ABSTRACT
Mycotoxins are toxic food contaminants that are naturally produced by certain fungi. They induce negative effects on human health by making food unsafe for consumption. In this study, analyses were performed to determine the levels and incidence of aflatoxins (AFs) in peanut products, tree nuts, spices, and Coix seeds; ochratoxin A (OTA) in wheat and roasted coffee, as well as OTA and AFs in rice; and citrinin (CIT) in red yeast rice (RYR) products. A total of 712 samples from nine different food categories were collected between 2012 and 2013. The samples were analyzed over 2 years for AFs, OTA, and CIT by methods recommended by the Ministry of Health and Welfare. These official analytical methods were extensively validated in-house and through interlaboratory trials. The analytical values of suspected contaminated specimens were confirmed by liquid chromatography - tandem mass spectrometry analysis to identify the specific mycotoxin present in the sample. We show that 689 samples (96.8%) complied with the regulations set by the Ministry of Health and Welfare. AFs were found in four peanut-candy products, one peanut-flour product, one pistachio product, one Sichuan-pepper product, and one Coix seed product. All had exceeded the maximum levels of 15 parts per billion for peanut and 10 parts per billion for other food products. Furthermore, 14 RYR samples contained CIT above 5 parts per million, and one RYR tablet exceeded the maximum amount allowed. Instances of AFs in substandard Sichuan pepper and Coix seeds were first detected in Taiwan. Measures were taken by the relevant authorities to remove substandard products from the market in order to decrease consumer exposure to mycotoxin. Border control measures were applied to importing food commodities with a higher risk of mycotoxin contamination, such as peanut, Sichuan pepper, and RYR products. Declining trends were observed in the noncompliance rate of AFs in peanut products, as well as that of CIT in RYR raw materials monitored from 2010 to 2013.
ABSTRACT
AIM: Despite the perceived importance of frailty, few studies focus on its impact on rural patients undergoing chronic dialysis. Comparison of different self-report questionnaires in assessing frailty among these patients has not been attempted before. METHODS: A prospectively enrolled chronic dialysis cohort from a rural centre was recruited for analysis. Six types of self-report questionnaires were administered to these patients. Clinical and dialysis-related laboratory parameters were collected. Correlation analyses between questionnaire results and dialysis complications were performed, and variables demonstrating significant correlations were entered into multivariate regression models to determine their independent associations. RESULTS: Six types of questionnaire (Strawbridge questionnaire, Edmonton Frail Scale, simple FRAIL scale, Groningen Frail Indicator, G8 questionnaire, and Tilburg Frail Indicator) were provided to rural patients undergoing chronic dialysis. Scores from each questionnaire showed significant association with each other, except the G8 questionnaire. Scores from the simple FRAIL scale correlated significantly with age (P = 0.02), female gender (P = 0.03), higher Liu's comorbidity index (P = 0.02), lower serum albumin (P = 0.03) and creatinine levels (P < 0.01), and higher ferritin levels (P = 0.02). The other five questionnaires did not show consistently significant relationships with important dialysis-related complications. Multivariate linear regression analysis identified an independently negative association between serum albumin and the simple FRAIL scale results (P = 0.01). CONCLUSION: This is the first study establishing the utility of different self-report questionnaires for assessing frailty in chronic dialysis patients. The simple FRAIL scale scores might demonstrate a closer relationship with dialysis-related complications.
