The effects of fine and coarse particulate matter on lung function among the elderly.

Impaired lung function is associated with morbidity and mortality in the elderly. However, there is a paucity of data regarding the long-term effects of particulate matter (PM) on lung function among the elderly. This study evaluated the exposure-response relationship between ambient PM and different lung function indices among the elderly in Taiwan. A cross-sectional survey of individuals aged ≥65 years was conducted in Taiwan from October 2015 to September 2016. Those who attended the annual health examination for the elderly in five hospitals of varying background PM concentrations were enrolled. The long-term (2015 annual mean concentration) exposure to air pollution was estimated by the Kriging method at the residence of each subject. The association between ambient PM exposure and lung function was evaluated by linear regression modeling, with adjustments for age, sex, height, weight, educational attainment, presence of asthma or chronic obstructive pulmonary disease, smoking status, season, and co-pollutants. There were 1241 subjects (mean age, 70.5 years). The mean residential PM2.5 and PM2.5-10 in 2015 was 26.02 and 18.01 µg/m3, respectively. After adjustments for confounders and co-pollutants, the FVC decrease was best associated with fine particles (PM2.5), whereas the FEV1, FEF25-75%, FEF25% and FEF50% decreases were best associated with coarse particles (PM2.5-10). An IQR (10 µg/m3) increase in PM2.5 decreased FVC by 106.38 ml (4.47%), while an IQR (7.29 µg/m3) increase in PM2.5-10 decreased FEV1 and FEF25-75% by 91.23 ml (4.85%) and 104.44 ml/s (5.58%), respectively. Among the Taiwanese elderly, long-term PM2.5 exposure mainly decreases the vital capacity of lung function. Moreover, PM2.5-10 has a stronger negative effect on the function of conductive airways than PM2.5.

Correlates of depressive symptoms in late middle-aged Taiwanese women: findings from the 2009 Taiwan National Health Interview Survey.

BACKGROUND: Previous studies have shown that depressive symptoms in middle-aged women were associated with a number of factors such as climacteric symptoms. Nevertheless, studies based on population-based data with a wide range of potential correlates are still scarce. Therefore, the aim of this study was to investigate the correlates of depressive symptoms in late middle-aged Taiwanese women using data from a nationally-representative, population-based survey. METHODS: Women aged 50.0-65.0 years were identified from the dataset of the 2009 Taiwan National Health Interview Survey. The outcome measure was depressive symptoms in the past week, evaluated using the Center for Epidemiologic Studies Short Depression Scale (CES-D 10) with a cut-off score of 10 or greater. Univariate and multiple logistic regression analyses were used to evaluate the correlates of depressive symptoms. RESULTS: The mean age of the 533 respondents was 56.7 years. Depressive symptoms were present in 53 respondents (9.9%). Multiple logistic regression analysis revealed that an education level of elementary school or below (adjusted odds ratio [AOR] = 3.19, P = 0.003), nulliparity (AOR = 8.10, P = 0.001), living alone (AOR = 5.47, P = 0.003), never having worked (AOR = 4.14, P = 0.008), lack of regular exercise (AOR = 3.01, P = 0.003), a perceived health status of fair or bad (AOR = 4.34, P < 0.001), and somatic climacteric symptoms (AOR = 2.32, P = 0.012) were independent and significant factors of depressive symptoms in late middle-aged Taiwanese women. CONCLUSIONS: Findings from this secondary analysis of a population-based survey suggested independent associations of somatic climacteric symptoms, and a number of socio-demographic and health-related factors with depressive symptoms in late middle-aged Taiwanese women.

Using Nonlinear Stochastic Evolutionary Game Strategy to Model an Evolutionary Biological Network of Organ Carcinogenesis Under a Natural Selection Scheme.

Molecular biologists have long recognized carcinogenesis as an evolutionary process that involves natural selection. Cancer is driven by the somatic evolution of cell lineages. In this study, the evolution of somatic cancer cell lineages during carcinogenesis was modeled as an equilibrium point (ie, phenotype of attractor) shifting, the process of a nonlinear stochastic evolutionary biological network. This process is subject to intrinsic random fluctuations because of somatic genetic and epigenetic variations, as well as extrinsic disturbances because of carcinogens and stressors. In order to maintain the normal function (ie, phenotype) of an evolutionary biological network subjected to random intrinsic fluctuations and extrinsic disturbances, a network robustness scheme that incorporates natural selection needs to be developed. This can be accomplished by selecting certain genetic and epigenetic variations to modify the network structure to attenuate intrinsic fluctuations efficiently and to resist extrinsic disturbances in order to maintain the phenotype of the evolutionary biological network at an equilibrium point (attractor). However, during carcinogenesis, the remaining (or neutral) genetic and epigenetic variations accumulate, and the extrinsic disturbances become too large to maintain the normal phenotype at the desired equilibrium point for the nonlinear evolutionary biological network. Thus, the network is shifted to a cancer phenotype at a new equilibrium point that begins a new evolutionary process. In this study, the natural selection scheme of an evolutionary biological network of carcinogenesis was derived from a robust negative feedback scheme based on the nonlinear stochastic Nash game strategy. The evolvability and phenotypic robustness criteria of the evolutionary cancer network were also estimated by solving a Hamilton-Jacobi inequality - constrained optimization problem. The simulation revealed that the phenotypic shift of the lung cancer-associated cell network takes 54.5 years from a normal state to stage I cancer, 1.5 years from stage I to stage II cancer, and 2.5 years from stage II to stage III cancer, with a reasonable match for the statistical result of the average age of lung cancer. These results suggest that a robust negative feedback scheme, based on a stochastic evolutionary game strategy, plays a critical role in an evolutionary biological network of carcinogenesis under a natural selection scheme.

Ambulatory medical services utilization for menstrual disorders among female personnel of different medical professions in Taiwan: a nationwide retrospective cohort study.

BACKGROUND: Menstrual disorders and their adverse symptoms can have a deleterious effect on both the private and working lives of women. Previous studies indicated that female nurses have elevated risk of menstrual disorders. Moreover, female nurses showed a higher incidence of ambulatory care visit for genitourinary diseases compared with other female medical personnel. However, little is known whether the medical services utilization for menstrual disorders were different among personnel from various medical professions. Therefore, the present study compared the ambulatory medical services utilization for menstrual disorders among personnel of six different medical professions in Taiwan using a nationwide, population-based health claim research database. METHODS: The National Health Insurance Research Database (NHIRD) was used to identify female medical professionals, aged 18 to 45 years, who obtained their licenses during January 1, 2000 to December 31, 2012. Personnel from six different medical professions were examined and they included (1) medical technologists and therapists, (2) registered nurses, (3) physicians, (4) doctors of Chinese medicine, (5) dentists, and (6) pharmacists. Diagnoses of menstrual disorders, based on International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes, were obtained from the ambulatory medical services utilization that occurred after their license date. Cox proportional hazards model was used to assess the hazards of medical services utilization for menstrual disorders using medical technologists and therapists as the reference category. RESULTS: A total of 7653 medical personnel were included in the analysis. Using the group containing medical technologists and therapists as the reference category, registered nurses (adjusted hazards ratio [AHR] = 1.13, p = 0.018) and doctors of Chinese medicine (AHR = 2.52, p < 0.001) showed a significant increased risk of medical services utilization for menstrual disorders. Conversely, physicians showed a significant decreased risk of medical services utilization for menstrual disorders (AHR = 0.58, p < 0.001). Regarding the nine specific menstrual disorders observed in this study, registered nurses and doctors of Chinese medicine showed an increased risk in six and four of them, respectively. Pharmacists showed an increased risk only in menorrhagia (AHR = 1.64, p = 0.020) and dentists showed no significant differences in any of the nine specific menstrual disorders compared with medical technologists and therapists. Physicians showed a significant decreased risk all specific menstrual disorders except menorrhagia and dysfunctional uterine bleeding. CONCLUSIONS: Findings from this population-based cohort study revealed that, compared with medical technologists and therapists, registered nurses and doctors of Chinese medicine exhibited significant increased risks in medical services utilization for menstrual disorders whereas physicians showed a significant decreased risk in menstrual disorders. Further studies should be conducted to delineate whether the differences in the medical services utilization is an indicator of risk of menstrual disorders or the results of varying patterns of health care seeking behavior among women of different medical professions.

Association between Helicobacter pylori Infection and Risk of Osteoporosis in Elderly Taiwanese Women with Upper Gastrointestinal Diseases: A Retrospective Patient Record Review.

Introduction. Helicobacter pylori (H. pylori) infection could lead to chronic local and systemic immune response. The resulting increase in proinflammatory cytokines could affect bone resorption and might increase the risk of osteoporosis. This study aimed to investigate the association between H. pylori infection and osteoporosis in elderly female patients with upper gastrointestinal diseases. Methods. A retrospective patient record review study was conducted in a regional teaching hospital in south Taiwan. Relevant information on female patients aged 65 and over who were diagnosed with diseases of esophagus, gastric ulcer, or duodenal ulcer during January 2008 to December 2010 were abstracted. Association between H. pylori infection and osteoporosis was evaluated using multivariate logistic regression analysis. Results. Of the 365 patients with a mean age of 77.3 years, 77 (21.1%) had H. pylori infection and 101 (27.7%) had been diagnosed with osteoporosis. Multivariate logistic regression analysis revealed that osteoporosis was significantly associated with H. pylori infection (adjusted odds ratio = 2.03, 95% confidence interval = 1.14-3.62) after adjusting for age group, body mass index group, and use of proton pump inhibitor. Conclusion. Osteoporosis was found to be associated with H. pylori infection in Taiwanese female patients with upper gastrointestinal diseases. Further studies with information on potential confounders are needed to confirm the association.

Anti-Bladder-Tumor Effect of Baicalein from Scutellaria baicalensis Georgi and Its Application In Vivo.

Some phytochemicals with the characteristics of cytotoxicity and/or antimetastasis have generated intense interest among the anticancer studies. In this study, a natural flavonoid baicalein was evaluated in bladder cancer in vitro and in vivo. Baicalein inhibits 5637 cell proliferation. It arrests cells in G1 phase at 100 µ M and in S phase below 75 µ M. The protein expression of cyclin B1 and cyclin D1 is reduced by baicalein. Baicalein-induced p-ERK plays a minor role in cyclin B1 reduction. Baicalein-inhibited p65NF- κ B results in reduction of cell growth. Baicalein-induced pGSK(ser9) has a little effect in increasing cyclin B1/D1 expression instead. The translation inhibitor cycloheximide blocks baicalein-reduced cyclin B1, suggesting that the reduction is caused by protein synthesis inhibition. On the other hand, neither cycloheximide nor proteasome inhibitor MG132 completely blocks baicalein-reduced cyclin D1, suggesting that baicalein reduces cyclin D1 through protein synthesis inhibition and proteasomal degradation activation. In addition, baicalein also inhibits cell invasion by inhibiting MMP-2 and MMP-9 mRNA expression and activity. In mouse orthotopic bladder tumor model, baicalein slightly reduces tumor size but with some hepatic toxicity. In summary, these results demonstrate the anti-bladder-tumor properties of the natural compound baicalein which shows a slight anti-bladder-tumor effect in vivo.

Association between fatigue and Internet addiction in female hospital nurses.

AIMS: To report a study conducted to examine the association between fatigue and Internet addiction among female hospital nurses. BACKGROUND: The Internet provides unprecedented convenience for social interaction and information retrieval. Although excessive Internet use has been demonstrated to correlate with fatigue in adolescents, no studies have examined whether it is associated with fatigue in nurses. DESIGN: Cross-sectional survey. METHODS: The study was conducted in August 2010. Female Registered Nurses working in a regional teaching hospital in southern Taiwan were asked to complete a paper-based questionnaire. The questionnaire included questions on demographics, the Chen Internet Addiction Scale and the Chalder Fatigue Scale. Multiple linear regression analysis was performed using Chalder fatigue scale as the dependent variable. RESULTS: Of the 564 (79% response) valid questionnaires returned, 6 and 10% of the participants were classified as diagnostic cases and possible cases of Internet addiction, respectively. Fatigue levels, adjusting for other potential confounders including work unit, shift work, regular self-medication, and self-perceived health status, was significantly associated with both possible cases of Internet addiction and diagnostic cases of Internet addiction. CONCLUSION: This study is the first in reporting a statistically significant association between fatigue levels and Internet addiction in female hospital nurses. RELEVANCE TO CLINICAL PRACTICE: Nurses should pay attention to their Internet activity and whether it adds to their fatigue levels. Addictive behaviour should promptly be dealt with to ensure that the best care is provided to patients.

4'-Chloro-3,5-dihydroxystilbene, a resveratrol derivative, induces lung cancer cell death.

AIM: To examine the antitumor effect of 4'-chloro-3,5-dihydroxystilbene, a resveratrol derivative, on lung adenocarcinoma A549 cells. METHODS: The cytotoxic IC(50) was determined by direct cell counting. Flow cytometry, monodansylcadaverine (MDC) staining, transfection, Western blot and a proteasome activity assay were used to study the cellular mechanism of 4'-chloro-3,5-dihydroxystilbene. A xenograft nude mouse model was used to analyze the antitumor effect in vivo. RESULTS: 4'-Chloro-3,5-dihydroxystilbene induced a rapid and persistent increase in the intracellular reactive oxygen species in the cells, but the cell death could not be inhibited by two antioxidant agents. The derivative caused sub-G(1) formation, a decrease in the mitochondria membrane potential and poly (ADP-ribose) polymerase degradation, and the caspase inhibitor Z-VAD-FMK could partially prevent cell death. It also induced a significant increase in intracellular acidic vacuoles, LC3-II formation and intracellular GFP-LC3 aggregation. An autophagic inhibitor partially reversed cell death. Additionally, 4'-chloro-3,5-dihydroxystilbene induced the accumulation of ubiquitinated conjugates and inhibited proteasome activity in cells. In an in vivo study, 4'-chloro-3,5-dihydroxystilbene retarded tumor growth in nude mice. CONCLUSION: These data suggest that the resveratrol derivative 4'-chloro-3,5-dihydroxystilbene could be developed as an anti-tumor compound.

Difference in the regulation of IL-8 expression induced by uropathogenic E. coli between two kinds of urinary tract epithelial cells.

Bacterial adherence to epithelial cells is a key virulence trait of pathogenic bacteria. The type 1 fimbriae and the P-fimbriae of uropathogenic Escherichia coli (UPEC) have both been described to be important for the establishment of urinary tract infections (UTI). To explore the interactions between the host and bacterium responsible for the different environments of UPEC invasion, we examined the effect of pH and osmolarity on UPEC strain J96 fimbrial expression, and subsequent J96-induced interleukin-8 (IL-8) expression in different uroepithelial cells. The J96 strain grown in high pH with low osmolarity condition was favorable for the expression of type 1 fimbriae; whereas J96 grown in low pH with high osmolarity condition was beneficial for P fimbriae expression. Type 1 fimbriated J96 specifically invaded bladder 5637 epithelial cells and induced IL-8 expression. On the contrary, P fimbriated J96 invaded renal 786-O epithelial cells and induced IL-8 expression effectively. Type 1 fimbriated J96-induced IL-8 induction involved the p38, as well as ERK, JNK pathways, which leads to AP-1-mediated gene expression. P fimbriated J96-induced augmentation of IL-8 expression mainly involved p38-mediated AP-1 and NF-kappaB transcriptional activation. These results indicate that different expression of fimbriae in J96 trigger differential IL-8 gene regulation pathways in different uroepithelial cells.

Wogonin, a bioactive flavonoid in herbal tea, inhibits inflammatory cyclooxygenase-2 gene expression in human lung epithelial cancer cells.

Wogonin, a naturally occurring plant flavonoid, is isolated from Chinese herbal plants Scutellaria baicalensis Georgi and S. barbata D. Don. The extract of S. baicalensis Georgi has been added to an assortment of health drinks or food supplements. Wogonin has been reported to exhibit anticancer and anti-inflammatory properties. Cyclooxygenase-2 (COX-2) is a key enzyme in the production of prostaglandins in inflammatory conditions. In this study, the effect of wogonin on phorbol 12-myristate 13-acetate (PMA)-induced COX-2 expression was investigated. It showed that wogonin inhibited PMA-induced COX-2 protein and mRNA levels in human lung epithelial cancer cells, and the mechanism of this inhibition was at the transcriptional level by using COX-2 gene promoter assay. Among various signal inhibitors, the mitogen-activated protein kinase kinase 1/2 (MEK1/2) inhibitor U0126 also inhibited PMA-induced COX-2 expression and COX-2 promoter activation. The activity of AP-1-driven promoter, but not nuclear factor-kappa B (NF-kappaB), was inhibited by U0126. The data indicated that MEK1/2-AP-1 is very important for PMA-induced COX-2 expression. Wogonin also inhibited PMA-induced AP-1 activation and the expression of c-Jun, a key component of AP-1. Taken together, it is suggested that wogonin inhibits PMA-induced COX-2 gene expression by inhibiting c-Jun expression and AP-1 activation in A549 cells.