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Neuroinflammation and brain structural abnormalities are found in bipolar disorder (BD). Elevated levels of cytokines and chemokines have been detected in the serum and cerebrospinal fluid of patients with BD. This study investigated the association between peripheral inflammatory markers and brain subregion volumes in BD patients.
Euthymic patients with bipolar I disorder (BD-I) aged 20–45 years underwent whole-brain magnetic resonance imaging. Plasma levels of monocyte chemoattractant protein-1 (MCP-1), chitinase-3-like protein 1 (also known as YKL-40), fractalkine (FKN), soluble tumour necrosis factor receptor-1 (sTNF-R1), interleukin-1β, and transforming growth factor-β1 were measured on the day of neuroimaging. Clinical data were obtained from medical records and interviewing patients and reliable others.
We recruited 31 patients with a mean age of 29.5 years. In multivariate regression analysis, plasma level YKL-40, a chemokine, was the most common inflammatory marker among these measurements displaying significantly negative association with the volume of various brain subareas across the frontal, temporal, and parietal lobes. Higher YKL-40 and sTNF-R1 levels were both significantly associated with lower volumes of the left anterior cingulum, left frontal lobe, right superior temporal gyrus, and supramarginal gyrus. A greater number of total lifetime mood episodes were also associated with smaller volumes of the right caudate nucleus and bilateral frontal lobes.
The volume of brain regions known to be relevant to BD-I may be diminished in relation to higher plasma level of YKL-40, sTNF-R1, and more lifetime mood episodes. Macrophage and macrophage-like cells may be involved in brain volume reduction among BD-I patients.
Atherosclerosis can result in serious cardiovascular disease (CVD) and is associated with inflammation and psychopharmacological treatment in bipolar disorder. We attempt to investigate the effects of lithium and inflammation on the atherosclerotic development in older bipolar adults at high risk for cardiovascular disease.
The euthymic out-patients with bipolar I disorder aged over 45 years and concurrent endocrine or cardiovascular disease were recruited to measure their bilateral carotid intima media thickness (CIMT) and circulating levels of lithium, valproate, sTNF-R1, sIL-6R, and lipid profile. All clinical information were obtained by directly interviewing patients and reviewing all medical records.
Forty eight patients with mean 48.3 years old and mean 27.2 years of age at illness onset were recruited. After controlling for the body mass index, multivariate regression analyses showed that older age, lower lithium level, and higher plasma sTNF-R1 level were associated with higher CIMT and collectively accounting for 33.1% of the variance in CIMT. Blood level of low density lipid or valproate has none relationship with CIMT.
Lithium treatment may protect older bipolar patient, even those at high risk for CVD, from atherosclerotic development. Furthermore, persistent inflammatory activation, particularly macrophage activation, may be associated with the accelerating development of atherosclerosis.
Background: Among patients with schizophrenia, there is evidence of a negative association between self-stigma and subjective quality of life (SQoL), and self-esteem was an important mediator in the association. We attempted to use a longitudinal study to investigate the aforementioned mediation on a sample with schizophrenia. Methods: We used longitudinal data retrieved from medical records of a psychiatric centre between June 2014 and December 2015. In the data, we retrieved information of self-stigma using the Self-Stigma Scale — Short; SQoL, using the WHO questionnaire on the Quality of Life — Short Form; and self-esteem, using the Rosenberg Self-Esteem Scale. All the measures were evaluated five times. Linear mixed-effect models accompanied by Sobel tests were used to tackle the mediating effects. Results: Data from 74 patients (57 males) with schizophrenia were eligible for analysis; their mean (SD) age was 39.53 (10.67); mean age of onset was 22.95 (8.38). Self-esteem was a mediator for patients in physical (p = .039), psychological (p = .003), and social SQoL (p = .004), but not in environment SQoL (p = .051). Conclusion: Based on our findings, mental health professionals could tailor different programs to patients with schizophrenia, such as self-stigma reduction and self-esteem improvement programs. However, treatment as a whole should be sensitive to both self-stigma and self-esteem. Also, we should consider individuals’ health and wellbeing from social perspectives of disability rather than the medical model of disability emphasising symptoms and medications.
The WHOQOL-BREF, a generic quality of life (QoL) instrument, has been widely used clinically and for research on older populations. However, its measurement equivalence/invariance (ME/I) has not been well examined for the elderly (≥ 65 years) across some different demographics.
The data were derived from a cross-sectional study with a convenience sampling design in Taiwan. We enrolled 244 elderly participants: men = 143 (58.6%); educational level ≤ primary school = 121 (49.6%). The ME/I was examined using multiple group confirmatory factor analysis (MGCFA) across gender and educational level.
The fit indices were satisfactory for the configural models of gender and educational level (standardized root mean square residual [SRMR] = 0.0742 and 0.0770; root mean square error of approximation [RMSEA] = 0.0655 and 0.0686; comparative fit index [CFI] = 0.953). In addition, MGCFAs showed that ME/I was supported across gender (ΔSRMR = 0.001 to 0.019; ΔRMSEA = −0.003 to 0.001; ΔCFI = −0.003 to 0.000) and educational level (ΔSRMR = 0.002 to 0.006; ΔRMSEA = −0.002 to 0.004; ΔCFI = −0.007 to 0.000).
The WHOQOL-BREF Taiwan version is appropriate for combined use and for comparisons in older people across gender and different educational levels.
The intercalated cell masses (ITCs) of the amygdala are clusters of GABAergic interneurons that surround the basolateral complex of the amygdala. ITCs have been increasingly implicated in the acquisition and extinction of conditioned fear responses, but the underlying cellular mechanisms remain unexplored. Here, we report that repetitive stimulation of lateral amygdala (LA) afferents with a modified theta burst stimulation (TBS) protocol and induces long-term potentiation (LTP) of excitatory synapses onto medial paracapsular ITC (Imp) neurons. This TBS-induced LTP is; (1) induced and expressed post-synaptically, (2) involves a rise in post-synaptic Ca2+ and the activation of NR2B-containing N-methyl-D-aspartate receptors (NMDARs), (3) dependent on calcium/calmodulin-dependent protein kinase II and cAMP-dependent protein kinase activation, and (4) associated with increased exocytotic delivery of α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors (AMPARs) to the post-synaptic membrane. Remarkably, auditory fear conditioning led to a persistent increase in AMPAR/NMDAR ratio of glutamatergic synaptic currents and occluded TBS-induced LTP at LA-Imp synapses. Furthermore, extinction training rescued the effect of fear conditioning on AMPAR/NMDAR ratio and LTP induction. These results show that a prominent form of LTP can be elicited at LA-Imp synapses and suggest that this synaptic plasticity may contribute to the expression of fear conditioning.
This paper reports a novel means of integrating a high-performance dual-modal ZnO piezoelectric transducer with a flexible stainless steel substrate (SUS304) to construct dual-modal vibration-power transducers. To fabricate vibration-power transducers, the off-axis RF magnetron sputtering method for the growth of ZnO piezoelectric thin films is adopted. The stainless steel substrate has a higher Young’s modulus than those of the other substrates, and behaves the long-term stability under vibration. The transducer includes a ZnO piezoelectric thin film deposited on the stainless steel substrate combined with Pt/Ti layers at room temperature, which is fabricated by an RF magnetron two-step sputtering system. In this report, the ZnO piezoelectric thin films deposited with the tilting angle of 34° are set by controlling the deposition parameters. Scanning electron microscopy and X-ray diffraction of ZnO piezoelectric thin films reveal a rigid surface structure and a high dual-modal orientation. To investigate the generating characteristics of the dual-modal transducer, two basic experiments of longitudinal and shear modes are carried out. Based on cantilever vibration theory, the cantilever length of 1 cm and a vibration area of 1 cm2 are used to fabricate a transducer with a low resonant-frequency of 65 Hz for the natural vibration. A mass loading at the front-end of the cantilever is critical to increase the amplitude of vibration and the power generated by the piezoelectric transducer. The maximum open circuit voltage of the power transducer is 19.4 V.
A novel allergy biosensor is designed and fabricated by using thin film bulk acoustic resonator (TFBAR) devices with shear mode ZnO piezoelectric thin films. To fabricate TFBAR devices, the off-axis RF magnetron sputtering method for the growth of piezoelectric ZnO piezoelectric thin films is adopted. The influences of the relative distance and sputtering parameters are investigated. In this report, the piezoelectric ZnO thin films with tilting angle are set by controlling the deposition parameters. The properties of the shear mode ZnO thin films are investigated by X-ray diffraction and scanning electron microscopy. The frequency response is measured using an HP8720 network analyzer with a CASCADE probe station. The resonance frequency of the shear mode is 796.75 MHz. The sensitivity of the shear mode is calculated to be 462.5 kHz·cm2/ng.
Owing to energy conservation of waste heat, Lead telluride, PbTe, based materials have promising good thermoelectric properties around a range of middle temperature (Fig. 1, from 300 to 600°C), due to their high melting point, fine chemical stability, and the high figure of merit Z. The general physical properties and factors affecting the figure of merit have been reviewed. This research is focused on the n-type of PbTe materials and collocated with analysis of densities, hardness, elastic modulus, and thermoelectric properties thermoelectric figure of merit ZT=GS2T/κ (where G is electrical conductivity, S is Seebeck coefficient , T is absolute temperature, and κ is thermal conductivity). Room temperature hardness and Young’s modulus are measured by nano-indentation. In this study, the hot-press compacts under the pressure of 4 ton/cm2 can reach the maximum density about 8.2 g/cm3, and hardness and elastic modulus are 0.6 GPa and 70 GPa, respectively. The figure of merit value (ZT) of PbTe in low temperature (around 340°C) was found about 1 with carrier concentration above 1019 cm−3. These results also indicate that the powder metallurgy parameters provide potentialities for further increase of the high efficiency of energy conversion in PbTe materials.
Three types of Ganium Nitride (GaN) transistors were studied in this work. The devices were fabricated and exhibited unique characteristics over on-state current and off-state blocking performances. We also compared the performance differences of devices fabricated by multiepitaxial GaN/AlGaN layers on different substrates (Sapphire and Si) and evaluated the correlations among starting substrate, device variation, and manufacturing uniformity. The first device is a normally-on device with Sapphire substrate which shows good drain saturation current (Idsat) and breakdown characteristics, but the gate leakage current is quite large. The second device is a normally-off GaN transistor named metal-insulate-semiconductor (MIS) heterojunction field-effect transistor (MIS-HFET) which exhibits good performance with threshold voltage (Vth) of 3V and breakdown voltage (Vbd) of over 1800V. However the third device is a normally-off GaN metal-oxide-semiconductor field-elect transistor (MOSFET) structure which is rather difficult to exhibit good blocking characteristic due to inadequate doping process control of the reduce-surface-field (RESURF) region.
A novel polymer dispersant, poly(oxyethylene)-segment imide (POEM) in the structure was incorporated in the nanocrystalline TiO2 film as the electrode. The uses of the dispersants could disperse TiO2 by decreasing the van der waals force among the nanoparticles, observed by TEM. The resultant TiO2/POEM film as the photoanode rendered the dye-sensitized solar cell (DSSC) with enhanced performance. By comparing to the traditional photoanode composing of polyethylene glycol (PEG) dispersed TiO2, the POEM dispersed TiO2 provided large surface area and high roughness in the dye adsorbed film. Furthermore, the fabricated TiO2/POEM photoanode has a better light-scattering property which contributes to the improvement for the short-circuit current density (Jsc) and the power-conversion efficiency (_) of the DSSC to be 19.1 mA cm-2 and 8.7%, respectively. The performance is superior to 13.2 mA cm-2 and 7.34% for a DSSC with the photoanode containing TiO2/PEG.
Little is known about outcomes after self-harm in East Asia.
To investigate mortality after self-harm in a Taiwanese population.
Between 2000 and 2003, 1083 individuals who self-harmed were identified through a population self-harm register in Nantou County, Taiwan, and followed until 2007 for date and cause of death on a national mortality database.
In total, 145 individuals died, 48 through suicide. The risks of all-cause and suicide mortality in the first year were 4.7% and 2.1% respectively, representing 8- and 131-fold age- and gender-standardised increases. Male gender and older age were independent risk factors for both suicide and non-suicide mortality. Use of more lethal methods in the index episode was associated with higher mortality but this was accounted for by gender.
Results in this sample support the recommendation that people with a history of recent self-harm should be a major target for suicide prevention programmes.
Repeated self-harm is relatively common and is linked with an elevated risk of eventual suicide. There has been no study of this involving a large sample from the Far East.
To estimate the risk over the medium term of non-fatal repetition of self-harm and identify predictive factors in those carrying out self-harm.
A total of 970 individuals who had self-harmed were recruited from a community-based suicide behaviour register system in Nantou, Taiwan from July 2000 to February 2003. Information regarding demography and suicide methods was collected. Individuals were followed-up until December 2005 to examine the risk of repeated self-harm and independent predictive factors.
Ninety cohort members had repeated self-harm during the follow-up period (accounting for 131 repeated self-harm episodes in all). The cumulative risks were 5.7% for the first year, 7.8% for the second year and 9.5% for the fourth year. The risk was highest within the first year after the self-harm event. Independent risk factors included female gender and self-cutting as well as self-poisoning with drugs. Effect of younger age was mediated through the choice of methods.
Individuals with self-harm have a high risk of repetition, especially within the first year. Suicide prevention strategies need to focus on intervening with this population to reduce their repetition.
Ternary Sn-In-Cu alloys are prepared and equilibrated at 250 °C for 2 to 20 weeks. The phases formed in these alloys are experimentally determined. The 250 °C Sn-In-Cu isothermal section is established according to the phase equilibrium information obtained in this study and that of the three constituent binary systems. It has eight single-phase regions, namely liquid, δ1-Cu41Sn11, ε-Cu3Sn, δ2-Cu7In3, η-(Cu6Sn5, Cu2In), Cu11In9, Cu2In3Sn, and α-(Cu) phases, 14 two-phase regions, and seven three-phase regions. In the Sn-In-Cu system at 250 °C, the η-Cu6Sn5 and η-Cu2In phases form a continuous solid solution and the ternary Cu2In3Sn compound is observed. The δ1-Cu41Sn11 phase is stabilized at 250 °C with the introduction of indium although it transforms into α-(Cu) and ε-Cu3Sn phases via a eutectoid reaction around 350 °C in the binary Sn-Cu system. Except for the Cu11In9 phase and the Cu2In3Sn ternary compound, the other binary compounds all have significant indium and tin mutual solubilities.
To evaluate the effect on decrease in blood pressure of modifying risk factors for stroke, such as blood lipid profiles, diet habits and indices of body weight, through a family-based nutrition health education programme among hypertensive patients and pre-hypertensive subjects without taking any antihypertensive drugs.
Design and setting
This was a community-based prospective study. The study population was randomly selected from communities in Taipei; potential subjects were invited by telephone to participate.
After excluding subjects whose blood pressure was normal and those using antihypertensive drugs, there were 390 participants included in the study. Subjects in the intervention group (n 293) received nutrition health education on blood pressure control and stroke-related risk factor modification at each visit. Non-intervention subjects (n 97) only acquired a general education sheet available in clinics. The blood pressure of study subjects was measured at baseline and 6-month follow-up to evaluate the intervention’s effect on decrease in blood pressure.
Significant decreases of 2·0 mmHg and 5·9 mmHg in systolic blood pressure were observed both in pre-hypertensive and hypertensive subjects in the intervention group. Additionally, intervention subjects with improvement of total cholesterol and LDL cholesterol, decrease in indices of body weight and increase in consumption of fruit and vegetables also had significant lowering of blood pressure.
The present study provided evidence that the blood pressure of pre-hypertensive and hypertensive subjects could decrease significantly, without taking antihypertensive drugs, after modifying blood lipid profiles and waist by dietary habits changed through a family-based nutrition heath education programme, resulting in a significant effect on stroke risk reduction.
We reviewed genotyping and medical records of 53 patients with end-stage renal disease and methicillin-resistant Staphylococcus aureus (MRSA) bacteremia in a medical center in Taiwan. In multivariate analysis, hospitalization within the previous year was independently negatively associated with infection with community-associated MRSA strains, and an increased number of years of dialysis predicted the recovery of patients infected with community-associated MRSA strains.
Intact seeds (seed+endocarp) from freshly harvested fruits of Prunus campanulata were dormant, and required 4–6 weeks of warm followed by 8 weeks of cold stratification for maximum germination percentage. Removing both endocarp and seed coat, however, promoted germination in a high percentage of non-stratified seeds. Treatment of intact, non-stratified seeds with gibberellic acid (GA3) was only partially effective in breaking dormancy. However, GA3 promoted germination of non-stratified seeds in which the endocarp (but not the seed coat) had been removed. The order of abscisic acid (ABA) concentration in fresh seeds was endocarp > seed coat > embryo, and its concentration in endocarp plus seed coat was about 6.2-fold higher than that in the embryo. Total ABA contents of seeds subjected to warm and/or cold moist stratification were reduced 6- to 12-fold. A higher concentration of GA4 was detected in embryos of non-dormant than in those of dormant seeds. Fluridone, a carotenoid biosynthesis inhibitor, was efficient in breaking dormancy of Prunus seeds. Paclobutrazol, a GA biosynthesis inhibitor, completely inhibited seed germination, and the inhibitory effect could be partially reversed by GA4, but not by GA3. Thus, dormancy in P. campanulata seeds is imposed by the covering layers. Dormancy break is accompanied by a decrease in ABA content of the covering layers and germination by an increase of embryonic GA4 content.
The impact of the outbreak of severe acute respiratory syndrome (SARS) was enormous, but few studies have focused on the infectious and general health status of healthcare workers (HCWs) who treated patients with SARS.
We prospectively evaluated the general health status of HCWs during the SARS epidemic.The Medical Outcome Study Short-Form 36 Survey was given to all HCWs immediately after caring for patients with SARS and 4 weeks after self-quarantine and off-duty shifts. Tests for detection of SARS Coronavirus antibody were performed for HCWs at these 2 time points and for control subjects during the SARS epidemic.
Tertiary care referral center in Taipei, Taiwan.
Ninety SARS-care task force members (SARS HCWs) and 82 control subjects.
All serum specimens tested negative for SARS antibody. Survey scores for SARS HCWs immediately after care were significantly lower than those for the control group (P < .05 by the t test) in 6 categories. Vitality, social functioning, and mental health immediately after care and vitality and mental health after self-quarantine and off-duty shifts were among the worst subscales. The social functioning, role emotional, and role physical subscales significantly improved after self-quarantine and off-duty shifts (P < .05, by paired t test). The length of contact time (mean number of contact-hours per day) with patients with SARS was associated with some subscales (role emotional, role physical, and mental health) to a mild extent. The total number of contact-hours with symptomatic patients with SARS was a borderline predictor (adjusted R2 = 0.069; P = .038) of mental health score.
The impact of the SARS outbreak on SARS HCWs was significant in many dimensions of general health. The vitality and mental health status of SARS HCWs 1 month after self-quarantine and off-duty shifts remained inferior to those of the control group.
Measurement of electromigration parameters in the lead-free solder SnAg3.5 was carried out by utilizing U-groove solder lines and atomic force microscopy in the temperature range of 100–150 °C. The drift velocity was measured, and the threshold current densities of the SnAg3.5 solder were estimated to be 4.4 × 104 A/cm2 at 100 °C, 3.3 × 104 A/cm2 at 125 °C, and 5.7 × 103 A/cm2 at 150 °C. These values represent the maximum current densities that the SnAg3.5 solder can carry without electromigration damage at the three stressing temperatures. The critical products for the SnAg3.5 solder were estimated to be 462 A/cm at 100 °C, 346 A/cm at 125 °C, and 60 A/cm at 150 °C. In addition, the electromigration activation energy was determined to be 0.55 eV in the temperature range of 100–150 °C. These values are very fundamental for current carrying capability and mean-time-to-failure measurement for solder bumps. This technique enables the direct measurement of electromigration parameters of solder materials.
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