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Significant changes in Taiwan’s psychiatric services over recent decades include expansion of community-based clinics and implementation of the Schizophrenia Pay-for-Performance programme.
Aims
This study aimed to assess the trend of the quality of healthcare for individuals with schizophrenia, using various indicators of the treatment process and outcomes between 2010 and 2019.
Method
Individuals with schizophrenia were identified using Taiwan’s National Health Insurance claims database. The quality of healthcare for individuals with schizophrenia was assessed using treatment process and outcome indicators, including antipsychotic types, medication adherence, daily dose for antipsychotics and concurrent use of other psychotropic agents. Outcome indicators included all-cause mortality, suicide deaths, psychiatric hospitalisation, emergency department visits and employment status.
Results
Antipsychotic medication usage has shifted towards second-generation antipsychotics (SGAs) and long-acting injectable antipsychotics (LAIs), with declines in first-generation antipsychotics. The percentage of medication adherence declined, while that of individuals with an adequate daily dose increased. Concurrently, anticholinergic and benzodiazepine use decreased while antidepressant and mood stabiliser use increased. Outcome indicators showed no significant change in all-cause mortality or suicide rates over time, but there were reductions in psychiatric hospitalisations and emergency department visits. Employment rates increased overall, particularly in urban areas.
Conclusions
The quality of healthcare for individuals with schizophrenia, as measured by treatment process and outcome indicators, improved alongside changes in Taiwan’s psychiatric services; however, causality cannot be inferred from our findings. Future research should evaluate the effectiveness of psychiatric service policies and continuously monitor healthcare quality to further enhance the lives of individuals with schizophrenia.
An experimental study of the equation of state for metallic powders under impact loading was carried out at a high-energy laser facility. A laser-ablatable micro-target was obtained to satisfy the laser equation of state for experimental study, and the precise characterization of the initial density was realized. The technique boosts the pressure of copper powder to 1400 GPa. The data consistency can effectively distinguish the data trends under different initial densities (~4.05 and 4.50 g/cm3). Experimental data can effectively distinguish the differences between the high-pressure Thomas–Fermi model and the Thomas–Fermi–Kirzhnits model, providing strong support for the WEOS-Pα model of the Institute of Applied Physics and Computational Mathematics, which is more in line with the actual state description of the material. This experimental technique can be extended to study the high-pressure physical properties of other powder particles.
Perimenopausal women often experience physiological and psychological decline due to the effects of oestrogen fluctuations and the decline of ovarian function, leading to significantly increased depression rates, decreases in the quality of life and mental health issues. Studies have shown that the gut microbiota exerts anti-perimenopausal depression (PMD) effects via the microbiota-gut-brain (MGB) axis, the mechanisms of which may be related to inflammation. In this review, we discuss the effects and mechanisms of gut microbiota in PMD and provide new insights for future PMD treatment.
Methods
This review elaborates on the role of MGB axis in PMD from different aspects of inflammation, including gut microbiota metabolites, inflammatory signaling pathways, and clinical applications.
Results
Disorders of gut microbiota and decreased levels of gut microbiota metabolites (short-chain fatty acids, monoamine neurotransmitters) may cause PMD. The mechanism of intestinal microbiota-mediated inflammation may be related to TLR4/NF-κB pathway, NOD-like receptor protein 3 (NLRP3) inflammasome pathway and JAK-STAT pathway. At the same time, it was found that gut microbiota (probiotics, prebiotics, etc.) had good therapeutic potential in the treatment of PMD.
Conclusions
MGB axis mediated inflammation may play an important role in PMD. The application of gut microbiota in the treatment of PMD patients has profound clinical transformation value, but a lot of efforts are still needed.
Accurately predicting neurosyphilis prior to a lumbar puncture (LP) is critical for the prompt management of neurosyphilis. However, a valid and reliable model for this purpose is still lacking. This study aimed to develop a nomogram for the accurate identification of neurosyphilis in patients with syphilis. The training cohort included 9,504 syphilis patients who underwent initial neurosyphilis evaluation between 2009 and 2020, while the validation cohort comprised 526 patients whose data were prospectively collected from January 2021 to September 2021. Neurosyphilis was observed in 35.8% (3,400/9,504) of the training cohort and 37.6% (198/526) of the validation cohort. The nomogram incorporated factors such as age, male gender, neurological and psychiatric symptoms, serum RPR, a mucous plaque of the larynx and nose, a history of other STD infections, and co-diabetes. The model exhibited good performance with concordance indexes of 0.84 (95% CI, 0.83–0.85) and 0.82 (95% CI, 0.78–0.86) in the training and validation cohorts, respectively, along with well-fitted calibration curves. This study developed a precise nomogram to predict neurosyphilis risk in syphilis patients, with potential implications for early detection prior to an LP.
In preparation for an experiment with a laser-generated intense proton beam at the Laser Fusion Research Center at Mianyang to investigate the 11B(p,α)2α reaction, we performed a measurement at very low proton energy between 140 keV and 172 keV using the high-voltage platform at the Institute of Modern Physics, Lanzhou. The aim of the experiment was to test the ability to use CR-39 track detectors for cross-section measurements and to remeasure the cross-section of this reaction close to the first resonance using the thick target approach. We obtained the cross-section σ = 45.6 ± 12.5 mb near 156 keV. Our result confirms the feasibility of CR-39 type track detector for nuclear reaction measurement also in low-energy regions.
Genetic approaches are increasingly advantageous in characterizing treatment-resistant schizophrenia (TRS). We aimed to identify TRS-associated functional brain proteins, providing a potential pathway for improving psychiatric classification and developing better-tailored therapeutic targets.
Methods
TRS-related proteome-wide association studies (PWAS) were conducted on genome-wide association studies (GWAS) from CLOZUK and the Psychiatric Genomics Consortium (PGC), which provided TRS individuals (n = 10,501) and non-TRS individuals (n = 20,325), respectively. The reference datasets for the human brain proteome were obtained from ROS/MAP and Banner, with 8,356 and 11,518 proteins collected, respectively. We then performed colocalization analysis and functional enrichment analysis to further explore the biological functions of the proteins identified by PWAS.
Results
In PWAS, two statistically significant proteins were identified using the ROS/MAP and then replicated using the Banner reference dataset, including CPT2 (PPWAS-ROS/MAP = 4.15 × 10−2 and PPWAS-Banner = 3.38 × 10−3) and APOL2 (PPWAS-ROS/MAP = 4.49 × 10−3 and PPWAS-Banner = 8.26 × 10−3). Colocalization analysis identified three variants that were causally related to protein expression in the human brain, including CCDC91 (PP4 = 0.981), PRDX1 (PP4 = 0.894), and WARS2 (PP4 = 0.757). We extended PWAS results from gene-based analysis to pathway-based analysis, identifying 14 gene ontology (GO) terms and the only candidate pathway for TRS, metabolic pathways (all P < 0.05).
Conclusions
Our results identified two protein biomarkers, and cautiously support that the pathological mechanism of TRS is linked to lipid oxidation and inflammation, where mitochondria-related functions may play a role.
The aim of this study was to assess the current status of disease-related knowledge and to analyze the relationship among the general condition, illness perception, and psychological status of patients with coronavirus disease 2019 (COVID-19).
Methods:
A hospital-based cross-sectional study was conducted on 118 patients using convenience sampling. The general questionnaire, disease-related knowledge questionnaire of COVID-19, Illness Perception Questionnaire (IPQ), and Profile of Mood States (POMS) were used to measure the current status of participants.
Results:
The overall average score of the disease-related knowledge of patients with COVID-19 was (79.19 ± 14.25), the self-care situation was positively correlated with knowledge of prevention and control (r = 0.265; P = 0.004) and total score of disease-related knowledge (r = 0.206; P = 0.025); the degree of anxiety was negatively correlated with the knowledge of diagnosis and treatment (r = −0.182; P = 0.049). The score of disease-related knowledge was negatively correlated with negative cognition (volatility, consequences, emotional statements) and negative emotions (tension, fatigue, depression) (P < 0.05); positively correlated with positive cognition (disease coherence) and positive emotion (self-esteem) (P < 0.05).
Conclusions:
It was recommended that we should pay more attention to the elderly and low-income groups, and increase the knowledge about diagnosis and treatment of COVID-19 and self-care in the future health education for patients.
Maternal supraphysiological estradiol (E2) environment during pregnancy leads to adverse perinatal outcomes. However, the influence of oocyte exposure to high E2 levels on perinatal outcomes remains unknown. Thus, a retrospective cohort study was conducted to explore the effect of high E2 level induced by controlled ovarian stimulation (COH) on further outcomes after frozen embryo transfer (FET). The study included all FET cycles (n = 10,581) between 2014 and 2017. All cycles were categorized into three groups according to the E2 level on the day of the human Chorionic Gonadotropin trigger. Odds ratios (ORs) and their confidence intervals (CIs) were calculated to evaluate the association between E2 level during COH and pregnancy outcomes and subsequent neonatal outcomes. From our findings, higher E2 level was associated with lower percentage of chemical pregnancy, clinical pregnancy, ongoing pregnancy, and live birth as well as increased frequency of early miscarriage. Preterm births were more common among singletons in women with higher E2 level during COH (aOR1 = 1.93, 95% CI: 1.22–3.06; aOR2 = 2.05, 95% CI: 1.33–3.06). Incidence of small for gestational age (SGA) was more common in both singletons (aOR1 = 2.01, 95% CI: 1.30–3.11; aOR2 = 2.51, 95% CI: 1.69–3.74) and multiples (aOR1 = 1.58, 95% CI: 1.03–2.45; aOR2 = 1.99, 95% CI: 1.05–3.84) among women with relatively higher E2 level. No association was found between high E2 level during COH and the percentage of macrosomia or large for gestational age. In summary, oocyte exposure to high E2 level during COH should be brought to our attention, since the pregnancy rate decreasing and the risk of preterm birth and SGA increasing following FET.
Wire-shaped supercapacitors (WSSCs) hold great promise in portable and wearable electronics. Herein, a novel kind of high-performance coaxial WSSCs has been demonstrated and realized by scrolling porous carbon dodecahedrons/Al foil film electrode on vertical FeOOH nanosheets wrapping carbon fiber tows (FeOOH NSs/CFTs) yarn electrode. Remarkably, ionogel is utilized as solid-state electrolyte and exhibits a high thermal/electrochemical stability, which effectively ensures the great reliability and high operating voltage of coaxial WSSCs. Benefiting from the intriguing configuration, the coaxial WSSCs with superior flexibility act as efficient energy storage devices and exhibit low resistance, high volumetric energy density (3.2 mW h/cm3), and strong durability (82% after 10,000 cycles). Importantly, the coaxial WSSCs can be effectively recharged by harvesting sustainable wind source and repeatedly supply power to the lamp without a decline of electrochemical performance. Considering the facile fabrication technology with an outstanding performance, this work has paved the way for the integration of sustainable energy harvesting and wearable energy storage units.
Maternal one-carbon metabolism during pregnancy is crucial for fetal development and programming by DNA methylation. However, evidence on one-carbon biomarkers other than folate is lacking. We, therefore, investigated whether maternal plasma methyl donors, that is, choline, betaine and methionine, are associated with birth outcomes. Blood samples were obtained from 115 women during gestation (median 26·3 weeks, 90 % range 22·7–33·0 weeks). Plasma choline, betaine, methionine and dimethylglycine were measured using HPLC-tandem MS. Multivariate linear and logistic regression models were used to estimate the association between plasma biomarkers and birth weight, birth length, the risk of small-for-gestational-age and large-for-gestational-age (LGA). Higher level of maternal betaine was associated with lower birth weight (–130·3 (95 % CI –244·8, –15·9) per 1 sd increment for log-transformed betaine). Higher maternal methionine was associated with lower risk of LGA, and adjusted OR, with 95 % CI for 1 sd increase in methionine concentration was 0·44 (95 % CI 0·21, 0·89). Stratified analyses according to infant sex or maternal plasma homocysteine status showed that reduction in birth weight in relation to maternal betaine was only limited to male infants or to who had higher maternal homocysteine status (≥5·1 µmol/l). Higher maternal betaine status was associated with reduced birth weight. Maternal methionine was inversely associated with LGA risk. These findings are needed to be replicated in future larger studies.
A “RE-free” and I-phase-containing Mg–8Sn-based alloy system was developed and successfully fabricated through the equal channel angular pressing (ECAP) process. The influence of the Zn/Al mass ratio on the microstructures and mechanical properties of the as-ECAPed Mg–8Sn–(5,6,7)Zn–2(wt%)Al alloys was investigated using an optical microscope, an X-ray diffractometer, a scanning electron microscope, a transmission electron microscope, and a universal testing machine. Grain size, dynamic recrystallization behavior, and texture were found to be greatly affected by the Zn/Al mass ratio. Furthermore, the ultimate tensile strength (250 MPa) and elongation (14.5%) of the alloy with a Zn/Al mass ratio of 3 were considerably increased compared to those of the as-ECAPed alloys with Zn/Al ratios of 2.5 and 3.5 (ultimate tensile strength and elongation of 215 MPa and 13% and 184 MPa and 10%, respectively). This significant enhancement was attributed to extensive grain boundary strengthening, precipitation strengthening, and higher work hardening capacity as well as texture randomization. The strength and ductility of the as-ECAPed alloys are also discussed in terms of the I-phase and Mg2Sn formation.
Stable isotopic analysis of carbon and nitrogen in human and faunal remains has been widely used to reconstruct prehistoric diets and environmental changes. Isotopic analysis of plant remains allows for a more extensive consideration of paleodiets and can potentially provide information about the environment in which the crops were grown. This paper reports the results of δ13C and δ15N analyses performed on modern and charred archaeological foxtail millet samples collected from the western part of the Chinese Loess Plateau. The δ13C mean value of modern samples is lower than that of ancient samples. There is a significant difference between grain and leaf δ15N values. These results challenge the standard assumption in isotope studies that the nitrogen isotope signals of the different part of plants consumed by humans and animals are the same. The 3–5‰ difference between human and animal δ15N values is always regarded as an indicator of whether human diets contained considerable animal protein. The difference between grain and leaf δ15N values makes this assumption problematic in a foxtail millet-dominated society.
The early Cambrian Period was a key interval in Earth history with regard to changes in both ocean chemistry and animal evolution. Although increasing ocean ventilation has been widely assumed to have played a key role in the rapid appearance, diversification and spatial colonization of early animals, this relationship is in fact not firmly established. Here, we report a high-resolution Fe-C-S-Al-Ti geochemical study of the lower Cambrian Wangjiaping section from an outer-shelf setting of the Yangtze Sea of South China. Iron speciation data document a redox transition from dominantly euxinic to ferruginous conditions during Cambrian Age 3 (c. 521–514 Ma). Interpretation of coexisting pyrite sulphur isotope (δ34Spy) records from Wangjiaping reveals relatively high marine sulphate availability at Wangjiaping. Furthermore, Wangjiaping section shows lower δ34Spy (‒2.1±5.3‰) and lower TOC (2.4±1.1%) values but higher positive correlation (R2 = 0.66, p < 0.01) between TOC and Fepy/FeHR relative to deeper sections reported previously, suggesting that euxinia developed at Wangjiaping in response to increasing marine productivity and organic matter-sinking fluxes. Our reconstructed redox conditions and fossils at Wangjiaping in comparison with previously well-studied strata in the inner-shelf Xiaotan and Shatan sections suggest that planktonic and benthic planktonic trilobites with bioturbation appeared in the oxic water columns, whereas only planktonic trilobites without bioturbation occurred within the anoxic (even euxinic) water columns during Cambrian Age 3. This finding indicates that spatial heterogeneity of redox conditions in the shelves had an important effect on early animal distribution in the Yangtze Block.
In this paper, we propose a fast proximity point algorithm and apply it to total variation (TV) based image restoration. The novel method is derived from the idea of establishing a general proximity point operator framework based on which new first-order schemes for total variation (TV) based image restoration have been proposed. Many current algorithms for TV-based image restoration, such as Chambolle’s projection algorithm, the split Bregman algorithm, the Bermúdez-Moreno algorithm, the Jia-Zhao denoising algorithm, and the fixed point algorithm, can be viewed as special cases of the new first-order schemes. Moreover, the convergence of the new algorithm has been analyzed at length. Finally, we make comparisons with the split Bregman algorithm which is one of the best algorithms for solving TV-based image restoration at present. Numerical experiments illustrate the efficiency of the proposed algorithms.
In this work, the relationship between the substrate crystallinity and the on-state resistances of silicon carbide (SiC) photoconductive semiconductor switches (PCSSs) was investigated. PCSSs with different channel lengths were fabricated on semi insulating 6H–SiC having different crystal qualities. A method was introduced for determining the photoconductive capacity of the SiC PCSSs. The experimental data suggest that the photoconductive capacity decreases sharply with the degradation of the full width at half maximum of the rocking curve of the 6H–SiC substrates. It is found that increasing the carrier mobility is a key factor for reducing the on-state resistance of the 6H–SiC PCSSs. Moreover, the results in this work present reference for the selection of 6H–SiC substrates for the fabrication of PCSSs and some other photoelectric devices.
This study reviews the results of the surgical management of 154 cases of ruptured aneurysm of the sinus of Valsalva. Of the patients0 73% were male, with an average age of 28 years. An associated ventricular septal defect was found in 40% and 23% had aortic valvar regurgitation. The aneurysms originated from the right coronary sinus in 79% and from the non-coronary sinus in the remainders. The aneurysms ruptured into the right ventricle in 73%, into the right atrium in 27% and into the left ventricle in less than 1%. Operative mortality was 4.5%. Long-term follow-up was achieved in 80% of patients, with a mean duration of 5.7 years and a range from two months to 29 years. Preoperative aortic regurgitation and preoperative functional class (NYHA III or IV) were both predictive of a worse long-term outcome. The optimal surgical approach was closure of the distal end of the fistula by direct suture together with reinforcement of the aortic sinus with a Dacron patch.
The Sanggan River is an alluvial river flowing through a graben basin system of the northern Shanxi Rift Zone, North China. During Pleistocene times, the river reach in the Datong Basin was affected successively by various external variables, such as invasion by basaltic flow, along-valley faulting and climatic change. Therefore, it provides excellent constraints for differentiating tectonically driven and climate-related fluvial incision in the context of tectonic subsidence. Based on equilibrium profile analysis, K–Ar dating of basalts (0.74–0.41 Ma), studies of the river terrace and of stream action history, we present a conceptual model for differentiating fault-driven and climate-related fluvial incision by the river. The results show that fluvial incision induced by tectonic lowering of the base-level due to along-valley movement on the Sanggan River fault is equal to fault displacement. The amount of post-basalt fluvial incision of the reach upstream from the lava dam is 23 to 25 m, of which the fault-driven and climate-related incisions are 15 m and 8 to 10 m, respectively, the former predominating over the latter. The total amount of incision in the lava dam reach is 40 to 47 m, of which the fault-driven and climate-related incisions are 10 m and 30–37 m, respectively; here the latter is predominant over the former. Since 0.41 ± 0.10 Ma, the rate of fluvial incision of the lava dam reach of the river has reached 98–115 m/Ma, which is 1.5–2 times as great as those of the reaches upstream and downstream from the lava dam. The higher rate of fluvial incision can be attributed to high water levels supplied by the onset and maintenance of backwater conditions in the reach upstream from the lava dam, due to the long period of warm and humid climate in this region. Plucking, abrasion and knickpoint migration appear to be the primary erosional processes in the lava dam reach.
Biomaterials such as DNA are currently being explored as potential application in nanotechnology. DNA templates were immobilized on crystal-violet-treated mica by spin coating as a grid-like network. The DNA templates were then activated with PdCl2, followed by reduction with dimethylamine borane (DMAB) to form seeding nanoclusters on the DNA chain. Afterward the DNA chain with deposition of zero-valence Pd nanoclusters was grew in a Co electroless plating bath. SEM/EDS analysis revealed that Co nanoparticles could be assembled on the DNA template to form magnetic nanowires with a diameter of 25nm to 250nm by a conventional electroless plating. Vibrating Sample Magnetometer analysis indicated that Co-DNA nanowires showed a paramagnetic characteristic. Grid-like networks of DNA template were effectively preserved after Co electroless plating. These characteristics indicated that DNA is an ideal template for the production of magnetic nanowires, which could be useful in the development of high-density memory storage or magnetic field sensors.
X-linked agammaglobulinemia (XLA) is caused by mutations in the Bruton's tyrosine kinase (Btk). The absence of functional Btk leads to failure of B-cell development that incapacitates antibody production in XLA patients leading to recurrent bacterial infections. Btk SH2 domain is essential for phospholipase C-γ phosphorylation, and mutations in this domain were shown to cause XLA. Recently, the B-cell linker protein (BLNK) was found to interact with the SH2 domain of Btk, and this association is required for the activation of phospholipase C-γ. However, the molecular basis for the interaction between the Btk SH2 domain and BLNK and the cause of XLA remain unclear. To understand the role of Btk in B-cell development, we have determined the stability and peptide binding affinity of the Btk SH2 domain. Our results indicate that both the structure and stability of Btk SH2 domain closely resemble with other SH2 domains, and it binds with phosphopeptides in the order pYEEI > pYDEP > pYMEM > pYLDL > pYIIP. We expressed the R288Q, R288W, L295P, R307G, R307T, Y334S, Y361C, L369F, and I370M mutants of the Btk SH2 domain identified from XLA patients and measured their binding affinity with the phosphopeptides. Our studies revealed that mutation of R288 and R307 located in the phosphotyrosine binding site resulted in a more than 200-fold decrease in the peptide binding compared to L295, Y334, Y361, L369, and I370 mutations in the pY + 3 hydrophobic binding pocket (∼3- to 17-folds). Furthermore, mutation of the Tyr residue at the βD5 position reverses the binding order of Btk SH2 domain to pYIIP > pYLDL > pYDEP > pYMEM > pYEEI. This altered binding behavior of mutant Btk SH2 domain likely leads to XLA.
Denote by A(x) = {a: |aτx| ≦ h} a circle zone on the three-dimensional sphere surface for each given h > 0. For a given integer m, we investigate how many zones chosen randomly are needed to contain at least one of the points on the sphere surface m times. As an application, the lifetime of a sphere roller is investigated. We present empirical formulas for the mean, standard deviation and distribution of the lifetime of the sphere roller. Furthermore, some limit behaviors of the above stopping time are obtained, such as the limit distribution, the law of the iterated logarithm, and the upper and lower bounds of the tail probability with the same convergent order.
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