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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.
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.
The objective of this study was to build a database to collect infectious disease information at the scene of a disaster through the use of 128 epidemiological questionnaires and 47 types of options, with rapid acquisition of information regarding infectious disease and rapid questionnaire customization at the scene of disaster relief by use of a personal digital assistant (PDA).
SQL Server 2005 (Microsoft Corp, Redmond, WA) was used to create the option database for the infectious disease investigation, to develop a client application for the PDA, and to deploy the application on the server side. The users accessed the server for data collection and questionnaire customization with the PDA.
A database with a set of comprehensive options was created and an application system was developed for the Android operating system (Google Inc, Mountain View, CA). On this basis, an infectious disease information collection system was built for use at the scene of disaster relief. The creation of an infectious disease information collection system and rapid questionnaire customization through the use of a PDA was achieved.
This system integrated computer technology and mobile communication technology to develop an infectious disease information collection system and to allow for rapid questionnaire customization at the scene of disaster relief. (Disaster Med Public Health Preparedness. 2017;11:668–673)
A 36-year-old woman, who had a history of myomectomy, presented with lightheadedness after changing position from sitting to standing and effort-related shortness of breath. Echocardiography demonstrated a hyperechoic elongated mobile mass extending from the inferior caval vein to the right atrium. The mass was surgically removed, and histological examination established the diagnosis of intravenous leiomyomatosis. This case caught the attention of our cardiology group to consider the diagnosis when an inferior caval vein or right atrium mass is found in a patient with a history of uterine leiomyomatosis.
Previous evidence has shown positive associations between post-traumatic
stress disorder (PTSD) and hypertension, dyslipidaemia and diabetes
mellitus, which are all risk factors for stroke, but the role of PTSD in
the subsequent development of stroke is still unknown.
To investigate the temporal association between PTSD and the development
Identified from the Taiwan National Health Insurance Research Database,
5217 individuals aged 18 years, with PTSD but with no history of stroke,
and 20 868 age- and gender-matched controls were enrolled between 2002
and 2009, and followed up until the end of 2011 to identify the
development of stroke.
Individuals with PTSD had an increased risk of developing any stroke
(hazard ratio (HR) 3.37, 95% CI 2.44–4.67) and ischaemic stroke (HR =
3.47, 95% CI 2.23–5.39) after adjusting for demographic data and medical
comorbidities. Sensitivity tests showed consistent findings (any stroke
HR = 3.02, 95% CI 2.13–4.28; ischaemic stroke HR = 2.89, 95% CI
1.79–4.66) after excluding the first year of observation.
Individuals with PTSD have an increased risk of developing any stroke and
ischaemic stroke. Further studies are required to investigate the
A model for predicting the austenite grain growth during a common heating process including continuous and isothermal heating processes in medium carbon alloy steel 42CrMo was developed. The isothermal austenite grain growth kinetics were studied with conditions involving soaking time and soaking temperature. The time exponent n in the model was obtained considering the influence of the initial grain size rather than simply utilizing Beck’s equation. The results showed that the value of the time exponent n is 3.55 ± 0.30 when the temperature is above 1000 °C, while the value is 8.33 when the temperature is below 1000 °C. When the temperature is below 1000 °C, the pinning effect of carbides contributes to the higher value of the time exponent. Based on the isothermal model and the rule of additivity, a model for predicting the grain growth occurring during continuous heating was proposed. A reasonable agreement between the calculations and experimental measurements of grain size was obtained. According to the model, the effect of the initial austenite grain size on the final austenite grain size during induction quenching was analyzed. The initial austenite grain size has a significant effect on the final austenite grain size. In order to obtain a refined quenched microstructure, it is necessary to refine the microstructure at room temperature.
We associate the topological entropy of monotone recurrence relations with the Aubry–Mather theory. If there exists an interval
such that, for each
, all Birkhoff minimizers with rotation number
do not form a foliation, then the diffeomorphism on the high-dimensional cylinder defined via the monotone recurrence relation has positive topological entropy.
Neurosyphilis (NS) may present with neuropsychiatric disorders characterized by cognitive impairment, personality disorders, and confusion, among others. Very few studies have focused on neuropsychiatric disorders secondary to NS in elderly people.
A retrospective chart review was performed to characterize the psychiatric findings, clinical signs and symptoms, laboratory findings, and brain magnetic resonance imaging results of ten elderly inpatients with NS.
In these ten patients, the most common presenting symptoms included a wide variety of psychiatric manifestations. The serum rapid plasma regain (RPR) and Treponema pallidum particle agglutination assay (TPPA) of the ten patients were positive, with positive CSF TPPA and RPR rates of 100% and 60%, respectively. In addition, 90% of the patients demonstrated abnormal imaging, including cerebral atrophy, infarct ischemic stroke, and hydrocephalus.
Our findings support the importance of serological tests for syphilis as a routine component of the evaluation of patients with clinically evident neurological or psychiatric symptoms. If the serology is positive, all of the patients should be examined with a lumbar puncture. Moreover, psychiatric illnesses secondary to NS in the elderly also deserve medical attention.
Chemical bath deposition (CBD) techniques for the growth of CdS polycrystalline thin films are now well developed. However, there usually appear different structures, grain sizes and energy gaps in CdS polycrystalline films by CBD, which implies that the influence of growth process on the structures and properties of CBD CdS thin films must be considered. In this paper, the optical, compositional and structural properties of CBD CdS thin films in the reaction process have been studied by XRD, AFM, XPS and optical transmission spectra measurements. The results can be explained using atomic mechanism and lattice transition in the CdS thin films.
In this paper, we proposed a phase-change random access memory (PCRAM) cell with a self-insulated structure (SIS), which is expected to have better thermal efficiency than the conventional structures. 3-D finite element simulation is used to study the most power consuming RESET process for both SIS and conventional normal bottom contact (NBC) cells driven by a MOSFET. Instead of programming current, power consumption is investigated to give a more fundamental comparison between the two structures. Thermal proximity effect for both kinds of cells is directly analyzed by simulating a 3×3 device array. The potential slow-quenching issue of SIS is also discussed.
The genetic diversity of dinitrogen-fixing bacteria associated with rice (Oryza sativa) was assessed by a polymerase chain reaction–restriction fragment length polymorphism (PCR–RFLP) approach on the nifH gene amplified directly from DNA extracted from washed rice roots and rhizospheric soil. Restriction digestion with the enzymes MnlI and HaeIII was performed to characterize 54 cloned nifH PCR products. RFLP profiles were clustered and analysed with the UPGMA program. Eight pairs of similar RFLP patterns (similarity>50%) and two pairs of homologous RFLP patterns (100% identity) were found from the washed roots and the rhizospheric soil, respectively. Three specific diazotrophic patterns were found from rhizospheric soil and rice roots. The analyses have revealed the presence of different nifH types, which appear to be significant components of the diazotrophic community in paddy fields, indicating that some of the diazotrophs may colonize the inside and the surface of the rice roots.
The effects of different concentrations of tumour necrosis factor-α (TNF-α) on rat adipocyte apoptosis were detected by optical microscopy, agarose gel electrophoresis and flow cytometry methods. The morphological changes of rat adipocyte apoptosis induced by TNF-α correlated linearly with the concentration of TNF-α, ranging from 5 to 20 ng/ml. High concentrations of TNF-α induced more obvious apoptosis. Significant morphological changes of rat adipocytes treated with 5 ng/ml TNF-α were noticed, but DNA ladders did not appear in the DNA electrophoresis analysis, i.e. morphological changes occurred earlier than the biochemical changes. TNF-α induced apoptosis in the rat adipocyte in a dose-dependent manner. The induced apoptotic effect of 5, 10, 15 and 20 ng/ml TNF-α was significantly different (P0.01), but the effect among 10, 15 and 20 ng/ml TNF-α treatments was not significantly different (P0.05). Thus the optimum concentration of TNF-α for inducing apoptosis was 10 ng/ml.
The distribution of genetic diversity between Oryza sativa L. ssp. indica and O. sativa L. ssp. japonica covering different ecological zones in Yunnan was studied, and specific markers of indica/japonica subspecies, paddy/upland rice and different ecological zones were screened, using 36 microsatellite primers and 113 accessions in the Yunnan landrace rice core collection. The genetic diversity of japonica was higher than that of indica, and the ecological zone with the highest and smallest genetic diversity lay in south-east and north-east Yunnan, respectively. This distribution was consistent at morphological and isozyme levels with studies on the entire Yunnan rice resources and core collection. In addition, the results showed that, among 416 markers, there were six indica/japonica-specific markers, 15 specific markers for paddy/upland rice and three specific markers in different ecological zones. The main conclusions are that the landrace rice core collection in Yunnan genetically represents the entire landrace rice resources in Yunnan, the centre of genetic diversity at DNA level lies in south-east Yunnan, and the DNA differentiation between indica and japonica is small. Furthermore, microsatellite markers were useful for studying the genetic diversity, classification and ecotype of germplasm resources and their core collection.
Ca-α-sialon compacts pressureless-sintered to intermediate temperatures, which consisted of both α-sialon and unreacted α–Si3N4 grains, were investigated with transmission electron microscopy for an overall composition Ca1.8Si6.6Al5.4O1.8N14.2. Special attention was paid to identification of the possible crystallographic orientation between a-sialon and the α–Si3N4 particles. In contrast to the frequently occurring heteroepitaxial nucleation of α-sialon in rare-earth-doped samples with low x values, this study showed that most of the newly formed α-sialon grains had no epitaxial orientation relationship with the α–Si3N4 particles, suggesting nonepitaxial heterogeneous nucleation to be a more probable mechanism for the Ca–α-sialon phase with high Ca concentrations.
(Y + Sm)–α-sialon compositions with and without α-sialon seeds were hot-pressed at 1800 °C for 1 h and then heat treated at 1800 °C for 4 h. The effect of α-sialon seeds on the microstructures of (Y + Sm)–α-sialon ceramics was studied by scanning electron microscopy. The results showed that hot-pressed α-sialon ceramics with elongated grains can be fabricated by adding 10 wt% seeds. Through heat treatment, the seed-free composition could also develop into a similar microstructure with big elongated grains dispersed in a fine matrix.
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