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tDCS application to the DLPFC is associated with the improvements of executive function, memory enhancement, language, processing speed, global cognitive symptoms and apathy over time after treatment. DLB is the second most common form of degenerative dementia. There is no FDA-approved medications that can slow, stop or improve the progression of cognitive declines in DLB. Identifying effective treatments is a critical issue for DLB. In neuropathology, extracelluar α-syn oligomers interfere with the expression of long-term potentiation(LTP), and influence memory and learning. tDCS has been proposed to affect long-term synaptic plasticity through LTP and long-term depression, thereby improving cognitive ability. So far, only two studies have evaluated the effect of tDCS in DLB. In this pilot study, we investigate the effect of tDCS on left DLPFC in DLB.
Method:
Fourteen DLB aged 55-90 years (mean age 76.4, with 4 males and 10 females) were included in a double-blind, randomized, sham-controlled cross over design study. DLB diagnostics is according to DSM-5 criteria. CDR ratings for DLB participants ranged from 0.5 to 2. The active tDCS (or sham) process consists of daily sessions of active tDCS (or sham) for 10 consecutive days. The anodal electrode was placed over the left DLPFC and the cathodal electrode was placed over the right supraorbital area, with a current intensity of 2 mA and an electrode size of 25 cm2 for 30 min in a session. Before and after these treatment sessions, all subjects received a series of neuropsychological tests, including CDR, MMSE, CASI, NPI and WCST. Chi-square test, Wilcoxon signed ranks test and Mann-Whitney U test were used to assess differences in participant demographic characteristics and to compare differences among groups.
Results:
The active tDCS group showed significant improvements on the three items of CASI, ‘language ability’, ‘concentration and calculation’, ‘categorical verbal fluency’, after active stimulations. There is no improvement in MMSE, CASI, NPI and WCST scores in the sham groups.
Conclusion:
These results suggest that left DLPFC anodal, and right deltoid cathodal tDCS, may have some cognitive benefits in DLB. Larger-scale trials are needed to confirm the effect of tDCS in DLB.
Key words: Transcranial Direct Current Stimulation, Dementia with Lewy Bodies, cognitive function, Wisconsin Card Sorting Test, left DLPFC
Transcranial direct current stimulation (tDCS) has been proposed to affect long-term synaptic plasticity through LTP and LTD, thereby improving cognitive ability. In pathology, the amyloid deposits in AD disrupts the balance between long-term potentiation (LTP) and long-term depression (LTD) of neuronal cells and synaptic plasticity. An increasing number of studies have been concluded a positive therapeutic effect on cognition in AD. In brain stimulation, dorsolateral prefrontal cortex (DLPFC) was associated with improvements in memory enhancement, language, processing speed, global cognitive symptoms, and apathy over a period of treatment. Theoretically, the aftereffect of tDCS would need to be re-stimulated by tDCS to maintain its delayed plastic response benefits. In this pilot study, we investigate the maintenance effects of continuing tDCS at three different times, weekly, every two weeks, and every four weeks, for 12 weeks.
Method:
Twenty-eight AD participants aged 55-90 years were enrolled (mean age 72.7, 77.3, and 76.2 in the three groups - maintained weekly (7 cases), biweekly (9 cases) and every 4 weeks (12 cases)). The anodal electrode was placed over the left dorsal lateral prefrontal cortex and the cathodal electrode was placed over the right supraorbital area. In each active session, we applied a current intensity of 2 mA and an electrode size of 25 cm2 for 30 min. All subjects received a series of neuropsychological assessments including CDR, MMSE, CASI and WCST at (1) baseline, (2) post-10sessions of tDCS (in 2weeks), and (3) post-maintenance phase (total of 12 weeks). Chi-square tests, Wilcoxon signed rank tests and Mann-Whitney U tests were used to assess differences in participant demographic characteristics and to compare differences in test scores between groups.
Results:
After 10 sessions of tDCS stimulations, the total CASI scores in the 1-week group improved significantly from baseline to 2 weeks. However, there are no significant difference in MMSE, CASI or WCST between baseline and after maintain phase stimulations in each group.
Conclusion:
Although tDCS has a positive effect in AD, it is recommended to prolong the number of tDCS stimulations, such as 20 sessions in 4 weeks.
In this study, a novel, cost-effective miniaturized tag antenna was developed for applications on the human body. To achieve impedance matching with the complex conjugate impedance of the Monza-4 tag chip (7.17–j74.22 Ω at 915 MHz), the proposed structure was configured by coarsely tuning the positions of vias and fine-tuning the small gaps of its coupled patches. For further reducing the profile and dimensions of the antenna, a design technique based on the three-dimensional dipole antenna current distribution was used. The proposed antenna configuration was not only miniaturized but also achieved a long stable reading distance (>5.0 m) and a wide impedance bandwidth of 71 MHz or 7.65% (covering the ultrahigh frequency radio frequency identification ranges in most regions), regardless of the location of the tag on the human body. Experiments were conducted to validate the simulated results, and adequate agreement was found between the simulated results and the measured results.
Urinary Na excretion is a potential risk factor for CVD. However, the underlying biological mechanisms and effects of salt sensitivity are unclear. The purpose of this study was to characterise the relative contribution of biological factors to the Na–CVD association. A total of 2112 participants were enrolled in this study. Structured questionnaires and blood and urine samples were obtained. Twenty-four-hour Na excretion was estimated using a single overnight urine sample. Hypertension, the metabolic syndrome and overweight status were considered to indicate salt sensitivity. Cox proportional hazard models were used to investigate the effects of salt sensitivity on urinary Na excretion and CVD risk. The traditional mediation approach was used to calculate the proportion of mediation. The mean age (sd) of the 2112 participants was 54·5 (sd 12·2) years, and they were followed up for a mean of 14·1 (sd 8·1) years. Compared with those in the lowest quartile, the highest baseline urinary Na excretion (>4·2 g/24 h) was associated with a 43 % higher CVD risk (hazard ratio, 1·43; 95 % CI 1·02, 1·99). Participants with high urinary Na excretion, hypertension or the metabolic syndrome had a significantly high risk of CVD. The carotid intima-media thickness had the largest mediating effect (accounting for 35 % of the Na–CVD association), followed by systolic blood pressure (BP) (33 %), left ventricular mass (28 %) and diastolic BP (14 %). Higher urinary Na excretion increased the risk of CVD, which was explained largely by carotid media-thickness and systolic BP.
Lysosomes are integration hubs for several signaling pathways, such as autophagy and endocytosis, and also crucial stores of ions, including Zn2+. Lysosomal dysfunction caused by changes in their morphology by fusion and fission processes can result in several pathological disorders. However, the role of Zn2+ in modulating the morphology of lysosomes is unclear. The resolution of conventional epifluorescence microscopy restricts accurate observation of morphological changes of subcellular fluorescence punctum. In this study, we used a modified epifluorescence microscopy to identify the center of a punctum from a series of z-stack images and calculate the morphological changes. We stained primary cultured rat embryonic cortical neurons with FluoZin3, a Zn2+-sensitive fluorescent dye, and Lysotracker, a lysosome-specific marker, to visualize the distribution of Zn2+-enriched vesicles and lysosomes, respectively. Our results revealed that treating neurons with N,N,N′,N′-tetrakis(2-pyridylmethyl)ethylenediamine, a cell-permeable Zn2+ chelator, shrank Zn2+-enriched vesicles and lysosomes by up to 25% in an hour. Pretreating the neurons with YM201636, a blocker of lysosome fission, could suppress this shrinkage. These results demonstrate the usefulness of the modified epifluorescence microscopy for investigating the homeostasis of intracellular organelles and related disorders.
Childbirth may pose many challenges to the psychological well-being of marriage-based immigrant mothers in interracial marriages, who must negotiate bi-dimensional acculturation – adaptation to the host culture and maintenance of her own heritage culture. We examined the temporal relationships between bi-dimensional acculturation and depressive symptoms from pregnancy to 1 year postpartum among marriage-based immigrant mothers in Taiwan using the cross-lagged structural equation modeling.
Methods
This study recruited 310 immigrant mothers, who were examined in the second and third trimesters, and again at 1 month, 3 months, 6 months, and 1 year postpartum from March 2013 to December 2015. Depressive symptoms and bi-dimensional acculturation were measured using the Edinburgh Postnatal Depression Scale and Bidimensional Acculturation Scale for Marriage-Based Immigrant Women, respectively.
Results
The study found that adaptation to the host culture followed a downward linear trajectory, while maintenance of the mother's own heritage culture followed an upward linear trajectory from pregnancy to 1 year postpartum. All but one cross-lagged path between bi-dimensional acculturation and depressive symptoms was statistically insignificant, though almost all cross-sectional associations were significant. Adaptation to host culture was negatively associated with depressive symptoms at all time points. The association between maintenance of heritage culture and depressive symptoms reversed from positive to negative after 6 months postpartum.
Conclusions
Adaptation to the host culture and maintenance of the mother's heritage culture differed in their associations with maternal depressive symptoms. Health professionals should assist immigrant mothers in adapting to the host culture while supporting their heritage culture in the childbearing period.
We conduct numerical simulations to investigate the formation and evolution of drops and vortex rings of particle-laden fingers in double-diffusive convection in stably stratified environments. We show that the temporal evolution can be divided into double diffusion, acceleration and deceleration phases. The acceleration phase is a result of the vanishing temperature perturbation in the drop during the descent in the layer of uniform temperature. The drop decelerates because it transforms into a vortex ring. A theoretical drag model is presented to predict the speed of the spherical drop with the low drop Reynolds number. By formulating the boundary condition based on the vorticity, our drag model gives a more general form of the drag coefficient for small spherical drops and shows good agreement in predicting the drag coefficient. Drops with five particle sizes are compared, and it is found that although the greater vertical settling enhances vertical transport, the final state differs little among the various sizes. Comparison of our drag model with the simulation results under various bulk conditions and previous experimental results shows good model predictability. Finally, a comparison with the salt-finger case shows that the diffusive nature of the dissolved scalar field, along with the wake effect, can result in an apparent loss of mass from the drop and a permanent presence of the connection between the drop and its parent finger. This makes the observed detachment of the particle-laden drop much less likely in the salt-finger case.
Information systems (IS) have facilitated workflow in the health care system for years. However, the utilization of IS in disaster medical assistance teams (DMATs) has been less studied.
Aim:
In Taiwan, we started a program in 2008 to build up an information system, MEDical Assistance and Information Dashboard (MED-AID), to improve the capability and increase the efficiency of our national DMAT.
Method: The mission of our national DMAT was to provide acute trauma care and subacute outpatient care in the field after an emergency event (e.g., earthquakes). We built the IS through a user-oriented process to fit the need of the DMAT. We first analyzed the response work in the DMAT missions and reviewed the current paperwork. We evaluated the eligibility and effectiveness of the core functions of DMATs by experts in Taiwan and then developed the IS. The IS was then tested and revised each year in two table-top exercises and one regional full-scale exercise by the DMAT staffs who came from different hospitals in Taiwan.
Results:
During the past 10 years, we identified several core concepts of IS of DMAT: patient tracking, medical record, continuity of care, integration of referral resources, disease surveillance, patient information reporting, and medical resources management. The application of the IS facilitate the DMAT in providing safe patient care with continuous recording and integrate patient referral resources based on geographic information. The IS also help the planning in real-time disease surveillance and logistic function in the medical resources monitoring.
Discussion:
Information systems could facilitate patient care and relieve the workload on information analysis and resources management for DMATs.
The purpose of this study was to investigate the effects of 8-week green tea extract (GTE) supplementation on promoting postexercise muscle glycogen resynthesis and systemic energy substrate utilisation in young college students. A total of eight healthy male participants (age: 22·0 (se 1·0) years, BMI: 24·2 (se 0·7) kg/m2, VO2max: 43·2 (se 2·4) ml/kg per min) participated in this study. GTE (500 mg/d for 8 weeks) was compared with placebo in participants in a double-blind/placebo-controlled and crossover study design with an 8-week washout period. Thereafter, all participants performed a 60-min cycling exercise (75 % VO2max) and consumed a carbohydrate-enriched meal immediately after exercise. Vastus lateralis muscle samples were collected immediately (0 h) and 3 h after exercise, and blood and gaseous samples were collected during the 3-h postexercise recovery period. An 8-week oral GTE supplementation had no effects on further promoting muscle glycogen resynthesis in exercised human skeletal muscle, but the exercise-induced muscle GLUT type 4 (GLUT4) protein content was greater in the GTE supplementation trial (P<0·05). We observed that, during the postexercise recovery period, GTE supplementation elicited an increase in energy reliance on fat oxidation compared with the placebo trial (P<0·05), although there were no differences in blood glucose and insulin responses between the two trials. In summary, 8-week oral GTE supplementation increases postexercise systemic fat oxidation and exercise-induced muscle GLUT4 protein content in response to an acute bout of endurance exercise. However, GTE supplementation has no further benefit on promoting muscle glycogen resynthesis during the postexercise period.
A new ultra-high frequency radio frequency identification (RFID) tag antenna, which is comprised a U-shaped tuning stub and a dipole radiator for different permittivity surfaces is investigated, fabricated, and measured. For a conjugate match to the NXP G2XM chip impedance of 29–j137 at 915 MHz, a dipole tag antenna with U-shaped stubconnected to dipole arms was designed. Simple size adjustments of the U-shaped tuning stub and dipole radiator of the antenna allow for easy control of the antenna resistance and inductive reactance, from which the chip impedance requirement may be readily satisfied. The read range of the prototype antenna attached on a different permittivity surfaces (εr = 1–4) can reach more than 4.5 m, which has been tested for an RFID reader with 4.0 W of effective isotropic radiated power. The antenna structure consists of two dipole load bars and two loop electrically connected. The design offers more choice of freedom to tune the input impedance of the proposed antenna. Measurement data are presented which are in good agreement with simulation results. The design is suitable for mounting on all kinds of objects. The fabricated tag sensitivity of −3 dBm, read range of 7 m on the x–z and y–z planes, and the measured orientation radiation patterns were obtained in the desired frequency band.
Business groups not only help affiliates circumvent market imperfections, but they also have great influence on the economic development of emerging markets. This study applies three ways to clarify the influence of business-group effects on affiliate performance. First, this study finds that the business group can explain a respectable portion of the variations in affiliate performance. Second, this study examines the impact of family ownership, resource abundance, and resource dispersion on affiliate performance and finds that group size and financial resources positively affect affiliate performance, while family ownership and group diversification do not have a significant effect on affiliate performance. Finally, the magnitude of business-group effects is subject to the ownership and resources of each business group. Family groups, large groups, and highly diversified groups have smaller business-group effects, while groups with high financial resources have greater business-group effects, indicating that business-group effects are heterogeneous and dependent on different group features. This study provides support to the resource-based and the institution-based views of business groups.
Three types of Ganium Nitride (GaN) transistors were studied in this work. The devices were fabricated and exhibited unique characteristics over on-state current and off-state blocking performances. We also compared the performance differences of devices fabricated by multiepitaxial GaN/AlGaN layers on different substrates (Sapphire and Si) and evaluated the correlations among starting substrate, device variation, and manufacturing uniformity. The first device is a normally-on device with Sapphire substrate which shows good drain saturation current (Idsat) and breakdown characteristics, but the gate leakage current is quite large. The second device is a normally-off GaN transistor named metal-insulate-semiconductor (MIS) heterojunction field-effect transistor (MIS-HFET) which exhibits good performance with threshold voltage (Vth) of 3V and breakdown voltage (Vbd) of over 1800V. However the third device is a normally-off GaN metal-oxide-semiconductor field-elect transistor (MOSFET) structure which is rather difficult to exhibit good blocking characteristic due to inadequate doping process control of the reduce-surface-field (RESURF) region.
Polyaniline nanofiber (PANF) was synthesized using interfacial polymerization and was mixed with aqueous solution of poly(vinyl alcohol) (PVA) to form PANF–PVA binaries. The PANF suspension in water could be stabilized by PVA for more than 3 months due to the hydrogen bonding interaction between PANF and PVA. The specific characteristics of PANF–PVA films was checked by scanning electron microscopy, conductivity measurement, thermogravimetric analysis, Fourier transform infrared spectroscopy, and cyclic voltammetry. The composite film contained 25 wt% PVA (PANF–PVA25) casting at 105 °C was found to have a porous structure and good conductivity. The presence of hydrogen bonding interaction between PANF and PVA improves the electroactivity and electroactive stability of PANF–PVA25 for electrochemical applications. However, an ether linkage between PANF and PVA polymer chain was also found as casting the PANF–PVA film at 200 °C, which is unfavorable for electrochemical applications.