HLA-DQ genotype and biochemical characterization of anti-transglutaminase 2 antibodies in patients with type 1 diabetes mellitus in Taiwan.

Human Leukocyte Antigen (HLA)-DQ2 and HLA-DQ8 are genetic risk factors for Type 1 Diabetes Mellitus (T1DM) and Celiac disease (CD) in Caucasians, but their association with Taiwanese Han population is unknown. We screened 532 Taiwanese T1DM patients for CD biomarkers including anti-tissue transglutaminase (TGM2), anti-gliadin and anti-neoepitope antibodies (Abs), sequencing DQB1 genotypes, and characterized the TGM2 Abs. We report that 3.76% of Taiwanese patients had TGM2-Abs and all had no CD's symptoms. In contrast to Caucasian's CD patients, DQ2/DQ8 only constituted ~4/5 of TGM2-Abs positive patients, while the other ~1/5 patients belonged to different HLA genotypes. Either anti-gliadin or anti-neoepitope Abs coexisted with ~3/4 of TGM2-Abs positive patients that were likely due to gluten-ingestion, while the cause of TGM2-Abs production for other ~1/4 of patients was unknown. Purified anti-TGM2 IgA (TGA) and anti-TGM2 IgG (TGG) could bind on endothelial cells surface, recognized native better than denatured forms of TGM2, and TGA inhibited TGM2's transamidation activity by up to 80% but TGG had no effects. Epitope mapping of all TGM2-Abs positive sera demonstrated that TGM2-Abs had heterogeneity in specificities. This is the first study on the differences between Taiwanese Han group and Caucasian in HLA genotypes and properties of TGM2-Abs.

Pollution prevention and waste phycoremediation by algal-based wastewater treatment technologies: The applications of high-rate algal ponds (HRAPs) and algal turf scrubber (ATS).

Following the escalating human population growth and rapid urbanization, the tremendous amount of urban and industrial waste released leads to a series of critical issues such as health issues, climate change, water crisis, and pollution problems. With the advantages of a favorable carbon life cycle, high photosynthetic efficiencies, and being adaptive to harsh environments, algae have attracted attention as an excellent agent for pollution prevention and waste phycoremediation. Following the concept of circular economy and biorefinery for sustainable production and waste minimization, this review discusses the role of four different algal-based wastewater treatment technologies, including high-rate algal ponds (HRAPs), HRAP-absorption column (HRAP-AC), hybrid algal biofilm-enhanced raceway pond (HABERP) and algal turf scrubber (ATS) in waste management and resource recovery. In addition to the nutrient removal mechanisms and operation parameters, recent advances and developments have been discussed for each technology, including (1) Innovative operation strategies and treatment of emerging contaminants (ECs) employing HRAPs, (2) Biogas upgrading utilizing HRAP-AC system and approaches of O2 minimization in biomethane, (3) Operation of different HABERP systems, (4) Life-cycle and cost analysis of HRAPs-based wastewater treatment system, and (5) Value-upgrading for harvested algal biomass and life-cycle cost analysis of ATS system.

Factors associated with diabetic nephropathy in children, adolescents, and adults with type 1 diabetes.

BACKBROUD/PURPOSE: Microalbuminuria and macroalbuminuria are markers of diabetic nephropathy (DN). The purpose of this study was to unravel the risk factors for DN in the young patients with type 1 diabetes (T1D). METHODS: 341 patients (160 males) with T1D diagnosed at the age 7.6 ± 4.0 years with disease duration 11.5 ± 6.5 years were assessed. Among them, 185 were young adults (aged 18.0-36.2 years). Urinary albumin creatinine ratio (UACR) was checked on morning spot urine. Microalbuminuria and macroalbuminuria were defined as a UACR of 30-300 mg/g and >300 mg/g, respectively, in at least 2 consecutive specimens. RESULTS: 50 (14.7%) patients were classified as microalbuminuria and 13 (3.8%) as macroalbuminuria. In all patients, multivariate logistic regression revealed that the most significant risk factors were average HbA1c (%), OR (95% CI) = 1.76 (1.37-2.25), P = 0.002); and male sex, OR = (odd ratio 2.31 (1.19-4.46), P = 0.013). In adult patients, the most significant factors were average HbA1c, OR = 1.74 (1.32-2.31), P = 0.003; and systolic blood pressure, OR = 1.06 (1.01-1.11), P = 0.011. Survival analysis showed average HbA1c levels significantly influenced the development of DN. CONCLUSION: The most important risk factors for DN were average HbA1c and age. When microalbuminuria is detected, proper treatment with ACEIs or ARBs and improving glycemic control can delay progression of DN.

Population-based incidence of diabetes in Australian youth aged 10-18 yr: increase in type 1 diabetes but not type 2 diabetes.

BACKGROUND: Global incidence of childhood type 2 diabetes has increased, with a greater rise amongst certain ethnic groups. OBJECTIVES: To examine the change in the incidence of type 1 and type 2 diabetes in Australian youth, aged 10-18 yr, in New South Wales, Australia. METHODS: Prospective population-based incidence study (2001-2008). Primary case ascertainment was from the Australasian Paediatric Endocrine Group Diabetes Register, secondary independent ascertainment from the National Diabetes Register. RESULTS: There were 202 incident cases of type 2 diabetes (96 boys, 48%). The mean age at diagnosis (±SD) was 14.6 ± 2.5 yr; 93% were overweight (International Obesity Taskforce Grade ≥1). Mean HbA1c was 8.8 ± 2.8%. Ethnicity was Caucasian 31%, Indigenous Australian 20%, Southeast Asian 11%, North African/Middle Eastern 9%, and NewZealander/Melanesian/Polynesian 8%. The mean annual incidence of type 2 diabetes was 3.0 per 100 000 per year (95% confidence interval (CI): 2.6-3.4) and did not change over time. The mean annual incidence of type 1 diabetes was 22.0 per 100 000 per year (95% CI: 20.8-23.1), and increased by 3.8% per year [incidence rate ratio IRR: 1.04, 95% CI: 1.02-1.06, p = 0.001]. Incidence was higher in Indigenous vs. non-Indigenous youth, IRR: 6.9 (95% CI: 4.7-10.2, p < 0.001). CONCLUSION: In 10-18 yr old youth, in Australia, the incidence of type 2 diabetes has remained steady during the last decade; however, the incidence of type 1 diabetes continues to rise. Most common diabetes in Australian youth is type 1 diabetes.

Utilizing microalgal hydrolysate from dairy wastewater-grown Chlorella sorokiniana SU-1 as sustainable feedstock for polyhydroxybutyrate and ß-carotene production by engineered Rhodotorula glutinis #100-29.

The objective of this study was to explore the potential of utilizing Chlorella sorokiniana SU-1 biomass grown on dairy wastewater-amended medium as sustainable feedstock for the biosynthesis of ß-carotene and polyhydroxybutyrate (PHB) by Rhodotorula glutinis #100-29. To break down the rigid cell wall, 100 g/L of microalgal biomass was treated with 3% sulfuric acid, followed by detoxification using 5% activated carbon to remove the hydroxymethylfurfural inhibitor. The detoxified microalgal hydrolysate (DMH) was used for flask-scale fermentation, which yielded a maximum biomass production of 9.22 g/L, with PHB and ß-carotene concentration of 897 mg/L and 93.62 mg/L, respectively. Upon scaling up to a 5-L fermenter, the biomass concentration increased to 11.2 g/L, while the PHB and ß-carotene concentrations rose to 1830 mg/L and 134.2 mg/L. These outcomes indicate that DMH holds promise as sustainable feedstock for the production of PHB and ß-carotene by yeast.

Integration of microalgae cultivation and anaerobic co-digestion with dairy wastewater to enhance bioenergy and biochemicals production.

A sequential anaerobic digestion and phycoremediation process was employed to recover nutrients and remove pollutants from dairy wastewater (DW), while simultaneously producing biomethane and biochemicals. Anaerobic digestion of 100% DW achieved a methane content and production rate of 53.7% and 0.17 L/L/d, respectively. This was accompanied by the removal of 65.5% chemical oxygen demand (COD), 86% total solid (TS), and 92.8% volatile fatty acids (VFAs). The anaerobic digestate was then used to grow Chlorella sorokiniana SU-1. Using 25% diluted digestate as the medium, SU-1 could reach 4.64 g/L biomass concentration, with total nitrogen (TN), total phosphorus (TP) and COD removal efficiencies of 77.6%, 87.1% and 70.4%, respectively. The obtained microalgal biomass (contained 38.5% carbohydrates, 24.9% proteins, 8.8% lipids) was used to co-digest with DW, resulting in good methane production performance. Co-digestion with 25% (w/v) algal biomass obtained a higher CH4 content (65.2%) and production rate (0.16 L/L/d) than other ratios.

The effects of gonadotropin-releasing hormone agonist on final adult height among girls with early and fast puberty.

Introduction: This study aimed to explore the impact of gonadotropin-releasing hormone agonists (GnRHa) on final adult height (FAH) in girls with early and fast puberty. Methods: A retrospective study was conducted by reviewing data from the medical records of the Pediatric Endocrinology Clinics between January 1, 2010, and December 31, 2020, at MacKay Children's Hospital. The treatment group included 109 patients who received 3.75 mg monthly for at least 1 year, whereas the control group consisted of 95 girls who received no treatment. Results: The treatment group was significantly older at the time of inclusion(chronological age (CA1), treatment vs. control, 8.7 vs. 8.4 years, p < 0.001), had a more advanced bone age (BA) (BA1, 11.5 vs. 10.8 years, p < 0.001), BA1-CA1 (2.7 vs. 2.2 years, p < 0.001), and shorter predicted adult height (PAH1) (153.3 vs. 157.1 cm, p = 0.005) that was significantly lower than their target height (Tht)(PAH1-Tht, -3.9 vs. -1.3 cm, p = 0.039). The FAHs of the GnRHa and the control group were similar (157.0 vs. 156.7 cm, p = 0.357) and were not significantly different from their Tht (FAH vs. Tht in the GnRHa group, 157.0 vs. 157.0 cm; control group, 156.7 vs. 157.0 cm). In the subgroup analysis, FAH was significantly higher after GnRHa treatment in those with PAH1 less than 153 cm and Tht (154.0 vs. 152.0 cm, p = 0.041), and those whose CA1 was between 8 and 9 years (158.0 vs. 155.4 cm, p = 0.004). We defined satisfactory FAH outcome as FAH-PAH1≥5 cm and significant factors were GnRHa therapy, PAH1 shorter than their Tht, age younger than 9 years, and faster growth velocity during the first year. Discussion: GnRHa is effective in restoring the Tht in some early and fast pubertal girls, especially in those with poorly PAH (PAH lower than 153 cm and shorter than their target height). A younger age at initiation of treatment and a faster growth velocity during treatment are associated with a better height gain.

Association between weight status and depressive symptoms in adolescents: role of weight perception, weight concern, and dietary restraint.

Adolescence obesity and depression are increasingly prevalent and are associated with various health complications. The aim of this study was to examine the association between weight status (normal weight, overweight, and obese) and depressive symptoms in adolescents and to explore the probable mediators, including overweight perception, greater weight concern, and dietary restraint. During the period October 2010 to January 2011, we recruited 869 adolescents (47 % girls; median age, 15.7 years) from four randomly selected high schools in Taipei city. The students were stratified into normal weight, overweight, or obese groups according to age- and gender-specific body mass index standards. Depressive symptoms were defined in students with a score of 29 or greater on the Center for Epidemiologic Studies Depression Scale. Overall, weight status was significantly associated with depressive symptoms (P = 0.02). Weight status was strongly associated with perceived overweight, greater weight concern, and dietary restraint. Those three variables were also associated with depressive symptoms. The association between overweight and depressive symptoms (odds ratio, 2.23; 95 % confidence interval, 1.30-3.82) became weaker after controlling for perceived overweight, greater weight concern, and dietary restraint. The association between weight status and depressive symptoms in adolescents was partly mediated by perceived overweight, greater weight concern, and dietary restraint. Further prospective cohort studies are needed to explore the association between weight status and depressive symptoms.

DDPG-Based Adaptive Robust Tracking Control for Aerial Manipulators With Decoupling Approach.

Aerial manipulators have the potential to perform various tasks with high agility and mobility, but the requirement of system parameters and the complicated dynamic model impede the implementation in practice. To deal with uncertain parameters and complexity of the coupled dynamic model, a decoupling approach is presented in this article by utilizing the adaptive/robust techniques and reinforcement learning approach for the tracking control of quadrotors with position control on the robotic arm. A reinforcement learning approach is proposed to control the robotic arm ensuring minimal effect on the quadrotor dynamics while following the desired trajectory. With the design of nominal inputs, the dynamic uncertainties from the quadrotor, robotic arm, and payload are coped with by utilizing the proposed adaptive algorithms. In addition, the residue of interactive force/torque after the use of DDPG is compensated by robust controllers so that the stability and tracking performance are guaranteed. Numerical examples and experiments are illustrated to demonstrate the efficacy of the presented aerial manipulator control structure and algorithms.

Integrating anaerobic digestion and microalgae cultivation for dairy wastewater treatment and potential biochemicals production from the harvested microalgal biomass.

Utilizing wastewaters as feedstock for microalgal cultivation has the dual benefits of water-saving and low nutrient costs, with simultaneous remediation of pollutants and generation of value-added biochemical products. This study employed two different strategies to treat raw dairy wastewaters with moderate and high chemical oxygen demand (COD) levels. For moderate-COD dairy wastewater, the wastewater was directly utilized as feedstock for algal cultivation, in which the effects of wastewater dilution ratios and algal inoculum sizes were investigated. The results show that the microalga strain used (Chlorella sorokiniana SU-1) was capable of obtaining a high biomass concentration of 3.2 ± 0.1 g/L, accompanied by 86.8 ± 6%, 94.6 ± 3%, and 80.7 ± 1%, removal of COD, total phosphorus (TP) and total nitrogen (TN), respectively. Meanwhile, the obtained microalgal biomass has lipids content of up to 12.0 ± 0.7% at a wastewater dilution ratio of 50% and an inoculum size of 2 g/L. For high-COD dairy wastewater, an integrated process of anaerobic digestion and microalgal phycoremediation was employed, and the effect of inoculum sizes was also studied. The inoculum size of 2 g/L gave highest biomass production of 4.25 ± 0.10 g/L with over 93.0 ± 2.0% removal of COD, TP, and TN. The harvested microalgal biomass has lipids and protein content of 12.5 ± 2.2% and 18.0 ± 2.2%, respectively. The present study demonstrated potential microalgal phycoremediation strategies for the efficient COD removal and nutrients recovery from dairy wastewater of different COD levels with simultaneous production of microalgal biomass which contains valuable components, such as protein and lipids.

Graves disease is more prevalent than Hashimoto disease in children and adolescents with type 1 diabetes.

Introduction: Autoimmune thyroid disease (AITD) is the most common associated autoimmune disorder in type 1 diabetes (T1D). Early detection of AITD is crucial to optimize glycemic control, growth, and intellectual development. In this prospective cohort study, we sought to characterize the prevalence, incident ages and risk factors of AITD in children and adolescents with T1D. Materials and methods: Patients with T1D diagnosed at ≤ 18 years at MacKay Children's Hospital, Taipei, from 1990 to 2019 underwent annual screening for AITD. Institutional Review Board-approved data on age, sex, and disease profile are collected. Statistical analysis was performed by using independent sample t test for continuous variables, chi-squared test for categorical variables, and Kaplan-Meier estimates of cumulative incidence of AITD were calculated. A p value of <0.05 was considered statistically significant. Results: We prospectively followed up 808 patients with T1D, 761 patients were included in the study. Of these patients, 197 (25.9%) of them had thyroid autoimmunity, meaning positivity of thyroid autoantibodies. Females had a higher prevalence of thyroid autoimmunity than males (59.9%, p = 0.012). Altogether, 5.5% patients developed AITD (4.1% had Graves disease; 1.4% had Hashimoto disease), at a mean age of 17.8 ± 8.5 years. The cumulative incidence of AITD at 30 years of disease duration was 0.29 in the total group and was significantly higher in females (0.39, n = 397) than in males (0.15, n = 364, p<0.001). Discussion: In Taiwan, the prevalence of AITD in pediatric population with T1D increases with age, a longer disease duration and female sex. For early detection of autoimmune thyroid disease in Taiwanese children and adolescents with T1D, an annual AITD screening program should be implemented.

The effects of estrogen induction therapy on pubertal presentations in turner syndrome patients.

OBJECTIVE: In this study, we investigated various pubertal presentations and progressions before and after estrogen induction therapy and the correlations with Turner syndrome karyotypes. MATERIALS AND METHODS: We reviewed the medical records of patients with Turner syndrome diagnosed before the age of 18 years between 2000 and 2019. Sixty-six patients were enrolled and distributed into 45,X monosomy group, X chromosome structural abnormalities group and X mosaicism group. The pubertal presentations were classified into spontaneous puberty, arrested puberty and no spontaneous puberty. All patients' karyotypes, pubertal progressions and laboratory data were collected and analyzed. RESULTS: The karyotypes were highly correlated with pubertal presentations. No spontaneous puberty was noticed in 58.3% 45,X monosomy patients, 50% patients with X chromosome structural abnormalities had arrested puberty, whereas 70% patients with X mosaicism had spontaneous puberty. Estrogen induction therapy in patients with no spontaneous puberty could induce puberty and the tempo of puberty may approximate to the spontaneous puberty group (median, 2.3 vs. 2.2 years, P = 0.95). In both interventional groups, the FSH level was distinguishable before treatment (median, 65.1 vs. 100.4 mIU/mL, P = 0.02). After long term estrogen therapy, the FSH could be suppressed to similar level in both interventional groups (median, 37.5 vs 34.5 mIU/mL, P = 0.84). Neither LH nor E2 level provided valuable information before and after treatment. CONCLUSION: The karyotypes were highly correlated with pubertal presentations at Turner syndrome patients. The integrity of 2nd X chromosome plays an important role. Low dose estrogen could mimic the tempo of puberty even delay induction age at Taiwan. The FSH data could provide predictive information of pubertal induction for both interventional groups.

Genetic studies of Prader-Willi patients provide evidence for conservation of genomic architecture in proximal chromosome 15q.

Prader-Willi syndrome (PWS) is a neurogenetic disorder associated with recurrent genomic recombination involving low copy repeats (LCRs) located in the human chromosome 15q11-q13. Previous studies of PWS patients from Asia suggested that there is a higher incidence of deletion and lower incidence of maternal uniparental disomy (mUPD) compared to that of Western populations. In this report, we present genetic etiology of 28 PWS patients from Taiwan. Consistent with the genetic etiology findings from Western populations, the type II deletion appears to be the most common deletion subtype. Furthermore, the ratio of the two most common deletion subtypes and the ratio of the maternal heterodisomy to isodisomy cases observed from this study are in agreement with previous findings from Western populations. In addition, we identified and further mapped the deletion breakpoints in two patients with atypical deletions using array CGH (comparative genomic hybridization). Despite the relatively small numbers of patients in each subgroup, our findings suggest that the genomic architecture responsible for the recurrent recombination in PWS is conserved in Taiwanese of the Han Chinese heritage and Western populations, thereby predisposing chromosome 15q11-q13 to a similar risk of rearrangements.

Poorly differentiated thyroid carcinoma in a 9-year-old boy: case report.

Poorly differentiated thyroid carcinoma (PDTC) is a rare disease with a poor prognosis in children. We describe a 9-year-old boy with a thyroid nodule composed of cystic and solid components, which became completely solid and hypoechoic and was subsequently proved to be PDTC. The tumor consisted of small- to intermediate-size round cells in a trabecular or insular pattern with hyperchromatic nuclei and mitotic figures. The tumor cells were positive for thyroid transcription factor 1 and thyroglobulin. PDTC is morphologically and prognostically between the well-differentiated and anaplastic carcinomas. It must be distinguished from the solid variant of papillary carcinoma and well-differentiated follicular carcinoma with a predominantly solid/trabecular growth pattern. The tumor stage was T2N0M0. The patient was treated with total thyroidectomy, left-sided neck level VI lymph node dissection, recombinant human thyrotropin-stimulated 131I ablation therapy, and thyroid-stimulating hormone suppression. Malignancy should be suspected in a cystic thyroid nodule that becomes solid and hypoechoic.

Assessment of body composition using bioelectrical impedance analysis in Prader-Willi syndrome.

This study investigated the use of bioelectrical impedance analysis (BIA) as a means of assessing body composition in patients with Prader-Willi syndrome (PWS). Segmental, multifrequency BIA was performed on 30 patients with PWS (16 males and 14 females; mean age: 8.1 ± 3.9 years; age range: 2.9-19.6 years) using eight tactile electrodes. No patient had received growth hormone treatment prior to baseline measurements. Standard deviation scores for height, weight, and body mass index were -0.96 ± 1.29, 2.28 ± 2.66, and 3.14 ± 2.74, respectively. Percentages of body fat, total body water, and soft lean mass were 45.9 ± 10.8%, 36.6 ± 7.3%, and 49.9 ± 9.9%, respectively. Body fat percentage was positively correlated with the body mass index standard deviation score (r = 0.665, p < 0.01). Follow-up BIA was also performed on five patients who received growth hormone therapy (duration of treatment: 1.5-4.6 years). All of these patients showed reductions in their body fat percentages after treatment. BIA confirmed a significantly higher percentage of body fat in patients with PWS compared with normal children. These findings and the follow-up data can be used to develop quality care strategies for patients with PWS.

Microalgae as sustainable food and feed sources for animals and humans - Biotechnological and environmental aspects.

Offering a potential solution for global food security and mitigating environmental issues caused by the expansion of land-based food production, the carbon-hunger and nutrient-rich microalgae emerged as a sustainable food source for both humans and animals. Other than as an alternative source for protein, microalgae offer its most valuable nutrients, omega-3 and 6 long-chain polyunsaturated fatty acids where the content can compete with that of marine fish with lower chemicals contamination and higher purity. Furthermore, the colorful pigments of microalgae can act as antioxidants together with many other health-improving properties as well as a natural colorant. In addition, the supplementation of algae as animal feed provides plentiful benefits, such as improved growth and body weight, reduced feed intake, enhanced immune response and durability towards illness, antibacterial and antiviral action as well as enrichment of livestock products with bioactive compounds. The significant breakthrough in algal biotechnology has made algae a powerful "cell factory" for food production and lead to the rapid growth of the algal bioeconomy in the food and feed industry. The first overview of this review was to present the general of microalgae and its potential capability. Subsequently, the nutritional compositions of microalgae were discussed together with its applications in human foods and animal feeds, followed by the exploration of their economic feasibility and sustainability as well as market trends. Lastly, both challenges and future perspectives were also discussed.

Diagnostic evaluation of central precocious puberty in girls.

BACKGROUND: The gonadotropin-releasing hormone (GnRH) stimulation test is the gold standard for confirming the activation of the hypothalamic-pituitary-gonadal axis in central precocious puberty (CPP). However, it is time-consuming and costly. Our aim was to search for a simpler diagnostic modality for CPP by 1) evaluating the performance of basal serum luteinizing hormone (LH), 2) constructing a practical scoring system, and 3) determining the optimal single sampling time for serum LH in the GnRH stimulation test. METHODS: Data of girls aged between 3 and 9 years at the time of the GnRH stimulation test, who attended our endocrine clinic at the MacKay Children's Hospital for signs of puberty between July 2014 and June 2019, were analyzed retrospectively. We recorded patients' age, height, weight, breast Tanner stage (BS), bone age, serum LH, and follicle-stimulating hormone (FSH). Receiver operating characteristic (ROC) curves and the Youden index were used to obtain the optimal basal serum LH level. Binary logistic regression was employed to construct a practical scoring system. Cross-sectional, cumulative frequency, and ROC curves were used to simplify the GnRH stimulation test. RESULTS: Overall, 381 sets of GnRH stimulation tests were performed in 313 patients. Basal serum LH ≥ 0.2 IU/L demonstrated 70% sensitivity and 70% specificity for predicting positive GnRH stimulation test results. The practical scoring system (3 × BS + 3 × LH + 4 × FSH) showed 76% sensitivity and 72% specificity. The serum LH level at 30 min after intravenous gonadorelin exhibited 99% sensitivity and 100% specificity. CONCLUSION: Single sampling of serum LH at 30th minute post-injection of GnRH demonstrated a diagnostic performance equivalent to the traditional GnRH stimulation test in diagnosing CPP. Therefore, this approach could become the simplest diagnostic modality.

Exposure effect of fungicide kasugamycin on bacterial community in natural river sediment.

The degradation of kasugamycin in water and the effects of kasugamycin on the bacterial communities in sediment and overlying water were analyzed over a 30-day period. Kasugamycin is generally regarded as nontoxic to microorganisms, but in this study we demonstrated that kasugamycin inhibited the growth of some aquatic bacteria but also stimulated the growth of other resistant bacteria. Microcosms were contaminated with kasugamycin at the 168.4 mg/L (700 times field application rate), and 1462.9 mg/L (6000 times field application rate). The percentages of kasugamycin degraded after 30 days of exposure were 34.1%, and 12.1% in the overlying water treated with 168.4 mg/L and 1462.9 mg/L, respectively. The degradation rates of kanamycin after 30 days of exposure were 1.92 mg/L/day for 164.8 mg/L treated water and 5.88 mg/L/day for 1462.9 mg/L treated water. Degradation rate of kasugamycin in overlying water was associated with an increase in the concentration of kasugamycin. Comparison of DGGE (denaturing gradient gel electrophoresis) profiles showed that the bacterial communities in treated microcosms were varied. Certain species were eliminated whereas some species were stimulated by the application of kasugamycin. The DGGE profiles and UPGMA (unweighted pair-group method using arithmetic averages) dendrograms revealed that the bacterial communities were more complex in treated sediment than in treated overlying water.

Validation of the Chinese version of the insulin treatment appraisal scale.

AIMS: To test the reliability and validity of the Chinese version of the Insulin Treatment Appraisal Scale (ITAS) questionnaire in patients with type 2 diabetes mellitus (T2DM). METHODS: A total of 200 patients with T2DM were consecutively recruited from the outpatient clinic in Taiwan. The World Health Organization guideline was followed to translate the questionnaire. The internal consistency was assessed by Cronbach's α coefficient and item-total correlations. The construct validity was evaluated by using confirmatory factor analysis, convergent validity, and discriminate validity. RESULTS: The Cronbach's α coefficient for estimates of internal consistency of the total scale was 0.72, and ranged from 0.76 to 0.77 for the subscales. A value of ≥0.40 was considered being substantial. The item-total correlation values were 14 out of 20 items having substantial correlations (4 out of 4 items on the positive appraisal scale and 10 out of 16 items on the negative appraisal scale). The confirmatory factor analysis confirmed both positive and negative factors with total explained variance 33.9% (12.2% for positive subscale and 21.7% for negative subscale). The success rate, calculated from the item-total correlation values, was 70% for the convergent validity (100% for positive subscale and 63% for negative subscale) and 90% for discriminate validity (100% for positive subscale and 88% for negative subscale), respectively. Both the ceiling effect and floor effect were 0%. CONCLUSIONS: The Chinese version of the ITAS questionnaire is a valid and reliable instrument for measuring the perceptions of insulin injection in patients with T2DM.