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A proportion of patients with bipolar disorder (BD) manifests with only unipolar mania (UM). This study examined relevant clinical features and psychosocial characteristics in UM compared with depressive-manic (D-M) subgroups. Moreover, comorbidity patterns of physical conditions and psychiatric disorders were evaluated between the UM and D-M groups.
This clinical retrospective study (N = 1015) analyzed cases with an average of 10 years of illness duration and a nationwide population-based cohort (N = 8343) followed up for 10 years in the Taiwanese population. UM was defined as patients who did not experience depressive episodes and were not prescribed adequate antidepressant treatment during the disease course of BD. Logistic regression models adjusted for relevant covariates were used to evaluate the characteristics and lifetime comorbidities in the two groups.
The proportion of UM ranged from 12.91% to 14.87% in the two datasets. Compared with the D-M group, the UM group had more psychotic symptoms, fewer suicidal behaviors, a higher proportion of morningness chronotype, better sleep quality, higher extraversion, lower neuroticism, and less harm avoidance personality traits. Substantially different lifetime comorbidity patterns were observed between the two groups.
Patients with UM exhibited distinct clinical and psychosocial features compared with patients with the D-M subtype. In particular, a higher risk of comorbid cardiovascular diseases and anxiety disorders is apparent in patients with D-M. Further studies are warranted to investigate the underlying mechanisms for diverse presentations in subgroups of BDs.
To investigate whether an after-school nutrition education (ASNE) programme can improve the nutrition knowledge and healthy eating behaviour of adolescents from economically disadvantaged families.
One-group pretest and posttest design. Nutrition knowledge and dietary intake were collected using a questionnaire, and anthropometric measurements were measured before and after the intervention. Nine components of healthy eating behaviour were assessed with reference to the Dietary Guideline of Taiwan. Pretest and posttest differences were analysed using generalised estimating equations.
Three after-school programmes in central and southern Taiwan. The ASNE programme comprised three monthly 1-h sessions (20–30-min lecture and 30–40-min interaction).
A total of 153 adolescents aged 10–15 years from economically disadvantaged families (seventy-eight elementary students and seventy-five junior high school students).
Elementary and junior high school students’ nutrition knowledge scores (range 0–6) increased by 0·28 (+ 5·7 %, P = 0·02) and 0·30 points (+ 6·18 %, P = 0·02), respectively, but their fruit intake decreased by 0·36 serving/d (–22·9 %, P = 0·02) and 0·29 serving/d (–18·9 %, P = 0·03), respectively. Junior high school students’ mean snacking frequency and fried food intake dropped to 0·75 d/week (–21·3 %, P = 0·008) and 0·10 serving/d (–28·8 %, P = 0·01), respectively.
Short-term ASNE programmes can increase nutrition knowledge and reduce snacking frequency and fried food intake despite a decrease in fruit intake among adolescents from economically disadvantaged families.
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.
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.
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.
A novel radio frequency identification tag antenna is composed of a resonant open-slot exciter and a dipole-type ground radiator. For a conjugate match to the Alien Higgs-4 chip impedance of 8−j149 Ω at 925 MHz, a quarter wavelength open-slot resonator embedded at the center of the dipole-type ground plane (130 × 18 mm2) was investigated and fabricated. Simple size adjustments and various loaded inductor of the open-slot resonator allow for easy control of the tag antenna resistance and inductive reactance, from which the chip impedance requirement can be easily obtained. The read range of the prototype antenna attached on a foam in the free space can reach more than 9 m, which has been tested for a radio frequency identification reader with 4.0-W of effective isotropic radiated power. Measurement data are in good agreement with simulation results.
In the foreland area of western Taiwan, some of the pre-orogenic basement-involved normal faults were reactivated during the subsequent compressional tectonics. The main purpose of this paper is to investigate the role played by the pre-existing normal faults in the recent tectonics of western Taiwan. In NW Taiwan, reactivated normal faults with a strike-slip component have developed by linkage of reactivated single pre-existing normal faults in the foreland basin and acted as transverse structures for low-angle thrusts in the outer fold-and-thrust belt. In the later stage of their development, the transverse structures were thrusted and appear underneath the low-angle thrusts or became tear faults in the inner fold-and-thrust belt. In SW Taiwan, where the foreland basin is lacking normal fault reactivation, the pre-existing normal faults passively acted as ramp for the low-angle thrusts in the inner fold-and-thrust belt. Some of the active faults in western Taiwan may also be related to reactivated normal faults with right-lateral slip component. Some main earthquake shocks related to either strike-slip or thrust fault plane solution occurred on reactivated normal faults, implying a relationship between the pre-existing normal fault and the triggering of the recent major earthquakes. Along-strike contrast in structural style of normal fault reactivation gives rise to different characteristics of the deformation front for different parts of the foreland area in western Taiwan. Variations in the degree of normal fault reactivation also provide some insights into the way the crust embedding the pre-existing normal faults deformed in response to orogenic contraction.
Average differences in children's language abilities by socioeconomic status (SES) emerge early in development and predict academic achievement. Previous research has focused on coarse-grained outcome measures such as vocabulary size, but less is known about the extent to which SES differences exist in children's strategies for comprehension and learning. We measured children's (N = 98) comprehension of passive sentences to investigate whether SES differences are more pronounced in overall knowledge of the construction or in more specific abilities to process sentences during real-time interpretation. SES differences in comprehension emerged when syntactic revision of passives was necessary, and disappeared when the need to revise was removed. Further, syntactic revision but not knowledge of the passive best explained the association between SES and a standardized measure of syntactic development. These results demonstrate that SES differences in syntactic development may result from how children recruit syntactic information within sentences.
We describe the development, pilot-testing, refinement, and four evaluations of Diagnostic Question Generator (DQGen), which automatically generates multiple choice cloze (fill-in-the-blank) questions to test children's comprehension while reading a given text. Unlike previous methods, DQGen tests comprehension not only of an individual sentence but of the context preceding it. To test different aspects of comprehension, DQGen generates three types of distractors: ungrammatical distractors test syntax; nonsensical distractors test semantics; and locally plausible distractors test inter-sentential processing.
(1) A pilot study of DQGen 2012 evaluated its overall questions and individual distractors, guiding its refinement into DQGen 2014.
(2) Twenty-four elementary students generated 200 responses to multiple choice cloze questions that DQGen 2014 generated from forty-eight stories. In 130 of the responses, the child chose the correct answer. We define the distractiveness of a distractor as the frequency with which students choose it over the correct answer. The incorrect responses were consistent with expected distractiveness: twenty-seven were plausible, twenty-two were nonsensical, fourteen were ungrammatical, and seven were null.
(3) To compare DQGen 2014 against DQGen 2012, five human judges categorized candidate choices without knowing their intended type or whether they were the correct answer or a distractor generated by DQGen 2012 or DQGen 2014. The percentage of distractors categorized as their intended type was significantly higher for DQGen 2014.
(4) We evaluated DQGen 2014 against human performance based on 1,486 similarly blind categorizations by twenty-seven judges of sixteen correct answers, forty-eight distractors generated by DQGen 2014, and 504 distractors authored by twenty-one humans. Surprisingly, DQGen 2014 did significantly better than humans at generating ungrammatical distractors and marginally better than humans at generating nonsensical distractors, albeit slightly worse at generating plausible distractors. Moreover, vetting DQGen 2014's output and writing distractors only when necessary would halve the time to write them all, and produce higher quality distractors.
A higher intake of fruits and vegetables (F&V) compared with animal-derived foods is associated with lower risks of all-cause-, cancer- and CVD-related mortalities. However, the association between consumption patterns and medical costs remains unclear. The effects of various food group costs on medical service utilisation and costs were investigated. The study cohort was recruited through the Elderly Nutrition and Health Survey in Taiwan between 1999 and 2000 and followed-up for 8 years until 2006. It comprised free-living elderly participants who provided a 24-h dietary recall. Daily energy-adjusted food group costs were estimated. Annual medical service utilisation and costs for 1445 participants aged 65–79 years were calculated from the National Health Insurance claim data. Generalised linear models were used to appraise the associations between the food group costs and medical service utilisation and costs. Older adults with the highest F&V cost tertile had significantly fewer hospital days (30 %) and total medical costs (19 %), whereas those in the highest animal-derived group had a higher number of hospital days (28 %) and costs (83 %) as well as total medical costs (38 %). Participants in the high F&V and low animal-derived cost groups had the shortest annual hospitalisation stays (5·78 d) and lowest costs (NT$38 600) as well as the lowest total medical costs (NT$75 800), a mean annual saving of NT$45 200/person. Older adults who spend more on F&V and less on animal-derived foods have a reduced medical-care system burden. This provides opportunities for nutritionally related healthcare system investment strategies.
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.
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.
Recent work in adult psycholinguistics has demonstrated that activation of semantic representations begins long before phonological processing is complete. This incremental propagation of information across multiple levels of analysis is a hallmark of adult language processing but how does this ability develop? In two experiments, we elicit measures of incremental activation of semantic representations during word recognition in children. Five-year-olds were instructed to select a target (logs) while their eye-movements were measured to a competitor (key) that was semantically related to an absent phonological associate (lock). We found that, like adults, children made increased looks to competitors relative to unrelated control items. However, unlike adults, children continued to look at the competitor even after the target word was uniquely identified and were more likely to incorrectly select this item. Altogether, these results suggest that early lexical processing involves cascading activation but less efficient resolution of competing entries.
In this study, we attempted to evaluate the effect of administration of a high quantity of red yeast rice on coenzyme Q10 (CoQ10) synthesis in the tissues of ICR mice. Eighty-eight adult male ICR mice were housed and divided into control and experimental groups for red yeast rice treatment. Animals were gavaged with a low (1 g/kg body weight) or a high dose (5 g/kg body weight, approximately five times the typical recommended human dose) of red yeast rice dissolved in soyabean oil. After gavagement, animals of the control group were immediately killed; mice of the experimental groups (eight for each subgroup) were killed at different time intervals of 0·5, 1, 1·5, 4 and 24 h. The liver, heart and kidney were taken for analysis of monacolin K (liver only) and CoQ10 analysis. Liver and heart CoQ10 levels declined dramatically in both groups administered red yeast rice, especially in the high-dose group, within 30 min. After 24 h, the levels of hepatic and cardiac CoQ10 were still reduced. A similar trend was also observed in the heart, but the inhibitory effect began after 90 min. The higher dose of red yeast rice presented a greater suppressive effect than did the lower dose on tissue CoQ10 levels. In conclusion, acute red yeast rice gavage suppressed hepatic and cardiac CoQ10 levels in rodents; furthermore, the inhibitory effect was responsive to the doses administered.
Formation mechanisms of perovskite Pb(Ni1/3Nb2/3)O3 (PNN) in the reaction-sintering process were investigated. Only the reflections of raw materials were detected at 400°C. For pellets heated to 500°C, pyrochlore phase Pb2Nb2O7 (P2N2) are found. Cubic Pb3Nb4O13 (P3N4) pyrochlore phase formed and became the main phase in pellets heated to 600°C. After being heated to 800°C, Pb3Nb2O8 (P3N2) pyrochlore phase formed in the pellets. As the pellets were heated to 900°C, the peak of NiNb2O6 columbite phase appeared. In pellets heated to 950°C, the weak peaks of PNN perovskite phase appeared. This means the perovskite phase formed at a temperature between 900°C and 950°C. As the pellets were heated to 1000°C, a large amount of PNN was formed and became dominant. The PbO, NiNb2O6 and Pb3Nb2O8 phases disappeared. The P3N4 content increased with temperature in pellets heated to 1050–1200°C. For pellets heated to 1250°C, the P3N4 content decreased significantly.
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