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Whether the first-degree relatives (FDRs) of patients with obsessive-compulsive disorder (OCD) have an increased risk of the major psychiatric disorders, namely schizophrenia, bipolar disorder, OCD, major depressive disorder (MDD), autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD), remains unclear.
Using the Taiwan National Health Insurance Research Database with the whole population sample size (n = 23 258 175), 89 500 FDRs, including parents, offspring, siblings, and twins, of patients with OCD were identified in our study. The relative risks (RRs) of major psychiatric disorders were assessed among FDRs of patients with OCD.
FDRs of patients with OCD had higher RRs of major psychiatric disorders, namely OCD (RR 8.11, 95% confidence interval (CI) 7.68–8.57), bipolar disorder (RR 2.85, 95% CI 2.68–3.04), MDD (RR 2.67, 95% CI 2.58–2.76), ASD (RR 2.38, 95% CI 2.10–2.71), ADHD (RR 2.19, 95% CI 2.07–2.32), and schizophrenia (RR 1.97, 95% CI 1.86–2.09), compared with the total population. Different familial kinships of FDRs, such as parents, offspring, siblings, and twins consistently had increased risks for these disorders. In addition, a dose-dependent relationship was found between the numbers of OCD probands and the risk of each major psychiatric disorder.
The FDRs, including parents, offspring, siblings, and twins, of patients with OCD have a higher risk of OCD, schizophrenia, bipolar disorder, MDD, ADHD, and ASD. The familial co-aggregation of OCD with OCD and other major psychiatric disorders was existent in a dose-dependent manner. Given the increased risks of psychiatric disorders, medical practitioners should closely monitor the mental health of the FDRs of patients with OCD.
The earliest colonisation of oceanic islands by Homo sapiens occurred ~50 000–30 000 years ago in the Western Pacific, yet how this was achieved remains a matter of debate. With a focus on East Asia, the research presented here tests the hypothesis that bamboo rafts were used for these early maritime migrations. The authors review the evidence for Palaeolithic seafaring in East Asia as the context for an experimental archaeology project to build two bamboo watercraft. Sea trials demonstrate the unsuitability of bamboo, at least in East Asia, indicating that more sophisticated and durable vessels would have been required to traverse the Kuroshio Current.
The condition of caregivers is important to the quality of care received by people with Parkinson’s disease (PD), especially at the late disease stages. This study addresses the distress placed on caregivers by participants’ neuropsychiatric symptoms at different stages of PD in Taiwan
This prospective study enrolled 108 people with PD. All participants were examined with the Unified Parkinson’s Disease Rating Scale (UPDRS), Neuropsychiatric Inventory (NPI), Mini-Mental State Examination (MMSE), Cognitive Abilities Screening Instrument (CASI), and Clinical Dementia Rating (CDR) scale. Caregiver distress was measured using the Neuropsychiatric Inventory Caregiver Distress Scale (NPI-D). Statistical analysis was used to explore the PD-related factors that contribute to caregiver distress.
The mean follow-up interval in the 108 PD participants were 24.0 ± 10.2 months with no participant lost to follow-up due to death. NPI-distress (the sum of NPI caregiver distress scale across the 12 domains of the NPI) was positively correlated with NPI-sum (the total score across the 12 domains of the NPI) (r = 0.787, p < 0.001), CDR (r = 0.403, p < 0.001), UPRDS (r = 0.276, p = 0.004), and disease duration (r = 0.246, p = 0.002), but negatively correlated with CASI (r = −0.237, p = 0.043) and MMSE (r = −0.281, p < 0.001). Multiple linear regression analysis showed that only NPI-sum and disease duration were independently correlated with NPI-distress.
The disease duration and NPI-sum are independent predictors of caregiver distress in Taiwanese populations with PD. Early detection and reduction of neuropsychiatric symptoms in people with PD can help decrease caregiver distress.
English as a lingua franca (ELF) refers to ‘any use of English among speakers of different first languages for whom English is the communicative medium of choice, and often the only option’ (Seidlhofer, 2011, p. 7*). ELF research started relatively recently. It was only discussed occasionally in the last century. Landmark changes were the publications of Jenkins (2000*) and Seidlhofer (2001*). These works inspired more research into ELF, as witnessed by a dramatically increased interest in ELF since then, resulting in a large number of journal articles, monographs, edited books (e.g. Mauranen & Ranta, 2009*) and large corpora (e.g. the Vienna-Oxford International Corpus of English, the Corpus of English as a Lingua Franca in Academic Settings, and the Asian Corpus of English). In addition, ELF researchers have launched the annual conference series (International Conference of English as a Lingua Franca), the Journal of English as a Lingua Franca, and the De Gruyter book series Developments in English as a Lingua Franca. These publications move from an initial understanding of ELF as a ‘variety’ or ‘varieties’ to a later conceptualisation of ELF as a dynamic, fluid and variable phenomenon. ELF has become a major focus of discussions and activities among both applied linguists and English language teaching professionals (Jenkins, Cogo, & Dewey, 2011).
The coastal environment of the Changjiang delta has been influenced by recent anthropogenic activities such as dam construction and increased sewage and fertilizer inputs. Previous work examined the compositional shift of marine plankton to assess ecological impacts of these activities on marine ecosystems in the Changjiang discharge area. Here we used benthic marine ostracodes collected in the Changjiang estuary and the adjacent East China Sea in the 1980s and the 2010s, respectively, to investigate temporal changes of the benthic community and controlling factors for the benthic fauna. Our results revealed more shoreward distribution of some well-known offshore ostracode species in the 2010s compared with the 1980s and a relatively more important role for environmental processes (e.g., bottom-water temperature, bottom-water salinity, and eutrophic conditions of surface water) than spatial processes (e.g., the flow of ocean currents) in structuring ostracode compositions. The temporal changes in the ostracode community are likely attributable to the combined effects of reduced fresh water and sediment discharge and eutrophic conditions of the Changjiang due to the many dams constructed along the Changjiang and population expansion in the Changjiang Basin. Results of redundancy analysis and variation partitioning suggest that ocean currents facilitated environmental filtering of ostracode species such that they could disperse to preferred environmental conditions. These findings highlight the potential uses of marine microfossils to better understand ecological impacts on benthic ecosystems in vulnerable Asian mega-deltas and provide insights into the integration of metacommunity concepts in disentangling dynamics of marine benthic communities.
Information systems (IS) have facilitated workflow in the health care system for years. However, the utilization of IS in disaster medical assistance teams (DMATs) has been less studied.
In Taiwan, we started a program in 2008 to build up an information system, MEDical Assistance and Information Dashboard (MED-AID), to improve the capability and increase the efficiency of our national DMAT.
Method: The mission of our national DMAT was to provide acute trauma care and subacute outpatient care in the field after an emergency event (e.g., earthquakes). We built the IS through a user-oriented process to fit the need of the DMAT. We first analyzed the response work in the DMAT missions and reviewed the current paperwork. We evaluated the eligibility and effectiveness of the core functions of DMATs by experts in Taiwan and then developed the IS. The IS was then tested and revised each year in two table-top exercises and one regional full-scale exercise by the DMAT staffs who came from different hospitals in Taiwan.
During the past 10 years, we identified several core concepts of IS of DMAT: patient tracking, medical record, continuity of care, integration of referral resources, disease surveillance, patient information reporting, and medical resources management. The application of the IS facilitate the DMAT in providing safe patient care with continuous recording and integrate patient referral resources based on geographic information. The IS also help the planning in real-time disease surveillance and logistic function in the medical resources monitoring.
Information systems could facilitate patient care and relieve the workload on information analysis and resources management for DMATs.
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.
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.
In contrast to voice traffic, wireless data traffic is mostly asymmetric and time-variant with a requirement for a dynamically adjusting technique to divide the uplink (UL) and downlink (DL) resource. In typical cellular systems, the length of UL resource and the length of DL resource are predetermined. In a typical frequency-division duplex (FDD) system, the UL and DL transmission use distinctive frequency bands, which is especially efficient in cases of symmetric traffic due to the avoidance of possible interference between UL and DL transmission. However the FDD system has difficulty in adjusting its UL and DL resource in asymmetric traffic since the resource division is operated by the duplexer in the hardware. A typical time-division duplex (TDD) system is capable of adjusting the UL and DL transmission in time domain. However, due to the requirement of synchronization in order to eliminate the interference, the UL and DL resource is still fixed. To support asymmetric and time-variant traffic, LTE provides small cell base stations (BSs) with dynamic TDD by supporting seven TDD UL/DL configurations, enabling the BSs dynamically to change the ratio of UP and DL resource to handle the time-variant traffic. Nevertheless, such a scheme also induces two type of interference: BS–BS interference and MS–MS interference. In this chapter the interference issues and several interference mitigation methods will be extensively discussed.
Dynamic TDD system overview
To divide the UL and DL traffic resource, some typical communication systems apply FDD, where different frequency bands are used for transmitting and receiving, the benefit of which is that no interference will be incurred between UL and DL signals. For the symmetrical traffic on UL and DL (e.g., voice service), the FDD system is suitable since the BS is assigned the same amount of radio resource in the UL and DL. Whereas for wireless data services, FDD is not flexible enough to handle this type of dynamic UL/DL traffic due to the character of the UL and DL traffic being asymmetric and time-variant in these cases.
Compared to FDD, TDD is different in that the UL and DL resource is divided in time domain and can be easily adjusted. It possesses an advantage of greater flexibility in handling the dynamic UL/DL traffic. In the TDD system, the boundary between the UL and DL duty cycle is adaptively adjustable according to service requirements.
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.
Congenital anomalies of the coronary arteries are present in 0.2–1.4% of the general population. These anomalies represent one of the most confusing issues in the field of cardiology and challenges for interventional cardiologists and cardiac surgeons if the anomalies are unrecognised. Double right coronary artery is one of the rarest coronary arteries. Previously, the probability of developing atherosclerotic changes in patients with a double right coronary artery was considered to be equal to that in those without it. In reality, however, a high prevalence of atherosclerotic coronary artery disease was found in patients with a double right coronary artery originating from a single ostium after our comprehensive literature search through the PubMed database. Owing to the fact that double right coronary artery is both a congenital and potentially atherosclerotic coronary artery disease at diagnosis, coronary intervention or cardiac operation is more complicated than previously believed. Individuals with a double right coronary artery may be unaware of its presence until an accidental finding during coronary angiography or cardiac operation and are at risk for unsuspected complications of atherosclerotic coronary artery disease or during cardiac operation. Therefore, it is important to obtain information on the anatomic variants of this congenital coronary anomaly in patients who are undergoing either coronary intervention, aortic root operation or myocardial revascularisation. To our knowledge, this is the first comprehensive article to discuss the anomalies and their clinical implications.
Glycogen stored in skeletal muscle is the main fuel for endurance exercise. The present study examined the effects of oral hydroxycitrate (HCA) supplementation on post-meal glycogen synthesis in exercised human skeletal muscle. Eight healthy male volunteers (aged 22·0 (se 0·3) years) completed a 60-min cycling exercise at 70–75 % and received HCA or placebo in a crossover design repeated after a 7 d washout period. They consumed 500 mg HCA or placebo with a high-carbohydrate meal (2 g carbohydrate/kg body weight, 80 % carbohydrate, 8 % fat, 12 % protein) for a 3-h post-exercise recovery. Muscle biopsy samples were obtained from vastus lateralis immediately and 3 h after the exercise. We found that HCA supplementation significantly lowered post-meal insulin response with similar glucose level compared to placebo. The rate of glycogen synthesis with the HCA meal was approximately onefold higher than that with the placebo meal. In contrast, GLUT4 protein level after HCA supplementation was significantly decreased below the placebo level, whereas expression of fatty acid translocase (FAT)/CD36 mRNA was significantly increased above the placebo level. Furthermore, HCA supplementation significantly increased energy reliance on fat oxidation, estimated by the gaseous exchange method. However, no differences were found in circulating NEFA and glycerol levels with the HCA meal compared with the placebo meal. The present study reports the first evidence that HCA supplementation enhanced glycogen synthesis rate in exercised human skeletal muscle and improved post-meal insulin sensitivity.
A void free 3C-SiC film grown on Si(100) can be achieved by low pressure chemical vapor deposition using the modified four-step method. The diffusion step plays an important role to enhance the quality of the 3C-SiC buffer layer on Si(100). X-ray photoelectron spectroscopy was used to characterize the bonding characteristics of the 3C-SiC buffer layer of about 10 nm thick. The Si-C bonds are partially formed on the as-carburized Si(100) before the diffusion step. The ratio of C-C to Si-C bonds on the as-carburized Si(100) is about 7:3, which can be lowered to about 1:9 after the diffusion step at 1350 oC for 5 min or at 1300 oC for 7 min. According to XPS data and Fick's second law, the diffusivity of Si across the 3C-SiC interlayer are determined to be 2.2×10-16 cm2/s and 3.13×10-16 cm2/s at 1300°C and 1350°C, respectively. The derived activation energy is 1.6 eV for the diffusion of Si atoms in the 3C-SiC buffer layer.
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.)
We have fabricated La0.6Ca0.4MnO3 periodic arrays exhibiting tunable optical properties and magnetic properties using nontoxic and environmentally friendly electron beam resist made from La0.6Ca0.4MnO3 sol-gel precursor. We studied their unique optical properties by using the spectral microreflectometer and their magnetic properties using the superconducting quantum interference device and magnetic force microscopy. Additionally, the resist has the ability to demonstrate both positive and negative resist behaviors depending on the electron beam dosage. With these special characteristics, we can fabricate periodic structure on a thin film possessing controlled optical reflectance properties with one fixed design electron beam pattern without changing the structural parameters but changing the electron beam dosage only. Our approach provides an uncomplicated route for the fabrication of nanometer scale magnetic patterns, which serve as the building blocks in the search for novel properties of periodic magnetic arrays.
The interfacial regimes of cobalt/pentacene/cobalt (Co/Pc/Co) trilayers were emulated through the ultrathin pentacene/cobalt (Pc/Co) and cobalt/pentacene (Co/Pc) bilayers. Employing the magneto-optical Kerr effect (MOKE) measurement, we found the coercivity of Co bottom film in a thickness of 3.4 nm experienced a slight reduction upon the adsorption of Pc molecules. For the bilayers prepared with reversed order of deposition, the Co film deposited on a 6.4 nm Pc layer showed no observable ferromagnetic order at room temperature until its thickness reached 3 nm. After the onset of magnetic order, the x-ray images acquired on Pc/Co revealed a complicated magnetization patterns comparing to those observed on Co/Pc bilayers. Because the spin-polarized carriers will interact with the environment along their transport path, the presence of a non-magnetic layer and the occurrence of complicated domain structures suggested the spin-polarized carriers would experience a greater disturbance on their spin coherence when crossing the Pc/Co interface.