Identification of serum metabolic signatures of environmental-leveled phthalate in the Taiwanese child population using NMR-based metabolomics.

Phthalates have become important environmental pollutants due to their high exposure frequency in daily life; thus, phthalates are prevalent in humans. Although several epidemiologic surveys have linked phthalates with several adverse health effects in humans, the molecular events underlying phthalate exposure have not been fully elucidated. The purpose of this study was to reveal associations between phthalate exposure and the serum metabolome in Taiwanese children using a metabolomic approach. A total of 256 Taiwanese children (8-10 years old) from two cohorts were enrolled in this study. Twelve urinary phthalate metabolites were analyzed by high-performance liquid chromatography/tandem mass spectrometry, while a nuclear magnetic resonance-based metabolomic approach was used to record serum metabolic profiles. The associations between metabolic profiles and phthalate levels were assessed by partial least squares analysis coupled with multiple linear regression analysis. Our results revealed that unique phthalate exposures, such as mono-isobutyl phthalate, mono-n-butyl phthalate, and mono (2-ethyl-5-oxohexyl) phthalate, were associated with distinct serum metabolite profiles. These phthalate-mediated metabolite changes may be associated with perturbed energy mechanisms, increased oxidative stress, and lipid metabolism. In conclusion, this study suggests that metabolomics is a valid approach to examine the effects of environmental-level phthalate on the serum metabolome. This study also highlighted potentially important phthalates and their possible effects on children.

Moving Beyond Single Word Acquisition of Speech Sounds to Connected Speech Development With Dynamic Assessment.

PURPOSE: The aim of this study was to document speech sound development across early childhood from a dynamic assessment (DA) perspective that captures a breadth of linguistic environments using the Glaspey Dynamic Assessment of Phonology (Glaspey, 2019), as well as to provide normative data for speech-language pathologists to compare speech skills when making clinical decisions and provide historical context. Targets of English were evaluated via DA for the (a) age of acquisition in single words; (b) continued development through connected speech; (c) early, mid, and late sequence; and (d) differences between single word and connected speech productions. METHOD: Data were extracted from the reported results of the norming study for the Glaspey Dynamic Assessment of Phonology, which included a representative sample of 880 children ages 3 years to 10;11 (years;months). Comparisons were made with 49 items including multisyllabic words, clusters, and phonemes of English across word positions. RESULTS: Assessment with DA showed that acquisition in single words is nearly complete by age 6 years with a 90% mastery level, and the sequence suggests an Early-13, Mid-16, and Late-14 for items by word position. In connected speech, a wider range of progression is evident from the emergence of sound production at 50%, 75%, and 90% mastery levels with observed changes between ages 3 and 10 years. CONCLUSIONS: Given a DA approach across connected linguistic environments, children continue to progress in their development of speech sounds from early childhood well into their school-age years and for some sounds beyond the age of 10 years. DA challenges the language system to better reflect children's developmental progression.

Lipid responses to environmental perfluoroalkyl substance exposure in a Taiwanese Child cohort.

Although recent epidemiologic studies have focused on some of the health effects of perfluoroalkyl substance (PFASs) exposure in humans, the associations between PFASs exposure and the lipidome in children are still unclear. The purpose of this study was to assess lipid changes in children to understand possible molecular events of environmental PFASs exposure and suggest potential health effects. A total of 290 Taiwanese children (8-10 years old) were included in this study. Thirteen PFASs were analyzed in their serum by high-performance liquid chromatography-tandem mass spectrometry (LC-MS). MS-based lipidomic approaches were applied to examine lipid patterns in the serum of children exposed to different levels of PFASs. LC coupling with triple quadrupole MS technology was conducted to analyze phosphorylcholine-containing lipids. Multivariate analyses, such as partial least squares analysis along with univariate analyses, including multiple linear regression, were used to analyze associations between s exposure and unique lipid patterns. Our results showed that different lipid patterns were discovered in children exposed to different levels of specific PFASs, such as PFTrDA, PFOS, and PFDA. These changes in lipid levels may be involved in hepatic lipid metabolism, metabolic disorders, and PFASs-membrane interactions. This study showed that lipidomics is a powerful approach to identify critical PFASs that cause metabolite perturbation in the serum of children and suggest possible adverse health effects of these chemicals in children.

Utilization Pattern of Traditional Chinese Medicine among Fracture Patients: A Taiwan Hospital-Based Cross-Sectional Study.

Traditional Chinese medicine (TCM) divides fracture treatment into three stages. Many TCM herbs and formulas have been used to treat fractures for thousands of years. However, research regarding the Chinese herbal products (CHPs) that should be used at different periods of treatment is still lacking. This study aims to identify the CHPs that should be used at different periods of treatment as well as confirm the TCM theory of fracture periods medicine. We used prescriptions of TCM outpatients with fracture diagnoses analyzed using the Chang Gung Research Database (CGRD) from 2000 to 2015. According to the number of days between the date of the fracture and the clinic visit date, all patients were assigned to one of three groups. Patients with a date gap of 0-13 days were assigned to the early period group; those with a date gap of 14-82 days were assigned to the middle period group; and those with a date gap of 83-182 days were assigned to the late period group. We observed the average number of herbal formulas prescribed by the TCM doctor at each visit was 2.78, and the average number of single herbs prescribed was 6.47. The top three prescriptions in the early fracture period were Zheng-gu-zi-jin-dang, Shu-jing-huo-xue-tang, and Wu-ling-san. In the middle fracture period, the top three formulas were Zheng-gu-zi-jin-dang, Shu-jing-huo-xue-tang, and Zhi-bai-di-huang-wan. In the late fracture period, the top three formulas were Shu-jing-huo-xue-tang, Gui-lu-er-xian-jiao, and Du-huo-ji-sheng-tang. The main single herbs used in the early fracture period were Yan-hu-suo, Gu-sui-bu, and Dan-shen. From the middle to the late period, the most prescribed single herbs were Xu-duan, Gu-sui-bu, and Yan-hu-suo. We concluded that the results showed that the CGRD utilization pattern roughly meets the TCM theory at different fracture periods.

Astrovirus gastroenteritis in hospitalized children of less than 5 years of age in Taiwan, 2009.

BACKGROUND/PURPOSE: Acute gastroenteritis is a common illness in children under 5 years old. Although rotavirus is a leading cause, other viruses including astrovirus are also important, but have been the subject of limited studies. This is a prospective study to investigate astrovirus gastroenteritis in hospitalized children in Taiwan. MATERIAL/METHOD: From January 2009 to December 2009, children below 5 years of age admitted to three hospitals in Taiwan due to acute gastroenteritis were eligible for this study. Stool specimens were sent for the detection of astrovirus by reverse transcriptase polymerase chain reaction; once positive for astrovirus, the sequencing and phylogenetic analysis of each strain was performed. RESULTS: A total of 989 children were enrolled during the study period. The overall positive rate of astrovirus was 1.6%, ranging from 1.03% to 2.26% in different hospitals, while rotavirus accounted for 20.2% of the patients. Six of the 16 children (37.5%) with astroviral infection had documented coinfection with rotavirus. The median age of infection was 28.2 months. The seasonal distribution of astrovirus peaked from April to June. Diarrhea alone (40% vs. 2.1%, p < 0.0001) was significantly more commonly seen than the triad of fever, vomiting and diarrhea (30% vs. 71%, p = 0.0062) in children with astroviral infection alone than in those with rotaviral infection alone. The mean duration of diarrhea was significantly longer in patients with mixed infection than those with astroviral infection alone (6.8 vs. 4.2 days, p = 0.013). Respiratory symptoms were noted in 10 children (62.5%). Serotype HAstV-1 was the most common (68.8%). CONCLUSION: Astrovirus accounted for 1.6% of infections in children under 5 years hospitalized with acute gastroenteritis in Taiwan. Compared with those caused by rotavirus, the incidence of gastroenteritis in hospitalized children caused by astrovirus was low and the disease severity was mild.