Spine trabecular bone scores and bone mineral density of postmenopausal Taiwanese women.

OBJECTIVES: The aims of the study were to determine the mean trabecular bone score (TBS) of postmenopausal Taiwanese women and to analyze the value of TBS in predicting osteoporosis. METHODS: A total of 1,915 postmenopausal women with lumbar spine and hip bone mineral density (BMD) and spine TBS were enrolled from a single medical center into this study. The women's BMD and TBS were measured using dual x-ray absorptiometry (Discovery Wi; Hologic, Bedford, Mass) and iNsight software (Med-Imaps SASU, Merignac, France), respectively. The women's demographic characteristics; lumbar spine, total hip, and femoral neck BMD; and lumbar spine TBS were recorded, and correlations among the parameters were identified using a 2-tailed Pearson test, in which a P value less than 0.05 was considered statistically significant. We developed simple linear regression models to represent changes related to TBS and performed an analysis of variance on the selected variables. RESULTS: The average age of the women was 62.5 ± 9.1 years (range, 25.7-93.7 years). The mean TBS was 1.300 ± 0.086 (range, 1.015-1.596). The TBS was weakly and negatively correlated with body mass index ( r = -0.078) and moderately and positively correlated with the lumbar spine BMD ( r = 0.619). The patients' lowest BMD values among those measured at multiple sites revealed a higher rate of osteoporosis (32.5%) than those measured at individual sites. Degraded TBS were noted in 21.2% of the participants, and a combination of BMD and TBS results predicted more individuals (7.8%) at a high risk of fracture than did the BMD result only. The rates of both osteoporosis and degraded TBS increased with age. CONCLUSIONS: Bone mineral density and TBS can be used in combination to predict osteoporosis in a greater number of postmenopausal Taiwanese women. Because the incidence of osteoporosis is the highest among older women, clinicians should pay careful attention to TBS degradation among older patients without low BMD.

Effect of varied hair protein fractions on the gel properties of keratin/chitosan hydrogels for the use in tissue engineering.

Keratin/chitosan composite is a readily available source for a hybrid hydrogel in tissue engineering. While human hair keratins could provide biological functions, chitosan could further enhance the mechanical strength of the hybrid hydrogels. However, hair keratin is a group of natural proteins, and the uncontrolled hair protein contents in a hydrogel may lead to the batch-to-batch inconsistent gel properties. The purpose of this study was to investigate the role of hair protein composition, including the keratin-associated proteins (KAPs, 6-30 kDa) and keratin intermediate filaments (KIFs, 45-60 kDa) on gel characteristics of the keratin/chitosan hydrogel. The various compressive and tensile modulus of the gel was observed based on the selection of different protein fractions as the significant gel components. These results thus suggest a straightforward method of preparing hair keratin/chitosan hydrogel with much more controllable gel properties by merely modulating the KAPs/KIFs ratios in a gel.

Side effects and medication adherence of tyrosine kinase inhibitors for patients with chronic myeloid leukemia in Taiwan.

Nonadherence is common in patients with chronic myeloid leukemia (CML) and leads to treatment failure and poor outcomes. Side effects due to treatment are also common in patients with CML. However, no study has investigated the link between side effects and medication adherence for patients with CML in Taiwan. Therefore, the aim of our study was to explore the influence of side effects on medication adherence in Taiwanese patients with CML.CML in chronic-phase patients treated with breakpoint cluster region-Abelson murine leukemia viral oncogene homolog 1 tyrosine kinase inhibitors were recruited. We designed a questionnaire to collect baseline patient information, medication adherence (measured using the 8-item Morisky Medication Adherence Scale), and side effects. Clinical outcomes were assessed by the 3-month early molecular response rate and the 12-month major molecular response rate. Statistical comparisons of different parameters between adherent and nonadherent groups were conducted.Fifty-eight patients were enrolled in this study, and 31% of them had poor adherence. The lack of information about treatment and medication was the major reason for poor medication adherence. Patients who were younger and unmarried were prone to poor adherence. The occurrence of side effects carried no statistically significant influence on adherence. Poor adherence resulted in a poor treatment response (lower 3-month early molecular response rate and lower 12-month major molecular response rate).Poor adherence is common in Taiwanese patients with CML. The main reason for a decrease in the adherence rate is the lack of comprehensive information about treatment and medication, particularly in young and single population. The next urgent step is to educate patients about their treatment and management of side effects to improve adherence and treatment outcome for patients with CML in Taiwan.

Ambient air particulates-bound metallic elements sources identifications during winter and summer at a Science Park.

The ambient air particulates pollutants of total suspended particulates (TSP) and PM2.5 were collected by using PS-1 and Wilbur PM2.5 sampler, simultaneously during the year of 2015-2017 at a photoelectric factory in Science Park of central Taiwan. And those of the ambient air atmospheric metallic elements (Cr, Mn, Ni, Cu, Zn, Pb) concentrations which attached on the TSP and PM2.5 were analyzed by using inductively coupled plasma optical emission spectrometer. In addition, identifying anthropogenic and natural pollutants sources were conducted by using the enrichment factor (EF) and principal component analysis (PCA) methods. The results indicated that the average TSP and PM2.5 concentrations were ranked highest in winter season, while summer season was ranked lowest during the year of 2015-2016. In addition, the average highest metallic element concentrations were occurred in winter season for both TSP and PM2.5 during the year of 2015-2016, while the average lowest metallic elements concentrations in TSP and PM2.5 were also occurred in winter season during the year of 2016-2017. Moreover, the EF analysis results showed that the metallic element Zn came from anthropogenic emission source. As for metallic element Mn, the results showed that metallic element Mn was mainly attributed to natural emission in this study. Finally, the PCA results showed that metallic elements Cr, Zn and Pb were the dominant emissions metallic elements in this study. As for PM2.5, the results showed that the metallic elements Cr, Cu and Pb were the dominant emissions metallic elements at this HPB sampling site.

Wet depositions of mercury during plum rain season in Taiwan.

The plum rain season in Taiwan is in May and June. The severest plum rain season over the last 21 years was in 2017. This study involves the collection of mercury wet depositions in the plum rain season of May-June in 2017. A DMA-80 (Direct Mercury Analyzer) was used to analyze the precipitated mercury concentrations and calculate the wet depositions of mercury in the plum rain season. The results indicate that the highest wet depositions of mercury in the aqueous phase were on 6/16, reaching 209.04 µg/m2 * day, while the lowest were on 5/15, at 0.18 µg/m2 * day. The mercury wet depositions in the particulate phase were highest on 6/17, when it exceeded 100 µg/kg, and lowest on particulate phase were occurred in 6/11, when it was 3.64 µg/m2 * day. The relationship between the wet depositions of mercury in the aqueous phase and rainfall was insignificant, while that between the wet depositions of mercury in the particulate phase and rainfall was significant. The wet depositions of mercury in this study were second highest (30.73 µg/m2 day) when compared with those in studies in the years 2007-2017. Although the rainfall in this study was only 564 mm H2O, high mercury concentrations obtained from the plum rain season result in the high wet depositions of mercury in Taichung, Taiwan.

Pharmacokinetics of dinalbuphine sebacate and nalbuphine in human after intramuscular injection of dinalbuphine sebacate in an extended-release formulation.

Nalbuphine is a semi-synthetic opioid indicated for the relief of moderate to severe pain. Its short half-life requires frequent injections in clinical practice, resulting in a greater incidence of adverse events. A prodrug of nalbuphine has been developed, dinalbuphine sebacate (DNS), dissolved in a simple oil-based injectable formulation, which could deliver and maintain an effective blood level of nalbuphine. An open-label, prospective, two-period study was performed in healthy volunteers to verify the extended blood concentration profile of nalbuphine. Twelve healthy Taiwanese were randomized to receive an intramuscular injection of 20 mg nalbuphine HCl and 150 mg DNS sequentially with a washout period of 5 days. To prevent DNS hydrolysis during sample analysis, the effect of four esterase inhibitors was evaluated in the quantitation of DNS in human whole blood and thenoyltrifluoroacetone was chosen. The bioavailability of nalbuphine from intramuscularly injected DNS relative to that from nalbuphine HCl was 85.4%. The mean absorption time of nalbuphine from DNS was 145.2 h. It took approximately 6 days for the complete release of DNS into the blood stream where DNS was rapidly hydrolysed to nalbuphine; suggesting a single injection of 150 mg DNS in our extended-release formulation could provide long-lasting pain relief.

Study of the ambient air metallic elements Cr, Cu, Zn, Cd and Pb at HAF sampling sites.

This study characterized diurnal variations in the compositions of total suspended particulates (TSP) and dry deposits of particulates from ambient air, and the metallic elements that are contained in them at harbor, airport and farmland (HAF) sampling sites from August, 2013 to July, 2014. Two-way ANOVA of the amounts of metallic elements in the TSP and dry deposits was carried out in all four seasons at the HAF sampling sites. The metallic elements Cr and Cu originated in local emission sources at the airport. Metallic elements Zn and Pb originated in local emission sources at the harbor. Finally, metallic element Cd originated in local emissions form farmland. The following results were also obtained. (1) The metallic composition of the TSP differed significantly from that of the dry deposits in all four seasons at the harbor and farmland sampling sites, but not at the airport sampling site. (2) High correlations coefficients were found between the amounts of metallic elements Cr and Cu in the TSP and those in the dry deposits at the airport sampling site. (3) Pb was present in the TSP and the dry deposits at the harbor sampling site.

Medication adherence to oral anticancer drugs: systematic review.

Many studies have demonstrated that non-adherence to oral anticancer drugs (OACDs) has challenged treatment efficacy. Otherwise, few validated tools exist to measure patients' adherence to medication regimen in clinical practice. To synthesize previous studies on adherence by cancer patients taking OACDs, especially in targeted therapy, a systematic search of several electronic databases was conducted. We analyzed existing scales' contents for various cancer patients and outcomes of studies assessing adherence. However, a well-validated scale designed particularly for OACD adherence is still lacking. Most adherence scales used in the studies reviewed contain items focused on measuring patients' medication-taking behavior more than their barriers to medication compliance and beliefs. However, non-adherence to OACDs is a complex phenomenon, and drug-taking barriers and patient beliefs significantly affect patients' non-adherence. To understand the key drivers and predisposing factors for non-adherence, we need to develop a well-validated, multidimensional scale.

The dose-response relationship between cumulative lifting load and lumbar disk degeneration based on magnetic resonance imaging findings.

BACKGROUND: Lumbar disk degeneration (LDD) has been related to heavy physical loading. However, the quantification of the exposure has been controversial, and the dose-response relationship with the LDD has not been established. OBJECTIVE: The purpose of this study was to investigate the dose-response relationship between lifetime cumulative lifting load and LDD. DESIGN: This was a cross-sectional study. METHODS: Every participant received assessments with a questionnaire, magnetic resonance imaging (MRI) of the lumbar spine, and estimation of lumbar disk compression load. The MRI assessments included assessment of disk dehydration, annulus tear, disk height narrowing, bulging, protrusion, extrusion, sequestration, degenerative and spondylolytic spondylolisthesis, foramina narrowing, and nerve root compression on each lumbar disk level. The compression load was predicted using a biomechanical software system. RESULTS: A total of 553 participants were recruited in this study and categorized into tertiles by cumulative lifting load (ie, <4.0 × 10(5), 4.0 × 10(5) to 8.9 × 10(6), and ≥8.9 × 10(6) Nh). The risk of LDD increased with cumulative lifting load. The best dose-response relationships were found at the L5-S1 disk level, in which high cumulative lifting load was associated with elevated odds ratios of 2.5 (95% confidence interval [95% CI]=1.5, 4.1) for dehydration and 4.1 (95% CI=1.9, 10.1) for disk height narrowing compared with low lifting load. Participants exposed to intermediate lifting load had an increased odds ratio of 2.1 (95% CI=1.3, 3.3) for bulging compared with low lifting load. The tests for trend were significant. LIMITATIONS: There is no "gold standard" assessment tool for measuring the lumbar compression load. CONCLUSIONS: The results suggest a dose-response relationship between cumulative lifting load and LDD.

The association of ambient air pollution with airway inflammation in schoolchildren.

The biologic mechanisms involved in airway inflammatory response to air pollution are not clearly understood. The authors conducted a longitudinal study to investigate whether exposure to ambient air pollutants affected inflammatory cells and mediators from nasal lavage in schoolchildren. Study participants were 100 elementary and middle-school students in New Taipei City, Taiwan. A structured respiratory health questionnaire was administered in September 2007, followed by monthly measurement of nasal inflammation from October 2007 to November 2009. During the study period, daily concentrations of air pollutants were obtained from the Environmental Protection Administration monitoring station and the Aerosol Supersite. Mixed-effects models were applied to examine the association between air pollution and nasal inflammatory cells and mediators, including percentages of neutrophils, eosinophils, and monocytes in lavaged cells and interleukin-8. A total of 824 measurements were obtained from 100 participants over a period of 10 months. The level of particulate matter with an aerodynamic diameter of 2.5 µm or less (PM(2.5)) was found to be associated with percentage of neutrophils (ß = 3.45%, 95% confidence interval: 0.89, 6.01) and interleukin-8 level (ß = 29.98 pg/mL, 95% confidence interval: 3.26, 56.69) in the nasal lavage on the day of exposure. In this longitudinal cohort study of schoolchildren, results indicated that exposure to PM(2.5) might induce nasal inflammation.

Chromosomal inversion between rrn operons among Streptococcus mutans serotype c oral and blood isolates.

Streptococcus mutans causes dental caries and infective endocarditis. The aim of this study was to determine genomic diversity among serotype c S. mutans laboratory and clinical strains and to characterize the genetic events involved. A genome-based approach using PFGE coupled with Southern hybridization was employed to examine a total of 58 serotype c oral and blood isolates and seven laboratory strains and to compare them with S. mutans UA159. No significant differences were found in the phenotypic characteristics of the strains tested, except that some of the strains exhibited smooth rather than rough colony morphology. In contrast, PFGE profiles of clinical isolates, from either diseased or healthy subjects, exhibited diverse patterns, suggesting that recombination or point mutations occurred frequently in vivo. Diverse PFGE patterns, with various lengths of insertions and deletions, could be detected even within a localized chromosomal region between rRNA operons. Comparative analysis using Southern hybridization with specific markers revealed that a large chromosomal inversion had also occurred between rrn operons in 25 strains.