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The coexistence of underweight (UW) and overweight (OW)/obese (OB) at the population level is known to affect iron-deficiency anemia (IDA), but how the weight status affects erythropoiesis during pregnancy is less clear at a population scale. This study investigated associations between the pre-pregnancy body mass index (pBMI) and erythropoiesis-related nutritional deficiencies.
Anthropometry, blood biochemistry, and 24-h dietary recall data were collected during prenatal care visits. The weight status was defined based on the pBMI. Mild nutrition deficiency-related erythropoiesis was defined if individuals had an ID, folate depletion, or a vitamin B12 deficiency.
The Nationwide Nutrition and Health Survey in Taiwan (Pregnant NAHSIT 2017-2019).
We included 1456 women aged 20 to 45 years with singleton pregnancies.
Among these pregnant women, 9.6% were UW, and 29.2% were either OW (15.8%) or OB (13.4%). A U-shaped association between the pBMI and IDA was observed, with decreased odds (OR; 95% CI) for OW subjects (0.6; 0.4˜0.9) but increased odds for UW (1.2; 0.8˜2.0) and OB subjects (1.2; 0.8˜1.8). The pBMI was positively correlated with the prevalence of a mild nutritional deficiency. Compared to normal weight (NW), OB pregnant women had 3.4-fold (3.4; 1.4˜8.1) higher odds for multiple mild nutritional deficiencies, while UW individuals had lowest odds (0.3; 0.1-1.2). A dietary analysis showed negative relationships of pBMI with energy, carbohydrates, protein, iron, and folate intakes, but positive relationship with fat intakes.
The pre-pregnancy weight status can possibly serve as a good nutritional screening tool for preventing IDA during pregnancy.
State formation occurred in Korea and Japan 1,000 years before it did in Europe, and it occurred for reasons of emulation and learning, not bellicist competition. State formation in historical East Asia occurred under a hegemonic system in which war was relatively rare, not under a balance-of-power system with regular existential threats. Korea and Japan emerged as states between the fifth and ninth centuries CE and existed for centuries thereafter with centralized bureaucratic control defined over territory and administrative capacity to tax their populations, field large militaries, and provide extensive public goods. They created these institutions not to wage war or suppress revolt: the longevity of dynasties in these countries is evidence of both the peacefulness of their region and their internal stability. Rather, Korea and Japan developed state institutions through emulation and learning from China. The elites of both copied Chinese civilization for reasons of prestige and domestic legitimacy in the competition between the court and the nobility.
Anticipatory pleasure deficits are closely correlated with negative symptoms in schizophrenia, and may be found in both clinical and subclinical populations along the psychosis continuum. Prospection, which is an important component of anticipatory pleasure, is impaired in individuals with social anhedonia (SocAnh). In this study, we examined the neural correlates of envisioning positive future events in individuals with SocAnh.
Forty-nine individuals with SocAnh and 33 matched controls were recruited to undergo functional MRI scanning, during which they were instructed to simulate positive or neutral future episodes according to cue words. Two stages of prospection were distinguished: construction and elaboration.
Reduced activation at the caudate and the precuneus when prospecting positive (v. neutral) future events was observed in individuals with SocAnh. Furthermore, compared with controls, increased functional connectivity between the caudate and the inferior occipital gyrus during positive (v. neutral) prospection was found in individuals with SocAnh. Both groups exhibited a similar pattern of brain activation for the construction v. elaboration contrast, regardless of the emotional context.
Our results provide further evidence on the neural mechanism of anticipatory pleasure deficits in subclinical individuals with SocAnh and suggest that altered cortico-striatal circuit may play a role in anticipatory pleasure deficits in these individuals.
Andrena camellia Wu is one of the primary pollinators of Camellia oleifera A. in China. In this paper, the essential number of individuals for efficient pollination by this species was calculated via two criteria, based on various indicators including counts of pollen grains in provisions, from single visits, and from single foraging trips overall; single flower visit duration; single flight period duration; number of eggs laid by a single female over their lifetime; and the average number of flowers per plant. Based on the number of pollen grains collected per flower visit, the essential number of females necessary is 2107 in a 1-ha Camellia oleifera garden with 1800 plants, while only 1998 female individuals are essentially needed when estimated based on the mean number of pollen grains collected in a single flight period. We argue that the essential number estimated by the former method is more reasonable and accurate for practical applications.
Anthropogenic greenhouse gas emissions are the primary cause of climate change and an estimated increase of 3.7 to 4.8 °C is predicted by the year 2100 if emissions continue at current levels. Polar bears (Ursus maritimus) and giant pandas (Ailuropoda melanoleuca) provide an interesting comparison study of the impact of climate change on bear species. While polar bears and giant pandas are arguably the most distant of the bear species with regard to life histories and behavior, both are likely to be significantly impacted by the broad-scale changes to their environment that are predicted to result from climate change. Herein, we review the conservation status of both species and their habitats, and present current and predicted evidence of the impacts of a changing climate on polar bear and giant panda survival.
To investigate whether an after-school nutrition education (ASNE) programme can improve the nutrition knowledge and healthy eating behaviour of adolescents from economically disadvantaged families.
One-group pretest and posttest design. Nutrition knowledge and dietary intake were collected using a questionnaire, and anthropometric measurements were measured before and after the intervention. Nine components of healthy eating behaviour were assessed with reference to the Dietary Guideline of Taiwan. Pretest and posttest differences were analysed using generalised estimating equations.
Three after-school programmes in central and southern Taiwan. The ASNE programme comprised three monthly 1-h sessions (20–30-min lecture and 30–40-min interaction).
A total of 153 adolescents aged 10–15 years from economically disadvantaged families (seventy-eight elementary students and seventy-five junior high school students).
Elementary and junior high school students’ nutrition knowledge scores (range 0–6) increased by 0·28 (+ 5·7 %, P = 0·02) and 0·30 points (+ 6·18 %, P = 0·02), respectively, but their fruit intake decreased by 0·36 serving/d (–22·9 %, P = 0·02) and 0·29 serving/d (–18·9 %, P = 0·03), respectively. Junior high school students’ mean snacking frequency and fried food intake dropped to 0·75 d/week (–21·3 %, P = 0·008) and 0·10 serving/d (–28·8 %, P = 0·01), respectively.
Short-term ASNE programmes can increase nutrition knowledge and reduce snacking frequency and fried food intake despite a decrease in fruit intake among adolescents from economically disadvantaged families.
To identify phenotypes of type 1 diabetes based on glucose curves from continuous glucose-monitoring (CGM) using functional data (FD) analysis to account for longitudinal glucose patterns. We present a reliable prediction model that can accurately predict glycemic levels based on past data collected from the CGM sensor and real-time risk of hypo-/hyperglycemic for individuals with type 1 diabetes.
A longitudinal cohort study of 443 type 1 diabetes patients with CGM data from a completed trial. The FD analysis approach, sparse functional principal components (FPCs) analysis was used to identify phenotypes of type 1 diabetes glycemic variation. We employed a nonstationary stochastic linear mixed-effects model (LME) that accommodates between-patient and within-patient heterogeneity to predict glycemic levels and real-time risk of hypo-/hyperglycemic by creating specific target functions for these excursions.
The majority of the variation (73%) in glucose trajectories was explained by the first two FPCs. Higher order variation in the CGM profiles occurred during weeknights, although variation was higher on weekends. The model has low prediction errors and yields accurate predictions for both glucose levels and real-time risk of glycemic excursions.
By identifying these distinct longitudinal patterns as phenotypes, interventions can be targeted to optimize type 1 diabetes management for subgroups at the highest risk for compromised long-term outcomes such as cardiac disease or stroke. Further, the estimated change/variability in an individual’s glucose trajectory can be used to establish clinically meaningful and patient-specific thresholds that, when coupled with probabilistic predictive inference, provide a useful medical-monitoring tool.
Schizotypy refers to schizophrenia-like traits below the clinical threshold in the general population. The pathological development of schizophrenia has been postulated to evolve from the initial coexistence of ‘brain disconnection’ and ‘brain connectivity compensation’ to ‘brain connectivity decompensation’.
In this study, we examined the brain connectivity changes associated with schizotypy by combining brain white matter structural connectivity, static and dynamic functional connectivity analysis of diffusion tensor imaging data and resting-state functional magnetic resonance imaging data. A total of 87 participants with a high level of schizotypal traits and 122 control participants completed the experiment. Group differences in whole-brain white matter structural connectivity probability, static mean functional connectivity strength, dynamic functional connectivity variability and stability among 264 brain sub-regions of interests were investigated.
We found that individuals with high schizotypy exhibited increased structural connectivity probability within the task control network and within the default mode network; increased variability and decreased stability of functional connectivity within the default mode network and between the auditory network and the subcortical network; and decreased static mean functional connectivity strength mainly associated with the sensorimotor network, the default mode network and the task control network.
These findings highlight the specific changes in brain connectivity associated with schizotypy and indicate that both decompensatory and compensatory changes in structural connectivity within the default mode network and the task control network in the context of whole-brain functional disconnection may be an important neurobiological correlate in individuals with high schizotypy.
To compare the sugar content of items at four multinational fast-food chains, across three countries.
Total sugar (g)/per serving was extracted from online nutrition information, and sugar/100 g serving was calculated. Foods were categorised as: breakfast sandwiches, burgers, sandwiches, desserts and condiments. Beverages were categorised as fountain, frozen or pre-packaged. Sugar (g) was compared across countries using linear mixed-effects models. Pairwise comparisons were performed with Tukey–Kramer adjustments.
USA, Germany and Australia.
Burger King™ (Hungry Jack’s™), Kentucky Fried Chicken™, McDonald’s™ and Subway™.
Differences in total sugar/100 g or ml were observed across countries for burgers (n 104), desserts (n 110), sandwiches (n 178), pre-packaged beverages (n 36) and frozen beverages (n 72). Comparing identical items across countries (e.g. BigMacTM from McDonalds in USA, Germany and Australia), burgers (n 10 available in all three countries) had lower sugar content in Australia (3·4 g/100 g) compared with the USA (4·7 g/100 g, P = 0·02) or Germany (4·6 g/100 g, P = 0·04), yet no differences were observed in other food categories. Comparing the same beverages across countries (e.g. chocolate shake from Burger King), frozen beverages (n 4 available in all three countries) had lower sugar content in Australia (14·2 g/100 ml), compared with the USA (20·3 g/100 ml, P = 0·0005) or Germany (17·8 g/100 ml, P = 0·0148), yet no differences were observed in other beverage categories.
Heterogeneity in fast-food sugar content across countries suggests that reductions are possible and should be implemented to reduce health risks associated with excess added sugar intake.
OBJECTIVES/GOALS: Juvenile idiopathic arthritis (JIA) is the most common childhood rheumatologic disease childhood and a cause of pain and potential disability. JIA has a strong genetic component and no known cure. The goal of this study is to evaluate allele-dependent effects of a novel JIA risk variant at 1q24.3. METHODS/STUDY POPULATION: JIA patients meeting criteria for the two most common disease subtypes (oligoarticular and RF neg polyarthritis) were genotyped using the Immunochip, an Illumina array with dense coverage of the HLA region and 186 other loci previously reported in autoimmune diseases. Phase I association findings (Hinks, 2013) and Phase II analysis (unpublished) of an expanded cohort (4,271 JIA and 14,390 controls) identified new risk loci, including rs78037977 at 1q24.3. We prioritized rs78037977 and predicted possible impacted mechanisms based on Bayesian predictions of attributable risk, the surrounding chromatin landscape, and transcription factor binding data. A luciferase reporter assay was used to assess allele-dependent enhancer activity. RESULTS/ANTICIPATED RESULTS: rs78037977 is located between FASLG and TNFSF18 at chromosome 1q24.3 is associated with JIA (p = 6.3x10−09), and explains 94% of the posterior probability at this locus; no other SNPs in linkage disequilibrium (r2>0.6). The chromatin landscape around rs78037977 contains H3K4Me1 and H3K27Ac marks, which are indicative of enhancer activity. Further, >160 transcription factors have chromatin immunoprecipitation followed by sequencing (ChIP-seq) peaks overlapping rs78037977 in various cellular contexts. In luciferase reporter assays, the region around rs78037977 containing the reference A allele had ~2-fold increased enhancer activity compared to the non-reference allele. DISCUSSION/SIGNIFICANCE OF IMPACT: This work provides in vitro evidence to support allele-dependent enhancer activity of a novel JIA-risk variant at 1q24.3. Our ongoing work investigates the effect of the DNA-containing region of rs78037977 on gene expression and differential transcription factor binding at rs78037977.
Surface waves called meniscus waves often appear in systems that are close to the capillary length scale. Since the meniscus shape determines the form of the meniscus waves, the resulting streaming circulation has features distinct from those caused by other capillary–gravity waves recently reported in the literature. In the present study, we produce symmetric and antisymmetric meniscus shapes by controlling boundary wettability and excite meniscus waves by oscillating the meniscus vertically. The symmetric and antisymmetric configurations produce different surface capillary–gravity wave modes and streaming flow structures. The root-mean-square speed of the streaming circulation increases with the second power of the forcing amplitude in both configurations. The flow symmetry of streaming circulation is retained under the symmetric meniscus, while it is lost under the antisymmetric meniscus. The streaming circulation pattern beneath the meniscus observed in our experiments is qualitatively explained using the method introduced by Nicolás & Vega (Fluid Dyn. Res., vol. 32 (4), 2003, pp. 119–139) and Gordillo & Mujica (J. Fluid Mech., vol. 754, 2014, pp. 590–604).
Introduction: Emergency department (ED) syncope management is extremely variable. We developed practice recommendations based on the validated Canadian Syncope Risk Score (CSRS) and outpatient cardiac monitoring strategy with physician input. Methods: We used a 2-step approach. Step-1: We pooled data from the derivation and validation prospective cohort studies (with adequate sample size) conducted at 11 Canadian sites (Sep 2010 to Apr 2018). Adults with syncope were enrolled excluding those with serious outcome identified during index ED evaluation. 30-day adjudicated serious outcomes were arrhythmic (arrhythmias, unknown cause of death) and non-arrhythmic (MI, structural heart disease, pulmonary embolism, hemorrhage)]. We compared the serious outcome proportion among risk categories using Cochran-Armitage test. Step-2: We conducted semi-structured interviews using observed risk to develop and refine the recommendations. We used purposive sampling of physicians involved in syncope care at 8 sites from Jun-Dec 2019 until theme saturation was reached. Two independent raters coded interviews using an inductive approach to identify themes; discrepancies were resolved by consensus. Results: Of the 8176 patients (mean age 54, 55% female), 293 (3.6%; 95%CI 3.2-4.0%) experienced 30-day serious outcomes; 0.4% deaths, 2.5% arrhythmic, 1.1% non-arrhythmic outcomes. The serious outcome proportion significantly increased from low to high-risk categories (p < 0.001; overall 0.6% to 27.7%; arrhythmic 0.2% to 17.3%; non-arrhythmic 0.4% to 5.9% respectively). C-statistic was 0.88 (95%CI0.86–0.90). Non-arrhythmia risk per day for the first 2 days was 0.5% for medium-risk, 2% for high-risk and very low thereafter. We recruited 31 physicians (14 ED, 7 cardiologists, 10 hospitalists/internists). 80% of physicians agreed that low risk patients can be discharged without specific follow-up with inconsistencies around length of ED observation. For cardiac monitoring of medium and high-risk, 64% indicated that they don't have access; 56% currently admit high-risk patients and an additional 20% agreed to this recommendation. A deeper exploration led to following refinement: discharge without specific follow-up for low-risk, a shared decision approach for medium-risk and short course of hospitalization for high-risk patients. Conclusion: The recommendations were developed (with online calculator) based on in-depth feedback from key stakeholders to improve uptake during implementation.
Background: Atrial fibrillation (AF) is a risk for stroke. The Canadian Cardiovascular Society advises patients who are CHADS65 positive should be started on oral anticoagulation (OAC). Our local emergency department (ED) review showed that only 16% of CHADS65 positive patients were started on OAC and that 2% of our patients were diagnosed with stroke within 90 days. We implemented a new pathway for initiation of OAC in the ED (the SAFE pathway). Aim Statement: We report the effectiveness and safety of the SAFE pathway for initiation of OAC in patients treated for AF in the ED. Measures & Design: A multidisciplinary group of physicians and pharmacist developed the SAFE pathway for patients who are discharged home from the ED with a diagnosis of AF. Step 1: contraindications to OAC, Step 2: CHADS65 score, Step 3: OAC dosing if indicated. The pathway triggers referral to AF clinic, family physician letter and follow up call from the ED pharmacist. Patients are followed for 90 days by a structured medical record review and a structured telephone interview. We record persistence with OAC, stroke, TIA, systemic arterial embolism and major bleeding (ISTH criteria). Patient outcomes are fed back to the treating ED physician. Evaluation/ Results: The SAFE pathway was introduced in two EDs in June 2018. In total, 177 patients have had the pathway applied. The median age was 70 (interquartile range (IQR) 61-78), 48% male, median CHADS2 score 2 (IQR 0-2). 19/177 patients (11%) had a contraindication to initiating OAC. 122 patients (69%) had no contraindication to OAC and were CHADS65 positive. Of these 122 patients, 109 were given a prescription for OAC (96 the correct dose, 9 too high a dose and 4 too low a dose). 6 patients declined OAC and the physician did not want to start OAC for 7 patients. 73/122 were contacted by phone at 90 days, 15 could not be reached and 34 have not completed 90 days of follow up since their ED visit. Of the 73 who were reached by phone after 90 days, 65 were still taking an anticoagulant. To date, 1 patient who declined OAC (CHADS2 score of 2) had a stroke within 90 days and one patient prescribed OAC had a gastrointestinal bleed. Discussion/Impact: The SAFE pathway appears safe and effective although we continue to evaluate and improve the process.
To assess healthy-related quality of life and psychosocial adjustment in children with newly diagnosed cancer and their parents immediately and 6 months after diagnosis and treatment of cancer.
A prospective, case control study was conducted on eighty-nine children with newly diagnosed cancer, aged between 6 months to 16.7 years (mean, 8.2 years), and ninety healthy children of matched age group and social background. The children were assessed with the Child Behavior Checklist (CBCL), and the Parenting Stress Index (PSI) and the SF-36 questionnaire were administered to their parents immediately after diagnosis of cancer, 3 months after chemotherapy, and 6 months after chemotherapy.
No matter at the period immediately after diagnosis of cancer, 3 months or 6 months after starting chemotherapy, the parents of children with cancer scored significantly worse on every domains of SF-36 except body pain and every subscales of PSI except distractibility/hyperactivity and attachment when compared with the control group. The cancer group scored consistently lower on all CBCL syndrome scales than the control group, with anxiety, depression and body pain being significantly different. After starting chemotherapy, the parents reported improved scores on quality of life and decreasing parenting stress in both parent and child domains since 3 months or 6 months after starting chemotherapy.
Considerable distress was experienced by both children with newly diagnosed cancer and their parents during the period immediately after diagnosis. However, parents can adjust gradually since 3 months after starting chemotherapy and experience improved quality of life.
White matter abnormalities have been repeatedly reported in both schizophrenia and bipolar disorder (BD) diseases from diffusion tensor imaging (DTI) studies respectively, while the empirical evidences about the diagnostic specificity of white matter abnormalities in these disorders are still limited.
25 patients with paranoid schizophrenia and 18 patients with bipolar mania were recruited from the in-patient unit of the Mental Health Centre, West China Hospital, China.
Patients were diagnosed according to the criteria of Diagnostic and Statistical Manual of Mental Disorders-Version IV (DSM- IV). 30 healthy controls were recruited from the community by means of leaflets distributed throughout Chengdu city.
This study sought to investigate the alterations in fractional anisotropy (FA) in white matter throughout the entire brain of patients from Chengdu, China with paranoid schizophrenia and bipolar mania.
Diffusion tensor imaging (DTI) was used to assess white matter integrity in patients with paranoid schizophrenia and bipolar mania, as well as in normal controls. The differences in FA were measured by use of voxel-based analysis.
Reduced FA was found in the left posterior corona radiate (PCR) in patients with bipolar mania and paranoid schizophrenia compared to the controls. Patients with bipolar mania also showed a significant reduction in FA in right posterior corona radiate and in right anterior thalamic radiation (ATR).
Common abnormalities in the left PCR might imply an overlap in white matter pathology of both diseases and might be related to the shared risk factors for both disorders.
This study used meta-analysis to comprehensively examine the factor analysis of the Children's Depression Inventory (CDI). Twenty-five studies (N = 18,897) consisting of 36 independent samples were identified. Generally, the CDI comprises five factors: Self-Depreciation, Somatic Concerns, Externalizing, Lack of Personal and Social Interest, and Dysphoric Mood. When reviewing individual items, the results of this meta-analysis suggest that self-depreciation had salient loadings on factors similar to Self-Depreciation, Externalizing, and Somatic Concerns. The variability in this item makes self-depreciation a poor marker for symptoms of Self-Depreciation, Externalizing, and Somatic Concerns, and hence suggests that it should be revised or excluded in future revisions of the CDI. The equivalence of factor structure is a prerequisite to comparing mean scores across groups. Hence, the factor structure of the CDI was examined for subgroups of studies. The 5-factor structure of the CDI was generally appropriate except in studies assessing depression of at-risk/clinical participants and participants using non-English versions of the CDI. For studies assessing depression among at-risk/clinical participants and participants using non-English versions of the CDI, factors similar to Self-Depreciation, Lack of Personal and Social Interest, and Externalizing were identified. The at-risk/clinical samples had an independent factor of Depressive Mood and Loneliness, while studies using non-English versions of the CDI had an independent factor of Sadness and Somatic Notably, the factor of Somatic Concerns was not identified in at-risk/clinical samples and items of sleep disturbance, fatigue, and reduced appetite had no salient loadings.
Although the deviations of brain volume deficits in sporadic and familial first-episode schizophrenia patients (FEP) had been presented, the difference of brain asymmetries remained unidentified.
To assess the potential differences of volumetric asymmetries of gray matter (GM) and white matter (WM) between groups.
To find out the different injury alteration of sporadic FEP and familial FEP.
42 sporadic and 30 familiar drug-naïve FEP with and 72 matched normal controls (NC) were recruited. Participants were assessed with neuropsychological tests and scanned by a 3.0T MRI to obtain T1-weighted and DTI images. Lateralization distribution maps of GM and WM volume were generated by employing optimized voxel-based morphometry. The asymmetries were analyzed by comparing calculating Laterality Index (LI) voxel by voxel.
All three groups showed similar overall brain torque. Familiar FEP have more regional extensive GM asymmetry brain lesions compared to sporadic FEP. There was no shared regional lesion between two groups. LIGM and LIWM in right superior temporal were negatively correlated. Significant negative correlations were also found between LIGM of left superior parietal lobule and LIWM of right superior parietal lobule, and between LIGM of right inferior parietal lobule and LIWM of left inferior parietal lobule. The asymmetry in distinct brain regions were related to cognitive deficits especially in the domains of language and memory.
The two patient groups had different alteration in injuries of brain asymmetry. Familiar FEP has more GM extensive asymmetry brain region, which may correlate with their high genetic burdens.
The purpose of this study was to predict quality of life (QoL) and associated factors in patients with chronic mental illness (CMI) in Kaohsiung, Taiwan.
Patients (N = 2,023; 52.9% male, 47.1% female) were recruited using cross-sectional and convenience sampling. Structured questionnaires, including a living conditions questionnaire, a psychotic symptom assessment scale, the Caregiver Burden Scale, the 5-item Brief Symptom Rating Scale (BSRS-5), and the Medical Outcomes Study Short Form-12 (MOS SF-12) were used to collect data.
Single-factor analyses showed that those who were single, employed, and younger had better QoL. Additionally, patients who had fewer psychological problems and lower levels of psychological distress reported better QoL. Current psychotic symptoms, especially positive symptoms, were negatively correlated with QoL. For disease factors, schizophrenic patients and hospitalized patients reported better QoL than both bipolar patients and community patients. For family factors, caregiver's attitude and caregiver's burden were negatively correlated with QoL. For social factors, unstable housing and community social dysfunction were negatively correlated with QoL. The results showed that all four dimensions (social, family, disease and personal factors) were significant predictors of the mental component summary (MCS) and physical component summary (PCS) dimensions of QoL.
Personal factors and disease factors were the most important predictors of QoL in CMI patients of this sample. Family factors were more important than social factors in the MCS dimension, but social factors were more important than family factors in the PCS dimension.
The presence of comorbid anxiety disorders (AD) and bipolar II disorders (BP-II) compounds disability complicates treatment, worsens prognosis, and has been understudied. The genes involved in metabolizing dopamine and encoding dopamine receptors, such as aldehyde dehydrogenase 2 (ALDH2) and dopamine D2 receptor (DRD2) genes, may be important to the pathogenesis of BP-II comorbid with AD. We aimed to clarify ALDH2 and DRD2 genes for predisposition to BP-II comorbid with and without AD. The sample consisted of 335 subjects BP-II without AD, 127 subjects BP-II with AD and 348 healthy subjects as normal control. The genotypes of the ALDH2 and DRD2 Taq-IA polymorphisms were determined using polymerase chain reactions plus restriction fragment length polymorphism analysis. Logistic regression analysis showed a statistically significant association between DRD2 Taq-I A1/A2 genotype and BP-II with AD (OR = 2.231, P = 0.021). Moreover, a significant interaction of the DRD2 Taq-I A1/A1 and the ALDH2*1*1 genotypes in BP-II without AD was revealed (OR = 5.623, P = 0.001) compared with normal control. Our findings support the hypothesis that a unique genetic distinction between BP-II with and without AD, and suggest a novel association between DRD2 Taq-I A1/A2 genotype and BP-II with AD. Our study also provides further evidence that the ALDH2 and DRD2 genes interact in BP-II, particularly BP-II without AD.