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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
Cognitive impairment is a growing problem with increasing burden in ageing global population. Older adults with major depressive disorder (MDD) have higher risk of dementia during ageing. Neurofilament light chain (NfL) has been proven as a potential biomarker related to dementia. The present study aims to assess the cognitive deficits in older adults with MDD and investigate their association with peripheral blood levels of NfL.
Design:
We enrolled 39 individuals with MDD and 15 individuals with mild neurocognitive disorder or major neurocognitive disorder, Alzheimer’s type. Both groups were over age 65 and with restricted Mini-Mental State Examination (MMSE) score. Demographic data, clinical variables, and plasma NfL levels were obtained. We used cluster analysis according to their cognitive profile and estimated the correlation between plasma NfL levels and cognitive impairment in each domain.
Result:
In the MDD group, participants have higher rate of family psychiatry history and higher rate of current alcohol use habit compared with patients with neurocognitive disorders. In the neurocognitive disorders group, participants showed significantly lower score in total MMSE and higher plasma NfL levels. Part of the MDD patients presented cognitive deficits similar to that of neurocognitive disorders (cluster A). In cluster A, the total MMSE score (r=-0.58277, p=0.0287) and the comprehension domain (r=-0.71717, p=0.0039) were negatively correlated to NfL levels after adjusting for age, while the associations had not been observed in the other cluster.
Conclusion:
We noted the negative correlation between NfL levels and cognitive performance in MDD patients whose cognitive manifestation were more similar to that of degenerative neurocognitive disorders. NfL might be a potential marker to predict patients with MDD to develop cognitive decline especially in domains typically found in Alzheimer’s disease. Further longitudinal studies are required to validate our findings for clinical implications.
Expertise in social perception, defined as the ability to decode another person's mental states based on basic behavioral signals (Allison et al., 2000; Beauchamp et al., 2008). The Reading the Mind in the Eyes Test (RMET) is a social-perception task of theory of mind (ToM, Meinhardt-Injac et al., 2020) and used to test different clinical disorders, like autism spectrum disorders (ASD, Peñuelas-Calvo et al., 2019). RMET has been used to demonstrate gender, cultural, genetic, and personality trait influences on ToM and elucidate its neurobiological mechanisms (Adams et al., 2010). In Taiwan, there has few sensitive tools to evaluate children's social perception, thus the purpose of this study is to examine psychometric properties of child's version of RMET in Taiwan (RMET-C-TW) and cross-cultural comparisons.
Participants and Methods:
RMET-C (Baron-Cohen et al., 2001) was used to assess mental state/emotion recognition (Vellante et al., 2013). It consists of photographs of the eye regions of 28 faces. Participants were asked to make a choice between four words presented, choose the one that best described for feel or think. One point was given to each correctly response. RMET-C-TW was double-translation of words to ensure cultural applicability in Taiwan. This study included both a normative sample and criteria sample. The normative sample consisted of 769 (385 male, 384 female) 3 to 9 grades students from northern Taiwan. The normative sample completed both the RMET-C-TW and Chinese Vocabulary Test (CVT) in groups at their own schools, the CVT was to ensure that participants had sufficient vocabulary skills to understand the options provided in REMT-C-TW. The criteria sample were collected from 46 matched, school-aged children with ASD (age mean = 10.52, SD = 1.62; IQ = 108.39, SD = 11.75), and normally developing controls (age mean = 10.66, SD=1.68; IQ = 109.70, SD = 12.12). These two groups were administered the (1) WISC-III (2) CVT (3) RMET-C-TW and (4) ToM Test.
Results:
The results showed that RMET-C-TW had acceptable test-retest reliability and internal consistency (test-retest reliability = .71, Cronbach α= .40). There were significant gender and age difference in the performance of RMET-C-TW, example female, older participants performed better. Item analysis showed 93% of items in the RMET-C-TW had cross- cultural consistency in the distribution of respondents' choices. In criteria sample, the control group's RMET-C-TW scores significantly better than ASD group. Physician diagnosis (r = .49, p < .01) and high-order ToM's scores (r = .33, p < .01) were significantly associated with RMET-C-TW scores.
Conclusions:
RMET-C-TW has acceptable reliability and good developmental validity (age-related growth) in three to nine grades, and future can be extended to different age and clinicians to understand the development of social perception. Therefore, RMET-C-TW can be used as an initial screening and cross-cultural tool for ASD. In addition, EF is divided into cold and hot, and hot EF makes a unique contribution to ToM in ASD (Kouklari et al., 2017), thus this tool may also be used in the future to understand the association of hot EF with social perception.
This paper presents systematic molecular dynamics modelling of Na-montmorillonite subjected to uniaxial compression and unidirectional shearing. An initial 3D model of a single-cell Na-montmorillonite structure is established using the Build Crystal module. The space group is C2/m, and COMPASS force fields are applied. Hydration analysis of Na-montmorillonite has been performed to validate the simulation procedures, where the number of absorbed water molecules varied with respect to the various lattice parameters. A series of uniaxial compression stress σzz and unidirectional shear stress τxy values are applied to the Na-montmorillonite structure. It is shown that the lattice parameter and hydration degree exhibit significant influence on the stress–strain relationship of Na-montmorillonite. The ultimate strain increases with increases in the lattice parameter but decreases in the number of water molecules. For saturated Na-montmorillonite, more water molecules result in a stiffer clay mineral under uniaxial compression and unidirectional shearing.
We present a self-biased three-stage GaN-based monolithic microwave integrated circuit low-noise amplifier (LNA) operating between 26 and 29 GHz for 5G mobile communications. The self-biasing circuit, common-source topology with inductive source feedback, and RLC negative feedback loops between gate and drain of the third transistor were implemented to achieve low noise, good port match, high stability, high gain, and compact size. Measurement results show that the LNA has a high and flat gain of 30.5 ± 0.4 dB with noise figure (NF) of 1.65–1.8 dB across the band. The three-stage topology also achieves high linearity, providing the 1 dB compression point output power (P1dB) of 21 dBm in the band. To our knowledge, this combination of NF, gain, and linearity performance represents the state of art of self-biased LNA in this frequency band.
This study aimed to investigate the relationship between depression in older nursing home residents and family caregivers’ (FCGs) depressive status and reasons for involvement with residents.
Design:
This study employed a cross-sectional design.
Setting:
Eight nursing homes in northern Taiwan.
Participants:
A total of 139 older resident–FCG pairs were recruited.
Measurements:
Depression was measured with the Geriatric Depression Scale-Short Form for nursing home residents and the Center for Epidemiologic Studies Depression Scale-Short Form for family members. Depression and demographic data were collected with face-to-face interviews. The meaning ascribed to caregivers’ nursing home visits was calibrated using the Family Meaning of Nursing-Home Visits scale. Multiple logistic regression was used to understand the factors related to residents’ depressive symptoms.
Results:
Depressive symptoms were present in 58.3% of the nursing home residents (n = 81). Depressive status of family members (Chi-square = 1.46, p = 0.23) or family’s visiting frequency (Chi-square = 1.64, p = 0.44) did not differ between residents with or without depressive symptoms. Factors associated with an increased risk of residents having depressive symptoms were age, self-perceived health status, and having a caregiver motivated to visit to assuage their guilt.
Conclusions:
Visiting a family member to assuage their guilt was the only caregiver variable associated with depressive symptoms for nursing home residents. This finding suggests that developing interventions to improve personal relationships between nursing home residents and family members might facilitate the emotional support of caregivers and psychological support for older nursing home residents in Taiwan.
We investigated the effects of botulinum toxin on gait in Parkinson’s disease (PD) patients with foot dystonia. Six patients underwent onabotulinum toxin A injection and were assessed by Burke–Fahn–Marsden Dystonia Rating Scale (BFMDRS), visual analog scale (VAS) of pain, Timed Up and Go (TUG), Berg Balance Test (BBT), and 3D gait analysis at baseline, 1 month, and 3 months. BFMDRS (p = 0.002), VAS (p = 0.024), TUG (p = 0.028), and BBT (p = 0.034) were improved. Foot pressures at Toe 1 (p = 0.028) and Midfoot (p = 0.018) were reduced, indicating botulinum toxin’s effects in alleviating the dystonia severity and pain and improving foot pressures during walking in PD.
Using received texts and excavated funerary epitaphs, this article examines the intricacies of gender and migration in early medieval China by exploring women's long-distance mobility from the fourth century to the sixth century, when what is now known as China was divided by the Northern Wei and a succession of four southern states—the Eastern Jin, Liu-Song, Southern Qi, and Liang. I focus on three types of migration in which women participated during this period: war-induced migration, family reunification, and religious journeys. Based on this analysis, I propose answers to two important questions: the connection between migration and the state, and textual representations of migrants. Though the texts under consideration are usually written in an anecdotal manner, the references to women, I argue, both reveals nuances in perceptions of womanhood at the time and elucidates the contexts within—and through—which long-distance travel became possible for women.
How do we think about migration? This question was the topic of the first installment of the 2019 Tanner Lectures on Human Values, given by the exiled Russian journalist Masha Gessen, at Harvard University. Gessen, who had reported on immigrants, began with a story of a Montenegro man whose family fled to the United States when he was five. Then they told a second story, then a third, followed by fifty-four more stories of individuals’ sorrows, despair, and dreams. Gessen's intent was to bring to life individual migrants, underscoring their diverse experiences. Individuality and complexity matter, because too often, people on the move are reduced to numbers in the news and in the eyes of governments.
Controlling the physical movement of people was a well-established tradition throughout imperial China. Scholars have argued that the Qin (221–206 BCE) and Han (206 BCE–220 CE) empires required their subjects to register personal information, including their place of residence, with local governments, and both empires exerted strict control over the flows of officials and those who traveled for personal reasons within the territory, mainly through checkpoints and travel documents. Recent studies have also shown that forced resettlement was a common means of mobility regulation. Ancient states, from the Qin to the Mongol empire, achieved their imperial goals through a variety of measures, one of the most important of which was the relocation of subjects and conquered peoples whenever and wherever they saw fit.
While deceptive behaviors are a natural part of human life, it is well known that human is generally bad at detecting deception. In this study, we present an automatic deception detection framework by comprehensively integrating prior domain knowledge in deceptive behavior understanding. Specifically, we compute acoustics, textual information, implicatures with non-verbal behaviors, and conversational temporal dynamics for improving automatic deception detection in dialogs. The proposed model reaches start-of-the-art performance on the Daily Deceptive Dialogues corpus of Mandarin (DDDM) database, 80.61% unweighted accuracy recall in deception recognition. In the further analyses, we reveal that (i) the deceivers’ deception behaviors can be observed from the interrogators’ behaviors in the conversational temporal dynamics features and (ii) some of the acoustic features (e.g. loudness and MFCC) and textual features are significant and effective indicators to detect deception behaviors.
Consumption of a high-fat diet increases fat accumulation and may further lead to inflammation and hepatic injuries. The aim of the study was to investigate the effects of Camellia oleifera seed extract (CSE) on non-alcoholic fatty liver disease (NAFLD). After a 16-week NAFLD-inducing period, rats were assigned to experimental groups fed an NAFLD diet with or without CSE. At the end of the study, we found that consuming CSE decreased the abdominal fat weight and hepatic fat accumulation and modulated circulating adipokine levels. We also found that CSE groups had lower hepatic cytochrome P450 2E1 and transforming growth factor (TGF)-β protein expressions. In addition, we found that CSE consumption may have affected the gut microbiota and reduced toll-like receptor (TLR)-4, myeloid differentiation primary response gene 88, toll/IL-1 receptor domain-containing adaptor-inducing interferon-β (TRIF) expression and proinflammatory cytokine concentrations in the liver. Our results suggest that CSE may alleviate the progression of NAFLD in rats with diet-induced steatosis through reducing fat accumulation and improving lipid metabolism and hepatic inflammation.
To explore whether and how group cognitive-behavioural therapy (GCBT) plus medication differs from medication alone for the treatment of generalised anxiety disorder (GAD).
Methods:
Hundred and seventy patients were randomly assigned to the GCBT plus duloxetine (n=89) or duloxetine group (n=81). The primary outcomes were Hamilton Anxiety Scale (HAMA) response and remission rates. The explorative secondary measures included score reductions from baseline in the HAMA total, psychic, and somatic anxiety subscales (HAMA-PA, HAMA-SA), the Hamilton Depression Scale, the Severity Subscale of Clinical Global Impression Scale, Global Assessment of Functioning, and the 12-item Short-Form Health Survey. Assessments were conducted at baseline, 4-week, 8-week, and 3-month follow-up.
Results:
At 4 weeks, HAMA response (GCBT group 57.0% vs. control group 24.4%, p=0.000, Cohen’s d=0.90) and remission rates (GCBT group 21.5% vs. control group 6.2%, p=0.004; d=0.51), and most secondary outcomes (all p<0.05, d=0.36−0.77) showed that the combined therapy was superior. At 8 weeks, all the primary and secondary significant differences found at 4 weeks were maintained with smaller effect sizes (p<0.05, d=0.32−0.48). At 3-month follow-up, the combined therapy was only significantly superior in the HAMA total (p<0.045, d=0.43) and HAMA-PA score reductions (p<0.001, d=0.77). Logistic regression showed superiority of the combined therapy for HAMA response rates [odds ratio (OR)=2.12, 95% confidence interval (CI) 1.02−4.42, p=0.04] and remission rates (OR=2.80, 95% CI 1.27−6.16, p=0.01).
Conclusions:
Compared with duloxetine alone, GCBT plus duloxetine showed significant treatment response for GAD over a shorter period of time, particularly for psychic anxiety symptoms, which may suggest that GCBT was effective in changing cognitive style.
Health system reform is considered a tough issue worldwide. Great efforts have been made toward health system building and strengthening. However, it is still unclear which health system is appropriate for different countries. This study aimed to systematically compare the characteristics of the establishment periods between eighty-eight counties of National Health Service (NHS) and Social Health Insurance (SHI).
Methods:
Forty-eight NHS countries and forty SHI countries with data availability were selected. The establishment years of current health systems and other eighteen indicators in economics, society, population and health during establishment periods were collected. Comparison between NHS and SHI was conducted by descriptive analysis of every indicator.
Results:
Most NHS countries were established during the cold war, while SHI had been set up since the cold war ended. The median of gross domestic product (GDP) per capita, urbanization rate and aging rate of SHI were USD 1535 in current dollars, 58.2 percent and 9.8 percent, respectively; compared with USD 1387, 41.2 percent and 4.7 percent, respectively of NHS. NHS countries had a smaller total population, lower mortality rate and elderly dependency ratio, while the birth rate and children's dependency ratio were higher. SHI countries showed a higher life expectancy and lower mortality rate in infants and children. NHS countries spent less in total health expenditure and a lower proportion of GDP. The median health expenditure per capita of SHI and NHS were USD 188 and USD 131 in current dollars, respectively. There was little difference among maternal mortality rates, and public and private health expenditure proportions.
Conclusions:
NHS and SHI countries had different characteristics during the health system establishment periods. NHS was established earlier than SHI overall, so that SHI revealed higher levels in economic and social development. Health outcomes of NHS countries were slightly lower than SHI ones, while health expenditure was more in SHI countries. Specific social, economic, demographic and health conditions should be considered when countries are building their own health systems.
The present study was undertaken to investigate the antiparasitic activity of extracellular products of Streptomyces albus. Bioactivity-guided isolation of chloroform extracts affording a compound showing potent activity. The structure of the compound was elucidated as salinomycin (SAL) by EI-MS, 1H NMR and 13C NMR. In vitro test showed that SAL has potent anti-parasitic efficacy against theronts of Ichthyophthirius multifiliis with 10 min, 1, 2, 3 and 4 h (effective concentration) EC50 (95% confidence intervals) of 2.12 (2.22–2.02), 1.93 (1.98–1.88), 1.42 (1.47–1.37), 1.35 (1.41–1.31) and 1.11 (1.21–1.01) mg L−1. In vitro antiparasitic assays revealed that SAL could be 100% effective against I. multifiliis encysted tomonts at a concentration of 8.0 mg L−1. In vivo test demonstrated that the number of I. multifiliis trophonts on Erythroculter ilishaeformis treated with SAL was markedly lower than that of control group at 10 days after exposed to theronts (P < 0.05). In the control group, 80% mortality was observed owing to heavy I. multifiliis infection at 10 days. On the other hand, only 30.0% mortality was recorded in the group treated with 8.0 mg L−1 SAL. The median lethal dose (LD50) of SAL for E. ilishaeformis was 32.9 mg L−1.
Sedative–hypnotic medication use has been related to severe adverse events and risks. This study investigated the prevalence of and characteristics associated with the use of sedatives and hypnotics among community-dwelling elderly persons aged 65 years and over in Taiwan.
Methods:
A representative sample of community-dwelling adults was recruited. Clinical and sociodemographic data were collected for assessing physical, mental, and cognitive functioning and disorders. Sedatives and hypnotics use was determined via both self-reporting and prescription records. Logistic regression modeling was used to evaluate associations between sedative–hypnotic use and demographic and health status.
Results:
Among the 3,978 participants aged 65 years and over, the rate of sedative–hypnotic use was 19.7% (n = 785). 4.5% (n = 35) of users reported sedative–hypnotic use without a doctor's prescription. Several sociodemographic characteristics were positively associated with sedative and hypnotic use, including older age, female gender, higher education level, married status, unemployment, and current alcohol consumption. Comorbid chronic and cardiovascular diseases, mental illness, depression, pain, and sleep problems also increased the likelihood of sedative–hypnotic use.
Conclusions:
This study is one of the largest pioneer studies to date to survey sedatives–hypnotics use among community-dwelling elderly. One in five community-dwelling older adults reported sedative–hypnotic drugs use in Taiwan, and about 5% of sedative and/or hypnotics usage was without a doctor's prescription. Findings could be helpful for drug-use safety interventions to identify target geriatric patients who are in general at higher risk of downstream harm associated with sedative–hypnotic use in geriatric patients.
Background: Among patients with schizophrenia, there is evidence of a negative association between self-stigma and subjective quality of life (SQoL), and self-esteem was an important mediator in the association. We attempted to use a longitudinal study to investigate the aforementioned mediation on a sample with schizophrenia. Methods: We used longitudinal data retrieved from medical records of a psychiatric centre between June 2014 and December 2015. In the data, we retrieved information of self-stigma using the Self-Stigma Scale — Short; SQoL, using the WHO questionnaire on the Quality of Life — Short Form; and self-esteem, using the Rosenberg Self-Esteem Scale. All the measures were evaluated five times. Linear mixed-effect models accompanied by Sobel tests were used to tackle the mediating effects. Results: Data from 74 patients (57 males) with schizophrenia were eligible for analysis; their mean (SD) age was 39.53 (10.67); mean age of onset was 22.95 (8.38). Self-esteem was a mediator for patients in physical (p = .039), psychological (p = .003), and social SQoL (p = .004), but not in environment SQoL (p = .051). Conclusion: Based on our findings, mental health professionals could tailor different programs to patients with schizophrenia, such as self-stigma reduction and self-esteem improvement programs. However, treatment as a whole should be sensitive to both self-stigma and self-esteem. Also, we should consider individuals’ health and wellbeing from social perspectives of disability rather than the medical model of disability emphasising symptoms and medications.
To develop a theoretical model explaining the longitudinal changes in the caregiving process for family caregivers of persons with mild cognitive impairment (MCI) in Taiwan.
Methods:
A longitudinal, grounded theory approach using in-depth face-to-face interviews and an open-ended interview guide. We conducted 42 interviews over a two-year period; each participant was interviewed at least once every six months. All participants were interviewed in their home. The participants total of 13 family caregivers of persons with MCI.
Results:
One core theme emerged: “protective preparation.” This reflected the family caregiving process of preparation for a further decline in cognitive function, and protection from the impact of low self-esteem, accidents, and symptoms of comorbidities for the family member with MCI. Protective preparation contained three components: ambivalent normalization, vigilant preparation, and protective management.
Conclusions:
Interventions to help family caregivers manage the changes in persons with MCI can reduce caregiver burden. Our findings could provide a knowledge base for use by healthcare providers to develop and implement strategies to reduce caregiver burden for family caregivers of persons with MCI.