We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Oncological and functional outcomes for T1-2 N0-1 (TNMv8) p16-positive oropharyngeal squamous cell carcinoma patients were analysed according to treatment: either transoral robotic surgery (TORS) (Surgery group – TORS and neck dissection ± adjuvant radiotherapy/chemoradiotherapy) or primary radiotherapy/chemoradiotherapy (Oncology group).
Methods
Single-centre retrospective observational study.
Results
The two-year disease-free survival rate was 88 per cent for the Oncology group (n = 42) and 95 per cent for the Surgery group (n = 44). The two-year overall survival rate was 98 per cent for the Oncology group and 100 per cent for the Surgery group. The functional swallowing outcome at two years post-treatment was similar in both groups. Subgroup analysis showed patients treated with surgery-only with no adjuvant treatment had the best functional outcome whilst patients treated with surgery and post-operative chemoradiotherapy had the worst functional outcome.
Conclusion
The overall oncological and functional outcomes at two years were similar in both groups. Patients treated with surgery-only had the best functional outcome without compromised oncological outcome.
This paper introduces a method to realize beam switching by using a substrate-integrated waveguide (SIW) Butler matrix combined with a slot array antenna. The Butler matrix consists of two hybrid couplers, two crossovers, two −45-degree phase shifters, and two 0-degree phase shifters. The slot array antenna is a 4 × 2 array. The operating frequency band of the slot array antenna, where the reflection coefficient is below −10 dB, is 26.5–31.5 GHz. The measured beamforming angles from input port 1 to input Port 4 of the Butler matrix are +46, −16, +15, and −50°, respectively. The corresponding antenna gains from input Port 1 to input Port 4 are 11.57 dB, 14.284 dB, 10.94 dB, and 12.864 dB, respectively. The dimensions of the Butler matrix and the slot array antenna are 56.8 mm × 21.2 mm × 0.254 mm. The dimensions of the SIW transmission channels between the Butler matrix and input Ports 1– 4 are 16.9 mm × 34 mm × 0.254 mm.
Malnutrition is a key factor in metabolic syndrome (MS) and sarcopenia, assessing the nutritional status of these patients is a pressing issue. The purpose of this study was to clarify sarcopenia and sarcopenic obesity in patients with MS based on nutritional status. This was a case–control study between MS/non-MS. Body composition was measured by dual-energy X-ray absorptiometry. Muscle function was assessed by handgrip strength, five times sit-to-stand test, gait speed test and short physical performance battery (SPPB). The Mini Nutritional Assessment (MNA) was performed to assess the nutritional status in the participants in this study. Overall, a total of 56 % and 13 % of participants suffered from possible sarcopenia and sarcopenia, respectively. There was a higher rate of possible sarcopenic obesity in the MS group than in the non-MS group (48·9 % v. 24·7 %, P < 0·01), and all the sarcopenia participants in the MS group had sarcopenic obesity. MNA score was significantly associated with sarcopenia status (P < 0·01). The MNA combined with body fat score showed better acceptable discrimination for detecting sarcopenic obesity and sarcopenia in MS (AUC = 0·70, 95 % CI 0·53, 0·86). In summary, there was a higher prevalence of possible sarcopenic obesity in MS, and all the MS patients with sarcopenia had sarcopenic obesity in the present study. We suggest that the MNA should be combined with body fat percentage to assess the nutritional status of MS participants, and it also serves as a good indicator for sarcopenia and sarcopenic obesity in MS.
Drillholes on shells provide a useful way to investigate prey and predator relationships. The current study documents predator–prey interactions exemplified by a faunal assemblage of the fossil gastropod Turritella cingulifera from the Pleistocene Szekou Formation in Hengchun Peninsula, Taiwan. All recognisable skeletal and shell fragments that are larger than 3 mm in size were collected and recorded. Processed bulk sediments (5.24 kg) contained 1462 molluscan shells, including 824 specimens of T. cingulifera, and 27 non-molluscan invertebrates. In the current study, approximately 41.6% (609/1462) of molluscs are drilled with at least one hole. Drilling intensities (DIs) regardless of shell completeness in all gastropods, bivalves and the turritelline gastropod T. cingulifera are 0.546, 0.060 and 0.413, respectively. DI on turritellids is significantly lower than that on other gastropods (χ2= 21.039, P < 0.001). Furthermore, the percentage of drillholes that occur in multiply drilled specimens is 34.7% (95/275) for turritelline gastropods based on complete to nearly complete specimens (n = 588). Our study shows no significant preference of drillhole position either on the suture or on the whorl (χ2= 0.055, P = 0.814). Most drillholes are located in whorls two to four proximal to the aperture. Drillhole diameters of the shells with one drillhole and ones with multiple drillholes are 1.0 and 0.5 mm on average, and the results of Mann–Whitney tests indicate that they are significantly different (P < 0.001). The first turritelline gastropod shell with an incomplete drillhole from Taiwan is documented here. The dominant drilling predators were naticids based on the drillhole morphology and the presence of naticids in the same assemblage. No apparent prey size selectivity is observed, so a ‘size refugium’ does not exist for the turritellids in the current study.
This paper extends the standard double-exponential jump-diffusion (DEJD) model to allow for successive jumps to bring about different effects on the asset price process. The double-exponentially distributed jump sizes are no longer assumed to have the same parameters; instead, we assume that these parameters may take a series of different values to reflect growing or diminishing effects from these jumps. The mathematical analysis of the stock price requires an introduction of a number of distributions that are extended from the hypoexponential (HE) distribution. Under such a generalized setting, the European option price is derived in closed-form which ensures its computational convenience. Through our numerical examples, we examine the effects on the return distributions from the growing and diminishing severity of the upcoming jumps expected in the near future, and investigate how the option prices and the shapes of the implied volatility smiles are influenced by the varying severity of jumps. These results demonstrate the benefits of the modeling flexibility provided by our extension.
Support vector machines (SVMs) based on brain-wise functional connectivity (FC) have been widely adopted for single-subject prediction of patients with schizophrenia, but most of them had small sample size. This study aimed to evaluate the performance of SVMs based on a large single-site dataset and investigate the effects of demographic homogeneity and training sample size on classification accuracy.
Methods
The resting functional Magnetic Resonance Imaging (fMRI) dataset comprised 220 patients with schizophrenia and 220 healthy controls. Brain-wise FCs was calculated for each participant and linear SVMs were developed for automatic classification of patients and controls. First, we evaluated the SVMs based on all participants and homogeneous subsamples of men, women, younger (18–30 years), and older (31–50 years) participants by 10-fold nested cross-validation. Then, we hold out a fixed test set of 40 participants (20 patients and 20 controls) and evaluated the SVMs based on incremental training sample sizes (N = 40, 80, …, 400).
Results
We found that the SVMs based on all participants had accuracy of 85.05%. The SVMs based on male, female, young, and older participants yielded accuracy of 84.66, 81.56, 80.50, and 86.13%, respectively. Although the SVMs based on older subsamples had better performance than those based on all participants, they generalized poorly to younger participants (77.24%). For incremental training sizes, the classification accuracy increased stepwise from 72.6 to 83.3%, with >80% accuracy achieved with sample size >240.
Conclusions
The findings indicate that SVMs based on a large dataset yield high classification accuracy and establish models using a large sample size with heterogeneous properties are recommended for single subject prediction of schizophrenia.
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.
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.
Unawareness of deficits is common and is associated with poor outcomes in Alzheimer's disease (AD); however, little is known about correlated neurobiochemical changes.
Methods:
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.
Results:
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.
Conclusions:
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.
Proper dry cow management is critical not only for subsequent milk production and fertility but also for mastitis control. A phenomenon of immunosuppression was commonly observed in transition cows, an example being the high susceptibility of the mammary gland during early the dry period to new infectious agents. Polymorphonuclear neutrophils (PMN) play important defence roles in the mammary gland of newly dried cows. One of the bactericidal mechanisms of PMN is through producing reactive oxygen species (ROS), which can be efficiently quantified by chemiluminescence (CL) assay. In the current study, the potential of intramammary application of a commercial Enterococcus faecium SF68 (SF68) product to enhance the local innate immunity of newly dried mammary glands was evaluated based on the CL assay. The preliminary experiments in vitro indicated virtual dose-responsiveness of ROS generation from three different cell preparations, bovine blood PMN, bovine blood PMN pre-conditioned with cow milk, and the post-diapedesis model somatic cells from cow milk, on their exposure to phorbol 12-myristate 13-acetate (PMA), viable SF68, and ultrasonicated SF68, but not dry-heated SF68. Because ultrasonication treatment was found to profoundly enhance the immunogenicity of SF68 in vitro, in the following animal trial, single infusion of either 5 or 10×107 original cfu of ultrasonicated SF68 was randomly applied to the front quarters and phosphate-bufferedsaline (PBS) applied to the rear quarters of each of the four experimental cows on the first day of milk stasis. The results showed that within the first post-infusion week, ultrasonicated SF68 induced a faster and greater (P<0·05) recruitment of PMN into mammary lumen with no apparent local or systemic inflammatory sign. Meanwhile, ultrasonicated SF68 also induced a greater (P<0·05) ROS production in response to PMA challenge by in situ somatic cells of mammary secretion. Taken together, ultrasonicated SF68 modulated ROS generation of bovine neutrophils, and would be a potential enhancer of udder innate immunity in drying-off dairy cows. More thorough work is warranted.
Boron-doped, single (∼54 nm) or double (∼21 + 54 nm) Si1−xGex layers were epitaxially grown on 300-mm-diameter p−-Si(100) device wafers with 20 nm technology node design features, by ultrahigh vacuum chemical vapor deposition. The Si1−xGex/Si wafers were annealed in the temperature range of 950–1050 °C for 60 s to investigate the effect of annealing on possible changes of Ge content and Si stress near the Si1−xGex/Si interface. High spectral resolution, micro-Raman spectroscopy was used as a nondestructive characterization technique with five excitation wavelengths of 363.8, 441.6, 457.9, 488.0, and 514.5 nm. Ge diffusion and generation of compressive stress at the Si1−xGex/Si interface were measured on all annealed wafers. Ge diffusion and the accumulation of compressive Si stress after annealing showed significantly different behaviors between single- and double-layer Si1−xGex/Si wafers. Raman characterization results were compared with secondary ion mass spectroscopy and high-resolution x-ray diffraction results.
Circulating levels of leptin and adiponectin are closely associated with obesity. However, it is not known whether there are common shared genes or environment exerting influences on the levels of leptin, adiponectin, and BMI. We aimed to assess the relative contribution of genes and environment to adiponectin, leptin, and BMI individually as well as simultaneously to the three measures. Our subjects included a total of 228 twin/sibling pairs aged 12 to 18 (130 monozygotic twins, 68 dizygotic twins and 30 sibling pairs) were recruited from the middle schools. Multivariate analyses were applied to twin/sibling data using structural equation modeling. The results showed that intraclass correlations for adiponectin, leptin and BMI were higher in the MZ twins than those in the DZ/SP group. The relative contribution of genes to adiponectin (39%) was comparable to those of shared environment (40%). In contrast, leptin and BMI were influenced mostly by genes (74% and 89%, respectively). The multivariate genetic analyses showed that a latent factor underlying the three measures was identified, with BMI being equivalent to this latent factor. The BMI-dependent genetic factor explains only 15% and 34% of variation of adiponectin and leptin, respectively. These data indicate a differential contribution of genetic factors for the variation of adiponectin, leptin and BMI. More importantly, only a small portion of the genetic influences on adiponectin and leptin was attributed to BMI. Our findings provided more insight into the complex regulation of adiponectin and leptin in obesity.
Accumulated evidence suggests that social support is influenced by genetic and environmental factors. However, there are little data that examine this issue from Asian samples. We reported results from a preliminary study that examined familial effects on social support in a Chinese adult twin sample. We administered a 10-item social support instrument that measures three dimensions of social support (i.e., objective support, subjective support, and utilization of support) developed for the Chinese population. Two hundred forty-two same-sex twin pairs, where both members of the pair completed the personal interview, were included in the final analysis. Structural equation modeling was used to estimate additive genetic (A), shared environmental (C), and nonshared environmental (E) effects on each dimension of social support. Familial factors (A+C) explained 56.63% [95% CI = 45.48–65.72%] and 42.42% [95% CI = 29.93–53.25%] of the total phenotypic variances of subjective support and utilization of support, respectively. For the objective support, genetic effects did not exist, but common environmental effect explained 37.56% [95% CI = 26.17–48.28%] of the total phenotypic variances. Neither gender nor age effects were seen on any dimension of social support. Except for objective support, genetic factors probably influence variation in subjective support and utilization of support. Shared environmental factors may influence all dimensions of social support.
Background: The Montreal Cognitive Assessment (MoCA) is an instrument for screening mild cognitive impairment (MCI). This study examined the psychometric properties and the validity of the Taiwan version of the MoCA (MoCA-T) in an elderly outpatient population.
Methods: Participants completed the MoCA-T, Mini-Mental State Examination (MMSE), and the Chinese Version Verbal Learning Test. The diagnosis of Alzheimer's disease (AD) was made based on the NINCDS-ADRDA criteria, and MCI was diagnosed through the criteria proposed by Petersen et al. (2001).
Results: Data were collected from 207 participants (115 males/92 females, mean age: 77.3 ± 7.5 years). Ninety-eight participants were diagnosed with AD, 71 with MCI, and 38 were normal controls. The area under the receiver operator curves (AUC) for predicting AD was 0.98 (95% confidence interval [CI] = 0.97–1.00) for the MMSE, and 0.99 (95% CI = 0.98–1.00) for the MoCA-T. The AUC for predicting MCI was 0.81 (95% CI = 0.72–0.89) using the MMSE and 0.91 (95% CI = 0.86–1.00) using the MoCA-T. Using an optimal cut-off score of 23/24, the MoCA-T had a sensitivity of 92% and specificity of 78% for MCI. Item response theory analysis indicated that the level of information provided by each subtest of the MoCA-T was consistent. The frontal and language subscales provided higher discriminating power than the other subscales in the detection of MCI.
Conclusion: Compared to the MMSE, the MoCA-T provides better psychometric properties in the detection of MCI. The utility of the MoCA-T is optimal in mild to moderate cognitive dysfunction.
In this report, electrical properties of an organic memory device with a tri-layer structure, MoO3 nano-clusters layer sandwiched between Alq3 thin films, are investigated. The device using this kind of structure exhibits a large ON/OFF density current ratio over 104, long retention time over 1hr, and an electrically programmable character. The formation of the bistable resistance switching of the device originates from a charge trapping effect of the MoO3 nano-clusters layer. Moreover, current density-voltage (J-V) characteristics of the device are quite different from those of OBDs using MoO3 nano-particles. No negative differential resistance is observed in the J-V curve of the device. This may be due to the distinct surface morphology of the MoO3 layer on the Alq3 thin film.
The interfacial regimes of cobalt/pentacene/cobalt (Co/Pc/Co) trilayers were emulated through the ultrathin pentacene/cobalt (Pc/Co) and cobalt/pentacene (Co/Pc) bilayers. Employing the magneto-optical Kerr effect (MOKE) measurement, we found the coercivity of Co bottom film in a thickness of 3.4 nm experienced a slight reduction upon the adsorption of Pc molecules. For the bilayers prepared with reversed order of deposition, the Co film deposited on a 6.4 nm Pc layer showed no observable ferromagnetic order at room temperature until its thickness reached 3 nm. After the onset of magnetic order, the x-ray images acquired on Pc/Co revealed a complicated magnetization patterns comparing to those observed on Co/Pc bilayers. Because the spin-polarized carriers will interact with the environment along their transport path, the presence of a non-magnetic layer and the occurrence of complicated domain structures suggested the spin-polarized carriers would experience a greater disturbance on their spin coherence when crossing the Pc/Co interface.
In this work, the charge-trapping distributions of polysilicon-oxide-nitride-oxide-silicon (SONOS) structure are studied. The trapping energy level of SiNx films with different composition ratio deposited by low-pressure chemical vapor deposition (LPCVD) were first characterized by photoluminescence (PL) measurement. Moreover, using F-N/CHE program and charge pumping techniques, the vertical location and the lateral distribution of programmed charges are investigated in the nitride films with different composition ratio. The study offers strong evidence that the density of charge-trapping levels in the Si-rich nitride is higher than the standard nitride. A simple qualitative model and calculation explains that the trapping level distributions in the SiNx films are shallower by increasing relative Si-content. Furthermore, we have observed the nitride trap vertical location was changed by adjusted Si/N composition ratio. And the lateral distribution of hot electron programmed charges in the modified nitride is broader than that in the standard nitride because it offered more charge-trapping sites and shallower charge-trapping levels. In summary, the study can help researchers to understand the nitride charge-trapping mechanism and the analysis of optical/electrical characteristics.
At a medical center in Taiwan, all workers were examined by chest radiography, to determine the prevalence of pulmonary tuberculosis. The prevalence of tuberculosis among all hospital workers was 0.12%, that among nurses was 0.35%, and that among externally contracted cleaners was 0.57%. All of the Mycobacterium tuberculosis isolates recovered from 2 nurses and from a patient with pulmonary tuberculosis were the Beijing strain, but the strains had different serotypes.
To rapidly establish a temporary isolation ward to handle an unexpected sudden outbreak of severe acute respiratory syndrome (SARS) and to evaluate the implementation of exposure control measures by healthcare workers (HCWs) for SARS patients.
Design:
Rapid creation of 60 relatively negative pressure isolation rooms for 196 suspected SARS patients transferred from 19 hospitals and daily temperature recordings of 180 volunteer HCWs from 6 medical centers.
Setting:
A military hospital.
Results:
Of the 196 patients, 34 (17.3%) met the World Health Organization criteria for probable SARS with positive results of serologic testing for SARS-associated coronavirus (SARS-CoV), reverse transcriptase polymerase chain reaction (RT-PCR) from nasopharyngeal or throat swabs for SARS-CoV, or both. Seventy-four patients had suspected SARS based on unprotected exposure to SARS patients; three of them had positive results on RT-PCR but negative serologic results. The remaining 88 patients did not meet the criteria for a probable or suspected SARS diagnosis. Of the 34 patients with probable SARS, 13 were transferred to medical centers to receive mechanical ventilation due to rapid deterioration of chest x-ray results, and three patients died of SARS despite intensive therapy in medical centers. During the study period, one nurse developed probable SARS due to violation of infection control measures, but there was no evidence of cross-transmission to other HCWs.
Conclusions:
Despite the use of full personal protection equipment, the facility failed to totally prevent exposures of HCWs to SARS but minimized the risk of nosocomial transmission. Better training and improvements in infection control infrastructure may limit the impact of SARS.
Copper metallization for GaAs was evaluated by using Cu/Ta/GaAs multilayers for its thermal stability. A thin Ta layer of 30 nm thickness was sputtered on the GaAs substrate as the diffusion barrier before copper film metallization. As judged from the results of sheet resistance, X-ray diffraction, Auger electron spectroscopy and transmission electron microscopy, the Cu/Ta films on GaAs were very stable up to 500 °C without Cu migration into GaAs. After 550 °C annealing, the interfacial mixing of Ta with GaAs substrate occurred, resulting in the formation of TaGa2 and TaAs2, and the diffusion of Ga and As through the Ta layer formed the Cu3Ga and Cu3As phases at the Cu/Ta interface. After 600 °C annealing, the reaction of GaAs with Ta and Cu formed TaAs and Cu3Ga, as a result of Cu migration and interfacial instability.