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Internet addiction (IA) refers to excessive internet use that causes cognitive impairment or distress. Understanding the neurophysiological mechanisms underpinning IA is crucial for enabling an accurate diagnosis and informing treatment and prevention strategies. Despite the recent increase in studies examining the neurophysiological traits of IA, their findings often vary. To enhance the accuracy of identifying key neurophysiological characteristics of IA, this study used the phase lag index (PLI) and weighted PLI (WPLI) methods, which minimize volume conduction effects, to analyze the resting-state electroencephalography (EEG) functional connectivity. We further evaluated the reliability of the identified features for IA classification using various machine learning methods.
Methods
Ninety-two participants (42 with IA and 50 healthy controls (HCs)) were included. PLI and WPLI values for each participant were computed, and values exhibiting significant differences between the two groups were selected as features for the subsequent classification task.
Results
Support vector machine (SVM) achieved an 83% accuracy rate using PLI features and an improved 86% accuracy rate using WPLI features. t-test results showed analogous topographical patterns for both the WPLI and PLI. Numerous connections were identified within the delta and gamma frequency bands that exhibited significant differences between the two groups, with the IA group manifesting an elevated level of phase synchronization.
Conclusions
Functional connectivity analysis and machine learning algorithms can jointly distinguish participants with IA from HCs based on EEG data. PLI and WPLI have substantial potential as biomarkers for identifying the neurophysiological traits of IA.
The exploration of molecular characteristics has emerged as a prominent trend to advance precision medicine. The utilization of genetic testing to guide therapy is integral to precision medicine. This study aims to investigate the potential patient populations for the reimbursement of next-generation sequencing (NGS) and assess the budget impact from the perspective of Taiwan’s single insurer, the National Health Insurance Administration.
Methods
To comprehend the scope for medicines with companion diagnostics (CDx) involved, we analyze the U.S. Food and Drug Administration-approved/cleared diagnostic tests, conduct a literature review to identify medicines approved by the European Medicines Agency that require a CDx, and identify the medicines with CDx involved covered by the National Health Insurance (NHI) in Taiwan. Subsequently, we explore the potential reimbursement indications for NGS testing and conduct a budget impact analysis to evaluate the expected financial impact for the NHI over a five-year period. Furthermore, sensitivity analyses are conducted to deal with uncertainty.
Results
We have compiled 13 cancer types for which NGS can serve as a companion diagnostic. These encompass non-small-cell lung cancer, colorectal cancer, breast cancer, ovarian cancer, biliary tract cancer, acute myeloid leukemia, acute lymphoblastic leukemia, melanoma, cholangiocarcinoma, prostate cancer, pancreatic cancer, gastrointestinal stromal tumor, and thyroid cancer/medullary thyroid cancer. The implementation of NGS reimbursement in NHI will benefit 25,000 to 30,000 patients undergoing targeted therapies. The projected incremental budget impact ranges from TWD570 million to TWD650 million (USD19 million to USD22 million) over five years.
Conclusions
This study focuses on evaluating the financial impact of incorporating NGS testing into NHI reimbursement for relevant cancer drug indications. The findings can serve as references for the planning of reimbursement policies. However, with the advancement of precision medicine, it is foreseeable that there will be a broader range of applications for NGS, and its cost will gradually decrease.
Introduction: Late-life depression (LLD) is associated with cognitive deficit with risk of future dementia. By examining the entropy of the spontaneous brain activity, we aimed to understand the neural mechanism pertaining to cognitive decline in LLD.
Methods: We collected MRI scans in older adults with LLD (n = 32), mild cognitive impairment [MCI (n = 25)] and normal cognitive function [NC, (n = 47)]. Multiscale entropy analysis (MSE) was applied to resting-state fMRI data. Under the scale factor (tau) 1 and 2, reliable separation of fMRI data and noise was achieved. We calculated the brain entropy in 90 brain regions based on automated anatomical atlas (AAL). Due to exploratory nature of this study, we presented data of group-wise comparison in brain entropy between LLD vs. NC, MCI vs. NC, and LLD and MCD with a p-value below 0.001.
Results: The mean Mini-Mental State Examination (MMSE) score of LLD and MCI was 27.9 and 25.6. Under tau 2, we found higher brain entropy of LLD in left globus pallidus than MCI (p = 0.002) and NC (p = 0,009). Higher brain entropy of LLD than NC was also found in left frontal superior gyrus, left middle superior gyrus, left amygdala and left inferior parietal gyrus. The only brain region with higher brain entropy in MCI than control was left posterior cingulum (p-value = 0.015). Under tau 1, higher brain entropy was also found in LLD than in MCI in right orbital part of medial frontal gyrus and left globus pallidus (p-value = 0.007 and 0.005).
Conclusions: Our result is consistent with prior hypothesis where higher brain entropy was found during early aging process as compensation. We found such phenomenon particular in left globus pallidus in LLD, which could be served as a discriminative brain region. Being a key region in reward system, we hypothesis such region may be associated with apathy and with unique pathway of cognitive decline in LLD. We will undertake subsequent analysis longitudinally in this cohort
High-resolution simulations of gravity currents in the lock-exchange configuration are conducted to study the flow within the head. The simulations exhibit the geometric features of the head as reported in the laboratory experiments and numerical simulations, and provide more detailed information on the flow within the head of a gravity current. The flow in the lower part of the head, where the lobes and clefts are forming at the leading edge, is qualitatively different from but interconnected to the flow in the upper part of the head, where steepening bulges are protruding from the upright surface above the clefts. Interestingly, regions of positive and negative streamwise vorticity are observed not only in the lower part of the head but also in the upper part of the head at staggered spanwise locations. We have shown that both the streamwise vorticity at the leading edge of the lobes in the lower part of the head and the streamwise vorticity at the steepening bulges in the upper part of the head are contributed from the twisting of spanwise vorticity into the streamwise direction, due to the geometric features of the lobes and the steepening bulges, and contributed from the baroclinic production of vorticity. Our results from visualization using tracers indicate that the ambient fluid ingested in and rising from the clefts is being swept towards the leading edge of a gravity current before being carried upwards from the leading edge to the upright surface above the left and right neighbouring lobes. Furthermore, the heavy fluid inside a lobe may descend towards the bottom boundary, move forward towards the leading edge and outwards towards the neighbouring clefts, and ultimately be carried upwards to the upright surface above the left and right neighbouring lobes. With the knowledge that the erosive power of a gravity current is concentrated in the head region, it is plausible that the bed material, once resuspended by a gravity current, may be lifted up away from the bottom boundary and be dispersed in both the streamwise and spanwise directions. The present study complements existing findings in the literature and provides new insights into the three-dimensional flow field within the head of a gravity current.
Certain rhythmic arterial pressure waves in humans and animals have been noticed for over one century. We found the novel and slowest arterial pressure waves in children following surgical repair for CHD, and examined their characteristics and clinical implications.
Methods:
We enrolled 212 children with 22 types of CHD within postoperative 48 h. We monitored haemodynamics (blood pressure, cardiac cycle efficiency, dP/dTmax), cerebral (ScO2), and renal (SrO2) oxygen saturation every 6 s. Electroencephalogram was continuously monitored. Mean blood flow velocity (Vm) of the middle cerebral artery was measured at 24 h.
Results:
We found the waves with a frequency of ∼ 90 s immediately following surgical repair in 46 patients in 12 types of CHD (21.7%), being most prevalent in patients with aortic arch abnormalities (Aorta Group, n = 24, 42.3%) or ventricular septal defect (Ventricular Septal Defect Group, n = 12, 23.5%). In Aorta and Ventricular Septal Defect Groups, the occurrence of the waves was associated with lower blood pressures, dP/dTmax, cardiac cycle efficiency, ScO2, SrO2, Vm, worse electroencephalogram background abnormalities, higher number of electroencephalogram sharp waves, and serum lactate (Ps <0.0001–0.07), and were accompanied with fluctuations of ScO2 and SrO2 in 80.6% and 69.6% of patients, respectively.
Conclusions:
The waves observed in children following cardiovascular surgery are the slowest ever reported, occurring most frequently in patients with aortic arch abnormalities or ventricular septal defect. While the occurrence of the waves was associated with statistically worse and fluctuated ScO2 and SrO2, worse systemic haemodynamics, and electroencephalogram abnormalities, at present these waves have no known clinical relevance.
Collision of two counterflowing gravity currents of equal densities and heights was investigated by means of three-dimensional high-resolution simulations with the goal of understanding the flow structures and energetics in the collision region in more detail. The lifetime of collision is approximately $3 \tilde {H}/\tilde {u}_f$, where $\tilde {H}$ is the depth of heavy and ambient fluids, and $\tilde {u}_f$ is the front velocity of the approaching gravity currents, and the lifetime of collision can be divided into three phases. During Phase I, $-0.2 \leqslant (\tilde {t}-\tilde {t}_c) \tilde {u}_f/\tilde {H} \leqslant 0.5$, where $\tilde {t}$ is the time, and $\tilde {t}_c$ is the time instance at which the two colliding gravity currents have fully osculated, geometric distortions of the gravity current fronts result in stretching of pre-existing vorticity in the wall-normal direction inside the fronts, and an array of vertical vortices extending throughout the updraught fluid column develop along the interface separating the two colliding gravity currents. The array of vertical vortices is responsible for the mixing between the heavy fluids of the two colliding gravity currents and for the production of turbulent kinetic energy in the collision region. The presence of the top boundary deflects the updraughts into the horizontal direction, and a number of horizontal streamwise vortices are generated close to the top boundary. During Phase II, $0.5 \leqslant (\tilde {t}-\tilde {t}_c) \tilde {u}_f/\tilde {H} \leqslant 1.2$, the horizontal streamwise vortices close to the top boundary induce turbulent buoyancy flux and break up into smaller structures. While the production of turbulent kinetic energy weakens, the rate of transfer of energy to turbulent flow due to turbulent buoyancy flux reaches its maximum and becomes the primary supply in the turbulent kinetic energy in Phase II. During Phase III, $1.2 \leqslant (\tilde {t}-\tilde {t}_c) \tilde {u}_f/\tilde {H} \leqslant 2.8$, the collided fluid slumps away from the collision region, while the production of turbulent kinetic energy, turbulent buoyancy flux and dissipation of energy attenuate. From the point of view of energetics, the production of turbulent kinetic energy and turbulent buoyancy flux transfers energy away from the mean flow to the turbulent flow during the collision. Our study complements previous experimental investigations on the collision of gravity currents in that the flow structures, spatial distribution and temporal evolution of the mean flow and turbulent flow characteristics in the collision region are presented clearly. It is our understanding that such complete information on the energy budgets in the collision region can be difficult to attain in laboratory experiments.
Coastal eutrophication and hypoxia remain a persistent environmental crisis despite the great efforts to reduce nutrient loading and mitigate associated environmental damages. Symptoms of this crisis have appeared to spread rapidly, reaching developing countries in Asia with emergences in Southern America and Africa. The pace of changes and the underlying drivers remain not so clear. To address the gap, we review the up-to-date status and mechanisms of eutrophication and hypoxia in global coastal oceans, upon which we examine the trajectories of changes over the 40 years or longer in six model coastal systems with varying socio-economic development statuses and different levels and histories of eutrophication. Although these coastal systems share common features of eutrophication, site-specific characteristics are also substantial, depending on the regional environmental setting and level of social-economic development along with policy implementation and management. Nevertheless, ecosystem recovery generally needs greater reduction in pressures compared to that initiated degradation and becomes less feasible to achieve past norms with a longer time anthropogenic pressures on the ecosystems. While the qualitative causality between drivers and consequences is well established, quantitative attribution of these drivers to eutrophication and hypoxia remains difficult especially when we consider the social economic drivers because the changes in coastal ecosystems are subject to multiple influences and the cause–effect relationship is often non-linear. Such relationships are further complicated by climate changes that have been accelerating over the past few decades. The knowledge gaps that limit our quantitative and mechanistic understanding of the human-coastal ocean nexus are identified, which is essential for science-based policy making. Recognizing lessons from past management practices, we advocate for a better, more efficient indexing system of coastal eutrophication and an advanced regional earth system modeling framework with optimal modules of human dimensions to facilitate the development and evaluation of effective policy and restoration actions.
Although maternal mental illnesses have been found to influence child health and development, little is known about the impact of maternal positive well-being on child health and development. Therefore, this longitudinal study investigated the effects of prenatal subjective well-being on birth outcomes and child development by considering the potential modifier effect of parity.
Methods
Pregnant women in early stages of pregnancy were recruited at five selected hospitals in Taipei, Taiwan, during their prenatal appointments since 2011. Self-reported evaluations were conducted at seven time points up to 2 years postpartum. Linear regression and generalized estimating equation models were used for examination.
Results
Higher prenatal eudaimonic well-being was associated with longer gestational length (adjusted beta [aβ] = 0.36, 95% confidence interval [CI] = 0.03, 0.68) and higher birth weight (aβ = 124.71, 95% CI = 35.75, 213.66). Higher positive and negative affect were associated with longer gestational length (aβ = 0.38, 95% CI = 0.06, 0.70) and smaller birth weight (aβ = −93.51, 95% CI = −178.35, −8.67), respectively. For child’s outcomes, we found an association between higher prenatal eudaimonic well-being and decreased risks of suspected developmental delay, particularly for children of multiparous mothers (adjusted odds ratio = 0.18, 95% CI = 0.05, 0.70). Higher levels of prenatal depression and anxiety were significantly associated with increased risks of suspected developmental delay for children of primiparous mothers.
Conclusions
Positive prenatal maternal mental health may benefit birth outcomes and child development, particularly for children of multiparous mothers. Interventions for improving prenatal mental health may be beneficial for child development.
COVID-19 has long-term impacts on public mental health, while few research studies incorporate multidimensional methods to thoroughly characterise the psychological profile of general population and little detailed guidance exists for mental health management during the pandemic. This research aims to capture long-term psychological profile of general population following COVID-19 by integrating trajectory modelling approaches, latent trajectory pattern identification and network analyses.
Methods
Longitudinal data were collected from a nationwide sample of 18 804 adults in 12 months after COVID-19 outbreak in China. Patient Health Questionnaire-9, Generalised Anxiety Disorder-7 and Insomnia Severity Index were used to measure depression, anxiety and insomnia, respectively. The unconditional and conditional latent growth curve models were fitted to investigate trajectories and long-term predictors for psychological symptoms. We employed latent growth mixture model to identify the major psychological symptom trajectory patterns, and ran sparse Gaussian graphical models with graphical lasso to explore the evolution of psychopathological network.
Results
At 12 months after COVID-19 outbreak, psychological symptoms generally alleviated, and five psychological symptom trajectories with different demographics were identified: normal stable (63.4%), mild stable (15.3%), mild-increase to decrease (11.7%), mild-decrease to increase (4.0%) and moderate/severe stable (5.5%). The finding indicated that there were still about 5% individuals showing consistently severe distress and approximately 16% following fluctuating psychological trajectories, who should be continuously monitored. For individuals with persistently severe trajectories and those with fluctuating trajectories, central or bridge symptoms in the network were mainly ‘motor abnormality’ and ‘sad mood’, respectively. Compared with initial peak and late COVID-19 phase, aftermath of initial peak might be a psychologically vulnerable period with highest network connectivity. The central and bridge symptoms for aftermath of initial peak (‘appetite change’ and ‘trouble of relaxing’) were totally different from those at other pandemic phases (‘sad mood’).
Conclusions
This research identified the overall growing trend, long-term predictors, trajectory classes and evolutionary pattern of psychopathological network of psychological symptoms in 12 months after COVID-19 outbreak. It provides a multidimensional long-term psychological profile of the general population after COVID-19 outbreak, and accentuates the essentiality of continuous psychological monitoring, as well as population- and time-specific psychological management after COVID-19. We believe our findings can offer reference for long-term psychological management after pandemics.
Edited by
Chu-Ren Huang, The Hong Kong Polytechnic University,Yen-Hwei Lin, Michigan State University,I-Hsuan Chen, University of California, Berkeley,Yu-Yin Hsu, The Hong Kong Polytechnic University
Edited by
Chu-Ren Huang, The Hong Kong Polytechnic University,Yen-Hwei Lin, Michigan State University,I-Hsuan Chen, University of California, Berkeley,Yu-Yin Hsu, The Hong Kong Polytechnic University
Edited by
Chu-Ren Huang, The Hong Kong Polytechnic University,Yen-Hwei Lin, Michigan State University,I-Hsuan Chen, University of California, Berkeley,Yu-Yin Hsu, The Hong Kong Polytechnic University
from
29
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An Interactive Perspective on Topic Constructions in Mandarin
Edited by
Chu-Ren Huang, The Hong Kong Polytechnic University,Yen-Hwei Lin, Michigan State University,I-Hsuan Chen, University of California, Berkeley,Yu-Yin Hsu, The Hong Kong Polytechnic University
Edited by
Chu-Ren Huang, The Hong Kong Polytechnic University,Yen-Hwei Lin, Michigan State University,I-Hsuan Chen, University of California, Berkeley,Yu-Yin Hsu, The Hong Kong Polytechnic University
Edited by
Chu-Ren Huang, The Hong Kong Polytechnic University,Yen-Hwei Lin, Michigan State University,I-Hsuan Chen, University of California, Berkeley,Yu-Yin Hsu, The Hong Kong Polytechnic University
Edited by
Chu-Ren Huang, The Hong Kong Polytechnic University,Yen-Hwei Lin, Michigan State University,I-Hsuan Chen, University of California, Berkeley,Yu-Yin Hsu, The Hong Kong Polytechnic University
Edited by
Chu-Ren Huang, The Hong Kong Polytechnic University,Yen-Hwei Lin, Michigan State University,I-Hsuan Chen, University of California, Berkeley,Yu-Yin Hsu, The Hong Kong Polytechnic University
Edited by
Chu-Ren Huang, The Hong Kong Polytechnic University,Yen-Hwei Lin, Michigan State University,I-Hsuan Chen, University of California, Berkeley,Yu-Yin Hsu, The Hong Kong Polytechnic University
from
29
-
An Interactive Perspective on Topic Constructions in Mandarin
Edited by
Chu-Ren Huang, The Hong Kong Polytechnic University,Yen-Hwei Lin, Michigan State University,I-Hsuan Chen, University of California, Berkeley,Yu-Yin Hsu, The Hong Kong Polytechnic University
Edited by
Chu-Ren Huang, The Hong Kong Polytechnic University,Yen-Hwei Lin, Michigan State University,I-Hsuan Chen, University of California, Berkeley,Yu-Yin Hsu, The Hong Kong Polytechnic University