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The purpose of this study was to predict quality of life (QoL) and associated factors in patients with chronic mental illness (CMI) in Kaohsiung, Taiwan.
Patients (N = 2,023; 52.9% male, 47.1% female) were recruited using cross-sectional and convenience sampling. Structured questionnaires, including a living conditions questionnaire, a psychotic symptom assessment scale, the Caregiver Burden Scale, the 5-item Brief Symptom Rating Scale (BSRS-5), and the Medical Outcomes Study Short Form-12 (MOS SF-12) were used to collect data.
Single-factor analyses showed that those who were single, employed, and younger had better QoL. Additionally, patients who had fewer psychological problems and lower levels of psychological distress reported better QoL. Current psychotic symptoms, especially positive symptoms, were negatively correlated with QoL. For disease factors, schizophrenic patients and hospitalized patients reported better QoL than both bipolar patients and community patients. For family factors, caregiver's attitude and caregiver's burden were negatively correlated with QoL. For social factors, unstable housing and community social dysfunction were negatively correlated with QoL. The results showed that all four dimensions (social, family, disease and personal factors) were significant predictors of the mental component summary (MCS) and physical component summary (PCS) dimensions of QoL.
Personal factors and disease factors were the most important predictors of QoL in CMI patients of this sample. Family factors were more important than social factors in the MCS dimension, but social factors were more important than family factors in the PCS dimension.
Abnormal brain connectivity has recently been reported in obsessive compulsive disorder (OCD). However, structural differences in the corpus callosum (CC), the primary structure connecting the two hemispheres, have not been extensively studied. In this case-control study, we recruited 30 patients with OCD and 30 healthy control subjects carefully matched for age, sex and handedness. Combining surface-based mesh-modeling and voxel-based morphometry (VBM), we compared callosal thickness and white matter (WM) density in patients and controls. We investigated associations between callosal structure and cortical gray matter (GM) density, and we related CC measures to neuropsychological performance in OCD. OCD patients showed small anterior and posterior callosal regions compared to healthy control subjects. In the OCD group, anterior callosal thickness was positively correlated with GM density of the right mid-dorso-lateral prefrontal (BA 9/46) area, while posterior callosal thickness was positively correlated with GM density in the left supramarginal gyrus (BA 40). Moreover, posterior callosal WM density was positively correlated with verbal memory, visuo-spatial memory, verbal fluency, and visuo-spatial reasoning performances. Callosal attributes were related to GM density in cortical areas innervated by the CC, and were also related to performance in cognitive domains impaired in the disorder. The CC may therefore be integrally involved in OCD.
This study aimed to determine the effectiveness of group music therapy to improve the depression and cognitive function of elderly persons with dementia.
This was a randomized clinical trial design with permuted block randomization.
Three nursing homes in Taiwan.
Of the 104 elderly persons with dementia randomly assigned to the experimental or control group, 100 completed the study: 49 in the experimental group and 51 in the control group.
The experimental group received 12 sessions of group music therapy of 30 min each. the control group maintained routine activities of daily living.
Groups were compared for depression and cognitive function before the intervention, at the 6th and 12th session and one month after cessation. Generalized estimating equations (GEEs) were used to estimate repeated effects of music therapy.
Results indicated that: 1) depression decreased at the 12th session (P < 0.001); 2) cortisol level was not significant decreased in the experimental and control group after music therapy; and 3) cognitive function improved significantly at 6th, 12th session, and one month follow-up (P < 0.044; P < 0.001; P < 0.026). Music therapy is more appropriate for mild and moderate dementia. the music therapy had more impact on dementia elders’ function of recall than on orientation, registration, attention and calculation, language and spatial.
Depression in elderly with dementia can be decreased and their cognitive function improved slightly through group music therapy. the mechanism behind the diminished cortisol levels in the effects of music therapy in dementia remains to be determined.
For electronic packaging structure, there are many design parameters that will affect its reliability performance, using experimental way to obtain the reliability result will take a considerable amount of time. Therefore, how to shorten the design time becomes a critical issue for new electronic packaging structure development. This research will combine artificial intelligence (AI) and simulation technology to assess the long-term reliability of wafer level packaging (WLP). A simulation technology using finite element method (FEM) with appropriate mechanics theories has been validated by multiple experiments will replace the experiment to create reliability results for different WLP structures. After a big WLP structure-reliability database created, this study will apply artificial neural network (ANN) theory to analyze this database and obtains a regression model for structure-reliability relationship of WLP. Once the regression model is established and validated, the WLP geometry, such as pad size, die and buffer layer thickness, and solder volume, etc. can be simply entered, and then the WLP reliability results can be immediately obtained through the ANN regression model.
Treatment for hoarding disorder is typically performed by mental health professionals, potentially limiting access to care in underserved areas.
We aimed to conduct a non-inferiority trial of group peer-facilitated therapy (G-PFT) and group psychologist-led cognitive–behavioural therapy (G-CBT).
We randomised 323 adults with hording disorder 15 weeks of G-PFT or 16 weeks of G-CBT and assessed at baseline, post-treatment and longitudinally (≥3 months post-treatment: mean 14.4 months, range 3–25). Predictors of treatment response were examined.
G-PFT (effect size 1.20) was as effective as G-CBT (effect size 1.21; between-group difference 1.82 points, t = −1.71, d.f. = 245, P = 0.04). More homework completion and ongoing help from family and friends resulted in lower severity scores at longitudinal follow-up (t = 2.79, d.f. = 175, P = 0.006; t = 2.89, d.f. = 175, P = 0.004).
Peer-led groups were as effective as psychologist-led groups, providing a novel treatment avenue for individuals without access to mental health professionals.
Declaration of interest
C.A.M. has received grant funding from the National Institutes of Health (NIH) and travel reimbursement and speakers’ honoraria from the Tourette Association of America (TAA), as well as honoraria and travel reimbursement from the NIH for serving as an NIH Study Section reviewer. K.D. receives research support from the NIH and honoraria and travel reimbursement from the NIH for serving as an NIH Study Section reviewer. R.S.M. receives research support from the National Institute of Mental Health, National Institute of Aging, the Hillblom Foundation, Janssen Pharmaceuticals (research grant) and the Alzheimer's Association. R.S.M. has also received travel support from the National Institute of Mental Health for Workshop participation. J.Y.T. receives research support from the NIH, Patient-Centered Outcomes Research Institute and the California Tobacco Related Research Program, and honoraria and travel reimbursement from the NIH for serving as an NIH Study Section reviewer. All other authors report no conflicts of interest.
Prior to integrated circuit (IC) packaging, die performance must be verified using probe cards to screen for defective products. With the decrease in IC line width, the dimensions of the pads used for performance verification and the spacing between adjacent pads have also decreased. However, when the pad pitch is reduced to less than 30 μm, commonly used probe cards will face manufacturing problems in miniaturization. To resolve probe card manufacturing problems caused by the miniaturization of IC components, the use of an anisotropic conductive film (ACF) in probe cards was proposed in this study. Theoretical calculations and experimental testing of this probe structure were conducted to demonstrate the feasibility of this concept.
In theoretical calculations, composite material and buckling theory were utilized to evaluate the buckling behavior of the ACF. In experimental testing, photolithography and electroplating techniques were used to control the line width and spacing intervals of the micron-scale metal wires in the ACF. After the ACF was fabricated, the mechanical properties of the ACF during wafer testing were assessed. Theoretical analyses and experimental testing verified that ACFs can potentially be applied to the performance verification of IC products. In the ACF structure, multiple probes came into contact with each pad. Therefore, ACFs can potentially be applied to the performance verification of IC components with pad diameters of less than 20 μm. The results of this study directly benefit the miniaturization of ICs.
A compact hybrid rocket motor design that incorporates a dual-vortical-flow (DVF) concept is proposed. The oxidizer (nitrous oxide, N2O) is injected circumferentially into various sections of the rocket motor, which are sectored by several solid fuel “rings” (made of hydroxyl-terminated polybutadiene, HTPB) that are installed along the central axis of the motor. The proposed configuration not only increases the residence time of the oxidizer flow, it also implies an inherent “roll control” capability of the motor. Based on a DVF motor geometry with a designed thrust level of 11.6 kN, the characteristics of the turbulent reacting flow within the motor and its rocket performance were analyzed with a comprehensive numerical model that implements both real-fluid properties and finite-rate chemistry. Data indicate that the vacuum specific impulse (Isp) of the DVF motor could reach 278 s. The result from a preliminary ground test of a lab-scale DVF hybrid rocket motor (with a designed thrust level of 3,000 N) also shows promising performance. The proposed DVF concept is expected to partly resolve the issue of scalability, which remains challenging for hybrid rocket motors development.
Aluminum alloys are in high demand for additive manufacturing (AM) processing. However, the physical properties of Al alloys are less favorable for the production of repeatable and reliable parts, with factors such as surface oxide scales, high thermal conductivity, and large solidification shrinkage. Despite these characteristics, processing strategies have been developed to overcome these hurdles. The objective of this article is to highlight the different microstructure–processing–properties characteristics for the three main families of aluminum alloys: pure, casting, and wrought chemistries. The article focuses on AM processes involving solidification, including powder bed and direct energy deposition for both powder and wire feedstock.
Swaziland has the highest prevalence of human immunodeficiency virus (HIV) in the world. Attrition (loss to follow-up and mortality) in people living with HIV/AIDS (PLWHA) already on treatment is a major challenge, undermining achievements of the antiretroviral treatment (ART) programme in Swaziland. The contributing factors to attrition in the Swazi context are unclear. This study aims to (1) estimate attrition from the ART programme 12 months after ART initiation in Swaziland, and (2) determine the predictors of attrition in PLWHA treated with ART in Swaziland. A retrospective cohort study using national baseline data was conducted. A competing-risk Cox proportional hazard regression was used to determine the predictors of attrition. We estimated 10·3% (95% confidence interval 10·1–10·6) attrition in 16 423 participants that initiated ART in 2012. Attrition was significantly associated with sex, age, district, treatment supporter at initiation, co-infection of HIV and TB, functional status, WHO clinical stage, and ownership of facility. Our study can form a base of policies, plans, and service delivery strategies for preventing and controlling attrition in Swaziland.
Public controversy regarding the potential overdiagnosis and overmedication of children with attention-deficit/hyperactivity disorder (ADHD) has continued for decades. This study used the National Health Insurance Research Database of Taiwan (NHIRD-TW) to explore trends in ADHD diagnosis in youths and the proportion of those receiving medication, with the aim of determining whether ADHD is overdiagnosed and overmedicated in Taiwan.
Youths (age ≤18 years) who had at least two NHIRD-TW claims records with ADHD diagnosis between January 2000 and December 2011 were selected as the subject cohort. In total, the study sample comprised 145 018 patients with ADHD (mean age at a diagnosis of ADHD: 7.7 ± 3.1 years; 21.4% females). The number of cases of ADHD were calculated annually for each year (from 2000 to 2011), and the number of cases per year who received medication was determined as those with at least one record of pharmacotherapy (immediate-release methylphenidate, osmotic controlled-release formulation of methylphenidate, and atomoxetine) in each year.
The prevalence rates of a diagnosis of ADHD in the youths ranged from 0.11% in 2000 to 1.24% in 2011. Compared with children under 6 years of age, the ADHD diagnosis rates in children aged between 7 and 12 years (ratio of prevalence rates = 4.36) and in those aged between 13 and 18 years (ratio of prevalence rates = 1.42) were significantly higher during the study period. The prevalence in males was higher than that in females (ratio of prevalence rates = 4.09). Among the youths with ADHD, 50.2% received medications in 2000 compared with 61.0% in 2011. The probability of receiving ADHD medication increased with age. More male ADHD patients received medications that females patients (ratio of prevalence rates = 1.16).
The rate of ADHD diagnosis was far lower than the prevalence rate (7.5%) identified in a previous community study using face-to-face interviews. Approximately 40–50% of the youths with ADHD did not receive any medications. These findings are not consistent with a systematic public opinion about overdiagnosis or overmedication of ADHD in Taiwan.
We recently demonstrated a sub-bandgap photoresponse with our wafer-scale
Au/TiO2 metallic-semiconductor photonic crystals (MSPhC). The
sub-bandgap energy with 590 nm peak could be absorbed in the form of hot
electron and injected to TiO2, which provides 5.28 times more energy
for photolysis than that of energy absorbed to flat TiO2. If the
solar energy already absorbed above 700 nm could be injected to the catalyst,
higher than 10 times improvement will be achieved, and above 20% solar to fuel
efficiency will be feasible with the robust but inefficient TiO2
catalyst. In order to achieve photocurrent near and above 700 nm spectrum, we
deposited gold nanorods on the surface of MSPhC to incur localized surface
plasmon (LSP) modes absorption and subsequent injection to the TiO2
catalyst. We used electrophoretic deposition (EPD) method to deposit nanorods on
the top, sidewall and bottom well surface of the photonic nanocavities. The
deposition of nanorods was achieved reasonably uniform and sparse not to block
the optical cavities of MSPhC. Flat gold surfaces were tested at 4 different
suspension densities to get the optimum gold nanorods density. Under 10V applied
electric field, positively charged gold nanorods at the concentration of
6.52×1013 #/mL could deposit MSPhC surface
with the density of 230 #/µm2, which was reasonably
uniform and sparse. Preliminary tests show an absorbance increase near 700 nm on
flat device coated with gold nanorods. Photocurrent measurement is under way to
demonstrate the enhanced hot electron transfer over full visible light and
near-infrared solar spectrum.
This paper presents a robust reliability analysis method for systems of multimodular redundant (MMR) controllers using the method of partitioning and parallel processing of a Markov chain (PPMC). A Markov chain is formulated to represent the N distinct states of the MMR controllers. Such a Markov chain has N2 directed edges, and each edge corresponds to a transition probability between a pair of start and end states. Because N can be easily increased substantially, the system reliability analysis may require large computational resources, such as the central processing unit usage and memory occupation. By the PPMC, a Markov chain's transition probability matrix can be partitioned and reordered, such that the system reliability can be evaluated through only the diagonal submatrices of the transition probability matrix. In addition, calculations regarding the submatrices are independent of each other and thus can be conducted in parallel to assure the efficiency. The simulation results show that, compared with the sequential method applied to an intact Markov chain, the proposed PPMC can improve the performance and produce allowable accuracy for the reliability analysis on large-scale systems of MMR controllers.
Information on the risk factors for community-associated skin and soft-tissue infections (SSTIs) due to methicillin-resistant Staphylococcus aureus in Asian populations is scarce. To this end we performed a case-control study of patients treated at two hospital-affiliated outpatient clinics in Taiwan to determine potential risk factors for MRSA SSTIs. S. aureus was isolated from 39 of 100 eligible patients, and 74% were MRSA. Apart from resistance to clindamycin and erythromycin, most MRSA isolates were susceptible to appropriate antimicrobials. The significant risk factors identified by multivariate analysis for MRSA SSTIs were male gender (P = 0·09), nasal carriage of MRSA (P = 0·02), exposure to an individual who had surgery within a year before infection (P = 0·02), and antibiotic treatment for SSTI in the year before infection (P = 0·04). The identification of such factors may assist provision of appropriate treatment to patients with suspected S. aureus SSTIs particularly in Taiwan.
Using an interdisciplinary model of financial planning, we investigated the factors contributing to perceived adequacy of retirement savings among Hong Kong workers by replicating a previous study of American and Dutch workers. The model was also tested for age differences in the way in which the variables operated within the model. These questions were examined using data from a phone survey conducted with 999 Hong Kong workers in 2012. We examined three psychological factors (future time orientation, goal clarity and financial knowledge), three social support variables (early learning from parents, spousal support and friend support) and three institutional factors (quality of employer pensions, trust in banks and fund managers, and trust in the government), as well as retirement savings planning activity and perceived retirement savings adequacy. Path analyses were used to test the model for the whole sample and separately for younger (N=437) and older (N=562) workers. Although a few age differences were found in the path analyses, the model was found to be useful in explaining the factors contributing to retirement savings planning and practices. Finally, we discuss how our findings differ from those of prior studies, and we assess their theoretical and practical implications.
Despite evidence of inhibitory control and visual processing impairment in attention deficit hyperactivity disorder (ADHD), knowledge about its corresponding alterations in the brain is still evolving. The current study used counting Stroop functional MRI and the Cambridge Neuropsychological Test Automated Battery (CANTAB) to investigate if brain activation of inhibitory control and visual processing would differ in youths with ADHD relative to neurotypical youths.
We assessed 25 youths with ADHD [mean age 10.9 (s.d. = 2.2) years] and 23 age-, gender- and IQ-matched neurotypical youths [mean age 11.2 (s.d. = 2.9) years]. The participants were assessed by using the Wechsler Intelligence Scale for Children, third edition, and two tests from the CANTAB: rapid visual information processing (RVP) and pattern recognition memory (PRM) outside the scanner.
Youths with ADHD showed more activation than neurotypical youths in the right inferior frontal gyrus [Brodmann area (BA) 45] and anterior cingulate cortex, which were correlated with poorer performance on the RVP test in the CANTAB. In contrast, youths with ADHD showed less activation than neurotypical youths in the left superior parietal lobule (BA 5/7), which was correlated with the percentage of correct responses on the PRM test in the CANTAB.
Our findings suggest that youths with ADHD might need more inhibitory control to suppress interference between number and meaning and may involve less visual processing to process the numbers in the counting Stroop task than neurotypical youths.
This nationwide population-based cohort study investigated the risk of tuberculosis (TB) in patients with end-stage renal disease (ESRD) and receiving dialysis. The evaluations included 4131 incident ESRD patients receiving dialysis and 16 524 age- and gender-matched controls, recruited between 1998 and 2009. We used Cox proportional hazards regression analysis to measure the association between TB and ESRD. Compared to the controls, the ESRD cohort had a significantly higher risk of TB within 1 year [incident rate ratio (IRR) 4·13], and 1–2 years (IRR 2·12), of occurrence of ESRD. The Cox proportional hazards model revealed that ESRD [hazard ratio (HR) 2·40], age >65 years (HR 2·41), male sex (HR 1·94), diabetes mellitus (HR 1·36), silicosis (HR 7·70) and chronic obstructive pulmonary disease (HR 1·61) are independent risk factors for TB. Patients with ESRD are associated with an increased risk of TB, and should thus be monitored more carefully for TB, especially within 2 years of onset of ESRD.
The preparation of site-specific atom-probe tomography (APT) samples containing localized features has become possible with the use of focused ion beams (FIBs). This technique was used to achieve the analysis of surface oxides and oxidized grain boundaries in this paper. Transmission electron microscopy (TEM), providing microstructural and chemical characterization of the same features, has also been used, revealing crucial additional information.
The study of grain boundary oxidation in stainless steels and nickel-based alloys is required in order to understand the mechanisms controlling stress corrosion cracking in nuclear reactors. Samples oxidized under simulated pressurized water reactor primary water conditions were used, and FIB lift-out TEM and APT specimens containing the same oxidized grain boundary were prepared and fully characterized. The results from both techniques were found fully consistent and complementary.
Chromium-rich spinel oxides grew at the surface and into the bulk material, along grain boundaries. Nickel was rejected from the oxides and accumulated ahead of the oxidation front. Lithium, which was present in small quantities in the aqueous environment during oxidation, was incorporated in the oxide. All phases were accurately quantified and the effect of different experimental parameters were analysed.
MOS capacitor composed of nc-CdSe embedded ZrHfO high-k gate dielectric stack was fabricated and characterized for nonvolatile memory functions. Detailed material and electrical properties have been investigated. With a large charge trapping capability, this kind of device can trap electrons or holes depending on the polarity and magnitude of the applied gate voltage. For the same stress time, the device trapped more holes than electrons under the same magnitude of gate voltage but different polarity. The negative differential resistance peak was observed at the room temperature due to the Coulomb blockade effect. The charge trapping mechanism was delineated with the constant voltage stress test. After 10 years of storage, about 56% of trapped charges still remain in the device.
This study investigates the influences of constant compensations which are produced by capillary or constant flow pump on the dynamic characteristics of a circular worktable supported by a closed-type hydrostatic thrust bearing. The dynamic behaviors of this worktable are analyzed by using Runge-Kutta method to solve the coupled motion equation of worktable and pressure equations of hydrostatic film flow. For various supply pressure parameters, external loads, and varieties of design parameters, the dynamic responses of worktable subjected to both external excitations of harmonic force and step force are simulated, respectively. The results reveal the influences of both constant compensations on the dynamic characteristics of hydrostatic bearing by the different responses of worktable and make the appropriate parameters of design can be found for the worktable-bearing system. The accomplishments of this study will help the designers who deal with the hydrostatic- bearing compensated by constant restrictions to select the design parameters to approach the optimum condition.