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Little is known about the suicide risk among cancer patients in Asian country.
To identify the risk and correlates of suicide death among cancer patients in Taiwan.
To provide the references for policy-making of suicide prevention and information for clinicians and care-givers.
We conducted a retrospective cohort study of cancer patients in Taiwan from 1985 to 2007 by linking two national-wide databases of the Taiwan Cancer Registry and the National Mortality File. Standardized mortality ratios (SMR) and 95% confidence intervals (CIs) were estimated based on the general population rates of suicide stratified by age, sex, and calendar year.
Among 930,230 registry cancer patients observed for 4,376,574 person-years, 2614 suicides were ascertained. Individuals with diagnosis of cancer had significantly higher risk to die by suicide (Man SMR = 2.46, 95% CI = 2.35–2.58; Woman SMR = 2.12, 95% CI = 1.98–2.28). Patients with cancers of head/neck, esophagus, and lung had additional higher risk to commit suicide. The risk of suicide elevated soon within first 3 months after cancer was diagnosed (Man SMR = 6.57, 95% CI = 5.82–7.41; Woman SMR = 5.83, 95% CI = 4.71–7.21).
Compared with general population, cancer patients had significantly higher risk to commit suicide in Taiwan. In addition to the prevention works focused on common risk factors of suicide death, clinicians and caretakers should pay special attention to patients with certain types of cancers and to those who were newly diagnosed to have cancers.
The aims of this study were to examine whether different domains of quality of life (QOL) are differently affected by depressive disorders by comparing QOL of subjects with and without depressive disorders, and to examine the association of QOL with self-stigma, insight and adverse effects of medication among subjects with depressive disorders.
The QOL on the four domains of the WHOQOL-BREF Taiwan version were compared between the 229 subjects with depressive disorders and 106 control subjects without depressive disorder. Among the subjects in the depressive group, the association between the four QOL domains and subjects' self-stigma, insight, and adverse effects of medication were examined using multiple regression analyses by controlling for the influence of depression, socio-demographic and clinical characteristics and family function.
The results found that subjects with depressive disorders had poorer QOL on the physical, psychological and social relationship domains than the non-depressive control group. The depressive subjects who had more severe self-stigma had poorer QOL on all four domains. The depressive subjects who had higher levels of awareness of illness had poorer QOL on the physical and psychological domains. The depressive subjects who perceived more severe adverse effects from medication had poorer QOL on the physical, psychological and environmental domains.
The results of this study demonstrate that different domains of QOL are differently affected by depressive disorders, and that clinicians must consider the negative influences of self-stigma, insight and adverse effects from medication on QOL of subjects with depressive disorders.
Excessive alcohol use has been associated with health, social and legal problems. Studies of alcohol-drinking problems have mainly focused on patients with alcohol-drinking problems and few studies have focused on their family members. The purpose of this study was to explore the perceptions of family members of problem-drinker patients about their own hazardous or harmful alcohol-drinking behaviours.
In this qualitative descriptive study, participants were recruited from three hospitals randomly selected from northern and central Taiwan (2:1). Hazardous-drinker patients and their family members were screened using the Chinese version AUDIT. AUDIT scores > 8 indicated harmful or hazardous drinkers. Data were collected in individual, audiotaped, in-depth interviews using an interview guide. Verbatim interview transcripts were analysed using ATLAS.ti, version WIN 7.0.
The sample of 35 family members with hazardous or harmful drinking behaviours perceived that their own alcohol-drinking behaviours were related to six major patterns: family habits, leisure activities with friends, work pressures, personal taste, a way to forget one's problems and to express happiness.
We recommend that programs to prevent harmful or hazardous drinking should emphasize understanding standard amounts of alcohol in alcoholic beverages, recommended amounts of alcohol consumption for males and females, knowledge about the long-term effects of excessive alcohol consumption; offer strategies to resist social pressure to drink; and build positive strategies for coping with stress.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
To report an outbreak of measles with epidemiological link between Hong Kong International Airport (HKIA) and a hospital.
Epidemiological investigations, patients’ measles serology, and phylogenetic analysis of the hemagglutinin (H) and nucleoprotein (N) genes of measles virus isolates were conducted.
In total, 29 HKIA staff of diverse ranks and working locations were infected with measles within 1 month. Significantly fewer affected staff had history of travel than non–HKIA-related measles patients [10 of 29 (34.5%) vs 28 of 35 (80%); P < .01]. Of 9 airport staff who could recall detailed exposure history, 6 (66.7%) had visited self-service food premises at HKIA during the incubation period, where food trays, as observed during the epidemiological field investigation, were not washed after use. Furthermore, 1 airport baggage handler who was admitted to hospital A before rash onset infected 2 healthcare workers (HCWs) known to have 2 doses of MMR vaccination with positive measles IgG and lower viral loads in respiratory specimens. Infections in these 2 HCWs warranted contact tracing of another 168 persons (97 patients and 71 HCWs). Phylogenetic comparison of H and N gene sequences confirmed the clonality of outbreak strains.
Despite good herd immunity with overall seroprevalence of >95% against measles, major outbreaks of measles occurred among HKIA staff having daily contact with many international pssengers. Lessons from severe acute respiratory syndrome (SARS) and measles outbreaks suggested that an airport can be a strategic epidemic center. Pre-exanthem transmission of measles from airport staff to HCWs with secondary vaccine failure poses a grave challenge to hospital infection control.
Schistosomiasis is an inflammatory disease that occurs when schistosome species eggs are deposited in the liver, resulting in fibrosis and portal hypertension. Schistosomes can interact with host inflammasomes to elicit host immune responses, leading to mitochondrial damage, generation of high levels of reactive oxygen species (ROS) and activation of apoptosis during inflammation. This study aims to examine whether ROS and NF-κB (p65) expression elicited other types of inflammasome activation in Schistosoma mansoni-infected mouse livers. We examine the relationship between inflammasome activation, mitochondrial damage and ROS production in mouse livers infected with S. mansoni. We demonstrate a significant release of ROS and superoxides and increased NF-κB (p65) in S. mansoni-infected mouse livers. Moreover, activation of the NLRP3 and AIM2 inflammasomes was triggered by S. mansoni infection. Stimulation of HuH-7 hepatocellular carcinoma cells with soluble egg antigen induced activation of the AIM2 inflammasome pathway. In this study, we demonstrate that S. mansoni infection promotes both NLRP3 and AIM2 inflammasome activation.
A liver transplant recipient developed hospital-acquired symptomatic hepatitis C virus (HCV) genotype 6a infection 14 months post transplant.
Standard outbreak investigation.
Patient chart review, interviews of patients and staff, observational study of patient care practices, environmental surveillance, blood collection simulation experiments, and phylogenetic study of HCV strains using partial envelope gene sequences (E1–E2) of HCV genotype 6a strains from the suspected source patient, the environment, and the index patient were performed.
Investigations and data review revealed no further cases of HCV genotype 6a infection in the transplant unit. However, a suspected source with a high HCV load was identified. HCV genotype 6a was found in a contaminated reusable blood-collection tube holder with barely visible blood and was identified as the only shared item posing risk of transmission to the index case patient. Also, 14 episodes of sequential blood collection from the source patient and the index case patient were noted on the computerized time log of the laboratory barcoding system during their 13 days of cohospitalization in the liver transplant ward. Disinfection of the tube holders was not performed after use between patients. Blood collection simulation experiments showed that HCV and technetium isotope contaminating the tip of the sleeve capping the sleeved-needle can reflux back from the vacuum-specimen tube side to the patient side.
A reusable blood-collection tube holder without disinfection between patients can cause a nosocomial HCV infection. Single-use disposable tube holders should be used according to the recommendations by Occupational Safety and Health Administration and World Health Organization.
Recurrent glioblastoma (GBM) has an unmet need for effective therapies. Toca 511 (vocimagene amiretrorepvec), a retroviral replicating vector with the transgene cytosine deaminase, selectively infects, persists and spreads in tumor. Subsequent oral administration of 5-fluorocytosine (Toca FC) produces 5-fluorouracil (5-FU) within infected cells. 5-FU kills cancer cells and myeloid derived suppressor cells, inducing robust antitumor immune responses in animal models. In 2 Phase 1 studies, Toca 511 was administered into the cavity wall after surgical resection (NCT01470794) or intratumoral injection by biopsy needle (NCT01156584). To provide context to the results observed, subjects were compared to an external lomustine treated control (Courtesy Denovo Biopharma; Wick 2010). Treatment with Toca 511/Toca FC from 2 Phase I studies showed significant improvement in OS HR equals to 0.48, p less than 0.001, with similar effect in the surgical resection (OS HR 0.45, p equals to 0.003) and intratumoral injection (OS HR 0.56, p equals to 0.060). Fewer related greater or equal to Grade 3 adverse events (AEs) were reported for Toca 511/Toca FC (2.5 percent) vs. lomustine (36.9 percent). There was a virtual absence of hematologic toxicity for Toca 511/Toca FC vs. lomustine (Grade greater or equal to 3 thrombocytopenia 23.8 percent). Discontinuations for AEs occurred in 0percent for Toca 511/Toca FC vs. 4.8 percent for lomustine. Toca 511 is surgically delivered and treatment-emergent AEs regardless of attribution included incision site pain (20 percent), procedural pain (12.5 percent), and wound infection (5 percent) vs. 0percent, 1.2 percent, 1.2 percent respectively for lomustine. Toca 511/Toca FC significantly improved survival and safety relative to lomustine. A Phase 2/3 trial has launched (NCT02414165).
Over the past decade, the PV industry has witnessed tremendous growth in manufacturing scale and technology advancement, with PV generated electricity cost ever approaching grid parity. Among them, Si based thin film technology has made substantial progress in demonstrating its inherent advantages in lower material cost, ease of manufacturing and higher energy yield, etc. More recently, reduced product prices and competing technologies from crystalline silicon and other thin film technologies have made amorphous and microcrystalline silicon based thin film technology very challenging, and requires further increase in module efficiency and decrease in manufacturing cost. As one of the few companies in the world with significant manufacturing capacity for tandem thin film Si PV products, Chint Solar (Astronergy) has been at the forefront of technology development for the mass production of large-scale (Gen. 5, 1.43m2) Si thin film solar modules in the last 5 years. We will review major technology advancements which have been mass production proven and led to the mass produced tandem silicon thin film module with 10.0% plus stabilized efficiency, along with the field performance of those modules.
Staggered bottom-gate hydrogenated nanocrystalline silicon (nc-Si:H) thin-film transistors (TFTs) were demonstrated on flexible colorless polyimide substrates. The dc and ac bias-stress stability of these TFTs were investigated with and without mechanical tensile stress applied in parallel to the current flow direction. The findings indicate that the threshold voltage shift caused by an ac gate-bias stress was smaller compared to that caused by a dc gate-bias stress. Frequency dependence of threshold voltage shift was pronounced in the negative gate-bias stress experiments. Compared to TFTs under pure electrical gate-bias stressing, the stability of the nc-Si:H TFTs degrades further when the mechanical tensile strain is applied together with an electrical gate-bias stress.
Polycrystalline silicon thin films were formed from the amorphous silicon thin film by the pulsed rapid thermal annealing process enhanced with a thin nickel seed layer through the vertical crystallization mechanism. In this paper, authors presented the results on the material properties of the crystallized film. The dopant and film thickness effects were also investigated. It has been demonstrated that a 2 μm thick amorphous silicon n+-i-p+ diode structure could be transformed into polycrystalline stack with a 4-pulse 1 sec 850°C heating and 5 sec cooling cycle process.
Tritiated amorphous and crystalline silicon is prepared by exposing silicon samples to tritium gas (T2) at various pressures and temperatures. Total tritium content and tritium concentration depth profiles in the tritiated samples are obtained using thermal effusion and Secondary Ion Mass Spectroscopy (SIMS) measurements. The results indicate that tritium incorporation is a function of the material microstructure rather than the tritium exposure condition. The highest tritium concentration attained in the amorphous silicon is about 20 at.% on average with a penetration depth of about 50 nm. In contrast, the tritium occluded in the c-Si is about 4 at.% with a penetration depth of about 10 nm. The tritium concentration observed in a-Si:H and c-Si is higher than reported results from post-hydrogenation experiments. The beta irradiation appears to catalyze the tritiation process and enhance the tritium dissolution in silicon material.
This paper reviews our research progresses of hydrogenated amorphous silicon (a-Si:H) and microcrystalline (μc-Si:H) based thin film solar cells. It coves the three areas of high efficiency, low cost process, and large-area proto-type multi-chamber system design and solar module deposition. With an innovative VHF power profiling technique, we have effectively controlled the crystalline evolution and made uniform μc-Si:H materials along the growth direction, which was used as the intrinsic layers of pin solar cells. We attained a 9.36% efficiency with a μc-Si:H single-junction cell structure. We have successfully resolved the cross-contamination issue in a single-chamber system and demonstrated the feasibility of using single-chamber process for manufacturing. We designed and built a large-area multi-chamber VHF system, which is used for depositing a-Si:H/μc-Si:H micromorph tandem modules on 0.79-m2 glass substrates. Preliminary module efficiency has exceeded 8%.
The hydrogenated amorphous silicon (a-Si:H) thin film transistors (TFTs) having a very high field-effect mobility of 1.76 cm2/V-s and a low threshold voltage of 2.43 V have been fabricated successfully using the hot wire chemical vapor deposition (HWCVD).
Hydrogenated amorphous silicon (a-Si:H) thin films were deposited on pre-oxidized Si wafers by electron cyclotron resonance chemical vapor deposition (ECRCVD). The rapid thermal annealing (RTA) treatments were applied to the as-grown samples in nitrogen atmosphere, and the temperature range for the RTA process is from 450 to 950 °C. The crystallization and grain growth behaviors of the annealed films were investigated by Raman spectroscopy, X-ray diffraction (XRD) and transmission electron microscopy (TEM). The onset temperature for the crystallization and grain growth is around 625 ∼ 650°C. The crystalline fraction of annealed a-Si:H films can reach ∼80%, and a grain size up to 17 nm could be obtained from the RTA treatment at 700 °C. We found that the crystallization continues when the grain growth has stopped.
Electromigration at 5 × 104 A/cm2 and 100 °C was conducted to grow composite Pb/Sn whiskers from SnPb solders, in which a Pb whisker grows first and then a whisker of Sn grows. In some cases, small Sn islands are embedded in Pb whiskers. The diameter of a composite whisker is <1 μm, which is much smaller than that of spontaneous Sn whisker growth on leadframes. The growth orientation of Pb whiskers was in the , [1¯11], and  directions. This investigation proposes that compressive stress generated by electromigration at the anode provides the force driving whisker growth. Therefore, accelerated tests of whisker growth at higher temperatures using electromigration are feasible.
The Taiwan-America Occultation Survey (TAOS) aims to determine the number of small icy bodies in the outer reach of the Solar System by means of stellar occultation. An array of 4 robotic small (D=0.5 m), wide-field (f/1.9) telescopes have been installed at Lulin Observatory in Taiwan to simultaneously monitor some thousand of stars for such rare occultation events. Because a typical occultation event by a TNO a few km across will last for only a fraction of a second, fast photometry is necessary. A special CCD readout scheme has been devised to allow for stellar photometry taken a few times per second. Effective analysis pipelines have been developed to process stellar light curves and to correlate any possible flux changes among all telescopes. A few billion photometric measurements have been collected since the routine survey began in early 2005. Our preliminary result of a very low detection rate suggests a deficit of small TNOs down to a few km size, consistent with the extrapolation of some recent studies of larger (30–100 km) TNOs.
Three-dimensional simulations for relieving the current crowding effect in solder joints under current stressing were carried out using the finite element method. Three possible approaches were examined in this study, including varying the size of the passivation opening, increasing the thickness of Cu underbump metallization (UBM), and adopting or inserting a thin highly resistive UBM layer. It was found that the current crowding effect in the solder bump could be successfully relieved with the thick Cu UBM or with the highly resistive UBM. Compared to the solder joint with Al/Ni(V)/Cu UBM, for instance, the maximum current density in a solder bump decreased dramatically by a factor of fifteen, say from 1.11 × 105 A/cm2 to 7.54 × 103 A/cm2 when a 20-μm-thick Cu UBM was used. It could be lowered by a factor of seven, say to 1.55 × 104 A/cm2, when a 0.7-μm UBM of 14770 μΩ cm was adopted. It is worth noting that although a resistive UBM layer was used, the penalty on overall resistance increase was negligible because the total resistance was dominated by the Al trace instead of the solder bump. Thermal simulation showed that the average temperature increase due to Joule heating effect was only 2.8 °C when the solder joints with UBM of 14770 μΩ cm were applied by 0.2 A.
Sol-gel derived catalyst systems of cobalt, nickel, and iron were used in the growth of gallium nitride (GaN) nanowires by thermal chemical vapor deposition. A diffusion barrier matrix of titania (TiO2) has been used in which the catalysts were dispersed to have control of the catalyst particle sizes and hence on the size and morphology of the GaN nanowires. This single-step and cost-effective processing of the catalyst bed produced good-quality GaN naowires with comparable structural and optical properties with those previously reported. In a particular case, a stress-induced cubic admixture to the otherwise hexagonal structural symmetry was observed. The samples were characterized by high-resolution scanning electron microscopy, x-ray diffraction, Fourier transform infrared spectroscopy, Raman spectroscopy, and cathodo-luminescence studies.
We have found that InxGa(1-x)N/GaN multi-quantum-well (MQW) light emitting diodes (LEDs) having periodic thickness variation (TV) in InxGa(1-x)N active layers exhibit substantially higher optical efficiency than LEDs with uniform InxGa(1-x)N layers. In these nano-structured LEDs, the thickness variation of the active layers is shown to be more important than In composition fluctuation in quantum confinement of excitons (carriers). Detailed STEM-Z contrast analysis, where image contrast is proportional to Z2 (atomic number)2, was carried out to investigate the thickness variation as well as the spatial distribution of In. In the nanostructured LEDs, there are short-range (SR-TV, 3 to 4 nm) and long-range thickness variations (LR-TV, 50 to 100 nm) in InxGa(1-x)N layers. It is envisaged that LR-TV is the key to quantum confinement of the carriers and enhancing the optical efficiency. We propose that the LR-TV thickness variation is caused by two-dimensional strain in the InxGa(1-x)N layer below its critical thickness. The SR-TV may be caused by In composition fluctuation. The observations on thickness variation are in good agreement with model calculations based upon strain effects.