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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.
Evidence suggests a familial coaggregation of major psychiatric disorders, including schizophrenia, bipolar disorder, major depression (MDD), autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD). Those disorders are further related to suicide and accidental death. However, whether death by suicide may coaggregate with accidental death and major psychiatric disorders within families remains unclear.
Aims
To clarify the familial coaggregation of deaths by suicide with accidental death and five major psychiatric disorders.
Method
Using a database linked to the entire Taiwanese population, 68 214 first-degree relatives of individuals who died by suicide between 2003 and 2017 and 272 856 age- and gender-matched controls were assessed for the risks of death by suicide, accidental death and major psychiatric disorders.
Results
A Poisson regression model showed that the first-degree relatives of individuals who died by suicide were more likely to die by suicide (relative risk RR = 4.61, 95% CI 4.02–5.29) or accident (RR = 1.62, 95% CI 1.43–1.84) or to be diagnosed with schizophrenia (RR = 1.53, 95% CI 1.40–1.66), bipolar disorder (RR = 1.99, 95% CI 1.83–2.16), MDD (RR = 1.98, 95% CI 1.89–2.08) or ADHD (RR = 1.34, 95% CI 1.24–1.44).
Conclusions
Our findings identified a familial coaggregation of death by suicide with accidental death, schizophrenia, major affective disorders and ADHD. Further studies would be required to elucidate the pathological mechanisms underlying this coaggregation.
Problematic internet use, especially in people with substance use disorder, may negatively affect their quality of life (QoL). However, it is unclear whether sleep quality is a key mediator in the association between problematic internet use and QoL among people with substance use disorder.
Aims
This study aimed to investigate the relationship between problematic internet use and QoL and how sleep quality may mediate the association between these two variables.
Method
Overall, 319 people (85% male) with substance use disorder (mean age 42.2 years, s.d. 8.9) participated in a cross-sectional study in Taiwan. The Smartphone Application-Based Addiction Scale, Bergan Social Media Addiction Scale, Internet Gaming Disorder-Short Form, Pittsburgh Sleep Quality Index and World Health Organization Quality of Life Questionnaire Brief Version were used.
Results
The prevalence of sleep problems was 56%. There were significant and direct associations between sleep quality and two types of problematic internet use, and between sleep quality and different dimensions of QoL. All types of problematic internet use were significantly and negatively correlated with QoL. Mediated effects of sleep quality in relationships between the different types of problematic internet use and all dimensions of QoL were significant, except for problematic use of social media.
Conclusions
Different types of problematic internet use in people with substance use disorder may be directly associated with reduced QoL. Sleep quality as a significant mediator in this association may be an underlying mechanism to explain pathways between problematic internet use and QoL in this population.
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.
More than one million runners have joined the marathon games since 2007 in Taiwan. There were over 150 marathon games held in Taiwan in 2018. The increase rate was 21% as compared to that of 2014. The medical encounter rate was 1.33% in 2015 and increased to 1.41% in 2017. The most common type of injury was muscle spasm. The second most common was abrasion due to falls. The treatment for muscle spasm was RICE only. Cardiac arrest of marathon runners was reported occasionally and time is critical for rescue.
Aim:
To shorten the rescue time of the runners in an emergency. Base on the prodromal research, BLE communication technology is further used to improve the rescue positioning communication technology in the marathon.
Methods:
After rescue notification devices have been set up in each 0.5 km on the runway of the marathon, the runner can send a rescue signal through the rescue notification devices in case of emergency. The rescue signal, periodically advertisement SN# with rescue mark, of the runner can be precisely located and the rescue can be started very soon.
Results:
In the simulation, the rescue signal can be located in 7.5 minutes, fastest in 3 seconds. The precision rate of timing is ±160ms/6σ that under IAAF accuracy requirement. The location error is less than 20 meters, and the rescue time can be shortened to one half as before.
Discussion:
The rescue time of runner is correlated with the quality of marathon EMS. It is critical to the runner, especially in cardiac arrest. By using BLE communication devices, the runner can be located faster and more precisely. As rescue time shortened, CPR & AED can be given sooner. The quality of marathon EMS will be improved substantially.
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.
Methods
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.
Results
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.
Conclusions
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.
Aims
To evaluate the risk of suicide attempt in adolescents and young adults with ADHD.
Method
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.
Results
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).
Conclusion
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.
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.
This study modified the surfaces of three kinds of TiNi-based shape memory alloys (SMAs) by dry electrical discharge machining (EDM) in nitrogen (N2) and acetylene (C2H2) gas mixture. The effects of composition of the dielectric medium and work-piece on the machining performance and surface characteristics were investigated. Increasing the ratio of acetylene gas in gas mixture was beneficial for improving the material removal rate (MRR). However, adding a large amount of acetylene gas resulted in unstable discharge. A recast layer, comprising nitrides and carbides, which well adhered on the EDMed surface exhibited high hardness. Among Ti50Ni50, Ti50Ni49.5Cr0.5, and Ti40.5Ni49.5Zr10 SMA as a work-piece, Ti40.5Ni49.5Zr10 SMA has the lowest MRR owing to it possessed the highest melting temperature and thermal conductivity. The recast layer on Ti40.5Ni49.5Zr10 SMA, comprising zirconium nitride, exhibited the highest hardness and adhesion among all the SMAs. However, the high-hardness recast layer deteriorated the shape recovery of the SMA.
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.
Aims
To investigate the temporal association between PTSD and the development of stroke.
Method
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.
Results
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.
Conclusions
Individuals with PTSD have an increased risk of developing any stroke and ischaemic stroke. Further studies are required to investigate the underlying mechanisms.
Numerical simulations and laboratory experiments were jointly conducted to investigate a bathtub vortex under the influence of a protruding cylinder in a rotating tank. In the set-up, a central drain hole is placed at the bottom of the tank and a top-down cylinder is suspended from the rigid top lid, with fluid supplied from the sidewall for mass conservation. The cylinder is protruded to produce the Taylor column effect. The flow pattern depends on the Rossby number ($\mathit{Ro}= U/ fR$), the Ekman number ($\mathit{Ek}= \nu / f{R}^{2} )$ and the height ratio, $h/ H$, where $R$ is the radius of the cylinder, $f$ is the Coriolis parameter, $\nu $ is the kinematic viscosity of the fluid, $h$ is the vertical length of the cylinder and $H$ is the height of the tank. It is found appropriate to choose $U$ to be the average inflow velocity of fluid entering the column beneath the cylinder. Steady-state solutions obtained by numerically solving the Navier–Stokes equations in the rotating frame are shown to have a good agreement with flow visualizations and particle tracking velocimetry (PTV) measurements. It is known that at $\mathit{Ro}\sim 1{0}^{- 2} $, the central downward flow surrounded by the neighbouring Ekman pumping forms a classic one-celled bathtub vortex structure when there is no protruding cylinder ($h/ H= 0$). The influence of a suspended cylinder ($h/ H\not = 0$) leads to several findings. The bathtub vortex exhibits an interesting two-celled structure with an inner Ekman pumping (EP) and an outer up-drafting motion, termed Taylor upwelling (TU). The two regions of up-drafting motion are separated by a notable finite-thickness structure, identified as a (thin-walled) Taylor column. The thickness ${ \delta }_{T}^{\ast } $ of the Taylor column is found to be well correlated to the height ratio and the Ekman number by ${\delta }_{T} = { \delta }_{T}^{\ast } / R= {(1- h/ H)}^{- 0. 32} {\mathit{Ek}}^{0. 095} $. The Taylor column presents a barrier to the fluid flow such that the fluid from the inlet may only flow into the inner region through the narrow gaps, one above the Taylor column and one beneath it (conveniently called Ekman gaps). As a result, five types of routes along which the fluid may flow to and exit at the drain hole could be identified for the multi-celled vortex structure. Moreover, the flow rates associated with the five routes were calculated and compared to help understand the relative importance of the component flow structures. The weaker influence of the Taylor column effect on the bathtub vortex at $\mathit{Ro}\sim 1$ or even higher $\mathit{Ro}\sim 1{0}^{2} $ is also discussed.
Comorbid personality pathologies may affect the outcome of patients with major depression (MD). The dopamine transporter gene DAT1 (SLC6A3) has been suggested to play a role in both depression and specific personality traits. The aim of this study was to assess five polymorphisms of the DAT1 gene (rs2550948, rs2975226, rs6347, rs27072, and 3′-VNTR) to determine whether this gene influences personality traits in patients with MD or its subgroups.
Methods
The DAT1 polymorphisms were analysed in 463 unrelated Han Chinese MD patients. The personality traits, novelty seeking (NS), and harm avoidance (HA), were examined using the Tridimensional Personality Questionnaire. The patients were also divided into four clinical subgroups on the basis of differences in their sex (male or female) and age at disease onset (early or late).
Results
There was no association between the DAT1 gene and either NS or HA in the total MD sample or in the sex-based subgroups. However, early-onset MD patients with the G/G genotype of rs2550948 and the T/T genotype of rs2975226 had lower NS scores than did patients with the other genotypes (pcorrected = 0.05 for rs2550948 and pcorrected = 0.005 for rs2975226).
Conclusion
Our study suggests that DAT1 promoter variants possibly influence specific personality traits in the early-onset subgroup of depressed patients in the Han Chinese population. Further prospective cohort studies are required to verify our preliminary finding and to confirm the effects of personality susceptibility on long-term disease outcomes.
The surface morphologies of AlGaN/AlN/GaN HEMT structures were examined by using the atomic force microscopy (AFM).These HEMT structures have been grown by metalorganic chemical vapor deposition (MOCVD) onto the sapphire (0001) substrates where the thicknesses of AlN interlayers were varied from 0 to 5 nm. After the growth of GaN buffer layer, the AlN intermediate and AlGaN top layers were subsequently deposited at 1130°C in an trimethylaluminum (TMAl) and ammonia (NH3) atmosphere. The surface of AlGaN layers shows the thick- and fine-thread patterns.
It was found that the root-mean-square (RMS) roughness of the samples with 0, 0.5, 2.5 and 5nm AlN interlayer thickness are 0.503, 0.534, 0.534 and 0.601nm, respectively. Although the cracks and rougher surfaces show that the qualities of AlGaN barrier layers have slightly degraded in the samples with thicker AlN layer. These phenomena could be attributed to the lattice mismatch and the growth temperature. In addition, the room-temperature two-dimensional electron gas (2DEG) mobility and density analysis were performed on the AlGaN surfaces and the measured results were discussed in detail.
Impulsive loading by the ground reaction force (GRF) around heelstrike during walking is closely related to joint degeneration and might be affected by joint movement of the locomotor system. Fifteen healthy males (age: 25.5 ±3 years) were studied to investigate the association between the quantitative joint angles, angular velocities and accelerations of the lower-limb joints, and the loading rates of the GRF. Apart from the gait speed, both the ipsilateral kinematics during the swing phase, and the contralateral kinematics around the beginning of the terminal double limb stance (DLS), may significantly contribute to the heelstrike and maximum loading rates of the GRF. The magnitude of the heelstrike impulsive GRF was particularly affected by the peak ankle dorsiflexion velocity during the swing phase of the ipsilateral limb. However, for generating the maximum loading rate of nearly eight times the magnitude of that of the heelstrike one needed more kinematic variables to be modulated in advance, especially the knee flexion velocities around the beginning of the terminal DLS of the contralateral limb. Knowledge of the joint mechanics of the locomotor system for controlling the magnitude of the impulsive GRF during normal walking might be helpful for gait retraining for the elderly or patients who might have excessive impulsive GRF and a high risk of joint degeneration.
Modulation of the cellular response by the administration of probiotic bacteria may be an effective strategy for preventing or inhibiting tumour growth. We orally pre-inoculated mice with probiotics Lactobacillus acidophilus NCFM (La) for 14 d. Subcutaneous dorsal-flank tumours and segmental orthotopic colon cancers were implanted into mice using CT-26 murine colon adenocarcinoma cells. On day 28 after tumour initiation, the lamina propria of the colon, mesenteric lymph nodes (MLN) and spleen were harvested and purified for flow cytometry and mRNA analyses. We demonstrated that La pre-inoculation reduced tumour volume growth by 50·3 %, compared with untreated mice at 28 d after tumour implants (2465·5 (sem 1290·4) v. 4950·9 (sem 1689·3) mm3, P < 0·001). Inoculation with La reduced the severity of colonic carcinogenesis caused by CT-26 cells, such as level of colonic involvement and structural abnormality of epithelial/crypt damage. Moreover, La enhanced apoptosis of CT-26 cells both in dorsal-flank tumour and segmental orthotopic colon cancer, and the mean counts of apoptotic body were higher in mice pre-inoculated with La (P < 0·05) compared with untreated mice. La pre-inoculation down-regulated the CXCR4 mRNA expressions in the colon, MLN and extra-intestinal tissue, compared with untreated mice (P < 0·05). In addition, La pre-inoculation reduced the mean fluorescence index of MHC class I (H-2Dd, -Kd and -Ld) in flow cytometry analysis. Taken together, these findings suggest that probiotics La may play a role in attenuating tumour growth during CT-26 cell carcinogenesis. The down-regulated expression of CXCR4 mRNA and MHC class I, as well as increasing apoptosis in tumour tissue, indicated that La may be associated with modulating the cellular response triggered by colon carcinogenesis.
We report that the high crystalline and high efficiency green emission semipolar {101̅1} InGaN/GaN multiple quantum wells (MQWs) grown on the {101̅1} facets of GaN nanopyramid arrays by selective area epitaxy. Clear and sharp interfaces of the semipolar {101̅1} InGaN/GaN MQWs was observed by transmission electron microscopy images. As comparing with (0001) MQWs, the internal electric field of {101̅1} MQWs was remarkably reduced from 1.7 MV/cm to 0.5 MV/cm, and the room temperature (RT) internal quantum efficiency (IQE) at green emission was enhanced by about 80%. This greatly enhancement of IQE is due to suppress the polarization effect in the {101̅1} MQWs which shorten the radiative recombination to compete with nonradiative recombination at RT. These results evince that the {101̅1} planes are promising for solving the efficiency green gap of III-nitride light emitters.
We compute the conjugacy classes of elements and the character tables of the maximal parabolic subgroups of the simple Ree groups 2F4(q2). For one of the maximal parabolic subgroups, we find an irreducible character of the unipotent radical that does not extend to its inertia subgroup.
We compute the conjugacy classes and character table of a Borel subgroup of the Ree groups 2F4(22n+1) for all n ≥ 1 and prove that these Borel subgroups are M-groups. We determine the degrees of the irreducible characters of the Sylow-2-subgroups of 2F4(22n+1) and show that the Isaacs–Malle–Navarro version of the McKay conjecture holds for 2F4(22n+1) in characteristic 2. For most of the calculations we use CHEVIE.
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.
The aim of the study was to elucidate the epidemiological features of Hepatitis C virus (HCV) infection among teenagers in an endemic area by conducting a mass screening study. We also investigated the clinical outcome of the anti-HCV-positive subjects by conducting subsequent short-term and long-term follow-up studies. All 2837 students of two junior middle schools in Tzukuan, aged 13–16 years, were invited to be screened for anti-HCV, HBsAg, AST and ALT in October 1995. A total of 2726 (96%) students responded. Anti-HCV, HCV RNA and aminotransferase levels were evaluated among anti-HCV-positive students 1 month and 30 months later, respectively. A total of 38 (1·4%; M/F = 22/16) participants were anti-HCV-positive. The anti-HCV-positive students had higher rates of exposures to transfusion, anti-HCV-positive families and surgery. The prevalence (2·8%) of the 7 maritime villages was markedly higher than that (0·7%) of the other 8 villages (P < 0·001). Subsequent follow-up studies demonstrated that there might be 5 cases of acute or recent HCV infection, and 6 cases who had recovered from chronic HCV infection.
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