[Sjögren's syndrome combined with cold agglutinin disease: A case report].

Sjögren's syndrome(SS)is a chronic autoimmune disease that affects exocrine glands, especially salivary and lacrimal glands. The main clinical manifestations are dry mouth and dry eyes, but also multi-organ and multi-system can be involved. Cold agglutinin disease(CAD)is an autoimmune disease characterized by red blood cell agglutination in the blood vessels of extremities caused by cold agglutinin at low temperature, resulting in skin microcirculation disturbance, or hemolytic anemia. Cold agglutinin disease is divided into two categories, primary cold agglutinin disease and secondary cold agglutinin disease. Primary cold agglutinin disease is characterized with cold agglutinin titer of 1 ∶4 000 or more and positive Coomb's test. However, the Coomb's test is not necessarily positive and the cold agglutinin titer is between 1 ∶32 and 1 ∶4 000 in secondary cold agglutinin disease. Here, we reported an elderly patient admitted to hospital due to fever. He was diagnosed with respiratory infection, but he showed incompletely response to the anti-infection treatment. Further laboratory tests showed the patient with positive ANA and anti-SSA antibodies. Additionally, the patient complained that he had dry mouth and dry eyes for 1 year. Schirmer test and salivate gland imaging finally confirmed the diagnosis Sjogren's syndrome. During the hospital stay, the blood clots were found in the anticoagulant tubes. Hemolytic anemia was considered as the patient had anemia with elevated reticulocytes and indirect bilirubin. In addition, further examination showed positive cold agglutination test with a titer of 1 ∶1 024, and cold agglutinin disease was an important type of cold-resistant autoimmune hemolytic anemia. Furthermore, the patient developed cyanosis after ice incubating at the tip of the nose. Hence, the patient was diagnosed as CAD and he was successfully treated with glucocorticoids instead of anti-infection treatments. Hence, the patient was diagnosed with SS combined with secondary CAD. SS combined CAD are rarely reported, and they are both autoimmune diseases. The abnormal function of B lymphocytes and the production of autoantibodies might be the common pathogenesis of them. Cold agglutinin disease can lead to severe hemolytic anemia, even life-threatening. In clinical practice, timely recognizing and dealing with CAD might promote the prognosis of the patient.

Commodity dynamism in the COVID-19 crisis: Are gold, oil, and stock commodity prices, symmetrical?

The current research intends to examine the commodities' dynamism connection with stock prices under the COVID-19 crisis. DCC-GARCH modeling was applied to the data of Asian economies, including China, India, Sri Lanka, Bangladesh, and Pakistan to achieve the study objectives. The study's results indicated a significant connection between gold prices with stock prices and oil prices for all Asian stock markets. The results of the study constructs were symmetrical. In general, the connection grows with the frequency. The lowest frequency months contributed the most to the total relationship, followed by more than 12 months. Overall, gold and oil prices influence the Asian stock markets. These research findings can avoid contagion in times of economic uncertainty. This study also suggested policy implications for better decision-making of key stakeholders. Dynamic coefficient values were about 0.8 of ß2 because nations' internal markets were more closely linked. There are also dynamic relationship factors between crude oil and foreign currency markets, where the correlations in India and China have always been around 0.

The Impact of Frailty on the Outcomes of Hemodialysis Vascular Access.

BACKGROUND: Frailty has been associated with mortality and adverse cardiovascular outcomes in patients with hemodialysis (HD), however the relevance of frailty on the outcomes of HD vascular access remains unclear. METHODS: We enrolled a cohort of patients with prevalent HD between August 2018 and November 2018. The presence of 5 frailty phenotypes was determined at enrollment, using the modified Fried's criteria. Data regarding vascular access events or mortality were linked to prospectively collected data up to 24 months after enrollment. RESULTS: Of the 382 patients screened, 313 were recruited in the final analysis. The participants' mean age was 66 years, and 42.5% were female. Among all participants, 40.3% were determined to be frail and 29.4% pre-frail. The frail phenotype was associated with age, female gender, lower body mass index, unemployment, lower education level, and higher dialysis clearance. During the follow-up period (median, 24 months), 112 patients had vascular access events (non-frail, 27.4%; pre-frail, 35.9%; frail, 46.1%; p = 0.003) and 45 patients experienced thrombosis of the vascular access (non-frail, 4.2%; pre-frail, 9.8%; frail, 18.3%; p = 0.002). Cox regression analysis showed that frail patients had a 2.2-fold higher risk of experiencing vascular access events than non-frail patients [hazard ratio (HR): 2.205, 95% confidence interval (CI): 1.377-3.532, p = 0.001], but the association was not significant (HR: 1.634, 95% CI: 0.938-2.848, p = 0.082) after multivariate adjustment. CONCLUSIONS: The frail phenotype is common in Taiwanese patients who undergo maintenance HD and is associated with adverse outcomes of dialysis vascular access.

Investigating the Relationship between Media Usage, Depression, and Quality of Life among Older Adults.

BACKGROUND: The uses and gratifications theory suggests that various types of media can greatly affect people's lives. This is especially true among older adults who tend to use media for leisure. However, there is insufficient research regarding the relationship between media usage, depression, and quality of life among older adults. PURPOSE: The purpose of this study was to explore the association between media usage (traditional and internet media), depression, and quality of life among older adults. METHODS: Using a cross-sectional design, this study recruited individuals aged 65 years and older in central Taiwan and collected data via a structured questionnaire. Contents of the questionnaire included demographic details, a media usage behavior questionnaire, the Brief Symptoms Rating Scale (BSRS-5), and the Quality of Life Scale developed by the World Health Organization (WHOQOL-BREF). Subsequently, multiple regression analyses were conducted to investigate the association between media usage, depression, and quality of life of older adults. RESULTS: The average age of the 252 participants (107 males) was 70.0 ± 5.4 years. Regression analysis revealed a significant, negative relationship between the number of hours spent watching television and the degree of depression. Additionally, the number of hours spent watching television was significantly negatively related to the quality of life in terms of both the psychological health and social relationships categories. In contrast, the number of hours spent reading newspapers and magazines was significantly positively related to quality of life in the categories of psychological health, social relationships, and environment. Finally, the number of hours spent browsing internet media was significantly positively related to the quality of life in the psychological health category. CONCLUSION: Media usage may affect the degree of depression and quality of life of older adults depending on the type of media and amount of usage.

Photomask-Free, Direct Selective Electroless Deposition on Glass by Controlling Surface Hydrophilicity.

This paper reports a new approach to realize direct selective electroless deposition (ELD) without the requirement of photolithography. This method involves sequential silane-compound modifications in which the first modification creates a hydrophobic surface on the TiO2-coated glass using a fluorine-rich alkoxysilane compound, followed by a laser ablation to create the pattern. Then, the entire substrate is immersed into an aqueous solution containing amino-silane equipped Pd nanoparticles for the second modification. Because most substrate surface is hydrophobic, the amino-silane-equipped Pd catalysts can only graft on the laser-ablated zone to accomplish selective ELD.

Manipulating the adhesion of electroless nickel-phosphorus film on silicon wafers by silane compound modification and rapid thermal annealing.

In this study, the effect of 3-2-(2-aminoethylamino) ethylamino propyl trimethoxysilane (ETAS) modification and post rapid thermal annealing (RTA) treatment on the adhesion of electroless plated nickel-phosphorus (ELP Ni-P) film on polyvinyl alcohol-capped palladium nanoclusters (PVA-Pd) catalyzed silicon wafers is systematically investigated. Characterized by pull-off adhesion, atomic force microscopy, X-ray spectroscopy and water contact angle, a time-dependent, three-staged ETAS grafting mechanism including islandish grafting, a self-assembly monolayer (SAM) and multi-layer grafting is proposed and this mechanism is well correlated to the pull-off adhesion of ELP Ni-P film. In the absence of RTA, the highest ELP Ni-P film adhesion occurs when ETAS modification approaches SAM, where insufficient or multi-layer ETAS grafting fails to provide satisfactory results. On the other hand, if RTA is applied, the best ELP Ni-P film adhesion happens when ETAS modification is islandish owing to the formation of nickel silicide, where SAM or multi-layer ETAS modification cannot provide satisfactory adhesion because the interaction between ETAS and PVA-Pd has been sabotaged during RTA. Evidenced by microstructural images, we also confirmed that ETAS can act as an efficient barrier layer for nickel diffusion to bulk silicon.

Functional regulation of Zfp36l1 and Zfp36l2 in response to lipopolysaccharide in mouse RAW264.7 macrophages.

BACKGROUND: The tristetraprolin (TTP) family of mRNA-binding proteins contains three major members, Ttp, Zfp36l1, and Zfp36l2. Ttp down-regulates the stability of AU-rich element-containing mRNAs and functions as an anti-inflammation regulator. METHODS: To examine whether other TTP family proteins also play roles in the inflammatory response, their expression profiles and the possible mRNA targets were determined in the knockdown cells. RESULTS: Ttp mRNA and protein were highly induced by lipopolysaccharide (LPS), whereas Zfp36l1 and Zfp36l2 mRNAs were down-regulated and their proteins were phosphorylated during early lipopolysaccharide stimulation. Biochemical and functional analyses exhibited that the decrease of Zfp36l2 mRNA was cross-regulated by Ttp. Knockdown of Zfp36l1 and Zfp36l2 increased the basal level of Mkp-1 mRNAs by prolonging its half-life. Increasing the expression of Mkp-1 inhibited the activation of p38 MAPK under lipopolysaccharide stimulation and down-regulated Tnfα, and Ttp mRNA. In addition, hyper-phosphorylation of Zfp36l1 might stabilize Mkp-1 expression by forming a complex with the adapter protein 14-3-3 and decreasing the interaction with deadenylase Caf1a. CONCLUSIONS: Our findings imply that the expression and phosphorylation of Zfp36l1 and Zfp36l2 may modulate the basal level of Mkp-1 mRNA to control p38 MAPK activity during lipopolysaccharide stimulation, which would affect the inflammatory mediators production. Zfp36l1 and Zfp36l2 are important regulators of the innate immune response.

Differential expression and functional analysis of the tristetraprolin family during early differentiation of 3T3-L1 preadipocytes.

The tristetraprolin (TTP) family comprises zinc finger-containing AU-rich element (ARE)-binding proteins consisting of three major members: TTP, ZFP36L1, and ZFP36L2. The present study generated specific antibodies against each TTP member to evaluate its expression during differentiation of 3T3-L1 preadipocytes. In contrast to the inducible expression of TTP, results indicated constitutive expression of ZFP36L1 and ZFP36L2 in 3T3-L1 preadipocytes and their phosphorylation in response to differentiation signals. Physical RNA pull-down and functional luciferase assays revealed that ZFP36L1 and ZFP36L2 bound to the 3' untranslated region (UTR) of MAPK phosphatase-1 (MKP-1) mRNA and downregulated Mkp-1 3'UTR-mediated luciferase activity. Mkp-1 is an immediate early gene for which the mRNA is transiently expressed in response to differentiation signals. The half-life of Mkp-1 mRNA was longer at 30 min of induction than at 1 h and 2 h of induction. Knockdown of TTP or ZFP36L2 increased the Mkp-1 mRNA half-life at 1 h of induction. Knockdown of ZFP36L1, but not ZFP36L2, increased Mkp-1 mRNA basal levels via mRNA stabilization and downregulated ERK activation. Differentiation induced phosphorylation of ZFP36L1 through ERK and AKT signals. Phosphorylated ZFP36L1 then interacted with 14-3-3, which might decrease its mRNA destabilizing activity. Inhibition of adipogenesis also occurred in ZFP36L1 and TTP knockdown cells. The findings indicate that the differential expression of TTP family members regulates immediate early gene expression and modulates adipogenesis.

Honokiol traverses the blood-brain barrier and induces apoptosis of neuroblastoma cells via an intrinsic bax-mitochondrion-cytochrome c-caspase protease pathway.

Neuroblastomas, an embryonic cancer of the sympathetic nervous system, often occur in young children. Honokiol, a small-molecule polyphenol, has multiple therapeutic effects and pharmacological activities. This study was designed to evaluate whether honokiol could pass through the blood-brain barrier (BBB) and induce death of neuroblastoma cells and its possible mechanisms. Primary cerebral endothelial cells (CECs) prepared from mouse brain capillaries were cultured at a high density for 4 days, and these cells formed compact morphologies and expressed the ZO-1 tight-junction protein. A permeability assay showed that the CEC-constructed barrier obstructed the passing of FITC-dextran. Analyses by high-performance liquid chromatography and the UV spectrum revealed that honokiol could traverse the CEC-built junction barrier and the BBB of ICR mice. Exposure of neuroblastoma neuro-2a cells and NB41A3 cells to honokiolinduced cell shrinkage and decreased cell viability. In parallel, honokiol selectively induced DNA fragmentation and cell apoptosis rather than cell necrosis. Sequential treatment of neuro-2a cells with honokiol increased the expression of the proapoptotic Bax protein and its translocation from the cytoplasm to mitochondria. Honokiol successively decreased the mitochondrial membrane potential but increased the release of cytochrome c from mitochondria. Consequently, honokiol induced cascade activation of caspases-9, -3, and -6. In comparison, reducing caspase-6 activity by Z-VEID-FMK, an inhibitor of caspase-6, simultaneously attenuated honokiol-induced DNA fragmentation and cell apoptosis. Taken together, this study showed that honokiol can pass through the BBB and induce apoptotic insults to neuroblastoma cells through a Bax-mitochondrion-cytochrome c-caspase protease pathway. Therefore, honokiol may be a potential candidate drug for treating brain tumors.