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Depression is a common mental disorder that substantially impairs a client's functioning. the aim of this study is to examine the predictive factors of quality of life (QOL) for depression from longitudinal perspectives. 237 outpatients with depression were recruited in the study. They were from a psychiatric outpatient clinic in northern Taiwan. All subjects were tested on the baseline and followed up twice during 3-year period. the average age of subjects was 47.1 years. Most subjects were female, married and lived with their spouses.Seventy subjects participated in both follow ups (T2 and T3). there were no significant differences on the demographic characteristics at T1 between the respondents (N = 70) and non-respondents (N = 167) except for gender. the subjects were tested on the WHOQOL-BREF-Taiwan version, occupational self assessment, mastery, social support and Center of Epidemiology Study-Depression Scale (CESD). the data were analyzed by mixed effect model using SAS computer program.The severity of depression could predict overall QOL, overall health and 13 items of QOL. the type of antidepressants had significant impact on the subjects’ QOL in 10 items. the occupational competence and sense of mastery predicted 13 items (50%) and 14 items (53.8%), respectively.In order to advance the treatment outcomes, the professionals should pay more attention on the enhancement of the sense of competence and mastery. We suggested that treatments should target at improving adaptive skills, lifestyle, and occupational competence.
Previous studies showed that persons with mental illness had poorer quality of life than persons with the other medical conditions. We developed a manualized treatment - Quality of Life Enhancement Program (QOLEP) based on literature review and clinical experiences. the contents of the program include 4 sessions of ‘occupational life scheduling’ and 4 sessions of ‘coping skills’ provided by an occupational therapist during a 4-week period (2 times/week) which each session lasts for one to two hours.
Twenty-one subjects were recruited from community mental health rehabilitation centers in northern Taiwan. They were randomly assigned to either treatment group (N=11) or control group (N=10). the subjects in the control group received general supportive therapy over the phone twice a week for 4 weeks. Both groups were evaluated at baseline and posttreatment. the mixed-effects linear model was applied to analyze the efficacy of the treatment.
The results showed that the subjects who participated in the QOLEP had significantly better physical QOL than that of control group (-9.66+4.24, p< .05). the suicidal ideation of the subjects for both groups decreased over time (2.64+3.16, p< .05). Most of the participants indicated that the activities were easily understood, helpful to them, and are willing to participate in the program again.
With the program developed based on concept of occupational engagement, we were able to demonstrate the efficacy of specific treatment on quality of life and used it as evidence to support future development in mental health area.
The shape memory properties of Ni–Al alloy are investigated using molecular dynamics simulation. The phase transformation behaviors for various Ni composition ratios are studied under quasistatic cooling and heating process. Various loadings, i.e., uniaxial, shear, and biaxial, are applied on a 68% Ni–Al alloy till plasticity takes place. The atomic configurations are inspected and analyzed using a common neighbor parameter. The shape recovery capability of the plastically deformed alloy is examined after heating above the phase transformation temperature. It is found that there would be shape recovery if the twinning plane reorientation or moving was the major yielding mechanism. For those loadings in which stacking faults or dislocations nucleate, the deformed model would not restore to its original shape after heating and the corresponding maximum shear stress is noticeably higher. There is no direct dependence between the yield strain and the shape recovery capability. Our findings could provide a possible explanation for the functional fatigue of the polycrystalline shape memory alloy.
Dementia screening is a public health priority in Taiwan, where the prevalence of dementia is increasing because of an aging population. However, the reasons affect community-dwelling people to accept a referral to memory specialist clinic after dementia screening was still unclear. To investigate the feasibility, acceptability, sensitivity, and specificity of the ascertain dementia 8-item informant questionnaire (AD8) to screen for patients with cognitive impairments in Taiwan's primary healthcare system.
Researchers invited community-dwelling people whose age was above 50-year-old to attend the Memory Screening Project. AD8 was used to perform the informant interview with adult patients who were attending the Memory Screening Project in Taiwan. Individuals who scored ≥2 on the AD8 was suggested to accept referral for further cognitive performance evaluation tests, which included three validated dementia tests, i.e. the Mini-Mental Screening Examination (MMSE), the Cognitive Abilities Screening Instrument (CASI), and the Clinical Dementia Rating (CDR).
Of the 102 participants who scored ≥2 on the AD8, only 25.5% attended the referral appointment. In participants who had achieved six or more years of education, AD8 scores were not significantly different between groups and could not differentiate between the non-dementia and patients with dementia in the receiver-operator characteristics curve analysis. In contrast, in those participants who had received less than six years of education, the AD8 scores significantly differentiated between non-dementia and patients with dementia (p = 0.03).
There was a low rate of attendance at a specialist memory clinic following referral after the AD8 interview. Higher levels of education facilitated individuals to make a decision to accept the recommended referral appointment, while the AD8 showed a higher rate of differentiation between individuals who had received an education of less than six years.
We investigated the effect of focused ion beam (FIB) imaging on the crystallinity of InAs using Raman scattering. A spatial correlation model was used to fit the broad band induced by FIB imaging. The fitting gives a correlation length of ~42 Å for the noisiest image condition (with an ion fluence of 7.4×1010 cm−2), implying severe damage in the surface layer of InAs. However, further increasing the fluence by several orders of magnitude only decreases the correlation length from 42 to 35 Å. We attribute the severe damage to the high beam current density and the low scanning speed of the FIB imaging process. These process conditions, along with low InAs thermal conductivity, also leads to a high local temperature in the exposed region that largely annihilated the defects and resulted in the nearly fluence-independent behavior.
Golden time of thrombolysis therapy in acute ischemic stroke is only three hours. Emergency medical services transport and hospital prenotification were not been strengthened in Taiwan.
In order to elevate the medical quality of acute ischemic stroke, we developed a Quality Control Circle (QCC) focused on a comprehensive thrombolysis service for patients with acute ischemic stroke administered pre-hospital and in an emergency department.
QCC activities contained early recognition of acute stroke by EMT, hospital prenotification, early emergency management, activate the stroke team, shorten the time to CT scan and report, and early thromobolytic therapy. There were three policy groups via quality method analysis which these methods aimed to improve the efficiency and quality of management process focused on acute ischemic stroke.
Group 1: After the implementation of QCC, the number of times of pre-hospital notification was six in Mar. 2010, achieve the expected standard. Group 2: Responses were received from 160 people for the pretest and 145 people for the posttest. In the pretest and posttest analysis, significant improvement in the attitudes of the physician group (p < 0.001) and general behavior (p < 0.001) were disclosed. The case-based educational module of acute stroke was better than the traditional oral lecture especially in the nursing group (p < 0.001). Group 3: The rate of administering thrombolytic therapy/total ischemic stroke increased from 3.1% to 10.5 % (from Mar to Apr, 2010) after running the organized service. These activities reached the goal of expected standard (5%). All above groups were set up into standardization. The thrombolytic rate in effect maintainence was still around 5% eight months later.
Setting up and running a organized thrombolysis service for patients with acute ischemic stroke prehospital and in the emergency department can be a good method to increase the rate of administration of thrombolytic therapy.
The beam position monitors (BPMs) with submicron-level resolution act as the major eyes of storage ring in detecting the position of electron beams and are used for feedback system to guide the beam orbit to the desired track. Compared to major improvements on backend electronics, the physical devices generate and transmit signals had little improvement due to the lack of control on manufacturing processes including all mechanical tolerance requirements. The design started with ANSYS to simulate mechanical deformation. Due to the small size (submillimetre) and complicated assembly of feedthrough structure, it is difficult to achieve 1 % tolerance (submicron) in all aspects including machining and brazing. The smallest tolerance for machining is 5 µ and the overall tolerance will be 30 µm. The influence of the tolerance on mechanical will be shown on time-domain reflectometry measurement. The resulted heat-related issue will also be discussed and addressed since the problem happened at SLAC (private communication with Albert Sheng at Stanford Linear Accelerator Center) and DIAMOND (presented at the RF Button Heating Mini-Workshop at EPAC 2008). Manufacturing steps will be described. The consequence of mismatch on manufacturing will be discussed. All related measurement and simulation data are presented in this paper.
Taiwan Photon Source (TPS) is under construction at the National Synchrotron Radiation Research Center (NSRRC). This 518 m circumference synchrotron accelerator will generate 3 GeV and 500 mA high-energy X-rays. Absorbers in the storage ring will receive relatively high power densities (at a distance of 2.2 m from the dipole source). Three types of crotch absorbers for B1–B3 storage chambers were designed and prototyped. An end absorber in B3 is also designed and implemented to protect the downstream components in the chamber from being heated by the synchrotron radiation. Intensive vacuum brazing between Oxygen Free High Conductivity copper (OFHC) and stainless steel was carried out while fabricating the absorber assembly. The analysis, design and construction of several absorbers are reported in this paper.
A vacuum system of 3 GeV Taiwan photon source (TPS, with circumference 518.4 m), is designed for low-outgassing aluminium beam ducts, low-impedance structure, oil-less pumping system and oil-less fabrication. A prototype (total length 14 m) of the TPS vacuum system has been fabricated. This one-cell prototype vacuum system consists of two bending-magnet chambers (~4 m long each), two straight chambers (~3 m long each), supporting stands, five beam positioning monitors and pumps. Two bending-magnet chambers were made by computer-numerical control machining, which was lubricated with ethanol to protect the surface from oil contamination. Next, these two bending chambers were cleaned with ozonated water to decrease the rate of thermal outgassing and photo-stimulated desorption. The rest chambers were also cleaned by chemical cleaning method. An automatic welding system then was used to implement the side-welding seams of bending chambers in a temperature- and humidity-controlled cleanroom. The bending and straight chambers were welded into one piece by ‘on-site welding’. After baking at 150°C for 24 h, an optimizing pressure could be achieved at 4.9 nPa.
The 3 GeV Taiwan Photon Source (TPS) is designed to produce an electron beam with small emittance and to be maintained with top-up operation. The vacuum systems of the TPS-pulsed magnets in the storage ring include four kicker ceramic chambers for the stored beam and an injection chamber for the injected beam. The prototypical design, manufacturing process and some test results for these chambers are described.
National Synchrotron Radiation Research Center (NSRRC) in Taiwan has initialized the construction of Taiwan Photon Source (TPS) synchrotron accelerator project. This 3 GeV, 500 mA beam current third-generation synchrotron accelerator will have a total of seven insertion device beam lines at day 1 after commissioning. That is, there will be one 2 × EPU48, five IU22 and one U5 undulator beamline. Corresponding front end components such as fixed masks, photon beam position monitor, photon absorber, slits and heavy metal shutter have been designed; manufacturing of these subsystems are on the way. Several prototype assemblies are completed, tested and will be reported in this paper.
The microstructure and composition of aluminum oxide films, formed by a two-step anodization process in various electrolytes at 100 V then subject to an intermediate heat treatment (500 °C, 2 min), were investigated. The anodization electrolytes used included ammonium adipate electrolyte, phosphoric acid electrolyte, ammonium dihydrogen phosphate electrolyte, and their mixtures. The cross-section morphologies, crystal structure, and chemical composition of aluminum anodic oxides were examined by transmission electron microscopy. X-ray photoelectron spectroscopy was carried out to study the surface chemical state of the anodic films. The corresponding capacitances and retention voltages of these oxide films were also explored. The results indicated that amorphous-to-crystalline transformation of the oxide, primarily in films formed in ammonium adipate electrolyte, was induced by the heat treatment. Electron diffraction analyses further revealed the oxide films consisted of two distinct zones, which included an inner amorphous layer and an outer layer containing crystalline γ′-Al2O3. This study found that the phosphorous species in either the primary or the re-anodization electrolytes had a potential to cause changes of Al and O distributions within the oxides. The oxide film primarily anodized in ammonium adipate and re-anodized in phosphoric acid had the highest capacitance due to its high degree of crystallinity and thinness compared to oxides formed in other electrolytes. The presence of phosphorus, from the primary anodization electrolytes, in the oxides could inhibit the formation of crystalline γ′-Al2O3 and, consequently, decrease the capacitances of the anodic films. At the same time, the retention voltage and hydration resistance of these oxide films were improved.
This paper considers an M/M/R/N queue with heterogeneous
servers in which customers balk (do not enter) with a constant
probability (1 - b). We develop the maximum likelihood
estimates of the parameters for the M/M/R/N queue with balking and
heterogeneous servers. This is a generalization of the M/M/2
queue with heterogeneous servers (without balking), and the
M/M/2/N queue with balking and heterogeneous servers in the
literature. We also develop the confidence interval formula for
the parameter ρ, the probability of empty system P0, and
the expected number of customers in the system E[N], of an
M/M/R/N queue with balking and heterogeneous servers. The effects
of varying b, N, and R on the confidence intervals of P0
and E[N] are also investigated.
Secondary mullite has been formed in 60 wt% kaolin–40 wt% Al2O3 ceramics by solution-precipitation in the glassy phase in contact with Al2O3 particle, showing a plate-like morphology, at temperatures above 1673 K. The lattice constant modification of secondary mullite has been determined: the lattice parameters of orthorhombic structure of a, b, and c axes decrease from 8.653, 8.770, and 3.167 Å to 7.958, 8.064, and 2.926 Å, respectively. The Al2O3 content in the secondary mullite crystals increases from 59.69 to 70.41 wt% when the grain width increases from 15 to 40 nm. Both the formation of secondary mullite and its grain growth are intimately related to the presence of the glassy phase originated from impurity (K2O) in the kaolin. Their locations as well as their chemical composition of mullite grains, Al2O3 grains, and glassy phase are provided by the meticulous experiments using high-resolution transmission electron microscopy, selected-area electron diffraction, and energy dispersive spectroscopy techniques.
Nanometer-scale surface topology modification has been demonstrated using NSOM (near-field scanning optical microscope) delivered femto-second pulses. The ablation laser has a pulse width of 150 femto-second and wavelength of 387-nm. The laser pulses are coupled into the free end of a multimode optical fiber that a nanometer-size NSOM probe was fabricated on the other end with small orifice. The transmitted laser pulses from the probe orifice illuminates and machines the substrate surface when the probe is in near-field range of the substrate surface. The produced feature on Silicon surface is as least 200-nm deep with hole diameter around 200-nm. Near-field coupling of the laser has the potential to achieve ablation of feature size less than diffraction limit. Using NSOM delivery method also allows us to take advantage of nanometer metrology in precision surface ablation or other type of preformed surface modification. The ability of monitoring surface topology of substrate in real time enables us to accomplish the in-situ surface processing. We have demonstrated the technique of drilling 200-nm air holes on a pre-formed 600-nm wide wave guide. This method can be used to fabricate one-dimensional photonic crystal on a waveguide in ambient environment. The experiment design and performance evaluation will be discussed.
Innovation can be of crucial concern to the development of any medical tradition. It is of particular importance for a proper understanding of Chinese medical developments, in part because of the long-held misgivings about traditional therapies as an unchanging heritage, which has led to an insistent differentiation between medicine and Chinese medicine, especially at the time when Lu Gwei-Djen (1904–1991) lived.
Transformation kinetics of mullite formation in kaolin–Al2O3 ceramics was studied by x-ray diffraction, transmission electron microscopy, and energy dispersion spectrometry. The mullitization process of kaolin–Al2O3 ceramics is described by two stages; one is the primary mullite transformation at 1273 to 1573 K, and the other is the secondary mullite formation at 1573 to 1873 K. The activation energy of 1164.6 kJ mol-1 obtained for the secondary mullite formation is lower than 1356.9 kJ mol-1 for the primary mullite transformation by the general form of the Johnson–Mehl–Avrami equation. The lower value of growth morphology parameter strongly supports that in the secondary mullite formation the added alumina is dissolved into glassy phase and the mullite is then precipitated.
Previous studies have shown the existence of a sympathetic component in some cranial nerves including the hypoglossal nerve. In this study, the horseradish peroxidase (HRP) tract-tracing retrograde technique and experimental degeneration method were used to elucidate the possible neuroanatomical relationship between the superior cervical ganglion (SCG) and the hypoglossal nerve of hamsters. About 10 % of the SCG principal neurons were HRP positive following the tracer application to the trunk of hypoglossal nerve. Most of the HRP-labelled neurons were multipolar and were randomly distributed in the ganglion. When HRP was injected into the medial branch of the hypoglossal nerve, some of the SCG neurons were labelled, but they were not detected when HRP was injected into the lateral branch. The present findings suggest that postganglionic sympathetic fibres from the SCG may travel along the hypoglossal nerve trunk via its medial branch to terminate in visceral targets such as the intralingual glands. By electron microscopy, the HRP reaction product was localised in the neuronal somata and numerous unmyelinated fibres in the SCG. In addition, HRP-labelled axon profiles considered to be the collateral branches of the principal neurons contained numerous clear round and a few dense core vesicles. Besides the above, some HRP-labelled small myelinated fibres, considered to be visceral afferents, were also present. Results of experimental degeneration following the severance of the hypoglossal nerve showed the presence of degenerating neuronal elements both in the hypoglossal nucleus and the SCG. This confirms that the hypoglossal nerve contains sympathetic component from the SCG which may be involved in regulation of the autonomic function of the tongue.
The magnetic critical behaviors in the perovskite-like (La1−xPbx)MnO3 series with x = 0.0 ∼ 0.5 are studied by means of dc magnetic measurements. All the samples crystallize in the rhombohedral unit cell with a C R 3 space group (a 0.54 nm and c 1.33 nm). The detailed crystallographic parameters of all the samples are obtained by the refinements of the powder x-ray diffraction data using the Rietveld method. The substitution effect of Pb2+ ions on La3+ sites induces a mixed-valence state of Mn3+/Mn4+ and enhances magnetic transition temperature in the (La1−xPbx)MnO3 system. The transition temperature TC increases with the Pb content from 225 K as x = 0 to 355 K as x = 0.5. The canonical spin-glass behaviors in low fields and the scaling behaviors of magnetic physical quantities are clearly observed in all our samples. The values of the related critical exponents and the scaling functions of magnetic data are close to those of the conventional spin glass systems.
In this study, we used x-ray diffraction patterns and dc magnetic measurements to investigate the crystallographic structure, magnetic properties and scaling behavior of the distorted perovskite La0.7(Ba1−xPbx)0.3CoO3 (0 ≤ x ≤ 0.5) system with a constant ratio of Co4+/Co3+. Samples with x = 0.0 and 0.1 were crystallized in the cubic structure with a ∼ 7.76 Å whereas samples with x ≥ 0.2 were crystallized in an orthorhombic Pbnm space group with a ∼ b ∼ 5.50 Å and c ∼ 7.85 Å. For all our samples the spin-glass-like behavior were observed in low temperature and low field ranges. The Pb2+ substitution on Ba2+ site does not significantly affect the ferromagnetic transition temperature TC, but does introduce large variation in the magnetic strength. In both the ferromagnetic and paramagnetic states the minimum values of the average effective moments provided by every Co ion occur at x = 0.3. We also observed the scaling behaviors of magnetic data in all samples. The derived values of the critical exponents (β, γ, δ) were consistent with those predicted by mean field theory and a three-dimensional Heisenberg model.