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In order to enhance enzyme activities of koji and further improve the health benefits and nutritional value of miso, puffed rice was used to prepare koji with optimization of fermentation utilizing response surface methodology (RSM), and the optimized puffed rice koji was used to produce miso and low-salt miso. Results showed that β-glucosidase activity increased by 1.98-fold after RSM optimization. The optimized puffed rice koji also showed the highest β-amylase and protease activities (237.1 and 968.8 units/g, respectively) compared to rice koji (108.7 and 637.4 units/g, respectively). Moreover, miso made from puffed-rice koji presented a much higher polyphenol content, antioxidant activity, and aglycone conversion. These findings clarified the relationship between changes in enzyme activities in koji and the important components of miso, and also advance solid-state fermentation research and development of functional miso.

Nontyphoid Salmonella(NTS) bacteremia causes high mortality and recurrence rates in human immunodeficiency virus (HIV)-infected patients. This study aimed to investigate the risk of recurrent NTS bacteremia in the era of combination antiretroviral therapy (cART).

Low-fat meat products always have harder texture, lower juiciness, and worse flavor. Due to their higher water-holding, water absorption, and organic molecule absorption, chia seeds (CHIA) have been applied in powders, nutrition bars, breads, and cookies. Hence, the objectives of this study were to: (1) analyze the nutritional compositions in CHIA; and (2) look for the possible application of CHIA on restructured ham-like products. CHIA has high amounts of α-linolenic acid, crude polysaccharides, and also contains essential amino acids, minerals, and polyphenols. Regarding processing properties of CHIA, a combination of CHIA and carrageenan (CA) increased (p<0.05) production yield of restructured ham-like products. A scanning electron microscope observation indicated that CHIA and CA addition can assist an emulsification in this ham-like product. Addition of 0.5% CA and 1.0% CHIA in this ham-like product showed the similar overall acceptance as products with added fat. Following storage at 4°C, higher (p<0.05) purge and centrifugation losses, as well as hardness of this ham-like product can be improved by adding CHIA and CA. CHIA addition also resulted in lower (p<0.05) lipid and protein oxidation, especially a 1.0% addition. In summary, due to both nutritional addition and improvements on physicochemical and sensorial properties of restructured ham-like products, CHIA seeds have great potential on the development of healthy and good-quality meat products.

The increasing use of indium in high-tech industries has inevitably caused its release into the environment. However, knowledge of its environmental fate has been very limited so far. This study investigates the indium uptake and accumulation by two staple crops, rice (Oryza sativaL.) and wheat (Triticum aestivumL.), and evaluates potential risks associated with their consumption. Rice and wheat were grown on three kinds of soil, including acidic soils spiked with a high indium concentration (1.0 mmol kg–1), which is considered the worst-case scenario, because high soil acidity promotes indium bioavailability. The results revealed that a large portion of soil indium was associated with iron hydroxides, even in acidic soils. Indium precipitates in soils resulted in relatively low availability at the plant root site. Most absorbed indium accumulated at the roots, with only a tiny portion reaching the grains. The corresponding Hazard Quotient indicated no adverse effects on human health. Due to the low translocation of indium from soil to grain, the consumption of rice and wheat grains harvested from indium-contaminated soils may pose an insignificant risk to human health. Further field studies are necessary to better elucidate the risks associated with consuming crops grown in indium-contaminated soils.

The 2013 American College of Cardiology/American Heart Association cholesterol guideline recommends high-intensity statin (HIS) in patients with atherosclerotic cardiovascular disease, but little is known about the efficacy and safety of HIS in Asian ethnicity. We assessed the effects of HIS in Taiwanese with acute myocardial infarction (AMI).

Vascular infections (VI) are potentially catastrophic complications of nontyphoid Salmonella(NTS). We aimed to develop a scoring model incorporating information from blood culture time to positivity (TTP-NTSVI) and compared the prediction capability for VI among adults with NTS bacteremia between TTP-NTSVI and a previously published score (Chen-NTSVI).

BackgroundTo investigate the relationship between blepharitis and metabolic syndrome (MetS) by using the Longitudinal Health Insurance Database (LHID) of Taiwan.MethodsThis retrospective cohort study was conducted using data collected from the LHID for the period from 2009 to 2013. This study enrolled patients who received a diagnosis of blepharitis according to the International Classification of Diseases, Ninth Revision, diagnostic code. The exclusion criteria were legal blindness, eyeball removal, ocular tumours prior to the diagnosis of blepharitis, and patients diagnosed with blepharitis and initiated antibiotic treatment concurrently. An age-matched, gender-matched and disease-matched population without blepharitis served as the control group. Multivariate analysis with a multiple Cox regression model was applied to analyse the data.ResultsIn this study, a total of 10 093 patients with blepharitis were included in the study group, and another 40 372 participants without blepharitis were included in the control group. Conditional logistic regression revealed a higher cumulative probability of hyperlipidaemia and coronary arterial disease. After adjustment, patients with blepharitis had a higher probability of developing new MetS than controls. According to subgroup analysis, hyperlipidaemia and coronary artery diseases were significantly correlated with the prior development of blepharitis. However, hypertension and diabetes mellitus and insulin resistance showed no correlation with blepharitis.ConclusionBlepharitis is significantly related to MetS and can serve as an early sign of MetS. Additional studies should examine the relationship between blepharitis and MetS in terms of severity.

Recent investigations have demonstrated that carotenoid extract of Dunaliella salinaalga (Alga) contains abundant β-carotene and has good anti-inflammatory activities. Murine macrophage (RAW264.7 cells) was used to establish as an in vitromodel of pseudorabies virus-induced reactive oxygen species (ROS) response. In this study, antioxidant activities of Alga were measured based on 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging, trolox equivalent antioxidant capacity assays, reducing power, and virus-induced ROS formation in RAW264.7 cells. Anti-inflammatory activities of Alga were assessed by its ability to inhibit the production of interleukin-6 and nitric oxide (NO) using enzyme-linked immunosorbent assay, then the Janus kinase/signal transducer and activator of transcription (JAK/STAT) pathway was investigated by measuring the inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), nuclear factor-κB (p50 and p65), JAK, STAT-1/3, and suppressor of cytokine signaling 3 (SOCS3) by Western blotting. In addition, Alga inhibited virus replication by plaque assay. Our results showed that the Alga had high antioxidant activity, significantly reduced the virus-induced accumulation of ROS, and inhibited the levels of nitric oxide and interleukin-6. Further studies revealed that Alga also downregulated the gene and protein expressions of iNOS, COX-2, nuclear factor-κB (p50 and p65), and the JAK/STAT pathway. The inhibitory effects of Alga were similar to pretreatment with specific inhibitors of JAK and STAT-3 in pseudorabies virus -infected RAW264.7 cells. Alga enhanced the expression of SOCS3 to suppress the activity of the JAK/STAT signaling pathway in pseudorabies virus-infected RAW264.7 cells. In addition, Alga has decreased viral replication (p < 0.005) at an early stage. Therefore, our results demonstrate that Alga inhibits ROS, interleukin6, and nitric oxide production via suppression of the JAK/STAT pathways and enhanced the expression of SOCS3 in virus-infected RAW264.7 cells.

Systemic lupus erythematosus (SLE) is a systemic autoimmune disorder characterized by varied clinical symptoms and can be comorbid with neuropsychiatric disorders. However, the association between SLE and dementia risk in patients with SLE remains unclear. In this study, we evaluated the incidence of dementia in patients with SLE. Patients were recruited from a nationwide cohort in 2004–2008 and categorized as SLE (n = 1,074; patients diagnosed with SLE) or non‐SLE (n = 5,370; age‐ and sex‐matched controls). Each patient was followed for up to 7 years, until either receiving a diagnosis of dementia or until December 31, 2010. Data were analyzed using the Kaplan‐Meier method and Cox regression analysis. The incidence rate of dementia was higher in the SLE cohort (357 per 100,000 person‐years) than in the non‐SLE cohort (180 per 100,000 person‐years). Patients with SLE had a higher risk of dementia than did those without SLE (crude hazard ratio [HR] 1.92; P< 0.05). Cox regression analysis revealed an adjusted HR for dementia in the SLE cohort of 2.14 (P< 0.001), after adjustment for other comorbid diseases and variables. Patients with SLE have a higher risk of dementia.

Background:Although high-intensity statin (HIS) is recommended in modern lipid guidelines, hemorrhagic stroke (HS) is one of the concerns in Asia because HIS was reported to increase the risk of intracerebral hemorrhage. Whether the HS risk is different among different high potency statins was unknown.Methods and Results:We screened the database of the Taiwan National Health Insurance from January 2013 to December 2018. Adults (≥ 18 years old) who received pitavastatin 2-4 mg/d plus ezetimibe 10 mg/d (combination group) and those who received atorvastatin 40 mg/day or rosuvastatin 20 mg/day (HIS group) for any reason were enrolled for further analysis. The primary endpoint was HS. We also assessed the differences of a composite safety outcome which included hospitalization for drug-related hepatitis or myopathy and new onset diabetes. All censored subjects were follow-up till December 2019. After 1:10 propensity matching, 41437 patients were included (37670 with HIS and 3767 with combination group). After median follow-up for 3.05 ± 1.66 years, HS occurred in 1.29% and multivariable analysis showed subjects in combination group had lower rate of HS than those in HIS group (combination vs. HIS, adjusted HR: 0.650, 95% CI: 0.443-0.953). Moreover, pre-specified subgroup analysis showed similar results in those with previous history of HS or ischemic stroke as whole population. In composite safety endpoint, there was no difference between these two groups (combination vs HIS, adjusted HR: 0.910, 95% CI: 0.809-0.953).Conclusions:Our study showed Asian general population with pitavastatin plus ezetimibe had less HS during follow-up comparing to those having HIS. These results suggested that pitavastatin plus ezetimibe was a favorable choice in Asian population who needed strict lipid control but with concern of HS.

Nontyphoidal Salmonella(NTS) is an important bacterial etiology of diarrheal disease, and it causes invasive diseases in immunocompromised hosts. For bacteremia from some species, blood culture with a rapid time to positivity (TTP) is associated with greater mortality. This study investigated TTP of NTS bacteremia and its relationship to clinical parameters and prognosis.

Immune system dysregulation is associated with end-stage renal disease. Although decreased cellular immunity increases susceptibility to herpes zoster, the risk of herpes zoster in patients with earlier stages of chronic kidney disease (CKD) is unclear.

Background Research has found evidence that chronic inflammation may promote atherosclerotic disease. The purpose of this study was to test the hypothesis that rhinosinusitis is a risk factor for stroke.Methods This prospective cohort study comprised patients recorded on the Taiwan Longitudinal Health Insurance Database 2005 (LHID2005) who had received a diagnosis of rhinosinusitis (n = 53,653) between January 1, 2004 and December 31, 2005. A control group (1:4) drawn from the same database was matched for age and gender (n = 214,624). Each patient was followed up using data entered until the end of 2006. Cox proportional hazard regressions were performed to evaluate the hazard ratios (HRs) after adjusting for potential confounding factors.Results We found that patients with rhinosinusitis were more likely to suffer strokes than the control population, after adjusting for potential confounders (adjusted HR, 1.39; 95% confidence interval [CI], 1.28∼1.50). The HR of stroke was 1.39 (95% CI, 1.28∼1.51) for acute sinusitis patients, and 1.34 (95% CI, 1.04∼1.74) for chronic sinusitis patients.Conclusion Both acute and chronic sinusitis are risk factors or markers for stroke that is independent of traditional stroke risk factors. Further research in this important area of epidemiology is warranted.

BACKGROUND: Systemic inflammation and dysregulated immune function in chronic obstructive pulmonary disease (COPD) is hypothesized to predispose patients to development of herpes zoster. However, the risk of herpes zoster among patients with COPD is undocumented. We therefore aimed to investigate the risk of herpes zoster among patients with COPD. METHODS: We conducted a cohort study using data from the Taiwan Longitudinal Health Insurance Database. We performed Cox regressions to compare the hazard ratio (HR) of herpes zoster in the COPD cohort and in an age- and sex-matched comparison cohort. We divided the patients with COPD into three groups according to use of steroid medications and performed a further analysis to examine the risk of herpes zoster. RESULTS: The study included 8486 patients with COPD and 33 944 matched control patients. After adjustment for potential confounding factors, patients with COPD were more likely to have incidents of herpes zoster (adjusted HR 1.68, 95% confidence interval [CI] 1.45–1.95). When compared with the comparison cohort, the adjusted HR of herpes zoster was 1.67 (95% CI 1.43–1.96) for patients with COPD not taking steroid medications. The adjusted HR of herpes zoster was slightly greater for patients with COPD using inhaled corticosteroids only (adjusted HR 2.09, 95% CI 1.38–3.16) and was greatest for patients with COPD using oral steroids (adjusted HR 3.00, 95% CI 2.40–3.75). INTERPRETATION: Patients with COPD were at increased risk of herpes zoster relative to the general population. The relative risk of herpes zoster was greatest for patients with COPD using oral steroids.

The virion host shutoff (vhs) protein is a virion component of Alphaherpesviruses, including pseudorabies virus. In this work, the upstream sequences of vhs gene of pseudorabies virus (TNL strain) was cloned and sequenced. We linked the upstream sequences of vhs gene to the CAT reporter gene and examined the promoter function of this region. The immediate–early protein IE180 of Pseudorabies Virus (PRV) is expressed immediately after infection and plays a vital role in the regulation of other viral genes. Our results demonstrated that the vhs promoter was regulated by the IE180 in a dosage-dependent manner; the vhs promoter was stimulated by low concentration of IE180 but suppressed by high concentration of IE180. Mutational analysis indicated that the only IE180 binding site at the vhs promoter was not essential for its function; however, a Sp1 binding site (15 bp downstream to TATA box) was critical to its function. In addition, the result of cotransfection demonstrated that early protein 0 (EP0) of PRV, another protein with transcriptional function, inhibited the activity of the vhs promoter.

The nucleotide sequence upstream to the glycoprotein E (gE) gene of pseudorabies virus (PrV, TNL strain) was cloned from the genomic virus DNA by polymerase chain reaction (PCR) and its DNA sequences were determined. The DNA segment, which was supposed to contain the gE promoter, was subcloned into a chloramphenicol acetyltransferase (CAT) reporter gene and the resulting plasmid was named pgEp-B-CAT. To examine the promoter function of this upstream sequence of gE gene, we transfected pgEp-B-CAT DNA into L–M cells and the promoter activity was analyzed by CAT assay. Results showed that our DNA fragment could exhibit promoter activity. Furthermore, we transfected L–M cells with pgEp-B-CAT for 48 h, then superinfected cells with pseudorabies virus, and performed CAT assay. It was found that PrV superinfection could slightly enhance the activity of gE promoter, suggesting that factors produced during viral infection could stimulate the promoter. To explore the possible mechanism of regulation at transcriptional level, the pgEp-B-CAT plasmid were cotransfected with eukaryotic vectors expressing viral regulatory proteins IE or EP0, and results indicated that the gE promoter was activated by IE protein whereas it was inhibited by EP0 protein. Moreover, the effect of exogenous IE or EP0 on the protein level of gE in PrV-infected cells was examined; conclusion similar to that of CAT assay were obtained.

We investigated the changes in antioxidative enzyme activities of two sweet potato cultivars under waterlogging and high-light conditions in the growth chamber. The activities of antioxidative enzymes were measured from leaf crude extract of sweet potato during the first five days of the treatments. Activities of superoxide dismutase and catalase were consistently increased in Taoyuan 1 sweet potato over time under waterlogging and high-light conditions. However, decreases in both superoxide dismutase and catalase activities were observed for cultivar Yongtsai under waterlogging and high-light conditions. Waterlogging, together with high-light intensity, impairs superoxide dismutase and catalase activities in the cultivar Yongtsai indicating its greater susceptibility to waterlogging and high-light stress. In contrast, the increase in activities of superoxide dismutase and catalase in Taoyuan 1 indicated its greater ability to detoxify reactive oxygen species during the treatment and ensured its reduced susceptibility to waterlogging and high-light stress. The activities of peroxidase may be inactivated by high-light treatment and, therefore, may not be associated with tolerance of sweet potato plants to waterlogging and high-light stress. Differences in susceptibility to waterlogging and high-light conditions in the leafy vegetable Yongtsai and storage root Taoyuan 1 are discussed.

The aim of this study is to estimate the risk of stroke in a 3-year period after pelvic inflammatory disease (PID) using a nationwide population-based study.

Background:Although 2018 ACC/AHA lipid guideline recommended high-intensity statin (HIS) for secondary prevention in younger patients (<75 years) with atherosclerotic cardiovascular disease (ASCVD), the safety of HIS in Asian population have not be well assessed.Methods and Results:We screened the databank of the Bureau of National Health Insurance in Taiwan from January 2010 to December 2013. Patients who were 18 to 75 years old and admitted for their new myocardial infarction (MI) were enrolled in this study. Patients (n=4402, age 57.4 ? 10.9 years, male 82.6%) receiving HIS during index hospitalization or within one year after discharge were recognized as HIS group and the others (n=24476, age 59.0 ? 10.5 years, male 80.0%) receiving moderate- or low-intensity statin were defined as control group. The study endpoints were the rates of hemorrhagic stroke and hospitalization for drug-related hepatitis or myopathy. All eligible patients were followed up for 3 years after discharge. Cox proportional hazards analyses and propensity score analyses with 1:4 matching were used to evaluate the effect of different intensity of statin on clinical outcomes. At 3-year follow-up, there was no difference in rate of hemorrhagic stroke between HIS and control groups (HIS vs control, adjusted HR: 0.934, 95% CI: 0.59-1.59). Similarly, patients in HIS group didn?t have higher hospitalization rate for drug-related hepatitis or myopathy comparing to those in control group at 3-year follow-up (HIS vs control, drug-related hepatitis, adjusted HR: 0.98, 95% CI: 0.53-1.80; drug-related myopathy, adjusted HR: 1.13, 95% CI: 0.62-2.05). Furthermore, we assessed statin dose-reducing and regimen-switching rates which were corresponding to patients with milder statin-associated adverse effects (SAAE) who didn?t need hospitalization of these 2 groups. We found there was no difference in regimen switching between 2 groups but patients in HIS group had higher dose-reducing rate comparing to those in control group (HIS vs control, 8.2% vs 1.4%, p<0.0001).Conclusions:Our study showed that MI patients with HIS might have higher rates of mild SAAE but not severe complications. These results implied that HIS is relatively safe in Asian population with ASCVD.

Background:In Asia, little information is available about the contemporary real-world treatment pattern for venous thromboembolism (VTE) including deep vein thrombosis (DVT) and pulmonary embolism (PE).Methods:In the Taiwan National Health Insurance Research Database from 2014 to 2016, consecutive patients (pts) (age ? 20 yrs) with VTE were included. The temporal trends of treatments were evaluated. The efficacy and safety of non-vitamin K antagonist oral anticoagulants (NOACs) versus warfarin were compared. Propensity score analysis was used to balance covariates and Cox proportional hazards models with adjustment were used to estimate outcomes.Results:Overall, 11414 pts (mean age 67.4 ? 16.4 yrs, 44.4% male) were enrolled. Warfarin use decreased from 99.7% in 2014 Q1 to 39.8% in 2016 Q4, whereas NOACs use increased from 0.3% to 60.2%. In 2016 Q4, 56.3% were treated with rivaroxaban, 3.1% with apixaban and 0.8% with edoxaban. Pharmacomechanical therapy was used in 5.63% in 2016 and did not change significantly during the study period. After 1:1 propensity score matching, 7294 pts treated with warfarin (n=3647) and NOACs (n=3647) were selected. NOACs were associated with lower rate of recurrent VTE compared with warfarin (adjusted hazard ratio [aHR] 0.788, 95% CI 0.649-0.956). A competing risk analysis showed similar result. The effects of NOACs were consistent among subgroups. Further analyses yielded an aHR of 0.943 (95% CI 0.746?1.192) for recurrent DVT and an aHR of 0.535 (95% CI 0.366?0.781) for recurrent PE. For all-cause mortality, NOACs were associated with a lower risk (aHR 0.844, 95% CI 0.765-0.930). Subgroup analysis found pts without cancer had more mortality benefit with NOACs. NOACs were also associated with a lower risk of major bleeding (aHR 0.804, 95% CI 0.648-0.998). A competing risk analysis showed similar result. Those who took antiplatelet agents concomitantly had more benefit in major bleeding risk reduction of NOACs.Conclusions:NOACs have become the major anticoagulants for Asian pts with VTE. Only a minority of pts received pharmacomechanical therapy. Compared with warfarin, NOACs were associated with a reduced risk of VTE recurrence, all-cause mortality and major bleeding in this large Asian cohort.

The novel coordination polymers Mμ3-C5O50.5μ4-C5O50.5anti-dpe0.5gauche-dpe0.5 [M  Mn 1a, Fe 1b, Cd 1c; dpe  1,2-bis4-pyridylethane] consist of a two-dimensional bilayered framework, each being constructed from the cross-linkage of two infinite 2D Mμ3-C5O50.5μ4-C5O50.5anti-dpe0.5 brick-wall layers by gauche-dpe ligands.