of the Longmen Shan. This article shows that static surface loading in the Zipingpu water reservoir induced Coulomb failure stresses on the nearby Beichuan thrust fault system at <17km depth. Triggering stresses exceeded levels of daily lunar and solar tides and perturbed a fault area measuring 416+/-96km^2. These stress perturbations, in turn, likely advanced the clock of the mainshock and directed the initial rupture propagation upward towards the reservoir on the "Coulomb-like" Beichuan fault with rate-and-state dependent frictional behavior. Static triggering perturbations produced up to 60 years (0.6%) of equivalent tectonic loading, and show strong correlations to the coseismic slip. Moreover, correlations between clock advancement and coseismic slip, observed during the mainshock beneath the reservoir, are strongest for a longer seismic cycle (10kyr) of M>7 earthquakes. Finally, the daily event rate of the micro-seismicity (M>0.5) correlates well with the static stress perturbations, indicating destabilization.Comment: 22 pages, 4 figures, 3 table

Androgen receptor phosphorylation at serine 515 by Cdk1 predicts biochemical relapse in prostate cancer patients

&lt;br&gt;Background:Prostate cancer cell growth is dependent upon androgen receptor (AR) activation, which is regulated by specific kinases. The aim of the current study is to establish if AR phosphorylation by Cdk1 or ERK1/2 is of prognostic significance.&lt;/br&gt; &lt;br&gt;Methods: Scansite 2.0 was utilised to predict which AR sites are phosphorylated by Cdk1 and ERK1/2. Immunohistochemistry for these sites was then performed on 90 hormone-naive prostate cancer specimens. The interaction between Cdk1/ERK1/2 and AR phosphorylation was investigated in vitro using LNCaP cells.&lt;/br&gt;&lt;br&gt;Results:Phosphorylation of AR at serine 515 (pAR(S515)) and PSA at diagnosis were independently associated with decreased time to biochemical relapse. Cdk1 and pCdk1(161), but not ERK1/2, correlated with pAR(S515). High expression of pAR(S515) in patients with a PSA at diagnosis of &#8804;20 ng ml(-1) was associated with shorter time to biochemical relapse (P=0.019). This translated into a reduction in disease-specific survival (10-year survival, 38.1% vs 100%, P&#60;0.001). In vitro studies demonstrated that treatment with Roscovitine (a Cdk inhibitor) caused a reduction in pCdk1(161) expression, pAR(S515)expression and cellular proliferation.&lt;/br&gt; &lt;br&gt;Conclusion: In prostate cancer patients with PSA at diagnosis of &#8804;20 ng ml(-1), phosphorylation of AR at serine 515 by Cdk1 may be an independent prognostic marker.&lt;/br&gt