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Major depressive disorder (MDD) is highly heterogeneous and can be classified as treatment-resistant depression (TRD) or antidepressant-responsive depression (non-TRD) based on patients' responses to antidepressant treatment. Methods for distinguishing between TRD and non-TRD are critical clinical concerns. Deficits of cortical inhibition (CI) have been reported to play an influential role in the pathophysiology of MDD. Whether TRD patients' CI is more impaired than that of non-TRD patients remains unclear.
Paired-pulse transcranial magnetic stimulation (ppTMS) was used to measure cortical inhibitory function including GABAA- and GABAB-receptor-related CI and cortical excitatory function including glutamate-receptor-related intracortical facilitation (ICF). We recruited 36 healthy controls (HC) and 36 patients with MDD (non-TRD, n = 16; TRD, n = 20). All participants received evaluations for depression severity and ppTMS examinations. Non-TRD patients received an additional ppTMS examination after 3 months of treatment with the SSRI escitalopram.
Patients with TRD exhibited reduced short-interval intracortical inhibition (SICI) and long-interval intracortical inhibition (LICI), as shown by abnormally higher estimates, than those with non-TRD or HC (F = 11.030, p < 0.001; F = 10.309, p < 0.001, respectively). After an adequate trial of escitalopram treatment, the LICI of non-TRD reduced significantly (t = − 3.628, p < 0.001), whereas the ICF remained lower than that of HC and showed no difference from pretreatment non-TRD.
TRD was characterized by relatively reduced CI, including both GABAA- and GABAB-receptor-mediated neurons while non-TRD preserved partial CI. In non-TRD, SSRIs may mainly modulate GABAB-receptor-related LICI. Our findings revealed distinguishable features of CI in antidepressant-resistant and responsive major depression.
Bipolar disorder is a highly heritable mental illness that transmits intergeneratively. Previous studies supported that first-degree relatives (FDRs), such as parents, offspring, and siblings, of patients with bipolar disorder, had a higher risk of bipolar disorder. However, whether FDRs of bipolar patients have an increased risk of schizophrenia, major depressive disorder (MDD), autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD) remains unclear.
Among the entire population in Taiwan, 87 639 patients with bipolar disorder and 188 290 FDRs of patients with bipolar disorder were identified in our study. The relative risks (RRs) of major psychiatric disorders were assessed among FDRs of patients with bipolar disorder.
FDRs of patients with bipolar disorder were more likely to have a higher risk of major psychiatric disorders, including bipolar disorder (RR 6.12, 95% confidence interval (CI) 5.95–6.30), MDD (RR 2.89, 95% CI 2.82–2.96), schizophrenia (RR 2.64, 95% CI 2.55–2.73), ADHD (RR 2.21, 95% CI 2.13–2.30), and ASD (RR 2.10, 95% CI 1.92–2.29), than the total population did. These increased risks for major psychiatric disorders were consistent across different familial kinships, such as parents, offspring, siblings, and twins. A dose-dependent relationship was also found between risk of each major psychiatric disorder and numbers of bipolar patients.
Our study was the first study to support the familial coaggregation of bipolar disorder with other major psychiatric disorders, including schizophrenia, MDD, ADHD, and ASD, in a Taiwanese (non-Caucasian) population. Given the elevated risks of major psychiatric disorders, the public health government should pay more attention to the mental health of FDRs of patients with bipolar disorder.
A novel radio frequency identification tag antenna is composed of a resonant open-slot exciter and a dipole-type ground radiator. For a conjugate match to the Alien Higgs-4 chip impedance of 8−j149 Ω at 925 MHz, a quarter wavelength open-slot resonator embedded at the center of the dipole-type ground plane (130 × 18 mm2) was investigated and fabricated. Simple size adjustments and various loaded inductor of the open-slot resonator allow for easy control of the tag antenna resistance and inductive reactance, from which the chip impedance requirement can be easily obtained. The read range of the prototype antenna attached on a foam in the free space can reach more than 9 m, which has been tested for a radio frequency identification reader with 4.0-W of effective isotropic radiated power. Measurement data are in good agreement with simulation results.
This study modified the surfaces of three kinds of TiNi-based shape memory alloys (SMAs) by dry electrical discharge machining (EDM) in nitrogen (N2) and acetylene (C2H2) gas mixture. The effects of composition of the dielectric medium and work-piece on the machining performance and surface characteristics were investigated. Increasing the ratio of acetylene gas in gas mixture was beneficial for improving the material removal rate (MRR). However, adding a large amount of acetylene gas resulted in unstable discharge. A recast layer, comprising nitrides and carbides, which well adhered on the EDMed surface exhibited high hardness. Among Ti50Ni50, Ti50Ni49.5Cr0.5, and Ti40.5Ni49.5Zr10 SMA as a work-piece, Ti40.5Ni49.5Zr10 SMA has the lowest MRR owing to it possessed the highest melting temperature and thermal conductivity. The recast layer on Ti40.5Ni49.5Zr10 SMA, comprising zirconium nitride, exhibited the highest hardness and adhesion among all the SMAs. However, the high-hardness recast layer deteriorated the shape recovery of the SMA.
Previous studies have found that social cohesion and trust (SCT) were associated with psychological well-being and physical health. In this study, we investigated the associations between SCT and mental and physical health among community-dwelling elderly in a town in southern Taiwan.
The study population consisted of 149 community-dwelling elderly aged 65 years and older (68 men, 81 women; mean age, 75.4 ± 6.1 years) residing in the town of Dashe in southern Taiwan. Activities of daily living (ADL), SCT, depression, subjective quality of life (QOL), current medical status, past medical history, and health behaviors were assessed in face-to-face interviews. Objective neurobehavioral functions were assessed using the timed up & go (TUG) test, functional reach test, and handgrip test.
Scores for ADL and Geriatric Depression Scale (GDS) were significantly correlated with SCT, and SCT was significantly correlated with all subjective QOL items. In addition, a strong correlation was observed between SCT and relationship with friends. Values for SCT (median ≥ 20) were significantly associated with both subjective sense of health (median ≥ 68) and subjective happiness (median ≥ 73) after adjusting for age, sex, and ADL.
SCT is an important variable that influences self-rated health and happiness, independently of ADL, age, and sex. When assessing geriatric psychological function, SCT should be examined more carefully, given its association with subjective sense of health and happiness, depression, and physical function.
Modulation of the cellular response by the administration of probiotic bacteria may be an effective strategy for preventing or inhibiting tumour growth. We orally pre-inoculated mice with probiotics Lactobacillus acidophilus NCFM (La) for 14 d. Subcutaneous dorsal-flank tumours and segmental orthotopic colon cancers were implanted into mice using CT-26 murine colon adenocarcinoma cells. On day 28 after tumour initiation, the lamina propria of the colon, mesenteric lymph nodes (MLN) and spleen were harvested and purified for flow cytometry and mRNA analyses. We demonstrated that La pre-inoculation reduced tumour volume growth by 50·3 %, compared with untreated mice at 28 d after tumour implants (2465·5 (sem 1290·4) v. 4950·9 (sem 1689·3) mm3, P < 0·001). Inoculation with La reduced the severity of colonic carcinogenesis caused by CT-26 cells, such as level of colonic involvement and structural abnormality of epithelial/crypt damage. Moreover, La enhanced apoptosis of CT-26 cells both in dorsal-flank tumour and segmental orthotopic colon cancer, and the mean counts of apoptotic body were higher in mice pre-inoculated with La (P < 0·05) compared with untreated mice. La pre-inoculation down-regulated the CXCR4 mRNA expressions in the colon, MLN and extra-intestinal tissue, compared with untreated mice (P < 0·05). In addition, La pre-inoculation reduced the mean fluorescence index of MHC class I (H-2Dd, -Kd and -Ld) in flow cytometry analysis. Taken together, these findings suggest that probiotics La may play a role in attenuating tumour growth during CT-26 cell carcinogenesis. The down-regulated expression of CXCR4 mRNA and MHC class I, as well as increasing apoptosis in tumour tissue, indicated that La may be associated with modulating the cellular response triggered by colon carcinogenesis.
All suicides (n=12 497) in Taiwan in 2001–2004 were identified from mortality records retrieved from the National Health Insurance Database. Altogether, 95.1% of females and 84.9% of males had been in contact with healthcare services in the year before their death. Females received significantly more diagnoses of psychiatric disorders (48.0% v. 30.2%) and major depression (17.8% v. 7.4%) than males. Such differences were consistent across different medical settings where contact with hospital-based non-psychiatric physicians was as common as with general practitioners (GPs). However, diagnoses of psychiatric disorders were underdiagnosed in both genders.
In this work, we report on the growth of ultraviolet (UV) AlGaN/GaN multiple quantum wells (MQWs) structure using atomic layer deposition (ALD) technique. The AlGaN/GaN MQW sample grown on the sapphire substrate consisted of three GaN QWs and four AlGaN barriers comprised AlN/GaN superlattices (SLs). The root-mean-square value of the surface morphology was only 0.35 nm observed from the atomic force microscope image and no crack was found on the surface. Both of the high resolution X-ray diffraction curves and transmission electron microscope images showed sharp interfaces between SLs layers and QWs with good periodicity. These results demonstrate that the ALD could be a very useful technique for controlling the crystalline quality and thickness of the III-nitride epilayer.
To investigate the impact of antimicrobial resistance on clinical and economic outcomes among hospitalized patients with multidrug-resistant (MDR) Acinetobacter baumannii bacteremia.
A retrospective, matched-cohort study.
A tertiary care university teaching hospital
A matched case-control (1:1) study was conducted to compare the differences in clinical and economic outcomes of patients with MDR A. baumannii bacteremia and patients with non-MDR A. baumannii bacteremia. Case patients were matched to control patients on the basis of sex, age, severity of underlying and acute illness, and length of hospital stay before onset of bacteremia.
Forty-six (95.8%) of 48 cases with MDR A. baumannii bacteremia were eligible for the study and matched with appropriate controls. The sepsis-related mortality rate was 34.8% among cases and 13.0% among controls, for an attributable mortality rate of 21.8% (adjusted odds ratio, 4.1 [95% confidence interval, 1.1-15.7]; P = .036). After the onset of bacteremia, cases and controls had a significantly different length of hospital stay (54.2 vs 34.1 days; P = .006), hospitalization cost (US$9,349 vs US$4,865; P = .001 ), and antibiotic therapy cost (US$2,257 vs US$1,610; P = .014). Thus, bacteremia due to MDR A. baumannii resulted in 13.4 days of additional hospitalization and US$3,758 of additional costs, compared with bacteremia due to non-MDR A. baumannii.
Patients with MDR A. baumannii bacteremia had a higher mortality rate and incurred greater medical costs than patients with non-MDR A. baumannii bacteremia.
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.
The high porosity and uniform pore size of mesoporous oxide films offer unique opportunities for microelectromechanical system (MEMS) devices that require low density and low thermal conductivity. This paper provides the first report in which mesoporous films were adapted for MEMS applications. Mesoporous SiO2 and Al2O3 films were prepared by spin coating using block copolymers as the structure-directing agents. The resulting films were over 50% porous with uniform pores of 8-nm average diameter and an extremely smooth surface. The photopatterning and etching characteristics of the mesoporous films were investigated and processing protocols were established which enabled the films to serve as the sacrificial layer or the structure layer in MEMS devices. The unique mesoporous morphology leads to novel behavior including extremely high etching rates and the ability to etch underlying layers. Surface micromachining methods were used to fabricate three basic MEMS structures, microbridges, cantilevers, and membranes, from the mesoporous oxides.
The high porosity and uniform pore size provided by mesoporous oxide films offer interesting opportunities for MEMS devices that require low density and low thermal conductivity. This paper describes recent efforts at adapting mesoporous films for MEMS fabrication. Mesoporous SiO2 and Al2O3 films were prepared using block copolymers as the structure-directing agents, leading to films which were 70% porous and < 5 nm surface roughness. A number of etchants were investigated and good etch selectivity was observed with both dry and wet systems. Micromachining methods were used to fabricate cantilevers, micro bridges and membranes.
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.
We report highly resolved, damage-free etching of GaAs and related materials. The etching is activated by excimer laser irradiation at 193 nm of samples maintained at low temperatures (∼140 K) in a chlorine atmosphere (∼5 mTorr). Since the etching is chemical in nature, structural damage to the substrate should not be present. Submicrometer resolution has been achieved by the use of electron beam lithography to pattern a Si3N4 contact mask. We have also successfully used our etching in the fabrication of a single-quantum-well, ridge-waveguide semiconductor laser.
We report excimer laser induced etching of GaAs samples covered with a layer of condensed Cl2. The experiments were performed at low temperatures (120-150 K) and in a chlorine ambient (PC12=1-40 mTorr). Spatially well-resolved, anisotropic etching has been demonstrated with an observed etch rate of 0.25 Å/pulse (0.1 μm/min for typical parameters). The etch rate is characterized as a function of the various system parameters (pressure, temperature, laser rep-rate, etc.), and a model is proposed to describe the etching mechanism.
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