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This study investigated the effects of glutamine (GLN) pretreatment on CD4+ T cell polarization and remote kidney injury in mice with gut-derived polymicrobial sepsis. Mice were randomly assigned to 3 groups: normal control fed with AIN-93G diet, and 2 sepsis groups provided with either AIN-93G-based diet or identical components except part of casein was replaced by GLN. Mice were given their respective diets for 2 weeks. Then, mice in the sepsis groups were performed with cecal ligation and puncture and were sacrificed at 72 h after the surgery. Blood, spleens and kidneys were collected for further examination. The results showed that sepsis resulted in decreased circulating and splenic total T lymphocyte and CD4+ T cell percentages, whereas interleukin (IL)-4-, and Foxp3-expressing CD4+ T cells percentages were upregulated. Compared to the sepsis control group, pretreatment with GLN maintained blood T and CD4+ T cells, reduced percentages of IL-4- and Foxp3-expressing CD4+ T cells. Also, a more pronounced activation and increased anti-apoptotic Bcl-2 gene expression of splenic CD4+ T cells were observed. Concomitant with the decreased plasma IL-6, keratinocyte-derived chemokine (KC) levels, the gene expression of KC, macrophage inflammatory protein-2 and renal injury biomarker Kim-1 were down-regulated when GLN was administered. These findings suggest that antecedent of GLN administration elicit a more-balanced blood T helper cell polarization, sustained T cell populations, prevented splenic CD4+ T cell apoptosis and attenuated kidney injury at late phase of polymicrobial sepsis. GLN may have benefits in subjects in risk of abdominal infection.
Schizophrenia is a complex mental disorder with high heritability and polygenic inheritance. Multimodal neuroimaging studies have also indicated that abnormalities of brain structure and function are a plausible neurobiological characterisation of schizophrenia. However, the polygenic effects of schizophrenia on these imaging endophenotypes have not yet been fully elucidated.
To investigate the effects of polygenic risk for schizophrenia on the brain grey matter volume and functional connectivity, which are disrupted in schizophrenia.
Genomic and neuroimaging data from a large sample of Han Chinese patients with schizophrenia (N = 509) and healthy controls (N = 502) were included in this study. We examined grey matter volume and functional connectivity via structural and functional magnetic resonance imaging, respectively. Using the data from a recent meta-analysis of a genome-wide association study that comprised a large number of Chinese people, we calculated a polygenic risk score (PGRS) for each participant.
The imaging genetic analysis revealed that the individual PGRS showed a significantly negative correlation with the hippocampal grey matter volume and hippocampus–medial prefrontal cortex functional connectivity, both of which were lower in the people with schizophrenia than in the controls. We also found that the observed neuroimaging measures showed weak but similar changes in unaffected first-degree relatives of patients with schizophrenia.
These findings suggested that genetically influenced brain grey matter volume and functional connectivity may provide important clues for understanding the pathological mechanisms of schizophrenia and for the early diagnosis of schizophrenia.
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.
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.
Challenges remain in the judgement of pathological murmurs in newborns at maternity hospitals, and there are still many simple major CHD patients in developing countries who are not diagnosed in a timely fashion. This study aimed to evaluate the accuracy of cardiac auscultation on neonatal CHD by general paediatricians.
We conducted a prospective study at three hospitals. All asymptomatic newborns underwent auscultation, pulse oximetry monitoring, and echocardiography. Major CHD was classified and confirmed through follow-up. We evaluated the accuracy of various degrees of murmurs for detecting major CHD to determine the most appropriate standards and time of auscultation.
A total of 6750 newborns were included. The median age of auscultation was 43 hours. Cardiac murmurs were identified in 6.6% of newborns. For all CHD, 44.4% had varying degrees of murmurs. A murmur of grade ≥2 used as a reference standard for major CHD had a sensitivity of 89.58%. The false positive rate of murmurs of grade ≥2 for detecting major CHD was significantly negatively related to auscultation time, with 84.4% of false positives requiring follow-up for non-major CHD cardiac issues. Auscultation after 27 hours of life could reduce the false positive rate of major CHD from 2.7 to 0.9%.
With appropriate training, maternity hospital’s paediatricians can detect major CHD with high detection rates with an acceptable false positive rate.
Choices between options represented in a multidimensional space, in which each dimension signifies a distinct attribute describing the objects, are presumably guided by the principle of value maximization. However, the current study assumes that in a real-world setting, those who are able to imagine things that do not actually exist could modify the multidimensional space by self-generating an unoffered but fictional dimension. We define the utility (Uv) assigned by the decision makers to the options on the offered/given dimension as value (v[x]) and the utility (Uw) on the self-generated/fictional dimension as worth (w[xc]). Our series of experiments demonstrated that an option with a greater value established strictly on that given set of dimensions might not necessarily be chosen (which contradicted the principle of value maximization). Choosing an option with less value (i.e. giving away the bigger pear) behavior can be described and explained by the “worth-based choice” approach, as people behave to select the option with the highest worth rather than that with the highest value. We are optimistic that the resulting findings will facilitate our understanding of the beauty of such a “one step further” choice and assist us in understanding the following: the ability to further generate a fictional dimension and to assign a delayed utility (worth) to the options on the fictional dimension, and to make a worth-based choice, which could eventually be taken as the operational definition to measure the degree of “fiction-generating ability”, as proposed by Harari (2014).
Cellulitis is a common infection of the skin and soft tissue. Susceptibility to cellulitis is related to microorganism virulence, the host immunity status and environmental factors. This retrospective study from 2001 to 2013 investigated relationships between the monthly incidence rate of cellulitis and meteorological factors using data from the Taiwanese Health Insurance Dataset and the Taiwanese Central Weather Bureau. Meteorological data included temperature, hours of sunshine, relative humidity, total rainfall and total number of rainy days. In otal, 195 841 patients were diagnosed with cellulitis and the incidence rate was strongly correlated with temperature (γS = 0.84, P < 0.001), total sunshine hours (γS = 0.65, P < 0.001) and total rainfall (γS = 0.53, P < 0.001). The incidence rate of cellulitis increased by 3.47/100 000 cases for every 1° elevation in environmental temperature. Our results may assist clinicians in educating the public of the increased risk of cellulitis during warm seasons and possible predisposing environmental factors for infection.
The current transient was studied on AlGaN/GaN HEMTs for RF power amplifiers under different temperatures. The current transient measurements include two different approaches. One is to measure the current transient from off-state (without bias) to a quiescent point (Q-point). Different transient behaviors were observed while switching to different Q-points. Another one is to measure the current transient from different currents to the Q-point of VDS = 28 V and ID = 100 mA/mm. The different currents before switching to Q-point of VDS = 28 V and ID = 100 mA/mm show the different transient characteristics. Most of the current transient demonstrates temperature independence in this study.
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.
The graphene band structure is derived by first constructing two sublattices of graphene structure. The electronic band structure of graphene can then be obtained by using the tight-binding model. With the knowledge of the graphene energy bands, density of states and carrier concentration of graphene are discussed, followed by the discussion of the Fermi energy, chemical potential, and Fermi level of graphene. In this chapter, temperature dependence of carrier concentration is also discussed. In general, a higher temperature leads to a higher carrier concentration because of thermally excited electron-hole pairs. A comparison of physical quantities for parabolic 2D/3D systems and monolayer graphene are given, and the comparison of the band structures for multilayer graphene are presented in the end.
Understand the fundamental concepts, theoretical background, major experimental observations, and device applications of graphene photonics with this self-contained text. Systematically and rigorously developing each concept and theoretical model from the ground up, it guides readers through the major topics, from basic properties and band structure to electronic, optical, optoelectronic, and nonlinear optical properties, and plasmonics and photonic devices. The connections between theory, modeling, experiment, and device concepts are demonstrated throughout, and every optical process is analyzed through formal electromagnetic analysis. Suitable for both self-study and a one-semester or one-quarter course, this is the ideal text for graduate students and researchers in photonics, optoelectronics, nanoscience and nanotechnology, and optical and solid-state physics, who are working in this rapidly developing field.
The purpose of this chapter is to describe the electronic properties of graphene, starting from the Boltzmann transport equation. The scattering of carriers in graphene is discussed. Different scattering mechanisms are presented and derived including charged-impurity scattering, defect scattering, acoustic phonon scattering, and optical phonon scattering. Intrinsic and extrinsic optical phonon scattering rates are calculated and discussed. Using Rode's method, a self-consistent scattering rate distribution can be found, and the scattering rate of surface optical phonons for graphene on different substrates can be calculated. A comparison of the scattering rates contributed by different scattering mechanisms are presented. With the knowledge of the scattering mechanisms, mobility and resistivity of graphene are calculated as a function of Fermi energy and temperature. At the end of the chapter, experimental results are given to compare with the theoretical results, followed by the discussion of the electronic transport properties of multilayer graphene.