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Compared with the general population, individuals with schizophrenia have a higher risk of periodontal disease, which can potentially reduce their life expectancy. However, evidence for the early development of periodontal disease in schizophrenia is scant. The current study investigated risk factors for periodontal disease in patients newly diagnosed with schizophrenia.
We identified a population-based cohort of patients in Taiwan with newly diagnosed schizophrenia who developed periodontal disease within 1 year of their schizophrenia diagnosis. Treatment with antipsychotics and other medications was categorised according to medication type and duration, and the association between medication use and the treated periodontal disease was assessed through logistic regression.
Among 3610 patients with newly diagnosed schizophrenia, 2373 (65.7%) had an incidence of treated periodontal disease during the 1-year follow-up. Female sex (adjusted odds ratios [OR] 1.40; 95% confidence interval [CI] 1.20–1.63); young age (adjusted OR 0.99; 95% CI 0.98–0.99); a 2-year history of periodontal disease (adjusted OR 2.45; 95% CI 1.84–3.26); high income level (adjusted OR 2.24; 95% CI 1.64–3.06) and exposure to first-generation (adjusted OR 1.89; 95% CI 1.54–2.32) and secondary-generation (adjusted OR 1.33; 95% CI 1.11–1.58) antipsychotics, anticholinergics (adjusted OR 1.24; 95% CI 1.03–1.50) and antihypertensives (adjusted OR 1.91; 95% CI 1.64–2.23) were independent risk factors for periodontal disease. Hyposalivation – an adverse effect of first-generation antipsychotics (FGAs) (adjusted OR 2.00; 95% CI 1.63–2.45), anticholinergics (adjusted OR 1.27; 95% CI 1.05–1.53) and antihypertensives (adjusted OR 1.90; 95% CI 1.63–2.22) – was associated with increased risk of periodontal disease. Therefore, hypersalivation due to FGA use (adjusted OR 0.72; 95% CI 0.59–0.88) was considered a protective factor.
The current study highlights that early prevention of periodontal disease in individuals with schizophrenia is crucial. Along with paying more attention to the development of periodontal disease, assessing oral health regularly, helping with oral hygiene, and lowering consumption of sugary drinks and tobacco, emphasis should also be given by physicians to reduce the prescription of antipsychotics to the extent possible under efficacious pharmacotherapy for schizophrenia.
Familial monozygotic (MZ) twinning reports are rare around the world, and we report a four-generation pedigree with seven recorded pairs of female MZ twins. Whole-genome sequencing of seven family members was performed to explore the featured genetic factors in MZ twins. For variations specific to MZ twins, five novel variants were observed in the X chromosome. These candidates were used to explain the seemingly X-linked dominant inheritance pattern, and only one variant was exonic, located at the 5′UTR region of ZCCHC12 (chrX: 117958597, G > A). Besides, consistent mitochondrial DNA composition in the maternal linage precluded roles of mitochondria for this trait. In this pedigree, autosomes also contain diverse variations specific to MZ twins. Pathway analysis revealed a significant enrichment of genes carrying novel SNVs in the epithelial adherens junction-signaling pathway (p = .011), contributed by FGFR1, TUBB6, and MYH7B. Meanwhile, TBC1D22A, TRIOBP, and TUBB6, also carrying similar SNVs, were involved in the GTPase family-mediated signal pathway. Furthermore, gene-set enrichment analysis for 533 genes covered by copy number variations specific to MZ twins illustrated that the tight junction-signaling pathway was significantly enriched (p < .001). Therefore, the novel changes in the X chromosome and the provided candidate variants across autosomes may be responsible for MZ twinning, giving clues to increase our understanding about the underlying mechanism.
Training students has been proven to be the optimal way to deliver cardiopulmonary resuscitation (CPR) skills. However, it is somehow unknown whether or not the current recommendations appropriate for Caucasian students are also suitable for East Asian students. The purpose of this study is to explore the best age for East Asian students to receive CPR training.
Students were recruited from six schools. Students participated in a standard CPR training program provided by tutors. Each student attended a 60-minute training session with a manikin. After being trained, within one hour, the student’s compression quality was assessed.
A total of 360 students who constituted 12 continuous grades were recruited for this study. Adequate compression depth and satisfactory compression rate with correct hand position could be achieved since the age of 12. However, successful compression rate and complete release could be achieved since the younger age of six.
Current recommendations for Caucasian students to cultivate a full-capacity CPR rescuer at the age of 12 are also appropriate for East Asian students. However, the optimal age for students to receive CPR training should be decided based on evidence and importance assessment of CPR.
He D, Huang K, Yang Y, Jiang W, Yang N, Yang H. What is the optimal age for students to receive cardiopulmonary resuscitation training? Prehosp Disaster Med. 2018;33(4):394–398.
The fruit plus accessory parts, and thus not only the fruit or seed, is the diaspore in some species of flowering plants. Atriplex centralasiatica, a summer annual salt-secreting cold-desert halophyte of central Asia that produces flat and humped diaspores, is such a species. The dispersal/germination units of this diaspore-heteromorphic species are fruits enclosed in persistent ‘bracteoles’. Germination of black and brown fruits (i.e. ‘bracteoles’ removed) of this species has been studied in some detail previously, but little attention has been given to the germination biology of the intact diaspores. The aim of this study was to compare the germination biology of the intact diaspores of A. centralasiatica, and their fates in the field during 12 months on the soil surface and buried at 5-cm depth. Fresh flat diaspores germinated to 42.7–51.3% in light (12-h photoperiod) and to 16.0–59.3% in constant dark, over a temperature range of 15–20/30°C, while no freshly matured humped diaspores did so under any temperature/light regime. Neither gibberellin (GA3) nor potassium nitrate (KNO3) had an effect on germination of either diaspore. Both diaspores readily imbibed water, and removal of ‘bracteoles’ released most of the dormancy. Thus, the ‘bracteoles’ are primarily responsible for diaspore dormancy in A. centralasiatica. Humped diaspores persisted for a longer period in the soil than flat ones. The germination requirements of intact natural dispersal/germination units of A. centralasiatica differ from those previously reported for fruits of this species.
This study investigated the effects of glycinin on the growth, intestinal oxidative status, tight junction components, cytokines and apoptosis signalling factors of fish. The results showed that an 80 g/kg diet of glycinin exposure for 42 d caused poor growth performance and depressed intestinal growth and function of juvenile Jian carp (Cyprinus carpio var. Jian). Meanwhile, dietary glycinin exposure induced increases in lipid peroxidation and protein oxidation; it caused reductions in superoxide dismutase (SOD), catalase and glutathione peroxidase (GPx) activities; and it increased MnSOD, CuZnSOD, GPx1b and GPx4a mRNA levels, suggesting an adaptive mechanism against stress in the intestines of fish. However, dietary glycinin exposure decreased both the activity and mRNA levels of nine isoforms of glutathione-S-transferase (GST) (α, μ, π, ρ, θ, κ, mGST1, mGST2 and mGST3), indicating toxicity to this enzyme activity and corresponding isoform gene expressions. In addition, glycinin exposure caused partial disruption of intestinal cell–cell tight junction components, disturbances of cytokines and induced apoptosis signalling in the distal intestines>mid intestines>proximal intestines of fish. Glycinin exposure also disturbed the mRNA levels of intestinal-related signalling factors Nrf2, Keap1a, Keap1b, eleven isoforms of protein kinase C and target of rapamycin/4E-BP. Interestingly, glutamine was observed to partially block those negative influences. In conclusion, this study indicates that dietary glycinin exposure causes intestinal oxidative damage and disruption of intestinal physical barriers and functions and reduces fish growth, but glutamine can reverse those negative effects in fish. This study provides some information on the mechanism of glycinin-induced negative effects.
Recent advances in digital microfluidics have led to tremendous interest in
miniaturized lab-on-a-chip devices for biochemical analysis. Synthesis tools
have also emerged for the automated design of lab-on-a-chip from the
specifications of laboratory protocols. However, none of these tools
considers control flow or addresses the problem of recovering from fluidic
errors that can occur during on-chip bioassay execution. We present a
synthesis method that incorporates control paths and an error-recovery
mechanism in the design of a cyberphysical digital microfluidic
lab-on-a-chip. A microcontroller coordinates the implementation of the
control-flow-based bioassay by intercepting the synthesis results that are
mapped to the software programs. Real-life bioassay applications are used as
case studies to evaluate the proposed design method. For a representative
protein assay, compared with a baseline chip design, the biochip with a
control path can reduce the completion time by 30% when errors occur during
the implementation of the bioassay. A fabricated biochip is also used to
demonstrate cyberphysical error recovery in a laboratory setting.
Microfluidic biochips have now come of age, with applications to biomolecular
recognition for high-throughput DNA sequencing, immunoassays, and
point-of-care clinical diagnostics . In particular, digital microfluidic
biochips, which use electrowetting-on-dielectric to manipulate discrete
droplets (or “packets of biochemical payload”) of picoliter
volumes under clock control, are especially promising .
Generalized quantiles of a random variable were defined as the minimizers of a general asymmetric loss function, which include quantiles, expectiles and M-quantiles as their special cases. Expectiles have been suggested as potentially better alternatives to both Value-at-Risk and expected shortfall risk measures. In this paper, we first establish the first-order expansions of generalized quantiles for extreme risks as the confidence level α↑ 1, and then investigate the first-order and/or second-order expansions of expectiles of an extreme risk as α↑ 1 according to the underlying distribution belonging to the max-domain of attraction of the Fréchet, Weibull, and Gumbel distributions, respectively. Examples are also presented to examine whether and how much the first-order expansions have been improved by the second-order expansions.
Depression among older adults is under-recognized either in the community or in general hospitals in Chinese culture. This study aimed to develop a culturally appropriate screening instrument for late-life depression in the non-psychiatric settings and to test its reliability and validity for a diagnosis of depression.
Using a Delphi method, we developed a geriatric depression inventory (GDI), consisting of 12 core symptoms of depressive disorder in old age. We investigated its reliability and validity on 89 patients with late-life depression and 249 non-depression controls. Both self-report (GDI-SR) and physician-interview (GDI-RI) versions were assessed.
Cronbach's α coefficient was 0.843 for GDI-SR and 0.880 for GDI-RI. Both GDI-SR and GDI-RI showed good concurrent validity with the 15-item Geriatric Depression Scale (GDS-15) (GDI-SR: r = 0.750, p < 0.001; GDI-RI: r = 0.733, p < 0.001). The area under the curve of the receiver operating characteristic (ROC) was 0.938 for GDI-SR and 0.961 for GDI-RI, suggesting good to excellent discrimination of depression versus non-depression. Using a cut-off of three items endorsed, sensitivity and specificity were 92.1% and 81.9% for GDI-SR, and 93.3% and 87.1% for GDI-RI.
The GDI, either based on self-report or rater interview, is a reliable and valid instrument for the detection of depression among older adults in non-psychiatric medical settings in Chinese culture.
Traditionally tissue engineering entails the seeding and culturing of differentiated somatic cells onto biodegradable scaffolds, with subsequent implantation of the cell–scaffold constructs into the defective or damaged sites to regenerate tissues . In this approach, the scaffold acts as a three-dimensional (3D) framework to provide physical support and accommodate cell growth and deposition of extracellular matrices, and its biodegradability allows the scaffold material to be resorbed in pace with new tissue formation. Despite some encouraging successes in clinical trials [2, 3], two key limitations with this approach include the limited source of exogenous donor cells and the lack of adequate vascularity to maintain vitality of the newly regenerated tissues. To address these limitations, current advanced tissue engineering techniques gear toward harnessing a biomimetic scaffold that provides a synthetic regenerative microenvironment to support natural tissue regeneration and angiogenesis . In addition to providing physical support, the ideal biomimetic scaffold would preferably also deliver bioactive factors, which instruct endogenous stem cell recruitment and differentiation three-dimensionally and in a controlled manner  (Figure 20.1). Various bioactive factors, including growth factors [6–8], nucleic acids , and integrin-binding ligands , have successfully been delivered or presented on biodegradable scaffolds. Among these, growth factors are the most important soluble signals in the natural regenerative microenvironment, being actively involved in stem cell recruitment, proliferation, and differentiation, angiogenesis, and tissue morphogenesis. Although they are potent, growth factors are expensive and have short half-lives in vivo. Therefore, scaffolds with controlled-release capacity are desired in order to preserve growth factor bioactivity and to prolong their function at therapeutic levels over an extended time period. However, there remain significant challenges in delivering growth factors effectively from scaffolds, including the need to preserve the bioactivity of growth factors during the possibly harsh incorporation process, the control of their release over an extended period during tissue regeneration, and the need for release to be restricted locally so as to avoid toxic or unwanted systemic side effects. Additionally, each individual delivery strategy is related, and sometimes restricted, to the type of scaffold utilized.
To prospectively investigate the incidence and prevalence of Wilson disease (WD) in Chinese Han population in Anhui Province, to analyze the genetic mutations in individuals with WD, and to provide basic epidemiological data regarding WD in this Chinese Han population.
Between November 2008 and June 2010, individuals aged from 7 to 75 years were screened for the cornea K-F ring in both eyes using slit lamp examination and random sampling methods based on age stratification and cluster level 1. The participants were from Anhui Province's Hanshan County, Jinzhai County, and Lixin County. The clinical manifestations of the brain, liver, kidney, skin, and other organs in each individual were also determined. Individuals with positive K-F rings and clinical manifestations indicative of WD underwent copper biochemistry evaluations, abdominal ultrasound testing, and ATP7B gene mutation screening to confirm or exclude the diagnosis of WD.
Of 153,370 individuals investigated in this study, nine were diagnosed with WD. In these WD individuals, three cases had neurological symptoms, one has hepatic symptoms, one was hepatic and neurological combined, and the other four cases were presymptomatic. Of the eight individuals in whom genetic mutations were detected, seven individuals had mutations in the ATP7B gene. The other individual had no ATP7B gene mutations but her copper biochemical test results met the diagnostic criteria for WD. The incidence and prevalence of WD in this population were approximately 1.96/100,000 and 5.87/100,000 respectively.
The Chinese Han population had a higher average prevalence of WD than the populations of the United States or Europe.
α-Bi2O3 thin films were deposited on different substrates by atomic layer deposition method. The results of X-ray diffraction, high-resolution transmission electron microscopy and X-ray photoelectron spectroscope correspond to α-Bi2O3. The Fourier transform infrared spectroscopy analyses indicate that the reaction is rather complete during the deposition. Optical properties of the films have been investigated using ultraviolet-infrared transmittance spectra in the temperature range of 8–300 K. It is found that the band gap Eg decreases from 3.12 to 3.03 eV with the temperature. The parameters αB and ΘB of the Bose-Einstein model are 69.3 meV and 293.9 K, respectively. The band narrowing coefficient dEg/dT is −0.435 meV/K at room temperature. The present results can be considerable for future application of Bi2O3-based electro-optic and wide temperature range optoelectronic devices.
The association of VEGF+405G/C (where VEGF is vascular endothelial growth factor) polymorphism and malignancy susceptibility attracts considerable attention because VEGF is one of the most potent angiogenic factors and plays a critical role in the onset and development of malignancy. However, the published findings remain inconclusive. In order to derive a more precise assessment of the association, we performed a meta-analysis including 30 published case-control studies from PubMed, Embase, and Ovid databases. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of the association. In the pooled analyses, no significant association was found between VEGF+405G/C polymorphism and malignancy susceptibility in different genetic models (G-allele vs. C-allele: OR = 1.00, 95% CI: 0.93–1.07; CC vs. GG: OR = 1.01, 95% CI: 0.88–1.15; GC+CC vs. GG: OR = 1.00, 95% CI: 0.91–1.10; CC vs. GC+GG: OR = 1.01, 95% CI: 0.90–1.13). When stratified by ethnicity, a weak association between this polymorphism and malignancy susceptibility was found in African under allelic frequency comparison (OR = 0.65, 95% CI: 0.43–0.98) and dominant genetic model comparison (OR = 1.95, 95% CI: 1.09–3.50). In summary, although our meta-analysis indicated a weak association of VEGF+405G/C polymorphism with malignancy susceptibility in African, no persuasive evidence of association between the polymorphism and malignancy susceptibility was detected in the pooled analyses. Therefore, more studies with larger scale of participants, especially Africans, are required to further evaluate gene-environment interaction on this polymorphism and malignancy susceptibility.
The present study was conducted to test the hypothesis that dietary arginine promotes digestion and absorption capacity, and, thus, enhances fish growth. This improvement might be related to the target of rapamycin (TOR) and eIF4E-binding protein (4E-BP). A total of 1200 juvenile Jian carp, Cyprinus carpio var. Jian, with an average initial weight of 6·33 (se 0·03) g, were fed with diets containing graded concentrations of arginine, namely, 9·8 (control), 12·7, 16·1, 18·5, 21·9 and 24·5 g arginine/kg diet for 9 weeks. An real-time quantitative PCR analysis was performed to determine the relative expression of TOR and 4E-BP in fish muscle, hepatopancreas and intestine. Dietary arginine increased (P < 0·05): (1) glutamate-oxaloacetate transaminase and glutamate-pyruvate transaminase activities in muscle and hepatopancreas; (2) intestine and hepatopancreas protein content, folds height, and trypsin, chymotrypsin, lipase, Na+/K+-ATPase, alkaline phosphatase, γ-glutamyl transpeptidase and creatine kinase activities in intestine; (3) Lactobacillus counts; (4) relative expression of TOR in the muscle, hepatopancreas and distal intestine (DI); (5) relative expression of 4E-BP in proximal intestine (PI) and mid-intestine (MI), as compared with the control group. In contrast, dietary arginine reduced (P < 0·05): (1) plasma ammonia content; (2) Aeromonas hydrophila and Escherichia coli counts; (3) relative expression of TOR in PI and MI; (4) relative expression of 4E-BP in the muscle, hepatopancreas and DI. The arginine requirement estimated by specific growth rate using quadratic regression analysis was found to be 18·0 g/kg diet. These results indicate that arginine improved fish growth, digestive and absorptive ability and regulated the expression of TOR and 4E-BP genes.
In wireless handset design, specifically power amplifiers (PAs), there is constant pressure to improve time-to-market while maintaining high yields. To meet these demands, designers need to evaluate current design practices and identify areas for improvement. Presently, some PA designers spend a great deal of time bench-tuning to optimize circuits. Because this is very time consuming, the main focus is obtaining the best “nominal” performance, and process variation is generally an afterthought. Frequently, new circuit topologies are implemented and minimal sample sizes are evaluated (often on a single wafer) leading to “one-wafer wonder” results.
Unfortunately, as the design is run over many wafers, normal process variations take their toll degrading the initial “hero” performance and, in the extreme case, lead to unacceptable yields. These variations are often blamed on the starting material or the fabrication process but, in reality, are due to expected process variations.
Including process statistics in the simulation phase can greatly reduce the occurrence of these frustrating events. To date, the implementation of statistical simulations in microwave designs (and III–V designs, specifically) has been limited, even though it is commonplace in silicon (Si) digital or analog-mixed signal design [1–6].
What are the barriers? The first is that methodology used in the Si design community is usually centered on inherently time-consuming Monte Carlo (MC) simulations [4–7]. While necessary for most Si designs, where neighboring device mismatches are critical, the additional complexity and added simulation time makes it “unfit” for III–V designs where devices are large and wafer turnround time is short (weeks compared to months).
Ferroelectric random access memory (FeRAM) is believed to be the most promising candidate for the next generation non-volatile memory due to its fast access time and low power consumption. Fabrication technologies of FeRAM can be divided into two parts: CMOS technologies for circuits which are standard and can be shared with traditional IC process line, and process relating to ferroelectric which is separated with CMOS process and defined as backend module. This paper described technologies for integrating ferroelectric capacitors into standard CMOS, mainly about modeling of ferroelectric capacitors and backend fabrication technologies. Hysteresis loop of the ferroelectric capacitor is the basis for FeRAM to store data. Models to describe this characteristic are the key for the design of FeRAM. A transient behavioral ferroelectric capacitor model based on C-V relation for circuit simulation is developed. The arc tangent function is used to describe the hysteresis loop. “Negative capacitance” phenomenon at reversing points of applied voltage is analyzed and introduced to the model to describe transient behaviors of the capacitor. Compact equivalent circuits are introduced to integrate this model into HSPICE for circuit simulation. Ferroelectric materials fabrication, electrodes integration and etching are the main technologies of FeRAM fabrication process. An metal organic chemical vapor deposition (MOCVD) process is developed to fabricate high quality Pb(Zr1-xTix)O3 (PZT) films. Pt is known to cause the fatigue problems when used as electrodes with PZT. Ir is used as electrodes to improve the fatigue property of PZT based capacitors, and mechanism of the fatigue is analyzed. Hard mask is used to reduce the size of the capacitors and damage caused in etching process. In our process, Al2O3 is developed as hard mask, which simplifies the FeRAM backend integration process.