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Somatic symptom disorders (SSD) and functional somatic syndromes (FSS) are often regarded as similar diagnostic constructs; however, whether they exhibit similar clinical outcomes, medical costs, and medication usage patterns has not been examined in nationwide data. Therefore, this study focused on analyzing SSD and four types of FSS (fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, functional dyspepsia).
Methods
This population-based matched cohort study utilized Taiwan's National Health Insurance (NHI) claims database to investigate the impact of SSD/FSS. The study included 2 615 477 newly diagnosed patients with SSD/FSS and matched comparisons from the NHI beneficiary registry. Healthcare utilization, mortality, medical expenditure, and medication usage were assessed as outcome measures. Statistical analysis involved Cox regression models for hazard ratios, generalized linear models for comparing differences, and adjustment for covariates.
Results
All SSD/FSS showed significantly higher adjusted hazard ratios for psychiatric hospitalization and all-cause hospitalization compared to the control group. All SSD/FSS exhibited significantly higher adjusted hazard ratios for suicide, and SSD was particularly high. All-cause mortality was significantly higher in all SSD/FSS. Medical costs were significantly higher for all SSD/FSS compared to controls. The usage duration of all psychiatric medications and analgesics was significantly higher in SSD/FSS compared to the control group.
Conclusion
All SSD/FSS shared similar clinical outcomes and medical costs. The high hazard ratio for suicide in SSD deserves clinical attention.
We explored long-term employment status and income before and after depression diagnosis among men and women and at different working ages in Taiwan.
Methods
Data from 2006 to 2019 were obtained from the National Health Insurance Research Database (NHIRD). Individuals with newly diagnosed depressive disorder aged 15 to 64 years during the study period were identified. An equal number of individuals without depression were matched for their demographic and clinical characteristics. Employment outcomes included employment status, which was categorized into employed or unemployed, and annual income. Based on the occupation categories and monthly insurance salary recorded in the Registry for Beneficiaries of the NHIRD, a subject was defined as unemployed if he or she differed from the income earner or the occupation category was unemployed. Monthly income was defined as zero for unemployed subjects and proxied as monthly insurance salary for others. Annual income was the sum of monthly income in each observation year.
Results
A total of 420,935 individuals with depressive disorder were included in the study, and an equal number of individuals with not diagnosed depression served as controls. Employment rate and income were lower in the depression group than in the control group before the year of diagnosis, with a difference of 5.7% in employment rate and USD 1,173 in annual income. This gap increased considerably after the year of diagnosis (7.3% in employment rate and USD 1,573 in annual incomes) and further widened in the subsequent years (8.1% in employment rate and USD 2,006 in annual incomes in the 5th following year). The drops in the employment rate and income caused by depression were more evident in men and older age groups than in women and younger age groups, respectively. However, the reduction in employment rate and income in the following years after the diagnosis was more considerable among younger age groups.
Conclusions
The effect of depression on employment status and income was significant during the year of diagnosis and continued afterwards. The effect on employment outcomes varied between genders and across all age groups.
Cognitive impairment is common in late-life depression, which may increase Alzheimer disease (AD) risk. Therefore, we aimed to investigate whether late-life major depressive disorder (MDD) has worse cognition and increases the characteristic AD neuropathology. Furthermore, we carried out a comparison between treatment-resistant depression (TRD) and non-TRD. We hypothesized that patients with late-life depression and TRD may have increased β-amyloid (Aβ) deposits in brain regions responsible for global cognition.
Methods
We recruited 81 subjects, including 54 MDD patients (27 TRD and 27 non-TRD) and 27 matched healthy controls (HCs). Neurocognitive tasks were examined, including Mini-Mental State Examination and Montreal Cognitive Assessment to detect global cognitive functions. PET with Pittsburgh compound-B and fluorodeoxyglucose were used to capture brain Aβ pathology and glucose use, respectively, in some patients.
Results
MDD patients performed worse in Montreal Cognitive Assessment (p = 0.003) and had more Aβ deposits than HCs across the brain (family-wise error-corrected p < 0.001), with the most significant finding in the left middle frontal gyrus. Significant negative correlations between global cognition and prefrontal Aβ deposits existed in MDD patients, whereas positive correlations were noted in HCs. TRD patients had significantly more deposits in the left-sided brain regions (corrected p < 0.001). The findings were not explained by APOE genotypes. No between-group fluorodeoxyglucose difference was detected.
Conclusions
Late-life depression, particularly TRD, had increased brain Aβ deposits and showed vulnerability to Aβ deposits. A detrimental role of Aβ deposits in global cognition in patients with late-onset or non-late-onset MDD supported the theory that late-life MDD could be a risk factor for AD.
The retention of patients under methadone maintenance treatment (MMT) is an indication for the effectiveness of the therapy. We aimed to explore the relation between mortality and the cumulative MMT duration.
Methods
A retrospective cohort analysis was performed using Taiwan Illicit Drug Issue Database (TIDID) and National Health Insurance Research Database (NHIRD) during 2012–2016. We included 9149 and 11 112 MMT patients as the short and long groups according to the length of their cumulative MMT duration, 1–364 and ⩾365 days, respectively. The risk of mortality was calculated by Cox proportional hazards regression model with time-dependent exposure to MMT, and the survival probability was plotted with the Kaplan-Meier curve.
Results
The mortality rates were 2.51 and 1.51 per 100 person-years in the short and long cumulative MMT duration groups, respectively. After adjusting for on or off MMT, age, sex, marital status, education level, maximum methadone dose, and comorbidities (human immunodeficiency virus, depression, hepatitis C virus, hepatitis B virus, alcoholic liver disease, and cardiovascular disease), the long group had a lower risk of death (hazard ratio = 0.67; 95% confidence interval 0.60–0.75) than the short group. Increased risk was observed in patients with advanced age, being male, unmarried, infected by HIV, HCV, and HBV, and diagnosed with depression, ALD, and CVD. Causes of death were frequently related to drug and injury.
Conclusions
Longer cumulative MMT duration is associated with lower all-cause and drug-related mortality rate.
Frozen embryo transfer (FET) has been adopted by growing number of reproductive medicine centers due to the improved outcome compared with fresh embryo transfer. However, few studies have focused on the impact of embryo cryopreservation duration on pregnancy-related complications and neonatal birthweight. Thus, a retrospective cohort study including all FET cycles with livebirth deliveries in a university affiliated hospital from May 2010 to September 2017 was conducted. These deliveries were grouped by the cryopreservation duration of the transferred embryo (≤3 months, 4–6 months, 7–12 months, and >12 months). The associations between embryo cryopreservation duration and pregnancy-related complications were evaluated among the groups using multinomial logistic regression. Neonatal birthweight was compared according to the stratification of singletons and multiples using multinomial and multilevel logistic regression, respectively. Among all 12,158 FET cycles, a total of 3864 livebirth deliveries comprising 2995 singletons and 1739 multiples were included. Compared with those within 3 months, women undergoing FET after a cryopreservation time longer than 3 months did not show any increased risk of gestational diabetes mellitus, gestational hypertension, preeclampsia, meconium staining of the amniotic fluid, or preterm birth. Furthermore, the risk of lower birthweight, macrosomia, small-for-gestational-age, or large-for-gestational-age for either singletons or multiples was not affected by long-term cryopreservation. In summary, embryo cryopreservation duration does not have negative effects on pregnancy-related complications or birthweight after FET.
While deceptive behaviors are a natural part of human life, it is well known that human is generally bad at detecting deception. In this study, we present an automatic deception detection framework by comprehensively integrating prior domain knowledge in deceptive behavior understanding. Specifically, we compute acoustics, textual information, implicatures with non-verbal behaviors, and conversational temporal dynamics for improving automatic deception detection in dialogs. The proposed model reaches start-of-the-art performance on the Daily Deceptive Dialogues corpus of Mandarin (DDDM) database, 80.61% unweighted accuracy recall in deception recognition. In the further analyses, we reveal that (i) the deceivers’ deception behaviors can be observed from the interrogators’ behaviors in the conversational temporal dynamics features and (ii) some of the acoustic features (e.g. loudness and MFCC) and textual features are significant and effective indicators to detect deception behaviors.
Rice (Oryza sativa L.) is the primary staple crop in Taiwan, and it can be grown twice a year. The prevalent subspecies grown in Taiwan is Japonica, and a transplanting system is used for rice production. Although the transplanting system is known for efficient weed control at the seedling stage, weedy red rice (WRR, O. sativa f. spontanea) infestation is progressively being reported. Fieldwork and previous studies have suggested that WRR infestation in Taiwan is probably related to growers’ operating practices and their perception of WRR. However, no data are available for a detailed investigation. The present study aimed to collect data on rice growers’ backgrounds, farming practices, and perceptions of WRR to quantify and characterize the patterns of farming operations for rice growers in Taiwan and to investigate factors contributing to WRR infestation. We collected 408 questionnaires completed by rice growers from 17 counties covering all rice production regions in Taiwan. The growers’ median age was 51 to 60 yr, and 75% of respondents had paddies from 0.25 to 2.75 ha in size, which corresponded with nationwide data for farmers’ backgrounds. In general, growers applied similar farming practices for both cropping seasons. Most respondents did not notice WRR infestation or consider it to be a problem: only 9.8% noticed a moderate to severe infestation of WRR in their fields. The major perceived causes of WRR infestation was seed impurity (55.1%) or cultivar degeneration (18.6%). Correlation analysis and farming patterns estimated with a nonnegative matrix factorization algorithm showed that WRR contamination rate was due to the use of dry or wet tillage. The present study provides the first quantitative and qualitative evidence of rice production practices and growers’ perceptions of WRR infestation in Taiwan.
Studies have suggested the detrimental effects of obesity and systemic inflammation on the cognitive function of patients with bipolar or major depressive disorder. However, the complex associations between affective disorder, obesity, systemic inflammation, and cognitive dysfunction remain unclear.
Methods
Overall, 110 patients with affective disorder (59 with bipolar I disorder and 51 with major depressive disorder) who scored ≥61 on the Global Assessment of Functioning and 51 age- and sex-matched controls were enrolled. Body mass index ≥25 kg/m2 was defined as obesity or overweight. Levels of proinflammatory cytokines—including interleukin-6, tumor necrosis factor (TNF)-α, and C-reactive protein (CRP)—were measured, and cognitive function was assessed using various methods, including the Wisconsin Card Sorting Test (WCST) and go/no-go task.
Results
Patients with bipolar I disorder or major depressive disorder were more likely to be obese or overweight, had higher CRP and TNF-α levels, and had greater executive dysfunction in the WCST than the controls. TNF-α level (P < .05) but not affective disorder diagnosis or obesity/overweight was significantly associated with cognitive function deficits, although obesity/overweight and diagnosis were significantly associated with increased TNF-α level.
Conclusions
Our findings may indicate that proinflammatory cytokines, but not obesity or overweight, have crucial effects on cognitive function in patients with bipolar I disorder or major depressive disorder, although proinflammatory cytokines and obesity or overweight were found to be strongly associated. The complex relationships between affective disorder diagnosis, proinflammatory cytokine levels, obesity or overweight, and cognitive function require further investigation.
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.
Blue-ice areas (BIAs) and their geographical distribution in Antarctica were mapped using Landsat-7 ETM+ images with 15 m spatial resolution obtained during the 1999–2003 austral summers and covering the area north of 82.5° S, and a snow grain-size image of the MODIS-based Mosaic of Antarctica (MOA) dataset with 125 m grid spacing acquired during the 2003/04 austral summer from 82.5°S to the South Pole. A map of BIAs was created with algorithms of thresholds based on band ratio and reflectance for ETM+ data and thresholds based on snow grain size for the MOA dataset. The underlying principle is that blue ice can be separated from snow or rock by their spectral discrepancies and by different grain sizes of snow and ice. We estimate the total area of BIAs in Antarctica during the data acquisition period is 234 549 km2, or 1.67% of the area of the continent. Blue ice is scattered widely over the continent but is generally located in coastal or mountainous regions. The BIA dataset presented in this study is the first map covering the entire Antarctic continent sourced solely from ETM+ and MODIS data. This dataset can potentially benefit other studies in glaciology, meteorology, climatology and paleoclimate, meteorite collection and airstrip site selection.
Team psychological safety — a non-threatening and safe climate — allows team members to express and share each other's opinions freely, and this sharing may produce more useful perspectives to induce team creativity. In a psychologically safe climate, transactive memory systems (TMSs) may be constructed for describing the specialised division of cognitive labour for solving information problems and thereby enabling team members to quickly gain and use knowledge across domains. As a consequence, further ideas may be generated within teams, increasing team creativity. Our research model is assessed using data from a sample of 110 team members from 40 research and development (R&D) teams in a leading technology company in Taiwan and analysed using the partial least squares method. The results of this study reveal that: (1) team psychological safety did not directly affect team creativity, (2) team psychological safety affects TMSs, (3) TMSs affect team creativity, and (4) TMSs fully mediate the relationship between team psychological safety and team creativity. This study also discusses the implications for team creativity.
R&D is uncertain work that involves the knowledge, skills, or perspectives of team members. When R&D teams develop new products or technologies, the need for psychological safety within the teams is increasingly emphasized. If R&D team members perceive that team psychological safety exists, they may be willing to offer knowledge or perspectives during the development process because they are not afraid of being rejected or embarrassed for speaking up. However, the application of the theory of team psychological safety to R&D teams is considerably limited. This study explores the antecedents and consequences of team psychological safety in R&D teams. Our research model is assessed using data from a sample of 245 team members from sixty technology R&D teams at a leading R&D institute and is analyzed using the partial least squares (PLS) method. The results of this study suggest that: (1) social capital exerts a positive and significant effect on team psychological safety; (2) team psychological safety has a positive and significant impact on team performance; (3) knowledge sharing and team learning positively and significantly mediate the relationship between team psychological safety and team performance; and (4) knowledge sharing exhibits a positive and significant effect on team learning. This study also discusses the implications of team psychological safety for R&D teams.
The phase evolution, nucleation, and sintered ceramics of barium titanate (BaTiO3, BT) powder prepared by solid-state synthesis with an ultrafine starting material (27 m2/g of BaCO3 and 190 m2/g of TiO2) were investigated in this study. Surface diffusion between BaCO3 and TiO2 was observed at a relatively low temperature of 400 °C by transmission electron microscopy. Rapid nucleation of the BT and cubic BT phases was observed at 500 °C by x-ray diffraction. The derivative thermogravimetry curve clearly shows a single step of BT formation at 600 °C. In short, pure BT particles with an average particle size of 250 nm and high tetragonality were prepared by solid-state synthesis, which produced X7R ceramics with high dielectric permittivity, high insulation resistance, and a clear core–shell structure.
Irritability is not uncommon after traumatic brain injury (TBI). Unfortunately, no instruments are available to directly measure this clinical feature. This study thus aimed to develop a specific scale to evaluate the irritability for patients with TBI. A total of 144 participants, which include 80 healthy participants and 64 patients suffering from TBI, were recruited. Irritability was assessed by the National Taiwan University Irritability Scale (NTUIS). Our results showed the NTUIS has good reliability. The factor analysis further revealed 2 different components: annoyance, and verbal aggression. Moreover, both self-reported and family-reported irritability postinjury were significantly higher than the irritability reported by the healthy participants. Indeed patients with TBI have significant problems with irritability after injuries, and thus a more specific assessment tool to carefully evaluate patients' irritability should be used.
Strenuous exercise is known to induce oxidative stress leading to the generation of free radicals. The purpose of the present study was to investigate the effects of lycopene, an antioxidant nutrient, at a relatively low dose (2·6 mg/kg per d) and a relatively high dose (7·8 mg/kg per d) on the antioxidant status of blood and skeletal muscle tissues in rats after exhaustive exercise. Rats were divided into six groups: sedentary control (C); sedentary control with low-dose lycopene (CLL); sedentary control with high-dose lycopene (CHL); exhaustive exercise (E); exhaustive exercise with low-dose lycopene (ELL); exhaustive exercise with high-dose lycopene (EHL). After 30 d, the rats in the three C groups were killed without exercise, but the rats in the three E groups were killed immediately after an exhaustive running test on a motorised treadmill. The results showed that xanthine oxidase (XO) activities of plasma and muscle, and muscular myeloperoxidase (MPO) activity in group E were significantly increased compared with group C. Compared with group E, the elevations of XO and MPO activities of muscle were significantly decreased in group EHL. The malondialdehyde concentrations of plasma and tissues in group E were significantly increased by 72 and 114 %, respectively, compared with those in group C. However, this phenomenon was prevented in rats of the ELL and EHL groups. There was no significant difference in the GSH concentrations of erythrocytes in each group; however, exhaustive exercise resulted in a significant decrease in the GSH content of muscle. In conclusion, these results suggested that lycopene protected muscle tissue from oxidative stress after exhaustive exercise.
Ink jet technology is applied to the industry application of CPU cooling in this study. The PZT actuated micro-cooling device which generating the micro-scale liquid droplet is used in the CPU cooling of desktop and laptop PCs. It consists the advantages of long lifetime of operation, simple and easily manufactured of the structure with PZT actuator. Since the high latent heat transfer rate, 2260 J/g, of water droplet for the liquid-vapor phase change cooling system, it removes heat from the CPU surface effectively for over 100 W. In order to design an efficient cooling device, it is important to study the PZT material property varies after the laser cutting process and the dimensional effects of PZT actuator on the nozzle plate vibration mode. The frequency and amplitude of the voltage used to energize the PZT transducer are also important parameters that should be properly controlled in order to achieve the optimal liquid breakup conditions. It also reveals the low noise and power consumption in the CPU cooling system with some appropriate operational conditions.