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We explored long-term employment status and income before and after depression diagnosis among men and women and at different working ages in Taiwan.
Data from 2006 to 2019 were obtained from the National Health Insurance Research Database (NHIRD). Individuals with newly diagnosed depressive disorder aged 15 to 64 years during the study period were identified. An equal number of individuals without depression were matched for their demographic and clinical characteristics. Employment outcomes included employment status, which was categorized into employed or unemployed, and annual income. Based on the occupation categories and monthly insurance salary recorded in the Registry for Beneficiaries of the NHIRD, a subject was defined as unemployed if he or she differed from the income earner or the occupation category was unemployed. Monthly income was defined as zero for unemployed subjects and proxied as monthly insurance salary for others. Annual income was the sum of monthly income in each observation year.
A total of 420,935 individuals with depressive disorder were included in the study, and an equal number of individuals with not diagnosed depression served as controls. Employment rate and income were lower in the depression group than in the control group before the year of diagnosis, with a difference of 5.7% in employment rate and USD 1,173 in annual income. This gap increased considerably after the year of diagnosis (7.3% in employment rate and USD 1,573 in annual incomes) and further widened in the subsequent years (8.1% in employment rate and USD 2,006 in annual incomes in the 5th following year). The drops in the employment rate and income caused by depression were more evident in men and older age groups than in women and younger age groups, respectively. However, the reduction in employment rate and income in the following years after the diagnosis was more considerable among younger age groups.
The effect of depression on employment status and income was significant during the year of diagnosis and continued afterwards. The effect on employment outcomes varied between genders and across all age groups.
Support vector machines (SVMs) based on brain-wise functional connectivity (FC) have been widely adopted for single-subject prediction of patients with schizophrenia, but most of them had small sample size. This study aimed to evaluate the performance of SVMs based on a large single-site dataset and investigate the effects of demographic homogeneity and training sample size on classification accuracy.
The resting functional Magnetic Resonance Imaging (fMRI) dataset comprised 220 patients with schizophrenia and 220 healthy controls. Brain-wise FCs was calculated for each participant and linear SVMs were developed for automatic classification of patients and controls. First, we evaluated the SVMs based on all participants and homogeneous subsamples of men, women, younger (18–30 years), and older (31–50 years) participants by 10-fold nested cross-validation. Then, we hold out a fixed test set of 40 participants (20 patients and 20 controls) and evaluated the SVMs based on incremental training sample sizes (N = 40, 80, …, 400).
We found that the SVMs based on all participants had accuracy of 85.05%. The SVMs based on male, female, young, and older participants yielded accuracy of 84.66, 81.56, 80.50, and 86.13%, respectively. Although the SVMs based on older subsamples had better performance than those based on all participants, they generalized poorly to younger participants (77.24%). For incremental training sizes, the classification accuracy increased stepwise from 72.6 to 83.3%, with >80% accuracy achieved with sample size >240.
The findings indicate that SVMs based on a large dataset yield high classification accuracy and establish models using a large sample size with heterogeneous properties are recommended for single subject prediction of schizophrenia.
Cognitive impairment is common in late-life depression, which may increase Alzheimer disease (AD) risk. Therefore, we aimed to investigate whether late-life major depressive disorder (MDD) has worse cognition and increases the characteristic AD neuropathology. Furthermore, we carried out a comparison between treatment-resistant depression (TRD) and non-TRD. We hypothesized that patients with late-life depression and TRD may have increased β-amyloid (Aβ) deposits in brain regions responsible for global cognition.
We recruited 81 subjects, including 54 MDD patients (27 TRD and 27 non-TRD) and 27 matched healthy controls (HCs). Neurocognitive tasks were examined, including Mini-Mental State Examination and Montreal Cognitive Assessment to detect global cognitive functions. PET with Pittsburgh compound-B and fluorodeoxyglucose were used to capture brain Aβ pathology and glucose use, respectively, in some patients.
MDD patients performed worse in Montreal Cognitive Assessment (p = 0.003) and had more Aβ deposits than HCs across the brain (family-wise error-corrected p < 0.001), with the most significant finding in the left middle frontal gyrus. Significant negative correlations between global cognition and prefrontal Aβ deposits existed in MDD patients, whereas positive correlations were noted in HCs. TRD patients had significantly more deposits in the left-sided brain regions (corrected p < 0.001). The findings were not explained by APOE genotypes. No between-group fluorodeoxyglucose difference was detected.
Late-life depression, particularly TRD, had increased brain Aβ deposits and showed vulnerability to Aβ deposits. A detrimental role of Aβ deposits in global cognition in patients with late-onset or non-late-onset MDD supported the theory that late-life MDD could be a risk factor for AD.
People with serious mental illness (SMI) have a significantly shorter life expectancy than the general population. This study investigates whether the mortality rate in this group has changed over the last decade.
Using Clinical Record Interactive Search software, we extracted data from a large electronic database of patients in South East London. All patients with schizophrenia, schizoaffective disorder or bipolar disorder from 2008 to 2012 and/or 2013 to 2017 were included. Estimates of life expectancy at birth, standardised mortality ratios and causes of death were obtained for each cohort according to diagnosis and gender. Comparisons were made between cohorts and with the general population using data obtained from the UK Office of National Statistics.
In total, 26 005 patients were included. In men, life expectancy was greater in 2013–2017 (64.9 years; 95% CI 63.6–66.3) than in 2008–2012 (63.2 years; 95% CI 61.5–64.9). Similarly, in women, life expectancy was greater in 2013–2017 (69.1 years; 95% CI 67.5–70.7) than in 2008–2012 (68.1 years; 95% CI 66.2–69.9). The difference with general population life expectancy fell by 0.9 years between cohorts in men, and 0.5 years in women. In the 2013–2017 cohorts, cancer accounted for a similar proportion of deaths as cardiovascular disease.
Relative to the general population, life expectancy for people with SMI is still much worse, though it appears to be improving. The increased cancer-related mortality suggests that physical health monitoring should consider including cancer as well.
Recent imaging studies of large datasets suggested that psychiatric disorders have common biological substrates. This study aimed to identify all the common neural substrates with connectomic abnormalities across four major psychiatric disorders by using the data-driven connectome-wide association method of multivariate distance matrix regression (MDMR).
This study analyzed a resting functional magnetic resonance imaging dataset of 100 patients with schizophrenia, 100 patients with bipolar I disorder, 100 patients with bipolar II disorder, 100 patients with major depressive disorder, and 100 healthy controls (HCs). We calculated a voxel-wise 4,330 × 4,330 matrix of whole-brain functional connectivity (FC) with 8-mm isotropic resolution for each participant and then performed MDMR to identify structures where the overall multivariate pattern of FC was significantly different between each patient group and the HC group. A conjunction analysis was performed to identify common neural regions with FC abnormalities across these four psychiatric disorders.
The conjunction of the MDMR maps revealed that the four groups of patients shared connectomic abnormalities in distributed cortical and subcortical structures, which included bilateral thalamus, cerebellum, frontal pole, supramarginal gyrus, postcentral gyrus, lingual gyrus, lateral occipital cortex, and parahippocampus. The follow-up analysis based on pair-wise FC of these regions demonstrated that these psychiatric disorders also shared similar patterns of FC abnormalities characterized by sensory/subcortical hyperconnectivity, association/subcortical hypoconnectivity, and sensory/association hyperconnectivity.
These findings suggest that major psychiatric disorders share common connectomic abnormalities in distributed cortical and subcortical regions and provide crucial support for the common network hypothesis of major psychiatric disorders.
Background: Executive dysfunction is not uncommon in patients with amnestic mild cognitive impairment (aMCI). This study aimed to investigate the applicability of executive function tests (EFTs) in aMCI as an aid in establishing the diagnosis of multi-domain MCI.
Methods: One hundred and twenty (120) aMCI patients, 126 Alzheimer's disease (AD) patients, and 100 normal controls were enrolled. The EFTs evaluated included the trail making test, digit backward span, Stroop color–word test, and design fluency and category fluency tests.
Results: Of the aMCI participants, 66% exhibited impairment in at least one EFT. Among the five selected EFTs, the category fluency test was the most discriminative in detecting executive dysfunction between patients with aMCI (standardized β = 0.264) or AD (standardized β = 0.361) with the controls, followed by the Stroop test. The performance of aMCI patients with two or more impaired EFTs was significantly different from those of controls but not from those of AD patients.
Conclusion: In the clinical setting, aMCI patients who fail in two or more EFTs may represent a unique population with multi-domain MCI that require close follow-up.
Blue marlin are sexually dimorphic in size-at-age and other biological characteristics. However, few studies have examined the possible impact of sexual dimorphism on the population parameters and the ratios of fishing to total mortality (the exploitation ratios) for this species. We analyzed sex-specific catch-at-length data for blue marlin collected from the Taiwanese tuna longline fishery in the northwest Pacific Ocean, ranging between 100–311 cm in eye to fork length (EFL) for females and 100–236 cm EFL for males, and show that the proportion of females in the catch (the sex ratio) increases with length, with females reaching larger body sizes than males. Minor differences in fishery sex ratios among months were observed. Growth parameters, length structures, and natural mortality rates were estimated to differ between males and females, while fishing mortality rates were found to be similar. Nevertheless, the exploitation ratio for females was higher than that for males. We suggest that growth parameters and natural mortality rates should be sex-specific when assessments for sexually-dimorphic species such as blue marlin are conducted, and that management of blue marlin fisheries could be developed based on size limit regulations for large individuals.
Based on a scanning electron microscope operated at 30 kV with a homemade specimen holder and a multiangle solid-state detector behind the sample, low-kV scanning transmission electron microscopy (STEM) is presented with subsequent electron tomography for three-dimensional (3D) volume structure. Because of the low acceleration voltage, the stronger electron-atom scattering leads to a stronger contrast in the resulting image than standard TEM, especially for light elements. Furthermore, the low-kV STEM yields less radiation damage to the specimen, hence the structure can be preserved. In this work, two-dimensional STEM images of a 1-μm-thick cell section with projection angles between ±50° were collected, and the 3D volume structure was reconstructed using the simultaneous iterative reconstructive technique algorithm with the TomoJ plugin for ImageJ, which are both public domain software. Furthermore, the cross-sectional structure was obtained with the Volume Viewer plugin in ImageJ. Although the tilting angle is constrained and limits the resulting structural resolution, slicing the reconstructed volume generated the depth profile of the thick specimen with sufficient resolution to examine cellular uptake of Au nanoparticles, and the final position of these nanoparticles inside the cell was imaged.
Polyaniline nanofiber (PANF) was synthesized using interfacial polymerization and was mixed with aqueous solution of poly(vinyl alcohol) (PVA) to form PANF–PVA binaries. The PANF suspension in water could be stabilized by PVA for more than 3 months due to the hydrogen bonding interaction between PANF and PVA. The specific characteristics of PANF–PVA films was checked by scanning electron microscopy, conductivity measurement, thermogravimetric analysis, Fourier transform infrared spectroscopy, and cyclic voltammetry. The composite film contained 25 wt% PVA (PANF–PVA25) casting at 105 °C was found to have a porous structure and good conductivity. The presence of hydrogen bonding interaction between PANF and PVA improves the electroactivity and electroactive stability of PANF–PVA25 for electrochemical applications. However, an ether linkage between PANF and PVA polymer chain was also found as casting the PANF–PVA film at 200 °C, which is unfavorable for electrochemical applications.
Episodic memory tasks are one of the most sensitive tools to discriminate Alzheimer’s disease (AD). This study aimed to validate a shorter version verbal memory test that will efficiently assess Chinese elderly with memory complaints. One hundred and eighty-five elderly with normal cognition (NC) and 217 AD patients were evaluated. Each participant received the Chinese Version Verbal Learning Test (CVVLT) consisting of 9 two-character nouns with 4 learning trials, 2 delayed recalls in 30 seconds and 10 minutes, and a word recognition test. In the NC elderly, age and sex had significant effects on recall scores in CVVLT, while education level showed an inverse correlation with 3 different patterns of errors made during the learning, recall, and recognition trials. AD patients had lower scores across all recall tests. In those with lower educational level, NC elderly had higher perseveration errors than AD patients. The cutoff value between the AD and NC groups in the 10-minute recall was 4/5 for those aged >75 years and 5/6 for those aged <75 years. This study has good validity in discriminating AD participants and the data here can help in diagnosing AD and mild cognitive impairment using the CVVLT. (JINS, 2010, 16, 244–251.)
To evaluate the effect on decrease in blood pressure of modifying risk factors for stroke, such as blood lipid profiles, diet habits and indices of body weight, through a family-based nutrition health education programme among hypertensive patients and pre-hypertensive subjects without taking any antihypertensive drugs.
Design and setting
This was a community-based prospective study. The study population was randomly selected from communities in Taipei; potential subjects were invited by telephone to participate.
After excluding subjects whose blood pressure was normal and those using antihypertensive drugs, there were 390 participants included in the study. Subjects in the intervention group (n 293) received nutrition health education on blood pressure control and stroke-related risk factor modification at each visit. Non-intervention subjects (n 97) only acquired a general education sheet available in clinics. The blood pressure of study subjects was measured at baseline and 6-month follow-up to evaluate the intervention’s effect on decrease in blood pressure.
Significant decreases of 2·0 mmHg and 5·9 mmHg in systolic blood pressure were observed both in pre-hypertensive and hypertensive subjects in the intervention group. Additionally, intervention subjects with improvement of total cholesterol and LDL cholesterol, decrease in indices of body weight and increase in consumption of fruit and vegetables also had significant lowering of blood pressure.
The present study provided evidence that the blood pressure of pre-hypertensive and hypertensive subjects could decrease significantly, without taking antihypertensive drugs, after modifying blood lipid profiles and waist by dietary habits changed through a family-based nutrition heath education programme, resulting in a significant effect on stroke risk reduction.
One of the parameters that limit the efficiency of a thin film solar cell, especially the a-Si and the nc-Si solar cell is the cell thickness. Although thicker film can absorb most of the sun light, the optical generated carriers will recombination through the numerous gap states in the film that obtained lower short circuit current and fill factor. In the controversy, thinner film could not absorb enough sun light that also limit the short circuit current. In this works, we utilize nanowire structure to solve the conflict between the light absorption and the carrier transport. The designed structure has ZnO:Al nanowire array on the substrate. The p-i-n a-Si solar cell structure is grown along the surface of each ZnO: Al nanowire sequentially. Under sunlight illumination, the light is absorbed in the axis direction of the nanowire. However, the carrier transport is along the radial direction of the solar cell. Therefore, the long nanowire could absorb most of the solar light. In the mean time, the thickness of the solar cell still is thin enough for photo-generated carrier transport. The dependence of short circuit current, open circuit voltage and fill factor to the length, diameter and density of ZnO:Al nanowires were simulated.
ZnO films were grown on (0001) sapphire substrates by atomic layer deposition (ALD) using diethylzinc (DeZn) and nitrous oxide (N2O) in an inductively heated reactor operated at atmospheric pressure. Low-temperature (LT) ZnO buffer layers having various thicknesses were deposited at 400¢J followed by subsequent growth of ZnO films at 600¢J. Some of the ZnO films were then post-annealed at 1000¢J in the N2O flow. Under certain growth conditions, ZnO nanowires were formed on the post-annealed ZnO samples. Room temperature (RT) photoluminescence (PL) spectra of the ZnO nanowires show strong ultraviolet (UV) near band edge emissions at 3.27 eV with a typical full width at half-maximum ( FWHM ) of ~130 meV and quenched defect luminescence at 2.8 eV. 10 K PL spectra of the post-annealed ZnO all exhibit sharp excitonic emissions with the dominant emission being located at 3.36 eV having a FWHM of 4.6 meV.
In this work, the charge-trapping distributions of polysilicon-oxide-nitride-oxide-silicon (SONOS) structure are studied. The trapping energy level of SiNx films with different composition ratio deposited by low-pressure chemical vapor deposition (LPCVD) were first characterized by photoluminescence (PL) measurement. Moreover, using F-N/CHE program and charge pumping techniques, the vertical location and the lateral distribution of programmed charges are investigated in the nitride films with different composition ratio. The study offers strong evidence that the density of charge-trapping levels in the Si-rich nitride is higher than the standard nitride. A simple qualitative model and calculation explains that the trapping level distributions in the SiNx films are shallower by increasing relative Si-content. Furthermore, we have observed the nitride trap vertical location was changed by adjusted Si/N composition ratio. And the lateral distribution of hot electron programmed charges in the modified nitride is broader than that in the standard nitride because it offered more charge-trapping sites and shallower charge-trapping levels. In summary, the study can help researchers to understand the nitride charge-trapping mechanism and the analysis of optical/electrical characteristics.
At a medical center in Taiwan, all workers were examined by chest radiography, to determine the prevalence of pulmonary tuberculosis. The prevalence of tuberculosis among all hospital workers was 0.12%, that among nurses was 0.35%, and that among externally contracted cleaners was 0.57%. All of the Mycobacterium tuberculosis isolates recovered from 2 nurses and from a patient with pulmonary tuberculosis were the Beijing strain, but the strains had different serotypes.
Penetrating injuries of the paranasal sinuses due to foreign bodies are rare, especially as a result of a traffic accident. Here we report a patient with a ballpoint pen lodged in his left eye following a traffic accident. The pen extended from the medial aspect of the left orbit, through the left ethmoid sinus and the nasal septum, to the right sphenoid sinus. We removed the pen uneventfully using endoscopic sinus surgery. There are no similar reports in the English literature and we therefore present this case because of its rarity.
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