Global, regional, and national time trends in myocarditis-related mortality, 1990-2019: An age-period-cohort analysis.

OBJECTIVE: The aim of this study was to analyze the tendency of myocarditis mortality in 204 countries and areas during the last three decades and its connection with age, epoch, and birth cohort. MATERIALS AND METHODS: The Global Burden of Disease 2019 Study acquired a cause-specific myocarditis mortality estimate. The net drift, as well as the influence caused by age, period, and birth cohort, were evaluated by the age-period-cohort model. Additionally, we analyzed the tendency in research intensity and international collaboration across countries using 3,983 myocarditis-related publications from four periods during 1990-2019. RESULTS: During the last three decades, 101 of 204 countries and areas experienced an increase (net drifts ≥0.0%) or stagnant declines (≥-0.5%) in the death rate. In particular, increasing death rate was generally discovered in most countries whose Socio-demographic indexes (SDIs) are high and middle-high, such as the United States [net drift=2.11% (95% CI 1.71-2.51)] and Italy [2.65% (1.24-4.08)]. Countries with a higher number of deaths were more active in this field of study, such as the United States (237 publications), China (120), and Italy (73). The United States and Italy, whose total link strengths were 209 and 135, respectively, were more active in international collaborative studies. CONCLUSIONS: Despite the global decrease in myocarditis death rate during the last three decades, negative period and cohort effects and elevated mortality were discovered in numerous countries, especially in those whose SDIs were high, and the age distribution of deaths shifted from adolescent to middle-aged and older populations. We also observed a decline in myocarditis research in some countries with increased mortality.

Arsenic accumulation in rice: Alternative irrigation regimes produce rice safe from arsenic contamination.

The natural occurrence of arsenic (As) in groundwater & soils and its bioaccumulation in rice grains is a major health concern worldwide. To combat the problem, best combination of irrigation management and suitable rice variety altering As content in grains must be ensured. With this aim, a field trial was conducted with two rice varieties and water management including alternate wetting and drying (AWD) and continuous flooding (CF) irrigation regimes with As contaminated groundwater (AsW) and temporarily stored groundwater (TSG) and river water for only CF (as control). Results revealed that As content in different portions of paddy plant was significantly different (P < 0.001) with irrigation practices and rice varieties. AWD irrigation with TSG accumulated lower As in rice grains compared with CF-AsW for both varieties. Data showed that AWD-TSG practice led to 61.37% and 60.34% grain As reduction for BRRI dhan28 and BRRI dhan29, respectively, compared with CF-AsW. For Principle Component Analysis (PCA), first principle component (PC1) explained 91.7% of the variability and irrigation water As, soil total and available As, straw As, root As and husk As were the dominating parameters. With significant (P < 0.05) variation in yields between the genotypes, AWD increased grain yield by 29.25% in BRRI dhan29 Compared with CF. However, translocation factor (TF) and bioconcentration factor (BCF) for both varieties were less than one for all the treatments. The addition of this study to our knowledge base is that, AWD-TSG with BRRI dhan29 can be an As-safe practice without compromising yields.

HBP1 deficiency protects against stress-induced premature senescence of nucleus pulposus.

OBJECTIVE: Senescence of nucleus pulposus (NP) cells is involved in the pathological process of intervertebral disc degeneration (IVDD). HMG-box transcription factor 1 (HBP1) is a transcriptional inhibitor that prevents proliferation and regulates premature senescence of cells. The aim of this study was to confirm whether HBP1 deficiency could protect stress-induced NP cells premature senescence. PATIENTS AND METHODS: Firstly, HBP1 protein level in human degenerated intervertebral disc tissues was detected. Then, NP cells were isolated from disc samples and transfected with plasmid to upregulate HBP1expression. H2O2 and interleukin-1b (IL-1b) were used to induce NP cells premature senescence in a different manner. Thereafter, cell viability, proliferation, and apoptosis were measured, and the protein expressions of collagen II, HBP1, and p16, were determined by Western blot or immunofluorescence. Finally, the mRNA levels of aggrecan, collagen I, IL-6, Transforming Growth Factor-α (TNF-α), and matrix metalloproteinase-3 (MMP-3) were determined by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). RESULTS: The data indicated that HBP1 was upregulated in degenerated NP tissues. HBP1 gene overexpression increased p16 expression, affected NP cell proliferation, and caused cell apoptosis. In addition, HBP1 also decreased the collagen II and aggrecan expressions but increased collagen I, IL-6, TNF-α, and MMP-3 levels. Moreover, the silencing of HBP1 markedly reversed the H2O2 and IL-1b induced NP cell senescence by reducing p16 expression, apoptotic cell population, and inflammatory response and by promoting cell proliferation. CONCLUSIONS: In summary, HBP1 accumulation contributes to the senescence of NP cells, and HBP1 deficiency protects stress-induced NP cells premature senescence.

Deep learning radiomic nomogram can predict the number of lymph node metastasis in locally advanced gastric cancer: an international multicenter study.

BACKGROUND: Preoperative evaluation of the number of lymph node metastasis (LNM) is the basis of individual treatment of locally advanced gastric cancer (LAGC). However, the routinely used preoperative determination method is not accurate enough. PATIENTS AND METHODS: We enrolled 730 LAGC patients from five centers in China and one center in Italy, and divided them into one primary cohort, three external validation cohorts, and one international validation cohort. A deep learning radiomic nomogram (DLRN) was built based on the images from multiphase computed tomography (CT) for preoperatively determining the number of LNM in LAGC. We comprehensively tested the DLRN and compared it with three state-of-the-art methods. Moreover, we investigated the value of the DLRN in survival analysis. RESULTS: The DLRN showed good discrimination of the number of LNM on all cohorts [overall C-indexes (95% confidence interval): 0.821 (0.785-0.858) in the primary cohort, 0.797 (0.771-0.823) in the external validation cohorts, and 0.822 (0.756-0.887) in the international validation cohort]. The nomogram performed significantly better than the routinely used clinical N stages, tumor size, and clinical model (P < 0.05). Besides, DLRN was significantly associated with the overall survival of LAGC patients (n = 271). CONCLUSION: A deep learning-based radiomic nomogram had good predictive value for LNM in LAGC. In staging-oriented treatment of gastric cancer, this preoperative nomogram could provide baseline information for individual treatment of LAGC.

LncRNA LET function as a tumor suppressor in breast cancer development.

OBJECTIVE: To evaluate the effect of long-chain non-coding RNA LET (lncRNA LET) on the regulatory of human breast cancer and its underlying mechanism. PATIENTS AND METHODS: The expression levels of lncRNA LET in breast cancer tissues, MDA-MB-231 cells and MCF-10A breast epithelial cells were detected by quantitative Real-Time Polymerase Chain Reaction (qRT-PCR). The proliferation of lncRNA LET was detected by MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide). Cell apoptosis was examined via flow cytometry. The invasion and migration of cells were detected by transwell and scratch assay. RESULTS: The expression of lncRNA LET was reduced in breast cancer tissues and MDA-MB-231 cells. Overexpression of lncRNA LET resulted in the inhibition of cell proliferation, invasion and migration ability, and promotion of cell apoptosis (p<0.05). Up-regulation of lncRNA LET repressed epithelial mesenchymal transition (EMT) process. CONCLUSIONS: LncRNA LET is a new type of molecule involved in the development of breast cancer, which may become a potential target for the treatment of breast cancer.

The interaction between smoking and CYP1A1 MspI polymorphism on lung cancer: a meta-analysis in the Chinese population.

Many studies have examined the interaction between CYP1A1 MspI gene polymorphism and smoking for the risk of lung cancer risk in Chinese, but their results have been inconsistent. Therefore, a meta-analysis was performed to ascertain this issue. PubMed, Springer Link, Ovid and other Chinese databases were searched to include all the relevant studies. Smoking status was categorised as 'smokers' and 'non-smokers.' The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using fixed or random effect model. Subgroup analyses according to ethnicity, source of control and geographical location were also conducted. This meta-analysis identified 13 studies containing 2248 lung cases and 3079 controls. Overall, a significant association between lung cancer and the variants of CYP1A1 MspI was found among smokers (type B and type C combined vs. type A: OR = 1.89, 95% CI = 1.15-3.11, P = 0.000 for heterogeneity), whereas not found among non-smokers. Similar to the overall results, stratified analyses showed that the increased risk of lung cancer was observed in population-based studies and north China among smokers (OR = 1.65, 95%CI = 1.03-2.66; OR = 2.00, 95% CI = 1.14-3.53). Our meta-analysis showed that there was an interaction between the CYP1A1 MspI and smoking on the risk of lung cancer in the Chinese population.

Combined body mass index with high-sensitivity C-reactive protein as independent predictors for chronic kidney disease in a relatively healthy population in Taiwan.

BACKGROUND/OBJECTIVES: Obesity, a chronic inflammatory state, increases risk of cardiovascular disease and insulin resistance, which are the leading cause of end-stage renal disease (ESRD). We evaluated the relationship between body mass index (BMI) and high-sensitivity C-reactive protein (hsCRP) level and impaired kidney function to determine the predictive value of both markers for estimating chronic kidney disease (CKD) risk in a healthy adult population in Taiwan. SUBJECTS/METHODS: In a retrospective cross-sectional study of 4100 subjects ⩾18 years, a multivariate logistic regression model was used to assess the relationship among BMI, high hsCRP levels and CKD. Receiver-operating characteristic curve and Youden index were developed to define the discrimination power of combining BMI with hsCRP for CKD prediction and to determine the best predictive index. RESULTS: Overweight/obese subjects with high hsCRP levels had the highest odds ratio for CKD (P=0.048). In females, combining BMI with hsCRP for CKD prediction was superior to that of males (0.890 vs 0.623, respectively; both P<0.001). For females, the Youden index was 25.65 kg/m(2) for BMI and 1.04 µg/ml for hsCRP. CONCLUSIONS: Overweight/obesity with higher hsCRP levels is associated with reduced renal function and increased risk for CKD. BMI and hsCRP levels can be used as surrogate markers for CKD risk, especially for females.

Effects of silicon on seed setting rate of rice intersubspecific hybrids.

The present study found semi-sterility in rice intersubspecific hybrids of 'Taichung 65' x 'Guangluai 4' and 'Ludao' x 'Qiuguang'. Embryo sac fertility was evaluated using the overall staining transparent method. The results showed that the embryo sac contained a normal egg cell, normal synergid cells, polar nuclei cells, and antipodal cells, indicating that semi-sterility was caused mainly by pollen semi-sterility. In the pot experiment, the effects of silicon on the seed-setting rate of the two intersubspecific hybrids were examined. The results showed that the rate of anther dehiscence, number of pollen per stigma of Fl plants, potential of pollen grain germination, and fertility of the spikelet were significantly improved by the utilization of silicon fertilizer.

Impact of body composition on estimated glomerular filtration rate in relatively healthy adults in Taiwan.

BACKGROUND/OBJECTIVES: Chronic kidney diseases are associated with changes in cardiometabolic risk (CMR) factors in which body composition parameters have been used as sensitive predictors. This study aimed to explore the associations of anthropometric indicators, body fat (BF), body mass index (BMI) and waist circumference (WC) with estimated glomerular filtration rate (eGFR) in an adult healthy Chinese population. SUBJECTS/METHODS: A cross-sectional study was conducted for the subjects undergoing annual health examinations. The associations of subjects with body composition parameters were analyzed using the cutoff values of BMI, BF and WC in accordance with the criteria for Asian or Taiwanese population by gender. RESULTS: A total of 3473 subjects, aged 30-45 years, who received physical examinations in 2007 were analyzed. The levels of CMR factors were significantly higher in males than in females. eGFR was negatively associated with BMI but positively related to BF. The additional roles of BMI and WC were observed in the subjects who were categorized according to BF. Females with normal weight obese were associated with increased eGFR, whereas a higher eGFR was found in males with low/normal BF and BMI or normal WC. CONCLUSIONS: Our data provided evidence that anthropometric parameters were associated with changes of eGFR in relatively healthy adults. Higher eGFR was observed in females with normal weight obese in whom hyperfiltration may be suspected, and this finding deserves further studies.

Association between waist-to-height ratio and chronic kidney disease in the Taiwanese population.

BACKGROUND: Obesity, metabolic syndrome (MS) and chronic kidney disease (CKD) are all becoming increasingly prevalent worldwide. Body mass index (BMI) has traditionally been employed to identify overweight or obese individuals, yet multiple studies have yielded conflicting results when BMI was used to evaluate the association between obesity and CKD. AIMS: The purpose of this large, population-based, multicentre study was to evaluate the associations of BMI and waist-to-height ratio (WHtR) with CKD. METHODS: A retrospective study of 41,600 subjects who had physical examinations from January 2010 to December 2011 was performed. Data such as life style and habits were collected by interviews, and systolic and diastolic blood pressure (SBP and DBP), height, body weight, waist circumference, total cholesterol (TC), high-density lipoproteins (HDL), triglycerides (TG), fasting blood glucose and creatinine levels were measured. The association of these factors with CKD was analysed by use of SPSS 15.0 software. RESULTS: The key findings of this study were that WHtR but not BMI was an independent predictor of CKD. Additionally, SBP was a predictor of CKD in males and females, and TG and TC were independent predictors of CKD in females. Such measures are components of MS, which may also be associated with the development of CKD. CONCLUSION: WHtR appears to be a better measure of central obesity than BMI, and is an easy-to-use, noninvasive tool for identifying individuals at risk of developing obesity-related CKD, and potentially also MS-related CKD.

Age and gender differences in the relationship between hepatitis C infection and all stages of Chronic kidney disease.

Chronic kidney disease (CKD) is a worldwide health issue with heavy economic burden. Chronic hepatitis C virus (HCV) infection is a common cause of CKD, which can significantly impact the progression and mortality among patients with CKD. The prevalence of both illnesses is high in Taiwan. A multicentre and population-based cross-sectional study including 24 642 subjects was conducted to explore the association of HCV infection with the prevalence and severity of CKD. The measurements of metabolic parameters, eGFR and CKD stages were compared between subjects with HCV seropositivity and seronegativity. The analyses of association between HCV infection with CKD stages and evaluation of potential risk factors of CKD were performed by gender and age (≤ and >45 years). HCV-seropositive subjects accounted for 6.9% and had a significantly older age. The prevalence of CKD increased in those with HCV seropositivity (16.5%). Significantly higher prevalence of CKD stages ≥3 in HCV-seropositive subjects was noticed (7.8%). Age (>45 year), male gender, alcohol drinking, hypertension, creatinine and HCV infection were the significant factors associated with the presence of CKD. HCV seropositivity was an independent risk factor of developing CKD and associated with an increased risk of having CKD of all stages. The higher prevalence of earlier stage of CKD warrants longitudinal studies with frequent testing on renal function and sufficient duration to determine the changes of eGFR over time. Implementation of effective treatment intervention is also required for these subjects to prevent the progression of CKD to late stages.

Percutaneous transhepatic cholangiobiopsy to determine the pathological cause of anastomotic stenosis after cholangiojejunostomy for malignant obstructive jaundice.

AIM: To investigate the feasibility and advantages of cholangiobiopsy during percutaneous transhepatic cholangiography in the histopathological diagnosis of anastomotic stenosis after cholangiojejunostomy for malignant obstructive jaundice. MATERIALS AND METHODS: Using biopsy forceps, specimens were collected from the site of stenosis in patients with recurrent jaundice (n = 24) who had previously undergone cholangiojejunostomy for malignant obstructive jaundice. RESULTS: Stenosis occurred in all patients at the biliary-enteric anastomosis based on percutaneous transhepatic cholangiography, and was the location of the biopsy. Satisfactory specimens were obtained from 22 out of 24 patients. The sensitivity was 91.7% (22/24). Tumour tissue was obtained in 18 cases, confirming disease recurrence. Histopathological changes in four patients were diagnosed as fibroplasia and/or inflammation. These were considered cicatricial stenoses based on histopathological, imaging, and laboratory findings. The remaining two histopathology-negative patients were proven to have recurrent tumour based on imaging, laboratory, and follow-up data. No complications occurred during biopsy, including gastrointestinal haemorrhage or perforation. Either cholangial drainage and/or an inner stent was used following biopsy, which resulted in a noticeable decrease in jaundice postoperatively (p < 0.05). CONCLUSION: Percutaneous transhepatic cholangiobiopsy using biopsy forceps for the diagnosis of anastomotic stenosis after cholangiojejunostomy for malignant biliary obstructive jaundice is easy to perform and safe, with a high level of sensitivity. Interventional therapies, such as percutaneous transhepatic cholangial drainage and stent placement, can be performed concurrently, markedly improving the symptoms of patients with obstructive jaundice.

Efficacy of alcohols and alcohol-based hand disinfectants against human enterovirus 71.

BACKGROUND: Human enterovirus 71 (HEV71) infections are a significant public health threat in the Asia-Pacific region and occasionally cause severe neurological complications and even death in children. Although good hand hygiene is important for controlling infection, relevant data regarding the efficacy of widely used hand disinfectants against HEV71 are still lacking. AIM: To investigate the virucidal activity of alcohols and alcohol-based hand disinfectants against HEV71. METHODS: A common alcohol-based hand disinfectant (0.5% chlorhexidine gluconate + 70% isopropanol) as well as different concentrations of isopropanol and ethanol were tested for virucidal activity against HEV71 using the suspension and the fingerpad tests. FINDINGS: In suspension tests, 85% and 95% ethanol achieved a mean log10 reduction factor in HEV71 titre of >3 and nearly 6, respectively, within 10 min. By contrast, 70% and 75% ethanol and any concentration of isopropanol (70-95%) produced a factor of <1 in this test after the same exposure time. In fingerpad tests, only 95% ethanol showed a mean log10 reduction factor of >4, while both 75% ethanol and a chlorhexidine gluconate-containing formula were ineffective against HEV71 with a mean log10 reduction factor of <1 after a 30 s exposure time. CONCLUSIONS: Widely used alcohol-based hand disinfectants based on 70% ethanol or isopropanol have poor effectiveness against HEV71. Ninety-five percent ethanol is the most effective concentration, but still cannot fully inactivate HEV71 and may be impractical for use in many instances. Hand hygiene with alcohol-based hand disinfectants alone is not recommended for preventing HEV71 transmission.

Psoriasis as initiator or amplifier of the systemic inflammatory march: impact on development of severe vascular events and implications for treatment strategy.

BACKGROUND: Psoriasis is a systemic disease associated with metabolic disorders and vascular complications. Both psoriasis and metabolic disorders are associated with systemic inflammation. We hypothesized that the sequence of events between the onset of psoriasis and metabolic disorder may affect the risk for subsequent development of vascular complications. METHODS: Nested case-control study was performed using the Taiwan National Health Insurance database. Accordingly, a total of 8180 psoriatic patients and 163,600 controls were included. Psoriasis was considered as the initiator of inflammatory march if metabolic disorder, including hypertension, diabetes mellitus and dyslipidemia, developed after onset of psoriasis. In patients with pre-existing metabolic disorder, psoriasis was considered as the amplifier of inflammatory march. RESULTS: In patients whose psoriasis served as the disease initiator, a lower risk for developing vascular disease (HR = 1.49; 95% CI = 1.11-2.00 and HR = 1.64; 95% CI = 1.31-2.05 for cerebrovascular and cardiovascular events, respectively) was found compared with patients whose psoriasis served as the disease amplifier (HR = 2.26; 95% CI = 1.72-2.97 and HR = 2.78; 95% CI = 2.26-3.42 for cerebrovascular and cardiovascular events, respectively) after adjusting for age and gender. In terms of treatment implications, methotrexate was associated with reduced risk for developing cerebrovascular event (HR = 0.22; 95% CI = 0.05-0.88) only in patients with psoriasis serving as the disease amplifier. CONCLUSIONS: Our results suggested that two scenarios of systemic inflammatory marches are present among psoriatic patients with metabolic disorder and judicious use of methotrexate may reduce the risk of cerebrovascular event, especially when psoriasis served as the disease amplifier of the systemic inflammatory march.

Mafa expression enhances glucose-responsive insulin secretion in neonatal rat beta cells.

AIM/HYPOTHESIS: Neonatal beta cells lack glucose-stimulated insulin secretion and are thus functionally immature. We hypothesised that this lack of glucose responsiveness results from a generalised low expression of genes characteristic of mature functional beta cells. Important glucose-responsive transcription factors, Mafa and Pdx1, regulate genes involved in insulin synthesis and secretion, and have been implicated in late beta cell development. The aim of this study was to assess whether Mafa and/or Pdx1 regulates the postnatal functional maturation of beta cells. METHODS: By quantitative PCR we evaluated expression of these and other beta cell genes over the first month compared with adult. After infection with adenovirus expressing MAFA, Pdx1 or green fluorescent protein (Gfp), P2 rat islets were evaluated by RT-PCR and insulin secretion with static incubation and reverse haemolytic plaque assay (RHPA). RESULTS: At P2 most beta cell genes were expressed at about 10% of adult, but by P7 Pdx1 and Neurod1 no longer differ from adult; by contrast, Mafa expression remained significantly lower than adult through P21. Overexpression of Pdx1 increased Mafa, Neurod1, glucokinase (Gck) mRNA and insulin content but failed to enhance glucose responsiveness. Similar overexpression of MAFA resulted in increased Neurod1, Nkx6-1, Gck and Glp1r mRNAs and no change in insulin content but, importantly, acquisition of glucose-responsive insulin secretion. Both the percentage of secreting beta cells and the amount of insulin secreted per beta cell increased, approaching that of adult beta cells. CONCLUSIONS/INTERPRETATION: In the process of functional maturation acquiring glucose-responsive insulin secretion, neonatal beta cells undergo a coordinated gene expression programme in which Mafa plays a crucial role.

OVO homologue-like 1 (Ovol1) transcription factor: a novel target of neurogenin-3 in rodent pancreas.

AIMS/HYPOTHESIS: The basic helix-loop-helix transcription factor neurogenin-3 (NGN3) commits the fates of pancreatic progenitors to endocrine cell types, but knowledge of the mechanisms regulating the choice between proliferation and differentiation of these progenitors is limited. METHODS: Using a chromatin immunoprecipitation cloning approach, we searched for direct targets of NGN3 and identified a zinc-finger transcription factor, OVO homologue-like 1 (OVOL1). Transactivation experiments were carried out to elucidate the functional role of NGN3 in Ovol1 gene expression. Embryonic and adult rodents pancreases were immunostained for OVOL1, Ki67 and NGN3. RESULTS: We showed that NGN3 negatively regulates transcription of Ovol1 in an E-box-dependent fashion. The presence of either NGN3 or NEUROD1, but not MYOD, reduced endogenous Ovol1 mRNA. OVOL1 was detected in pancreatic tissue around embryonic day 15.5, after which OVOL1 levels dramatically increased. In embryonic pancreas, OVOL1 protein levels were low in NGN3(+) or Ki67(+) cells, but high in quiescent differentiated cells. OVOL1 presence was maintained in adult pancreas, where it was detected in islets, pancreatic ducts and some acinar cells. Additionally OVOL1 presence was lacking in proliferating ductules in regenerating pancreas and induced in cells as they began to acquire their differentiated phenotype. CONCLUSIONS/INTERPRETATION: The timing of OVOL1 appearance in pancreas and its increased levels in differentiated cells suggest that OVOL1 promotes the transition of cells from a proliferating, less-differentiated state to a quiescent more-differentiated state. We conclude that OVOL1, a downstream target of NGN3, may play an important role in regulating the balance between proliferation and differentiation of pancreatic cells.

Use of oseltamivir during an outbreak of influenza A in a long-term care facility in Taiwan.

We studied the effectiveness of oseltamivir during an outbreak of influenza A among previously vaccinated patients and staff in a long-term care facility. Seven of 14 staff members and 14 of 41 residents developed either influenza-like illness (ILI) or other respiratory symptoms during a 14-day period from late January to 8 February 2004. On 9 February, therapeutic oseltamivir (75 mg twice daily for five days) was administered to one staff member and seven residents who had developed ILI within the previous 48 h (treatment group). Prophylactic oseltamivir (75 mg once daily for seven days) was administered to 12 staff members and 30 residents who were asymptomatic or whose respiratory symptoms did not meet the diagnosis of ILI (prophylaxis group). The remaining four residents and one staff member had had ILI for more than two days (with subsiding symptoms) and did not receive oseltamivir ('no-oseltamivir' group). None of the 42 subjects in the prophylaxis group developed ILI. Presence of influenza A virus was demonstrated in 24 subjects: seven out of eight in the treatment group, 12 of 42 in the prophylaxis group and all five in the no-oseltamivir group. For confirmation of diagnosis, real-time reverse transcription-polymerase chain reaction was more sensitive than antigen detection and virus isolation. In-time therapeutic and prophylactic oseltamivir successfully interrupted an outbreak of influenza A in a long-term care facility.

Origin of excitatory drive to a spinal locomotor network.

A long-standing hypotheses is that locomotion is turned on by descending excitatory synaptic drive. In young frog tadpoles, we show that prolonged swimming in response to a brief stimulus can be generated by a small region of caudal hindbrain and rostral spinal cord. Whole-cell patch recordings in this region identify hindbrain neurons that excite spinal neurons to drive swimming. Some of these hindbrain reticulospinal neurons excite each other. We consider how feedback excitation within the hindbrain may provide a mechanism to drive spinal locomotor networks.