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Research suggests an association between metabolic disorders, such as type 2 diabetes mellitus (T2DM), and schizophrenia. However, the risk of metabolic disorders in the unaffected siblings of patients with schizophrenia remains unclear.
Using the Taiwan National Health Insurance Research Database, 3135 unaffected siblings of schizophrenia probands and 12,540 age-/sex-matched control subjects were included and followed up to the end of 2011. Individuals who developed metabolic disorders during the follow-up period were identified.
The unaffected siblings of schizophrenia probands had a higher prevalence of T2DM (3.4% vs. 2.6%, p = 0.010) than the controls. Logistic regression analyses with the adjustment of demographic data revealed that the unaffected siblings of patients with schizophrenia were more likely to develop T2DM (odds ratio [OR]: 1.39, 95% confidence interval [CI]: 1.10–1.75) later in life compared with the control group. Moreover, only female siblings of schizophrenia probands had an increased risk of hypertension (OR: 1.47, 95% CI: 1.07–2.01) during the follow-up compared with the controls.
The unaffected siblings, especially sisters, of schizophrenia probands had a higher prevalence of T2DM and hypertension compared with the controls. Our study revealed a familial link between schizophrenia and T2DM in a large sample. Additional studies are required to investigate the shared pathophysiology of schizophrenia and T2DM.
In the recent years, the development of wind turbines has been so hectic in Taiwan. The design of the turbine blades directly impacts power effectiveness. In this study, the effects of manufacturing parameters and environmental factors on the mechanical properties of carbon fiber/epoxy composites that are used in turbine blades are discussed. Parameters of the manufacturing process affect the mechanical properties. Carbon composites made by a different numbers of layers are tested on various aspects of performance such as mechanical strength and corrosion resistance.
We used all 167 typhoon warnings issued by the Taiwanese Central Weather Bureau from 1958–2006 to assess the long-term effect of cyclone disturbance on vascular epiphytes. Tracks and eyes of past typhoons were plotted as circles with radii of Beaufort scale 7 and 10, and the frequency of each cohort in 1-km2 grid cells was calculated. The presence of vascular epiphytes in the same grid cells was predicted using species distribution models (SDMs). First, we used herbarium specimens and other sources to compile a comprehensive georeferenced vascular epiphyte database that contained 39084 records in 331 species. Next, we assigned each epiphyte record to a cell in the same 1-km2 grid as above. Finally, we used SDMs (MaXent), based on 30 environmental variables except typhoon frequency, to predict the potential presence of each species in the grid cells. For our analysis we only considered cells east of the central mountain ridge where typhoons hit with full force. After elimination of rare species and species that could not be validated in the SDMs, we were left with 156 epiphyte species in 10725 1-km2 cells. The number of projected species in the cells was 36.5 on average, varying between two and 82 species. Correlation analyses showed that, over time, typhoons led to a decrease in epiphyte richness at Beaufort scale 7 and 10 (Pearson's r = −0.07 and −0.08 respectively). Ferns, orchids, hemiepiphytes and dicotyledons generally showed the same pattern, except hemiepiphytes that showed a positive correlation at B7 (Pearson's r = 0.15). A partial canonical correspondence ordination analysis showed that, independent of temperature- and rainfall-related variables, Beaufort scale 7 and 10 typhoons also had significant influence on the species composition of the vascular epiphyte communities in the landscape. We recommend in situ monitoring of epiphytes over a long period to corroborate the suggestion from this indirect study that typhoons have a long-term effect on the distribution of epiphytes in Taiwan.
Meltwater is important to understanding glacier health and dynamics. Since melt measurements are uncommon, ice ablation estimates are often based on models including the positive degree day (PDD) model. The PDD estimate is popular since it only requires air temperature as input, but suffers from the lack of physical motivation of an energy-balance model. We present a physics-based alternative to the PDD model that still only takes air/surface temperature as input. The model resembles the PDD model except accounting for time lags in ablation when cold ice needs to be warmed. The model is expressed as a differential equation with a single extra parameter related to the efficiency of heating a near-surface layer of ice. With zero thickness, the model reduces to the PDD model, providing a physical basis for the PDD model. Applying the model to data from Greenland, it improves modestly upon the PDD model, with the main improvement being better prediction of early season melting. This new model is a useful compromise, with some of the physics of more realistic models and the simplicity of a PDD model. The model should improve estimates of meltwater production and help constrain PDD parameters when empirical calibration is challenging.
Studies conducted in sub-Saharan Africa suggest a high prevalence of depression and suicidality among adolescents living with HIV (ALWH). This is an important public health issue because depression is known to compromise HIV treatment adherence. However, the drivers of depression and suicidality in this population are unclear. We conducted a cross-sectional study to estimate the associations between internalized stigma, bullying, major depressive disorder, and suicidality.
We conducted a cross-sectional survey between November 2016 and March 2017, enrolling a consecutive sample of 224 ALWH aged 13–17 years. We collected information on demographic characteristics, internalized HIV-related stigma (using the six-item Internalized AIDS-Related Stigma Scale), bullying victimization (using the nine-item Social and Health Assessment Peer Victimization Scale), major depressive disorder [using the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID)], and suicidality (also using the MINI-KID). We fitted multivariable logistic regression models to estimate the associations between stigma, bullying, major depressive disorder, and suicidality.
Thirty-seven participants (16%) had major depressive disorder, 30 (13%) had suicidality, and nine (4%) had high-risk suicidality. Ninety-one participants (41%) had high levels of internalized stigma, while 97 (43%) reported two or more bullying events in the past year. In multivariable logistic regression models, major depressive disorder had a statistically significant association with bullying (AOR = 1.09; 95% CI 1.00–1.20; p = 0.04); while suicidality (low, moderate, high risk) had statistically significant associations with both bullying (AOR = 1.09; 95% CI 1.01–1.17; p = 0.02) and stigma (AOR = 1.30; 95% CI 1.03–1.30; p = 0.02).
Among ALWH in rural Uganda, stigma and bullying are strongly associated with major depressive disorder and suicidality. There is a need to incorporate psychological interventions in the mainstream HIV care to address these challenges for optimal management of HIV among ALWH.
This study investigated the flow bifurcations of flows driven by a pressure gradient in a rectangular curved tube. When fluid flows within a curved tube, due to the centrifugal effect, secondary vortices can be induced in the cross section of the tube. The secondary flow states are dependent on the magnitude of the pressure gradient (q) and the aspect ratio (γ). In this study, the continuation method was applied to investigate the flow bifurcations in a curved tube with increasing pressure gradient (1 < q < 6000) and aspect ratio (0.9 < γ < 1.4).
The bifurcation diagrams are composed of solution branches, which are linked by limiting points or bifurcation points. The flow states in a solution branch belong to the same group. The ranges of the flow states and the relationship between the states can also be derived from the bifurcation diagrams. In this study, two types of bifurcation were found, one in the range of 0.9 < γ < 1.17, and another in the range of 1.18 < γ < 1.4. The ranges of stable flow solutions and the distributions of limit and bifurcation points in both pressure gradient and aspect ratio are derived in this study.
To assess the association between food insecurity and depression symptom severity stratified by sex, and test for evidence of effect modification by social network characteristics.
A population-based cross-sectional study. The nine-item Household Food Insecurity Access Scale captured food insecurity. Five name generator questions elicited network ties. A sixteen-item version of the Hopkins Symptom Checklist for Depression captured depression symptom severity. Linear regression was used to estimate the association between food insecurity and depression symptom severity while adjusting for potential confounders and to test for potential network moderators.
In-home survey interviews in south-western Uganda.
All adult residents across eight rural villages; 96 % response rate (n 1669).
Severe food insecurity was associated with greater depression symptom severity (b=0·4, 95 % CI 0·3, 0·5, P<0·001 for women; b=0·3, 95 % CI 0·2, 0·4, P<0·001 for men). There was no evidence of effect modification by social network factors for women. However, for men who are highly embedded within in their village social network, and (separately) for men who have few poor contacts in their personal network, the relationship between severe food insecurity and depression symptoms was stronger than for men on the periphery of their village social network, and for men with many poor personal network contacts, respectively.
In this population-based study from rural Uganda, food insecurity was associated with mental health for both men and women. Future research is needed on networks and food insecurity-related shame in relation to depression symptoms among food-insecure men.
School attendance rates in sub-Saharan Africa are among the lowest worldwide, placing children at heightened risk for poor educational and economic outcomes. One understudied risk factor for missed schooling is household water insecurity, which is linked to depression among women and may increase children's water-fetching burden at the expense of educational activities, particularly among children of depressed caregivers. In this study conducted in rural Uganda, we assessed the association between household water insecurity and child school participation and the mediating pathways behind these associations.
We conducted a population-based, cross-sectional study of female household heads (N = 257) and their children ages 5–17 (N = 551) in the rural regions surrounding the town of Mbarara, in southwestern Uganda. We used multivariable linear regressions to estimate the association between water insecurity and missed schooling. We then assessed the extent to which the association was mediated by caregiver depression.
Among children, water insecurity had a statistically significant association with the number of missed school days (a standard deviation increase in water insecurity resulted in 0.30 more missed school days in the last week). The estimated association was partially mediated by caregiver depression. When stratified by sex, this mediating pathway remained significant for boys, but not among girls.
Water insecurity is a risk factor for missed schooling among children in rural Uganda. Caregiver depression partially mediated this relationship. Also addressing caregiver mental health in water insecure families may more fully address the needs of sub-Saharan African families and promote educational participation among youth.
Worldwide, tobacco smoke is still the leading cause of preventable morbidity and mortality. Many smokers develop chronic smoking-related conditions that require emergency department (ED) visits. However, best practices for ED smoking cessation counselling are still unclear.
A randomized controlled trial was conducted to determine whether an “ask, advise, and refer” approach increases 12-month, 30-day quit rates in the stable adult ED smoking population compared to usual care. Patients in the intervention group were referred to a community counselling service that offers a quitline, a text-based program, and a Web-based program. Longitudinal intention-to-treat analyses were performed.
From November 2011 to March 2013, 1,295 patients were enrolled from one academic tertiary care ED. Six hundred thirty-five were allocated to usual care, and 660 were allocated to intervention. Follow-up data were available for 70% of all patients at 12 months. There was no statistically significant difference in 12-month, 30-day quit rates between the two groups. However, there was a trend towards higher 7-day quit attempts, 7-day quit rates, and 30-day quit rates at 3, 6, and 12 months in the intervention group.
In this study, there was a trend towards increased smoking cessation following referral to a community counselling service. There was no statistically significant difference. However, if ED smoking cessation efforts were to provide even a small positive effect, such an intervention may have a significant public health impact given the extensive reach of emergency physicians.
Understanding grounding-line dynamics is necessary for predictions of long-term ice-sheet stability. However, despite growing observations of the tidal influence on grounding-line migration, this short-timescale migration is poorly understood, with most modeling attempts assuming beam theory to calculate displacements. Here we present an improved model of tidal grounding-line migration that treats migration as an elastic fracture problem, forced by the additional ocean water pressure from the tide. This new model predicts that the grounding line cannot be assumed to be in hydrostatic equilibrium and, furthermore, that migration is inherently asymmetric and nonlinear, with migration distances that are not proportional to the tidal load. Specifically, for constant surface slope, the grounding line migrates upstream approximately ten times further as the tide rises from mean sea level to high tide than it migrates downstream as the tide falls from mean sea level to low tide, and migration distances are substantially larger than simple flotation arguments suggest. Numerical tests also show that the dependence of migration distance on elastic moduli and ice-sheet thickness are inconsistent with predictions of beam theory for a range of realistic values. Finally, applying the new model to observations in Antarctica results in new estimates of bed slopes, though these estimates remain uncertain due to imperfect knowledge of the relevant rheological parameters.
The behavior of marine-terminating ice sheets, such as the West Antarctic ice sheet, is of interest due to the possibility of rapid grounding-line retreat and consequent catastrophic loss of ice. Critical to modeling this behavior is a choice of basal rheology, where the most popular approach is to relate the ice-sheet velocity to a power-law function of basal stress. Recent experiments, however, suggest that near-grounding line tills exhibit Coulomb friction behavior. Here we address how Coulomb conditions modify ice-sheet profiles and stability criteria. The basal rheology necessarily transitions to Coulomb friction near the grounding line, due to low effective stresses, leading to changes in ice-sheet properties within a narrow boundary layer. Ice-sheet profiles ‘taper off’ towards a flatter upper surface, compared with the power-law case, and basal stresses vanish at the grounding line, consistent with observations. In the Coulomb case, the grounding-line ice flux also depends more strongly on flotation ice thickness, which implies that ice sheets are more sensitive to climate perturbations. Furthermore, with Coulomb friction, the ice sheet grounds stably in shallower water than with a power-law rheology. This implies that smaller perturbations are required to push the grounding line into regions of negative bed slope, where it would become unstable. These results have important implications for ice-sheet stability in a warming climate.
Prior to integrated circuit (IC) packaging, die performance must be verified using probe cards to screen for defective products. With the decrease in IC line width, the dimensions of the pads used for performance verification and the spacing between adjacent pads have also decreased. However, when the pad pitch is reduced to less than 30 μm, commonly used probe cards will face manufacturing problems in miniaturization. To resolve probe card manufacturing problems caused by the miniaturization of IC components, the use of an anisotropic conductive film (ACF) in probe cards was proposed in this study. Theoretical calculations and experimental testing of this probe structure were conducted to demonstrate the feasibility of this concept.
In theoretical calculations, composite material and buckling theory were utilized to evaluate the buckling behavior of the ACF. In experimental testing, photolithography and electroplating techniques were used to control the line width and spacing intervals of the micron-scale metal wires in the ACF. After the ACF was fabricated, the mechanical properties of the ACF during wafer testing were assessed. Theoretical analyses and experimental testing verified that ACFs can potentially be applied to the performance verification of IC products. In the ACF structure, multiple probes came into contact with each pad. Therefore, ACFs can potentially be applied to the performance verification of IC components with pad diameters of less than 20 μm. The results of this study directly benefit the miniaturization of ICs.
Ocean tides influence the flow of marine-terminating glaciers. Observations indicate that the large fortnightly variations in ice flow at Rutford Ice Stream in West Antarctica originate in the floating ice shelf. We show that nonlinear variations in ice shelf buttressing driven by tides can produce such fortnightly variations in ice flow. These nonlinearities in the tidal modulation of buttressing stresses can be caused by asymmetries in the contact stress from migration of the grounding line and bathymetric pinning points beneath the ice shelf. Using a simple viscoelastic model, we demonstrate that a combination of buttressing and hydrostatic stress variations can explain a diverse range of tidal variations in ice shelf flow, including the period, phase and amplitude of flow variations observed at Rutford and Bindschadler Ice Streams.
The aim of this post-hoc analysis was to evaluate the efficacy of lurasidone in treating major depressive disorder (MDD) with mixed features including irritability.
The data in this analysis were derived from a study of patients meeting DSM–IV–TR criteria for unipolar MDD, with a Montgomery–Åsberg Depression Rating Scale (MADRS) total score ≥26, presenting with two or three protocol-defined manic symptoms, and who were randomized to 6 weeks of double-blind treatment with either lurasidone 20–60 mg/d (n=109) or placebo (n=100). We defined “irritability” as a score ≥2 on both the Young Mania Rating Scale (YMRS) irritability item (#5) and the disruptive-aggressive item (#9). Endpoint change in the MADRS and YMRS items 5 and 9 were analyzed using a mixed model for repeated measures for patients with and without irritability.
Some 20.7% of patients met the criteria for irritability. Treatment with lurasidone was associated with a significant week 6 change vs. placebo in MADRS score in both patients with (–22.6 vs. –9.5, p<0.0001, effect size [ES]=1.4) and without (–19.9 vs. –13.8, p<0.0001, ES=0.7) irritability. In patients with irritable features, treatment with lurasidone was associated with significant week 6 changes vs. placebo in both the YMRS irritability item (–1.4 vs. –0.3, p=0.0012, ES=1.0) and the YMRS disruptive-aggressive item (–1.0 vs. –0.3, p=0.0002, ES=1.2).
In our post-hoc analysis of a randomized, placebo-controlled, 6-week trial, treatment with lurasidone significantly improved depressive symptoms in MDD patients with mixed features including irritability. In addition, irritability symptoms significantly improved in patients treated with lurasidone.
In recent years, compact camera modules (CCMs) have been widely used in consumer electrical and electronic products. CCMs with low cost specially are necessary for portable devices. Therefore, the present group recently developed a miniaturized open-loop controlled camera module with low cost for cellphone applications, in which the Lorentz force is balanced by a magnetic restoring force. To enhance the performance of the camera module, this article reports a pattern structure to modify the linearity of the magnetic restoring force. We fabricated a CCM prototype with the dimensions of 8.5 mm × 8.5 mm × 5 mm and demonstrated the usefulness of the pattern structure with the CCM prototype. Its potential applications are foreseeable in portable devices, such as cellphones, web cameras, personal digital assistants and other commercial electronics.
The aim of the study was to evaluate the comparative risk of self-harm associated with the use of different antidepressants.
A cohort study was conducted using data from Taiwan's National Health Insurance Research Database from 2001 to 2012. A total of 751 606 new antidepressant users with depressive disorders were included. The study outcome was hospitalization due to self-harm (International Classification of Diseases, Ninth Revision, Clinical Modification codes: E950–E958 and E980–E988). Cox proportional hazards models with stratification of the propensity score deciles were used to estimate the hazard ratios of self-harm hospitalization during the first year following the initiation of antidepressant treatment.
There were 1038 hospitalization episodes due to self-harm that occurred during the follow-up of 149 796 person-years, with an overall incidence rate of 6.9 [95% confidence interval (CI) 6.5–7.4] per 1000. Compared with fluoxetine, the risk of self-harm hospitalization was higher for maprotiline [adjusted hazard ratio (aHR) = 3.00, 95% CI 1.40–6.45], milnacipran (aHR = 2.34, 95% CI 1.24–4.43) and mirtazapine (aHR = 1.40, 95% CI 1.06–1.86), lower for bupropion (aHR = 0.51, 95% CI 0.30–0.86), and similar level of risk was found for other selective serotonin reuptake inhibitors (citalopram, escitalopram, fluvoxamine, paroxetine and sertraline).
The risk of self-harm may vary across different antidepressant drugs. It would be of importance to conduct further research to investigate the influence of antidepressant use on self-harm behaviors.
EVA foams, like all other polymers, also exhibit strain-rate effects and hysteresis. However, currently available approaches for predicting the mechanical response of polymeric foam subjected to an arbitrarily imposed loading history and strain-rate effect are highly limited. Especially, the strain rates in the intermediate rate domain (between 100 and 102 s–1) are extremely difficult to study. The use of data generated through the drop tower technique for implementation in constitutive equations or numerical models has not been considered in past studies. In this study, an experiment including a quasi-static compression test and drop impact tests with a high speed camera was conducted. An inverse analysis technique combined with a finite element model for material parameter identification was developed to determine the stress–strain behavior of foam at different specific strain rates. It was used in this study to simulate multiple loading and unloading cycles on foam specimens, and the results were compared with experimental measurements.
The effects of various parameters, such as thermal properties of substrates, thermal interface materials (TIMs) and heat sinks on the thermal performance of the light emitting diode (LED) light bars and backlight module are investigated experimentally and numerically in terms of junction temperature (Tj) and thermal resistances from junction to air (Rj-a). The results show that the measured Rj-a of the light bars by powering-on five LEDs in the test is different from one by powering-on only one LED, resulting from the extra heat coming from the adjacent LED packages affecting the Tj for the case of powering-on five LEDs. For the modules, Rj-a is significantly reduced by using the heat sinks for all backlight modules, and aluminum and iron heat sinks do not show any obvious difference in heat dissipation along with any substrates and TIMs. Furthermore, both experimental and simulation results show that the thermal conductivity of the substrates are more important and dominant than TIM and heat sink for the Rj-a of the backlight modules concerned, and also demonstrate that the thermal field for the local model can represent the one in full-scale backlight module.
Gender and age are the top two risk factors considered in pricing life insurance products. Although it is believed that mortality rates are also related to other factors (e.g. smoking, overweight, and especially marriage), data availability and marketing often limit the possibility of including them. Many studies have shown that married people (particularly men) benefit from the marriage, and generally have lower mortality rates than unmarried people. However, most of these studies used data from a population sample; their results might not apply to the whole population. In this study, we explore if mortality rates differ by marital status using mortality data (1975–2011) from the Taiwan Ministry of the Interior. In order to deal with the problem of small sample sizes in some marital status groups, we use graduation methods to reduce fluctuations in mortality rates. We also use a relational approach to model mortality rates by marital status, and then compare the proposed model with some popular stochastic mortality models. Based on computer simulation, we find that the proposed smoothing methods can reduce fluctuations in mortality estimates between ages, and the relational mortality model has smaller errors in predicting mortality rates by marital status. Analyses of the mortality data from Taiwan show that mortality rates differ significantly by marital status. In some age groups, the differences in mortality rates are larger between marital status groups than between smokers and non-smokers. For the issue of practical consideration, we suggest modifications to include marital status in pricing of life insurance products.
Recently, compact and high-resolution camera modules with auto-focusing (AF) function have been integrated into cell phones in order to capture sharp photographs. Consumer demands AF camera modules in cell phones to have high performance with low cost. Accordingly, the present study proposes a new electromagnetic design of miniature AF voice coil motor (VCM) actuator with closed-loop control for cell phone camera modules to satisfy the requirements. The structure of the proposed AF VCM actuators was designed by using simulation methods. The performance of the proposed AF VCM actuators was demonstrated by a laboratory-built prototype. The experimental results have shown that the proposed AF VCM actuator has excellent performance with lower power consumption, higher positioning repeatability, and lower cost, when compared to previous AF VCM actuators with open-loop control or closed-loop control.