Effect of various different pretreatment methods on infrared combined hot air impingement drying behavior and physicochemical properties of strawberry slices.

In current work, the effect of freezing (F), ultrasound (U), and freeze- ultrasound (FU) pretreatment on infrared combined with hot air impingement drying kinetics, cell ultrastructure, enzyme activity, and physicochemical properties of strawberry slices were explored. Results showed that FU pretreatment enhanced cell membrane permeability via forming micropores, altered water status by transforming bound water into free water and thus promoted moisture diffusivity and decreased drying time by 50% compared to the control group. FU pretreatment also extensively decreased pectin methylesterase enzyme activity and maintained quality. The contents of total phenols, anthocyanins, vitamin C, antioxidant activity, and a* value of dried strawberries pretreated by FU were extensively increased compared to the control group. U and FU pretreatments were beneficial for retaining aromatic components and organic sulfides according to e-nose analyses. The findings indicate that FU is a promising pretreatment technique as it enhances drying process and quality of strawberry slices.

Association Between Use of Sodium-Glucose Cotransporter-2 Inhibitors or Angiotensin Receptor-Neprilysin Inhibitor and the Risk of Atherosclerotic Cardiovascular Disease With Coexisting Diabetes and Heart Failure.

PURPOSE: This study was to investigate the association between the use of Sodium-glucose Cotransporter-2 inhibitors (SGLT2i) or angiotensin receptor-neprilysin inhibitor (ARNI; ie, Sacubitril + valsartan, Product name ENTRESTO) and the risk of atherosclerotic cardiovascular disease (ASCVD) in patients with coexisting diabetes and heart failure. Specifically, the study compared outcomes between patients using SGLT2i or valsartan + sacubitril and those not using these medications. METHODS: This study utilized data from the National Health Insurance Research Database (NHIRD) from 2017 to 2018. The case group consisted of 8691 patients with coexisting diabetes and heart failure who did not use SGLT2i or Entresto, while the control group consisted of 8691 patients with coexisting diabetes and heart failure who used SGLT2i or Entresto. The primary outcome was ASCVD, including a composite of cardiovascular death and hospitalization for worsening heart failure. Secondary outcomes included all-cause death, cause of cardiovascular death, and recurrence of heart failure, non-fatal myocardial infarction, non-fatal stroke (including ischemic stroke and hemorrhagic stroke) and new renal replacement therapy. RESULTS: The study found that the use of SGLT2 inhibitors or ARNI was associated with a lower risk of ASCVD in patients with coexisting diabetes and heart failure. CONCLUSION: The study suggests that the use of SGLT2 inhibitors, alone or in combination with Entresto, may be effective in reducing the risk of ASCVD and its associated adverse outcomes in patients with diabetes and heart failure. This finding has important implications for the management of these conditions.

SOX1 Functions as a Tumor Suppressor by Repressing HES1 in Lung Cancer.

The development of lung cancer is a complex process that involves many genetic and epigenetic changes. Sex-determining region Y (SRY)-box (SOX) genes encode a family of proteins that are involved in the regulation of embryonic development and cell fate determination. SOX1 is hypermethylated in human cancers. However, the role of SOX1 in the development of lung cancer is unclear. We used quantitative methylation-specific polymerase chain reaction (MSP), quantitative reverse transcription polymerase chain reaction (RT-PCR) analysis, and web tools to confirm the frequent epigenetic silencing of SOX1 in lung cancer. Stable overexpression of SOX1 repressed cell proliferation, anchorage-independent growth, and invasion in vitro as well as cancer growth and metastasis in a xenograft mouse model. Knockdown of SOX1 by the withdrawal of doxycycline partly restored the malignant phenotype of inducible SOX1-expressing NSCLC cells. Next, we discovered the potential downstream pathways of SOX1 using RNA-seq analysis and identified HES1 as a direct target of SOX1 using chromatin immunoprecipitation (ChIP)-PCR. Furthermore, we performed phenotypic rescue experiments to prove that overexpression of HES1-FLAG in SOX1-expressing H1299 cells partly reversed the tumor-suppressive effect. Taken together, these data demonstrated that SOX1 acts as a tumor suppressor by directly inhibiting HES1 during the development of NSCLC.

Synthesis Metakaolin-Based Geopolymer Incorporated with SiC Sludge Using Design of Experiment Method.

This study uses metakaolin, sodium hydroxide, sodium metasilicate, and water content as the reaction variables in the application of the design of experiment (DOE) method. At the same time, the various component factors and their interactions were analyzed to understand how these factors affect the mechanical properties of a metakaolin-based geopolymer incorporated with SiC sludge (SCSGPs). The results of the statistical analysis showed that the compressive strength of SCSGPs was affected by the Na/Si molar ratio (NSR) (p-level = 0.000 <0.05), the Na/Al molar ratio (NAR) (p-level= 0.000 <0.05), and the interaction between the dissolution rate of Si (DRA). Within the design scope of this study, the maximum compressive strength of SCSGPs and the coefficients of the NSR, the NAR, and the DRA of SCSGPs was evaluated. The multiple regression analysis and the tested coefficient of r2 were also studied. The multiple regression analysis models provide an effective reference for the application of SCSGPs.

The role of a synanthropic bird in the nest niche expansion of a secondary cavity nester to man-made structures.

Species with similar ecological characters often compete with each other; however, a species may also facilitate the survival or reproduction of another ecologically similar species, although such interaction is rarely documented in birds. Here, we reported a facilitative species interaction between Asian house martins (Delichon dasypus) and russet sparrows (Passer cinnamomeus), both passerines using closed nests, in a montane farming area of Taiwan. We found that Asian house martins constructed dome-shaped nests in human houses that provided additional nest sites for russet sparrows, secondary cavity nesters with greatly declining populations in Taiwan. Russet sparrows that used house martin nests had reproductive success comparable to those that used artificial nest boxes. However, Asian house martins avoided reclaiming sparrow-used nests, which reduced their available nest sites. Interestingly, our results imply that man-made structures may be used as a conservation tool to improve the breeding of the endangered russet sparrows via this facilitative interaction.

[Effect of a Simple Home-Based Oral Care Regimen on Oral Mucositis in Patients With Oral Cavity and Nasopharyngeal Cancer: A Quasi-Experimental Study].

BACKGROUND: The majority of patients with oral cavity and nasopharyngeal cancer experience severe oral mucositis during concurrent radiochemotherapy. The effectiveness of routine nursing education remains limited. PURPOSE: To evaluate the effect of a simple home-based oral care regimen on oral mucositis. METHODS: A double-group quasi-experimental design was adopted in this study. The participants were all newly diagnosed patients with oral cavity and nasopharyngeal cancer who were scheduled to receive concurrent radiochemotherapy in a northern medical center. A total of 31 patients in the experimental group and 32 patients in the control group were enrolled as participants. The control group received routine care, while the experimental group received an additional six- to seven-week two-way interactive home-based oral care regimen. The measurement tools included a plaque record and oral assessment guide (OAG) implemented twice during the study period. Study data were collected at 8 time points, including before treatment, at 1-5 weeks of treatment, at the end of treatment, and at one-month post-treatment. Data analysis was performed using two-way repeated measures ANCOVA. RESULTS: After controlling for OAG score, nutrition, age, living habits, and oral hygiene, the development of mucositis was found to be significantly slower in the experimental group than in the control group during the traumatic phase (effect of group: F = 11.1, p < .01; effect of group x time: F = 3.5, p = .01). However, both groups reported a statistically similar rate of improvement during the repair phase (effect of group and group x time: F = 0.19, p = .67). CONCLUSIONS / IMPLICATIONS FOR PRACTICE: The simple home-based oral care regimen introduced in this study may be used to improve traumatic oral mucositis in patients with oral cavity and nasopharyngeal cancer. It is recommended that even after the completion of radiotherapy, medical staffs should continue to strengthen patients' execution of proper oral care to maintain the positive effect until the mucositis has abated.

Notch1/Hes1­PTEN/AKT/IL­17A feedback loop regulates Th17 cell differentiation in mouse psoriasis­like skin inflammation.

IL­17A, the effector cytokine of T helper (Th) 17 cells, plays a crucial role in the pathogenesis of psoriasis. The Notch1 and PI3K/AKT signaling pathways are implicated in Th17 cell differentiation and IL­17A production. The present study aimed to evaluate the regulatory effect of the Notch1/hairy and enhancer of split 1 (Hes1)­PTEN/AKT/IL­17A feedback loop on Th17 cell differentiation via the PI3K/AKT inhibitor LY294002 in a mouse model of psoriasis. Mice were randomly divided into 3 groups: a control group, a model group [5% imiquimod (IMQ)­induced group] and an intervention group (5% IMQ­induced plus LY294002­treated group). Skin structural characteristics were recorded and evaluated by hematoxylin and eosin staining. The weights of the spleens and inguinal lymph nodes were measured. Th17 cell percentage, as well as the mRNA and protein expression levels of Notch1, Notch1 intracellular domain (NICD1), Hes1, PTEN, AKT, phosphorylated (p)­AKT, mTOR complex 1 (mTORC1), p­mTORC1, S6 kinase (S6K)1, S6K2 and IL­17A were detected in skin samples of the three experimental groups. Additionally, splenic mononuclear cells from model mice were treated by 10 and 50 µM LY294002 to further evaluate its regulatory effect on Notch1/Hes1­PTEN/AKT/IL­17A feedback loop. Increased Th17 cell percentage, increased expression of Notch1, NICD1, Hes1, AKT, p­AKT, mTORC1, p­mTORC1, S6K1, S6K2 and IL­17A, and decreased PTEN levels were observed in model mice alongside marked psoriasis­like skin inflammation, splenomegaly and lymphadenopathy. LY294002 treatment significantly alleviated the severity of psoriasis­like skin inflammation in the intervention mice, attenuated the degree of epidermal hyperplasia and dermal inflammatory cell infiltration, and mitigated splenomegaly and lymphadenopathy. In addition, LY294002 treatment reversed the increased Th17 cell percentage, as well as the increased expression of Notch1, NICD1, Hes1, AKT, p­AKT, mTORC1, p­mTORC1, S6K1, S6K2 and IL­17A, and the decreased expression of PTEN. In vitro study from 5% IMQ­induced mouse splenic mononuclear cells presented that high dose of LY294002 exerted more obviously regulatory effect on Notch1/Hes1­PTEN/AKT/IL­17A feedback loop. The current findings suggested that the Notch1/Hes1­PTEN/AKT/IL­17A feedback loop regulates Th17 cell differentiation within the disease environment of psoriasis. Blocking the Notch1/Hes1­PTEN/AKT/IL­17A feedback loop may thus be a potential therapeutic method for management of psoriatic inflammation.

Risk of Retinopathy of Prematurity in Preterm Births with Respiratory Distress Syndrome: A Population-Based Cohort Study in Taiwan.

BACKGROUND: Respiratory distress syndrome (RDS) is a risk factor that plays an important role in retinopathy in preterm infants. We used population data of infants to investigate this relationship. This study evaluated whether respiratory distress syndrome was associated with an increased incidence of ROP in preterm infants. METHODS: From the National Health Insurance claims data of Taiwan in the 2000-2009 period, preterm infants were identified to establish a RDS cohort (N = 7573) and a comparison cohort without RDS (N = 11428). We followed each infant for one year to identify incident retinopathy of prematurity (ROP) for comparison between the two cohorts. The RDS cohort for comparisons of hazard ratio (HR) with 95% confidence interval (CI) were calculated. RESULTS: Low birth weight, an extended stay in the neonatal intensive care unit (NICU), female gender, and RDS were factors associated with an increased incidence of ROP. The ROP incidence was 2.5-fold higher in RDS children than in control (30.3 versus 11.9 per 100 person-years), with an adjusted HR (aHR) of 1.28 (95% CI = 1.18-1.39). The incidence increased as the birth weight decreased in both cohorts, but the RDS cohort to the comparison cohort aHR decreased as the birth weight decreased, not significant for groups with birth weights less than 1500g. The aHR for RDS children was the highest for infants with a normal birth weight: 3.33 (95% CI = 2.09-5.31). Among infants with RDS, the ROP incidence increased to 51.0 per 100 person-years in those who underwent invasive ventilation, or to 76.3 per 100 person-years for NICU stay for ≥30 days. CONCLUSION: Preterm infants with RDS are at an elevated risk of developing ROP, not limited to those with low birth weights.

Population-Based Study on Cancer Incidence in Pharmacist: A Cohort Study in Taiwan.

Cancer is increasing in rate globally and is leading cause of death among no communicable chronic diseases (NCDs) after cardiovascular disease (CVD). Most of the research focuses on the risk of occupational injury, job stress, mental illness, substance abuse and workplace safety in physicians and nurses. However, fewer studies have investigated the risk of cancer in pharmacists. We compared the matched general population to investigate the risk of cancer in pharmacists in Taiwan. Data were obtained from the Health and Welfare Data Science Center of the Ministry of Health and Welfare in Taiwan. We established a pharmacist group that included 11,568 pharmacists and selected a 4-fold comparison (n = 46,272) for the non-clinics comparison group, frequency being matched by age, gender and Charlson Comorbidity Index (CCI) score. The pharmacists had a lower but non-significant risk of all cancer (Adjusted hazard ratio [aHR] = 0.96; 95% confidence interval [CI] = 0.85-1.07) compared with the general population. Female pharmacists had a higher risk of cancer than male pharmacists ([aHR] = 1.23; 95% CI = 1.06-1.43). Pharmacists had higher risks of breast cancer in females (aHR = 1.68; 95% CI = 1.35-2.08) and of prostate cancer in males (aHR = 2.18; 95% CI = 1.35-2.08) when compared with the general population. Occupational risk factors could play a role, but they were not evaluated. These epidemiological findings require additional studies to clarify cancer risk mechanisms in pharmacists.

Recycling of Silicon Carbide Sludge on the Preparation and Characterization of Lightweight Foamed Geopolymer Materials.

This study used silicon carbide sludge (SCS) to prepare lightweight foaming geopolymer materials (FGPs) by the direct foaming method. Results showed that when the SCS replacement level was 10%, the bulk density of the lightweight FGPs with added foaming agent amounts of 0.5% and 2.0% was 0.59 and 0.49 g/cm3, respectively; at a curing time of 28 days, the lightweight FGPs with amounts of added foaming agent of 0.5% and 2.0% had bulk densities that were 0.65 and 0.58 g/cm3, respectively. When the SCS replacement level was 10%, and the amount of added foaming agent was 2.0%, the porosity ratio of the lightweight FGP increased from 31.88% to 40.03%. The mechanical strength of the lightweight FGPs with SCS replacement levels of 10% and 20% was 0.88 and 0.31 MPa, respectively. Additionally, when the amount of foaming agent increased to 2.0%, the thermal conductivity of the lightweight FGPs with SCS replacement levels of 10% and 20% were 0.370 and 0.456 W/m⋅K, respectively. When the curing time was 1 day, and the amount of added foaming agent was 0.5%, the reverse-side temperature of the lightweight FGPs with SCS replacement levels of 10% and 20% were 286 and 311 °C, respectively. The k value of the O2 reaction decreased from 2.94 × 10-4 to 1.76 × 10-4 because the reaction system was affected by the presence of SiC sludge, which was caused the reaction to consume O2 to form CO2. The results have been proposed to explain that the manufactured lightweight FGPs had a low thermal conductivity (0.370-0.456 W/m⋅K). Therefore, recycling of silicon carbide sludge in lightweight foaming geopolymer materials has potential as fire resistance material for the construction industry.

Stroke risk associated with NSAIDs uses in women with dysmenorrhea: A population-based cohort study.

OBJECTIVE: Dysmenorrhea is among the most common type of gynecological problem, affecting young women across the globe. This study assessed the comparative risk of stroke associated with the use of nonsteroidal anti-inflammatory drugs (NSAIDs) and non-NSAIDs in women with dysmenorrhea while taking into account the following factors such as age, history of pregnancy, NSAIDs uses and its duration of use, and selected comorbidities. METHODOLOGY: We used a quantitative research approach based on a comparative case-control study design. The study data was selected from the Longitudinal Health Insurance Database (LHID) 2000, of the Taiwan National Health Research Institutes. Among the estimated 23.4 million insured Taiwanese, who were covered by the Taiwan health insurance system, in the 2000 registry of beneficiaries, one million individuals were randomly selected from the database. A total of 24,955 females suffering from dysmenorrhea were selected for the study. Out of those 3238 (13%) participated in the study group and 21,717 (87%) were randomly distributed into the controls group. Women in the age range, 15-49 years, who did not have any history of stroke, hysterectomy, and/or ovariectomy, were included in the study. A comparative proportional distribution analysis was used for data analysis. RESULTS: Age and use of NSAIDs and its duration of usage were factors associated with an increased incidence of stroke. The stroke incidence rate was 12.77 per 10,000 person-years, and 1.83-fold higher in NSAIDs use cohort than in comparisons with adjusted hazard ratio (aHR) of 1.47 (95% CI = 0.93-2.32). Among women with dysmenorrhea use of NSAIDs, the stroke incidence increased to 2.29-fold (aHR 95% CI = 1.36-3.84) in those use for ≧24 days per month and to 0.51-fold (aHR 95% CI = 0.13-2.10) in those use for 6-12 days per month. CONCLUSIONS: Women with dysmenorrhea who use NSAIDs have a higher risk of stroke. Especially young women, the risk of stroke is further increased, and the longer the medication, the higher the risk of stroke. Every woman with symptoms of dysmenorrhea deserves specialized outpatient treatment and care.

Vaccination distribution by community pharmacists under the COVID-19 vaccine appointment system in Taiwan.

Pharmacists play a critical role in implementing and promoting public health policies, particularly during pandemics, thanks to their exceptional skills, knowledge, expertise, and accessibility to the public. This study aimed to increase the roll-out of COVID-19 vaccines in a coordinated manner to ensure equal accessibility to all Taiwanese residents. A total of 3301 health insurance special pharmacies, equivalent to 80% of all community pharmacies in Taiwan, are assisting the public in scheduling vaccines. Once pharmacists had ensured adequate vaccine availability, vaccinations were scheduled depending on the time of registration on the platform for vaccination appointments. The roll-out of this program saw a significant number of people register and receive the vaccine throughout the country, and the number of individuals who received both a first and second dose increased significantly. Community pharmacy-based distribution of the vaccine to the public signifies the novel and innovative involvement of pharmacists in government initiatives to promote public health. Our study shows that community pharmacies can potentially enhance the efficiency and equitable distribution of health supplies and resources, particularly during pandemics.

Medical Costs of Stroke Care Between Women With and Without Dysmenorrhea: A Population-Based Comparison.

Objective: This study investigated the medical care costs of stroke type between age-matched cohorts with and without dysmenorrhea using the National Health Insurance Research Database (NHIRD). Methods: We collected all 66,048 women with dysmenorrhea and 66,048 women without dysmenorrhea whose age (15-44-year-old) and index year (from 1997 to 2013) were matched for comparison. We assessed the incidence and compared the risk of stroke and stroke subtype in two cohorts. The proportional distributions of stroke subtypes by age between the two cohorts were compared among the women with stroke, and their hospitalization rate was also estimated. In addition, medical cost, length of stay, and the medical cost within 30 days after stroke were compared between the two cohorts. Results: The stroke risk in dysmenorrhea was greater than comparisons (HR = 1.26, 95% CI = 1.11-1.42). Proportionally, hemorrhagic stroke (HS) significantly decreased with age in both cohorts, whereas ischemic stroke (IS) significantly increased with age when both cohorts were combined. The dysmenorrhea cohort had a higher portion of transient cerebral ischemia (TIA) stroke than comparisons (31.3 vs. 24.2%, p = 0.01) and a lower risk of hospitalization for IS (OR = 0.48, 95% CI = 0.21-0.69). Among the four-stroke subtypes, the cost of care for TIA was the least (US$157 ± 254). The average cost for stroke care was not significantly different between women with and without dysmenorrhea. Conclusion: The hospitalization rate and medical costs of TIA are lower than other types. All women should prevent and treat TIA as soon as possible to avoid recurrence or progression to major stroke events and reduce medical costs, regardless of whether they have dysmenorrhea.

Population-based study on birth outcomes among women with hypertensive disorders of pregnancy and gestational diabetes mellitus.

To evaluate birth outcomes in women with hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM), we used insurance data of Taiwan to evaluate 11 adverse neonatal outcomes of infants born to women with HDP (N = 7775) and with both HDP and GDM (HDP/GDM) (N = 1946), comparing to women with neither disorder (N = 19,442), matched by age. The impacts of preeclampsia/eclampsia were also evaluated. Results showed that Caesarean section delivery was near 1.7-fold greater in the HDP/GDM and HDP groups than in comparisons. The preterm delivery rates were more than threefold greater in HDP/GDM group and HDP group than in comparisons with adjusted odds ratios (aORs) of 4.84 (95% confidence interval (CI) 4.34-5.40) and 3.92 (95% CI 3.65-4.21), respectively, followed by jaundice (aORs 2.95 (95% CI 2.63-3.33) and 1.90 (95% CI 1.76-2.06)), and small gestation age (SGA) (aORs 6.57 (95% CI 5.56-7.75) and 5.81 (95% CI 5.15-6.55)). Incidence rates of birth trauma, patent ductus arteriosus, atrial septal defect, respiratory distress syndrome, and neonatal hypoglycemia were also higher in the HDP/GDM and HDP groups than in the comparison group. Most adverse outcomes increased further in women with preeclampsia or eclampsia. In conclusion, women with HDP are at elevated risks of adverse neonatal outcomes. Risks of most adverse outcomes increase further for women with both HDP and GDM. Preeclampsia or eclampsia may also contribute to these outcomes to higher risk levels. Every pregnant woman with these conditions deserves specialized prenatal care.

Effects of the Health-Awareness-Strengthening Lifestyle Program in a Randomized Trial of Young Adults with an At-Risk Mental State.

BACKGROUND: Increasing health awareness in health promotion is considered as one of the less stigmatized interventions for improving help-seeking behaviors and total well-being. This study aimed to explore the short-term and long-term effectiveness of the health-awareness-strengthening lifestyle (HASL) program on Taiwanese young adults with at-risk mental state. METHODS: A pre- and post-test randomized trial was conducted on 92 young adults with at-risk mental state. The HASL program was provided to the experimental group as intervention, and it was only provided to the control group passively by request after the post-test for ethical reasons. The program was conducted once every six weeks, 60-90 min per session, for a total of three times. Mental health risk, anxiety level, health promotion lifestyles, quality of life, physiological index, and physical exercises were assessed one week before and after the program for both groups and followed up to 6 and 12 months for experimental group only. RESULTS: Compared to the control group, those in the experimental group showed significant improvements regarding anxiety level, health promotion lifestyles, and quality of life one week after participating in the program. Furthermore, the experimental group also showed an additional long-term positive effect on mental risk, physical exercises, and physical health after the follow-ups. CONCLUSIONS: The outcomes highlighted the interventions of the HASL program leading to more positive health effects on young adults with at-risk mental state. The implementation of similar clinical service is recommended for young adults with at-risk mental state.

Outcomes of Infection and Risk of Mortality in Liver Transplant Patients with Simultaneous Splenectomy.

PURPOSE: The purpose of this study was to compare the outcomes of infection between liver transplant patients with and without simultaneous splenectomy. METHODS: We retrospectively analyzed the records of 211 patients who underwent liver transplantation in the Tri-Service General Hospital from 2012 to 2017. The frequency of blood cultures obtained after liver transplantation; incidence of bacteremia, pathogens, and complications; and overall survival rates were compared between the groups. RESULTS: One hundred thirty-three of 211 patients underwent liver transplantation without simultaneous splenectomy. There were no significant differences in the frequency of blood cultures obtained after liver transplantation (non-splenectomy group and splenectomy group: 63% and 62%, respectively); incidences of bacteremia after liver transplantation (21% and 21%, respectively), repeat bacteremia (39% and 35%, respectively), cytomegalovirus infection (4% and 3%, respectively), herpes infection (6% and 7%, respectively), and fungal infection (3% and 3%, respectively); and overall survival rate between the two groups. However, there was a significant difference in infection-related deaths between the groups. Simultaneous splenectomy and episodes of antibody-related rejection were significant risk factors associated with infection-related death in multivariate analyses. CONCLUSION: Although simultaneous splenectomy does not increase the incidence of infection, simultaneous splenectomy definitely carries risks of infection-related mortality in liver transplantation.

Regulation of carcinogenesis and mediation through Wnt/ß-catenin signaling by 3,3'-diindolylmethane in an enzalutamide-resistant prostate cancer cell line.

Enzalutamide (ENZ) is an important drug used to treat castration-resistant prostate cancer (CRPC), which inhibits androgen receptor (AR) signaling. Previous study showed that 3,3'-diindolylmethane (DIM) is an AR antagonist that also inhibits Wnt signaling and epithelial-mesenchymal transition (EMT). To investigate whether combined treatment with ENZ and DIM can overcome ENZ resistance by regulating Wnt signaling to inhibit AR signaling and EMT in ENZ-resistant prostate cancer cells, 22Rv1 cells were cultured in normal medium and treated with ENZ, DIM, and DIM with ENZ. Exposure of ENZ-resistant cells to both DIM and ENZ significantly inhibited cell proliferation without cytotoxicity and invasion in comparison with the control. DIM significantly increased the E-cadherin expression and inhibited the expressions of Vimentin and Fibronectin, subsequently inhibiting EMT. Co-treatment with ENZ and DIM significantly increased the expressions of GSK3ß and APC and decreased the ß-catenin protein expression, causing inhibition of Wnt signaling and AR expression, it also significantly decreased the AR-v7 expression and down-regulated AR signaling. Via suppression of Wnt and AR signaling, co-treatment increased the E-cadherin and decreased the Vimentin and Fibronectin RNA and protein expressions, then inhibited EMT. Co-treatment with DIM and ENZ regulated Wnt signaling to reduce not only the AR expression, but also the AR-v7 expression, indicating suppression of EMT that inhibits cancer cell proliferation, invasion and migration to ameliorate ENZ resistance.

The pharmaceutical practice of mask distribution by pharmacists in Taiwan's community pharmacies under the Mask Real-Name System, in response to the COVID-19 outbreak.

BACKGROUND: Pharmacists hold to their promise to foster, implement and promote the health of the population and to prevent disease, given their knowledge, skills, and proximity to the locals. The objective of this study was to foster equality and cost-effectiveness in the distribution and sale of masks to all Taiwanese citizens, in response to the COVID-19 pandemic. METHODS: All 6336 special community pharmacies participating in the NHI (National Health Insurance) served as mask-selling sites. Access to masks by citizens was determined and controlled, based on the weekly rationing of the number of purchasable masks per citizen and the last digit of their NHI card number. Masks were available on different weekdays for holders of cards ending with odd and even numbers, except on Sundays, when everyone was eligible to buy a mask. RESULTS: Implementing the program has provided equal access to masks for all citizens across Taiwan. It has stabilized the pricing of masks and mitigated the public's anxiety of a perceived likely market shortage. CONCLUSION: The community pharmacy-based approach to the distribution of prevention face masks to citizens represents a new and innovative engagement of pharmacists in public health promotion and protection initiatives. Community pharmacies can greatly improve the efficiency, reliability, and cost-saving of the distribution of public health resources to local communities, especially in the face of an epidemic.

Epigenetic Silencing of LMX1A Contributes to Cancer Progression in Lung Cancer Cells.

Epigenetic modification is considered a major mechanism of the inactivation of tumor suppressor genes that finally contributes to carcinogenesis. LIM homeobox transcription factor 1α (LMX1A) is one of the LIM-homeobox-containing genes that is a critical regulator of growth and differentiation. Recently, LMX1A was shown to be hypermethylated and functioned as a tumor suppressor in cervical cancer, ovarian cancer, and gastric cancer. However, its role in lung cancer has not yet been clarified. In this study, we used public databases, methylation-specific PCR (MSP), reverse transcription PCR (RT-PCR), and bisulfite genomic sequencing to show that LMX1A was downregulated or silenced due to promoter hypermethylation in lung cancers. Treatment of lung cancer cells with the demethylating agent 5-aza-2'-deoxycytidine restored LMX1A expression. In the lung cancer cell lines H23 and H1299, overexpression of LMX1A did not affect cell proliferation but suppressed colony formation and invasion. These suppressive effects were reversed after inhibition of LMX1A expression in an inducible expression system in H23 cells. The quantitative RT-PCR (qRT-PCR) data showed that LMX1A could modulate epithelial mesenchymal transition (EMT) through E-cadherin (CDH1) and fibronectin (FN1). NanoString gene expression analysis revealed that all aberrantly expressed genes were associated with processes related to cancer progression, including angiogenesis, extracellular matrix (ECM) remodeling, EMT, cancer metastasis, and hypoxia-related gene expression. Taken together, these data demonstrated that LMX1A is inactivated through promoter hypermethylation and functions as a tumor suppressor. Furthermore, LMX1A inhibits non-small cell lung cancer (NSCLC) cell invasion partly through modulation of EMT, angiogenesis, and ECM remodeling.

NKX6.1 Represses Tumorigenesis, Metastasis, and Chemoresistance in Colorectal Cancer.

Accumulating evidence suggests that NKX6.1 (NK homeobox 1) plays a role in various types of cancer. In our previous studies, we identified NKX6.1 hypermethylation as a promising marker and demonstrated that the NKX6.1 gene functions as a metastasis suppressor through the epigenetic regulation of the epithelial-to-mesenchymal transition (EMT) in cervical cancer. More recently, we have demonstrated that NKX6.1 methylation is related to the chemotherapy response in colorectal cancer (CRC). Nevertheless, the biological function of NKX6.1 in the tumorigenesis of CRC remains unclear. In this study, we showed that NKX6.1 suppresses tumorigenic and metastatic ability both in vitro and in vivo. NKX6.1 represses cell invasion partly through the modulation of EMT. The overexpression of NKX6.1 enhances chemosensitivity in CRC cells. To further explore how NKX6.1 exerts its tumor-suppressive function, we used RNA sequencing technology for comprehensive analysis. The results showed that differentially expressed genes (DEGs) were mainly related to cell migration, response to drug, transcription factor activity, and growth factor activity, suggesting that these DEGs are involved in the function of NKX6.1 suppressing cancer invasion and metastasis. Our results demonstrated that NKX6.1 functions as a tumor suppressor partly by repressing EMT and enhancing chemosensitivity in CRC, making it a potential therapeutic target.