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Attention-deficit/hyperactivity disorder (ADHD) is associated with a higher risk of burn injury than in the normal population. Nevertheless, the influence of methylphenidate (MPH) on the risk of burn injury remains unclear. This retrospective cohort study analysed the effect of MPH on the risk of burn injury in children with ADHD.
Data were from Taiwan's National Health Insurance Research Database (NHIRD). The sample comprised individuals younger than 18 years with a diagnosis of ADHD (n = 90 634) in Taiwan's NHIRD between January 1996 and December 2013. We examined the cumulative effect of MPH on burn injury risk using Cox proportional hazards models. We conducted a sensitivity analysis for immortal time bias using a time-dependent Cox model and within-patient comparisons using the self-controlled case series model.
Children with ADHD taking MPH had a reduced risk of burn injury, with a cumulative duration of treatment dose-related effect, compared with those not taking MPH. Compared with children with ADHD not taking MPH, the adjusted hazard ratio for burn injury was 0.70 in children taking MPH for <90 days (95% confidence interval (CI) 0.64–0.77) and 0.43 in children taking MPH for ≥90 days (95% CI 0.40–0.47), with a 50.8% preventable fraction. The negative association of MPH was replicated in age-stratified analysis using time-dependent Cox regression and self-controlled case series models.
This study showed that MPH treatment was associated with a lower risk of burn injury in a cumulative duration of treatment dose-related effect manner.
Maternal supraphysiological estradiol (E2) environment during pregnancy leads to adverse perinatal outcomes. However, the influence of oocyte exposure to high E2 levels on perinatal outcomes remains unknown. Thus, a retrospective cohort study was conducted to explore the effect of high E2 level induced by controlled ovarian stimulation (COH) on further outcomes after frozen embryo transfer (FET). The study included all FET cycles (n = 10,581) between 2014 and 2017. All cycles were categorized into three groups according to the E2 level on the day of the human Chorionic Gonadotropin trigger. Odds ratios (ORs) and their confidence intervals (CIs) were calculated to evaluate the association between E2 level during COH and pregnancy outcomes and subsequent neonatal outcomes. From our findings, higher E2 level was associated with lower percentage of chemical pregnancy, clinical pregnancy, ongoing pregnancy, and live birth as well as increased frequency of early miscarriage. Preterm births were more common among singletons in women with higher E2 level during COH (aOR1 = 1.93, 95% CI: 1.22–3.06; aOR2 = 2.05, 95% CI: 1.33–3.06). Incidence of small for gestational age (SGA) was more common in both singletons (aOR1 = 2.01, 95% CI: 1.30–3.11; aOR2 = 2.51, 95% CI: 1.69–3.74) and multiples (aOR1 = 1.58, 95% CI: 1.03–2.45; aOR2 = 1.99, 95% CI: 1.05–3.84) among women with relatively higher E2 level. No association was found between high E2 level during COH and the percentage of macrosomia or large for gestational age. In summary, oocyte exposure to high E2 level during COH should be brought to our attention, since the pregnancy rate decreasing and the risk of preterm birth and SGA increasing following FET.
Attention-deficit hyperactivity disorder (ADHD) increases the risk of suicidal behaviours through psychiatric comorbidities; however, a significant direct association has not been observed between ADHD and suicide attempts.
To evaluate the risk of suicide attempt in adolescents and young adults with ADHD.
Using a nationwide, population-based insurance claims database, this longitudinal cohort study enrolled 20 574 adolescents and young adults with ADHD and 61 722 age- and gender-matched controls between 2001 and 2009. Any suicide attempt was identified from enrolment to 31 December 2011. The association between ADHD medications and the likelihood of suicide attempt was assessed.
ADHD was an independent risk factor for any suicide attempt (hazard ratio = 3.84, 95% CI = 3.19–4.62) and repeated suicide attempts (hazard ratio = 6.52, 95% CI = 4.46–9.53). Subgroup analyses of men, women, adolescents and young adults demonstrated the same trend. Methylphenidate or atomoxetine treatment did not increase the risk of suicide attempt or repeated suicide attempts. Long-term methylphenidate treatment was associated with a significantly decreased risk of repeated suicide attempts in men (hazard ratio = 0.46, 95% CI = 0.22–0.97).
ADHD was a risk factor for suicide attempt and a stronger predictor of repeated suicide attempts, independent of comorbidities. Further investigation is warranted to explore the mechanism underlying the association between ADHD and suicidal behaviours.
Apathy is a condition characterized by a lack of motivation that manifests in emotional, behavioral, and cognitive domains. Although previous studies have indicated that apathy is associated with frontal lesions, few studies have focused on the different subdomains of apathy, and no in vivo human biochemical data have been obtained to examine the neurochemical changes related to apathy in patients with Alzheimer's disease (AD). Thus, we investigated the frontal neurochemical alterations related to apathy among patients with AD using proton magnetic resonance spectroscopy (1H MRS).
Apathy was assessed through the Apathy Evaluation Scale (AES). 1H MRS was performed to measure neurochemical metabolite levels in the anterior cingulate region and right orbitofrontal region. Associations between neurochemical metabolites and the total score and subscores of each domain of the AES were analyzed.
Altogether, 36 patients completed the study. Patients with lower N-acetylaspartate/creatine ratios (NAA/Cr) in the anterior cingulate region demonstrated higher total apathy scores (β = −0.56, p = 0.003) with adjustments for age, gender, educational level, dementia severity, and depression severity. In a further analysis, a lower NAA/Cr in the anterior cingulate region was associated with all subdomains of apathy, including cognition (β = −0.43, p = 0.028), behavior (β = −0.55, p = 0.002), and emotion (β = −0.50, p = 0.005). No statistically significant associations were discovered in the right orbitofrontal region.
Our results suggest that apathy, in each of its cognitive, behavioral, or emotional subdomains is associated with brain neurochemical alterations in the anterior cingulate region. Abnormal neuronal integrity over the anterior cingulate cortex may exhibit a central role in causing all aspects of apathy in patients with AD.
Obesity and hyperlipidaemia increase the risk of CVD. Some strains of probiotics have been suggested to have potential applications in cardiovascular health by lowering serum LDL-cholesterol. In this work, high-fat diet-induced hyperlipidaemia in hamsters was treated with different doses (5×108 and 2·5×109 cells/kg per d) of heat-killed Lactobacillus reuteri GMNL-263 (Lr263) by oral gavage for 8 weeks. The serum lipid profile analysis showed that LDL-cholesterol and plasma malondialdehyde (P-MDA) were reduced in the GMNL-263 5×108 cells/kg per d treatment group. Total cholesterol and P-MDA were reduced in the GMNL-263 2·5×109 cells/kg per d treatment group. In terms of heart function, the GMNL-263 2·5×109 cells/kg per d treatments improved the ejection fraction from 85·71 to 91·81 % and fractional shortening from 46·93 to 57·92 % in the high-fat diet-fed hamster hearts. Moreover, the GMNL-263-treated, high-fat diet-fed hamster hearts exhibited reduced Fas-induced myocardial apoptosis and a reactivated IGF1R/PI3K/Akt cell survival pathway. Interestingly, the GMNL-263 treatments also enhanced the heat-shock protein 27 expression in a dose-dependent manner, but the mechanism for this increase remains unclear. In conclusion, supplementary heat-killed L. reuteri GMNL-263 can slightly reduce serum cholesterol. The anti-hyperlipidaemia effects of GMNL-263 may reactivate the IGF1R/PI3K/Akt cell survival pathway and reduce Fas-induced myocardial apoptosis in high-fat diet-fed hamster hearts.
We propose a method to measure the capture-to-display delay (CDD) of a visual communication application. The method does not require modifications to the existing system, nor require the encoder and decoder clocks be synchronized. Furthermore, we propose a solution to solve the multiple-overlapped-timestamp problem due to the exposure time of the camera. We analyze the measurement error, and implement the method in software to measure the CDD of a cellphone video chat application over various types of networks. Experiments confirm the effectiveness of our proposed method.
Unawareness of deficits is common and is associated with poor outcomes in Alzheimer's disease (AD); however, little is known about correlated neurobiochemical changes.
Proton magnetic resonance spectroscopy was used to examine neurobiochemical correlates of unawareness of deficits as assessed by the Dementia Deficit Scale in 36 patients with AD. Magnetic resonance spectroscopy spectra were acquired from the anterior cingulate area and right orbitofrontal area. Concentrations of N-acetyl-aspartate (NAA), total creatine, and other neurometabolites were calculated.
Nineteen (52.8%) participants had relative unawareness of deficits. This condition was negatively correlated with NAA/creatine in the anterior cingulate area (β = −0.36, p = 0.025) and positively correlated with NAA/creatine in the right orbitofrontal area (β = 0.41, p = 0.009) after controlling for dementia severity.
These findings suggest unawareness of deficits in AD was associated with the altered neurochemical metabolites in the anterior cingulate area and right orbitofrontal area. However, the two areas might have opposite neuronal functions in unawareness of deficits.
An approach formulated by vector algebra is proposed to deal with great circle sailing problems. Using the technique of the fixed coordinates system and relative longitude concept, derivations of formulae for this approach are simpler than those of the conventional methods. Due to fixing the initial great circle course, the great circle track (GCT) is determined. Since the course is fixed (known as “COFI” in this paper), the proposed approach, which we have named the “COFI method”, can directly calculate the waypoints along the GCT. It is considered that the COFI method is a more understandable and straightforward method to solve waypoint problems than older approaches in the literature. Based on the COFI method, a program has been developed for the navigator. In addition, the spherical triangle method with respect to the equator crossing point (STM-E) is developed by supplemental theorem. Several examples are demonstrated to validate the proposed COFI method and STM-E.
In this work, the effects of annealing treatment on the crystalline structure and mechanical property changes of polypropylene random copolymer (PPR) were comparatively investigated. Wide angle x-ray diffraction and differential scanning calorimetry were used to study the crystalline structure evolution of the annealed PPR sample. The relaxation behavior of the annealed PPR sample was analyzed using dynamic mechanical analysis. The mechanical properties and the toughening mechanism were also investigated. The results showed that the crystalline structure evolution of the annealed PPR sample depended on the annealing temperature. Due to the largely increased molecular chain mobility in the amorphous region, which promoted the plastic deformation of the annealed PPR sample under the impact condition, largely enhanced impact strength was achieved at a moderate annealing temperature. Further results showed that relatively shorter annealing duration could induce the apparent changes of crystalline structure and mechanical properties of the PPR sample.
This study investigated the microstructure and machining characteristics of a Zr38.5Ti16.5Cu15.25Ni9.75Be20 bulk metallic glass (Zr-BMG) alloy machined using electro-discharge machining (EDM). After EDM, the hardening effect near the outer surface of the electro-discharge machined (EDMed) Zr-BMG alloy originated from the surface carbides of the recast layer, ZrC and TiC. The thickness of the recast layer, crater size, and the surface roughness increased with greater pulse energy. Furthermore, the EDM can generate a porous recast layer and convert the Zr-BMG alloy surface into a carbide surface, which is a potential method to fabricate biomaterials. Experimental results also show that the material removal rate of this alloy in the EDM process was significantly related to the pulse current IP and pulse duration τP. Many electro-discharge craters and recast materials were observed on the surface of the EDMed Zr-BMG alloy. The surface roughness of the EDMed Zr-BMG alloy was found to obey the empirical equation of Ra = β(IP × τP)α.
Background: Executive dysfunction is not uncommon in patients with amnestic mild cognitive impairment (aMCI). This study aimed to investigate the applicability of executive function tests (EFTs) in aMCI as an aid in establishing the diagnosis of multi-domain MCI.
Methods: One hundred and twenty (120) aMCI patients, 126 Alzheimer's disease (AD) patients, and 100 normal controls were enrolled. The EFTs evaluated included the trail making test, digit backward span, Stroop color–word test, and design fluency and category fluency tests.
Results: Of the aMCI participants, 66% exhibited impairment in at least one EFT. Among the five selected EFTs, the category fluency test was the most discriminative in detecting executive dysfunction between patients with aMCI (standardized β = 0.264) or AD (standardized β = 0.361) with the controls, followed by the Stroop test. The performance of aMCI patients with two or more impaired EFTs was significantly different from those of controls but not from those of AD patients.
Conclusion: In the clinical setting, aMCI patients who fail in two or more EFTs may represent a unique population with multi-domain MCI that require close follow-up.
The present study investigated dietary intake, glucose metabolism and sex hormones in women with polycystic ovary syndrome (PCOS). A total of forty-five women (aged 25–40 years) with PCOS and 161 control women (aged 25–43 years) with non-PCOS-related infertility were recruited. Anthropometry, glucose tolerance and sex hormones were determined and dietary intake was assessed. Women with PCOS had lower serum sex hormone-binding globulin and increased BMI, waist:hip ratio, luteinising hormone, ratio of luteinising hormone:follicle-stimulating hormone, testosterone and free androgen index (FAI). Postprandial glucose, fasting insulin and insulin resistance were elevated in women with PCOS. Women with PCOS had reduced energy and carbohydrate intake but higher fat intake. Serum sex hormone-binding globulin level was negatively associated with BMI in both groups and negatively correlated with macronutrient intake in the PCOS group with hyperandrogenism. However, FAI was positively correlated with BMI, waist circumference and glucose metabolic parameters in both groups. Therefore, women with PCOS consume lower energy and carbohydrate compared with those with non-PCOS-related infertility and macronutrient intake is only negatively associated with serum sex hormone-binding globulin level in the PCOS group with hyperandrogenism.
The effect of direct current (dc) substrate bias on the promotion of nanocrystallization in Si network has been studied, specifically within He-diluted SiH4 plasma in radio frequency (RF)-plasma-enhanced chemical vapor deposition. In view of organizing nanocrystallinity, controlled transmission of energy to the growing surface is needed and that is obtainable from metastable helium (He*) bombardment and, in particular, ionic helium (He+) bombardment under negative substrate bias. The structural morphology has been adequately regulated to a homogeneous network restraining from an exclusive columnar structure that is coherent to low-temperature growth. Notable improvements in the film quality in terms of enhanced crystallinity with low hydrogen content as well as reduced incubation volume, bulk void, and surface roughness have been demonstrated, even at low substrate temperature and low RF power. Use of appropriate dc substrate-bias has been identified as a supplementary parameter efficiently organizing the growth, making it more device-friendly.
We have demonstrated and studied polymeric solid-state dye lasers (SSDLs) fabricated by three-dimensional (3D) polystyrene colloidal crystals and tert-butyl roadamine B (t-Bu RhB) doped Poly (methyl methacrylate) (PMMA) films with different film thickness. The sandwich-typed resonator cavities with different active layer thickness display single-mode lasing oscillations in the reflection bandgap of the colloidal crystals. The lasing thresholds could be optimized by changing the thickness of t-Bu RhB doped PMMA films, which is as low as 7.43 W/cm2. Adjusting active layer thickness would provide an opportunity to accelerate the development of fabricating polymeric SSDLs with low threshold.
Episodic memory tasks are one of the most sensitive tools to discriminate Alzheimer’s disease (AD). This study aimed to validate a shorter version verbal memory test that will efficiently assess Chinese elderly with memory complaints. One hundred and eighty-five elderly with normal cognition (NC) and 217 AD patients were evaluated. Each participant received the Chinese Version Verbal Learning Test (CVVLT) consisting of 9 two-character nouns with 4 learning trials, 2 delayed recalls in 30 seconds and 10 minutes, and a word recognition test. In the NC elderly, age and sex had significant effects on recall scores in CVVLT, while education level showed an inverse correlation with 3 different patterns of errors made during the learning, recall, and recognition trials. AD patients had lower scores across all recall tests. In those with lower educational level, NC elderly had higher perseveration errors than AD patients. The cutoff value between the AD and NC groups in the 10-minute recall was 4/5 for those aged >75 years and 5/6 for those aged <75 years. This study has good validity in discriminating AD participants and the data here can help in diagnosing AD and mild cognitive impairment using the CVVLT. (JINS, 2010, 16, 244–251.)
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.