Mevastatin promotes neuronal survival against Aß-induced neurotoxicity through AMPK activation.

Statins or HMG-CoA reductase inhibitors have been shown to be effective at lowering cholesterol levels, and the application of these molecules has gradually emerged as an attractive therapeutic strategy for neurodegenerative diseases. Epidemiological studies suggest that statin use is associated with a decreased incidence of Alzheimer's disease (AD). Thus, statins may play a beneficial role in reducing amyloid ß (Aß) toxicity, the most relevant pathological feature and pathogenesis of AD. However, the precise mechanisms involved in statin-inhibited Aß toxicity remain unclear. In the present study, we report that mevastatin significantly protects against Aß-induced neurotoxicity in SK-N-MC neuronal cells by restoring impaired insulin signaling. This protection appears to be associated with the activation of AMP-activated protein kinase (AMPK), which has long been known to increase insulin sensitivity. Our results also indicate that high levels of cholesterol likely underlie Aß-induced neurotoxicity and that activation of AMPK by mevastatin alleviates insulin resistance. Signaling through the insulin receptor substrate-1/Akt pathway appears to lead to cell survival. These findings demonstrate that mevastatin plays a potential therapeutic role in targeting Aß-mediated neurotoxicity. The molecule presents a novel therapeutic strategy for further studies in AD prevention and therapeutics.

Comprehensive risk factors, asthma control, and life quality pathways in adults with asthma: A structural equation modeling analysis.

OBJECTIVES: Previous studies reported that environmental factors, particularly the work environment, were related to quality of life (QoL) in patients with asthma. However, the pathway that links workplace and QoL in adults with asthma is still not clear. The aim of this study was to explore the comprehensive environmental factors, asthma control, and QoL pathways in patients with asthma. STUDY DESIGN AND SETTING: Two cohorts of patients with asthma were established, including a prospective phase cohort in 2006 and a cross-sectional phase cohort in 2012. The Asthma Control Test was used to determine the level of disease control, and QoL was assessed by using the Taiwanese version of an asthma quality-of-life questionnaire. In 2014, a structural equation model was applied to explore the pathways from the risk factors to QoL. RESULTS: The structural equation model for predicting QoL provided a good fit (χ(2) [degrees of freedom] = 43.81 [38]; root mean square error of approximation 0.021 [90% confidence interval, 0.001-0.044]) after combining the two cohorts. The wheeze frequency, allergic response frequency, parental asthma, and asthma control were directly associated with QoL. We found that patients who were obese and who worked in poor environments had increased work symptoms and wheeze frequency during the previous year in a cross-sectional phase cohort. However, we did not find that body mass index was a significant factor in a prospective cohort. The patients with obesity and with frequent work symptoms, which induced poor asthma control, were possible mechanisms in the pathway from workplace exposure to poor QoL in the observed adults with asthma in our combined data. CONCLUSION: Body mass index, the work environment, and the wheeze frequency should be considered when assessing asthma control and QoL in adult patients with asthma. Patients who reduce their body weight or avoid exposure to poor workplaces may find this useful for their asthma control and improvement of their QoL.

Factors associated with computer literacy among nurses.

Nowadays, many hospitals have adopted information technology (IT) to help nurses in their practice; therefore, computers have become critical instruments for nurses. Many researchers have studied what information literacy or computer competencies a nurse should possess, but less research has focused on the types of factors associated with computer literacy. The purpose of this study was to discover which variables influence the computer literacy of nurses. The questionnaire was the instrument for data collection. The respondents were 180 nurses in Taiwan. The results of this study revealed that computer experience of nurses and personal innovation in IT were both factors associated with computer literacy and computer anxiety. The findings could assist nursing managers to screen computer-literate nurses and course designers in nursing school or hospitals to add more practical trainings in courses.

Adherence to self-care behavior and glycemic effects using structured education.

AIMS/INTRODUCTION: The purpose of the present study was to examine glycemic control in suboptimally controlled type 2 diabetes provided by a structured education group using the Diabetes Conversation Map™ (CM™) vs usual care in a university-based hospital primary care clinic. MATERIALS AND METHODS: This was a randomized, pragmatic clinical trial. Patients with type 2 diabetes were randomly assigned to structured education or usual care groups. The primary outcome was the difference in the mean change of glycated hemoglobin (HbA1c) from baseline to 12 months. Secondary outcomes included the percentage achieving therapeutic HbA1c goal and self-behavioral changes. RESULTS: A total of 245 patients were randomly assigned to two groups (CM™ group n = 121; usual care group, n = 116). The absolute reduction of HbA1c was significantly greater in the CM™ group at 3 and 6 months (Δ = -0.59% and Δ = -1.13%, P < 0.01), but the difference was no longer statistically significant at 9 and 12 months (Δ = -0.43% and Δ = -0.49%), based on an intention-to-treat analysis. A per-protocol analysis showed the significant change was maintained at 12 months (Δ = -0.67%). In the intervention group, greater percentages of patients achieved their American Association of Diabetes Educators Self-Care Behaviours™ framework (AADE7) behavioral goals at 3 months, in particular being active, problem-solving, reducing risk and health coping. CONCLUSIONS: In type 2 diabetic patients with suboptimally controlled glucose, there were greater improvements in glucose control and self-care behavioral goals in those who underwent the CM™ education program compared with outcomes achieved in patients receiving usual care.

Burdens of mercury in residents of Temirtau, Kazakhstan I: hair mercury concentrations and factors of elevated hair mercury levels.

Mercury (Hg) is released either naturally in the environment or by anthropogenic activities. During its global circulation, Hg presents in a diversity of chemical forms and transforms between each other. Among Hg species, methylmercury (MeHg) is readily absorbed by humans via the aquatic food chain and thus it is very neurotoxic to exposed populations including fetuses due to perinatal exposure. In 2005, a survey was carried out in Temirtau, an Hg-contaminated site in North Central Kazakhstan, to investigate Hg concentrations in the hair samples of the residents and the relationship between Hg exposure levels and the related factors. Among the 289 hair samples, Hg concentrations ranged from 0.009 to 5.184µg/g with a mean of 0.577µg/g. Nearly 17% of the population exceeded 1µg/g for hair Hg, which corresponds to the reference of dose (RfD) 0.1µg/kg body weight/day developed by the United States Environmental Protection Agency (USEPA). Subgroups of males, people aged over 45 and fishermen or anglers were found to have elevated Hg exposure levels in their hair. A positive correlation was found between Hg concentrations in hair and frequencies of river fish consumption. As a result, the finding that people were exposed to high levels of Hg was expected due to the frequent consumption of fish caught from the polluted River Nura or the neighbouring lakes. A regression model showed that approximately 41% of variance of Hg concentrations in the study population's hair was attributed to the variables of gender, residential location, age and fishery occupation. The model implied that demographic characteristics together with dietary behaviour should be taken into account in studies associated with Hg exposure risk, in order to clearly define the group potentially sensitive to Hg exposure.

Burdens of mercury in residents of Temirtau, Kazakhstan: II: verification of methodologies for estimating human exposure to high levels of Hg pollution in the environment.

A considerable amount of work has been conducted developing exposure estimate models for quantitative evaluation of mercury (Hg) intake and human health risks, but few have assessed the applicability and the validity for evaluating the risks posed by Hg in the environment and have achieved very mixed results. The present study focused on verifying estimated daily Hg intake using exposure equations with either the deterministic or probabilistic (the Monte Carlo) approaches. The simulated daily Hg intake doses were compared with those established from measured Hg concentrations in the hair of 289 participants. The results showed that the single-value deterministic method for simulating Hg exposure levels overestimated the level of risk by a factor of 1.5 when compared with the highest concentration of Hg observed in the hair of the study population. Contrarily, the average daily Hg intake doses simulated using the probabilistic simulation were similar in distribution to the biomarker data. When the reference dose (RfD) of 0.1 microg/kg body weight/day was adopted as the acceptable dose for daily intake rate, there were approximately 19 percent estimated to have potential Hg exposure risks based on the Monte Carlo simulation. This percentage was favourably similar to the 17 percent determined from Hg concentrations in the hair samples. The difference between the probabilistic simulation and the data derived from hair Hg levels was considered mainly due to the uncertainties in unconfirmed questionnaire-based survey data, small sampling sizes and the surrogates used in the exposure models. The findings implied that the existing exposure models together with the probabilistic approach were appropriate for research of human exposure to Hg.