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In this study, perceived moral obligations were included in the protection motivation theory (PMT) model to explain people's intentions to participate in climate change mitigation behaviors. Empirical data and structural equation modeling results of a nationwide cross-sectional survey in Taiwan confirmed the higher explanatory power of the moral extension PMT model than that of the original PMT model. As expected, threat and coping appraisal of climate change affect protection motivation. In addition, perceived moral obligation affects protection motivation. This protection motivation enhances the intention to participate in climate change mitigation behaviors. The mediation effect of protection motivation was also verified in the moral extension PMT model. Practical implications and suggestions are proposed for the government and related authorities as well as environmental groups to encourage people to participate in climate change mitigation behaviors.

The objective of this study is to examine the effectiveness of the four themes of life (“thanks, sorry, love, and farewell”) board game to enhance interpersonal communication, interpersonal relationships, and self-efficacy; and decrease loneliness. The participants were a convenience sample of 91 older people recruited from two community activity centers in Taiwan. Using a quasi-experimental method, participants from one of the community activity centers were enrolled as the experimental group, and participants from the other center were enrolled as the control group. The experimental group played the four themes of life board game for 4 weeks. The control group participated in routine community center activities. Compared to the control group, the experimental group had statistically significantly larger improvements in scores on interpersonal communication, self-efficacy, and loneliness at 3 months after the end of the intervention. This study provides a reference for the design interventions for promoting health in older people.

Amyotrophic lateral sclerosis (ALS) is a progressive nervous system disease that causes motor neuron (MN) degeneration and results in patient death within a few years. To recapitulate the cytopathies of ALS patients’ MNs, SOD1G85R mutant and corrected SOD1G85G isogenic-induced pluripotent stem cell (iPSC) lines were established. Two SOD1 mutant ALS (SOD1G85R and SOD1D90A), two SOD1 mutant corrected (SOD1G85G and SOD1D90D), and one sporadic ALS iPSC lines were directed toward MNs. After receiving ~90% purity for MNs, we first demonstrated that SOD1G85R mutant ALS MNs recapitulated ALS-specific nerve fiber aggregates, similar to SOD1D90A ALS MNs in a previous study. Moreover, we found that both SOD1 mutant MNs showed ALS-specific neurite degenerations and neurotransmitter-induced calcium hyperresponsiveness. In a small compound test using these MNs, we demonstrated that gastrodin, a major ingredient of Gastrodia elata, showed therapeutic effects that decreased nerve fiber cytopathies and reverse neurotransmitter-induced hyperresponsiveness. The therapeutic effects of gastrodin applied not only to SOD1 ALS MNs but also to sporadic ALS MNs and SOD1G93A ALS mice. Moreover, we found that coactivation of the GSK3β and IGF-1 pathways was a mechanism involved in the therapeutic effects of gastrodin. Thus, the coordination of compounds that activate these two mechanisms could reduce nerve fiber cytopathies in SOD1 ALS MNs. Interestingly, the therapeutic role of GSK3β activation on SOD1 ALS MNs in the present study was in contrast to the role previously reported in research using cell line- or transgenic animal-based models. In conclusion, we identified in vitro ALS-specific nerve fiber and neurofunctional markers in MNs, which will be useful for drug screening, and we used an iPSC-based model to reveal novel therapeutic mechanisms (including GSK3β and IGF-1 activation) that may serve as potential targets for ALS therapy.

Introduction A previous study has shown that Ala-Thr-Pro-Gly-Asp-Glu-Gly (ATPGDEG) peptide identified from boiled abalone by-products has high antioxidant activities and antihypertensive effect. Objective In this study, we further investigated its antiphotoaging activities by ultraviolet B (UVB)-induced HaCaT cells. Result UVB irradiation significantly increased the content of intercellular reactive oxygen species (ROS) and the production of matrix metalloproteinases (MMPs) in HaCaT cells and decreased its content of collagen. First, the generation of intercellular ROS was reduced by abalone peptide in UVB-induced HaCaT cells. And activities of MMP-1 and MMP-9 were reduced by abalone peptide in a dose-dependent manner. Furthermore, western blot analysis demonstrated that abalone peptide downregulated the expression of p38, c-Jun N-terminal kinases, and extracellular signal-regulated kinases via mitogen-activated protein kinases (MAPKs) and NF-κB signaling to protect type I pro collagen and DNA damage. Molecular docking simulation confirms that abalone peptide inhibited activities of MMP-1 and MMP-9 by docking their active site, among them N-terminal Ala, C-terminal Gly, and Pro at the third position of N-terminal made a great contribution. Conclusion and recommendation Abalone peptide could protect type I procollagen synthesis in UVB-irradiated HaCaT cells, and it is a potential peptide for the treatment of skin photoaging in the future.

In this study, we investigated the protective effects of a peptide (YGDEY, Tyr-Gly-Asp-Glu-Tyr) isolated from tilapia skin gelatin hydrolysates (TGHs), against UVB-induced photoaging in human keratinocytes (HaCaT) cells. Results showed that YGDEY significantly decreased levels of intracellular reactive oxygen species (ROS), increased antioxidant factors (Superoxide Dismutase, SOD and Glutathione, GSH) expression and maintained balance between GSH and GSSG in HaCaT cells. Comet assay shows that YGDEY can protect DNA from oxidative damage. Furthermore, it significantly inhibited MMP-1 (collagenase) and MMP-9 (gelatinase) expression and increased Type I procollagen production. In addition, the molecular docking study showed that YGDEY may form active sites with MMP-1 and MMP-9. Moreover, Western blot analysis was utilized to measure the protein levels of UVB-induced mitogen-activated protein kinase (MAPK) and nuclear factor-kappa B (NF-κB) signaling pathways. Therefore, these results suggested that YGDEY has a therapeutic effectiveness in prevention of UVB-induced cellular damage, and it is a candidate worthy of being developed as a potential natural antioxidant and food additive.

Objective The aim of this study was to evaluate the cerebral outcomes of patients underwent novel triple‐branched stent graft implantation combined with the intraoperative monitoring of regional cerebral oxygen saturation. Methods One hundred thirty‐seven consecutive patients who underwent the surgery of triple‐branched stent graft implantation in our department were enrolled in this retrospective case‐control study. The patients in group A received brain protection based on the intraoperative monitoring of regional cerebral oxygen saturation and the patients in group B received conventional brain protection. The general clinical data, the types of corrective surgeries, the intraoperative situations, the postoperative complications, and the midterm outcomes of the patients were analyzed. Results The incidence of postoperative cerebral dysfunction in the patients of group A was significantly lower than that in the patients in group B (3.2% vs 14.9%, P = .020). We found significant differences in the incubation times (30.3 ± 22.1 vs 42.3 ± 27.9 hours, P = .014), the lengths of intensive care unit stay (58.0 ± 54.3 vs 79.7 ± 55.5 hours, P = .004), and the hospital stays (19.3 ± 6.7 vs 24.9 ± 17.3 days, P = .045). A descending trend in the mortality rates was observed between the patients in the two groups based on the 20 months of observation; however, this trend was not statistically significant (1.6% vs 6.8%, P = .218). Conclusions The novel triple‐branched stent graft implantation procedure combined with intraoperative monitoring of the regional cerebral oxygen saturation was an effective treatment for Stanford type A aortic dissection, with a relatively low incidence of postoperative cerebral dysfunction.

Background: Gastrointestinal hemorrhage (GH) is one of the most serious complications after cardiovascular surgery. The aim of the study was to provide an optimal therapeutic strategy for preventing postoperative GH in high-risk patients. Methods: This retrospective case-control study included 188 adult patients at high risk of postoperative GH. These patients were divided into two groups based on a strategy for preventing postoperative GH: Group A (n = 97) received continuous intravenous infusion of proton-pump inhibitor (PPI) combined with early enteral nutrition, and Group B (n = 91) received a bolus intravenous infusion of PPI combined with late enteral nutrition. The clinical features of the groups were examined. Results: The incidence of postoperative GH in the patients of group A was significantly lower than the patients in group B. The duration from the end of surgery to eating for the first time in the patients of group A was significantly shorter than in the patients of group B. A descending trend in 30-day mortality was observed in the patients of group A compared with group B, but no significant difference was found between the two groups. Conclusion: Continuous intravenous infusion of PPI combined with early enteral nutrition could effectively prevent GH and reduce 30-day mortality after cardiovascular surgery in high-risk patients.

To explore how people attribute meanings to climate change in Taiwan, this study applied social representations theory (SRT) to develop a self-report semi-structured questionnaire that was used to collect data. To fill a research gap, structural equation modeling (SEM) was adopted to examine the determinants of social representation factors that may affect the public’s intentions to engage in pro-environmental behaviors (PEBs). Exploratory factor analysis results obtained from 180 valid online responses indicated four factors for social representations of climate change, namely Emerging Climate Change Risk, Media Coverage and Influence, Psychological Distance, and Pro-environmental Behavior Intentions. The results of SEM analysis obtained from the total of 245 valid online and paper-and-pencil responses revealed that Emerging Climate Change Risk and Media Coverage and Influence helped explain the public’s PEBs intentions, but Psychological Distance did not. This exploratory study provides preliminary knowledge of public understanding of and response toward climate change in the Taiwanese society and demonstrates a novel application of SEM analysis to test the direct effects of social representations of climate change on PEB intentions.

Marine microalgae have been widely applied in cosmaceuticals, nutraceuticals, and functional foods. In the present study, we first investigated the hepatoprotective effects of peptide purified from microalgae, Isochrysis zhanjiangensis on HepG2 cells alcoholic injury. I. zhanjiangensis was hydrolyzed utilizing chymotrypsin, trypsin, pepsin, and by vitro gastrointestinal digestion. Among hydrolysates, the gastrointestinal hydrolysate showed relatively high free radical scavenging ability preliminarily and was purified with following sequential chromatography methods. The amino acid sequence and molecular mass of the purified peptide from I. zhanjiangensis (PIZ) was identified as Asn-Asp-Ala-Glu-Tyr-Gly-Ile-Cys-Gly-Phe (NDAEYGICGF; MW, 1088.16 Da) via Q-TOF ESI/MS. Additionally, PIZ attenuated ethanol-induced cytotoxicity and inhibited the production of intracellular reactive oxygen species by DCFH-DA assay. Western blot results showed that superoxide dismutase (SOD) and glutathione (GSH) levels up-regulated with PIZ treatment before alcohol exposure while gamma-glutamyltransferase (GGT) protein expression down-regulated. These results provide an opportunity to discover new highly active peptide against alcohol toxicity in HepG2 cells.

This study investigated the effects of an 8-week horticultural activity intervention on attitudes toward aging, sense of hope, and hand–eye coordination in 88 older adults in residential care facilities. In the experimental group, the mean score for “attitudes toward aging” increased from 3.81 before the intervention to 4.74 points after the intervention (standard deviation SD = 0.24 and 0.27, respectively), and the control group dropped from 3.75 to 3.70 (standard deviations, respectively SD = 0.27 and 0.28). The mean score for “sense of hope” increased from 3.28 before the intervention to 3.81 points after the intervention (SD = 0.49 and 0.26, respectively). In contrast to the control group, the mean score gradually declined from 3.26 to 3.16 points (standard deviation SD = 0.54 and 0.48, respectively). In the test of hand–eye coordination, the time required to complete the cup stacking test significantly decreased from 33.56 to 25.38 s in the experimental group but did not significantly change in the control group. Generalized estimating equation analysis revealed a significant interaction between group and time (p &lt, 0.001). The data trends revealed significant differences in outcomes between the experimental group and the control group. At 3 months after the end of the study, the effect size in the experimental group remained higher than that in the control group.

BACKGROUND The accumulation of advanced glycation end products (AGEs) have been implicated in the development and progression of diabetic vasculopathy. However, the role of profilin-1 as a multifunctional actin-binding protein in AGEs-induced atherosclerosis (AS) is largely unknown. AIM To explore the potential role of profilin-1 in the pathogenesis of AS induced by AGEs, particularly in relation to the Janus kinase 2 (JAK2) and signal transducer and activator of transcription 3 (STAT3) signaling pathway. METHODS Eighty-nine individuals undergoing coronary angiography were enrolled in the study. Plasma cytokine levels were detected using ELISA kits. Rat aortic vascular smooth muscle cells (RASMCs) were incubated with different compounds for different times. Cell proliferation was determined by performing the MTT assay and EdU staining. An AGEs-induced vascular remodeling model was established in rats and histological and immunohistochemical analyses were performed. The mRNA and protein levels were detected using real-time PCR and Western blot analysis, respectively. In vivo, shRNA transfection was performed to verify the role of profilin-1 in AGEs-induced proatherogenic mediator release and aortic remodeling. Statistical analyses were performed using SPSS 22.0 software. RESULTS Compared with the control group, plasma levels of profilin-1 and receptor for AGEs (RAGE) were significantly increased in patients with coronary artery disease, especially in those complicated with diabetes mellitus (P < 0.01). The levels of profilin-1 were positively correlated with the levels of RAGE (P < 0.01); additionally, the levels of both molecules were positively associated with the degree of coronary artery stenosis (P < 0.01). In vivo, tail vein injections of AGEs induced the release of proatherogenic mediators, such as asymmetric dimethylarginine, intercellular adhesion molecule-1, and the N-terminus of procollagen III peptide, concomitant with apparent aortic morphological changes and significantly upregulated expression of the profilin-1 mRNA and protein in the thoracic aorta (P < 0.05 or P < 0.01). Downregulation of profilin-1 expression with an shRNA significantly attenuated AGEs-induced proatherogenic mediator release (P < 0.05) and aortic remodeling. In vitro, incubation of vascular smooth muscle cells (VSMCs) with AGEs significantly promoted cell proliferation and upregulated the expression of the profilin-1 mRNA and protein (P < 0.05). AGEs (200 μg/mL, 24 h) significantly upregulated the expression of the STAT3 mRNA and protein and JAK2 protein, which was blocked by a JAK2 inhibitor (T3042-1) and/or STAT3 inhibitor (T6308-1) (P < 0.05). In addition, pretreatment with T3042-1 or T6308-1 significantly inhibited AGEs-induced RASMC proliferation (P < 0.05). CONCLUSION AGEs induce proatherogenic events such as VSMC proliferation, proatherogenic mediator release, and vascular remodeling, changes that can be attenuated by silencing profilin-1 expression. These results suggest a crucial role for profilin-1 in AGEs-induced vasculopathy.

Background:Sedentary behaviours may be related to factors such as self-efficacy, mood and social support. However, there is a paucity of longitudinal follow-up studies examining factors related to sedentary behaviour from physical-psychosocial perspectives in patients with heart failure.Aims:The purpose of this study was to explore the multidimensional associated factors and impacts of sedentary behaviour in heart failure patients.Methods:A longitudinal design was used. A convenience sample of 128 heart failure patients recruited from two large medical centres in northern Taiwan was obtained. Patients were interviewed with structured questionnaires to assess physical activity, symptom distress, exercise self-efficacy, anxiety and depression, social support, sleep quality and quality of life before discharge and at 3 and 6 months after discharge.Results:Heart failure patients reported low physical activity and tended to be sedentary. Sedentary behaviour was gradually reduced from hospitalization to 6 months after discharge. Sleep quality, quality of life, analgesic use, symptom distress and exercise self-efficacy were significant associated factors that explained 42.1–51% of the variance in sedentary behaviour. Patients with high sedentary behaviour had significantly greater depression and poorer sleep and quality of life than those with low sedentary behaviour at hospitalization and showed a significant improvement in depression at 3 and 6 months after discharge.Conclusion:Sedentary behaviour is common in heart failure patients and has impacts on depression and quality of life. An appropriate physical activity programme focusing on disease self-management and enhancing self-efficacy is needed for heart failure patients to improve their sedentary behaviour and quality of life.

Alcoholic liver disease (ALD) threatens human health, so it is imperative that we find ways to prevent or treat it. In recent years, the study of polysaccharides has shown that they have different kinds of bioactivities. Among them are many biological effects that have been attributed to polysaccharide precursors. D-Isofloridoside (DIF) is one of the polysaccharide precursors from the marine red alga Laurencia undulata. This study evaluated the effect of DIF on alcohol-induced oxidative stress in human hepatoma cells (HepG2). As a result, DIF attenuated alcohol-induced cytotoxicity, reduced the amount of intracellular reactive oxygen species (ROS), and effectively reduced alcohol-induced DNA damage in HepG2 cells. In addition, a western blot showed that, after DIF treatment, the expression levels of glutathione (GSH), superoxide dismutase (SOD), and B-cell lymphoma-2 (bcl-2) increased, while the expression levels of &gamma, glutamyl transferase (GGT), BCL2-associated X (bax), cleaved caspase-3, and mitogen-activated protein kinase (p38 and c-Jun N-terminal kinase ) signal transduction proteins reduced. This showed that DIF may protect cells by reducing the amount of intracellular ROS and inhibiting intracellular oxidative stress and apoptotic processes. Finally, molecular docking demonstrated that DIF can bind to SOD, GGT, B-cell lymphoma-2, and bax proteins. These results indicated that DIF can protect HepG2 cells from alcohol-induced oxidative stress damage, making it an effective potential ingredient in functional foods.

Mankind is now facing serious sustainability challenges of the environment and the society from climate change to inequity social problems. Consumers can take responsibility to society and the environment by purchasing products that are least harmful to humans and nature. By doing so, the opportunities of life and consumption of other people and future generations are affected as little as possible. Previous studies indicated that the inclusion of perceived moral obligations in the theory of planned behavior (TPB) model has greatly improved the prediction of individual’s behavioral intention. Self-identity was also found as a significant predictor of pro-environmental behaviors. But an individual’s skepticism and uncertainty of climate change may reduce his or her willingness to act pro-environmental behaviors. In view of the growing coffee consumption market in Taiwan and the environmental impact of coffee production, this study aims to explore Taiwanese public’s attitude toward purchasing sustainability labeled coffee and their purchase intentions. People’s perceived moral obligation and pro-environmental self-identity are included in the TPB model to increase the model’s explanatory power. The moderating effect of people’s skeptical attitude toward climate change is also considered in this study. A nationwide and self-reported questionnaire was distributed in Taiwan. The collected data was analyzed by moderated regression analysis. The research results revealed that as expected the original three components in the TPB model (i.e., attitudes, subjective norms, and perceived behavioral control) have influences on people’s purchase intentions of sustainability labeled coffee, the additional two factors (i.e., perceived moral obligations and pro-environmental self-identity) also have influences on people’s purchase intentions of sustainability labeled coffee. Moreover, the moderating effect of climate change skepticism on the positive relationship between pro-environmental self-identity and purchase intentions of sustainable labeled coffee was verified. The empirical research findings facilitate a better understanding of Taiwanese public’s attitude toward purchasing sustainability labeled coffee and their purchase intentions.

BACKGROUND Lifestyle is among the most important factors affecting individual health status. Limited access to health information may limit the ability of people with visual impairment or blindness to practice healthy lifestyles. However, no studies have investigated how lifestyle practices affect health specifically in visually impaired and blind populations. PURPOSE The aim of this study was to investigate the lifestyle behaviors of visually impaired and blind massage therapists (VIBMTs) in Taiwan. METHODS This exploratory study used a purposive sampling technique to recruit 50 VIBMTs who were employed at massage stations in southern Taiwan. All of the participants completed the Health-Promoting Lifestyle Profile II (HPLP-II) and a survey of demographic characteristics. Descriptive and inferential statistical tests, including the Mann-Whitney U test and the Kruskal-Wallis H test, were used. Statistical significance was defined as p < .05 in two-tailed tests. RESULTS Fifty participants completed both the HPLP-II and the demographic survey. The mean subscale score for the HPLP-II was 2.52 ± 0.37. The lowest scores were on the physical activity (2.09 ± 0.67) and nutrition (2.35 ± 0.39) subscales, and the highest scores were on the spiritual growth (2.89 ± 0.56) and interpersonal relations (2.79 ± 0.46) subscales. Scores on the stress management and physical activity subscales were significantly higher in men than in women (p < .05). In addition, mean HPLP-II scores were significantly higher in VIBMTs who exercised regularly compared with those who did not (p < .05). Compared with nonsmokers, current smokers had significantly higher scores on the stress management subscale (p < .05). CONCLUSIONS/IMPLICATIONS FOR PRACTICE The low physical activity scores in this population may be improved by developing physical activity programs for the home and workplace and by establishing community recreational and exercise facilities for visually impaired populations. The low scores for nutrition may be improved by establishing nutrition education programs that are designed specifically for VIBMTs to increase their consumption of fresh produce and other healthy foods and by requiring food manufacturers to use labels that may be easily read or understood by visually impaired populations.

Genetically modified (GM) foods have received substantial attention in recent years for being associated with unnaturalness, untrustworthiness, moral considerations, uncertainty, unhealthiness, and risks. This study highlighted the relevance of how social representations of genetically modified (GM) foods influence the Taiwanese public's willingness to consume GM foods.; Results: Moderated regression analysis results revealed that the social representation dimensions of adherence to technology and food as a necessity positively influenced the public's willingness to consume GM foods; however, the dimension of resistance to and suspicion of novelties had a negative influence. Food technology neophobia played a role in predicting people's willingness to consume GM foods and exerted moderating effects to enhance the negative relationship between the respondents' resistance to and suspicion of novelties and their willingness to consume GM foods. This neophobia also changed the positive relationship between food as a necessity and willingness to consume GM foods into negative. One-way ANOVA results revealed that food technology neophobia influences the public's specific social representations of GM foods, personal domain-specific innovativeness, and willingness to consume GM foods.; Conclusion: Innovations in the food industry exhibit a high market failure rate partially because of the phenomenon known as food technology neophobia, which refers to rejection of new or unfamiliar foods. The findings of this empirical study can facilitate the development of a clearer understanding of people's acceptance and usage of emerging technologies applied in the innovation of food products in Taiwan. © 2018 Society of Chemical Industry.; © 2018 Society of Chemical Industry.

Purpose The purpose of this paper is to extend the technology readiness and acceptance model (TRAM) to consider an individual’s health consciousness (HC), thereby improving the capability of the model to predict an individual’s attitude toward and intention to download and use dietary and fitness apps. Design/methodology/approach A total of 994 participants completed a self-reported online questionnaire. Structural equation modeling and χ2 difference testing were conducted to compare the predictive capability of the proposed health consciousness TRAM (HC-TRAM) and the TRAM. The comparison of the proposed HC-TRAM in terms of potential and actual users of dietary and fitness apps was also discussed. Findings The results obtained from the HC-TRAM and the TRAM indicate that in addition to technology readiness, HC exerts a positive effect on the perceived ease of use and usefulness of dietary and fitness apps. χ2 difference test results indicated that the predictive capability of the proposed HC-TRAM is higher than that of the TRAM. Practical implications The drivers and inhibitors of a person’s readiness to embrace modern information technology play roles when predicting his or her intention to download and use dietary and fitness apps. HC should be promoted by encouraging people to eat right and regularly perform appropriate exercise to prevent obesity and overweight, thereby maintaining a healthy lifestyle. Originality/value This study incorporated individual cognitive factors and HC into the TRAM to fill the literature gap and deepen and broaden existing theoretical frameworks of the TRAM in the public health sector.

Despite a growing understanding of health-related quality of life (HRQOL) and its determinants in hemodialysis (HD) patients, little is known about the effects and interrelationships concerning the perception of autonomy support and basic need satisfaction of HD patients on their HRQOL. Based on self-determination theory (SDT), this study examines whether HD patients' perceived autonomy support from health care practitioners (physicians and nurses) relates to the satisfaction of HD patients' basic needs and in turn influences their HRQOL.A questionnaire was administered to 250 Taiwanese HD patients recruited from multiclinical centers and regional hospitals in northern Taiwan. Structural equation modeling (SEM) analysis was conducted to examine the causal relationships between patient perceptions of autonomy support and HRQOL through basic need satisfaction.The empirical results of SEM indicated that the HD patients' perceived autonomy support increased the satisfaction of their basic needs (autonomy, competency, and relatedness), as expected. The higher degree of basic need satisfaction led to higher HRQOL, as measured by physical and mental component scores.Autonomy support from physicians and nurses contributes to improving HD patients' HRQOL through basic need satisfaction. This indicates that staff caring for patients with severe chronic diseases should offer considerable support for patient autonomy.

Recent food safety scandals in Taiwan have caused panic among the Taiwanese public and have become a primary concern because foods were discovered containing a dangerous amount of illegal additives. The theory of planned behavior (TPB) model is extremely useful for predicting people’s food choices and consumption habits. This study included an examination of the public attention to and perceived credibility of mass media food safety information and the perceived risk as background factors in the extended TPB model to predict public intention to take precautions to avoid consuming foods with additives. The empirical results of structural equation modeling analysis with 487 useful samples revealed that the extended TPB model has an increased explanatory power relative to the original model regarding the intention of the public in Taiwan to take precautions to avoid consuming foods that contain additives. In addition to attitudes toward and perceived behavioral control of the consumption of food with additives, the impact of risk perceptions plays an important role in determining an individual’s intention to take precautions to avoid consuming foods that contain additives. The attention of an individual to food additive scandal news and their perceived risk determine their attitude toward consuming food with additives. An individual’s perceived risk of consuming food with additives was determined through the attention paid to food additive scandal news and the perceived credibility of such news.

BACKGROUND Practicing a health-promoting lifestyle is believed to be effective for delaying or preventing the onset of diabetes. However, although empowerment interventions have proven effective for encouraging the adoption of a health-promoting lifestyle in people with diabetes, these interventions are rarely promoted to people with prediabetes. PURPOSE The aims of this study were to develop an empowerment program for people with prediabetes and to examine its efficacy in terms of the adoption of a health-promoting lifestyle and improvements in blood sugar, body mass index, and self-efficacy. METHODS A randomized controlled trial was conducted between May and December 2013. A convenience sample of people with a fasting blood sugar level of 100-125 mg/dl during the previous 3 months was recruited from the health examination center of a hospital in Kaohsiung, Taiwan. Participants were assigned to either the experimental group or the control group using block randomization with a block size of 8. The experimental group (n = 38) participated in a 4-month empowerment program (the ABC empowerment program), which encouraged participants to practice a health-promoting lifestyle in three phases: awareness raising, behavior building, and results checking. The control group (n = 40) received routine clinical care. Statistical analyses included descriptive statistics, independent t test, paired t test, and generalized estimated equations. RESULTS After controlling for the differences at baseline and considering the interaction between group and time from baseline to 1 week and 3 months after completing the intervention, the generalized estimating equation showed significantly larger improvements in a health-promoting lifestyle, blood sugar, and self-efficacy in the experimental group than in the control group (p < .01). Furthermore, the experimental group achieved a larger reduction in body mass index than the control group at 3 months after completing the intervention (p = .001). CONCLUSIONS/IMPLICATIONS FOR PRACTICE The empowerment program was shown to have short-term, positive effects on behavioral, physical, and psychosocial outcomes in a Taiwan population with prediabetes. The results of this study provide a useful reference not only for healthcare personnel when implementing empowerment interventions in people with prediabetes but also for nursing educators and healthcare policymakers.

The aim of this article is to identify the factors that predict self-perceived nursing competency among new nurses in Taiwan. This quantitative cross-sectional survey was performed with a convenience sample of 105 new nurses. Data were collected with questionnaires. Multiple linear regression showed perceived benefit of preceptor policies to nursing capacity and age accounted for 21.1% of the variance in dependent variables for self-perceived nursing competency importance. Satisfaction with current preceptor, satisfaction with current nursing job, and participation in interprofessional education conferences accounted for 22% of the variance in dependent variables for self-perceived nursing competency adequacy. The results could be a reference to design nursing education curricula that improve clinical training and retention of new nurses. J Contin Educ Nurs. 2017;48(3):129–137.

Abalone (Haliotis discus hannai) is a precious seafood in the market. It has been reported that biological active substances derived from abalone have anti-oxidative, anti-inflammatory, anti-bacterial, and anti-thrombosis potential. However, there were few studies to assess whether they have anti-cancer potential. In this study, we evaluated the anti-metastasis and anti-pro-angiogenic factors and mechanism of action of boiled abalone byproduct peptide (BABP, EMDEAQDPSEW) in human fibrosarcoma (HT1080) cells and human umbilical vein endothelial cells (HUVECs). The results demonstrated that BABP treatment significantly lowers migration and the invasion of HT1080 cells and HUVECs. BABP inhibits phorbol 12-myristate 13-acetate (PMA)-induced matrix metalloproteinase (MMP) expression and activity by blocking mitogen-activated protein kinases (MAPKs) and NF-κB signaling and hypoxia-induced vascular endothelial growth factor (VEGF) secretion and hypoxia inducible factor (HIF)-1α accumulation through suppressing the AKT/mTOR signal pathway. BABP treatment inhibits VEGF-induced VEGFR-2 expression and tube formation in HUVECs. The effect of BABP on anti-metastatic and anti-vascular activity in HT1080 cells and HUVECs revealed that BABP may be a potential pharmacophore for tumor therapy in the future.

Background Postoperative cerebral complications (PCC) are common and serious postoperative complications for patients with Stanford type A aortic dissection (AAD). The aim of this study was to evaluate the risk factors for PCC in these patients and to provide a scientific basis for effective prevention of PCC. Methods In this retrospective case-control study, 125 patients with AAD who underwent thoracotomy in our department from October 2017 to October 2018 in the department of cardiovascular surgery, Fujian Medical University Union Hospital were divided into two groups: patients with PCC (n = 12), and patients without PCC (n = 113). The general clinical data, the types of corrective surgeries, the intraoperative situations, the postoperative complications, and the midterm outcomes of the patients were analyzed. Results The patients with PCC were significantly older than the patients without PCC (P = 0.016), and the incidence of the preoperative cerebral disease history in the patients with PCC was significantly higher than those of the PCC (−) group (P = 0.024). The Euro SCORE II of patients with PCC was dramatically higher than the patients without PCC (P = 0.005). There were significant differences between the two groups in terms of the duration of cardiopulmonary bypass (CPB) (P = 0.010) and the length of moderate hypothermic circulatory arrest (MHCA) combined with selective cerebral perfusion (SCP) (P = 0.000). The monitoring of rcSO2 indicated that there was significant difference between the two groups in terms of the bilateral baseline (P = 0.000). Patients with PCC were observed to have experienced significantly longer intubation times (P = 0.000), ICU stays (P = 0.001), and postoperative hospital stays (P = 0.009), and they also had dramatically higher rates of pulmonary infection (P = 0.000), multiple organ dysfunction syndrome (P = 0.041) and tracheotomy (P = 0.022) after surgeries. The duration of MHCA+SCP (OR:9.009, P = 0.034) and the average baseline value of rcSO2 (OR:0.080, P = 0.009) were ultimately identified as significant risk factors. Conclusions PCC has a serious influence on the prognoses of patients following surgical treatment with AAD. The duration of MHCA+SCP and the average baseline value of rcSO2 were the independent risk factors for PCC.

Angiotensin II (Ang II) is closely involved in endothelial injury during the development of hypertension. In this study, the protective effects of the tilapia by-product oligopeptide Leu-Ser-Gly-Tyr-Gly-Pro (LSGYGP) on oxidative stress and endothelial injury in Angiotensin II (Ang II)-stimulated human umbilical vein endothelial cells (HUVEC) were evaluated. LSGYGP dose-dependently suppressed the fluorescence intensities of nitric oxide (NO) and reactive oxygen species (ROS), inhibited the nuclear factor-kappa B (NF-&kappa, B) pathway, and reduced inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), and endothelin-1 (ET-1) expression, as shown by western blot. In addition, it attenuated the expression of gamma-glutamyltransferase (GGT) and heme oxygenase 1 (HO-1), as well as increasing superoxide dismutase (SOD) and glutathione (GSH) expression through the nuclear factor erythroid 2-related factor 2 (Nrf2) pathway. Other experiments revealed that LSGYGP increased the apoptotic inhibition ratio between cleaved-caspase-3/procaspase-3, reduced expressions of pro-apoptotic ratio between Bcl-2/Bax, inhibited phosphorylation of mitogen-activated protein kinases (MAPK), and increased phosphorylation of the serine/threonine kinase (Akt) pathway. Furthermore, LSGYGP significantly decreased Ang II-induced DNA damage in a comet assay, and molecular docking results showed that the steady interaction between LSGYGP with NF-&kappa, B may be attributed to hydrogen bonds. These results suggest that this oligopeptide is effective in protecting against Ang II-induced HUVEC injury through the reduction of oxidative stress and alleviating endothelial damage. Thus, it has the potential for the therapeutic treatment of hypertension-associated diseases.

In this study, we investigated the protective effects of a peptide (YGDEY, Tyr-Gly-Asp-Glu-Tyr) isolated from tilapia skin gelatin hydrolysates (TGHs), against UVB-induced photoaging in human keratinocytes (HaCaT) cells. Results showed that YGDEY significantly decreased levels of intracellular reactive oxygen species (ROS), increased antioxidant factors (Superoxide Dismutase, SOD and Glutathione, GSH) expression and maintained balance between GSH and GSSG in HaCaT cells. Comet assay shows that YGDEY can protect DNA from oxidative damage. Furthermore, it significantly inhibited MMP-1 (collagenase) and MMP-9 (gelatinase) expression and increased Type I procollagen production. In addition, the molecular docking study showed that YGDEY may form active sites with MMP-1 and MMP-9. Moreover, Western blot analysis was utilized to measure the protein levels of UVB-induced mitogen-activated protein kinase (MAPK) and nuclear factor-kappa B (NF-κB) signaling pathways. Therefore, these results suggested that YGDEY has a therapeutic effectiveness in prevention of UVB-induced cellular damage, and it is a candidate worthy of being developed as a potential natural antioxidant and food additive.

Vasculogenic mimicry (VM) formed by tumor cells plays a vital role in the progress of tumor, because it provides nutrition for tumor cells and takes away the metabolites. Therefore, the inhibition of VM is crucial to the clinical treatment of tumors. In this study, we investigated the anti-tumor effect of a novel peptide, KVEPQDPSEW (AATP), isolated from abalone (Haliotis discus hannai) on HT1080 cells by migration, invasion analysis and the mode of action. The results showed that AATP effectively inhibited MMPs by blocking MAPKs and NF-&kappa, B pathways, leading to the downregulation of metastasis of tumor cells. Moreover, AATP significantly inhibited VM and pro-angiogenic factors, including VEGF and MMPs by suppression of AKT/mTOR signaling. In addition, molecular docking was used to study the interaction of AATP and HIF-1&alpha, and the results showed that AATP was combined with an active site of HIF-1&alpha, by a hydrogen bond. The effect of AATP on anti-metastatic and anti-vascular in HT1080 cells revealed that AATP may be a potential lead compound for treatment of tumors in the future.

According to a previous study, YGDEY from tilapia fish skin gelatin hydrolysates has strong free radical scavenging activity. In the present study, the protective effect of YGDEY against oxidative stress induced by ethanol in HepG2 cells was investigated. First, cells were incubated with YGDEY (10, 20, 50, and 100 μM) to assess cytotoxicity, and there was no significant change in cell viability. Next, it was established that YGDEY decreased the production of reactive oxygen species (ROS). Western blot results indicated that YGDEY increased the levels of superoxide dismutase (SOD) and glutathione (GSH) and decreased the expression of gamma-glutamyltransferase (GGT) in HepG2 cells. It was then revealed that YGDEY markedly reduced the expressions of bax and cleaved-caspase-3 (c-caspase-3); inhibited phosphorylation of Akt, IκB-α, p65, and p38; and increased the level of bcl-2. Moreover, the comet assay showed that YGDEY effectively decreased the amount of ethanol-induced DNA damage. Thus, YGDEY protected HepG2 cells from alcohol-induced injury by inhibiting oxidative stress, and this may be associated with the Akt/nuclear factor-κB (NF-κB)/mitogen-activated protein kinase (MAPK) signal transduction pathways. These results demonstrate that YGDEY from tilapia fish skin gelatin hydrolysates protects HepG2 cells from oxidative stress, making it a potential functional food ingredient.

Nitric oxide (NO) overproduction via induction of inducible nitric oxide synthase (iNOS) is implicated in vasodilatory shock in sepsis, leading to septic encephalopathy and accelerating cerebral ischemic injury. An abbreviated urea-cycle ( l -citrulline- l -arginine-NO cycle) has been demonstrated in cerebral perivascular nitrergic nerves and endothelial cells but not in normal cerebral vascular smooth muscle cell (CVSMC). This cycle indicates that argininosuccinate synthase (ASS) catalyzes l -citrulline ( l -cit) conversion to form argininosuccinate (AS), and subsequent AS cleavage by argininosuccinate lyase (ASL) forms l -arginine ( l -arg), the substrate for NO synthesis. The possibility that ASS enzyme in this cycle was induced in the CVSMC in sepsis was examined. Blood-vessel myography technique was used for measuring porcine isolated basilar arterial tone. NO in cultured CVSMC and in condition mediums were estimated by diaminofluorescein (DAF)-induced fluorescence and Griess reaction, respectively. Immunohistochemical and immunoblotting analyses were used to examine iNOS and ASS induction. l -cit and l -arg, which did not relax endothelium-denuded normal basilar arteries precontracted by U-46619, induced significant vasorelaxation with increased NO production in these arteries and the CVSMCs following 6-hour exposure to 20 μg/ml lipopolysaccharide (LPS) or lipoteichoic acid (LTA). Pre-treatment with pyrrolidine dithiocarbamate (PDTC) and salicylate (SAL) (NFκB inhibitors), aminoguanidine (AG, an iNOS inhibitor), and nitro- l -arg (NLA, a non-specific NOS inhibitor) blocked NO synthesis in the CVSMC and attenuated l -cit- and l -arg-induced relaxation of LPS- and LTA-treated arteries. Furthermore, immunohistochemical and immunoblotting studies demonstrated that expression of basal iNOS and ASS in the smooth muscle cell of arterial segments denuded of endothelium and the cultured CVSMCs was significantly increased following 6-hour incubation with LPS or LTA. This increased iNOS- and ASS-proteins expression in both preparations was inhibited by SAL, but was further increased by AG. These results indicate that LPS and LTA induce the l -cit- l -arg-NO cycle via induction of iNOS and ASS in the CVSMCs, accounting for massively increased NO-production and cerebral vasodilation in septic shock. Simultaneous inhibition of both pathways and NFκB-activation may be necessary to efficiently decrease or normalize NO production in the CVSMCs in this disease condition, and/or prevention and treatment of cerebral vessel-related brain dysfunctions. Our results further suggest to avoid using iNOS inhibitors alone which may cause upregulation of iNOS and ASS resulted from feedback-inhibition of iNOS activity. Accordingly, combined treatments with specific iNOS-activity inhibitor and inhibitor for iNOS genomic expression may provide a strategy in optimally managing brain sepsis and related encephalopathy associated with enhanced iNOS expression and NO overproduction.

This study explored the relationship between the fractional exhaled nitric oxide (FeNO) level and the efficacy of inhaled corticosteroid (ICS) in asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) patients with different disease severity. A total of 127 ACOS patients with ACOS (case group) and 131 healthy people (control group) were enrolled in this study. Based on the severity of COPD, the ACOS patients were divided into: mild ACOS; moderate ACOS; severe ACOS; and extremely severe ACOS groups. We compared FeNO levels, pulmonary function parameters including percentage of forced expiratory volume in 1 second (FEV1) to predicted value (FEV1%pred), ratio of FEV1 to forced vital capacity (FEV1/FVC), inspiratory capacity to total lung capacity (IC/TLC) and residual volume to total lung capacity (RV/TLC), arterial blood gas parameters, including PH, arterial partial pressure of oxygen (PaO2) and arterial partial pressure of carbon dioxide (PaCO2), total serum immunoglobulin E (IgE), induced sputum eosinophil (EOS), plasma surfactant protein A (SP-A), plasma soluble receptor for advanced glycation end products (sRAGE), sputum myeloperoxidase (MPO), sputum neutrophil gelatinase-associated lipocalin (NGAL) and Asthma Control Test (ACT) scores, and COPD Assessment Test (CAT) scores. Compared with pre-treatment parameters, the FeNO levels, RV/TLC, PaCO2, total serum IgE, induced sputum EOS, plasma SP-A, sputum MPO, sputum NGAL, and CAT scores were significantly decreased after 6 months of ICS treatment, while FEV1%pred, FEV1/FVC, IC/TLC, PH, PaO2, plasma sRAGE, and ACT scores were significantly increased in ACOS patients with different disease severity after 6 months of ICS treatment. This finding suggests that the FeNO level may accurately predict the efficacy of ICS in the treatment of ACOS patients., Graphical Abstract

This study examined whether the causal relationships of protection motivation theory (PMT) can be applied to explain and predict the public's behavioural intentions for safe food choice through protection motivation of health and well-being promotion in Taiwan. In addition, the public's perceived food risk management quality and perceived product safety liability of food providers involved in food safety scandals were considered in the PMT model. The results of structural equation modelling indicated that, compared with the original PMT model, the extended PMT model demonstrates higher explanatory and predictive power of a person's protection motivation to mitigate food safety problems, but lower explanatory and predictive power of a person's behavioural intentions to make safe food choices. The empirical results drawn from the extended PMT model revealed that in addition to perceived vulnerability regarding the threat of food safety scandals and perceived self-efficacy, a person's perceived product safety liability of food providers involved in food safety scandals is a significant predictor of his or her protection motivation, which subsequently influences his or her behavioural intentions regarding safe food choices.

Background: To explore the risk factors for and the prognosis of postoperative acute respiratory distress syndrome (ARDS) in patients with Stanford type A aortic dissection (AD). Methods: This retrospective nested case-control study included 527 Stanford type A AD patients who were divided into ARDS groups and non-ARDS groups. The clinical features of the groups were examined. Results: The fifty-nine patients in the ARDS group exhibited extended durations of cardiopulmonary bypass (CPB) (P=0.004), deep hypothermic circulatory arrest (DHCA) (P=0.000), ventilator support (P=0.013) and intensive care unit (ICU) stay (P=0.045), higher hospital costs (P=0.000), larger perioperative transfusions volumes [red blood cells (RBC): P=0.002, platelets (PLT): P=0.040, fresh frozen plasma (FFP): P=0.001], more frequent pulmonary infection (P=0.018) and multiple organ dysfunction syndrome (MODS) (P=0.040) and a higher rate of in-hospital mortality (P=0.020). The ARDS group exhibited worse statuses in terms of oxygenation index (OI) values (P=0.000) and Apache II scores (P=0.000). DHCA (P=0.000, odds ratio (OR)=2.589) and perioperative transfusion (RBC: P=0.000, OR=2.573; PLT: P=0.027, OR=1.571; FFP: P=0.002, OR=1.929) were independent risk factors for postoperative ARDS. The survival rates and median survival times after discharge were similar between the two groups (P=0.843). Conclusions: DHCA duration and perioperative transfusion volume were independent risk factors for postoperative ARDS which warrants greater attention by the cardiac surgeons.

The abuse of ketamine and amphetamine analogs is associated with incidence of hypertension and strokes involving activation of sympathetic activities. Large cerebral arteries at the base of the brain from several species receive dense sympathetic innervation which upon activation causes parasympathetic-nitrergic vasodilation with increased regional blood flow via axo-axonal interaction mechanism, serving as a protective mechanism to meet O2 demand in an acutely stressful situation. The present study was designed to examine effects of ketamine and amphetamine analogs on axo-axonal interaction-mediated neurogenic nitrergic vasodilation in porcine basilar arteries using techniques of blood-vessel myography, patch clamp and two-electrode voltage clamp, and calcium imaging. In U46619-contracted basilar arterial rings, nicotine (100μM) and electrical depolarization of nitrergic nerves by transmural nerve stimulation (TNS, 8Hz) elicited neurogenic nitrergic vasodilations. Ketamine and amphetamine analogs concentration-dependently inhibited nicotine-induced parasympathetic-nitrergic vasodilation without affecting that induced by TNS, nitroprusside or isoproterenol. Ketamine and amphetamine analogs also concentration-dependently blocked nicotine-induced inward currents in Xenopus oocytes expressing α3β2-nicotinic acetylcholine receptors (nAChRs), and nicotine-induced inward currents as well as calcium influxes in rat superior cervical ganglion neurons. The potency in inhibiting both inward-currents and calcium influxes is ketamine>methamphetamine>hydroxyamphetamine. These results indicate that ketamine and amphetamine analogs, by blocking nAChRs located on cerebral perivascular sympathetic nerves, reduce nicotine-induced, axo-axonal interaction mechanism-mediated neurogenic dilation of the basilar arteries. Chronic abuse of these drugs, therefore, may interfere with normal sympathetic-parasympathetic interaction mechanism resulting in diminished neurogenic vasodilation and, possibly, normal blood flow in the brainstem.

Background and purpose Effective management of hypotension refractory to vasoconstrictors in severe sepsis is limited. A new strategy to ameliorate endotoxemic hypotension by inducing endothelium-dependent constriction of large arteries was assessed. Experimental approach Endotoxemia in rats was induced by injection of LPS (10 mg·kg(-1), i.v.). Haemodynamics were measured in vivo, reactivity of isolated mesenteric arteries by myography and expression of proteins and enzyme activities by immunohistochemistry, biochemistry and molecular biology. Key results Six hours after LPS, the hypotension was promptly reversed following injection (i.v. or i.p.) of oroxylin-A (OroA) . In isolated LPS-treated but not normal mesenteric arteries, OroA (1-10 μM) induced endothelium-dependent, sustained constriction, blocked by endothelin-1 (ET-1) receptor antagonists. OroA further enhanced LPS-induced expression of endothelin-converting enzyme, ET-1 mRNA and proteins and ET-1 release, OroA also enhanced phosphorylation of Rho-associated protein kinase (ROCK) and reversed LPS-induced suppression of RhoA activities in smooth muscle of arteries with endothelium. Activated- phosphorylation of smooth muscle ROCK was blocked by ET-1-receptor antagonists and ROCK inhibitors. Moreover, OroA post-treatment suppressed, via inhibiting NF-κB activation, inducible NOS expression and circulating NO. Conclusions and implications Reversal of endotoxemic hypotensive by OroA was due to release of endothelial ET-1, upregulated by LPS, from mesenteric arteries, inducing prompt and sustained vasoconstriction via activation of vascular smooth muscle RhoA/ROCK-pathway. In late endotoxemia, OroA-induced vasoconstriction was partly due to decreased circulating NO. Activation of endothelium-dependent constriction in large resistance arteries and suppression of systemic inflammation offer new strategies for acute management of endotoxemic hypotensive shock.

This study aims to extend the theory of planned behavior (TPB) model to explain people's intentions to engage in energy savings and carbon reduction behaviors that can help mitigate climate change in Taiwan. People's moral obligation to perform such pro-environmental behaviors is further considered in the TPB model. The results indicate that the extended TPB model including moral obligation can increase the explanatory power of the original one. In addition to one's attitudes and subjective norm, one's moral obligation to reduce impact on global warming and climate change plays a significant role in predicting one's intentions to engage in energy savings and carbon reduction behaviors to mitigate climate change problems.

Vascular dysfunction plays a critical role in the pathogenesis of sepsis. We elucidated the mechanisms underlying the amelioration of lipopolysaccharide (LPS)-induced vascular inflammation by oroxylin A (OroA) post-treatment in rats. The animals were intraperitoneally injected with LPS (10 mg/kg) to induce systemic inflammation and intravenously (iv) administered OroA (15 mg/kg) 6 h after the LPS treatment. The assessments included biochemical changes in peripheral blood, vascular reactivity which was evaluated by blood-vessel myography, morphological/histological assessment of inflammation, toll-like receptor (TLR)-4-mediated interleukin-1-receptor-associated-kinase (IRAK)-4 activation, changes in adhesion molecule expression, and endothelial junctional stability in the aorta. LPS significantly enhanced the proinflammatory cytokine release, increased vascular cell adhesion molecule (VCAM)-1 expression, disrupted endothelial tight junction, reduced vascular endothelial barrier stability, and increased macrophage infiltration and accumulation in the aorta. All observed pathological changes and vascular inflammation were significantly reversed by the OroA post-treatment. Importantly, OroA suppressed the increased adhesion molecule expression and the endothelial barrier disruption by inhibiting LPS-activated IRAK-4-targeted inhibitory nuclear factor kappa B kinase (IKK) α/β complex phosphorylation, without directly affecting the interaction between LPS and TLR-4. Moreover, the iNOS activity induced by the LPS challenge was inhibited by the OroA pretreatment of the isolated aortic rings. These results suggest that OroA regulates the vascular tone by inhibiting vascular hyporeactivity caused by NO overproduction and reverses the endothelial barrier dysfunction and inflammation by inhibiting the IRAK-4-mediated IKKα/β phosphorylation. Overall, these findings suggest OroA administration as a potentially useful therapeutic approach for clinical interventions in septic shock.