Keywords: CHLE, chilblain lupus erythematosus; CTLA-4, cytotoxic T-lymphocyte–associated antigen 4; SCLE, subacute cutaneous lupus erythematosus; belatacept; chilblains systemic lupus erythematous; immunosuppression; kidney transplant.

The Oregon continental shelf is embedded within the northern California Current System, a wind-driven, eastern boundary system that includes the equatorward flowing California Current and the poleward flowing California Undercurrent. During spring and summer months, equatorward winds drive the upwelling of cold, nutrient-rich, and oxygen-poor waters from depth onto the shelf, fueling a highly productive marine ecosystem that supports several valuable commercial fisheries. This data article describes a time series of hydrographic data collected on a biweekly to monthly schedule from March 1997 to July 2021 along the Newport Hydrographic Line (NHL; 44.652°N, 124.1 - 124.65°W) located west of Newport, Oregon. The NHL, with its 2-4 week sampling rate and inclusion of biological data such as zooplankton net tows, is the only long-term, high-frequency dataset of its kind for the California Current and as such is crucial to understanding the connectivity between changes in ocean-climate and ecosystem structure and function. Data were collected using Sea-Bird Scientific conductivity, temperature, depth (CTD) profilers with associated dissolved oxygen sensors at seven stations located between 1.9 and 46.3 km from shore. Water depths for the seven stations range from 30 to 296 m. Data collected during each cruise were processed using Sea-Bird Scientific's Seasoft software package. These CTD station data were gridded to a 0.01° x 1 dbar longitude - pressure grid using linear interpolation to create cross-shelf hydrographic sections of temperature, practical salinity, potential density, spiciness, and dissolved oxygen. From the gridded section data, seasonal climatologies were calculated for each variable at each location in the longitude - pressure section using harmonic analysis with a three-harmonic fit to the gridded transect observations. The station data, gridded transect data and monthly climatologies for all five variables are available via Zenodo at https://doi.org/10.5281/zenodo.5814071.

Keywords: California current; Climatology; Dissolved oxygen; Oregon; Potential density; Practical salinity; Seawater temperature; Spiciness.

High-resolution computed micro-tomography is an important area of science, which correlates well with several experimental methodologies and serves as a basis for advanced computational physics studies, in which high-resolution images are used as input to different scientific simulation models. The dataset presented herein includes (raw) grayscale images obtained using the Bruker Skyscan 1272 X-Ray tomograph; filtered images acquired through contrast enhancement and noise reduction filters; and segmented images obtained by using the IsoData segmentation method. All images have a resolution of 2.25 µm (isometric voxels) and size of 1000³ voxels.

Keywords: Digital rock; MicroCT; Permeability; Porosity; Rock core.

Using a longitudinal field survey, we collected data on how implementing an activity-based work environment impacts employees across time [1]. The sample consisted of 100 employees in a government organization implementing an activity-based working environment, with each employee surveyed on three time-points. The sample included all employees affected by the implementation. At each time-point, the response rate was 87%, 75%, and 69%, respectively. The sample was approximately 75% female at each time-point. Data collection took place about two months before the activity-based environment was implemented (condition 1), again about four months after implementation (condition 2), and finally, about nine months after implementation (condition 3). All data were collected using an online survey. The survey included questions on privacy, psychological ownership, and attitude towards activity-based work, in addition to questions on productivity, job satisfaction, job strain, and satisfaction with the work environment.

Keywords: Activity-based working; Employee attitudes; Employee outcomes; Longitudinal.

Blood phenylalanine-to-tyrosine (Phe/Tyr) ratio is an important indicator of metabolic control in phenylketonuria patients. We present the data that highlights the role of Phe/Tyr-ratio in the evaluation of tetrahydrobiopterin (BH₄)-responsiveness in patients with hyperphenylalaninemia. Our data complements the results from the original research article by Tansek et al., 2012 [1]. We performed a BH₄-loading test in 32 patients after four days of increased protein intake (2000 mg/kg body weight). Blood sampling was performed 96, 72, 48, 24, 16 h, and moments before oral administration of BH₄ in a dose of 20 mg/kg body weight. Additional blood samples were collected 8 and 24 h after its administration. Phenylalanine (Phe) and Tyrosine (Tyr) levels were determined from dried blood spots by tandem mass spectrometry. Phe/Tyr-ratio reached a plateau after three days of increased dietary protein intake. Fifteen patients (47%) responded to BH₄, defined as a decrease of Phe-of at least 30% after 24 h of BH₄ administration. Phe/Tyr-ratios were significantly higher in non-responders compared to responders. In the responder group, Phe/Tyr-ratios decreased in average of 67% (p = 0.001) and 45% (p = 0.001) after 8 and 24 h of BH₄ administration, respectively. Phe/Tyr-ratio decreased after 8 h of drug administration also in the non-responder group, but not 24 h after administration.

Keywords: BH4, tetrahydrobiopterin; BH4-responsiveness; F, female; Hyperphenylalaninemia; M, male; MHP, mild hyperphenylalaninemia; NI, not included; NR, non-responder; Phe, phenylalanine; Phe/Tyr-ratio, phenylalanine-to-tyrosine ratio; Phenylalanine-to-tyrosine ratio; Phenylketonuria; R, responder; Tandem mass spectrometry; Tetrahydrobiopterin; Tyr, tyrosine; cPKU, classic phenylketonuria; mPKU, mild phenylketonuria.

Highly precise dose delivery to the target (tumor or cancerous tissue) is a key point when brain diseases are treated applying recent stereotactic techniques: intensity-modulated, image-guided radiotherapy, volumetric modulated arc therapy, Gamma knife radiosurgery. The doses in one single shot may vary between tens and hundreds of Gy and cause significant cell/tissue/organ damages. This indicates the need for implementation of quality assurance (QA) measures which are realized performing treatment dose verification with more than one calibrated quality assurance method or tool, especially when functional radiosurgery with a high dose (up to 40 Gy in our case) shall be delivered to the target using small 4 mm collimator. Application of two dosimetry methods: radiochromic film dosimetry using RTQA2 and EBT3 films and dose gel dosimetry using modified nPAG polymer gels for quality assurance purposes in stereotactic radiosurgery treatments using Leksell Gamma Knife© Icon™ facility is discussed in this paper. It is shown that due to their polymerization ability upon irradiation nPAG gels might be potentially used as a quality assurance tool in Gamma knife radiosurgery: they indicate well pronounced linear dose response in hypo-fractionated (up to 10 Gy) dose range and are sensitive enough to irradiation dose changes with a high (at least 0.2 mm) spatial resolution. Dose assessment sensitivity of gels depends on parameters of a dose evaluation method (optical or magnetic resonance imaging), however, is similar to this estimated using film dosimetry, which is set as a standard dosimetry method for dose verification in radiotherapy.

Keywords: Gamma knife; MRI; QA; dose verification; film dosimetry; functional stereotactic radiosurgery; gel dosimetry.

Wnt/β-catenin is believed to regulate different sets of genes with different coactivators, cAMP response element-binding protein (CREB)-binding protein (CBP) or p300. However, the factors that determine which coactivators act on a particular promoter remain elusive. ICG-001 is a specific inhibitor for β-catenin/CBP but not for β-catenin/p300. By taking advantage of the action of ICG-001, we sought to investigate regulatory mechanisms underlying β-catenin coactivator usage in human pancreatic carcinoma PANC-1 cells through combinatorial analysis of chromatin immunoprecipitation-sequencing and RNA-sequencing. CBP and p300 preferentially bound to regions with the TCF motif alone and with both the TCF and AP-1 motifs, respectively. ICG-001 increased β-catenin binding to regions with both the TCF and AP-1 motifs, flanking the genes induced by ICG-001, concomitant with the increments of the p300 and AP-1 component c-JUN binding. Taken together, AP-1 possibly coordinates β-catenin coactivator usage in PANC-1 cells. These results would further our understanding of the canonical Wnt/β-catenin signaling divergence.

Keywords: AP-1; Coactivator CREB-binding protein; Wnt; p300; β-catenin.

Purpose: Spatially fractionated radiation therapy (SFRT), which delivers highly nonuniform dose distributions instead of conventionally practiced homogeneous tumor dose, has shown high rates of clinical response with minimal toxicities in large-volume primary or metastatic malignancies. However, prospective multi-institutional clinical trials in SFRT are lacking, and SFRT techniques and dose parameters remain variable. Agreement on dose prescription, technical administration, and clinical and translational design parameters for SFRT trials is essential to enable broad participation and successful accrual to rigorously test the SFRT approach. We aimed to develop a consensus for the design of multi-institutional clinical trials in SFRT, tailored to specific primary tumor sites, to help facilitate development and enhance the feasibility of such trials.

Methods and materials: Primary tumor sites with sufficient pilot experience in SFRT were identified, and fundamental trial design questions were determined. For each tumor site, a comprehensive consensus effort was established through disease-specific expert panels. Clinical trial design criteria included eligibility, SFRT technology and technique, dose and fractionation, target- and normal-tissue dose parameters, systemic therapies, clinical trial endpoints, and translational science considerations. Iterative appropriateness rank voting, expert panel consensus reviews and discussions, and public comment posting were used for consensus development.

Results: Clinical trial criteria were developed for head and neck cancer and soft-tissue sarcoma. Final consensus among the 22 trial design categories each (a total of 163 criteria) was high to moderate overall. Uniform patient cohorts of advanced bulky disease, standardization of SFRT technologies and dosimetry and physics parameters, and collection of translational correlates were considered essential to trial design. Final guideline recommendations and the degree of agreement are presented and discussed.

Conclusions: This consensus provides design guidelines for the development of prospective multi-institutional clinical trials testing SFRT in advanced head and neck cancer and soft-tissue sarcoma through in-advance harmonization of the fundamental clinical trial design among SFRT experts, potential investigators, and the SFRT community.

Purpose: Gender inequity in medicine harms society, and often originates in the context of broader societal discrimination. This study explores the experiences of older women in the radiation oncology specialty in Japan and the United States, with an emphasis on understanding how broader gender inequity affects career trajectory. Radiation oncology is an ideal setting to investigate cross-cultural physician gender equity issues, because few women enter the field despite fewer barriers (eg, frequent emergencies, evening/weekend hours, long procedures) that are commonly cited by women as deterrents in specialty selection.

Methods and materials: Between 2012 and 2016, the authors interviewed 14 older women in radiation oncology (department chairs or full professors), with 6 from Japan and 8 from the United States. Multiple analysts identified themes to explore the impact of societal gender inequity on female radiation oncologists' careers.

Results: Five themes were identified: (1) childhood gender constructs affect career aspirations, (2) persistent sexism and gender-based workplace challenges affect women's careers, (3) gender inequity in the home affects women's careers, (4) non-gender-related factors intersect to affect women's career satisfaction, and (5) attaining gender equity appears to be even more challenging in Japan compared with the United States.

Conclusions: Female radiation oncologists in 2 of the most technologically advanced countries report that gender discrimination across their lifespans substantially affects career success. Because gender inequality reflects societal injustice and negatively affects scientific progress and patient outcomes, future research should focus on global approaches to address professional and domestic gender constructs that impede women's career progress.

Introduction: Birth asphyxia is a condition of impaired gas exchange in newborns when the Apgar score is < 7 in the first 5 min. It accounts 31.6% of all neonatal deaths, and the leading causes of neonatal mortality in Ethiopia. Identifying its determinant factors is very important to prevent the problem.Therefore, this study was aimed at identifying the determinant factors of birth asphyxia among newborns at Benishangul Gumuz region hospital.

Methods and materials: The hospital-based unmatched case-control study was done from March 04 to July 16, 2019 in Benishangul Gumuz Region Hospitals. Total sample size is 275 with 69 cases and 206 controls. Newborns with an Apgar score of less than 7 at 5 min were taken as cases, and those with greater or equal to 7 were taken as controls. All asphyxiated newborns were enrolled as cases, where as in every three-step non-asphyxiated newborns were taken as controls. The data was entered into Epi Info 7 and exported to SPSS for analysis. Bivariable logistic regression analysis was used. Those variables with a p-value <0.05 were identified as significant determinants of birth asphyxia.

Results: In the current study, anemia during pregnancy [AOR = 2.95, 95% CI: (1.02, 8.54)], no ANC visit at all [AOR = 4.26, 95% CI: (1.23,14.7)], prolapsed cord [AOR = 4.52, 95% CI: (1.3, 21)], and low birth weight [AOR = 4.1, 95% CI: (1.11, 15.36] were all determinant factors for birth asphyxia.

Conclusion: and Recommendations: The identified determinants of birth asphyxia were anemia during pregnancy, no ANC visit at all, prolapsed cord, cesarean birth, and low birth weight.Based on our study, most of identified determinant factors of birth asphyxia were preventable so, policy makers, clinicians, and other stakeholders need to invest their maximum effort on prevention of birth asphyxia.

Keywords: Birth asphyxia; Determinants; Ethiopia; Newborns.

Purpose: To report use of intraoperative optical coherence tomography (OCT) for nanothin Descemet stripping automated endothelial keratoplasty (DSAEK) in a patient with an extremely thickened cornea due to advanced bullous keratopathy.

Observations: A 90-year-old woman with a history of multiple trabeculectomies was referred to us for treatment of advanced bullous keratopathy (1400 μm central corneal thickness). Nanothin DSAEK was planned and performed. In brief, after the removal of the loose corneal epithelium, the anterior chamber was meticulously observed using a surgical microscope and oblique light via an endoillumination probe; however, the visibility of the anterior chamber was limited because of severe corneal edema. Subsequently, a nanothin (47 μm) DSAEK graft stained with trypan blue was inserted into the anterior chamber using an NS endoinserter. Intraoperative OCT was used successfully to visualize the graft unfolding, air tamponade, and graft attachment. At 3 months postoperatively, significant corneal clearing (625 μm central corneal thickness), improvement of visual acuity (decimal 0.04), and pain relief were obtained.

Conclusions and importance: Intraoperative OCT is useful for nanothin DSAEK even when the surgical microscope view is compromised by a remarkably thickened host cornea due to advanced bullous keratopathy. As an alternative to a penetrating keratoplasty, less invasive nanothin DSAEK was successfully performed.

Keywords: Descemet-stripping automated endothelial keratoplasty; Intraoperative optical coherence tomography; Nanothin.

Purpose: To describe an atypical case of necrotizing herpetic retinitis (NHR) that presented initially with mild anterior uveitis, optic disc swelling, and peripapillary serous retinal detachment (SRD).

Observations: A 48-year-old Asian Indian man presented with blurred central vision and pain in his left eye. Examination revealed mild anterior chamber inflammation, optic disc swelling, and a peripapillary SRD in the affected eye. Multimodal imaging, including widefield fluorescein angiography, showed optic disc leakage and confirmed the presence of a peripapillary SRD, but was otherwise unremarkable with no evidence of retinitis. The patient was diagnosed with presumed Vogt-Koyanagi-Harada disease and was treated with systemic corticosteroids. While there was objective visual improvement initially, the patient subsequently noted peripheral vision loss and was found to have peripheral necrotizing retinitis and occlusive retinal vasculitis in affected eye. Polymerase chain reaction-based testing of aqueous humor detected varicella zoster virus DNA, confirming the diagnosis of NHR.

Conclusion and importance: Optic disc edema and peripapillary SRD may precede the development of overt retinitis in some patients with NHR.

Keywords: Acute retina necrosis; Optic neuropathy; Papillitis.

Purpose: To report a very rare case of silicone oil (SO) migration and emphysema development in the orbit and periorbital tissue, including the lids and subconjunctival space, after a fourth pars plana vitrectomy (PPV) for retinal detachment (RD) treatment.

Observations: A 53-year-old woman with a recurrent rhegmatogenous RD in the right eye underwent a fourth PPV under local anesthesia and 23-gauge vitrectomy with fluid-air exchange and SO injection. Localized choroidal detachment occurred during fluid-air exchange near the end of the surgery. High-pressure infusion of air was used as a temporary control measure prior to SO injection. In the early postoperative period, the patient developed hemifacial and periorbital swelling and the air trapped in the upper lid was associated with lid ptosis and conjunctival chemosis. The emphysema resolved with clinical management, and the mechanical ptosis subsided after partial SO removal from the lid.

Conclusions and importance: The SO migration and emphysema in our case were presumably related to the multiple previous sclerotomies. Periorbital emphysema can show spontaneous resolution, but the migrated SO requires surgical management.

Keywords: Air-fluid exchange; Emphysema; Orbital; Pars plana vitrectomy; Periorbital; Retinal detachment; Silicone oil.

Brown syndrome is characterized by limited elevation of the eye in an adducted position, most often secondary to mechanical restriction of the superior oblique tendon/trochlea complex. It can be constant or intermittent/recurrent. We report on a 5 years-old boy who complained of seeing dark curtain and had strange head movements. He had similar symptoms 6 months prior. Examination revealed binocular vertical diplopia, multiplanar abnormal head position and limitation of the elevation of the right eye adduction only. Pain was elicited during attempt to elevate and adduct the right eye, with downshoot of right eye, and reflexive eyelid closure. The patient was diagnosed with intermittent idiopathic Brown syndrome. One day later, the patient was found to be asymptomatic, and had spontaneous resolution without any treatment. Literature on acquired Brown's syndrome in children is scarce. Very few have described the idiopathic intermittent or recurrent form. The acute, short and recurrent pattern of our patient's symptoms showed an atypical, non-classical presentation and course. The initial misleading symptoms presented a diagnostic challenge. These might be explained by the prominent acute inflammatory component upon presentation, and we suggest two theories that might explain such an atypical clinical course.

Keywords: Abnormal head position; Brown syndrome; Intermittent Brown; Recurrent Brown.

A 36-year-old man presented complaining of bilateral painless vision loss. He was admitted with chronic ethanol abuse, as well as sporadic cocaine consumption three days before symptom onset. General medical evaluation dismissed cerebral and cardiovascular events. Blood tests revealed folic acid deficiency. Visual acuity (VA) was count fingers in both eyes (OU). Fundoscopic findings included remarkable bitemporal peripapillary hemorrhages. A diagnosis of toxic-ischemic optic neuropathy was made. The hemorrhages resolved after three weeks, with VA recovering to 20/20 OU. The sequelae included bitemporal peripapillary retinal fiber loss on optical coherence tomography, and central scotomas observed on visual field tests. This is the first report of cocaine as a triggering agent for a classical presentation of toxic optic neuropathy and the presence of peripapillary hemorrhages in its initial stages.

Keywords: Drugs abuse; Nutritional deficiency; Peripapillary hemorrhages; Toxic optic neuropathy.

Aim: To investigate the clinical relevance of the radiotherapy (RT) dose bath in patients treated for lower grade glioma (LGG).

Methods: Patients (n = 17) treated with RT for LGG were assessed with neurocognitive function (NCF) tests and structural Magnetic Resonance Imaging (MRI) and categorized in subgroups based on tumour lateralisation. RT dose, volumetric results and cerebral microbleed (CMB) number were extracted for contralateral cerebrum, contralateral hippocampus, and cerebellum. The RT clinical target volume (CTV) was included in the analysis as a surrogate for focal tumour and other treatment effects. The relationships between RT dose, CTV, NCF and radiological outcome were analysed per subgroup.

Results: The subgroup with left-sided tumours (n = 10) performed significantly lower on verbal tests. The RT dose to the right cerebrum, as well as CTV, were related to poorer performance on tests for processing speed, attention, and visuospatial abilities, and more CMB.In the subgroup with right-sided tumours (n = 7), RT dose in the left cerebrum was related to lower verbal memory performance, (immediate and delayed recall, r = -0.821, p = 0.023 and r = -0.937, p = 0.002, respectively), and RT dose to the left hippocampus was related to hippocampal volume (r = -0.857, p = 0.014), without correlation between CTV and NCF.

Conclusion: By using a novel approach, we were able to investigate the clinical relevance of the RT dose bath in patients with LGG more specifically. We used combined MRI-derived and NCF outcome measures to assess radiation-induced brain damage, and observed potential RT effects on the left-sided brain resulting in lower verbal memory performance and hippocampus volume.

Keywords: CFT, Rey Complex Figure Test; CMB, Cerebral Microbleed; COWAT, Controlled Oral Word Association Test; CTV, Clinical Target Volume; Cerebral microbleeds; FLAIR, Fluid-Attenuated Inversion Recovery; FoV, Field-of-View; Glioma; IDH, Isocitrate DeHydrogenase; LGG, Lower Grade Glioma; MRI, Magnetic Resonance Imaging; NCF, Neurocognitive Function; NTCP, Normal Tissue Complication Prediction; Neurocognitive function; RAVLT-DR, Rey’s Auditory Verbal Learning Test – delayed recall; RAVLT-IR, Rey’s Auditory Verbal Learning Test – immediate recall; RIBD, Radiation-Induced Brain Damage; RT, Radiotherapy; Radiotherapy; SDMT, Symbol Digit Modalities Test; SWI, Susceptibility-Weighted Imaging; T, Tesla; TE, Echo Time; TI, Inversion Time; TMTA, Trail Making Test part A; TMTB, Trail Making Test part B; TMTBA, Trail Making Test part B divided by A; TR, Repetition Time; UMCG, University Medical Center Groningen; Verbal memory; Volumetry; WHO, World Health Organisation.

Background: T long-term effects of cognitive therapy and behavior therapy (CTBT) for menopausal symptoms are unknown, and whether the effects are different between natural menopause and treatment-induced menopause are currently unclear. Therefore, we sought to conduct an accurate estimate of the efficacy of CTBT for menopausal symptoms.

Methods: We conducted searches of Cochrane Library, EMBASE, PsycINFO, PubMed, and Web of Science databases for studies from 1 January 1977 to 1 November 2021. Randomized controlled trials (RCTs) comparing intervention groups to control groups for menopausal symptoms were included. Hedge's g was used as the standardized between-group effect size with a random-effects model.

Results: We included 14 RCTs comprising 1618 patients with a mean sample size of 116. CTBT significantly outperformed control groups in terms of reducing hot flushes [g = 0.39, 95% confidence interval (CI) 0.23-0.55, I2 = 45], night sweats, depression (g = 0.50, 95% CI 0.34-0.66, I2 = 51), anxiety (g = 0.38, 95% CI 0.23-0.54, I2 = 49), fatigue, and quality of life. Egger's test indicated no publication bias.

Conclusions: CTBT is an effective psychological treatment for menopausal symptoms, with predominantly small to moderate effects. The efficacy is sustained long-term, although it declines somewhat over time. The efficacy was stronger for natural menopause symptoms, such as vasomotor symptoms, than for treatment-induced menopause symptoms. These findings provide support for treatment guidelines recommending CTBT as a treatment option for menopausal symptoms.

Keywords: Anxiety; behavior therapy; cognitive therapy; depression; menopausal symptoms; meta-analysis.

Pooled testing has been widely adopted recently to facilitate large-scale community testing during the COVID-19 pandemic. This strategy allows to collect and screen multiple specimen samples in a single test, thus immensely saving the assay time and consumable expenses. Nevertheless, when the outcome of a pooled testing is positive, it necessitates repetitive retesting steps for each sample which can pose a serious challenge during a rising infection wave of increasing prevalence. In this work, we develop a unique barcoded primer-assisted sample-specific pooled testing strategy (Uni-Pool) where the key genetic sequences of the viral pathogen in a crude sample are extracted and amplified with concurrent tagging of sample-specific identifiers. This new process improves the existing pooled testing by eliminating the need for retesting and allowing the test results-positive or negative-for all samples in the pool to be revealed by multiplex melting curve analysis right after real-time polymerase chain reaction. It significantly reduces the total assay time for large-scale screening without compromising the specificity and detection sensitivity caused by the sample dilution of pooling. Our method was able to successfully differentiate five samples, positive and negative, in one pool with negligible cross-reactivity among the positive and negative samples. A pooling of 40 simulated samples containing severe acute respiratory syndrome coronavirus-2 pseudovirus of different loads (min: 10 copies/μL; max: 10³ copies/μL) spiked into artificial saliva was demonstrated in eight randomized pools. The outcome of five samples in one pool with a hypothetical infection prevalence of 15% in 40 samples was successfully tested and validated by a typical Dorman-based pooling.

Objectives: Rheumatoid arthritis (RA) is a common autoimmune disease. However, the positive diagnosis value of the current biomarkers is unsatisfactory. Here, we aimed to identify RA-associated susceptibility genes and explore their potential as novel biomarkers for the diagnosis of RA.

Methods: Peripheral blood mononuclear cells (PBMCs) were collected from healthy controls and RA patients. RNA-seq and bioinformatics analyses were performed to identify the hub genes associated with RA. Then, the expression of hub genes was assessed in mRNA expression profiles from GEO datasets. Real time-quantitative PCR (RT-qPCR) was performed to further confirm the expression of the hub genes using the PBMCs that were collected from RA patients (n=47) and healthy controls (n=40). Finally, we evaluated the diagnostic potential of the candidate mRNAs.

Results: RNA-seq analyses revealed 178 dysregulated genes measured by changes in mRNAs between the healthy controls and the RA patients. We identified 3 candidate mRNAs, including ASPM, DTL and RRM2, all of which were highly expressed in RA. RRM2 showed a significant higher expression in remissive RA compared with active RA. Significant correlations were observed between DTL and IL-8, TNF-α which were tested in serum by ELISA, between RRM2 and CDAI, DAS-28, tender and swollen joints, respectively. The expression level of RRM2 was significantly higher in RA patients with the Anti-CCP- than with the Anti-CCP+. The AUC (RA vs. OA) value of RRM2 was 0.941 (p<0.0001; sensitivity=0.867; specificity=0.904).

Conclusions: RRM2 showed high diagnosis efficiency for RA patients. Therefore, the findings provided a novel candidate biomarker for the diagnosis of RA.

Methotrexate (MTX) is used in the treatment of several childhood cancers and is a main component of the treatment regimen for osteosarcoma. MTX has been linked with side effects of varying severity; headaches, nausea, emesis, lethargy, blurred vision, aphasia, hemiparesis, paresis, convulsions, leukoencephalopathy, and arachnoiditis are symptoms of MTX toxicity. MTX-induced neurotoxicity can occur in up to 15% of patients receiving high-dose MTX. The effects may be transient but can have life-threatening implications, sometimes requiring intubation for respiratory support and airway protection. Elevated homocysteine levels in the cerebrospinal fluid are documented in cases of MTX-induced neurotoxicity; dextromethorphan is used as an initial treatment for MTX-induced neurotoxicity as it works as a noncompetitive antagonist for the N-methyl D-aspartate receptors and suppresses homocysteine activity. In severe cases requiring intubation, medications for sedation are utilized. Ketamine is also an N-methyl D-aspartate receptor antagonist, and as such, may be considered as an optimal treatment choice when sedation is required. We describe the use of ketamine in a pediatric patient with MTX-induced neurotoxicity. The use of ketamine in the treatment of MTX-induced neurotoxicity has not been described in the literature.

Adrenergic receptors (ARs) are the primary targets of catecholamines released from the sympathetic nerve endings during their activation. ARs play a central role in autonomic nervous system and serve as important targets of widely used drugs. Several ARs gene polymorphisms were found to be associated with cardiovascular disease in previous clinical studies. Although more precise mechanism of the polymorphisms influence on autonomic control of cardiovascular system was studied in many previous physiological studies, their results are not unequivocal. This paper reviews the results of clinical and physiological studies focused on the impact of selected common single nucleotide polymorphisms of ARs genes involved in sympathetic control on cardiovascular system and its control. In summary, many studies assessed only a very limited range of cardiovascular control related parameters providing only very limited view on the complex cardiovascular control. The overview of partially contradicting results underlines a need to examine wider range of cardiovascular measures including their reactivity under various stress conditions requiring further study. It is expected that an effect of one given polymorphism is not very prominent, but it is suggested that even subtle differences in cardiovascular control could - on a longer time scale - lead to the development of severe pathological consequences.

Introduction: Nonadherence to antihypertensive medications has been found increasingly prevalent in Thailand, yet the critical cultural resources of Islamic belief systems and family support are seldom mobilized to support adherence. Our study aimed to develop, implement, and evaluate an Islamic-based intervention program to promote medication adherence among Muslim older adults with uncontrolled hypertension in southern Thailand.

Method: An action research with codesign and family participation principles was utilized. Within action research cycles, interviews with Thai-Muslim older adults, family primary caregivers, and health care professionals were undertaken alongside participant observations.

Results: A qualitative audit demonstrated an improved medication adherence with all stakeholders expressing their desire to further engage and maintain the new intervention program.

Discussion: Engaging with Islamic doctrine and concepts of family participation could support an improvement in antihypertensive medication adherence for Muslim older adults. Codesigning enables recognition of community belief systems, forming an important step toward improving community-based medication adherence.

Keywords: Islamic doctrine; Thai-Muslim; action research; family participation; medication adherence; older adults.