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The coronavirus disease 2019 (COVID-19) pandemic is an unprecedented global health crisis that may cause mental health problems and heighten suicide risk. We investigated the impact of the COVID-19 pandemic on trends in suicide attempts and suicide deaths in New Taipei City, Taiwan.
The current study used the official daily data on suicide attempts and deaths in New Taipei City, Taiwan (4 million inhabitants) between 2015 and 2020 from the Taiwan National Suicide Prevention Reporting System. Interrupted time-series (ITS) analyses with parameters corrected by the estimated autocorrelations were applied on weekly aggregated data to examine whether the suicide trends during the early COVID-19 pandemic (late January to July 2020) deviated from previous trends (January 2015 to late January 2020). The impact due to the suicide prevention policy change was also examined (since August 2020).
ITS analyses revealed no significant increases in both mean and trend on weekly suicide deaths during the COVID-19 pandemic and after the policy change. In contrast, there was a significant increasing trend in weekly suicide attempts since the COVID-19 outbreak at the rate of 1.54 attempts per week (95% confidence interval 0.49–2.60; p = 0.004). Sex difference analysis revealed that, however, this increasing trend was observed only in females not in males.
The COVID-19 pandemic has different impacts on suicides attempts and deaths during the early pandemic in New Taipei City, Taiwan. The COVID-19 outbreak drastically increased the trend of suicide attempts. In contrast, the number of suicide deaths had remained constant in the investigated periods.
Consumption of sugar-sweetened beverages (SSB) is associated with overweight and obesity in children and adolescents. Although existing research confirms the significance of economic and social factors as determinants of SSB intake, comparative studies on political factors and cross-national analyses are lacking. Research indicates that including women in the process of political decision-making promotes healthcare and child protection. This study examined how women’s parliamentary representation influences children’s and adolescents’ SSB intake compared with adults.
The study used cross-national food and beverage intake data from the Global Dietary Database. The outcome measurement was SSB consumption (g/day) for different population groups. We modelled SSB intake as a function of age groups, women’s parliamentary representation at the national level (the independent variable), regime types (the contextual factor) and import tariffs on SSB (the mediator) using country and time-fixed effects regression models.
One-hundred eighty-five countries across three waves from 2005 to 2015.
Different population groups.
The impact of female representation on reducing SSB consumption is more prevalent in children and adolescents than in adults. Furthermore, the effect of women’s parliamentary representation on SSB consumption among children and adolescents is conditional on a country’s democratic status. Finally, the marginal effect decreases when import tariffs on SSB are considered a link in a causal chain. No changes in adult SSB intake are statistically significant.
The findings suggest that the presence of women in the legislature can have a substantial impact on child and adolescent health.
Contrasting the well-described effects of early intervention (EI) services for youth-onset psychosis, the potential benefits of the intervention for adult-onset psychosis are uncertain. This paper aims to examine the effectiveness of EI on functioning and symptomatic improvement in adult-onset psychosis, and the optimal duration of the intervention.
360 psychosis patients aged 26–55 years were randomized to receive either standard care (SC, n = 120), or case management for two (2-year EI, n = 120) or 4 years (4-year EI, n = 120) in a 4-year rater-masked, parallel-group, superiority, randomized controlled trial of treatment effectiveness (Clinicaltrials.gov: NCT00919620). Primary (i.e. social and occupational functioning) and secondary outcomes (i.e. positive and negative symptoms, and quality of life) were assessed at baseline, 6-month, and yearly for 4 years.
Compared with SC, patients with 4-year EI had better Role Functioning Scale (RFS) immediate [interaction estimate = 0.008, 95% confidence interval (CI) = 0.001–0.014, p = 0.02] and extended social network (interaction estimate = 0.011, 95% CI = 0.004–0.018, p = 0.003) scores. Specifically, these improvements were observed in the first 2 years. Compared with the 2-year EI group, the 4-year EI group had better RFS total (p = 0.01), immediate (p = 0.01), and extended social network (p = 0.05) scores at the fourth year. Meanwhile, the 4-year (p = 0.02) and 2-year EI (p = 0.004) group had less severe symptoms than the SC group at the first year.
Specialized EI treatment for psychosis patients aged 26–55 should be provided for at least the initial 2 years of illness. Further treatment up to 4 years confers little benefits in this age range over the course of the study.
The concurrent incidence of autoimmune comorbidities in obsessive–compulsive disorder (OCD) is known. However, the association between OCD and related autoimmune skin diseases (ASDs) has not been well studied.
This study aimed to investigate the association between OCD and the risk of ASDs.
To assess the risk of developing ASDs, we recruited 44 324 patients with OCD and 177 296 matched controls from the National Health Insurance Research Database in Taiwan. A Cox regression model was used for the analyses.
After adjusting for confounders, an increased risk of ASDs among the patients with OCD (adjusted hazard ratio [aHR]: 6.36; 95% confidence interval [CI]: 5.43-7.45) was found when compared to the controls. Statistically significant associations were found between OCD and seven individual ASDs, including psoriasis (aHR: 12.52; 95% CI: 8.78-17.85), lichen planus (aHR: 27.22; 95% CI: 13.09-56.60), alopecia areata (aHR: 13.69; 95% CI: 9.38-19.98), autoimmune bullous diseases (aHR: 4.30; 95% CI: 2.03-9.11), hidradenitis suppurativa (aHR: 29.95; 95% CI: 3.35-267.62), vitiligo (aHR: 9.35; 95% CI: 5.35-16.32), and lupus erythematosus (aHR: 2.10; 95% CI: 1.52-2.91).
Patients with OCD had an increased risk of developing ASDs compared to matched controls. Further studies are required to clarify the underlying mechanisms.
This paper describes a reconstruction method for atom probe tomography based on a bottom-up approach accounting for (i) the final tip morphology (which is frequently induced by inhomogeneous evaporation probabilities across the tip surface due to laser absorption, heat diffusion effects, and inhomogeneous material properties), (ii) the limited (and changing) field of view, and (iii) the detector efficiency. The reconstruction starts from the final tip morphology and reverses the evaporation sequence through the pseudo-deposition of defined small reconstruction volumes, which are then stacked together to create the full three-dimensional (3D) tip. The subdivision in small reconstruction volumes allows the scheme to account for the changing tip shape and field of view as evaporation proceeds. Atoms within the same small reconstruction volume are reconstructed at once by placing atoms back onto their possible lattice sites through a trajectory-matching process involving simulated and experimental hit maps. As the ejected ion trajectories are simulated using detailed electrostatic modeling inside the chamber, no simplifications have been imposed on the shape of the trajectories, projection laws, or tip surface. We demonstrate the superior performance of our approach over the conventional reconstruction method (Bas) for an asymmetrical tip shape.
Shock-tube experiments on eight kinds of two-dimensional multi-mode air–SF$_6$ interface with controllable initial conditions are performed to examine the dependence of perturbation growth on initial spectra. We deduce and demonstrate experimentally that the amplitude development of each mode is influenced by the mode-competition effect from quasi-linear stages. It is confirmed that the mode-competition effect is closely related to initial spectra, including the wavenumber, the phase and the initial amplitude of constituent modes. By considering both the mode-competition effect and the high-order harmonics effect, a nonlinear model is established based on initial spectra to predict the amplitude growth of each individual mode. The nonlinear model is validated by the present experiments and data in the literature by considering diverse initial spectra, shock intensities and density ratios. Moreover, the nonlinear model is successfully extended based on the superposition principle to predict the growths of the total perturbation width and the bubble/spike width from quasi-linear to nonlinear stages.
This study aimed to explore the relationships between situational and psychological factors and Hong Kong citizens’ plastic waste management (PWM) intentions based on an extended theory of planned behaviour model with situational factors. A total of 996 Hong Kong permanent residents were surveyed, and data were analysed using structural equation modelling. The results revealed that situational factors had a direct and positive effect on PWM intention, but also affected PWM intention indirectly through their significant effects on attitude and perceived behavioural control regarding PWM. The implications for environmental education and policy are discussed.
To investigate the safety and feasibility of midazolam for conscious sedation in transcatheter device closure of atrial septal defects guided solely by transthoracic echocardiography.
A retrospective analysis was performed on 55 patients who underwent transcatheter device closure of atrial septal defects from October, 2019 to May, 2020. All patients received intravenous midazolam and local anesthesia with lidocaine to maintain sedation. A group of previous patients with unpublished data who underwent the same procedure with general anesthesia was set as the control group. The relevant clinical parameters, the Ramsay sedation scores, the numerical rating scale, and the post-operative satisfaction questionnaire were recorded and analyzed.
In the midazolam group, the success rate of atrial septal defect closure was 98.2%. Hemodynamic stability was observed during the procedure. None of the patients needed additional endotracheal intubation for general anesthesia. Compared with the control group, the midazolam group had no statistically significant differences in the Ramsay sedation score and numerical rating scale scores. Patients in the midazolam group experienced more post-operative satisfaction than those in the control group.
Conscious sedation using midazolam is a safe and effective anesthetic technique for transcatheter device closure of atrial septal defects guided solely by transthoracic echocardiography.
The consumer survey reported in this research paper aims to understand how Chinese mothers learn about and confirm the origin of powdered infant formulas (henceforward formulas), their knowledge level and preferences between formulas from different origins. With globalization, dairy companies can source ingredients for domestic production and manufacture finished products across the world. Chinese consumers are now facing a variety of formulas with different brand origin, main ingredient origin (‘nai yuan’), manufacturing origin, and country-of-purchase. Drawing on a large representative sample of Chinese mothers who have purchased formulas, we found that most of them had intensively engaged in learning about and confirming formulas' origin through different strategies. However, they may not interpret related cues correctly: a majority of Chinese mothers incorrectly considered the ‘main ingredient origin’ as the ‘manufacturing place’ and could not necessarily recognize between ‘foreign’ and ‘domestic’ brands. Among formulas from different origins, authentic foreign branded, produced and packaged formulas showed a high popularity in Tier 1 & 2 cities and among more knowledgeable consumers. In low-tier cities, these products were equally popular as domestically branded and produced formulas using imported milk powders and other ingredients. Formulas directly acquired from overseas markets through unofficial channels were least favoured by consumers. The study shows that Chinese consumers' previous one-sided endorsement towards foreign formulas appears to have weakened. Decisions made by formula companies on the origin of the main ingredient and the place of manufacture would influence product attractiveness, and the segments of Chinese consumers to target.
Engineered biomaterials provide unique functions to overcome the bottlenecks seen in biomedicine. Hence, a technique for rapid and routine tests of collagen is required, in which the test items commonly include molecular weight, crosslinking degree, purity, and sterilization induced structural change. Among them, the crosslinking degree mainly influences collagen properties. In this study, second harmonic generation (SHG) and coherent anti-Stokes Raman scattering (CARS) microscopy are used in combination to explore the collagen structure at molecular and macromolecular scales. These measured parameters are applied for the classification and quantification among the different collagen scaffolds, which were verified by other conventional methods. It is demonstrated that the crosslinking status can be analyzed from SHG images and presented as the coherency of collagen organization that is correlated with the mechanical properties. Also, the comparative analyses of SHG signal and relative CARS signal of amide III band at 1,240 cm−1 to δCH2 band at 1,450 cm−1 of these samples provide information regarding the variation of the molecular structure during a crosslinking process, thus serving as nonlinear optical signatures to indicate a successful crosslinking.
Anticipatory pleasure deficits are closely correlated with negative symptoms in schizophrenia, and may be found in both clinical and subclinical populations along the psychosis continuum. Prospection, which is an important component of anticipatory pleasure, is impaired in individuals with social anhedonia (SocAnh). In this study, we examined the neural correlates of envisioning positive future events in individuals with SocAnh.
Forty-nine individuals with SocAnh and 33 matched controls were recruited to undergo functional MRI scanning, during which they were instructed to simulate positive or neutral future episodes according to cue words. Two stages of prospection were distinguished: construction and elaboration.
Reduced activation at the caudate and the precuneus when prospecting positive (v. neutral) future events was observed in individuals with SocAnh. Furthermore, compared with controls, increased functional connectivity between the caudate and the inferior occipital gyrus during positive (v. neutral) prospection was found in individuals with SocAnh. Both groups exhibited a similar pattern of brain activation for the construction v. elaboration contrast, regardless of the emotional context.
Our results provide further evidence on the neural mechanism of anticipatory pleasure deficits in subclinical individuals with SocAnh and suggest that altered cortico-striatal circuit may play a role in anticipatory pleasure deficits in these individuals.
Despite increasing economic integrations with China, worries exist in China's neighboring countries about China's implicit political intention. Do people view trading with China differently? In this article, we incorporate the political context of trade agreements by showing that trade with partners who come with political costs is less likely to be supported. Using a nationally representative survey experiment from Taiwan, we find that trading with China garners less support than trading with Japan or Malaysia, and nationalism suppresses self-interest when the proposed trading partner is China. We show that national attachment, which is neither a proxy for political identification nor a proxy for national chauvinism, becomes a stronger predictor of trade preferences toward China. While the political tension between China and Taiwan is unique, many countries see at least one other country posing a negative externality. Our finding suggests strongly identified nationalists would oppose engaging with a hostile outsider regardless of their self-interest.
To evaluate age-related differences in the independent/combined association of added sugar intake from soda and body adiposity with hyperuricaemia in gender-stratified US adults.
Consumption of added sugar from soda was calculated from 24-h dietary interviews and categorised into none, regular and excessive consumption. Hyperuricaemia was defined as serum uric acid levels >417 mmol/l in men and >357 mmol/l in women. Multiple regression models with interaction terms and logistic models adjusted for covariates were conducted under survey-data modules.
National Health and Nutrition Examination Survey during 2007–2016.
15 338 adults without gout, failing kidneys, an estimated glomerular filtration rate < 30 or diabetes were selected.
The age-stratified prevalence rate of hyperuricaemia was 18·8–20·4 % in males and 6·8–17·3 % in females. Hyperuricaemia prevalence of approximately 50 % was observed in young and middle age males who consumed excessive added sugar from soda. Excessive added sugar intake was observed to be associated with 1·5- to 2·0-fold and 2·0- to 2·3-fold increased risk of the probability of hyperuricaemia in young and middle age males and middle age females, respectively. Study participants, regardless of age or gender, who were obese and consumed excessive added sugar from soda had the highest risk of having hyperuricaemia.
Our study revealed that the association between hyperuricaemia and consumption of excessive added sugar from soda may vary by age and gender. Obese adults who consumed excessive added sugar from soda had the highest risk of hyperuricaemia, a finding that was found across all age-specific groups for both genders.
The objective of this study was to analyze differences in birth weight and overweight/obesity in a Shanghai twin cohort. We also wanted to study their association and explore possible risk factors for the discordance of overweight/obesity within twins. This was an internal case–control study designed for twins. The 2012 Shanghai Twin Registration System baseline survey data of a total of 3417 twin pairs were statistically analyzed using SPSS22 software. Results show that the body mass index (BMI) of the Shanghai twin population increased with age. Twins with a high birth weight had a higher BMI and a higher rate of overweight and obesity; 0- to 6-year-old twins, male twins and dizygotic (DZ) twins had higher rates of overweight/obesity than other groups. The greater the discordant birth weight rate of twins, the more obvious the difference in BMI (p < .05). There was a significant difference in overweight/obesity between twins with a relative difference of birth weight ≥15% in DZ twins (p < .05). DZ twins, male twins and 0- to 6-year-old twins were more likely to be discordant in overweight/obese than others. The discordant birth weight within twins was not a risk factor for discordant overweight/obesity. However, attention should be paid to childhood obesity, and appropriate interventions should be made at the appropriate time. Genetics may play an important role in the occurrence and development of overweight/obesity. In conclusion, discordant growth and development in the uterus early in life may not lead to discordant weight development in the future.
We study the axisymmetric evolution of a liquid film on a solid sphere governed by gravity, capillarity and viscous forces. The lubrication equations established in spherical coordinates are numerically solved using finite elements and local similarity solutions are obtained. Results show that the evolution behaves differently at early and late stages. At the early stage, the interface evolves in such a way that the capillary effect can be ignored. At the late stage, there emerge four zones from top to bottom: a thin film, a ridge ring, a dimple ring and a pendant drop. Each zone is governed by the balance of different forces, and hence is characterized by an individual physical mechanism. Consequently, the pendant drop is quasi-static, and the film thicknesses of other regions follow different scaling laws. The position of the dimple remains unchanged at the late stage.
Exposure to adverse childhood experiences (ACEs) is not only associated with one's adverse health outcomes in adulthood but also increases the risk of child developmental problems in offspring. However, the mechanisms involved in the transmission of the effects of maternal ACEs to the offspring largely remain unexplored. This study sought to identify possible psychosocial pathways of intergenerational effects of maternal ACEs on child development at 6 months. Data from a longitudinal study on maternal childhood adversity and maternal psychosocial risk during pregnancy as well as maternal mental health problems and child development at 6 months postnatal were used. Structural equation modeling with bootstrapping was used to estimate the indirect effects of maternal ACEs on child development at 6 months. The model showed that maternal ACEs indirectly influenced offspring's development via maternal stressful events during pregnancy and pre- and postnatal mental health problems. This finding highlights the possible interventions at the prenatal and postnatal periods. Early identification of women who have ACEs or who are at psychosocial risk during pre- and postnatal periods is critical to provide interventions to buffer those negative effects on offspring's development. Future studies are needed to longitudinally assess the effects of maternal ACEs on child development over time.
Schizotypy refers to schizophrenia-like traits below the clinical threshold in the general population. The pathological development of schizophrenia has been postulated to evolve from the initial coexistence of ‘brain disconnection’ and ‘brain connectivity compensation’ to ‘brain connectivity decompensation’.
In this study, we examined the brain connectivity changes associated with schizotypy by combining brain white matter structural connectivity, static and dynamic functional connectivity analysis of diffusion tensor imaging data and resting-state functional magnetic resonance imaging data. A total of 87 participants with a high level of schizotypal traits and 122 control participants completed the experiment. Group differences in whole-brain white matter structural connectivity probability, static mean functional connectivity strength, dynamic functional connectivity variability and stability among 264 brain sub-regions of interests were investigated.
We found that individuals with high schizotypy exhibited increased structural connectivity probability within the task control network and within the default mode network; increased variability and decreased stability of functional connectivity within the default mode network and between the auditory network and the subcortical network; and decreased static mean functional connectivity strength mainly associated with the sensorimotor network, the default mode network and the task control network.
These findings highlight the specific changes in brain connectivity associated with schizotypy and indicate that both decompensatory and compensatory changes in structural connectivity within the default mode network and the task control network in the context of whole-brain functional disconnection may be an important neurobiological correlate in individuals with high schizotypy.
A higher dietary intake or serum concentration of betaine has been associated with greater lean body mass in middle-aged and older adults. However, it remains unknown whether betaine intake is associated with age-related loss of skeletal muscle mass (SMM). We assessed the association between dietary betaine intake and relative changes in SMM after 3 years in middle-aged adults. A total of 1242 participants aged 41–60 years from the Guangzhou Nutrition and Health Study 2011–2013 and 2014–2017 with body composition measurements by dual-energy X-ray absorptiometry were included. A face-to-face questionnaire was used to collect general baseline information. After adjustment for potential confounders, multiple linear regression found that energy-adjusted dietary betaine intake was significantly and positively associated with relative changes (i.e. percentage loss or increase) in SMM of legs, limbs and appendicular skeletal mass index (ASMI) over 3 years of follow-up (β 0·322 (se 0·157), 0·309 (se 0·142) and 0·303 (se 0·145), respectively; P < 0·05). The ANCOVA models revealed that participants in the highest betaine tertile had significantly less loss in SMM of limbs and ASMI and more increase in SMM of legs over 3 years of follow-up, compared with those in the bottom betaine tertile (all Ptrend < 0·05). In conclusion, our findings suggest that elevated higher dietary betaine intake may be associated with less loss of SMM of legs, limbs and ASMI in middle-aged adults.
Non-communicable diseases (NCDs) including obesity, diabetes, and allergy are chronic, multi-factorial conditions that are affected by both genetic and environmental factors. Over the last decade, the microbiome has emerged as a possible contributor to the pathogenesis of NCDs. Microbiome profiles were altered in patients with NCDs, and shift in microbial communities was associated with improvement in these health conditions. Since the genetic component of these diseases cannot be altered, the ability to manipulate the microbiome holds great promise for design of novel therapies in the prevention and treatment of NCDs. Together, the Developmental Origins of Health and Disease concept and the microbial hypothesis propose that early life exposure to environmental stimuli will alter the development and composition of the human microbiome, resulting in health consequences. Recent studies indicated that the environment we are exposed to in early life is instrumental in shaping robust immune development, possibly through modulation of the human microbiome (skin, airway, and gut). Despite much research into human microbiome, the origin of their constituent microbiota remains unclear. Dust (also known as particulate matter) is a key determinant of poor air quality in the modern urban environment. It is ubiquitous and serves as a major source and reservoir of microbial communities that modulates the human microbiome, contributing to health and disease. There are evidence that reported significant associations between environmental dust and NCDs. In this review, we will focus on the impact of dust exposure in shaping the human microbiome and its possible contribution to the development of NCDs.
Singapore's first study on Minimum Income Standards (MIS) focusing on older people was completed in 2018. The study took place in the context of rapid demographic ageing and an income security regime built around a defined contribution pension scheme and intergenerational family support. Moreover, social policies in Singapore tend to lack transparent numerical benchmarks and policy making is not systematically informed by clear notions of needs and standards. With some adaptations, the MIS approach developed in the UK was used to generate a definition of a basic standard of living in Singapore and separate budgets for four household types: elderly man living alone (aged 65 and above), elderly woman living alone, elderly couple, and older man or woman living alone (aged 55 to 64). This chapter sets out the background of the study, presents its method and findings, and explains the significance of introducing MIS to a policy setting such as Singapore.
Income security and policy making
Singapore has one of Asia's fastest-ageing populations (UN, 2018). Increasing life expectancy implies more years in retirement and has made old age income security one of the most pressing policy concerns. The worry is also especially acute as co-residence with adult children and their cash contributions have traditionally been the pillar of income security for elderly persons in the absence of comprehensive formal social security (Ng, 2011a). As family sizes shrink, access to income support from children is projected to decline (Ng, 2015). Co-residence rates have also been steadily declining. At the same time, there are still gaps in income security policy. The primary source of public pensions is the Central Provident Fund (CPF), a defined contribution scheme which attracts mandatory monthly contributions from both employer and employee, and pays an annuity from the age of 65 (CPF Board, 2018). The amount of payment depends on how much savings the individual has accumulated and there are no separate non-contributory pensions. A means-tested public assistance scheme covering less than 1 per cent of the elderly population has been the primary recourse for persons with insufficient incomes (MSF, 2018a, 2018b).
In recent years, several new schemes have been introduced to supplement the CPF and public assistance, such as the Goods and Services Tax (GST) Voucher – Cash (MOF, 2018) and Silver Support Scheme (MOM, 2018a).