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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.
This study aimed to determine the effects of supplementing the diet of adult Nile tilapia Oreochromis niloticus with phosphatidylcholine (PC) on growth performance, body composition, fatty acid composition and gene expression. Genetically Improved Farmed Tilapia fish with an initial body weight of 83·1 (sd 2·9) g were divided into six groups. Each group was hand-fed a semi-purified diet containing 1·7 (control diet), 4·0, 6·5, 11·5, 21·3 or 41·0 g PC/kg diet for 68 d. Supplemental PC improved the feed efficiency rate, which was highest in the 11·5 g PC/kg diet. Weight gain and specific growth rate were unaffected. Dietary PC increased PC content in the liver and decreased crude fat content in the liver, viscera and body. SFA and MUFA increased and PUFA decreased in muscle with increasing dietary PC. Cytoplasmic phospholipase A2 and secreted phospholipase A2 mRNA expression were up-regulated in the brain and heart in PC-supplemented fish. PC reduced fatty acid synthase mRNA expression in the liver and visceral tissue but increased expression in muscle. Hormone-sensitive lipase and lipoprotein lipase expression increased in the liver with increasing dietary PC. Growth hormone mRNA expression was reduced in the brain and insulin-like growth factor-1 mRNA expression in liver reduced with PC above 6·5 g/kg. Our results demonstrate that dietary supplementation with PC improves feed efficiency and reduces liver fat in adult Nile tilapia, without increasing weight gain, representing a novel dietary approach to reduce feed requirements and improve the health of Nile tilapia.
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.
Isolation of multidrug-resistant gram-negative bacteria (MDR-GNB) from patients in the community has been increasingly observed. A prediction model for MDR-GNB colonization and infection risk stratification on hospital admission is needed to improve patient care.
A 2-stage, prospective study was performed with 995 and 998 emergency department patients enrolled, respectively. MDR-GNB colonization was defined as isolates resistant to 3 or more classes of antibiotics, identified in either the surveillance or early (≤48 hours) clinical cultures.
A score-assigned MDR-GNB colonization prediction model was developed and validated using clinical and microbiological data from 995 patients enrolled in the first stage of the study; 122 of these patients (12.3%) were MDR-GNB colonized. We identified 5 independent predictors: age>70 years (odds ratio [OR], 1.84 [95% confidence interval (CI), 1.06–3.17]; 1 point), assigned point value in the model), residence in a long-term-care facility (OR, 3.64 [95% CI, 1.57–8.43); 3 points), history of cerebrovascular accidents (OR, 2.23 [95% CI, 1.24–4.01]; 2 points), hospitalization within 1 month (OR, 2.63 [95% CI, 1.39–4.96]; 2 points), and recent antibiotic exposure (OR, 2.18 [95% CI, 1.16–4.11]; 2 points). The model displayed good discrimination in the derivation and validation sets (area under ROC curve, 0.75 and 0.80, respectively) with the best cutoffs of<4 and ≥4 points for low- and high-risk MDR-GNB colonization, respectively. When applied to 998 patients in the second stage of the study, the model successfully stratified the risk of MDR-GNB infection during hospitalization between low- and high-risk groups (probability, 0.02 vs 0.12, respectively; log-rank test, P<.001).
A model was developed to optimize both the decision to initiate antimicrobial therapy and the infection control interventions to mitigate threats from MDR-GNB.
Asians and Pacific Islanders have higher circulating serum ferritin (SF) compared with Caucasians but the clinical significance of this is unclear. There is a higher prevalence of metabolic syndrome (MetS) in Taiwanese Indigenous than Han Chinese. Genetically, Indigenous are related to Austronesians and account for 2 % of Taiwan's population. We tested the hypothesis that accumulation of Fe in the body contributes to the ethnic/racial disparities in MetS in Taiwan.
A population-based, cross-sectional study.
National Nutrition and Health Survey in Taiwan and Penghu Island.
A total of 2638 healthy adults aged ≥19 years. Three ethnic groups were included.
Han Chinese and Indigenous people had comparable levels of SF. Austronesia origin was independently associated with MetS (OR = 2·61, 95 % CI 2·02, 3·36). After multiple adjustments, the odds for MetS (OR = 2·49, 95 % CI 1·15, 5·28) was significantly higher among Indigenous people in the highest SF tertile compared with those in the lowest tertile. Hakka and Penghu Islanders yielded the lowest risks (OR = 1·08, 95 % CI 0·44, 2·65 and OR = 1·21, 95 % CI 0·52, 2·78, respectively). Indigenous people in the highest SF tertile had increased risk for abnormal levels of fasting glucose (OR = 2·34, 95 % CI 1·27, 4·29), TAG (OR = 1·94, 95 % CI 1·11, 3·39) and HDL-cholesterol (OR = 2·10, 95 % CI 1·18, 3·73) than those in the lowest SF tertile.
Our results raise the possibility that ethnic/racial differences in body Fe store susceptibility may contribute to racial and geographic disparities in MetS.
Proper dry cow management is critical not only for subsequent milk production and fertility but also for mastitis control. A phenomenon of immunosuppression was commonly observed in transition cows, an example being the high susceptibility of the mammary gland during early the dry period to new infectious agents. Polymorphonuclear neutrophils (PMN) play important defence roles in the mammary gland of newly dried cows. One of the bactericidal mechanisms of PMN is through producing reactive oxygen species (ROS), which can be efficiently quantified by chemiluminescence (CL) assay. In the current study, the potential of intramammary application of a commercial Enterococcus faecium SF68 (SF68) product to enhance the local innate immunity of newly dried mammary glands was evaluated based on the CL assay. The preliminary experiments in vitro indicated virtual dose-responsiveness of ROS generation from three different cell preparations, bovine blood PMN, bovine blood PMN pre-conditioned with cow milk, and the post-diapedesis model somatic cells from cow milk, on their exposure to phorbol 12-myristate 13-acetate (PMA), viable SF68, and ultrasonicated SF68, but not dry-heated SF68. Because ultrasonication treatment was found to profoundly enhance the immunogenicity of SF68 in vitro, in the following animal trial, single infusion of either 5 or 10×107 original cfu of ultrasonicated SF68 was randomly applied to the front quarters and phosphate-bufferedsaline (PBS) applied to the rear quarters of each of the four experimental cows on the first day of milk stasis. The results showed that within the first post-infusion week, ultrasonicated SF68 induced a faster and greater (P<0·05) recruitment of PMN into mammary lumen with no apparent local or systemic inflammatory sign. Meanwhile, ultrasonicated SF68 also induced a greater (P<0·05) ROS production in response to PMA challenge by in situ somatic cells of mammary secretion. Taken together, ultrasonicated SF68 modulated ROS generation of bovine neutrophils, and would be a potential enhancer of udder innate immunity in drying-off dairy cows. More thorough work is warranted.
The electrode materials for VRFB should possess higher electric conductivity, corrosion resistance and hydrophilic properties in sulfuric acid. The characteristics of the electrode materials affect the stability and the energy efficiency of VRFB. Carbon materials are the best suited for VRFB applications. In this study, the calcined treatment, acid treatment and ozone treatment were used to modify the surface of carbon papers. The redox reaction of [VO]2+/[VO2]+ on the modified carbon papers was evaluated by cyclic voltammetry (CV). The surface compositions of carbon materials were analyzed by X-ray photoelectron spectrometry (XPS). The experimental results reveal that three oxidative methods enhance the redox reaction of [VO]2+/[VO2]+. The calcined treatments and acid treatments also enhanced hydrolysis reaction. The mole ratio of O/C apparently increased, but the binding energy of C1s and O1s were not chemically shifted in the acid treatment. The intensity of binding energy of O1s, between 532 eV and 534 eV, apparently increased in the ozone and calcined treatments. The Ox treated samples were more hydrophilic than the Oz treated samples. In the Ox treated samples, the decrease of Rct value indicates that was contributed from the redox reaction of [VO]2+/[VO2]+ and hydrolysis reaction. It does not completely benefit the energy efficiency of VRFB. The 5 x 5 cm2 modified carbon papers were used as electrode materials in the VRFB. The voltage efficiency, coulomb efficiency and energy efficiency reached 93 %, 90 % and 83 %, respectively, at a current density of 12 mA．cm-2 at 0.8-1.8 V.
To compare potential risk factors for complications and recurrence after radiofrequency catheter ablation in symptomatic atrioventricular reentrant tachycardia in children and adolescents.
We retrospectively reviewed the data of 213 consecutive patients with symptomatic atrioventricular reentrant tachycardia who underwent both electrophysiological study and radiofrequency catheter ablation, divided these patients into two groups, children (age <12 years) and adolescents (12 ≤ age < 18 years), and compared the location of the accessory pathway, success rate, recurrence rate, complications, presence of congenital heart disease, presence of intermittent ventricular pre-excitation, and presence of Wolff–Parkinson–White syndrome in the two groups.
The position of the accessory pathway was mostly right sided in children (61.3%) and left sided in adolescents (61.5%). Children had significantly more congenital heart disease than adolescents (6.4% versus 0.8%). Univariate analysis showed children or adolescents with right-sided accessory pathways to be 6.84 times and those with accessory pathways on both sides of the septum 25 times more likely to relapse than those with a single accessory pathway. Multivariate analysis indicated that children or adolescents with two accessory pathways were six times, and those with intermittent ventricular pre-excitation nine times more at risk of relapsing following radiofrequency ablation than those with single accessory pathways. All five complications occurred in children.
The findings suggest that the position and number of accessory pathways and presence of intermittent ventricular pre-excitation are related to risks of recurrence of atrioventricular reentrant tachycardia in children and adolescents.
Sleep deprivation causes cognitive dysfunction in which impaired neuronal plasticity in hippocampus may underlie the molecular mechanisms of this deficiency. Considering calcium-mediated NMDA receptor subunit 1 (NMDAR1) and neuronal nitric oxide synthase (nNOS) activation plays an important role in the regulation of neuronal plasticity, the present study is aimed to determine whether total sleep deprivation (TSD) would impair calcium expression, together with injury of the neuronal plasticity in hippocampus. Adult rats subjected to TSD were processed for time-of-flight secondary ion mass spectrometry, NMDAR1 immunohistochemistry, nNOS biochemical assay, cytochrome oxidase histochemistry, and the Morris water maze learning test to detect ionic, neurochemical, bioenergetic as well as behavioral changes of neuronal plasticity, respectively. Results indicated that in normal rats, strong calcium signaling along with intense NMDAR1/nNOS expression were observed in hippocampal regions. Enhanced calcium imaging and neurochemical expressions corresponded well with strong bioenergetic activity and good performance of behavioral testing. However, following TSD, both calcium intensity and NMDAR1/nNOS expressions were significantly decreased. Behavioral testing also showed poor responses after TSD. As proper calcium expression is essential for maintaining hippocampal neuronal plasticity, impaired calcium expression would depress downstream NMDAR1-mediated nNOS activation, which might contribute to the initiation or development of TSD-related cognitive deficiency.
Sn/Ni–8.0 at.%V (Ni–7.0 wt%V) couples are prepared and the interfacial reactions at 210 and 250 °C are examined. In the early stage of reaction at 250 °C, a T phase is formed as a result of fast diffusion of Sn into the Ni–8.0 at.%V substrate. With a longer reaction, the outer region of the T phase transforms to a Ni-depletion layer, which has not been observed previously. Both the T phase and the Ni-depletion layer are analyzed using transmission electronic microscopy. This newly found Ni-depletion layer is composed of Sn and nanosize “VSn2(V2Sn3)” particulates. The solid/solid reaction paths in the Sn/Ni–8.0 at.%V couples evolve from Sn/T/Ni–V, Sn/Ni3Sn4/T/Ni–V to Sn/Ni3Sn4/VSn2(V2Sn3). During the liquid/solid reactions, the paths are liquid/T/Ni–V, liquid/liquid + Ni3Sn4/T/Ni–V, liquid/liquid + Ni3Sn4/liquid + VSn2(V2Sn3)/T/Ni–V, and liquid/liquid + Ni3Sn4/liquid + VSn2(V2Sn3).
Nanosized lithium manganate powders are successfully synthesized via a newly developed reverse-microemulsion (RμE) process. Monophasic LiMn2O4 powders are obtained after calcining the precursor powders at 700°C. The particle size of the spinel compound significantly depends on the concentration of the aqueous phase. Increasing the water-to-oil volume ratio results in an increase in the particle size. While the aqueous phase is equal to 0.5 M, the size of the obtained LiMn2O4 powder is around 60-70 nm. It is found that the specific capacity of nanosized LiMn2O4 particles is greater than that of submicron particles. The large surface area of ultrafine particles is considered to facilitate the intercalation and deintercalation of lithium ions during the cycling test.
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.
In this work, we study the thermal stability and interaction between SiOF and Cu. Blanket SiOF films with various F concentration were deposited by PE-CVD. A dielectric constant as low as 3.2 was obtained. Copper were deposited on these SiOF and a series of post-deposition anneal were performed. Dielectric constant of SiOF was measured after deposition and again after anneal. AES and SIMS depth profile are utilized to determine the interdiffusion between Cu and SiOF under different annealing conditions. Breakdown voltage and dielectric constant were determined form C-V and I-V measurement using a MIS ( Cu/ SiOF/ p-Si) diode. This results of leakage current measurement and flat band shift measurement suggest that the fluorine in the SiOF film will retard the cu diffusion.
Selective tungsten chemical vapor deposition (W-CVD) is one of the most attractive technique for filling deep submicron contact hole and via hole for the ULSI application. In this work, we firstly find out the anomalous selective W growth for the contact hole. The tungsten only nucleates from the side ring of the contact hole bottom. Several predeposition treatments prior to W growth can improve this anomalous feature and excellently selective W growth can be achieved. Auger electron spectroscopy (AES) is utilized to investigate the interface of Si/W. A model has been proposed to explain this anomalous selective tungsten growth.
Visible-light-driven Ag3VO4 photocatalysts were successfully synthesized using low-temperature hydrothermal synthesis method. Under various hydrothermal conditions, the structures of silver vanadates were tuned by manipulating the hydrothermal time and the ratio of silver to vanadium. X-ray diffraction (XRD) results reveal that the powders prepared in a stoichiometric ratio consisted of pure α-Ag3VO4 or mixed phases of Ag4V2O7 and α-Ag3VO4. With increasing the Ag-to-V mole ratio to 6:1, the resulting samples were identified as pure monoclinic structure α-Ag3VO4. UV-vis spectroscopy indicated that silver vanadate particles had strong visible light absorption with associated band gaps in the range of 2.2-2.5 eV. The sample synthesized in the excess silver exhibited higher photocatalytic activity than that synthesized in a stoichiometric ratio. The powder synthesized at silver-rich at 140℃ for 4 h (SHT4) exhibited the highest photocatalytic activity among all samples. The reactivity of SHT4 (surface area, 3.52 m2 g-1) on the decomposition of gaseous benzene was about 16 times higher than that of P25 (surface area, 49.04 m2 g-1) under visible light irradiation. A well developed crystallinity of Ag3VO4 of SHT 4 was considered to enhance the photocatalytic efficiency.
Previous scholars considered competence a ‘fuzzy concept’ and addressed confusions such as ‘competency vs. competence’ and ‘competence vs. core competence’. However, the issue ‘What is the essence of employee competence?’ remains unclear. By inference, the essence of competence is addressed in adoption of an organization's sustained competitive advantage viewpoint different from the traditional viewpoint of enhancing individual employability. This paper contends that employee competence is strategically driven by organizational core competence. Psychologically, employee competence and organizational core competence are similar and linked in terms of person–organization fit and person–job fit. A contextual competence framework is established enlightening the essence of employee competence and redefines competence as a ‘temporary asset’ rooted in the interactively organizational context. Contextual variables including shared values, mutual trust and mutual investment bolster the alignment between employee competence and organizational core competence and develop employee competence as firm-specific, thus becoming a source for sustained organizational competitive advantage.
Our previous studies demonstrated prompt elevation of proteinase activity in mammary secretion of drying-off cows and goats. The current study examined the progressive changes in composition of cow mammary secretion following drying-off and, in parallel, characterized the mode of peptide neogenesis using matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS) and liquid chromatography-electrospray-ionization (LC-ESI) MS/MS. The results show that the percentage of casein of total milk protein at time of drying-off was 76%, which dropped to 41%, 24%, and 16%, respectively, 1, 2, and 3 weeks after drying-off. Levels of β-lactoglobulin and α-lactoalbumin in mammary secretions of drying-off cows decreased prominently while levels of lactoferrin, BSA, and casein derived-proteins increased concomitantly compared with regular milk. A fractionation procedure was applied to remove molecules larger than 10 kDa before MALDI-TOF MS and LC-ESI MS/MS and the results show that the MALDI-TOF MS peptide profile of mammary secretion ranging from m/z 600 to 4000 was apparently modified after drying-off for 1 week, whereas species 1590 m/z and 2460 m/z were most obviously enriched compared with regular milk. LC-ESI MS/MS results were used to map peptide sequence with Mascot search server and under no post translational modification to reduce database size and 202 novel β-casein-derived peptides were successfully identified in mammary secretion after drying-off for 1 week in contrast to regular milk. Accordingly at least 48 additional cleavage positions were assigned on β-casein for mammary secretion. Among the 202 novel peptides, 5 are homologous with confirmed opioid agonists, angiotensin 1-converting enzyme inhibitors, or immuno-modulators. In conclusion, peptides are released in situ from milk proteins within short intervals following drying-off in cows. They might play roles in the transition of mammary glands from lactating to non-lactating. With specified post-translational modifications and focused functional screening, novel peptides are yet to be discovered in dry cow mammary secretion.