Seasonal Disparities of Human Health Risk and Particle-Bound Metal Characteristics Associated with Atmospheric Particles in a Fishery Harbor

The effects of atmospheric pollution from ship emissions have been considered for several harbors worldwide. The health risk assessment and source apportionment of particle-bound metals in a fishery harbor were investigated in this study. The most abundant metal elements in particulate matter (PM) on all sampling days in three seasons were Fe (280.94 ± 136.93 ng/m3), Al (116.40 ± 71.25 ng/m3), and Zn (110.55 ± 26.70 ng/m3). The ratios of V/Ni were 1.44 ± 0.31, 1.48 ± 0.09 and 1.87 ± 0.06 in PM10, PM2.5, and PM1, respectively. Meanwhile, the ratios higher than 1 indicated that fuel oil combustion from ship emission in fishery harbor. The highest deposits of total particle-bound metals in the human respiratory tract were in the head airway (HA), accounting for 76.77 ± 2.29% of the total particle-bound metal concentration, followed by 5.32 ± 0.13% and 2.53 ± 0.15% in the alveolar region (AR) and tracheobronchial (TB) region, respectively. The total cancer risk (CR) of inhalation exposure to local residents exceeded 10-6. Mean total CR values followed the sequence: autumn (1.24 × 10-4) > winter (8.53 × 10-5) > spring (2.77 × 10-6). Source apportionment of related metal emissions was mobile pollution emissions (vehicle/boat) (37.10-48.92%), metal fumes of arc welding exhaust (19.68-34.42%), spray-painting process (12.34-16.24%), combustion emissions (6.32-13.12%), and metal machining processes (9.04-16.31%) in Singda fishing harbor. These results suggest that proper control of heavy metals from each potential source in fishing harbor areas should be carried out to reduce the carcinogenic risk of adverse health effects.

Adverse pulmonary impacts of environmental concentrations of oil mist particulate matter in normal human bronchial epithelial cell

Airborne oil mist particulate matter (OMPM) is generated during industrial processes such as metalworking and may be associated with pulmonary dysfunction. In this study, we employed the normal human bronchial epithelial BEAS-2B cell line to elucidate the association between pulmonary toxicity and OMPM of 2.5-10 μm, 1.0-2.5 μm and <1.0 μm particle sizes (OMPM_10-2.5, OMPM_2.5-1.0 and OMPM_1.0). We measured OMPM concentrations at a precision machinery factory to estimate lung deposition rates and select realistic environmental concentrations for testing. All OMPMs (1-50 μg/cm²) significantly decreased BEAS-2B cell viability (>38% of control), except for low-dose OMPM_1.0 (1 μg/cm²). OMPM_10-2.5 and OMPM_2.5-1.0, but not OMPM_1.0, induced oxidative stress (1.5-4-fold increase compared with the control) and increased the production of proinflammatory cytokines (1.5-3-fold). However, only OMPM_1.0 induced pulmonary epithelial barrier dysfunction via depletion of zonula occludens (0.65-0.8-fold) and α1-antitrypsin proteins (0.65-0.8-fold). In conclusion, a higher risk of lung disease was associated with smaller particle size OMPM. Exposure to OMPM_1.0 may be a potential risk factor for chronic obstructive pulmonary disease. The evidence also demonstrates that occupational exposure to OMPM may cause pulmonary disease at very low concentrations.

Human health-risk assessment based on chronic exposure to the carbonyl compounds and metals emitted by burning incense at temples

Health effects resulting from the smoke of carbonyl compounds (aldehydes and ketones) and metal-containing incense particles at temples during incense burning periods were evaluated at temple A (without incense reduction activities) and B (with incense reduction activities), Nantou County, in 2018. The predominant size fractions of particles were PM₁, PM_1-2.5, and PM_2.5-10 at both temples. The total particle mass at temple A was approximately 1.1 times that of temple B due to incense reduction at temple B. The most abundant metal elements in all particle size fractions at both temples were Fe, Al, and Zn. Metal species of incense smoke are divided into three groups by hierarchical cluster analysis and heatmaps, showing higher metal contents in groups PM₁, PM_18-10, and PM_18-2.5 at temple A. In contrast, higher metal contents were observed in PM_18-10 and PM_2.5-1 at temple B. Most of the carbonyl species were formaldehyde and acetaldehyde, released during incense burning periods, with concentrations ranging from 6.20 to 13.05 μg/m³ at both temples. The total deposited fluxes of particle-bound metals at temples A and B were determined to be 83.00% and 84.82% using the International Commission on Radiological Protection (ICRP) model. Health-risk assessments revealed that the risk values of metals and carbonyls were above recommended guidelines (10^-6) at temple A. Since worshippers and staff are exposed to incense burning environments with poor ventilation over a long period, these toxic organic compounds and metals increase health risks in the respiratory tract. Therefore, incense reduction is important to achieve healthy temple environments.

Severe myocardial bridge presenting as paroxysmal atrioventricular block

Chest pain complicated with electrocardiographic changes is not an uncommon scenario in emergency departments, which should be examined cautiously. We describe a 51-years-old man with a myocardial bridge of coronary artery presenting with simultaneous Mobitz type I atrioventricular block on electrocardiography. Echocardiography excluded valvular abnormality and systolic/diastolic dysfunction. Coronary angiography confirmed the diagnosis of a myocardial bridge at the middle segment of the left anterior descending artery, involving the most dominant septal perforator branch with marked systolic compression. The patient underwent coronary artery bypass grafting surgery and was followed up uneventfully at the outpatient department with medical treatment of diltiazem and clopidogrel. The present case is being reported to highlight that clinicians should be alert to such a congenital abnormality as a potential cause of repeated myocardial infarction and conduction abnormality.

PM2.5 collecting in a tire manufacturing plant affects epithelial differentiation of human umbilical cord derived mesenchymal stem cells by Wnt/β-catenin pathway

Mesenchymal stem cells (MSCs) can differentiate into pulmonary epithelial cells by Wnt/β-catenin pathway and promote lung repair. However, whether fine particulate matter (PM_2.5) could affect Wnt pathway and finally reduce the ability of MSCs to differentiate into epithelial cells is still unknown. This study aimed to investigate whether PM_2.5 could inhibit the epithelial differentiation of human umbilical cord-derived MSCs cells (hUCMSCs) and the related underlying mechanism. hUCMSCs were incubated with different concentrations of PM_2.5. Then, the cell viability, reactive oxygen species level, and single-cell sphere formation were assessed. The underlying mechanism of PM_2.5 in epithelial differentiation of hUCMSCs was further evaluated by co-culturing hUCMSCs with A549 cells. Our results demonstrated that PM_2.5 exposures could affect the expressions of β-catenin and lung epithelial markers (zonula occludens-1 (ZO-1); cytokeratins 5 and 19) in the co-cultured hUCMSCs. The Wnt/β-catenin pathway is involved in regulating the epithelial differentiation of MSCs. As expected, co-treatment with Wnt3a, which is the activator of the Wnt pathway, attenuated the downregulation of lung epithelial markers (ZO-1; cytokeratins 5 and 19) and paracrine factors (keratinocyte growth factor and hepatocyte growth factor) caused by PM_2.5. Altogether, these results demonstrated that PM_2.5 could affect the epithelial differentiation of hUCMSCs via the Wnt/β-catenin pathway.

Comparative health risk of inhaled exposure to organic solvents, toxic metals, and hexavalent chromium from the use of spray paints in Taiwan

The study investigated the exposure of spray painters to organic solvents, toxic metals, and hexavalent chromium over 21 working days in 2017. The results found these concentrations of 12 VOCs to be below the short-term exposure limit (STEL) established by the US Occupational Safety and Health Administration (OSHA). The mass concentration of total particulate matter (PM) exposure to workers was 20.01 ± 10.78 mg/m³, which exceeds OSHA's permissible exposure level of 15 mg/m³. The mean concentration of the total metals for all particle sizes was 109.1 ± 12.0 μg/m³, and those for lead (496,017.0 ng/m³) and iron (252,123.8 ng/m³) were the highest of metal elements. Significantly, the mean concentrations of Pb and As exceeded OSHA's permissible exposure limits (PELs) of 0.05 and 0.01 mg/m³, respectively. The total hexavalent chromium concentration was 1163.01 ng/m³, and the individual particle sizes (PM_1-2.5, PM₁, and PM_0.25) were strongly and positively correlated with the Cr(VI) concentrations for PM_2.5. The study determined that approximately 56.14% of the hexavalent chromium inhaled during the spray-painting process was deposited in the upper respiratory system of the head airway region, followed by the alveolar and tracheobronchial regions, with fractions of 11.93 and 0.05%, respectively. Although the mean ratio of hexavalent chromium to total chromium was only 3.6% for all particle sizes, the cancer risk of the total particles in Cr(VI) (1.6 × 10^-3) exceeded the acceptable risk value (10^-6). The cancer risks of As and Cr(VI) associated with quasi-ultrafine particles, PM_0.5-1, PM_1-2.5, and PM_> 2.5, also exceeded 10^-6. Comparison of the carcinogenicity risk of VOCs and metals suggests that the adverse health effect of inhaled particles on spray-painting workers is more serious than that from VOC exposure.

Attempted suicide by poisoning of self-prepared arsenic trioxide solution

Introduction:

Arsenic is a traditional poison that has a history extending back to ancient times.

Case presentation:

A 43-year-old male presented to our Emergency Department 50 min after ingestion of 300 mL self-prepared arsenic trioxide solution (砒霜). He produced the solution from heating xionghuang (雄黃), an arsenic sulfide mineral (As4S4) which is a Chinese herb, for academic purposes a few years ago.

Discussion:

Supportive care including fluid replacement and decontamination with gastric lavage and chelation therapy with intravenous dimercaptopropanesulphonate sodium was given to patient. Spot urine arsenic to creatinine ratio significantly decreased from 343,124 nmol/mmol (day 3) to 7116 nmol/mmol (day 5). He had an uneventful course without any neurological deficit.

Conclusions:

Treatment of acute arsenic poisoning includes supportive care, decontamination, and chelation therapy. DMPS is an antidote for arsenic poisoning and its use should be directed by clinical status and urinary arsenic excretion.

Effects of heavy metals on health risk and characteristic in surrounding atmosphere of tire manufacturing plant, Taiwan

The health and environmental effects of metal-containing carbon black (CB) particles emitted from a CB feeding area near a tire manufacturing plant were investigated.

Metabolic Acidosis Complicating Ingestion of Disinfectant Floor Cleaner Containing Butoxyethanol

Butoxyethanol intoxication has seldom been reported. We describe a case of ingestion of butoxyethanol-containing cleaner resulting in high anion gap metabolic acidosis, which resolved after treatment with ethanol and haemodialysis. The presentations and treatments of previous cases are highlighted. Discussion is centred on the toxicological pathway of butoxyethanol and the role of alcohol dehydrogenase inhibitor.

Comparison of Mortality among Severe Trauma Patients Treated in a Trauma Centre versus a Non-Trauma Centre

Introduction

In Taiwan, patients with major trauma are often sent to the closest non-trauma centre for initial resuscitation and transferred to distant trauma centres subsequently. This study aimed to evaluate the in-hospital mortality of severe trauma patients treated in a trauma centre versus in a non-trauma centre.

Methods

This prospective observational study reviewed 223 patients with major trauma (defined as Injury Severity Scale [ISS] score >15) who visited either a Level I trauma centre or a non-trauma centre from April 2013 to March 2014. Data of clinical status, trauma mechanisms, laboratory and radiology, interventions, and mortality/survival were evaluated. Logistic regression analysis was performed to assess effects of initial hospital treatment on mortality.

Results

A total of 158 major trauma patients were taken to the trauma centre hospital, and 65 patients were taken to the non-trauma centre. Age > 70 years (odds ratio [OR] 6.24, 95% confidence interval [CI] 1.01 to 38.62, compared to age ≤40 years), Glasgow Coma Scale [GCS] 3-8 (OR 19.00, 95% CI 2.30-157.01, compared to GCS 13-15), GCS 9-12 (OR 28.88, 95% CI 4.40-189.86, compared to GCS 13-15), ISS score >25 (OR 6.95, 95% CI 1.27-38.08) and taken to non-trauma centre initially (OR 30.90, 95% CI 5.00-191.27) were significantly associated with mortality.

Conclusion

Initial treatment of patients with major trauma in a non-trauma centre was associated with increased mortality compared to initial treatment in a trauma centre.

Bleeding Pelvic Fractures: Updates and Controversies in Acute Phase Management

Background

The management of patients with haemodynamic instability related to pelvic fractures is a major challenge with high mortality and morbidity. The treatment priorities have long been a source of debate. Many advocate emergent external fixation (EX-FIX) as the first line of treatment, whereas another school favours the efficacy of transcatheter arterial embolisation (TAE). Decision-making within the ‘Golden Hour’ in the emergency department (ED) is crucial to patients' ultimate outcome. Our aim was to evaluate the current management pathways in our centre and to review the latest literature.

Methods

We present a 2-year case series (from January 2005 to December 2006) of patients with pelvic ring disruption and haemodynamic instability. Data were collected regarding patients' demographics, fracture patterns according to the Young & Burgess classification, concomitant intra-abdominal injuries, treatment pathway and the response to treatment.

Results

There were 7 patients identified. Five were males and 2 were females, with a mean age of 42 years. Fracture types included 3 lateral compression, 1 anteroposterior compression, 2 vertical shear, and 1 combined mechanism. Four patients had significant intraperitoneal haemorrhage identified by Focused Assessment by Sonography for Trauma (FAST). They all needed laporotomy and pelvic packing, initially or subsequently. EX-FIXs were offered to 6 patients as the primary intervention, and 4 of them subsequently required diagnosis with angiography followed by therapeutic embolisation to restore haemodynamic stability. Only 1 patient underwent a second angiographic study to control the arterial bleeding. Two patients died of severe intra-abdominal injuries within 24 hours after admission.

Conclusion

In patients with pelvic fractures and hypotension, EX-FIX is currently the first line of treatment, with variable efficacy. On the other hand, the high successful embolisation rate and reasonable safety profile of TAE in our patients have been impressive. The latter offers a much better alternative to surgical intervention in selected patients. However, precautions should be taken including proper pelvic stabilisation by non-invasive devices, creation of a safe environment in the angiography suite, and early multidisciplinary decision in the ED.

The Use of Glucagon and other Antidotes in a Case of Beta-Blocker and Calcium Channel Blocker Overdose

We report a case of metoprolol and nifedipine overdose complicated by hypotension which responded to intravenous boluses of calcium chloride and glucagon. The blood pressure was subsequently stabilised by continuous glucagon infusion with the aid of an insulin-dextrose drip. The discussion is focused on the role of antidotes and catecholamine inotropes in the management of beta-blocker and calcium channel blocker poisoning.

Work-Related Crushing Injuries with Amputations of Digits, Hands and Forearms

Objective

To review work-related crushing injuries leading to amputation of digits, hands and forearms, by focusing on patients' demographics, and clinical outcomes.

Design

Retrospective descriptive study.

Setting

Regional hospital, Hong Kong.

Patients

Patients with work-related crushing injuries causing amputation of digits, hands or forearms admitted to hospital for treatment from January 2003 to August 2005.

Methods

Patients' age, sex, past medical history, occupations, context of injuries including injuring objects and levels of amputation were studied. During a 9-month follow up period, patients' need for urgent operation, length of hospital stay, duration of sick leave and change of occupational status were analysed.

Results

Eighty-eight patients were studied. The age distribution ranged from 19 to 81 years, with 50% being less than 40 years of age. Most patients (93%) were healthy adult before the injury. Industries frequently involved were construction (24%), manufacturing (17%) and transportation (14%). Machineries and metallic tools were the most common injuring objects. Eighty-four percent of the amputation injuries involved the finger(s), and 13% the thumb. Most patients (91%) required urgent operation. The mean length of hospital stay was 4 days. The mean duration of sick leave was 152 days. The estimated wage loss was around HK$145,000 per accident. Only 42% of the patients could fully resume working without job restriction.

Conclusion

Traumatic amputation as a severe work-related injury is common in Hong Kong. It frequently affects the young and healthy workforce, resulting in devastating physical and psychological disabilities. The clinical, social and economical significances are enormous and far-reaching.

Industrial PM2.5 cause pulmonary adverse effect through RhoA/ROCK pathway

According to the Chinese Ministry of Health, industrial pollution-induced health impacts have been the leading cause of death in China. While industrial fine particulate matter (PM_2.5) is associated with adverse health effects, the major action mechanisms of different compositions of PM_2.5 are currently unclear. In this study, we treated normal human lung epithelial BEAS-2B cells with industrial organic and water-soluble PM_2.5 extracts under daily alveolar deposition dose to elucidate the molecular mechanisms underlying adverse pulmonary effects induced by PM_2.5, including oxidative damage, inflammatory response, lung epithelial barrier dysfunction, and the recruitment of macrophages. We found that water-soluble PM_2.5 extracts caused more severe cytotoxic effects on BEAS-2B cells compared with that of organic extracts. Both organic and water-soluble PM_2.5 extracts induced activation of the RhoA/ROCK pathway. Inflammatory response, epithelial barrier dysfunction, and the activation of NF-кB caused by both PM_2.5 extracts were attenuated by ROCK inhibitor Y-27632. This indicated that both PM_2.5 extracts could cause damage to epithelial cells through RhoA/ROCK-dependent NF-кB activation. Furthermore, the upregulation of macrophage adhesion induced by both PM_2.5 extracts was also attenuated by Y-27632 in a co-culture model of macrophages and the epithelial cells. Therefore, our results support that industrial PM_2.5 extracts-induced activation of the RhoA/ROCK-dependent NF-кB pathway induces pulmonary adverse effect. Thus, pharmacological inhibition of ROCK activation might have therapeutic potential in preventing lung disease associated with PM_2.5.

Carbon black aggregates cause endothelial dysfunction by activating ROCK

Carbon black nanoparticles (CBNs) have been associated with the progression of atherosclerosis. CBNs normally enter the bloodstream and crosslink together to form agglomerates. However, most studies have used nano-sized CB particles to clarify the involvement of CBN exposure in CBN-induced endothelial dysfunction. Herein, we studied endothelial toxicity of CBN aggregates (CBA) to human EA.hy926 vascular cells. Cell viability, lactate dehydrogenase leakage, and oxidative stress were affected by the highest concentration of CBA. Moreover, transmission electron microscopic results showed that CBA entered cells through membrane enclosed vesicles. Rho-associated kinase (ROCK) is involved in regulating vascular diseases. Thus, we co-treated with the of ROCK inhibitor Y-27632 to study whether other adverse effects caused by CBA are related to activating ROCK. As expected, co-treatment with Y-27632 attenuated CBA-induced cytoskeletal damage, dysfunction of the endothelial barrier, and expression of inflammatory factors. Taken together, these results demonstrate that aggregated CBNs can cause endothelial dysfunction possibly by activating ROCK.

Dramatic band gap reduction incurred by dopant coordination rearrangement in Co-doped nanocrystals of CeO2

A dramatic band gap narrowing of 1.61 eV has been observed in Co-doped nanocrystals of CeO₂ (ceria), as a result of thermal annealing, without changing the ceria crystal structure and the Co concentration. As demonstrated by x-ray absorption fine structures, thermal annealing incurs an oxygen coordination rearrangement around Co atoms from an octahedral coordination to a square-planar coordination. First principle calculation using density functional theory reveals two stable oxygen coordination types surrounding Co, consistent with the experimental observation. The band gap values calculated for the two stable coordination types differ dramatically, reproducing the experimentally observed band gap narrowing. These prominent effects due to local structure rearrangement around dopant atoms can lead to unprecedented methods for band gap engineering in doped nanocrystal oxides.

Effects of lipid form and source on digestibility of fat and fatty acids in growing pigs

The objective of this study was to compare the effect of source (corn DDGS, rice bran, or soybean) or form of oil (extracted or intact) on apparent total tract digestibility (ATTD) and true total tract digestibility (TTTD) of acid-hydrolyzed ether extract (AEE) and fatty acids. The study determined and compared the ATTD or TTTD of AEE and fatty acids in extracted corn oil, rice oil, and soybean oil with intact oil in corn DDGS, full-fat rice bran, and full-fat soybean. Seventy-eight barrows (initial BW = 47.2 ± 3.9 kg; Duroc × Landrace × Yorkshire) were allotted to 1 of 13 dietary treatments in a randomized complete block design with 6 barrows in each dietary treatment. The 13 experimental diets included 1 cornstarch-soybean meal basal diet (AEE, 0.56%) and 3 diets containing 6% extracted oils (corn oil, rice oil, and soybean oil) and 9 diets supplemented with 3 levels of corn DDGS (17%, 34%, and 51%), full-fat rice bran (14%, 28%, and 42%), and full-fat soybean (12%, 24%, and 36%). These diets provided about 2%, 4%, and 6% intact oil, respectively. The barrows were housed in individual metabolism crates and were fed the assigned test diets at 4% of initial BW per day. A 5-d total collection of feces followed a 7-d diet adaptation period. The ATTD of AEE were calculated for each diet. The endogenous flow of AEE associated with each ingredient and values for TTTD were calculated using regression methods. The ATTD of AEE were greater ( < 0.05) for extracted oil than for intact oil. Compared to extracted oil, intact oil had lower ( < 0.01) ATTD of palmitic acid (C16:0), stearic acid (C18:0), oleic acid (C18:1), linoleic acid (C18:2), and linolenic acid (C18:3). However, a source by form interaction ( < 0.01) was observed for ATTD of C18:0, C18:2, and C18:3. The ATTD of C18:0, C18:2, and C18:3 in extracted corn and rice oil were greater compared with intact corn DDGS and rice oil ( < 0.05), while there was no significant difference for the ATTD of C18:0, C18:2, and C18:3 between extracted soybean oil and intact oil in full-fat soybean. In conclusion, lipids that are extracted have a greater digestibility compared with intact lipids, and this is especially true regarding saturated fatty acids. The ATTD of AEE in 2 forms of rice oil (intact oil and extracted oil) was less than the values in corn oil and soybean oil. The TTTD of AEE in corn DDGS and full-fat soybeans were greater than in full-fat rice bran.

Social Cooperation and Disharmony in Communities Mediated through Common Pool Resource Exploitation

It was theorized that when a society exploits a shared resource, the system can undergo extreme phase transition from full cooperation in abiding by a social agreement, to full defection from it. This was shown to happen in an integrated society with complex social relationships. However, real-world agents tend to segregate into communities whose interactions contain features of the associated community structure. We found that such social segregation softens the abrupt extreme transition through the emergence of multiple intermediate phases composed of communities of cooperators and defectors. Phase transitions thus now occur through these intermediate phases which avert the instantaneous collapse of social cooperation within a society. While this is beneficial to society, it nonetheless costs society in two ways. First, the return to full cooperation from full defection at the phase transition is no longer immediate. Community linkages have rendered greater societal inertia such that the switch back is now typically stepwise rather than a single change. Second, there is a drastic increase in social disharmony within the society due to the greater tension in the relationship between segregated communities of defectors and cooperators. Intriguingly, these results on multiple phases with its associated phenomenon of social disharmony are found to characterize the level of cooperation within a society of Balinese farmers who exploit water for rice production.

Concentrations of minerals in pig feed ingredients commonly used in China

Mineral concentrations were determined in 13 different feed ingredients commonly used in swine diets. Ingredients included corn and 4 corn co-products: corn gluten feed, corn gluten meal, corn germ meal, and corn distillers dried grains with solubles (DDGS). Wheat, wheat bran, and wheat shorts were also included, and 5 oilseed meals including soybean meal, rapeseed meal, sunflower meal, cottonseed meal, and peanut meal were used as well. Corn grain contained 88.7% dry matter (DM) and 0.46% K (DM basis). Greater concentrations of DM, ash, Ca, P, nonphytate P, Cu, Fe, Mn, and Zn were observed in corn gluten feed, corn DDGS, and corn germ meal compared with corn grain (P < 0.05). In general, minerals in corn DDGS were approximately three times greater than in corn grain and about 90% of the total P in corn DDGS was in the nonphytate bound form. Corn gluten meal had the least concentrations (P < 0.05) of most minerals, but the greatest (P < 0.05) concentrations of Fe (373.55 mg/kg, DM basis), Cu (11.88 mg/kg, DM basis), and Se (0.92 mg/kg, DM basis). On a DM-basis, concentrations of DM, Ca, P, phytate bound P, and Fe in wheat grain were 88.2%, 0.10%, 0.34%, 0.16%, and 53.48 mg/kg, respectively. Wheat bran contained more (P < 0.05) K, Mg, Cl, Fe, Zn, and Mn compared with wheat and wheat shorts. On a DM-basis, 2.72% K was observed in soybean meal, which was more (P < 0.05) than in the other oilseed meals. However, rapeseed meal had the greatest (P < 0.05) concentration of ash (9.37%), Ca (1.01%), P (1.05%), and Fe (526.49 mg/kg) among the oilseed meals, but only 16.2% of the total P in rapeseed meal was non-phytate P. In contrast, more than 50% of the P in soybean meal and peanut meal was non-phytate P. The least (P < 0.05) concentration of Cu (6.73 mg/kg, DM basis) was observed in rapeseed meal and the greatest (P < 0.05) concentration (32.75 mg/kg) was analyzed in sunflower meal. Concentrations of most minerals in soybean meal, rapeseed meal, sunflower meal, cottonseed meal, and peanut meal varied considerably compared with published values. In conclusion, the concentration of minerals in 13 commonly used feed ingredients were analyzed and results indicated considerable variation among and within feed ingredients for most minerals, which for some minerals may be a result of differences in minerals in the soil in which the ingredients were grown, but processing likely also contributes to differences among ingredients.

Energy content and amino acid digestibility of flaxseed expellers fed to growing pigs

This study was conducted to determine the DE and ME as well as the apparent ileal digestibility (AID) and standardized ileal digestibility (SID) of CP and AA in flaxseed expellers fed to growing pigs. In Exp. 1, the DE and ME were determined using 66 crossbred growing pigs (Duroc × Landrace × Yorkshire; 54.2 ± 2.3 kg BW) fed 1 of 11 diets in a completely randomized design. The diets included a corn-soybean meal basal diet and 10 experimental diets containing 29.16% flaxseed expellers supplemented at the expense of corn and soybean meal. In Exp. 2, 11 growing pigs (35.5 ± 3.4 kg), fitted with a T-cannula at the distal ileum, were assigned to 6 × 11 Youden square design with 6 periods and 11 diets. The diets included a N-free diet based on cornstarch and sucrose and 10 test diets containing 40% flaxseed expellers as the sole source of AA. Chromic oxide (0.3%) was used as an indigestible marker. There was considerable variation in the chemical composition among the 10 flaxseed expellers. The CV were greater than 10% for ether extract (EE), NDF, ADF, crude fiber, and Ca and ranged from 7 to 12% for the AA. On a DM basis, the DE and ME ranged from 2,786 to 3,730 and from 2,588 to 3,530 kcal/kg, respectively. The apparent total tract digestibility of GE ranged from 59.91 to 75.83% (mean = 70.92%). Ether extract, GE, and NDF were the best predictors to determine DE and ME. The best prediction equations were DE = -3,231 + (1.58 × GE) - (25.79 × % NDF) ( = 0.90) or DE = 4,189 + (56.78 × % EE) - (30.59 × % NDF) ( = 0.85) and ME = -2,968 + (1.47 × GE) - (24.82 × % NDF) ( = 0.85) or ME = 3,931 + (53.77 × % EE) - (29.31 × % NDF) ( = 0.82), respectively. In Exp. 2, there were significant differences in the AID and SID of CP and all AA with the exception of Phe ( < 0.05). The AID and SID of CP averaged 70.16 and 78.04%, respectively. For the indispensable AA, the AID and SID of Thr were the least, with average values of 70.70 and 76.68%, respectively. The digestibility of Arg and Met were the greatest, averaging over 88 and 91% for AID and SID, respectively. The AID and SID of Lys ranged from 66.10 to 81.82% (mean = 74.14%) and from 70.90 to 85.41% (mean = 78.13%), respectively. These results indicate that there is significant variability in chemical composition, energy content, and the SID and AID of CP and AA among the selected flaxseed expellers. The DE and ME of flaxseed expellers are primarily related to their EE and NDF concentrations.

Rapid synthesis of Ti-MCM-41 by microwave-assisted hydrothermal method towards photocatalytic degradation of oxytetracycline

This study employed microwave-assisted hydrothermal method to synthesize Ti-MCM-41, which are mesoporous materials with a high surface area and excellent photocatalytic ability. Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), transmission electron microscopy (TEM), and ultraviolet-visible spectroscopy (UV-Vis) were employed. The XRD findings showed that Ti-MCM-41 exhibited a peak at 2θ of 2.2°, which was attributed to the hexagonal MCM-41 structure. The BET (Brunauer-Emmett-Teller) results agreed with the TEM findings that Ti-MCM-41 has a pore size of about 3-5nm and a high surface area of 883m(2)/g. FTIR results illustrated the existence of Si-O-Si and Si-O-Ti bonds in Ti-MCM-41. The appearance of Ti 2p peaks in the XPS results confirmed the FTIR findings that the Ti was successfully doped into the MCM-41 structure. Zeta (ζ)-potential results indicated that the iso-electric point (IEP) of Ti-MCM-41 was at about pH3.02. In this study, the photocatalytic degradation of oxytetracycline (OTC) at different pH was investigated under Hg lamp irradiation (wavelength 365nm). The rate constant (K'obs) for OTC degradation was 0.012min(-1) at pH3. Furthermore, TOC (total organic carbon) and high resolution LC-MS (liquid chromatography-mass spectrometry) analyses were conducted to elucidate the possible intermediate products and degradation pathway for OTC. The TOC removal efficiency of OTC degradation was 87.0%, 74.4% and 50.9% at pH3, 7 and 10, respectively. LC-MS analysis results showed that the degradation products from OTC resulted from the removal of functional groups from the OTC ring.

The Nutritive Values in Different Varieties of Corn Planted in One Location Fed to Growing Pigs over Three Consecutive Years

This experiment was conducted to determine the effect of variety and planting year on the nutritive values of corn fed to growing pigs. Four corn varieties examined in this experiment were planted in the same village located in Longhua County, Heibei Province, China, in 2012, 2013, and 2014, respectively. During each year, corn was hand-harvested in early October and sun dried to about 14% moisture content. Three batches of twenty-four barrows (33.27±4.30, 31.88±2.93, 34.21±3.81 kg body wight [BW] in 2012, 2013, and 2014, respectively) were used and allotted to a complete block design with 4 diets and 6 replicate pigs per diet. Pigs were individually placed in metabolic crates. The four experimental diets were formulated by mixing each variety of corn and vitamins and minerals, respectively. A five-day collection period followed a seven-day diet acclimation period. The results indicated that variety of corn significantly influenced the available energy content (digestible energy [DE] on dry matter basis, p<0.05; metabolizable energy (ME) on dry matter basis, p<0.05, respectively), and the apparent total tract digestibility (ATTD) of organic matter (p<0.01), dry matter (p<0.05), gross energy (p<0.05), neutral detergent fiber (p<0.01), acid detergent fiber and ether extract (p<0.05). The planting year also significantly influenced the available energy contents (DE on dry matter basis, p<0.05; ME on dry matter basis, p<0.01, respectively) and the ATTD of neutral detergent fiber (p<0.01), acid detergent fiber (p<0.01), crude protein (p<0.01), and ether extract (p<0.01). No interaction was observed between the variety and planting year in DE and ME contents in corn. In conclusion, the variety and planting year significantly influenced the available energy and nutrient digestibility of corn fed to growing pigs.

Characteristics and aerosol size distributions of metal-containing paint particles at a spray-painting workplace

The health effects of metal-containing paint-particles at various particle-size distributions on workers in a spray-painting workplace at an industrial ventilation equipment manufacturing plant.

Characteristics of particle-bound polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) in atmosphere used in carbon black feeding process at a tire manufacturing plant

Concentrations of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) were estimated for different particle size distributions in a carbon black feeding process at a tire manufacturing plant on 15 days in March and April of 2014. A total of 75 integrated air samples were collected using a micro-orifice uniform deposition impactor (MOUDI). Particle-bound PCDD/Fs were analyzed using a high-resolution gas chromatograph/high-resolution mass spectrometer (HRGC/HRMS). Concentrations of thoracic particles and total particles produced in the carbon black feeding process of a tire manufacturing plant were measured in ranges of 0.19-2.61 and 0.28-4.22 mg/m(3), respectively. On all sampling days, the three most abundant species of PCDD/Fs were OCDD, 1,2,3,4,6,7,8-HpCDF, and OCDF. The mean concentrations of total PCDD/Fs were 0.74-6.83 pg/m(3) within five particle size ranges. Total I-TEQ in particulate matter (PM)<1.0 was 2.2 and 3.2 times higher than those in PM>18 and PM2.5-10, respectively. However, the total I-TEQ of thoracic PM contributed approximately 74 % of the total I-TEQ of total PM. The assessment of health risk indicates that exposure to fractions of thoracic PM by inhalation poses a significant cancer risk (>10(-6)).

Unconventional interplay between heterovalent dopant elements: Switch-and-modulator band-gap engineering in (Y, Co)-Codoped CeO2 nanocrystals

We report the experimental observation and theoretical explanation of an unconventional interplay between divalent Co and trivalent Y dopants, both of which incur oxygen vacancies in the CeO₂ host that has predominantly tetravalent Ce cations. The Co dopant atoms were experimentally found to act as a switch that turns on the dormant effect of Y-modulated band-gap reduction. As revealed by density functional theory (DFT) calculations with structures verified by synchrotron-radiation x-ray measurements, a Co 3d band that hybridizes with Ce 4f band was lowered due to reduced O 2p repulsion arising from oxygen vacancies incurred by Y doping and therefore gave rise to the observed band-gap narrowing effect. Such switch-and-modulator scheme for band-gap engineering in nanocrystal materials can lead to important applications in environmental protection and solar energy harvesting technologies.

Alterations in white matter micro-integrity of the superior longitudinal fasciculus and anterior thalamic radiation of young adult patients with depression

BACKGROUND

This study surveyed the characteristics of white matter (WM) micro-integrity in patients who were diagnosed with major depressive disorder (MDD) without co-morbidities.

METHOD

A total of 44 patients with MDD and 27 normal controls were enrolled in our study. Diffusion tensor imaging images of patients and controls were pre-processed and analysed to estimate differences in WM micro-integrity between patients and controls by performing comparisons of the values obtained from fractional anisotropy (FA). FA outputs of patients and controls were compared by a non-parametric permutation-based method with global brain volume, age and gender as covariates. In addition, the between-group differences of radial diffusivity (RD) and axial diffusivity (AD) were assessed to explain the alterations in FA values. Correlations between clinical variables (such as depression severity, anxiety severity, illness duration) and FA values were also estimated in each group and across both groups.

RESULTS

The patients with MDD had significantly lower FA values than the controls, for the left superior longitudinal fasciculus (SLF) and the right anterior thalamic radiation (ATR). The reductions in FA values occurred in combination with elevated RD values in the bilateral SLF and decreased AD values in the bilateral ATR. FA values were negatively correlated with depression severity in the SLF and with illness duration in the right SLF and ATR.

CONCLUSIONS

MDD patients had significant alterations in the WM micro-integrity of the left SLF and the right ATR.

Conduction control at ferroic domain walls via external stimuli

Intriguing functionalities at nano-sized domain walls have recently spawned a new paradigm for developing novel nanoelectronics due to versatile characteristics. In this study, we explore a new scenario to modulate the local conduction of ferroic domain walls. Three controlling parameters, i.e., external electrical field, magnetic field and light, are introduced to the 90° domain walls (90° DWs) of BiFeO₃. Electrical modulation is realized by electrical transport, where the mobility of 90° DWs can be altered by gating voltage. We further use the ferromagnetic/antiferromagnetic coupling to reveal the inherent magnetism at the DWs. With an established magnetic nature, magnetotransport has been conducted to introduce magnetic controlling parameter, where a giant positive magnetoresistance change can be observed up to 200%. In addition, light modulated conduction, a core factor for multifunctional applications, is successfully demonstrated (current enhancement by a factor of 2 with 11 W white lamp). These results offer new insights to discover the tunability of domain wall nanoelectronics.

Establishing the thermal threshold of the tropical mussel Perna viridis in the face of global warming

With increasing recognition that maximum oxygen demand is the unifying limit in tolerance, the first line of thermal sensitivity is, as a corollary, due to capacity limitations at a high level of organisational complexity before individual, molecular or membrane functions become disturbed. In this study the tropical mussel Perna viridis were subjected to temperature change of 0.4 °C per hour from ambient to 8-36 °C. By comparing thermal mortality against biochemical indices (hsp70, gluthathione), physiological indices (glycogen, FRAP, NRRT) and behavioural indices (clearance rate), a hierarchy of thermal tolerance was therein elucidated, ranging from systemic to cellular to molecular levels. Generally, while biochemical indices indicated a stress signal much earlier than the more integrated behavioural indices, failure of the latter (indicating a tolerance limit and transition to pejus state) occurred much earlier than the other indices tending towards thermal extremities at both ends of the thermal spectrum.

Photocatalytic degradation of Rhodamine B by microwave-assisted hydrothermal synthesized N-doped titanate nanotubes

Microwave-induced nitrogen-doped titanate nanotubes (NTNTs) were characterized by transmission electron microscopy (TEM), X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), Fourier transform infrared spectroscopy (FT-IR), Zeta potential analysis, specific surface area (SBET), and UV-Visible spectroscopy. TEM results indicate that NTNTs retain a tubular structure with a crystalline multiwall and have a length of several hundred nanometers after nitrogen doping. XRD findings demonstrate that the crystalline structure of NTNTs was dominated by anatase, which is favored for photocatalytic application. The Ti-O-N linkage observed in the XPS N 1s spectrum is mainly responsible for narrowing the band gap and eventually enhancing the visible light photoactivity. FT-IR results demonstrated the existence of H₃O⁺, which could be excited by photo-generated holes to form hydroxyl radicals and degrade environmental pollutants. After sintering at 350°C, the UV-Vis absorbance edges of NTNTs significantly shift to the visible-light region, which indicates N atom doping into the nanotubes. Photocatalytic degradation of Rhodamine B (RhB) via NTNTs show good efficiency, with pseudo first-order kinetic model rate constants of 3.7 × 10⁻³, 2.4 × 10⁻³ and 8.0 × 10⁻⁴ sec⁻¹ at pH3, 7, and 11, respectively.

Test of genuine multipartite nonlocality without inequalities

In this Letter we propose a set of conditions on the joint probabilities as a test of genuine multipartite nonlocality without inequality. Our test is failed by all nonsignaling local models in which even nonlocal correlations among some observables (not all) are allowed as long as these correlations respect the nonsignaling principle. A pass of our test by a state therefore indicates that this state cannot be simulated by any nonsignaling local models; i.e., the state exhibits genuine multipartite nonlocality. It turns out that all entangled symmetric n-qubit (n≥3) states pass our test and therefore are n-way nonlocal. Also we construct two Bell-type inequalities from our proposed test whose violations indicate genuine multipartite nonlocal correlations.

Highly efficient beamline and spectrometer for inelastic soft X-ray scattering at high resolution

The design, construction and commissioning of a beamline and spectrometer for inelastic soft X-ray scattering at high resolution in a highly efficient system are presented. Based on the energy-compensation principle of grating dispersion, the design of the monochromator-spectrometer system greatly enhances the efficiency of measurement of inelastic soft X-rays scattering. Comprising two bendable gratings, the set-up effectively diminishes the defocus and coma aberrations. At commissioning, this system showed results of spin-flip, d-d and charge-transfer excitations of NiO. These results are consistent with published results but exhibit improved spectral resolution and increased efficiency of measurement. The best energy resolution of the set-up in terms of full width at half-maximum is 108 meV at an incident photon energy tuned about the Ni L3-edge.

Characteristics of nano-/ultrafine particle-bound PAHs in ambient air at an international airport

Concentrations of 22 polycyclic aromatic hydrocarbons (PAHs) were estimated for individual particle-size distributions at the airport apron of the Taipei International Airport, Taiwan, on 48 days in July, September, October, and December of 2011. In total, 672 integrated air samples were collected using a micro-orifice uniform deposition impactor (MOUDI) and a nano-MOUDI. Particle-bound PAHs (P-PAHs) were analyzed by gas chromatography with mass selective detector (GC/MSD). The five most abundant species of P-PAHs on all sampling days were naphthalene (NaP), phenanthrene (PA), fluoranthene (FL), acenaphthene (AcP), and pyrene (Pyr). Total P-PAHs concentrations were 152.21, 184.83, and 188.94 ng/m(3) in summer, autumn, and winter, respectively. On average, the most abundant fractions of benzo[a]pyrene equivalent concentration (BaPeq) in different molecular weights were high-weight PAHs (79.29 %), followed by medium-weight PAHs (11.57 %) and low-weight PAHs (9.14 %). The mean BaPeq concentrations were 1.25 and 0.94 (ng/m(3)) in ultrafine particles (<0.1 μm) and nano-particles (<0.032 μm), respectively. The percentages of total BaPeq in nano- and ultrafine particulate size ranges were 52.4 % and 70.15 %, respectively.

Long-term disease-free survival in three ovarian cancer patients with a single relapse

Recurrent ovarian cancer with long-term survival is uncommon and often associated with poor prognosis. We report three cases of patients with advanced ovarian cancer who have achieved long-term disease-free survival following a single prior relapse. Case 1 relapsed with a localized bulky tumor and received a complete surgical resection and chemotherapy. Case 2 had a persistent central pelvic tumor after debulking surgery and second-line chemotherapy, and yet achieved excellent control with concurrent chemoradiation to the true pelvis. Case 3 relapsed with paraaortic lymph node metastasis and probable lung metastasis (subsequently negated by positron emission tomography) and received chemotherapy alone. These three patients have since remained disease-free for 13, 12, and seven years, respectively, since their first relapse. We conclude that select patients can obtain long-term disease-free survival after the first relapse by accurate restaging and aggressive multimodality treatment.

All entangled pure states violate a single Bell's inequality

We show that a single Bell's inequality with two dichotomic observables for each observer, which originates from Hardy's nonlocality proof without inequalities, is violated by all entangled pure states of a given number of particles, each of which may have a different number of energy levels. Thus Gisin's theorem is proved in its most general form from which it follows that for pure states Bell's nonlocality and quantum entanglement are equivalent.

Volatile hydrocarbon emissions from vehicles and vertical ventilations in the Hsuehshan traffic tunnel, Taiwan

The concentrations of 56 volatile organic hydrocarbons (VOCs) were measured simultaneously in the southbound bore, the northbound bore and the exhaust air shafts of the Hsuehshan tunnel near Yilan, Taiwan during 2007 and 2008. A total of 60 integrated air samples were collected using stainless steel canisters and analyzed using GC/FID and GC/MS. The highest temperature and lowest relative humidity were observed at the exit of the tunnel owing to the accumulation in the tunnel of waste heat that was exhausted from vehicles. The five most abundant species in all samples were ethylene, acetylene, isopentane, propylene, and toluene. The exit/entrance ratios of total non-methane hydrocarbon (NMHC) concentration were 7.8 and 4.8 for the southbound and northbound bores, respectively. Furthermore, the most abundant species of emission rate (ER) is toluene (21.93-42.89 mg s(-1)), followed by isopentane, ethylene, propylene and 1-butene, with ER ranging from 2.50 to 9.31 mg s(-1) for the three shafts. The ozone formation potential (OFP)/total NMHC ratios in three exhaust air shafts show that the reactivities of these emissions are similar to those of vehicle emissions.

Nationwide population-based epidemiologic study of rheumatoid arthritis in Taiwan

OBJECTIVES

Epidemiological studies of rheumatoid arthritis in Asia are rare. The aim of this research was to study the epidemiology and associated medical expenses of rheumatoid arthritis in Taiwan.

METHODS

Cases of rheumatoid arthritis, based on the 1987 American College of Rheumatology criteria, were retrieved from the National Health Insurance Research Database with corresponding International Classification of Diseases, Ninth Revision code (ICD-9) 714.0 from January 2000 to December 2007, and limited to those 16 years and older. Age- and sex-specific incidences were estimated by dividing the incidence number by population data obtained from the Department of Statistics, Ministry of the Interior.

RESULTS

There were a total of 40,995 cases. The average age-adjusted annual incidence rate was 15.8 per 100,000. The adjusted incidence rates were very stable at 20.9-25.2/100,000/year and 7.0-8.2/100,000/year for females and males, respectively, during the study period. The adjusted average incidence ratio of females/males was 3.1. The age-specific incidence peaked in the 60-64 and 70-74 year age groups for females and males, respectively. The adjusted prevalence rate increased steadily during the study period from 57.7/100,000 in 2000 to 99.6/100,000 in 2007. The average total yearly expense per patient increased from 1,155 United States Dollars (USD) in 2000 to 1,821 USD in 2007. Sicca syndrome (ICD-9 code 710.2) was the most common co-existing ICD-9 code.

CONCLUSIONS

This is the first incidence study based on the 1987 American College of Rheumatology criteria in Asia. The prevalence rate based on these criteria was lower than in previous Asia studies. The medical expenses increased continuously.

Network extreme eigenvalue: from mutimodal to scale-free networks

The extreme eigenvalues of adjacency matrices are important indicators on the influence of topological structures to the collective dynamical behavior of complex networks. Recent findings on the ensemble averageability of the extreme eigenvalue have further authenticated its applicability to the study of network dynamics. However, the ensemble average of extreme eigenvalue has only been solved analytically up to the second order correction. Here, we determine the ensemble average of the extreme eigenvalue and characterize its deviation across the ensemble through the discrete form of random scale-free network. Remarkably, the analytical approximation derived from the discrete form shows significant improvement over previous results, which implies a more accurate prediction of the epidemic threshold. In addition, we show that bimodal networks, which are more robust against both random and targeted removal of nodes, are more vulnerable to the spreading of diseases.

The effectiveness of physical leisure time activities on glycaemic control in adult patients with diabetes type 2: A Systematic Review

REVIEW QUESTION/OBJECTIVE

The objective of this systematic review is to synthesise the best available evidence on the effectiveness of physical leisure time activities on glycaemic control in adult patients with diabetes type 2.The specific review question is:What is the effectiveness of physical leisure time activities on glycaemic control in patients with diabetes type 2?

BACKGROUND

Type 2 diabetes results from the body's ineffective use of insulin. Diabetes is a group of diseases marked by high levels of blood glucose resulting from defects in insulin production, insulin action, or both.Type 2 diabetes was previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes. According to 2011 National Diabetes Fact Sheet, diabetes affected 25.8 million people of all ages of United States population during 2005-2008, include 18.8 million diagnosed people and seven million undiagnosed people. Among United States residents ages 65 years and older, 10.9 million, or 26.9 percent, had diabetes in 2010. Recent World Health Organization (WHO) calculations indicate diabetes kills more than one million people annually, almost 80% of which occur in low- and middle-income countries. Almost half of diabetes deaths occur in people aged under 70 years; 55% of diabetes deaths are in women. WHO projects that diabetes deaths will double between 2005 and 2030.Type 2 diabetes is associated with older age, obesity, family history of diabetes, history of gestational diabetes, impaired glucose metabolism, physical inactivity, and race. It is a common outcome of uncontrolled blood sugar and over time leads to serious complications including hypertension, blindness, kidney damage, lower-limb amputations, heart disease, and stroke. Good glycaemic control is a major goal in the treatment of type 2 diabetes mellitus to prevent and delay those severe long-term complications. Physical activity is considered to be a substantial part of the treatment of type 2 diabetes mellitus, as well as diet and medication. Physical activity is a common physiological stressor that causes perturbation to glucose homeostasis and energy needs.Several studies have reported the effects of physical activity on improving insulin sensitivity, cardio-respiratory fitness, glycaemic control, and psychosocial well-being. The American Diabetes Association suggests that people with type 2 diabetes spend at least 150 minutes a week on moderate-intensity physical activity (50-70% of maximum heart rate), or at least 90 minutes a week on vigorous physical activity (>70% of maximum heart rate). Recent studies also indicate that moderate-intensity aerobic physical activity could help type 2 diabetes patients to maintain ideal glycaemic control. Boule et al found physical activity training could reduce haemoglobin A1c (HbA1c) (control group vs. exercise group: 8.31% vs. 7.65%) by 0.66%. This is close to the effect of intense glucose-lowering pharmacological treatment found in the United Kingdom Prospective Diabetes Study. A 1% absolute decrease in the HbA1c value is associated with a 15% to 20% decrease in major cardiovascular events and a 37% reduction in microvascular complications.According to Zhao, Ford, Chaoyang's report (2011), only 25-42% of older adults with diabetes mellitus met recommendations for total physical activity based on the 2007 American Diabetes Association and 2008 Department of Health and Human Services guidelines. Various barriers to regular physical activity had been described, such as health problems, lack of time or energy, no exercise partner, lack of family support, and motivation and working time. An active lifestyle does not require complex exercise programmes. Instead, regular daily physical activity is believed to enable individuals to reduce the risk of chronic diseases and may enhance their quality of life. Recently, it has been thought that, instead of structured physical activity, lifestyle physical activity is a better alternative for diabetes patients. Moderate or vigorous lifestyle or leisure time physical activities included jogging, walking, gardening, tai chi chuan, and qigong (an ancient Chinese breathing exercise that combines aerobics, isometric and isotonic movements and meditation). According to data from recent studies, moderate physical leisure time activities for at least 60 minutes every week can effectively improve glycaemic control in patients with diabetes type 2.Those measure indicators of glycaemic control including glycated hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), and postprandial plasma glucose (PPG) were used to assess glycaemic control in diabetic patients. HbA1c value reflects the mean plasma glucose concentration over two to three months. Fasting plasma glucose (FPG) and postprandial plasma glucose (PPG) reflect short-term plasma glucose change. Glycated haemoglobin is a form ofhaemoglobin that is measured primarily to identify the averageplasmaglucoseconcentration over prolonged periods of time. The fasting plasma glucose test measures fasting blood sugar levels and the postprandial plasma glucose test is often used to test the effectiveness of the body's carbohydrate metabolism and the ability to produce insulin. In 2010, Psaltopoulou et al gathered current information from meta-analyses on dietary and lifestyle practices concerning reduction of risk to develop type 2 diabetes. In 2009, Thomas et al completed a systematic review in which fourteen randomised controlled trials involving a total of 377 participants comparing exercise against no exercise in type 2 diabetes were identified. Trials ranged from eight weeks to twelve months duration. Compared with the control, the exercise intervention significantly improved glycaemic control as indicated by a decrease in glycated haemoglobin levels of 0.6%. This systematic review will differ from these two previously published reviews in that it aims to explore the effectiveness of different kinds of moderate or vigorous physical leisure time activities in improving glycaemic control in patients with diabetes type 2. A search of MEDLINE, DARE database, CINAHL, the Cochrane Library of Systematic Reviews and Joanna Briggs Institute Library of Systematic Reviews found no existing reviews or review underway on this topic.

Genetic polymorphisms of the DNA repair gene MPG may be associated with susceptibility to rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic autoimmune disease and can lead to deformities and severe disabilities, due to irreversible damage of tendons, joints, and bones. A previous study indicated that a DNA repair system was involved in the development of RA. In this study, we investigated the association of four N-methylpurine-DNA glycosylase (MPG) gene polymorphisms (rs3176364, rs710079, rs2858056, and rs2541632) with susceptibility to RA in 384 Taiwanese individuals (192 RA patients and 192 control subjects). Our data show a statistically significant difference in genotype frequency distributions at rs710079 and rs2858056 SNPs between RA patients and control groups (P = 0.040 and 0.029, respectively). Our data also indicated that individuals with the GG genotype at rs2858056 SNP may have a higher risk of developing RA. In addition, compared with the haplotype frequencies between case and control groups, individuals with the GCGC haplotype appeared to be at a greater risk of RA progression (P = 0.003, OR = 1.75; 95&percnt; CI = 1.20-1.55). Our results suggest that rs710079 and rs2858056 polymorphisms and the GCGC haplotype in the MPG gene are associated with the risk of RA progression, and thus may be used as molecular markers of RA if they are confirmed by further research.

Emissions of C2 - C12 hydrocarbons in the Hsuehshan tunnel, Taiwan

The concentrations of 56 hydrocarbons from C2 to C12 were measured simultaneously in the southbound bore, the northbound bore and the exhaust air shafts of the Hsuehshan tunnel near Yilan, Taiwan for 12 days during 2007 and 2008. A total of 60 integrated air samples were collected using stainless steel canisters and analyzed using GC/FID and GC/MS. The five most abundant species in all samples were ethylene, acetylene, isopentane, propylene and toluene. The exit/entrance ratios of total non-methane hydrocarbons (NMHC) concentration were 7.8 and 4.8 for the southbound and northbound bores, respectively. Furthermore, the exhaust from the vertical shafts affects air quality in the neighborhood. The most abundant species of emission rate (ER) was toluene (21.93-42.89 mg/sec), followed by isopentane, ethylene, propylene and 1-butene, with ER ranging from 2.50 to 9.31 mg/sec. The species in the three exhaust air shafts showed that the reactivities of these emissions are similar to those of vehicle emissions. Notably, the control of emissions in the vertical shafts of the vehicle tunnel will be important in the future.

Successful salvage treatment of recurrent endometrial cancer with multiple lung and abdominal metastases

The prognosis of recurrent endometrial carcinoma is generally poor except for isolated vaginal or pelvic relapse without previous radiation. Recurrences associated with infield failure or distant metastasis carry a poor prognosis. We report a case of recurrent endometrial carcinoma treated with cytoreductive surgery, targeted radiation to lung metastasis defined by CT and PET and adjuvant chemo-hormone therapy followed by maintenance progestin therapy with a good outcome. This case implied that chemo-hormone therapy with targeted radiation should be evaluated in recurrent endometrial cancer with positive progesterone receptor for salvage treatment.

Applying model simulation and photochemical indicators to evaluate ozone sensitivity in southern Taiwan

Ozone sensitivity was investigated using CAMx simulations and photochemical indicator ratios at three sites (Pingtung City, Chao-Chou Town, and Kenting Town) in Pingtung County in southern Taiwan during 2003 and 2004. The CAMx simulations compared fairly well with the hourly concentrations of ozone. Simulation results also showed that Pingtung City was mainly a volatile organic compounds (VOC)-sensitive regime, while Chao-Chou Town was either a VOC-sensitive or a NOx-sensitive regime, depending on the seasons. Measurements of three photochemical indicators (H2O2, HNO3, and NOy) were conducted, and simulated three transition ranges of H2O2/HNO3 (0.5-0.8), O3/HNO3 (10.3-16.2) and O3/NOy (5.7-10.8) were adopted to assess the ozone sensitive regime at the three sites. The results indicated that the three transition ranges yield consistent results with CAMx simulations at most times at Pingtung City. However, both VOC-sensitive and NOx-sensitive regimes were important at the rural site Chao-Chou Town. Kenting Town, a touring site at the southern end of Taiwan, was predominated by a NOx-sensitive regime in four seasons.

Measurement and source characteristics of carbonyl compounds in the atmosphere in Kaohsiung city, Taiwan

The concentrations of eighteen atmospheric carbonyls species were measured by the LpDNPH-Cartridge and the microcomputer air sampling device at Nan-Chie (northern part) and Hsiung-Kong (southern part) sites in Kaohsiung city, southern Taiwan. These samples were then analyzed using a high performance liquid chromatography (HPLC). Measurements showed that the highest concentrations of carbonyls were formaldehyde (18.33 and 18.74 microg m(-3)) at the Nan-Chie and Hsiung-Kong site, followed by acetaldehyde (14.90 and 15.71 microg m(-3)). The concentrations of total carbonyls were higher at Hsiung-Kong site (66.96 microg m(-3)) than at Nan-Chie site (60.41 microg m(-3)). The concentrations of total carbonyls at Nan-Chie site (or Hsiung-Kong site) were 74.06 microg m(-3) (89.99 microg m(-3)) in summer and 37.14 microg m(-3) (46.50 microg m(-3)) in winter, due to the fact that photochemical activities are stronger in summer than in winter. The results of principal component analysis (PCA)/absolute principal component scores (APCS) suggest that the primary pollution sources at Nan-Chie were vehicle exhausts (gasoline and diesel engines), stationary emissions (petrochemical and food industry) and restaurant emissions, and the primary pollution sources at Hsiung-Kong were vehicle exhausts (gasoline and diesel engines), stationary emissions (metal assembly and petrochemical industry) and restaurant emissions.

What are the ten new commandments in severe polytrauma management?

This review aims to provide a concise overview of the trauma management evolution in the past decade. 1) Trauma care priorities have incorporated staff protection against infection and early decision making in addition to the conventional ABCDE. 2) Five stratified levels for DAM have replaced the non-specific conventional Plans A & B. 3) CT scanning can be the tunnel to death for the hemodynamically unstable patient. 4) DPL has virtually been replaced by the FAST USG. 5) Direct whole-body MDCT provides rapid imaging diagnosis & expedites the definitive treatment but carries high radiation hazards. 6) The dynamic shock assessment by fluid resuscitation response provides more outcome-specific evaluation than the static blood volume loss model. 7) DCR comprising of permissive hypotension, hemostatic resuscitation & DCS aims to overcome the lethal triad of trauma. Early transfusion of blood components of FFP & platelet concentrates improves the outcome in massive blood transfusion. 8) DCS aims to rectify the deranged physiology and not to fully restore the damaged anatomy. 9) A pre-defined protocol for major pelvic fracture can be life-saving and the novel Pre-PPP (pre-peritoneal pelvic packing) may further reduce mortality coupled with the necessary TCAE. 10) Injury prevention is equally important if not more than the trauma resuscitation & operation.

Measurement and receptor modeling of atmospheric polycyclic aromatic hydrocarbons in urban Kaohsiung, Taiwan

The concentrations of 21 individual polycyclic aromatic hydrocarbons (PAHs) and total suspended particles (TSPs) were measured using high-volume air samplers at Tzuo-Yin and Hsiung-Kong sites in Kaohsiung City, Taiwan, for four seasons from 2005 to 2006. The gaseous and particulate phases of individual PAHs were identified using a gas chromatograph with a flame-ionization detector (GC/FID). Measurements show that the concentrations of total (gas+particulate) PAHs generally followed the seasonal variations of the concentrations of TSP (107.2-117.1 microg m(-3)), being the highest in winter (143.9-182.9 ng m(-3)) and lowest in summer (81.4-95.2 ng m(-3)) at both sites. Most PAH species were low-weight PAHs (approximately 80.8-82.0%), followed by high-weight PAHs (10.5-14.6%) and medium-weight PAHs (6.5-6.8%). The fractions of gaseous PAHs decreased with molecular weight or ring number. The particle phase (60.2(73.5%) dominated the high-weight PAHs. Results of receptor model show that industrial combustions (49.1-63.7%) contributed most to ambient PAHs, followed by restaurant emissions (18.4-39.7%) and mobile sources (11.3-22.8%) at the Tzuo-Yin site. At the Hsiung-Kong, mobile sources (49.5-63.3%) contributed most to ambient PAHs, followed by restaurant emissions (19.8-36.6%) and industrial combustions (13.7-27.1%). The differences in the results at the two sites are mainly attributed to the different industries at each site.

Risk factors for extra-pulmonary tuberculosis compared to pulmonary tuberculosis

BACKGROUND

Tuberculosis (TB) continues to be a major global health problem. Extra-pulmonary TB (EPTB) manifests with protean symptoms, and establishing a diagnosis is more difficult than pulmonary TB (PTB).

SETTING

A university-affiliated hospital in southern Taiwan.

OBJECTIVE

To analyse the risk factors for EPTB compared with PTB.

DESIGN

This retrospective study compared patients with EPTB and PTB in southern Taiwan by analysing their demographic data and clinical underlying diseases. Risk factors for EPTB were further analysed.

RESULTS

A total of 766 TB patients were enrolled in this study, with 102 (13.3%) EPTB and 664 (86.7%) PTB cases. Of the 766 patients, 3% of PTB patients had EPTB, while 19.6% of EPTB patients also had PTB. The most frequently involved EPTB site was the bone and joints (24.5%). The incidence of EPTB vs. PTB decreased significantly for each decade increase in patient age. Multivariate logistic regression analysis showed that being female, not being diabetic, having end-stage renal disease and not smoking were independent risk factors for EPTB.

CONCLUSION

This study defines the risk factors for EPTB compared with PTB. Awareness of these factors is essential for physicians to have a high index of suspicion for accurate and timely diagnosis.

Functional and computational assessment of missense variants in the ataxia-telangiectasia mutated (ATM) gene: mutations with increased cancer risk

The functional consequences of missense variants are often difficult to predict. This becomes especially relevant when DNA sequence changes are used to determine a diagnosis or prognosis. To analyze the consequences of 12 missense variants in patients with mild forms of ataxia-telangiectasia (A-T), we employed site-directed mutagenesis of ataxia-telangiectasia mutated (ATM) cDNA followed by stable transfections into a single A-T cell line to isolate the effects of each allele on the cellular phenotype. After induction of the transfected cells with CdCl2, we monitored for successful ATM transcription and subsequently assessed: 1) intracellular ATM protein levels; 2) ionizing radiation (IR)-induced ATM kinase activity; and 3) cellular radiosensitivity. We then calculated SIFT and PolyPhen scores for the missense changes. Nine variants produced little or no correction of the A-T cellular phenotype and were interpreted to be ATM mutations; SIFT/PolyPhen scores supported this. Three variants corrected the cellular phenotype, suggesting that they represented benign variants or polymorphisms. SIFT and PolyPhen scores supported the functional analyses for one of these variants (c.1709T>C); the other two were predicted to be "not tolerated" (c.6188G>A and c.6325T>G) and were classified as "operationally neutral." Genotype/phenotype relationships were compared: three deleterious missense variants were associated with an increased risk of cancer (c.6679C>T, c.7271T>G, and c.8494C>T). In situ mutagenesis represents an effective experimental approach for distinguishing deleterious missense mutations from benign or operationally neutral missense variants.