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Major depressive disorder (MDD) is highly heterogeneous and can be classified as treatment-resistant depression (TRD) or antidepressant-responsive depression (non-TRD) based on patients' responses to antidepressant treatment. Methods for distinguishing between TRD and non-TRD are critical clinical concerns. Deficits of cortical inhibition (CI) have been reported to play an influential role in the pathophysiology of MDD. Whether TRD patients' CI is more impaired than that of non-TRD patients remains unclear.
Paired-pulse transcranial magnetic stimulation (ppTMS) was used to measure cortical inhibitory function including GABAA- and GABAB-receptor-related CI and cortical excitatory function including glutamate-receptor-related intracortical facilitation (ICF). We recruited 36 healthy controls (HC) and 36 patients with MDD (non-TRD, n = 16; TRD, n = 20). All participants received evaluations for depression severity and ppTMS examinations. Non-TRD patients received an additional ppTMS examination after 3 months of treatment with the SSRI escitalopram.
Patients with TRD exhibited reduced short-interval intracortical inhibition (SICI) and long-interval intracortical inhibition (LICI), as shown by abnormally higher estimates, than those with non-TRD or HC (F = 11.030, p < 0.001; F = 10.309, p < 0.001, respectively). After an adequate trial of escitalopram treatment, the LICI of non-TRD reduced significantly (t = − 3.628, p < 0.001), whereas the ICF remained lower than that of HC and showed no difference from pretreatment non-TRD.
TRD was characterized by relatively reduced CI, including both GABAA- and GABAB-receptor-mediated neurons while non-TRD preserved partial CI. In non-TRD, SSRIs may mainly modulate GABAB-receptor-related LICI. Our findings revealed distinguishable features of CI in antidepressant-resistant and responsive major depression.
Bipolar disorder is a highly heritable mental illness that transmits intergeneratively. Previous studies supported that first-degree relatives (FDRs), such as parents, offspring, and siblings, of patients with bipolar disorder, had a higher risk of bipolar disorder. However, whether FDRs of bipolar patients have an increased risk of schizophrenia, major depressive disorder (MDD), autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD) remains unclear.
Among the entire population in Taiwan, 87 639 patients with bipolar disorder and 188 290 FDRs of patients with bipolar disorder were identified in our study. The relative risks (RRs) of major psychiatric disorders were assessed among FDRs of patients with bipolar disorder.
FDRs of patients with bipolar disorder were more likely to have a higher risk of major psychiatric disorders, including bipolar disorder (RR 6.12, 95% confidence interval (CI) 5.95–6.30), MDD (RR 2.89, 95% CI 2.82–2.96), schizophrenia (RR 2.64, 95% CI 2.55–2.73), ADHD (RR 2.21, 95% CI 2.13–2.30), and ASD (RR 2.10, 95% CI 1.92–2.29), than the total population did. These increased risks for major psychiatric disorders were consistent across different familial kinships, such as parents, offspring, siblings, and twins. A dose-dependent relationship was also found between risk of each major psychiatric disorder and numbers of bipolar patients.
Our study was the first study to support the familial coaggregation of bipolar disorder with other major psychiatric disorders, including schizophrenia, MDD, ADHD, and ASD, in a Taiwanese (non-Caucasian) population. Given the elevated risks of major psychiatric disorders, the public health government should pay more attention to the mental health of FDRs of patients with bipolar disorder.
Attention-deficit hyperactivity disorder (ADHD) increases the risk of suicidal behaviours through psychiatric comorbidities; however, a significant direct association has not been observed between ADHD and suicide attempts.
To evaluate the risk of suicide attempt in adolescents and young adults with ADHD.
Using a nationwide, population-based insurance claims database, this longitudinal cohort study enrolled 20 574 adolescents and young adults with ADHD and 61 722 age- and gender-matched controls between 2001 and 2009. Any suicide attempt was identified from enrolment to 31 December 2011. The association between ADHD medications and the likelihood of suicide attempt was assessed.
ADHD was an independent risk factor for any suicide attempt (hazard ratio = 3.84, 95% CI = 3.19–4.62) and repeated suicide attempts (hazard ratio = 6.52, 95% CI = 4.46–9.53). Subgroup analyses of men, women, adolescents and young adults demonstrated the same trend. Methylphenidate or atomoxetine treatment did not increase the risk of suicide attempt or repeated suicide attempts. Long-term methylphenidate treatment was associated with a significantly decreased risk of repeated suicide attempts in men (hazard ratio = 0.46, 95% CI = 0.22–0.97).
ADHD was a risk factor for suicide attempt and a stronger predictor of repeated suicide attempts, independent of comorbidities. Further investigation is warranted to explore the mechanism underlying the association between ADHD and suicidal behaviours.
To develop a theoretical model explaining the longitudinal changes in the caregiving process for family caregivers of persons with mild cognitive impairment (MCI) in Taiwan.
A longitudinal, grounded theory approach using in-depth face-to-face interviews and an open-ended interview guide. We conducted 42 interviews over a two-year period; each participant was interviewed at least once every six months. All participants were interviewed in their home. The participants total of 13 family caregivers of persons with MCI.
One core theme emerged: “protective preparation.” This reflected the family caregiving process of preparation for a further decline in cognitive function, and protection from the impact of low self-esteem, accidents, and symptoms of comorbidities for the family member with MCI. Protective preparation contained three components: ambivalent normalization, vigilant preparation, and protective management.
Interventions to help family caregivers manage the changes in persons with MCI can reduce caregiver burden. Our findings could provide a knowledge base for use by healthcare providers to develop and implement strategies to reduce caregiver burden for family caregivers of persons with MCI.
To investigate the effect of Mn on antioxidant status and on the expressions of heat shock proteins/factors in tissues of laying broiler breeders subjected to heat challenge, we used a completely randomised design (n 6) with a factorial arrangement of 2 environmental temperatures (normal, 21±1°C, and high, 32±1°C)×3 dietary Mn treatments (a Mn-unsupplemented basal diet (CON), or a basal diet supplemented with 120 mg Mn/kg diet, either as inorganic Mn sulphate (iMn) or as organic Mn proteinate (oMn)). There were no interactions (P>0·10) between environmental temperature and dietary Mn in any of the measured indices. High temperature decreased (P<0·003) Mn content, and also tended (P=0·07) to decrease Cu Zn superoxide dismutase (CuZnSOD) activity in the liver and heart. However, an increased Mn superoxide dismutase (MnSOD) activity (P<0·05) and a slight increase in malondialdehyde level (P=0·06) were detected in breast muscle. Up-regulated (P<0·05) expressions of heat shock factor 1 (HSF1) and HSF3 mRNA and heat shock protein 70 (HSP70) mRNA and protein were found in all three tissues. Broiler breeders fed either iMn or oMn had higher tissue Mn content (P<0·0001), heart MnSOD and CuZnSOD activities (P<0·01) and breast muscle MnSOD protein levels (P<0·05), and lower (P<0·05) breast muscle HSP70 mRNA and protein levels compared with those fed CON. Broiler breeders fed oMn had higher (P<0·03) bone Mn content than those fed iMn. These results indicate that high temperature decreases Mn retention and increases HSP70, HSF1 and HSF3 expressions in the tissues of laying broiler breeders. Furthermore, dietary supplementation with Mn in either source may enhance the heart’s antioxidant ability and inhibit the expression of HSP70 in breast muscle. Finally, the organic Mn appears to be more available than inorganic Mn for bone in laying broiler breeders regardless of environmental temperatures.
To investigate the effect of Mn on antioxidant status and expression levels of heat-shock proteins/factors in tissues of laying broiler breeders subjected to heat challenge, we used a completely randomised design (n 6) with a factorial arrangement of 2 environmental temperatures (normal, 21 (sem 1)°C and high, 32 (sem 1)°C)×3 dietary Mn treatments (an Mn-unsupplemented basal diet (CON), or a basal diet supplemented with 120 mg Mn/kg diet as inorganic Mn sulphate (iMn) or organic Mn proteinate (oMn)). There were no interactions (P>0·10) between environmental temperature and dietary Mn in all of the measured indices. High temperature decreased (P<0·003) Mn content, and also tended (P=0·07) to decrease copper zinc superoxide dismutase (CuZnSOD) activity in the liver and heart. However, an increased manganese superoxide dismutase (MnSOD) activity (P<0·05) and a slight increase of malondialdehyde level (P=0·06) were detected in breast muscle. Up-regulated (P<0·05) expression levels of heat-shock factor 1 (HSF1) and HSF3 mRNA and heat-shock protein 70 (HSP70) mRNA and protein were found in all three tissues. Broiler breeders fed either iMn or oMn had higher tissue Mn content (P<0·0001), heart MnSOD and CuZnSOD activities (P<0·01) and breast muscle MnSOD protein levels (P<0·05), and lower (P<0·05) breast muscle HSP70 mRNA and protein levels than those fed CON. Broiler breeders fed oMn had higher (P<0·03) bone Mn content than those fed iMn. These results indicate that high temperature decreases Mn retention and increases HSP70 and HSF1, HSF3 expression levels in tissues of laying broiler breeders. Furthermore, dietary supplementation with Mn in either source may enhance heart antioxidant ability and inhibit the expression of HSP70 in breast muscle. Finally, the organic Mn appears to be more available than inorganic Mn for bone in laying broiler breeders regardless of environmental temperatures.
Previous evidence has shown positive associations between post-traumatic
stress disorder (PTSD) and hypertension, dyslipidaemia and diabetes
mellitus, which are all risk factors for stroke, but the role of PTSD in
the subsequent development of stroke is still unknown.
To investigate the temporal association between PTSD and the development
Identified from the Taiwan National Health Insurance Research Database,
5217 individuals aged 18 years, with PTSD but with no history of stroke,
and 20 868 age- and gender-matched controls were enrolled between 2002
and 2009, and followed up until the end of 2011 to identify the
development of stroke.
Individuals with PTSD had an increased risk of developing any stroke
(hazard ratio (HR) 3.37, 95% CI 2.44–4.67) and ischaemic stroke (HR =
3.47, 95% CI 2.23–5.39) after adjusting for demographic data and medical
comorbidities. Sensitivity tests showed consistent findings (any stroke
HR = 3.02, 95% CI 2.13–4.28; ischaemic stroke HR = 2.89, 95% CI
1.79–4.66) after excluding the first year of observation.
Individuals with PTSD have an increased risk of developing any stroke and
ischaemic stroke. Further studies are required to investigate the
A photoactivated ZnO nanomesh with precisely controlled dimensions and geometries is fabricated by using nanosphere lithography process. The nanomesh structures effectively increase the surface-to-volume ratio to improve the sensing response under the same testing gas. And the periodical nanostructures also increase the effective light path and lead to more efficient light activation for gas sensing. With the increase of the photoinduced oxygen ions by UV illumination, a distinguished sensing response is observed at room temperature. In the optimized case, the sensing response (△R/R0) of the ZnO nanomesh at the butanol concentration of 500 ppm is 97.5%, which is 4.54 times higher than the unpatterned one.
A radio-frequency magnetron sputtering technique and subsequent rapid thermal annealing (RTA) at 600, 700, 800, and 900 °C were implemented to grow high-quality Ga-doped MgxZn1-xO (GMZO) epi-layers. The GMZO films were deposited using a radio-frequency magnetron sputtering system and a 4 inch ZnO/MgO/Ga2O3 (75/20/5 wt %) target. The Hall results, X-ray diffraction (XRD), and transmittance were determined and are reported in this paper. The Hall results indicated that the increase in mobility was likely caused by the improved crystallization in the GMZO films after thermal annealing. The XRD results revealed that MgxZn1-xO (111) and MgO2 (200) peaks were obtained in the GMZO films. The absorption edges of the as-grown and annealed GMZO films shifted toward the short wavelength of 373 nm at a transmittance of 90%. According to these results, GMZO films are feasible for forming transparent contact layers for near-ultraviolet light-emitting diodes.
This study examined the combined effect of family ownership and high-discretion organizational slack on the international involvement of Taiwanese firms. Employing a sample of 179 publicly listed high-tech firms in Taiwan over a period of 6 years (2000–2005), we found that firms with high levels of international involvement, that is, a higher degree of internationalization, (i) were not closely held, and (ii) were not excessively controlled by the family. Further, high-discretion organizational slack (indicated by resources that can be deployed in a flexible fashion such as in cash and receivables) moderated the negative relationship between family control and international involvement. This relationship is stronger with a higher level of high-discretion slack. The results support the hypothesis that family control and high-discretion organizational slack negatively influence the decision to internationalize.
In this work, high quality silicon dioxide (SiO2) films were prepared by large-area plasmaenhanced chemical vapor deposition (LA-PECVD) using tetraethylorthosilicate(TEOS)-oxygen based chemistry. The effects of various short-time plasma treatments on these as-deposited TEOS oxide were also investigated. Different plasma treatments such as O2, N2O, and NH3 were used in our experiments. Electrical characteristics were exploited to examine the effects of plasma treatments. It was shown that after N2O, and NH3 plasma treatments, the electrical strength of oxide was enhanced. Besides, NH3 plasma treatment exhibited the highest enhancement efficiency. O2- plasma treatment, however, showed some harmful effects on the electrical properties of the TEOS oxide. The reliability tests including charge to breakdown (Qbd) and bias temperature stress (BTS) were also analyzed in these samples. Although better pre-stress characteristics were observed in those samples treated by NH3-plasma, samples with N2O plasma treatment showed superior stress endurance. Consequently, N2O plasma treatment seems to be the best candidate for future TFTs under the consideration of long-term reliability.
Nanosized lithium manganate powders are successfully synthesized via a newly developed reverse-microemulsion (RμE) process. Monophasic LiMn2O4 powders are obtained after calcining the precursor powders at 700°C. The particle size of the spinel compound significantly depends on the concentration of the aqueous phase. Increasing the water-to-oil volume ratio results in an increase in the particle size. While the aqueous phase is equal to 0.5 M, the size of the obtained LiMn2O4 powder is around 60-70 nm. It is found that the specific capacity of nanosized LiMn2O4 particles is greater than that of submicron particles. The large surface area of ultrafine particles is considered to facilitate the intercalation and deintercalation of lithium ions during the cycling test.
The study reported is about an integrated wireless physiological monitor module of the flexible patch type, used on a non-woven material to package this module by a hot press process. The module can monitor the body temperature and heart rate. Experimental results showed that the specification and accuracy should be 25-40 °C ± 0.5 °C and 50-200 bpm ± 2 bpm. The main advantage of the module is that the postural change can be monitored. At the same time, it has also a good adhesion between substrate and components, without crack of conductor trace line after bending the module repeatedly. Thickness is about 2 mm. The aim of this study is to speed up the physiological technology and to create more efficiency by miniaturization. In addition, the acceptance level of wearing it is increased by the small and ergonomic design.
The thermal expansion of thin deuterated polystyrene (dPS) films supported on energetically repulsive, fluorinated polyimide (PI) substrates (PI/dPS bilayer) was measured via neutron reflectometry as a function of initial dPS film thickness. Film thickness was measured before and after capping with a top layer of the same repulsive, high glass transition polyimide that comprised the substrate layer (PI/dPS/PI trilayer) in an attempt to observe any effects of the dPS free surface in the bilayer geometry. Bulk thermal expansion behavior, characterized by a discontinuous change in coefficient of thermal expansion (CTE) at the glass transition (Tg), is observed in films with thickness > 70 rim. For thicknesses between 70 nm and 40 nm a transition is seen from bulk behavior in bilayer films to glassy thermal behavior in the trilayer films persisting up to 20 °C above the bulk Tg. In films with thickness < 40 nm the bulk glassy CTE persists well above the bulk Tg for both bilayer and trilayer films
As the industry develops processes for the 65 and 45 nm technology nodes, post etch/ash cleaning faces new challenges with far more stringent requirements on surface cleanliness and materials loss. The introduction and integration of new materials, such as metal hard mask, creates additional requirements for wafer cleaning due to the occurrence of new defect modes related to metal hard mask. These include organometallic residue and metal fluorite compounds precipitating with time. We have developed a novel aqueous solution (AQ) based single wafer cleaning process to address these new defect modes. Physical characterization results and process integration electrical data and reliability data (TEM cross section review of the vias) are presented in this paper.
The main conclusions can be summarized as follows: (1) In the dual damascene Cu/low-k process flow with hard mask, there are three typical residues after etch/ash: generic polymer residue, organometallic residue strongly bonded to metal maks, and time-dependent metal fluoride residue. (2) Generic polymer residue is very well characterized [1,2] and is usually easy to remove with solvent or aqueous solution [2,3]. (3)We developed an oxidizing chemistry based process to undercut the hard mask for the organometallic residue removal, which proved highly effective. (4)The time-dependent metal fluoride reside makes queue time control after etch/ash very critical (<1 hour). We developed a process with a fluorine based aqueous chemistry to address the metal fluoride residue, which proved highly effective. With this new process, queue time control is not required. (5) The post etch/ash cleaning for the Cu/low-k structure with metal hard mask typically employs the solvent/dry plasma ash multi-step procedure . The new process developed in this research reduced the multi-step process to one wet clean step with two different aqueous chemistries in sequence. (6) The integration electrical data shows that the new single step aqueous cleaning process performance is comparable to, or even better than that from the solvent/dry plasma ash multi cleaning process. (7) Blanket Cu loss with the new process is about 23A/min, however TEM analysis of the vias after full integration shows Cu loss, we are working to improve the integration related Cu loss.
Biomaterials such as DNA are currently being explored as potential application in nanotechnology. DNA templates were immobilized on crystal-violet-treated mica by spin coating as a grid-like network. The DNA templates were then activated with PdCl2, followed by reduction with dimethylamine borane (DMAB) to form seeding nanoclusters on the DNA chain. Afterward the DNA chain with deposition of zero-valence Pd nanoclusters was grew in a Co electroless plating bath. SEM/EDS analysis revealed that Co nanoparticles could be assembled on the DNA template to form magnetic nanowires with a diameter of 25nm to 250nm by a conventional electroless plating. Vibrating Sample Magnetometer analysis indicated that Co-DNA nanowires showed a paramagnetic characteristic. Grid-like networks of DNA template were effectively preserved after Co electroless plating. These characteristics indicated that DNA is an ideal template for the production of magnetic nanowires, which could be useful in the development of high-density memory storage or magnetic field sensors.