Publications by authors named "Wen-Ling Chen"

66 Publications

Lipid changes in extrapulmonary organs and serum of rats after chronic exposure to ambient fine particulate matter.

Sci Total Environ 2021 Aug 10;784:147018. Epub 2021 Apr 10.

Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan.

Fine particulate matter (PM) is able to pass through the respiratory barrier to enter the circulatory system and can consequently spread to the whole body to cause toxicity. Although our previous studies have revealed significantly altered levels of phosphorylcholine-containing lipids in the lungs of rats after chronic inhalation exposure to PM, the effects of PM on phosphorylcholine-containing lipids in the extrapulmonary organs have not yet been elucidated. In this study, we examined the lipid effects of chronic PM exposure on various organs and serum by using a rat inhalation model followed by a mass spectrometry-based lipidomic approach. Male Sprague-Dawley rats were continuously exposed at the whole body level to nonfiltered and nonconcentrated ambient air from the outside environment of Taipei city for 8 months, while the control rats inhaled filtered air simultaneously. After exposure, serum samples and various organs, including the testis, pancreas, heart, liver, kidney, spleen, and epididymis, were collected for lipid extraction and analysis to examine the changes in phosphorylcholine-containing lipids after exposure. The results from the partial least squares discriminant analysis models demonstrated that the lipid profiles in the PM exposure group were different from those in the control group in the rat testis, pancreas, heart, liver, kidney and serum. The greatest PM-induced lipid effects were observed in the testes. Decreased lyso-phosphatidylcholines (PCs) as well as increased unsaturated diacyl-PCs and sphingomyelins in the testes may be related to maintaining the membrane integrity of spermatozoa, antioxidation, and cell signaling. Additionally, our results showed that decreased PC(16:0/18:1) was observed in both the serum and testes. In conclusion, exposure to chronic environmental concentrations of PM caused lipid perturbation, especially in the testes of rats. This study highlighted the susceptibility of the testes and suggested possible molecular events for future study.
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http://dx.doi.org/10.1016/j.scitotenv.2021.147018DOI Listing
August 2021

Wide-scope screening for pharmaceutically active substances in a leafy vegetable cultivated under biogas slurry irrigation.

Sci Total Environ 2021 Jan 13;750:141519. Epub 2020 Aug 13.

Water Research Unit, Faculty of Science and Technology, University Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia.

The use of livestock waste for the production of biogas and the application of biogas slurry to agricultural soil can resolve livestock waste problems and reduce synthetic fertiliser use. However, the migration of veterinary drugs to land and crops resulting from biogas slurry irrigation is a potential food safety concern. This study employed an ultra-performance liquid chromatography coupled with quadrupole-time of flight high-resolution mass spectrometry system for wide-scope suspect screening of pharmaceutically active substances on crop cultivated under biogas slurry irrigation. Briefly, a total of 22 pak choi samples were obtained from a greenhouse farmed in tropical south Taiwan between March 2019 and March 2020. Molecular spectra and fragmented ions (between m/z 70 and 1100) were acquired. Ion features were searched and matched with a library consisting of 1068 compounds. The matrixes in the crop production environment including soil, livestock wastewater, biogas slurry, and groundwater were included in this study to elucidate potential sources of the pharmaceutically active substances. Results demonstrated 23 suspects were matched with high mass accuracy (mass error within ±5.0 ppm) in pak choi. The detection of both bufexamac and nandrolone were confirmed using standards, where a new system of identification points was applied. Nandrolone was detected throughout the pak choi samples as well as livestock wastewater. Tetracycline, macrolide, and sulfonamide antibiotics were presented in biogas slurry and soil but not pak choi. This is the first study to reveal the presence of multiclass pharmaceutically active substances in a crop supplied as food. Such findings suggest that anabolics and antibiotics should be closely monitored in the corps irrigated by biogas slurry in future.
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http://dx.doi.org/10.1016/j.scitotenv.2020.141519DOI Listing
January 2021

New insights of metal free 2D graphitic carbon nitride for photocatalytic degradation of bisphenol A.

J Hazard Mater 2021 01 17;402:123509. Epub 2020 Jul 17.

Institute of Food Safety and Health, College of Public Health, National Taiwan University, 17 Xuzhou Rd., Taipei, 100, Taiwan, ROC; Department of Public Health, College of Public Health, National Taiwan University, 17 Xuzhou Rd., Taipei, 100, Taiwan, ROC.

Polymeric oxygen rich exfoliated graphitic carbon nitride (exfoliated GCN, EGCN) was synthesized by the acid treatment of bulk GCN. The photocatalyst was characterized using X-ray diffraction, scanning electron microscopy, X-ray photoelectron spectroscopy, Fourier transform infrared spectroscopy, and point of zero charge. EGCN shows high valance band hole transfer under short-time visible light (λ > 420 nm) exposure for photocatalytic mineralization of bisphenol A (BPA). Enhanced BPA removal was achieved by EGCN (99 %) due to formation of OH radicals (HO/h →OH/H). Major factors affecting BPA degradation including catalyst dose, wide pH range, and pollutant concentration were optimized. Repeated cycles of BPA degradation were performed with negligible rate decreased from 0.045 to 0.029 min. The degradation profile and plausible reaction mechanism of BPA was established and well justified by the byproducts identified by mass analysis HR-ESI-MS. Therefore, the as-synthesized metal free EGCN, active under visible light, offers a new platform for complete mineralization of byproducts of halogenated organic contaminants.
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http://dx.doi.org/10.1016/j.jhazmat.2020.123509DOI Listing
January 2021

The Effects of Biofeedback Training and Smartphone-Delivered Biofeedback Training on Resilience, Occupational Stress, and Depressive Symptoms among Abused Psychiatric Nurses.

Int J Environ Res Public Health 2020 04 22;17(8). Epub 2020 Apr 22.

School of Nursing, College of Nursing, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Kaohsiung 807, Taiwan.

Psychiatric ward (PW) nurses are at a higher risk to encounter workplace violence than are other healthcare providers, and many interventions have been developed to improve their mental health. We compared the effectiveness of biofeedback training (BT) and smartphone-delivered BT (SDBT) interventions on occupational stress, depressive symptoms, resilience, heart rate variability, and respiration rate in a sample of abused PW nurses. This was a quasi-experimental study. Structured questionnaires were administered before and six weeks after the intervention. Data were collected from April 2017 to October 2017. A total of 159 abused PW nurses were randomly assigned to BT, SDBT, and control groups, and 135 of them completed all processes of our protocol, with the study consisting of 119 females (88.1%) and 16 males (11.9%) and their age range being from 22 to 59 with the mean age of 35.61 and a standard deviation of 8.16. Compared to the controls, both the BT and the SDBT intervention groups experienced significant improvements in depressive symptoms, resilience, and respiration rate; and the SDBT group experienced significant reductions in occupational stress. Considering the cost, accessibility, restrictions time and space, SDBT be used as an effective intervention in people with resilience or occupational stress.
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http://dx.doi.org/10.3390/ijerph17082905DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7215829PMC
April 2020

[A Nursing Experience Enhancing the Resilience Capacity of a Patient With Chronic Schizophrenia].

Hu Li Za Zhi 2020 Feb;67(1):113-119

MSN, RN, Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan, ROC.

The article describes the author's nursing experience providing psychiatric homecare to a patient with chronic schizophrenia using the concept of resilience. Holistic nursing assessments were conducted via clinical observations during home visits every two weeks from May 24th to September 20th, 2018. Through these assessments, the main health problems of the patient were defined as ineffective self-health management, ineffective coping skills, and insufficient resilience. The nursing interventions implemented were designed to establish the patient's capacity to effectively and correctly self-manage health status, achieve emotional accommodation, and reduce parent-child conflicts. In order to enhance the resilience of the patient, the patient was guided to review important support resources over the course of illness, to detect the barriers of returning society, to apply the beneficial skills of health management, and then extend the status of employment and to enhance self-fulfillment.
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http://dx.doi.org/10.6224/JN.202002_67(1).14DOI Listing
February 2020

Targeted profiling of chlorinated transformation products and the parent micropollutants in the aquatic environment: A comparison between two coastal cities.

Chemosphere 2020 Mar 2;242:125268. Epub 2019 Nov 2.

Research Center for Environmental Changes, Academia Sinica, Taiwan.

This study investigated chlorinated transformation products (TPs) and their parent micropollutants, aromatic pharmaceuticals and personal care products (PPCPs) in the urban water bodies of two metropolitan cities. Nine PPCPs and 16 TPs were quantitatively or semi-quantitatively determined using isotope dilution techniques and liquid chromatography-tandem mass spectrometry. TPs and most PPCPs were effectively removed by conventional wastewater treatments in a wastewater treatment plant (WWTP). Chlorinated parabens and all PPCPs (at concentrations below 1000 ng/L) were present in the waters receiving treated wastewater. By contrast, the waters receiving untreated wastewater contained higher levels of PPCPs (up to 9400 ng/L) and more species of chlorinated TPs including chlorinated parabens, triclosan, diclofenac, and bisphenol A. The very different chemical profiles between the water bodies of the two cities of similar geographical and climatic properties may be attributed to their respective uses of chemicals and policies of wastewater management. No apparent increase in the number of species or abundances of TPs was observed in either the chlorinated wastewater or the seawater rich in halogens. This is the first study to elucidate and compare the profiles of multiple TPs and their parent PPCPs in the water bodies of coastal cities from tropical islands. Our findings suggest that chlorinated derivatives of bisphenol A, diclofenac, triclosan, and parabens in the surface water originate from sources other than wastewater disinfection or marine chlorination. Although further studies are needed to identify the origins, conventional wastewater treatments may protect natural water bodies against contamination by those chlorinated substances.
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http://dx.doi.org/10.1016/j.chemosphere.2019.125268DOI Listing
March 2020

Dysregulation of cystathionine γ-lyase promotes prostate cancer progression and metastasis.

EMBO Rep 2019 10 29;20(10):e45986. Epub 2019 Aug 29.

Institute of Molecular and Genomic Medicine, National Health Research Institutes, Zhunan, Miaoli County, Taiwan.

Hydrogen sulfide (H S), an endogenous signaling gaseous molecule, is involved in various physiological activities, including vessel relaxation, regulation of cellular bioenergetics, inflammation, and angiogenesis. By using xenograft orthotopic implantation of prostate cancer PC3 cells and subsequently comparing bone metastatic with primary tumor-derived cancer cells, we find that H S-producing enzyme cystathionine γ-lyase (CTH) is upregulated in bone-metastatic PC3 cells. Clinical data further reveal that the expression of CTH is elevated in late-stage prostate cancer patients, and higher CTH expression correlates with poor survival from The Cancer Genome Atlas (TCGA) prostate cancer RNA-seq datasets. CTH promotes NF-κB nuclear translocation through H S-mediated sulfhydration on cysteine-38 of the NF-κB p65 subunit, resulting in increased IL-1β expression and H S-induced cell invasion. Knockdown of CTH in PC3 cells results in the suppression of tumor growth and distant metastasis, while overexpression of CTH in DU145 cells promotes primary tumor growth and lymph node metastasis in the orthotopic implanted xenograft mouse model. Together, our findings provide evidence that CTH generated H S promotes prostate cancer progression and metastasis through IL-1β/NF-κB signaling pathways.
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http://dx.doi.org/10.15252/embr.201845986DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6776913PMC
October 2019

The synergy between RSC, Nap1 and adjacent nucleosome in nucleosome remodeling.

Biochim Biophys Acta Gene Regul Mech 2019 02 26;1862(2):129-140. Epub 2018 Dec 26.

Department of Life Sciences and Institute of Genome Sciences, National Yang-Ming University, Taiwan. Electronic address:

Eukaryotes have evolved a specific strategy to package DNA. The nucleosome is a 147-base-pair DNA segment wrapped around histone core proteins that plays important roles regulating DNA-dependent biosynthesis and gene expression. Chromatin remodeling complexes (RSC, Remodel the Structure of Chromatin) hydrolyze ATP to perturb DNA-histone contacts, leading to nucleosome sliding and ejection. Here, we utilized tethered particle motion (TPM) experiments to investigate the mechanism of RSC-mediated nucleosome remodeling in detail. We observed ATP-dependent RSC-mediated DNA looping and nucleosome ejection along individual mononucleosomes and dinucleosomes. We found that nucleosome assembly protein 1 (Nap1) enhanced RSC-mediated nucleosome ejection in a two-step disassembly manner from dinucleosomes but not from mononucleosomes. Based on this work, we provide an entire reaction scheme for the RSC-mediated nucleosome remodeling process that includes DNA looping, nucleosome ejection, the influence of adjacent nucleosomes, and the coordinated action between Nap1 and RSC.
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http://dx.doi.org/10.1016/j.bbagrm.2018.11.008DOI Listing
February 2019

Concentrations of perfluoroalkyl substances in foods and the dietary exposure among Taiwan general population and pregnant women.

J Food Drug Anal 2018 07 17;26(3):994-1004. Epub 2018 Jan 17.

Institute of Environmental Health, National Taiwan University, Taipei, Taiwan; Department of Public Health, National Taiwan University, Taipei, Taiwan. Electronic address:

This study quantified five perfluorocarboxylic acids (PFCAs) and two perfluorosulfonic acids in cereals, meats, seafood, eggs, pork liver, and milk in Taiwan using ultra-performance liquid chromatography-tandem mass spectrometry and evaluated the dietary exposure of the general population and pregnant women using per capita consumption and a questionnaire, respectively. Perfluorooctanoic acid (PFOA) and PFCAs of 10-12 carbons were found in almost all of the samples in considerable concentrations in rice and pork liver, reaching as high as 283 ng/g (PFOA in pork liver); the levels are two to three orders of magnitude higher than previous reports. Perfluorooctane sulfonate (PFOS), the most frequently mentioned perfluoroalkyl substance, was rarely detected in many food items (detection frequencies <20% in rice, flour, pork, chicken, salmon, squid, eggs, and milk) at <0.4 ng/g, except for beef, pork liver and some seafood (detection frequencies: 100%, GMs: 0.05-3.52 ng/g). Compared to populations in Western countries, people in Taiwan are exposed to much more perfluorohexanoic acid, PFOA, perfluorodecanoic acid, and perfluoroundecanoic acid (11.2, 85.1, 44.2, and 4.45 ng/kg b.w./day, respectively), mainly due to the higher contaminations in food. The exposure of 8.0 μg PFOA/person/day in the 95 percentile of pregnant women was due to their frequent consumption of pork liver.
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http://dx.doi.org/10.1016/j.jfda.2017.12.011DOI Listing
July 2018

Systematic screening and identification of the chlorinated transformation products of aromatic pharmaceuticals and personal care products using high-resolution mass spectrometry.

Sci Total Environ 2018 Oct 8;637-638:253-263. Epub 2018 May 8.

Department of Environmental Science and Engineering, College of Engineering, Tunghai University, No. 1727, Sec. 4, Taiwan Boulevard, Xitun District, Taichung 40704, Taiwan.

Pharmaceuticals and personal care products (PPCPs) are an emerging concern because of the large amount of PPCPs that is discharged and its potential ecological effects on the aquatic environment. Chlorination has proven efficient for removing some aromatic PPCPs from wastewater, but the formation of by-products has not been thoroughly investigated partly because of analytical difficulties. This study developed a method for systematically screening and identifying the transformation products (TPs) of multiple aromatic PPCPs through high-resolution mass spectrometry (HRMS). We spiked an environmentally relevant concentration (5000 ng/L) of three anti-inflammatory drugs, four parabens, bisphenol A, oxybenzone, and triclosan in the Milli-Q water and water containing natural organic matter (NOM). Low-dose chlorination (0.2-0.7 mg/L) was performed. We compared the chemical profiles of the chlorinated and untreated water and selected the ions to be identified based on the results of t-test and the ratio of signal intensities. Compound matching and isotopic pattern comparison were applied to characterising the molecular formulae of TPs. The fragmentation of the PPCPs and TPs was used in elucidating the structures of the TPs. The confirmation of TPs was achieved by comparing the retention time and fragment patterns of TPs with the isomer standards. In the chlorinated water, the aromatic PPCPs were substantially removed, except for the anti-inflammatory drugs (removal rates -5.2%-26%). Even with moderate chlorine dosages, all of the aromatic PPCPs, except for acetylsalicylic acid, were transformed into chlorinated derivatives in the Milli-Q water, and so were some PPCPs in the NOM-added water. The results of structure elucidation and compound confirmation as well as the increases in log K suggested that chlorination could transform aromatic PPCPs into more persistent, bioaccumulative, and toxic TPs. The presence of these TPs in the effluents where the PPCPs are removed through chlorination may pose increased risks to aquatic organisms.
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http://dx.doi.org/10.1016/j.scitotenv.2018.05.011DOI Listing
October 2018

Wild-type p53 upregulates an early onset breast cancer-associated gene GAS7 to suppress metastasis via GAS7-CYFIP1-mediated signaling pathway.

Oncogene 2018 07 30;37(30):4137-4150. Epub 2018 Apr 30.

Institute of Molecular and Genomic Medicine, National Health Research Institute, Miaoli, Taiwan.

The early onset breast cancer patients (age ≤ 40) often display higher incidence of axillary lymph node metastasis, and poorer five-year survival than the late-onset patients. To identify the genes and molecules associated with poor prognosis of early onset breast cancer, we examined gene expression profiles from paired breast normal/tumor tissues, and coupled with Gene Ontology and public data base analysis. Our data showed that the expression of GAS7b gene was lower in the early onset breast cancer patients as compared to the elder patients. We found that GAS7 was associated with CYFIP1 and WAVE2 complex to suppress breast cancer metastasis via blocking CYFIP1 and Rac1 protein interaction, actin polymerization, and β1-integrin/FAK/Src signaling. We further demonstrated that p53 directly regulated GAS7 gene expression, which was inversely correlated with p53 mutations in breast cancer specimens. Our study uncover a novel regulatory mechanism of p53 in early onset breast cancer progression through GAS7-CYFIP1-mediated signaling pathways.
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http://dx.doi.org/10.1038/s41388-018-0253-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6062498PMC
July 2018

Self-rated health is associated with subsequent functional decline among older adults in Japan.

Int Psychogeriatr 2017 09 31;29(9):1475-1483. Epub 2017 May 31.

Center for Southeast Asian Studies,Kyoto University,Kyoto,Japan.

Background: Previous studies have reported that self-rated health (SRH) predicts subsequent mortality. However, less is known about the association between SRH and functional ability. The aim of this study was to examine whether SRH predicts decline in basic activities of daily living (ADL), even after adjustment for depression, among community-dwelling older adults in Japan.

Methods: A three-year prospective cohort study was conducted among 654 residents aged 65 years and older without disability in performing basic ADL at baseline. SRH was assessed using a visual analogue scale (range; 0-100), and dichotomized into low and high groups. Information on functional ability, sociodemographic factors, depressive symptoms, and medical conditions were obtained using a self-administered questionnaire. Logistic regression analysis was used to examine the association between baseline SRH and functional decline three years later.

Results: One hundred and eight (16.5%) participants reported a decline in basic ADL at the three-year follow-up. Multiple logistic regression analysis showed that the low SRH group had a higher risk for functional decline compared to the high SRH group, even after controlling for potential confounding factors (odds ratio (OR) = 2.4; 95% confidence interval (CI) = 1.3-4.4). Furthermore, a 10-point difference in SRH score was associated with subsequent functional decline (OR = 1.37; 95% CI = 1.16-1.61).

Conclusions: SRH was an independent predictor of functional decline. SRH could be a simple assessment tool for predicting the loss or maintenance of functional ability in community-dwelling older adults. Positive self-evaluation might be useful to maintain an active lifestyle and stay healthy.
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http://dx.doi.org/10.1017/S1041610217000692DOI Listing
September 2017

Hip Ganglion Cyst Causing Femoral Nerve Dysesthesia.

Am J Phys Med Rehabil 2017 12;96(12):e227

From the Department of Physical Medicine and Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan, ROC (WL-C); and Department of Medical Imaging, Taipei Medical University Hospital, Taipei, Taiwan, ROC (JCHT).

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http://dx.doi.org/10.1097/PHM.0000000000000737DOI Listing
December 2017

Perinatal imaging findings and molecular genetic analysis of thanatophoric dysplasia type 1 in a fetus with a c.2419T>G (p.Ter807Gly) (X807G) mutation in FGFR3.

Taiwan J Obstet Gynecol 2017 Feb;56(1):87-92

Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan; Department of Bioengineering, Tatung University, Taipei, Taiwan.

Objective: We present perinatal imaging findings and molecular genetic analysis of thanatophoric dysplasia type I (TD1) in a fetus.

Case Report: A 28-year-old woman was referred for genetic counseling at 22 weeks of gestation because of abnormal prenatal ultrasound findings. Level II ultrasound examination revealed a narrow chest, shortened and curved long limbs, protrusion of the abdomen, and macrocephaly. A tentative diagnosis of TD1 was made. After genetic counseling, the pregnancy was terminated and a malformed fetus was delivered. Postnatal radiography findings were consistent with the diagnosis of TD1, with additional findings of short ribs, platyspondyly, and horizontal acetabular roofs. Molecular genetic analysis using umbilical cord tissue revealed a heterozygous mutation of c.2419T>G (p.Ter807Gly) (X807G) in the fibroblast growth factor receptor 3 gene (FGFR3).

Conclusion: A second-trimester fetus with a heterozygous c.2419T>G mutation in FGFR3 may present characteristic ultrasound and X-ray findings of TD1.
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http://dx.doi.org/10.1016/j.tjog.2016.12.013DOI Listing
February 2017

Occurrence of nonylphenol and bisphenol A in household water pipes made of different materials.

Environ Monit Assess 2015 Oct 13;188(10):562. Epub 2016 Sep 13.

Institute of Environmental Health, National Taiwan University, Taipei, Taiwan.

We assessed the occurrence of nonylphenol (NP) and bisphenol A (BPA) in tap water supplied through polyvinyl chloride (PVC), stainless steel, and galvanized pipes. Water samples were collected from selected households in Taipei and Kaohsiung (Northern and Southern Taiwan, respectively) in different seasons to elucidate the effects of pipeline materials and ambient temperatures on NP and BPA concentrations in tap water. We detected higher concentrations of NP in tap water from households using PVC pipes (64-195 ng/L) than from those using stainless steel pipes (17-44 ng/L) and galvanized pipes (27-96 ng/L). To verify that water can absorb NP and BPA from PVC pipes, we sealed Milli-Q and tap water in PVC and stainless steel pipes to assess the potential release of NP and BPA from the pipes into the water. Both NP and BPA concentrations initially increased with contact time in the PVC pipes, and the concentration profiles during the retention appeared to be more strongly affected by ambient temperatures. Concentration variations in the stainless steel pipes were smaller than those in the PVC pipes.
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http://dx.doi.org/10.1007/s10661-016-5556-0DOI Listing
October 2015

Evaluation of three-dimensional scapular kinematics and shoulder function in patients with short malunion of clavicle fractures.

J Orthop Sci 2016 Nov 5;21(6):739-744. Epub 2016 Aug 5.

Department of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan. Electronic address:

Background: The presence of short malunion of clavicle fractures could result in alterations in static scapular position and dynamic scapular motion. Nevertheless, no report has ever addressed the kinematic changes of the scapula in patients with short malunion of clavicular fractures. The goal of this study was to compare the changes of shoulder function, and the consequent scapular kinematic changes between the fractured side and the sound side of the shoulder in non-surgically treated patients.

Methods: Fourteen patients with a short malunion (>10 mm) of midshaft clavicular fracture following conservative treatment were recruited. Outcome analysis included standard clinical follow-up, plain radiography, Shoulder Pain and Disability Index (SPADI) score, shoulder range of motion (ROM), shoulder muscle strength and scapular resting position. The 3-dimensional scapular motion during arm movement in the scapular plane was recorded using an electromagnetic tracking device. The kinematic changes between the fractured side and sound side were analyzed.

Results: The mean shortening length of the clavicle was 12.9 ± 2.8 mm. The fractured sides showed a significantly higher SPADI score and limited ROM in both shoulder flexion and abduction. Significantly weaker shoulder external rotators (1.1 kg, p = 0.017) and lower trapezius (0.7 kg, p = 0.041) were found in the fractured sides when compared with the sound side. The fractured side exhibited significantly more forward shoulder (3.9 mm, p = 0.034) and slightly more anteriorly tilted scapula (5.8°, p = 0.094) in static scapular position. Scapular kinematics showed that the fractured side trended toward greater scapular internal rotation and smaller posterior tilt during arm elevation and lowering phases, especially after the arm rising above horizontal level.

Conclusions: This study showed that significant changes in scapular kinematics and shoulder function were found after short malunion of clavicle fractures. Recognition and evaluation of the changes could lead to a comprehensive framework regarding the treatment of shortened clavicle fractures.
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http://dx.doi.org/10.1016/j.jos.2016.07.005DOI Listing
November 2016

Measuring Ochratoxin A Concentrations in Coffee Beverages with Immunoaffinity Columns and Ultra-Performance Liquid Chromatography/Tandem Mass Spectrometry.

J AOAC Int 2016 Mar-Apr;99(2):469-74. Epub 2016 Mar 9.

National Taiwan University, Institute of Environmental Health and Department of Public Health, 17 Hsu-Chou Rd, Taipei 10055, Taiwan.

This study developed and validated a method for measuring concentrations of ochratoxin A (OTA) in coffee beverages, not coffee beans. The new method involved extraction using immunoaffinity columns and ultra-performance LC (UPLC)-MS/MS using isotope-dilution techniques. The combination of a fused-core column and UPLC significantly shortened chromatographic time to 3 min compared to reported UPLC methods. The method was sensitive, with an LOD and LOQ of 0.52 and 1.73 pg/mL, respectively. Quantitative intraday (n = 4) and interday (n = 4) biases and RSD were both below 15%. The OTA levels in 40 samples of freshly brewed coffee from chain stores, 24 samples of canned ready-to-drink coffee, and 6 beverages made from instant coffee granules ranged from 1.60 to 93.2 pg/mL (90% positive), 6.00 to 131 pg/mL (100% positive), and 21.8 to 59.0 pg/mL (100% positive), respectively. Based on published tolerable daily intake, men and women in Taiwan should consume no more than 6.3 and 5.1 fifteen gram packages of instant coffee per day, respectively. Specific suggestions were not made for brewed coffee and canned coffee because of their large variation in OTA concentrations. This study should be more relevant to actual human exposure than those studying OTA in green, roasted, and ground coffee beans alone.
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http://dx.doi.org/10.5740/jaoacint.15-0233DOI Listing
February 2017

Quantitative determination of ultra-trace carbazoles in sediments in the coastal environment.

Chemosphere 2016 May 24;150:586-595. Epub 2016 Feb 24.

Helmholtz-Zentrum Geesthacht, Centre for Materials and Coastal Research, Institute of Coastal Research, Department for Environmental Chemistry, Geesthacht 21502, Germany. Electronic address:

Carbazole and some of its derivatives may possess dioxin-like toxicity and could be persistent in the environment, but information on their distribution and environmental fate is limited. This study developed and validated an ultra-trace targeted-analysis method for the determination of carbazole, 1,2-benzocarbazole, and 13 halogenated carbazoles in sediments from the river, coast, and North Sea. An 8-g sediment sample was extracted using accelerated solvent extraction combined with in-cell cleanup and analyzed using gas chromatography-tandem mass spectrometry. The method was sensitive and reliable with method detection limits ranging from 4.54 to 52.9 pg/g, and most of the quantification biases and relative standard deviations were <20 and <15%, respectively. Carbazole and 1,2-benzocarbazole were the predominant substances in the sediments (median 565 and 369 pg/g, respectively) followed by 3,6-dichlorocarbazole (median 196 pg/g). The detection frequencies of carbazole, benzo-, 3-chloro-, and 3,6-dichlorocarbazole were >75%, while those of 3,6-dibromo-, 1-bromo-3,6-dichloro-, and 1,8-dibromo-3,6-dichlorocarbazole were approximately 50%. Brominated carbazoles occurred more frequently in marine than river-influenced sediments, which could indicate halogenation after discharge into the river. This is the first study regarding these substances in coastal environments without apparent contamination history. The ubiquity and bioaccumulative potential of these substances needs to be considered.
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http://dx.doi.org/10.1016/j.chemosphere.2016.02.051DOI Listing
May 2016

Postcard intervention for depression in community-dwelling older adults: A randomised controlled trial.

Psychiatry Res 2015 Sep 11;229(1-2):545-50. Epub 2015 Jun 11.

The Center for Southeast Asian Studies, Kyoto University, Japan.

Depression in older adults erodes their health, quality of life and the economy. Existing interventions are not feasible for broad application at the community. Postcard intervention only requires a few resources, and previous studies have shown its effectiveness for patients following drug overdose, self-harm and hospitalisation for major depression. The purpose of the present study is to evaluate the effectiveness of a postcard intervention. Participants were community-dwelling individuals, aged 65 or older, who eat meals alone and with the score of 4 or higher on the 15-item Geriatric Depression Scale (GDS-15). We enrolled 184 eligible participants, with 93 in the intervention and 91 in the control arm. Postcards were sent to participants once a month for eight months. Primary outcome was the GDS-15 score at post-intervention. Secondary outcomes were quality of life and activities of daily living. There was no significant difference in primary and secondary outcomes between completers of the intervention and the control arm. However, most of the participants who received intervention thought the intervention was effective. The postcard intervention for depression in community-dwelling elderly people in Japan is neither feasible nor effective. However, the descriptive results suggest that the intervention may be effective given different parameters.
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http://dx.doi.org/10.1016/j.psychres.2015.05.054DOI Listing
September 2015

Association between risk perception, subjective knowledge, and depression in community-dwelling elderly people in Japan.

Psychiatry Res 2015 May 11;227(1):27-31. Epub 2015 Mar 11.

The Center for Southeast Asian Studies, Kyoto University, 46 Yoshida Shimoadachi-cho, Sakyo-ku, Kyoto 606-8501, Japan.

Risk perception is one of the core factors in theories of health behavior promotion. However, the association between knowledge, risk perception, and depressed mood in depression is unknown. The aim of this study was to clarify the relationships between subjective knowledge, risk perception, and objective scores of depression in community-dwelling elderly people in Japan. A total of 747 elderly participants (mean age: 76.1, female: 59.8%) who completed the 15-item Geriatric Depression Scale (GDS-15) along with items assessing subjective knowledge and risk perception were included in the analysis. We assessed the correlation between subjective knowledge and risk perception, and then compare GDS-15 scores by level of subjective knowledge and risk perception. Subjective knowledge was weakly associated with risk perception and related to lower GDS-15 scores in a dose-response pattern, which did not change after adjusting for age, gender, basic activities of daily living (ADL), instrumental ADL, years of education and history of depression. There was no significant association between risk perception and GDS-15 scores. The relationship between knowledge, risk perception, and depressed mood in younger generations is unclear, but warrants examination.
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http://dx.doi.org/10.1016/j.psychres.2015.03.002DOI Listing
May 2015

[Depression and related factors in mothers of school-aged children with attention-deficit hyperactivity disorder].

Hu Li Za Zhi 2015 Feb;62(1):39-49

School of Nursing, Kaohsiung Medical University, Taiwan, ROC.

Background: The mothers of children with attention-deficit hyperactivity disorder tend to experience depression at higher levels because of the poor social interaction and deviant behaviors of their children. These depressed mothers often harm themselves and negatively impact their family and community.

Purpose: This study examines maternal depression and its related factors in the mothers of school-aged children with attention-deficit hyperactivity disorder.

Methods: A cross-sectional study with a purposive sampling of 100 mothers of school-age children with attention-deficit hyperactivity disorder was developed. Data were collected using a structured questionnaire that included the Parenting Stress Index (PSI), social support scale, and the Beck Depression Inventory (BDI). The Pearson product moment correlation and stepwise multiple regression were used to analyze data.

Results: The findings showed that almost half of the mothers with school-aged ADHD children suffered higher pa-renting stress and that 34% required professional psychiatry referral. In addition, 40% of the participants suffered from depression. Higher levels of parenting stress were associated with a higher incidence of depression (r = .647, p < .001). Participants with better social support had lower depression levels (r = -.327, p < .01). 'Parenting stress' and having a monthly total household income of ≤ NT$40,000 were significant predictors of maternal depression. 'Maternal stress' was the most significant predictor, with a total explained variance of 41.9% (R(2) change = 41.9%).

Conclusions: The results of this study are intended to help medical staff better care for the mothers of school-aged children with ADHD. These results will assist in the evaluation of maternal depression, parenting stress, and levels of required social support. It will especially help in the evaluation of maternal depression symptoms of those mothers of low socioeconomic status with high parenting stress. Providing these mothers with parental training, education on effective parenting and discipline strategies, and better social support may effectively reduce maternal depression, which will help minimize the negative impacts of this depression on the family and the community.
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http://dx.doi.org/10.6224/JN.62.1.39DOI Listing
February 2015

Buddhist social networks and health in old age: A study in central Thailand.

Geriatr Gerontol Int 2015 Nov 11;15(11):1210-8. Epub 2014 Dec 11.

The Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan.

Aim: Religious social networks are well known for their capacity to improve individual health, yet the effects of friendship networks within the Buddhist context remain largely unknown. The present study aimed to compare health status and social support in community-dwelling older adults according to their level of Buddhist social network (BSN) involvement, and to examine the association between BSN involvement and functional health among older adults.

Methods: A cross-sectional survey was carried out among 427 Buddhist community-dwelling older adults aged ≥60 years in Nakhon Pathom, Thailand. Data were collected from home-based personal interviews using a structured questionnaire. Health status was defined according to the measures of basic and advanced activities of daily living (ADL), the 15-item Geriatric Depression Scale and subjective quality of life. Perceived social support was assessed across the four dimensions of tangible, belonging, emotional and information support. Multiple logistic regression was used for analysis.

Results: Older adults with BSN involvement reported better functional, mental and social health status, and perceived greater social support than those without BSN involvement. In addition, BSN involvement was positively associated with independence in basic and advanced ADL. After adjusting for age, sex, education, income, morbidity and depressive symptoms, BSN showed a strong association with advanced ADL and a weak association with basic ADL.

Conclusion: The results show that involvement in BSN could contribute positively to functional health, particularly with regard to advanced ADL. Addressing the need for involvement in these networks by older adults might help delay functional decline and save on healthcare costs.
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http://dx.doi.org/10.1111/ggi.12421DOI Listing
November 2015

Depression and subjective economy among elderly people in Asian communities: Japan, Taiwan, and Korea.

Arch Gerontol Geriatr 2015 Mar-Apr;60(2):322-7. Epub 2014 Nov 13.

The Center for Southeast Asian Studies, Kyoto University, 46 Yoshida Shimoadachi-cho, Sakyo-ku, Kyoto 606-8501, Japan.

The objective of this study is to investigate the cross-cultural relationship between depressive state and subjective economic status, as well as subjective quality of life (QOL) and activities of daily living (ADL) among elderly people in communities in Japan, Taiwan, and Korea. We studied 595 subjects aged 65 years or older in three Asian communities (261 subjects in T town in Japan, 164 in D town in Taiwan, and 170 in H town in Korea). The Geriatric Depression Scale-15, a self-rating questionnaire assessing ADL, subjective QOL, social situations, and past and current medical status, was used. Depression of the elderly was associated with dependence in basic ADL, subjective QOL, and subjective sense of low economic status. After adjusting for the effects of age, sex, and basic ADL, subjective sense of low economic status was closely associated with depression in community-living elderly people in all three communities in Asia. In conclusion, absolute and objective economic status is an important contributing factor to depressive state or psychosocial deterioration, however, we should pay more attention to the roles of perception of low economic status in determining depressive state in community-dwelling elderly people.
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http://dx.doi.org/10.1016/j.archger.2014.11.003DOI Listing
July 2015

Ipsative imputation for a 15-item Geriatric Depression Scale in community-dwelling elderly people.

Psychogeriatrics 2014 Sep;14(3):182-7

Department of Field Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Background: Missing data are inevitable in almost all medical studies. Imputation methods using the probabilistic model are common, but they cannot impute individual data and require special software. In contrast, the ipsative imputation method, which substitutes the missing items by the mean of the remaining items within the individual, is easy and does not need any special software, but it can provide individual scores. The aim of the present study was to evaluate the validity of the ipsative imputation method using data involving the 15-item Geriatric Depression Scale.

Methods: Participants were community-dwelling elderly individuals (n = 1178). A structural equation model was constructed. The model fit indexes were calculated to assess the validity of the imputation method when it is used for individuals who were missing 20% of data or less and 40% of data or less, depending on whether we assumed that their correlation coefficients were the same as the dataset with no missing items. Finally, we compared path coefficients of the dataset imputed by ipsative imputation with those by multiple imputation.

Results: When compared with the assumption that the datasets differed, all of the model fit indexes were better under the assumption that the dataset without missing data is the same as that that was missing 20% of data or less. However, by the same assumption, the model fit indexes were worse in the dataset that was missing 40% of data or less. The path coefficients of the dataset imputed by ipsative imputation and by multiple imputation were compatible with each other if the proportion of missing items was 20% or less.

Conclusion: Ipsative imputation appears to be a valid imputation method and can be used to impute data in studies using the 15-item Geriatric Depression Scale, if the percentage of its missing items is 20% or less.
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http://dx.doi.org/10.1111/psyg.12060DOI Listing
September 2014

Relationships between each category of 25-item frailty risk assessment (Kihon Checklist) and newly certified older adults under Long-Term Care Insurance: A 24-month follow-up study in a rural community in Japan.

Geriatr Gerontol Int 2015 Jul 15;15(7):864-71. Epub 2014 Oct 15.

School of Public Health, Kyoto University, Kyoto, Japan.

Aim: The 25-item Kihon Checklist (KCL) is the official self-administered questionnaire tool to screen frail older adults, consisting of seven categories: physical strength, nutritional status, oral function, houseboundness, cognitive function, depression risk and a score of more than 9 out of 1-20 items. The aim of the present study was to evaluate the relationships between each category of the KCL and newly certified cases under the Long-Term Care Insurance (LTCI) in Japan during 24 months.

Method: The study population consisted of 883 community-dwelling adults aged 65 years or older uncertified by LTCI completing a questionnaire, which included the KCL and scales of basic/advanced activities of daily living (ADL), quality of life (QOL), and depressive symptoms. The participants were categorized into the risk or non-risk group depending on the official criteria of each KCL category. The outcome was the incidence of newly certified cases by LTCI during 24 months. The difference between the risk and non-risk group was analyzed by Cox regression hazard models.

Results: Scores in basic/advanced ADL and QOL were higher, and the score in the geriatric depression scale was lower in the non-risk than the risk group in KCL criteria. In men, the incidence of newly certified cases was higher in the risk group of the physical strength category after adjusting for age and the other categories of the KCL.

Conclusion: The physical strength category in men was the only significant predictor of the incidence of newly certified cases by LTCI. Further studies are required to improve the assessment item of cognitive function in KCL under LTCI.
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http://dx.doi.org/10.1111/ggi.12360DOI Listing
July 2015
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