The impact of shared decision making with patient decision aids on the rotavirus vaccination rate in children: A randomized controlled trial.

Rotavirus vaccination reduces the incidence and severity of acute gastroenteritis due to rotavirus infection. However, because of a lack of understanding and private payment for the rotavirus vaccine, the rotavirus vaccination rate is still low in some countries. We intended to assess the impact of shared decision-making (SDM) with the assistance of patient decision aids (PDAs) on the rotavirus vaccination rate, and the knowledge, confidence, and congruence of value among baby's parents when decision-making. The study was a two-group, outcome assessor-blind, randomized, controlled trial. The families of 1-month-old infants for routine vaccination were enrolled; they were divided randomly into non-SDM and SDM groups. The influence of SDM on the acceptance of rotavirus vaccination was assessed when their infants were 2 months old. Outcome measures were decisional conflict, decision-making difficulties, and rotavirus vaccine knowledge, and the overall rotavirus vaccination rate. The study enrolled 180 participants. SDM, parents' education level, and rotavirus vaccination of a previous child were variables that influenced acceptance of rotavirus vaccination. The SDM group scored significantly higher for understanding the information on the oral rotavirus vaccine than the non-SDM group, which helped them to decide whether to vaccinate the baby against rotavirus. The rotavirus vaccination rate was 16.7% higher in the SDM group than the non-SDM group. SDM assisted with PDAs gives more information and helps infants' families understand what they need, reduces their decision conflict, and increases their baby's vaccination against rotavirus, which promotes public health. The clinical trial is registered at ClinicalTrials.gov (NCT03804489).

Association between lifestyle and hematological parameters: A study of Chinese male steelworkers.

BACKGROUND: Increasing evidence suggests an association between lifestyle and white blood cell (WBC) count; however, no study has examined the effects of lifestyle associations on hematological parameters. The aim of this study was to examine the association between lifestyle factors and hematological parameters in a large population-based sample of Chinese male steelworkers. METHODS: This study included 3189 male workers at a steel plant who responded to a cross-sectional questionnaire on basic attributes, lifestyle, and sleep. All workers in the plant underwent periodic health checkups. Hematological parameters were also examined at the checkup. RESULTS: Stepwise linear regression analyses showed that smoking, poor sleep, shift work, and obesity were all significant factors associated with WBC count. Obesity was independently associated with RBC count. Furthermore, smoking and obesity were associated with hemoglobin, and smoking, poor sleep, and obesity were independently associated with hematocrit. Moreover, smoking was the main factor associated with MCV and MCH. When the subjects were divided into quartiles according to WBC count, RBC count, hemoglobin, hematocrit, MCV, MCH, and increased WBC count were associated with smoking, poor sleep, shift work, and obesity. Increased hemoglobin was associated with smoking and obesity. Furthermore, an increased RBC count was associated with obesity, and increased hematocrit was associated with smoking, poor sleep, and obesity. Similarly, increased MCV and MCH were also associated with smoking. CONCLUSION: This study indicates that lifestyle factors may exert an important effect on hematological parameters (eg, WBC count, RBC count, hemoglobin, hematocrit, MCV, and MCH).

Shift work is associated with metabolic syndrome in male steel workers-the role of resistin and WBC count-related metabolic derangements.

AIMS: There is increasing evidence linking a shift work schedule with various adverse health effects. The present study aimed to examine the relationship between shift work and the metabolic syndrome (MetS) in male steel workers, and also the possible mechanism of shift work-related metabolic derangements. METHODS: A total of 1732 men aged 42 ± 8 years were enrolled in this cross-sectional study, including 862 day workers and 870 shift workers. Circulating levels of resistin were measured by ELISA using monoclonal specific antibodies. RESULTS: The shift workers had higher rates of MetS and its components (central obesity, hypertension, and hypertriglyceridemia) than the day workers. In multiple logistic regression analysis, shift work was independently associated with MetS. In further analysis, the shift workers had elevated circulating levels of resistin (13 ± 10 vs. 10 ± 7 ng/mL) and total white blood cell (WBC) count (6.865 ± 1.819 vs. 6.304 ± 1.547 109/L) than the day workers. In addition, both resistin level and total WBC count were significantly associated with shift work, MetS, and its components (body mass index, fasting glucose, triglyceride, and high-density lipoprotein-cholesterol levels), and plasma resistin levels were significantly associated with total WBC count (ß = 0.34, p < 0.0001). CONCLUSION: Shift work was independently associated with MetS in male steel workers. Resistin and WBC count were associated with shift work-related metabolic derangements.

Anatomy of Shoulder Girdle Muscle Modifications and Walking Adaptation in the Scaly Chinese Pangolin (Manis Pentadactyla Pentadactyla: Pholidota) Compared with the Partially Osteoderm-Clad Armadillos (Dasypodidae).

Because pangolins are unique mammals with a body and limbs almost entirely sheathed in hard keratinous overlapping scales and with digging and climbing abilities, the shoulder girdle muscles may differ significantly from those of other mammals including the partially osteoderm-clad armadillos. Therefore, we conducted a functional anatomical study of the shoulder girdle muscles in Chinese pangolins (Manis pentadactyla pentadactyla, Pholidota) and some armadillo species (Dasypodidae). Our CT scans revealed that the pangolin's overlapping scales are hard structures completely encasing the limbs. The armadillo's limbs, however, are covered with small relatively soft non-overlapping scales embedded in the skin, and articulate completely free of the hard osteodermal carapace. The attachments of some shoulder girdle muscles in the pangolin have moved from the surrounding edges of the scapula to the spine, and they, therefore, fully cover the scapula. In addition, some pangolin shoulder girdle muscles cross the shoulder joint to insert on the distal humerus, but this does not occur in armadillos. We cannot rule out the possibility that these muscle modifications represent adaptations for digging and/or climbing in pangolins. Our results and previous literature do not establish specific links between them and locomotive modes. However, we propose that the Chinese pangolin may use its derived muscular features when walking to move its armor-restricted forelimbs more effectively by swinging its head from side to side.

Insular variation of the craniodental morphology in the Siberian weasel Mustela sibirica.

We compared craniodental morphology among 5 populations of the Siberian weasel Mustela sibirica including 2 insular ones (Tsushima and Taiwan). Skulls of the insular individuals tended to be smaller than those of continental ones. Shape differences were also detected, but not so pronounced. Considering these results, the Taiwan population should be regarded as a distinct subspecies M. s. taivana from the mainland ones. The Tsushima population may also possibly be a distinct subspecies from the mainland ones, but more detailed studies using a larger number of specimens are needed for a conclusion. The introduced population in Honshu is also differentiated from the source population. This suggests a high morphological plasticity in M. sibirica.

BSRS-5 (5-item Brief Symptom Rating Scale) scores affect every aspect of quality of life measured by WHOQOL-BREF in healthy workers.

PURPOSE: This study aims to evaluate and quantify the possible effect of psychological symptoms on healthy workers' quality of life (QOL). METHODS: The workers were recruited from a factory in south Taiwan. We assessed their psychological symptoms with a 5-item brief symptom rating scale (BSRS-5) and measured the QOL using the Taiwanese version of the World Health Organization Quality of Life (WHOQOL)-BREF. Multiple linear regression analysis was conducted to explore the association between the two tools after control of confounding by other predictors. RESULTS: A total of 1,080 workers, who attended a physical examination, completed questionnaires and informed consent forms. Scores on the BSRS-5 significantly predicted scores in each domain and items of the WHOQOL-BREF. The magnitude of psychological domain score seemed to be affected the most; every 1 point increase in BSRS-5 was associated with a 0.39 raw score (equivalent to 2.44 percentile) decrease in QOL. The sleep facet of WHOQOL appeared to have the highest association, followed by items of negative feelings, energy, and concentration. CONCLUSIONS: The BSRS-5 score is predictive for scores of all four domains and 26 items of the Taiwanese version of the WHOQOL-BREF for regular factory workers.

Establishing the pangolin mitochondrial D-loop sequences from the confiscated scales.

Pangolin scales are encountered in traditional East Asian medicines (TEAM) and the ever increasing demand for these scales has escalated the decline in the numbers of these mammals. The identification of protected pangolin species is necessary to enforce international and national legislation as well as assist with conservation measures. There is limited morphological feature on a pangolin scale thus requiring DNA analysis as a means of identification. We report on the isolation of DNA from pangolin scales and a strategy for obtaining the full length of the mitochondrial D-loop, being 1159 bp. Primer sets creating five overlapping amplicons were designed to amplify sections of this mitochondrial DNA locus. DNA from the blood stain of nineteen Formosan pangolins (Manis pentadactyla pentadactyla) along with 145 scale samples that were suspected to have come from pangolins, was amplified and sequenced; leading to a total of 91 D-loop sequences being obtained. The 19 Formosan pangolin sequences produced 5 haplotypes and 72 of the 145 seized scales provided useable sequence classified as a further 38 haplotypes. The D-loop sequences from those scales suspected to be from a pangolin had a higher similarity to any of the 19 samples taken from M. p. pentadactyla compared to a D-loop sequence from Manis tetradactyla (the only pangolin D-loop sequence in GenBank, NC_004027). These 43 haplotypes were used to establish a local database for the D-loop sequence of pangolins and add to the data of Manis sp. held on GenBank. The PCR amplification strategy development in this study could be used in forensic DNA identification of scales suspected to be from protected pangolin species.

Origins and founder effects on the Japanese masked palm civet Paguma larvata (Viverridae, Carnivora), revealed from a comparison with its molecular phylogeography in Taiwan.

The source areas of the Japanese populations of the masked palm civet Paguma larvata (Viverridae, Carnivora), an alien species in Japan, have not been identified. In the present study, to reveal their origins and genetic features, we determined the full mitochondrial DNA cytochrome b sequences (1,140 base-pairs) of a total of 206 individuals of P. larvata from the Honshu and Shikoku islands of Japan (186 animals) and Taiwan (20 animals), and investigated their molecular phylogeography and the genetic relationships between populations in these countries. We found that each animal from Japan exhibited one of four haplotypes (JA1, JA2, JA4, and JA5), and that JA1 and JA4 were more frequent in eastern Honshu and Shikoku-central Honshu, respectively. By contrast, six haplotypes consisting of four new types (TW1, TW2, TW3, and TW4) and the previously reported two types (JA1 and JA4) were identified from 20 animals from native populations in Taiwan. Within Taiwan, one haplotype set (JA1, TW1, and TW2) was distributed in the western region, while a second (JA4, TW3, and TW4) was found in the eastern region; these regions are separated by high mountain ranges. Our comparison of haplotype distributions strongly demonstrated that the eastern Japanese populations originated from animals of western Taiwan, and that the western Japanese populations originated from those of eastern Taiwan. In addition, the lower genetic variability and particular distribution patterns of haplotypes in Japan showed founder effects, which may have resulted from multiple introductions of P. larvata to Japan from Taiwan.

The association between low levels of lead in blood and occupational noise-induced hearing loss in steel workers.

As the use of leaded gasoline has ceased in the last decade, background lead exposure has generally been reduced. The aim of this study was to examine the effect of low-level lead exposure on human hearing loss. This study was conducted in a steel plant and 412 workers were recruited from all over the plant. Personal information such as demographics and work history was obtained through a questionnaire. All subjects took part in an audiometric examination of hearing thresholds, for both ears, with air-conducted pure tones at frequencies of 500, 1000, 2000, 3000, 4000, 6000 and 8000 Hz. Subjects' blood samples were collected and analyzed for levels of manganese, copper, zinc, arsenic, cadmium and lead with inductive couple plasma-mass spectrometry. Meanwhile, noise levels in different working zones were determined using a sound level meter with A-weighting network. Only subjects with hearing loss difference of no more than 15 dB between both ears and had no congenital abnormalities were included in further data analysis. Lead was the only metal in blood found significantly correlated with hearing loss for most tested sound frequencies (p<0.05 to p<0.0001). After adjustment for age and noise level, the logistic regression model analysis indicated that elevated blood lead over 7 microg/dL was significantly associated with hearing loss at the sound frequencies of 3000 through 8000 Hz with odds ratios raging from 3.06 to 6.26 (p<0.05-p<0.005). We concluded that elevated blood lead at level below 10 microg/dL might enhance the noise-induced hearing loss. Future research needs to further explore the detailed mechanism.

Cranial variation in the pantropical spotted dolphin, Stenella attenuata , in the Pacific Ocean.

Cranial variation in 129 pantropical spotted dolphins (Stenella attenuata) from the western and eastern tropical Pacific was investigated morphometrically. This study revealed significant sexual dimorphism in the dolphin skulls. Differences between the genders were mostly recorded in the rostrum and braincase, which are wider and more robust in males. This sexual variation was interpreted in terms of differences in behavioral and life-history strategies between genders. Geographical variation among populations of the eastern tropical Pacific (ETP), Japan, and Taiwan was also significant, with different sexual patterns. While no clear trend in geographical variation was detected in males, there was a positive relationship in females between morphological differences and geographical distance. That is, Japanese and Taiwanese female specimens were morphologically more similar than revealed by other pairwise comparisons between them and the ETP specimens. Moreover, two canonical discriminant functions further discriminated the three populations for males and females, respectively. The two functions showed that the rostrum and braincase are the principal elements in discrimination of geographical variation in males, while only the rostrum is the major discriminant morph of geographical variation in females. In addition, tests based on Mahalanobis distance-squares were conducted to assign six specimens from the western tropical Pacific to the above three populations to clarify the similarities among them.

Synthesis and characterization of nonsteroidal glucocorticoid receptor modulators for multiple myeloma.

Structure-activity relationship studies centered around 3'-substituted (Z)-5-(2'-(thienylmethylidene))1,2-dihydro-9-hydroxy-10-methoxy-2,2,4-trimethyl-5H-chromeno[3,4-f]quinolines are described. A series of highly potent and efficacious selective glucocorticoid receptor modulators were identified with in vitro activity comparable to dexamethasone. In vivo evaluation of these compounds utilizing a 28 day mouse tumor xenograft model demonstrated efficacy equal to dexamethasone in the reduction of tumor volume.

Accumulation of trace elements used in semiconductor industry in Formosan squirrel, as a bio-indicator of their exposure, living in Taiwan.

Concentrations of 17 trace elements were analyzed using inductively coupled plasma-mass spectrometry (ICP-MS) in Formosan squirrels (Callosciurus erythraeus) of Taiwan and Japan to document trace element pollution in Taiwan. High concentrations of elements used to produce semiconductors - Ga, As, Cd, In and Tl - were found in animals captured in Miaoli County, which is the nearest site to Hsinchu City, a chief city of Taiwan's semiconductor industry. Significant correlations between Ga, As, In and Tl were found in the kidney, liver, lung and muscle tissues of Taiwanese squirrels. Hierarchical cluster analysis indicated that Ga, As, In and Tl were of the same clade, indicating that Ga, As, In and Tl were discharged from an identical origin. Molar ratios of Ga/As concentration in lungs of animals captured in Miaoli resembled those of animals after intratracheal administration of particulate gallium arsenide (GaAs). This result might indicate that the higher concentrations of Ga and As in the specimens in Miaoli resulted from atmospheric exposure to GaAs.