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This study explores the impact of the tropical sea surface temperature (SST) independent of the preceding winter El Nino-Southern Oscillation (ENSO) events (ENSO-independent SST) on the interannual variability of the South China Sea Summer Monsoon (SCSSM) and the associated mechanisms. During summer, the ENSO-independent SST component dominates across tropical ocean regions. The tropical ENSO-independent SSTs during spring and summer in the Maritime Continent (MC), the equatorial central-eastern Pacific (CEP), and the tropical Atlantic Ocean (TAO) regions play a comparably significant role in the interannual variation of the SCSSM intensity, compared to the tropical SST dependent on the preceding winter ENSO. The ENSO-independent SST anomalies (SSTA) in the TAO during spring and summer exhibit significant persistence. They can influence the SCSSM through westward propagation of teleconnection, as well as through eastward-propagating Kelvin waves. In summer, the SSTA in the MC, CEP, and TAO regions contribute jointly to the variability of the SCSSM. The MC SSTA affects local convection and generates anomalous meridional circulation to impact the SCSSM intensity. The CEP SSTA directly influences the SCSSM via the Matsuno-Gill response mechanism and indirectly affects it via meridional circulation by modulating vertical motions over the MC through zonal circulation. The TAO SSTA impacts the SCSSM through both westward and eastward pathways, as well as by influencing zonal circulation patterns in the tropical and subtropical North Pacific. The results offer valuable insights into the factors influencing the interannual variability of the SCSSM intensity.

Human T‐cell lymphotropic virus type 1 is vertically transmitted in neonatal life and is causatively associated with adult T‐cell leukemia (ATL) and HTLV‐1‐associated myelopathy/tropical spastic paraparesis (HAM/TSP) in adults. Persistence of HTLV‐1 in host T cells, clonal expansion of the HTLV‐1 carrying T cells, and emergence of malignantly transformed T cells are in accord with the multistep model of human cancer and roles for continuous interaction between host genes and environmental factors. This article reviews two lines of HTLV‐1 investigation, one regarding worldwide surveillance of HTLV‐1 infection foci by serological testing and molecular analysis of HTLV‐1 isolates, and the other focusing on genetics of the human leukocyte antigen (HLA) that determines the ethnic background of HTLV‐1 permissiveness and susceptibility to ATL or HAM/TSP. The serological surveillance revealed transcontinental dispersal of HTLV‐1 in the prehistoric era that started out of Africa, spread to Austro‐Melanesia and the Asian continent, then moved to North America and through to the southern edge of South America. This was highlighted by an Andean mummy study that proved ancient migration of paleo‐mongoloid HTLV‐1 from Asia to South America. Phylogenetic analysis of HLA alleles provided a basis for ethnic susceptibility to HTLV‐1 infection and associated diseases, both ATL and HAM/TSP. Ethnicity‐based sampling of peripheral blood lymphocytes has great potential for genome‐wide association studies to illuminate ethnically defined host factors for viral oncogenesis with reference to HTLV‐1 and other pathogenic elements causatively associated with chronic disease and malignancies. (Cancer Sci 2011; 102: 295–301)

Background and aims To explore the biological variation (BV) of kidney injury markers in serum and urine of healthy subjects within 24 hours to assist with interpretation of future studies using these biomarkers in the context of known BV. Materials and methods Serum and urine samples were collected every 4 hours (0, 4, 8, 12, 16 and 20 hours) from 31 healthy subjects within 24 hours and serum creatinine (s-Crea), serum β2-microglobin (s-β2MG), serum cystatin C (s-CYSC), serum neutrophil gelatinase-associated lipoprotein (s-NGAL), urine creatinine (u-Crea), urine β2-microglobin (u-β2MG), urine cystatin C (u-CYSC), urine neutrophil gelatinase-associated lipoprotein (u-NGAL) were measured. Outlier and variance homogeneity analyses were performed, followed by CV-ANOVA analysis on trend-corrected data (if relevant), and analytical (CV A ), within-subject (CV I ), and between-subject (CV G ) biological variation were calculated. Results The concentration of kidney injury markers in male was higher than that in female, except for u-CYSC and u-NGAL. There were no significant difference in serum and urine kidney injury markers concentration at different time points. Serum CV I was lower than urine CV I , serum CV G was higher than CV I , and urine CV G was lower than CV I . The individual index (II) of serum kidney injury markers was less than 0.6, while the II of urinary kidney injury markers was more than 1.0. Conclusions This study provides new short-term BV data for kidney injury markers in healthy subjects within 24 hours, which are of great significance in explaining other AKI / CKD studies.

Abstract Objective We evaluated the intraday changes of thyroid function biomarkers in healthy subjects to help clinicians diagnose thyroid diseases in appropriate timing. Methods Blood samples were collected from 31 subjects at 0:00, 4:00, 8:00, 12:00, 16:00 and 20:00 on the sampling day and analyzed for thyroid-stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), free T3 (FT3), and free T4 (FT4). The intraday concentration changes were analyzed using Friedman’s 2-way analysis of variance by ranks. Results The concentrations of TSH, T3, T4, FT3, and FT4 in males were significantly higher than those in females (P < .01). The obvious peak circadian rhythm of TSH was observed at 0:00 AM with gradual decline thereafter, whereas other biomarkers showed no rhythmic changes. Conclusion Sex differences should be considered in interpreting thyroid function tests. It is important to select the sampling time according to the clinician’s diagnostic needs, especially at night when TSH secretion peaks.

Background: Patellar dislocation is one of the most common knee injuries in the adolescent population. It is often combined with osteochondral fracture. The purpose of this study was to compare the outcomes between fixation and excision of osteochondral fractures not involving the bearing surface in adolescent patients with patellar dislocations. Methods: Patients who underwent surgery for osteochondral fracture following patellar dislocation in our institution from 2007 to 2014 were retrospectively evaluated. Visual analog scale (VAS) of pain and the International Knee Documentation Committee (IKDC) form were used to assess knee pain and function at follow-up. Patient satisfaction was evaluated. Differences in the values of variables among groups were assessed using t-test if equal variance or Mann-Whitney U-test if not equal variance. The Pearson's Chi-square test was applied for dichotomous variables if expected frequency was >5 or Fisher's exact test was applied if not. A value of P < 0.05 was considered statistically significant. Results: Forty-three patients were included, with the average age of 14.1 ± 2.3 (range, 9.0-17.0) years. Nineteen underwent fixation of osteochondral fractures and 24 did not. The average follow-up time was 28 ± 10 months. There was no significant difference in age, gender, follow-up time, causes of injury, times of dislocation, and location of osteochondral fracture between fixation and excision groups. The fixation group had a significantly longer surgery time (82 ± 14 min) and larger size of osteochondral fracture (2.30 ± 0.70 cm2) than the excision group (43 ± 10 min, 1.88 ± 0.62 cm2, respectively, t = 10.77, P < 0.01 and t = 0.84, P < 0.05). At the last follow-up, the average IKDC score in the fixation group (82.52 ± 8.71) was significantly lower than that in the excision group (89.51 ± 7.19, t = 2.65, P < 0.01). There was no significant difference in VAS of pain and patients' satisfaction. There were 7 (16%) patients with recurrent dislocation. Conclusion: Excision of osteochondral fractures has equivalent or better outcomes compared to fixation in adolescent patients with patellar dislocations when these fractures do not involve the bearing surface.

Objective To provide the cobweb classification system (CCS) for the precise digital location and description of the neurological compression in cervical degenerative disease (CDD), and the reliability and the clinical subgroup analysis of the system were tested and analyzed. Methods The CCS consisted of three parts: compression zones (1‐12), degrees (a, b) and ossification (s, m, h). Computerized tomography (CT) and magnetic resonance imaging (MRI) images from 238 CDD patients were reviewed. All compression cases were classified by five independent reviewers with varied clinical experience in spine surgery. The reliability of the CCS was tested by calculating the kappa (κ) statistics value. Finally, 74 patients with anterior cervical surgery treatment were enrolled for the clinical subgroup analysis. Results For the small compression, including single and double compression zones, there was a good interobserver reliability between the reviewers (κ coefficient = .855, P < .001). For the large compression with three or more involved zones, there was a fair reliability between the reviewers (κ coefficient = .696, P < .001). The whole intraobserver reliability was good (κ coefficient = .923, P < .001). For clinical practice, the operative time in the large compression and the m/h group was significantly longer than the small compression and the s group, respectively (P < .05), and the blood loss in the m/h group was significantly increased as well (P < .01). Though the preoperative Japanese Orthopedic Association score in Group b was lower than Group a (P < .05), all patients had achieved significant clinical improvement at last follow‐up. Conclusions The CCS can be used to provide detailed and objective descriptions of the location, extent, and severity of neurological compressions in CDD with satisfactory reliability. Surgeons should pay more attention to the patient with large zone, degree b, and ossification compression, because the operation may be more challenging. We propose the cobweb classification system (CCS) for the digital location and description of the neurological compression in cervical degenerative disease (CDD). With satisfactory reliability, the CCS can be used to provide detailed and objective descriptions of the location, extent and severity of neurological compressions in CDD.

In a prospective study of 101 mother-child pairs in Jamaica, we examined the association of provirus load in breast milk and the risk of mother-to-child transmission of human T lymphotropic virus type I. The provirus load in breast milk was a strong predictor of risk of transmission to children (relative risk, 2.34/quartile), after adjustment for other known risk factors. The risk of transmission increased from 4.7/1000 personmonths when the provirus load in breast milk was <0.18% to 28.7/1000 person-months when it was >1.5%. Provirus detection in maternal breast milk predicted transmission months before infection in children was detected by serologic testing.

Human T lymphotropic virus type I (HTLV-I) is endemic in southern Japan and the Caribbean, but the incidence of HTLV-I-associated diseases varies across geographic areas. We compared markers of disease pathogenesis among 51 ageand sex-matched HTLV-I carrier pairs from Japan and Jamaica. The mean antibody titer (P = .03) and detection of anti-Tax antibody (P = .002) were higher in Jamaican subjects than in Japanese subjects, but provirus load was similar between the 2 groups (P = .26). The correlation between antibody titer and provirus load was more prominent among Jamaican subjects than among Japanese subjects (P = .06). These findings underscore the differences in host immune response to HTLV-I infection in 2 populations.

ObjectiveWe examined the association between mother-to-child human T cell lymphotropic virus type I (HTLV-I) transmission and human leukocyte antigen (HLA) class I types MethodsIn 1989, children born to HTLV-I–infected mothers in Jamaica were enrolled and prospectively evaluated for HTLV-I infection. HLA class I types in mothers and children were determined by DNA-based polymerase chain reaction methods. Associations between HLA class I types and transmission of HTLV-I were analyzed using proportional-hazards regression models adjusted for the duration of breast-feeding. Transmission risk in children still breast-feeding at 12 months was determined using actuarial methods ResultsOf 162 children, 28 (17%) became infected. After Bonferroni’s adjustment for multiple comparisons, the transmission risk was not influenced by any specific HLA class type or the A2 supertype. However, compared with children who shared 3 HLA class I types with their mothers (the minimum number possible), the transmission risk increased 1.8-fold with 4 shared types and 3.0-fold with 5 or 6 shared types (Ptrend=.039; 1.75-fold increase for each additional concordant HLA type). This association was independent of maternal HTLV-I proviral level, antibody titer, and household income ConclusionsWe found a significant dose-response relationship between HTLV-I transmission via breast-feeding and mother-child HLA class I type concordance. Immunological interactions between a child’s cells and maternal cells may influence the risk of HTLV-I infection by breast-feeding, perhaps because antigens on maternal cells are seen by the child as being “self.”

The Editor-in-Chief has retracted this article [1] because of an error in the meta analysis. Re-examination of the data has showed that there is only one published randomized controlled trial comparing Superion with XStop. Due to a misunderstanding of the published clinical data, the conclusions drawn in the article are incorrect. Author Xing Yu approved this retraction, none of the other authors replied to correspondence from the publisher about this retraction.