Insect biorefinery: A circular economy concept for biowaste conversion to value-added products.

With rapid growing world population and increasing demand for natural resources, the production of sufficient food, feed for protein and fat sources and sustainable energy presents a food insecurity challenge globally. Insect biorefinery is a concept of using insect as a tool to convert biomass waste into energy and other beneficial products with concomitant remediation of the organic components. The exploitation of insects and its bioproducts have becoming more popular in recent years. This review article presents a summary of the current trend of insect-based industry and the potential organic wastes for insect bioconversion and biorefinery. Numerous biotechnological products obtained from insect biorefinery such as biofertilizer, animal feeds, edible foods, biopolymer, bioenzymes and biodiesel are discussed in the subsequent sections. Insect biorefinery serves as a promising sustainable approach for waste management while producing valuable bioproducts feasible to achieve circular bioeconomy.

Spatial effects of urban green infrastructure on instream water quality assessed by chemical and sensory indicators.

Urban green infrastructure has been simulated effectively and economically to reduce volume and pollutants of stormwater runoffs but its spatial effects remain unclear. A snap sampling campaign was carried out for surface water quality in the downtown waterway network of a pilot sponge city (Suzhou) in China, dividing into 7 subwatersheds according to the digital elevation map. In total, 144 sampling points were investigated and measured for chemical quality of surface water while 68 out of the sampling points had a sensory evaluation questionnaire interview for water quality with 321 respondents, in whom the native residents scored a significant spatiality of water quality. The downtown waterway network had phosphorus-limited eutrophic surface water with total nitrogen worse than Class V of the national guidelines. Chemical and sensory evaluation indexes of surface water quality had significant spatial consistency (p < 0.001). All types of green spaces (%) in subwatershed, especially along the urban waterway network (waterfront) and roadside, and in the 100 m riparian buffer zone, significantly influenced nutrient loads in surface water. Findings of the present study suggest that the 100 m riparian buffer zone would be priority areas and the waterfront and roadside should be the highly efficient spots for planning strategy on urban green infrastructure implementation to reduce nutrient loads in surface water and to improve urban landscape aesthetics.

Quantitative assessment of the microstructure of the mesorectum with different prognostic statuses by intravoxel incoherent motion diffusion-weighed magnetic resonance imaging.

BACKGROUND: The mesorectum surrounding the rectum provides an ideal substrate for tumour spread. However, preoperative risk assessment is still an issue. This study aimed to investigate the microstructural features of mesorectum with different prognostic statuses by intravoxel incoherent motion diffusion-weighted imaging (IVIM DWI). METHODS: Patients with pathologically proven rectal adenocarcinoma underwent routine high-resolution rectal magnetic resonance imaging (MRI) and IVIM DWI sequences were acquired. The MRI-detected circumferential resection margin (mrCRM) and extramural vascular invasion (mrEMVI) were evaluated. IVIM parameters of the mesorectum adjacent to (MAT) and distant from (MDT) the tumour were measured and compared between and within the prognostic factor groups. RESULTS: The positive mrCRM (pMAT < 0.001; pMDT = 0.013) and mrEMVI (pMAT = 0.001; pMDT < 0.001) groups demonstrated higher D values in the MAT and MDT than the corresponding negative groups. Conversely, the positive mrCRM (p = 0.001) and mrEMVI (p < 0.001) groups both demonstrated lower f values in the MAT. Similarly, in the self-comparison between the MAT and MDT in the above subgroups, D showed a significant difference in all subgroups (p < 0.001 for all), and f showed a significant difference in the positive mrCRM (p = 0.001) and mrEMVI (p = 0.002) groups. Moreover, the MAT displayed a higher D* in the positive mrCRM (p = 0.014), negative mrCRM (p = 0.009) and negative mrEMVI groups (p < 0.001). CONCLUSION: The microstructure of the mesorectum in patients with rectal cancer with poor prognostic status shows changes based on IVIM parameters. IVIM parameters might be promising imaging biomarkers for risk assessment of tumour spread in mesorectum preoperatively.

Safety Assessment of 3S, 3'S Astaxanthin Derived from Metabolically Engineered K. marxianus.

Previous reviews have already explored the safety and bioavailability of astaxanthin, as well as its beneficial effects on human body. The great commercial potential in a variety of industries, such as the pharmaceutical and health supplement industries, has led to a skyrocketing demand for natural astaxanthin. In this study, we have successfully optimized the astaxanthin yield up to 12.8 mg/g DCW in a probiotic yeast and purity to 97%. We also verified that it is the desired free-form 3S, 3'S configurational stereoisomer by NMR and FITR that can significantly increase the bioavailability of astaxanthin. In addition, we have proven that our extracted astaxanthin crystals have higher antioxidant capabilities compared with natural esterified astaxanthin from H. pluvialis. We also screened for potential adverse effects of the pure astaxanthin crystals extracted from the engineered probiotic yeast by dosing SD rats with 6, 12, and 24 mg/kg/day of astaxanthin crystals via oral gavages for a 13-week period and have found no significant biological differences between the control and treatment groups in rats of both genders, further confirming the safety of astaxanthin crystals. This study demonstrates that developing metabolically engineered microorganisms provides a safe and feasible approach for the bio-based production of many beneficial compounds, including astaxanthin.

Anthropogenic metal loads in nearshore sediment along the coast of China mainland interacting with provincial socioeconomics in the period 1980-2020.

Metal pollutions have been accused of consequences of the anthropogenic activities but few quantitative delineations between environmental metal loads and socioeconomic development presented. A meta-data analysis study was carried out on metal loads in coastal sediment in the provinces of China mainland reported in literature in the period 1980-2020. Eight metals with well-recognized anthropogenic sources were selected including arsenic (As), cadmium (Cd), chromium (Cr), copper (Cu), mercury (Hg), nickel (Ni), lead (Pb), and zinc (Zn). Screened with three criteria, a total of 1173 records from 405 published studies were finalized as the metal loads dataset in coastal sediment. Evident provincial patterns were observed among the selected metals but element dependent after transformed to sample number weighted contents (Cw). Against the regional marine backgrounds, anthropogenic increment rate (Ranthrop) of metal loads in nearshore sediment presented better provincial differentiation with the extremes at 7.58 for As and 62.13 for Cu in Guangdong, 91.25 for Hg in Zhejiang, 3.19 for Ni in Tianjin, 7.72 for Pb in Fujian, and 13.51 for Zn in Liaoning. Metal loads in coastal sediment could be explained by characteristic industries in the provinces. Nearshore sediment in Guangdong had high risk to metal loads and other provinces at low-to-medium risk to the lowest thresholds of sediment quality guidelines in China and USA. Canonical correlations identified considerably interactive explanations between integrative hazard quotients (Æ©HQ) of the selected metals in nearshore sediment and non-agricultural GDP per capita of non-agricultural population/urban population percentile provincially but few significant fittings by the classic environmental Kuznets Curve model quantitatively. Findings of this study explored uncertainty from both sides in explaining the interactions, i.e., data integrity of metal loads in coastal sediment in literature and appropriation of socioeconomic indicators in relation to metal emission industries.

Sedimentary spectrum and potential ecological risks of residual pharmaceuticals in relation to sediment-water partitioning and land uses in a watershed.

Pharmaceutical residues in river surficial sediment are prone to anthropogenic impacts and environmental factors in watershed, but the mechanisms remain unclear. This study attempted to reveal surficial sediment-water pseudo-partitioning and anthropogenic (land use) patterns of pharmaceutical residues in surficial sediment among 23 subwatersheds of Jiulong River, southeast China with a gradient of urban land use percentile in dry and wet seasons. Thirty-eight out of target 86 compounds from six-category pharmaceuticals were quantified and ranged from below the quantification limits (0.001 mg kg-1 dry mass) up to 8.19 mg kg-1 dry mass (chlortetracycline) using a developed SPE-HPLC-MS/MS protocol. Antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs) collectively dominated sedimentary pharmaceutical residues for 34.5-99.8% of the total quantified compounds (median at 92%). Land uses in subwatersheds showed high consistency with sedimentary pharmaceutical residues in the dry season rather than the wet season, especially for human use only and veterinary use only compounds. Surficial sediment-water partitioning of pharmaceutical compounds influenced their sedimentary residues regardless of season, which were determined by properties of compound and surficial sediment interactively. All tetracycline compounds, trimethoprim (sulfonamides synergist), caffeine (central nervous system drug), and oxfendazole (antiparasitic drug) were quantified to pose high potential ecological risks to aquatics. Findings of this study suggest that pseudo-persistent legacy of human and veterinary pharmaceuticals requires a wider coverage of pharmaceutical compounds for a comprehensive ecological assessment in the environment and more involvement of anthropogenic impacts and socioeconomic factors in the future studies.

Legacy organochlorines in estuarine sediment in relation to socioeconomic pattern in multi-coastal watersheds.

Estuarine sediment quality is highly associated with anthropogenic activities in watersheds. This study attempts to couple socioeconomic patterns with estuarine sediment quality via legacy organochlorines in 14 Chinese coastal watersheds. Sedimentary concentrations of HCHs, DDTs, and PCBs showed a significant spatiality in estuary, up to 48.7 ± 15.1, 89.0 ± 46.4, and 54.5 ± 17.2 ng g-1, which were predominated by ß-HCH, p,p'-DTs, and tri- to penta-PCBs, respectively. Ecological risk of organochlorines was negligible except few moderate risks for DDTs and PCBs against the first class quality of the marine sediment quality guidelines of China. Sedimentary DDT and PCB concentrations were significantly delineated by an environmental Kuznets curve model as a function of non-agricultural GDP per capita in watersheds, while HCHs by an increasing linear model. Findings of this study provide a tool to quantify the contribution of anthropogenic development in watershed to environmental change in estuary across the world.

Characterizing interactions of socioeconomic development and environmental impact at a watershed scale.

Worldwide socioeconomic development has resulted in huge irretrievable environmental problems in various ecosystems. This study employed seven coastal watersheds in two provinces, Zhejiang and Fujian, China forming a gradient to testify the environmental Kuznets curve (EKC) interactions between socioeconomic development and environmental impact at a watershed scale. Annual socioeconomic indicators, including gross domestic product (GDP) and its components, registered population (agricultural and non-agricultural population), and electricity consumption, and annual discharges of chemical oxygen demand (COD) and ammonium were collected at a county level, and land use pattern to generate watershed level dataset in the period of 2011-2016. Results indicated that non-agricultural GDP per capita of the non-agricultural population and discharge of COD or ammonium per unit of total GDP were top-ranked pair-indicators significantly fitting the EKC model instead of the classic GDP per capita and pollutants. The development of seven selected watersheds have passed the turning point of the EKC and entered impact-reducing development stages along the EKC, i.e., the three Zhejiang watersheds are at the low-impact development stage, the Huotong Stream watershed from Fujian province was at impact-declining development stage right, and other three Fujian watersheds were at medium-impact development stage. In term of the environmental impact indicator, pollutant discharge per unit of total GDP serves as a development impact indictor per se. These findings might provide an EKC-based approach to support and strategize the watershed management for sustainable development in the world.

Losses of natural coastal wetlands by land conversion and ecological degradation in the urbanizing Chinese coast.

Coastal wetland ecosystems have experienced serious losses of area and ecological function and are currently facing worldwide challenges due to coastal development and global climate change. This study attempted to explore patterns and possible factors driving loss of natural coastal wetlands due to land conversion (permanent loss) and ecological degradation (temporal loss) in three urbanizing coastal city clusters, China in the period of 1990-2015. The natural coastal wetland area was substantially lost due to land conversion highly related to regional economic development. The ecological degradation, assessed as a function of surface water quality, resulted in much greater impairment area of natural coastal wetlands. This impairment was predominantly driven by inbound river pollutants' discharge, rather than local discharge. This study suggests that the ecological degradation should be considered as well as the land conversion loss for conserving the remaining natural coastal wetland ecosystems. The pollutant discharges from the inbound river watersheds need to be mitigated as the local discharges for reducing the functional degradation of the natural coastal wetlands while the regional economic development plan should consider the conservation needs of the remaining natural coastal wetlands worldwide.

Integrative Application of Life Cycle Assessment and Risk Assessment to Environmental Impacts of Anthropogenic Pollutants at a Watershed Scale.

Intense human activities have led to increasing deterioration of the watershed environment via pollutant discharge, which threatens human health and ecosystem function. To meet a need of comprehensive environmental impact/risk assessment for sustainable watershed development, a biogeochemical process-based life cycle assessment and risk assessment (RA) integration for pollutants aided by geographic information system is proposed in this study. The integration is to frame a conceptual protocol of "watershed life cycle assessment (WLCA) for pollutants". The proposed WLCA protocol consists of (1) geographic and environmental characterization mapping; (2) life cycle inventory analysis; (3) integration of life-cycle impact assessment (LCIA) with RA via characterization factor of pollutant of interest; and (4) result analysis and interpretation. The WLCA protocol can visualize results of LCIA and RA spatially for the pollutants of interest, which might be useful for decision or policy makers for mitigating impacts of watershed development.

Cost drivers for breast, lung, and colorectal cancer care in a commercially insured population over a 6-month episode: an economic analysis from a health plan perspective.

AIMS: In the absence of clinical data, accurate identification of cost drivers is needed for economic comparison in an alternate payment model. From a health plan perspective using claims data in a commercial population, the objective was to identify and quantify the effects of cost drivers in economic models of breast, lung, and colorectal cancer costs over a 6-month episode following initial chemotherapy. RESEARCH DESIGN AND METHODS: This study analyzed claims data from 9,748 Cigna beneficiaries with diagnosis of breast, lung, and colorectal cancer following initial chemotherapy from January 1, 2014 to December 31, 2015. We used multivariable regression models to quantify the impact of key factors on cost during the initial 6-month cancer care episode. RESULTS: Metastasis, facility provider affiliation, episode risk group (ERG) risk score, and radiation were cost drivers for all three types of cancer (breast, lung, and colorectal). In addition, younger age (p < .0001) and human epidermal growth factor receptor-2 oncogene overexpression (HER2+)-directed therapy (p < .0001) were associated with higher costs in breast cancer. Younger age (p < .0001) and female gender (p < .0001) were also associated with higher costs in colorectal cancer. Metastasis was also associated with 50% more hospital admissions and increased hospital length of stay (p < .001) in all three cancers over the 6-month episode duration. Chemotherapy and supportive drug therapies accounted for the highest proportion (48%) of total medical costs among beneficiaries observed. CONCLUSIONS: Value-based reimbursement models in oncology should appropriately account for key cost drivers. Although claims-based methodologies may be further augmented with clinical data, this study recommends adjusting for the factors identified in these models to predict costs in breast, lung, and colorectal cancers.

Surface sediment quality relative to port activities: A contaminant-spectrum assessment.

Ports are facing increasing environmental concerns with their importance to the global economy. Numerous studies indicated sediment quality deterioration in ports; however, the deterioration is not discriminated for each port activity. This study investigated a spectrum of contaminants (metals and organic pollutants) in surface sediments at 20 sampling points in Port Ningbo, China, one of the top five world ports by volume. The spectrum of contaminants (metals and organic pollutants) was quantified following marine sediment quality guidelines of China and USA and surface sediment quality was assessed according to thresholds of the two guidelines. Coupling a categorical matrix of port activities with the matrix of sedimentary contaminants revealed that contaminants were highly associated with the port operations. Ship repair posed a severe chemical risk to sediment. Operations of crude oil and coal loadings were two top activities related to organic pollutants in sediments while port operations of ore and container loadings discharged metals. Among the 20 sampling points, Cu, Zn, Pb, and DDT and its metabolites were the priority contaminants influencing sediment quality. Overall, surface sediments in Port Ningbo had relatively low environmental risks but ship repair is an environmental concern that must be addressed. This study provides a practical approach for port activity-related quality assessment of surface sediments in ports that could be applicable in many world sites.

Occurrence, source analysis and risk assessment of androgens, glucocorticoids and progestagens in the Hailing Bay region, South China Sea.

The occurrence and spatial distribution of 40 steroids in the environmental matrices of the Hailing Bay region, South China Sea, were investigated by rapid resolution liquid chromatography-tandem mass spectrometry (RRLC-MS/MS). Seventeen, 14 and 11 of 40 steroids were detected with the concentrations ranging from 0.04 (testosterone) to 40.00 ng/L (prednisolone), 1.33 (4-hydroxy-androst-4-ene-17-dione) to 1855 ng/L (androsta-1,4-diene-3,17-dione) and <0.19 (androsta-1,4-diene-3,17-dione) to 2.37 ng/g (progesterone) in the seawater, the municipal sewage discharged effluent and the sediment samples, respectively. The concentrations and risk quotients (RQs) of the steroids detected in the water samples decreased in the order of municipal sewage discharge site>wharves~aquaculture zones~tourism areas>offshore areas. The distribution of steroids in the marine environment was significantly correlated with the levels of chemical oxygen demand (COD) and ammonium nitrogen (NH4-N). Source analysis indicated that untreated municipal sewage was the main source of steroids in the marine environment. Furthermore, progesterone was found to be a reliable chemical indicator to surrogate different steroids in both the water and sediment phases based on the correlation analysis.

Anthropogenic land uses elevate metal levels in stream water in an urbanizing watershed.

Land use/cover change is a dominant factor affecting surface water quality in rapidly developing areas of Asia. In this study we examined relationships between land use and instream metal loadings in a rapidly developing mixed land use watershed in southeastern China. Five developing subwatersheds and one forested reference site (head water) were instrumented with timing- and rainfall-triggered autosampler and instream loadings of anthropogenic metals (Cu, Zn, Pb, Cr, Cd, and Mn) were monitored from March 2012 to December 2013. Farm land and urban land were positively, and forest and green land were negatively associated with metal loadings (except Cr) in stream water. All developing sites had higher loadings than the reference head water site. Assessed by Chinese surface water quality standard (GB3830-2002), instream loadings of Cu and Zn occasionally exceeded the Class I thresholds at monitoring points within farmland dominated subwatersheds while Mn loadings were greater than the limit for drinking water sources at all monitoring points. Farm land use highly and positively contributed to statistical models of instream loadings of Cu, Zn, Cd, and Mn while urban land use was the dominant contributor to models of Pb and Cd loadings. Rainfall played a crucial role in metal loadings in stream water as a direct source (there were significant levels of Cu and Zn in rain water) and as a driver of watershed processes (loadings were higher in wet years and seasons). Urbanization effects on metal loadings in this watershed are likely to change rapidly with development in future years. Further monitoring to characterize these changes is clearly warranted and should help to develop plans to avoid conflicts between economic development and water quality degradation in this watershed and in watersheds throughout rapidly developing areas of Asia.

Functional assessment of metal oxide nanoparticle toxicity in immune cells.

Understanding the nanoparticle-cell interaction is critical for the safe development of nanomaterials. Herein, we explore the impact of three metal oxide nanoparticles, nonporous Stober SiO(2), mesoporous SiO(2), and nonporous anatase TiO(2) nanoparticles, on primary culture mast cells. Using transmission electron microscopy and inductively coupled plasma atomic emission spectroscopy, we demonstrate that each class of nanoparticle is internalized by the mast cells, localizing primarily in the secretory granules, with uptake efficiency increasing in the following order: nonporous SiO(2) < porous SiO(2) < nonporous TiO(2) nanoparticles. The influence of nanoparticle-laden granules was assessed using carbon-fiber microelectrode amperometry measurements that reveal functional changes in chemical messenger secretion from mast cell granules. Both nonporous and porous SiO(2) nanoparticles cause a decrease in the number of molecules released per granule, with nonporous SiO(2) also inducing a decrease in the amperometric spike frequency and, therefore, having a larger impact on cell function. As the two classes of SiO(2) nanoparticles vary only in their porosity, these results suggest that, while the mesoporous SiO(2) has a drastically larger total surface area due to the pores, the cell-contactable surface area, which is higher for the nonporous SiO(2), is more important in determining a nanoparticles' cellular impact. In comparison, exposure to nonporous TiO(2) slows the kinetics of secretion without altering the number of molecules released from the average granule. The varying immune cell response following exposure to nonporous SiO(2) and nonporous TiO(2) indicates that the nanoparticle-cell interactions are also modulated by surface chemistry.

Assessment of the tumorigenesis and drug susceptibility of three new canine mammary tumor cell lines.

Three canine mammary tumor (CMT) cell lines, namely DE-E, DE-F and DE-SF, have been established from a surgically excised specimen of a malignant mammary tumor. These CMT cell lines have been cultured for over 200 passages. The cell doubling time was estimated to be approximately 30 h for all three cell lines. DE-E, DE-F and DE-SF were epithelial, fibroblast and spindle fibroblast in morphology, respectively. Under electron microscope, DE-F and DE-SF cells displayed a higher nucleus/cytoplasm ratio as compared with DE-E. Variation in chromosome number was also observed in the three cell lines. In addition to the morphological characteristics, these cell lines displayed differential patterns of several known mammary tumor cell markers. Following xenotransplantation of the CMT cells into nude mice, DE-F and DE-SF developed tumors within 2 weeks, whereas DE-E failed to develop any visible tumor up to 8 weeks after injection. Lastly, the CMT cell lines exhibited differential chemoresistance to several anti-tumor drugs, including melatonin, cyclosporine A, tamoxifen and indole, suggesting that these cell lines can be used as a comparative experimental model for the tumorigenesis of mammary carcinomas and a valuable tool for anti-cancer drug screening.

Structure elucidation and preliminary assessment of hydrolase activity of PqsE, the Pseudomonas quinolone signal (PQS) response protein.

In bacteria, the transcription of virulence genes is usually controlled by a cell density-dependent process known as "quorum sensing" (QS). QS relies on small diffusible signaling molecules that cross the bacterial cell wall and activate target transcription factors after a threshold concentration has been reached. Besides two hierarchical QS circuits based on N-acylhomoserine lactones, the human opportunistic pathogen Pseudomonas aeruginosa integrates a signaling system that depends on 2-heptyl-3-hydroxy-4-quinolone, termed "Pseudomonas quinolone signal" (PQS). PQS is produced from genes encoded in the pqs operon, which in addition to the biosynthetic enzymes PqsA-D contains a fifth gene, pqsE, that is not required for production of PQS but whose disruption leads to loss of signal transduction in several but not all pqs operon-dependent processes. PqsE was hence termed "PQS response protein", but its exact mechanism of action is unknown. We have determined the crystal structure of recombinant PqsE and show that it possesses a metallo-beta-lactamase fold with an Fe(II)Fe(III) center in the active site. A copurified ligand was assigned as benzoate and may indicate that PqsE exerts its regulatory effect by converting a chorismate-derived molecule. Further, PqsE was found to slowly hydrolyze phosphodiesters including single- and double-stranded DNA as well as mRNA and also the thioester S-(4-nitrobenzoyl)mercaptoethane. Higher activity was observed after incubation with Co(2+) and, to lesser entent, Mn(2+), suggesting that the Fe(II)Fe(III) center of recombinant PqsE may be an artifact of heterologous expression. A crystal complex of the E182A mutant with bis-pNPP was obtained and suggests a catalytic mechanism for hydrolysis.

Impact on drug cost and use of Medicare part D of medication therapy management services delivered in 2007.

OBJECTIVE: To describe experiences with medication therapy management (MTM) services delivered to benefciaries of Mirixa's health plan clients. SETTING: United States during 2007. PRACTICE DESCRIPTION: Three intervention modalities were offered to provide MTM services: community pharmacy, pharmacist-staffed call centers, and educational mailings. Available data were analyzed to identify any differences among patients receiving any of the three interventions. Patients included in the analysis were those who qualifed for MTM services between April 1, 2007, and June 30, 2007. MTM services were provided for these patients between May 1, 2007, and December 31, 2007. PRACTICE INNOVATION: The MirixaPro platform was created to document the activities associated with the five core elements of an MTM service (medication therapy review, creation of a personal medication record, creation of a medication-related action plan [MAP], intervention and/or referral, and documentation and follow-up). It provides a framework for capturing safety interventions, follow-ups with prescribers, and pharmacist instructions to the patients. MAIN OUTCOME MEASURES: Part D drug costs, use, and generic dispensing ratio in the pre- and post-MTM periods. RESULTS: 21,336 patients received MTM services from a community pharmacist (face to face, 9,140; by phone, 12,196), 3,436 patients received MTM services from a call center pharmacist, and 49,021 patients received an educational mailing. Patients who had a face-to-face session had a decline in mean monthly drug costs of $29 (from $658 to $629), while drug costs decreased by $40 (from $677 to $637) when the community pharmacist provided the services over the telephone. Mean monthly drug costs decreased by $15 (from $676 to $661) for patients receiving MTM services from a call center pharmacist and did not change for patients receiving an educational mailing ($698 in both periods). CONCLUSION: Among patients who received MTM services in 2007, drug costs decreased for those who received service from community pharmacists, decreased somewhat for patients who received service from a call center pharmacist, and were unchanged for those who received MTM via mailing. Further studies are needed to assess the effect of various types of MTM interventions on fnancial, clinical, and humanistic outcomes.

The functional assessment of Alpinia pricei on metabolic syndrome induced by sucrose-containing drinking water in mice.

This study was designed to test whether Alpinia pricei (AP), a member of the ginger family indigenous to Taiwan, reduced metabolic syndrome induced by sucrose-containing drinking water in C57BL/6J mice. Mice given a chow diet were divided into a control group (C) or a test group given 30% sucrose water (SW) to drink ad libitum. After 22 weeks, mice in the SW group were subdivided into SW and SW + AP groups, the latter receiving a chow diet with an ethanol extract of AP (1500 mg/kg dosage). Four weeks later, bio-indexes associated with metabolic syndrome were measured. Compared with the C group, the SW group had significantly higher body weight, visceral fat weights, serum and tissue lipid, serum insulin level and the area under the curve for blood glucose of the insulin tolerance test (p < 0.05). These indicators in the SW + AP group were lower than in the SW group except for serum lipid, although slightly higher than the C group. The SW + AP group also showed significantly lower serum levels of leptin and tumor necrosis factor-alpha and a significantly higher level of adiponectin than the SW group. These results indicated that visceral adiposity and insulin resistance induced by sucrose water drinking might be alleviated by AP supplementation.