Ouabain, ATPase inhibitor, potentially enhances the effect of polyhexamethylene biguanide on Acanthamoeba castellanii.

Acanthamoeba, a free-living amoeba, is commonly found in various natural environments, such as rivers and soil, as well as in public baths, swimming pools, and sewers. Acanthamoeba can cause severe illness such as granulomatous amoebic encephalitis and Acanthamoeba keratitis (AK) in humans. AK, the most recognized disease, can cause permanent visual impairment or blindness by affecting the cornea. AK commonly affects contact lens wearers who neglect proper cleaning habits. The symptoms of AK include epithelial and stromal destruction, corneal infiltrate, and intense ocular pain, occasionally necessitating surgical removal of the entire eyeball. Current AK treatment involves the hourly application of eye drops containing polyhexamethylene biocide (PHMB). However, studies have revealed their ineffectiveness against drug-resistant strains. Acanthamoeba can form cysts as a survival mechanism in adverse environments, though the exact mechanism remains unknown. Our experiments revealed that sodium P-type ATPase (ACA1_065450) is closely linked to encystation. In addition, various encystation buffers, such as MgCl2 or NaCl, induced the expression of P-type ATPase. Furthermore, we used ouabain, an ATPase inhibitor, to inhibit the Na+/K+ ion pump, consequently decreasing the encystation rate of Acanthamoeba. Our primary objective is to develop an advanced treatment for AK. We anticipate that the combination of ouabain and PHMB may serve as an effective therapeutic approach against AK in the future.

Public Fear and Risk Perception During Dengue Fever Outbreak in Taiwan.

This study aimed to understand the public reaction to the 2015 dengue outbreak in Taiwan by determining the key influencing factors. A total of 1104 respondents aged 18 years and over, were recruited by telephone between November 20 and 28, 2015, to investigate fear, risk perception, and psychological distress during the dengue outbreak. Multiple logistic regression analysis showed that fear of dengue was more prevalent in the areas that were most affected, as well as those with infected friends or relatives. Fear was also more pronounced among females and the elderly group, especially in terms of perceived risk of infection, severity of the infection, the uncertain cured rate, the adverse effects on daily life, in which all lead to psychological distress. Fear of dengue fever, perceived risk of dengue infection, and psychological distress associated with the dengue fever pandemic were the main variables investigated in this study. Since media mass can serve as a unified platform for all public health communications, it is recommended that the government utilizes the power of media to deliver pandemic prevention measures. Specifically, health education interventions related to risk communication should focus on the most infected areas while taking gender and age into consideration.

Volatile cinnamaldehyde induces systemic salt tolerance in the roots of rice (Oryza sativa).

Cinnamaldehyde (CA) is a volatile plant secondary metabolite that exhibits strong anti-pathogenic activities. Nonetheless, less is known about the effect of CA on plant tolerance to abiotic stresses. In this study, we delineated the effects of CA fumigation on rice roots (Oryza Sativa L cv. TNG67) under salinity stress (200 mM NaCl). Our result showed that CA vapor significantly alleviated salinity-induced ROS accumulation and cell death. This CA-induced alleviation appears to be mediated primarily by the upregulation of proline metabolism genes, the rapid proline accumulation, and the decrease of Na+ /K+ ratio as early as 3 h after NaCl treatment. Of note, the activities of peroxidase (POD; EC 1.11.1.7) isozymes a and b were decreased by CA fumigation, and the activities of catalase (CAT; EC 1.11.1.6) and superoxide dismutase (SOD; EC 1.15.1.1) were not significantly affected. Our findings suggest that CA vapor might be useful for priming rice roots to withstand salinity stress, which is more prevalent due to the ongoing global climate change. To the best of our knowledge, this is the first study to show modulation of macro- and micro-elements as well as antioxidative factors after CA fumigation of salinity-stressed rice roots.

Effectiveness of Health Coaching in Smoking Cessation and Promoting the Use of Oral Smoking Cessation Drugs in Patients with Type 2 Diabetes: A Randomized Controlled Trial.

INTRODUCTION: This study looked into the effectiveness of a 6 month health coaching intervention in smoking cessation and smoking reduction for patients with type 2 diabetes. METHODS: The study was carried out via a two-armed, double-blind, randomized-controlled trial with 68 participants at a medical center in Taiwan. The intervention group received health coaching for 6 months, while the control group only received usual smoking cessation services; some patients in both groups participated in a pharmacotherapy plan. The health coaching intervention is a patient-centered approach to disease management which focuses on changing their actual behaviors. By targeting on achieving effective adult learning cycles, health coaching aims to help patients to establish new behavior patterns and habits. RESULTS: In this study, the intervention group had significantly more participants who reduced their level of cigarette smoking by at least 50% than the control group (p = 0.030). Moreover, patients participating in the pharmacotherapy plan in the coaching intervention group had a significant effect on smoking cessation (p = 0.011), but it was insignificant in the control group. CONCLUSIONS: Health coaching can be an effective approach to assisting patients with type 2 diabetes participating in a pharmacotherapy plan to reduce smoking and may help those who participate in pharmacotherapy plan to quit smoking more effectively. Further studies with higher-quality evidence on the effectiveness of health coaching in smoking cessation and the use of oral smoking cessation drugs in patients with type 2 diabetes are needed.

Gender Impact on Diabetes Distress Focus at Medical Communication Concerns, Life and Interpersonal Stress.

INTRODUCTION: along with the rapidly aging population in many countries around the world, the global prevalence of diabetes and suffering from diabetes-related depression have risen in middle-aged and elderly adults. However, given that psychological stress is deeply influenced by culture, gender inequality in these statistics is often exhibited and increases with age. The aim of this study was to explore the gender difference in diabetes distress among middle-aged and elderly diabetic patients. METHODS: 395 participants from four hospitals were recruited for a cross-sectional survey. The Taiwan Diabetes Distress Scale (TDDS) was used to measure diabetes distress. Linear regression was conducted to assess the gender difference in different types of diabetes distress. RESULTS: there was significant gender difference in each diabetes distress domain. In particular, men who had received diabetes education in the past six months seemed to be more concerned about diabetes complications and felt pressured to communicate with doctors. In addition, women seemed to be more affected by diabetes distress because of their marital status, especially for married women. CONCLUSIONS: diabetes distress seems to have significant gender differences; however, more longitudinal research is needed on the causal relationship between gender and diabetes distress.

Effects of the Powder from Hoggery Desulfurization Tanks on the Salinity Resistance of Lettuce.

Lettuce is an important vegetable cultivated worldwide, even in regions with highly saline soils. A large amount of research discusses the application of sulfur on the increase of antioxidation in plants. The powder from hoggery desulfurization tanks contained high amounts of sulfur and small amounts of other nutrients for plants. This powder can be added to liquid fertilizer to create high-sulfur liquid fertilizer (HSLF). This study observed the cell morphologies of lettuce root apices under salt stress after the application of HSLF. Lettuce plants were cultivated in hydroponic solutions containing one of two NaCl (0 and 40 mM) and three HSLF (0.0, 1.5, and 3.0 g L-1) concentrations. Salinity reduced the K+/Na+ ratio in the plant leaves; however, this reduction was smaller in the HSLF-treated plants. Except for phosphate and potassium, nutrient absorption is inhibited under conditions of high salinity. Using scanning electron microscopy, we observed apices more integrated on cell roots after increasing HSLF supplement under non-salt-stressed conditions. In addition, the cells were repaired after increasing the supplement of HSLF under the condition of 40 mM NaCl. Although salt stress reduced plant growth, the reductions were minimized in the HSLF-treated plants. The application of HSLF potentially alleviated salt injury in lettuce root apices and was probably associated with the improvement of phosphorus and potassium absorption and increasing K+/Na+ ratios in lettuce plants.

Exploring and Developing a New Culturally-Appropriate Diabetes Distress Scale in Taiwan.

Introduction: The aim of this study was to develop and validate a new diabetes distress scale suitable for Chinese and Taiwanese culture. Methods: This study collected the current diabetes distress measurement tools, re-organized current definitions about the domains of diabetes distress, and then developed a new tool. Three hundred and ninety-five participants from four hospitals in northern Taiwan were recruited by cluster randomized sampling for validity test. Results: We found the new diabetes distress scale had appropriate reliability and validity, including an acceptable model fit for the 12-item scale. Conclusions: This new diabetes distress scale might be more directly related to emotional distress issues blood glucose control, improve the clinical conspicuity of diabetes distress, and even benefit the overall care of diabetic patients in Taiwan. Further studies about the validity and reliability of this new tool in a nationwide setting are needed.

Effectiveness of Health Coaching in Diabetes Control and Lifestyle Improvement: A Randomized-Controlled Trial.

BACKGROUND: The study aimed to look into the effectiveness of a 6-month health coaching intervention for HbA1c and healthy diet in the treatment of patients with type 2 diabetes. METHODS: The study was carried out via a two-armed, randomized controlled trial that included 114 diabetic patients at a medical center in Taiwan. During the 6-month period, the intervention group had health coaching and usual care for 6 months, and the control group had usual care only. The outcome variables were HbA1c level and healthy diet for follow-up measurement in the third and sixth month. RESULTS: The study discovered a significant decrease in HbA1c and health diet improvement after the 6-month health coaching. Patients in the intervention group decreased their daily intake of whole grains, fruits, meats and protein, and fats and oils while increasing their vegetables intake. CONCLUSIONS: Health coaching may be conducive to the blood sugar control and healthy diet of patients with type 2 diabetes. Further study on health coaching with higher-quality evidence is needed.

From Cognition to Behavior: Associations of Workplace Health Culture and Workplace Health Promotion Performance With Personal Healthy Lifestyles.

Introduction: The aim of this study was to explore associations of workplace health culture and workplace health promotion (WHP) performance with employees' healthy lifestyles and health statuses. Methods: In total, 27 enterprises and 1,732 participants were recruited for a cross-sectional designed survey. At the group level, Workplace Health Scorecard was used to measure WHP performance, and it was filled out by the WHP representative at each workplace. At the personal level, a personal questionnaire was used to measure workplace health culture, healthy lifestyles, and health statuses. A hierarchical linear model analysis was used to assess correlations between these variables. Results: Workplace health culture was significantly related to WHP performance, healthy lifestyles, and health statuses. In particular, the peer support domain was greatly related to healthy behaviors like physical activity (ß = 0.596, p < 0.001), vegetable consumption (ß = 0.291, p < 0.001) and fruit consumption (ß = 0.285, p < 0.05), and it may illustrate the importance of establishing peer support to promote healthy behaviors. Conclusions: WHP performance was significantly related to workplace health culture especially health policies, health climate, and peer and supervisor support. Hence, building a good workplace health culture should be taken seriously, and more studies exploring associations of health culture and WHP performance with employees' health are needed.

Under COVID-19 Pandemic: A Quasi-Experimental Trial of Observation on Diabetes Patients' Health Behavior Affected by the Pandemic From a Coaching Intervention Program.

Introduction: The aim of this study was to explore the impact of diabetes self-management and HbA1c affected by the COVID-19 pandemic and the epidemic prevention work. Methods: This quasi-experimental study collected a pooled data from a randomized-control study between February and May 2020 in which 114 participants who presented type 2 diabetes were recruited. The intervention group had health coaching and usual care, whereas the control had usual care only. The main outcome variables of this observation study were the change of HbA1c, physical activity, and eating out behavior within this time interval. Results: We found that the eating out behavior of both groups had decreased, and if a health coach helped the patients set physical activity goals in the two groups, the physical activity behavior will not be impacted due to the pandemic. Conclusions: While every country is focusing on COVID-19 pandemic prevention, especially when strict home quarantine measures and social distancing are adopted, reminding and assisting chronic patients to maintain good self-management behavior may lessen the social and medical system burdens caused by the deterioration of chronic conditions due to the excessive risk prevention behavior and the epidemic prevention work. Trial Registration: www.isrctn.com, identifier number: ISRCTN14167790, date: 12 July, 2019.

A Novel Pathogenic HSPG2 Mutation in Schwartz-Jampel Syndrome.

Schwartz-Jampel syndrome is a rare autosomal recessive disease caused by mutation in the heparan sulfate proteoglycan 2 (HSPG2) gene. Its cardinal symptoms are skeletal dysplasia and neuromuscular hyperactivity. Herein, we identified a new pathogenic mutation site (NM_005529.6:c.1125C>G; p.Cys375Trp) of HSPG2 leading to Schwartz-Jampel syndrome by whole-exome sequencing. This mutation carried by the asymptomatic parents was previously registered in a single-nucleotide polymorphism database of the National Institutes of Health as a coding sequence variant rs543805444. The pathogenic nature of this missense mutation was demonstrated by in silico pathogenicity assessment, clinical presentations, and cellular function of primary fibroblast derived from patients. Various in silico software applications predicted the mutation to be pathogenic [Sorting Intolerant From Tolerant (SIFT), 0; Polyphen-2, 1; CADD (Combined Annotation Dependent Depletion), 23.7; MutationTaster, 1; DANN (deleterious annotation of genetic variants using neural networks); 0.9]. Needle electromyography revealed extensive complex repetitive discharges and multiple polyphasic motor unit action potentials in axial and limb muscles at rest. Short exercise test for myotonia showed Fournier pattern I. At cellular levels, mutant primary fibroblasts had reduced levels of secreted perlecan and impaired migration ability but normal capability of proliferation. Patients with this mutation showed more neuromuscular instability and relatively mild skeletal abnormality comparing with previously reported cases.

Structural Insight into Integrin Recognition and Anticancer Activity of Echistatin.

Echistatin (Ech) is a short disintegrin with a long 42NPHKGPAT C-terminal tail. We determined the 3-D structure of Ech by X-ray crystallography. Superimposition of the structures of chains A and B showed conformational differences in their RGD loops and C-termini. The chain A structure is consistent with our NMR analysis that the GPAT residues of the C-terminus cannot be observed due to high flexibility. The hydrogen bond patterns of the RGD loop and between the RGD loop and C-terminus in Ech were the same as those of the corresponding residues in medium disintegrins. The mutant with C-terminal HKGPAT truncation caused 6.4-, 7.0-, 11.7-, and 18.6-fold decreases in inhibiting integrins αvß3, αIIbß3, αvß5, and α5ß1. Mutagenesis of the C-terminus showed that the H44A mutant caused 2.5- and 4.4-fold increases in inhibiting αIIbß3 and α5ß1, and the K45A mutant caused a 2.6-fold decrease in inhibiting αIIbß3. We found that Ech inhibited VEGF-induced HUVEC proliferation with an IC50 value of 103.2 nM and inhibited the migration of A375, U373MG, and Panc-1 tumor cells with IC50 values of 1.5, 5.7, and 154.5 nM. These findings suggest that Ech is a potential anticancer agent, and its C-terminal region can be optimized to improve its anticancer activity.

Improved Antithrombotic Activity and Diminished Bleeding Side Effect of a PEGylated αIIbß3 Antagonist, Disintegrin.

Polymer polyethylene glycol (PEG), or PEGylation of polypeptides improves protein drug stability by decrease degradation and reduces renal clearance. To produce a pharmaceutical disintegrin derivative, the N-terminal PEGylation technique was used to modify the disintegrin derivative [KGDRR]trimucrin for favorable safety and pharmacokinetic profiles and antithrombotic efficacy. We compared intact [KGDRR]trimucrin (RR) and PEGylated KGDRR (PEG-RR) by in vitro and in vivo systems for their antithrombotic activities. The activity of platelet aggregation inhibition and the bleeding tendency side effect were also investigated. PEG-RR exhibited optimal potency in inhibiting platelet aggregation of human/mouse platelet-rich plasma activated by collagen or ADP with a lower IC50 than the intact derivative RR. In the illumination-induced mesenteric venous thrombosis model, RR and PEG-RR efficaciously prevented occlusive thrombosis in a dose-dependent manner. In rotational thromboelastometry assay, there was no effect of PEG-RR in human whole blood coagulation even given at a higher concentration (30 µg/mL), while RR slightly prolonged clotting time. However, RR and PEG-RR were not associated with severe thrombocytopenia or bleeding in FcγRIIa-transgenic mice at equally efficacious antithrombotic dosages. We also found the in vivo half-life of PEGylation was longer than RR (RR: 15.65 h vs. PEG-RR: 20.45 h). In conclusion, injectable PEG-RR with prolonged half-life and decreased bleeding risk is a safer anti-thrombotic agent for long-acting treatment of thrombus diseases.

The Biochemical and Functional Characterization of M28 Aminopeptidase Protein Secreted by Acanthamoeba spp. on Host Cell Interaction.

Acanthamoeba are a free-living protozoan whose pathogenic strain can cause severe human diseases, such as granulomatous encephalitis and keratitis. As such, the pathogenic mechanism between humans and Acanthamoeba is still unknown. In our previous study, we identified the secreted Acanthamoeba M28 aminopeptidase (M28AP) and then suggested that M28AP can degrade human C3b and iC3b for inhibiting the destruction of Acanthamoeba spp. with the human immune response. We constructed the produced the recombinant M28AP from a CHO cell, which is a mammalian expression system, to characterize the biochemical properties of Acanthamoeba M28AP. The recombinant M28AP more rapidly hydrolyzed Leu-AMC than Arg-AMC and could be inhibited by EDTA treatment. We show that recombinant M28AP can be delivered into the individual cell line and cause cell line apoptosis in a co-culture model. In conclusion, we successfully investigated the potential molecular characteristics of M28AP.

Effectiveness of Short-Term Health Coaching on Diabetes Control and Self-Management Efficacy: A Quasi-Experimental Trial.

Introduction: The aim of this study was to explore the effectiveness in HbA1c lowering and self-efficacy of diabetes self-management of a 6 months coaching intervention. Methods: This paper was a two-armed coaching intervention study in which 116 participants who presented type 2 diabetes were recruited at a medical center. The intervention group had health coaching and usual care for 6 months, whereas the control had usual care only. The main outcome variables were HbA1c level and self-efficacy of diabetes self-management, in followed-up measure at 3 and 6 months. Results: We found that an approximate 0.68% (CI = 0.40 to 0.96) reduction in HbA1c was achieved after a 6-month health coaching. Both physical activity and self-efficacy of diabetes self-management were shown to benefit by health coaching. Conclusions: Health coaching might be an effective strategy to enhance self-management for diabetes patients in Taiwan where "Diabetes Shared Care Network" had been implemented for over 20 years. Consider limitations of this study, more studies with designs that yield higher quality evidence for the role of health coaching in diabetic patients are needed. Clinical Trial Registration: www.isrctn.com (ID number: ISRCTN52454940, date: 10 May, 2018, retrospectively registered).

Identification and characterization of a secreted M28 aminopeptidase protein in Acanthamoeba.

Acanthamoeba is a free-living pathogenic protozoan that is distributed in different environmental reservoirs, including lakes and soil. Pathogenic Acanthamoeba can cause severe human diseases, such as blinding keratitis and granulomatous encephalitis. Therefore, it is important to understand the pathogenic relationship between humans and Acanthamoeba. By comparison of systemic analysis results for Acanthamoeba isolates, we identified a novel secreted protein of Acanthamoeba, an M28 aminopeptidase (M28AP), which targets of the human innate immune defense. We investigated the molecular functions and characteristics of the M28AP protein by anti-M28 antibodies and a M28AP mutant strain generated by the CRISPR/Cas9 system. Human complement proteins such as C3b and iC3b were degraded by Acanthamoeba M28AP. We believe that M28AP is an important factor in human innate immunity. This study provides new insight for the development of more efficient medicines to treat Acanthamoeba infection.

Exploring and Developing the Workplace Health Culture Scale in Taiwan.

Background: The aim of this study was to develop and validate the workplace health culture scale. Methods: This paper collected and re-organized current definitions about health culture from literature and created the domains and items to develop a new tool. Six enterprises and 2,431 participants were recruited from northern Taiwan for validity test. Results: We found the workplace health culture scale had appropriate reliability and validity, including a good model fit for the 25-item scale. Conclusions: Workplace health culture might be an important domain to the work of WHP. More validity and reliability studies about WHCS in wider industries and the correlation between WHCS and other WHP indicators are needed.

Factors influencing interest in recreational sports participation and its rural-urban disparity.

OBJECTIVES: Recreational sports are important leisure activities. However, most studies investigating barrier factors and motivation for participation in recreational sports have been limited to specific areas (e.g., a city or school) or demographic groups (e.g., adolescents). Therefore, this study set out to gain a more comprehensive understanding of the behavioral and socioeconomic factors influencing interest in recreational sports participation in Taiwan, as well as to evaluate the effect of any urban-rural divide. METHODS: This study analyzed data collected by the "Taiwan Social Change Survey" (program five, wave 3) "Leisure Life" questionnaire. We used hierarchical linear modeling to assess respondent interest in recreational sports participation and evaluated the influence of behavioral factors, socioeconomic factors, and residence location (urban/rural). RESULTS: Of the 2,146 participants in this study, 50.3% were male, and the average age was 43.9 years. Location of residence (urban/rural) accounted for 35.3% of the variation in interest in recreational sports participation, while the remaining 64.7% came from the individual level. Participants who lived in rural settings were less interested in recreational sports than their urban counterparts. Gender, educational attainment, participation frequency, health-motivated interest, and appearance-motivated interest were also associated with interest in recreational sports participation. CONCLUSIONS: Different communication strategies may be needed to effectively reach different demographic groups. We suggest that future public health campaigns aiming to increase recreational sports participation include tailored interventions and messages to effectively encourage leisure physical activities among all, regardless of demographic boundaries.

Effects of the RGD loop and C-terminus of rhodostomin on regulating integrin αIIbß3 recognition.

Rhodostomin (Rho) is a medium disintegrin containing a 48PRGDMP motif. We here showed that Rho proteins with P48A, M52W, and P53N mutations can selectively inhibit integrin αIIbß3. To study the roles of the RGD loop and C-terminal region in disintegrins, we expressed Rho 48PRGDMP and 48ARGDWN mutants in Pichia pastoris containing 65P, 65PR, 65PRYH, 65PRNGLYG, and 65PRNPWNG C-terminal sequences. The effect of C-terminal region on their integrin binding affinities was αIIbß3 > αvß3 ≥ α5ß1, and the 48ARGDWN-65PRNPWNG protein was the most selective integrin αIIbß3 mutant. The 48ARGDWN-65PRYH, 48ARGDWN-65PRNGLYG, and 48ARGDWN-65PRNPWNG mutants had similar activities in inhibiting platelet aggregation and the binding of fibrinogen to platelet. In contrast, 48ARGDWN-65PRYH and 48ARGDWN-65PRNGLYG exhibited 2.9- and 3.0-fold decreases in inhibiting cell adhesion in comparison with that of 48ARGDWN-65PRNPWNG. Based on the results of cell adhesion, platelet aggregation and the binding of fibrinogen to platelet inhibited by ARGDWN mutants, integrin αIIbß3 bound differently to immobilized and soluble fibrinogen. NMR structural analyses of 48ARGDWN-65PRYH, 48ARGDWN-65PRNGLYG, and 48ARGDWN-65PRNPWNG mutants demonstrated that their C-terminal regions interacted with the RGD loop. In particular, the W52 sidechain of 48ARGDWN interacted with H68 of 65PRYH, L69 of 65PRNGLYG, and N70 of 65PRNPWNG, respectively. The docking of the 48ARGDWN-65PRNPWNG mutant into integrin αIIbß3 showed that the N70 residue formed hydrogen bonds with the αIIb D159 residue, and the W69 residue formed cation-π interaction with the ß3 K125 residue. These results provide the first structural evidence that the interactions between the RGD loop and C-terminus of medium disintegrins depend on their amino acid sequences, resulting in their functional differences in the binding and selectivity of integrins.

Association Between Organization Culture, Health Status, and Presenteeism.

OBJECTIVE: The aim of this study was to examine relationships of organizational culture and health behaviors with presenteeism. METHOD: Data of a self-reported questionnaire were collected from 816 employees, who joined the study on a voluntary basis, in seven enterprises in northern Taiwan. RESULTS: Organizational culture and health behaviors were found to be significantly associated with presenteeism. After adjusting for confounding factors, the number of health complaints seemed to be more suitable than chronic diseases in predicting presenteeism. CONCLUSIONS: This study result implied that advantage could be taken of organizational culture and employees' health behaviors to reduce presenteeism in the workplace.