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Abstract Background Postoperative thirst is one of the most intense, common and easily ignored subjective discomforts in patients after gynecological surgery. This study aimed to investigate whether early oral hydration on demand in the postanesthesia care unit (PACU) after gynecological laparoscopy under general anesthesia can appease postoperative thirst and increase patient comfort. Methods Participants were randomized into the intervention and control groups. Patients in the intervention group were allowed to achieve early oral hydration on demand in the PACU if they were evaluated as fully conscious, with stable vital signs, grade 5 muscle strength, and well-recovered cough and swallowing reflex. However, the total amount of water intake throughout the entire study should not exceed 0.5mL/kg. During the study, the frequency of water intake, the total amount of water intake and adverse events were accurately recorded. The control group was managed according to the routine procedures and began to drink water 2 h after anesthesia. The intensity of thirst and subjective comfort in patients were assessed using the visual analog scale (VAS) when they entered and left the PACU. Results No statistically significant differences were identified in age, height, weight, body mass index, pre-operative fasting time, duration of surgery, intraoperative fluid intake, intraoperative blood loss, intraoperative urine volume, and thirst intensity and subjective comfort scores between the groups before intervention (P > 0.05). After intervention, the VAS score for thirst intensity in the intervention group significantly decreased (P

Abstract Previous studies exploring the effects of the business cycle on sleep have mostly focused on the general population, and their results have been inconclusive. This study aimed to explore the effects of the 2008 economic crisis and personality traits on the subjective sleep quality of outpatients with mood disorders. In this cross-sectional study, patients with mood disorders were recruited from two medical centers and a psychiatric hospital. Socio-demographics, the Eysenck Personality Questionnaire-Revised, and the Pittsburgh Sleep Quality Index (PSQI) were collected through in-person interviews. Candidate predictors significantly associated with PSQI scores in univariate analysis were included in a multiple linear regression model. There were 334 participants; 29% had unipolar depression, and 71% had bipolar affective disorder. The average PSQI score was 11.0 (±4.0). A higher degree of neuroticism [β(se) = 0.49 (0.07), p

Research into next-generation propellants with green fuel–oxidizer pairs to replace the currently used highly toxic hydrazine–N2O4 system has attracted widespread attention. Ionic liquids (ILs) and hydrogen peroxide have demonstrated their feasibility as a green fuel and an oxidizer, respectively. However, the realisation of effective auto-ignition is the key problem. In this study, a new strategy to trigger the auto-ignition of ILs fuels with hydrogen peroxide by using a unique copper-containing liquid as the promoter is developed. The copper-containing promoter is designed such that its cationic structure is similar to that of the ILs fuels. Based on the principle of “like dissolves like,” the fuel and promoter can be miscible at any ratio to eventually form a catalytic fuel. In addition, the physicochemical properties (e.g. density, viscosity and decomposition temperature) and performance parameters (e.g. ignition delay time and specific impulse) of the as-prepared catalytic fuel are completely characterised. Owing to their excellent hypergolic performance with a short ignition delay time of 16 ms, in combination with the advantages of simple preparation, perfect solubility and green characteristics, the catalytic fuel–oxidizer pair demonstrates promise as bipropellants for rocket applications.

Abstract The occurrence of many autoimmune diseases takes root on the disrupted balance among Treg cells, Teff cells, etc. Low-dose interleukin-2 (IL-2) cytokine demonstrates promising clinical efficacy in the expansion of Treg cells and the treatment of autoimmune diseases. However, its clinical application is hindered by the small therapeutic index and short half-life. Previous studies have shown that non-covalent complex of human IL-2 and anti-IL-2 antibody biases cytokine activity towards Treg cells and extends IL-2’s half-life. The clinical translation of such complex is non-trivial. In this study, we discover an anti-human IL-2 antibody and engineer a covalently-linked single-agent fusion of human IL-2 and its antibody that selectively expands Treg cells and exhibits superior disease control activity in animal models of ulcerative colitis and systemic lupus erythematosus, with proper safety profile and good developability. These studies pave the road for its clinical development in diverse autoimmune diseases.

Reheating furnaces are used to uniformly heat billets (blooms, billets, or slabs) to between 1000°C and 1300°C before hot rolling. Cascade control is widely used in temperature controllers of the reheating furnace. Unfortunately, the relationship between temperature indicator controllers (TIC) and flow indicator controllers (FIC) usually changes with a single slope. It means that temperature load disturbances cannot be effectively resolved. In this study, the relationship between TIC and FIC is proposed to be nonlinear with multiple slopes, which is used to accelerate the temperature response and increase the temperature stability under high or low load conditions. The temperature controller parameters are more diverse, so this study optimizes the temperature controller parameters and determines the characteristic curves between TIC and FIC effectively and quickly by using the Taguchi method. The performance of the multi-slope method and the single-slope method is evaluated in an actual heating furnace. The experimental results show that the proposed method in this study improves the mean square error and standard deviation by 33.76% and 22.44%, respectively. After commissioning, the parameter combination (including the characteristic curve) has a remarkable performance in the heating zone, which can be used to reduce temperature disturbance, accelerate the temperature response, and increase temperature stability in the reheating furnace.

Background: Hemodialysis (HD) is a public health issue, and HD-induced infection is a major risk factor for mortality. Toll-like receptor 4 (TLR4) plays a key role in the pathogenesis of infection. However, polymorphisms of TLR4 contribute to infection are still unknown. Aim: This study aimed to examine the correlation between polymorphisms of TLR4 and mortality among HD patients. Methods: This retrospective cohort study included 585 participants from Tri-Service General Hospital in Taipei from 2011 to 2015. All participants were genotyped for TLR4 rs10116253T/C and rs7873784G/C by the iPLEX Gold single-nucleotide polymorphisms assay. Analysis of the conditional Cox proportional hazard model was used to test the association between TLR4 polymorphisms and mortality. Results: Our results show that adjustment with age and gender, TLR4 rs10116253T/C demonstrates an association with mortality (hazard ratio [HR] =1.38, 95% confidence interval [CI] =1.00–1.89) in a dominant model, especially in infection-related mortality (HR = 2.14, 95% CI = 1.04–4.43) of HD patients. Conclusion: The results demonstrate that TLR4 rs10116253T/C may play a role in the etiology of infection among HD patients.

Accurate measurement of the pretightening stress for bolts has great significance for improving the assembly quality and safety, especially in severe environments. In this study, AlN thin film transducers were deposited on GH4169 nickel base alloy bolts using the RF magnetron sputtering, enabling a systematic investigation into the correlation between structures and the intensity of ultrasonic echo signals. Employing the finite element method resulted in consistency with the experimental data, enabling further exploration of the enhancement mechanism. With the increasing thickness of both the piezoelectric layer and the electrode layer, the intensity of the ultrasonic echo signals saw a great enhancement. The maximum-intensity observed increase is 14.7 times greater than that of the thinnest layers. Specifically, the thicker piezoelectric layer improves its mechanical displacement, while the increased thickness of the electrode layer contributes to better densification. An electrode diameter of nearly 4 mm is optimal for an AlN thin film transducer of M8 bolts. For pretightening the stress measurement, the sample with a strong and stable echo signal shows a low measurement error of pretightening below ±2.50%.

This study investigated cross-cultural similarities and variations in children's developing understanding of mixed emotions. Four- to 9-year-old US (n = 56) and Chinese (n = 98) children listened to stories in which the protagonist encountered a situation combining positive and negative components. Children were asked whether the story protagonist would feel the appropriate positive emotion as well as the appropriate negative emotion. Despite being able to recall the positive and negative components of the stories, both US and Chinese children often agreed to only one emotion. However, when children did not agree to only one emotion, US children were more likely than Chinese children to agree to both emotions, whereas Chinese children were more likely than US children to deny both emotions. Overall, the findings confirm that the recognition of mixed emotions is challenging for children under the age of 10. They also suggest, however, that mixed emotions are conceptualized differently in the two cultures: US children tend to assume that positive and negative emotions can coexist whereas Chinese children tend to assume that they neutralize each other.

A mixture of controlled-release urea and normal urea (CRUNU) is an efficient nitrogen (N) fertilizer type, but little is known about its effects on stem lodging resistance, grain yield, and yield stability of wheat. In this study, a 4-year field experiment (from 2017 to 2021) was conducted to analyze the effects of N fertilizer types (CRUNU and normal urea (NU)) and application rates (low level (L), 135 kg ha−1; medium level (M), 180 kg ha−1; high level (H), 225 kg ha−1) on population lodging resistance, basal internode strength, lignin content and synthetase activity, stem lodging resistance, grain yield, and yield stability of wheat. Our results showed that the two N fertilizer types had the highest lodging rate under high N application rates, and the M-CRUNU treatment showed the lowest lodging rate. Compared with NU, CRUNU improved the wheat population lodging resistance under the three N application rates, mainly related to improving wheat population characteristics and breaking the strength of the second basal internode. Correlation analysis showed that the breaking strength of the second basal internode was related to the physical characteristics, chemical components, and micro-structure of the internode. Compared with NU, CRUNU significantly increased wheat grain yield by 4.47, 14.62, and 3.12% under low, medium, and high N application rates, respectively. In addition, CRUNU showed no significant difference in grain yield under medium and high N application rates, but it presented the highest yield stability under the medium N application rate. In summary, CRUNU, combined with the medium N application rate, is an efficient agronomic management strategy for wheat production.

Triple-negative breast cancer (TNBC) is highly aggressive with a poor prognosis because of a lack of cell markers as drug targets. α9-Nicotinic acetylcholine receptor (nAChR) is expressed abundantly in TNBC; thus, it is a valuable biomarker for TNBC detection and treatment. In this study, we utilized thermodynamically stable three-way junction (3WJ) packaging RNA (pRNA) as the core to construct RNA nanoparticles with an α9-nAChR RNA aptamer as a targeting ligand and an anti-microRNA-21 (miR-21) as a therapeutic module. We compared the configuration of the two RNA nanoparticles and found that 3WJ-B-α9-nAChR-aptamer fluorescent RNA nanoparticles (3WJ-B-α9-apt-Alexa) exhibited better specificity for α9-nAChR in TNBC cells compared with 3WJ-C-α9-nAChR. Furthermore, 3WJ-B-α9-apt-Alexa bound more efficiently to TNBC patient-derived xenograft (PDX) tumors than 3WJ fluorescent RNA nanoparticles (3WJ-Alexa) with little or no accumulation in healthy organs after systemic injection in mice. Moreover, 3WJ-B-α9-nAChR-aptamer RNA nanoparticles carrying anti-miR-21 (3WJ-B-α9-apt-anti-miR-21) significantly suppressed TNBC-PDX tumor growth and induced cell apoptosis because of reduced miR-21 gene expression and upregulated the phosphatase and tensin homolog (PTEN) and programmed cell death 4 (PDCD4) proteins. In addition, no pathological changes were detected upon toxicity examination of treated mice. In conclusion, the 3WJ-B-α9-nAChR-aptamer RNA nanoparticles established in this study efficiently deliver therapeutic anti-miR-21, indicating their potential as a novel TNBC therapy.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is characterized by excessive fat accumulation in the liver. Intracellular oxidative stress induced by lipid accumulation leads to various hepatocellular injuries including fibrosis. However, no effective method for mitigating MASLD without substantial side effects currently exists. Molecular hydrogen (H2) has garnered attention due to its efficiency in neutralizing harmful reactive oxygen species (ROS) and its ability to penetrate cell membranes. Some clinical evidence suggests that H2 may alleviate fatty liver disease, but the precise molecular mechanisms, particularly the regulation of lipid droplet (LD) metabolism, remain unclear. This study utilized an in vitro model of hepatocyte lipid accumulation induced by free fatty acids (FFAs) to replicate MASLD in HepG2 cells. The results demonstrated a significant increase in LD accumulation due to elevated FFA levels. However, the addition of hydrogen-rich water (HRW) effectively reduced LD accumulation. HRW decreased the diameter of LDs and reduced lipid peroxidation and FFA-induced oxidative stress by activating the AMPK/Nrf2/HO-1 pathway. Overall, our findings suggest that HRW has potential as an adjunctive supplement in managing fatty liver disease by reducing LD accumulation and enhancing antioxidant pathways, presenting a novel strategy for impeding MASLD progression.

Abstract Background We evaluated hyperglycemia-associated mortality in the Taiwanese population by conducting a 10-year retrospective cohort study. Methods: From 2007 to 2017, all participants, regardless of their age or underlying diseases, were identified at a Health Screening Center in Taiwan. Overall, 114,534 participants were included in the analysis. They were classified into three subgroups according to glycemia and smoking status by combining survival for data analysis. Results: The mean follow-up time, age, and body mass index (BMI) were 8.14 ± 2.22 years, 40.95 ± 12.14 years, and 23.24 ± 3.65 kg/m2, respectively. The cumulative death rate increased from 0.9% in the normal fasting blood glucose(FBG) subgroup to approximately 6% in the diabetes FBG subgroup. After adjusting for age, gender, BMI, high-density lipoprotein, triglycerides, waist circumference(WC), and smoking status, the hazard ratio (HR) for all-cause, cancer, and heart disease mortality in the diabetes mellitus(DM) subgroup was 1.560, 1.381, and 1.828, respectively.HR was 0.989 in all-cause, 0.940 in cancer, and 1.326 in heart disease in the pre-DM subgroup. Conclusion Being tested for pre-DM is related to a higher risk of death from heart disease in the Taiwanese population at baseline. Therefore, cardiovascular risk must be actively measured among diabetes patients every visit.

Abstract This letter proposes a high-gain shared-aperture array for vehicular communications which integrates the hybrid zeroth-order-resonance (ZOR) patch and the higher-order metasurface antenna (MA). In terms of each array element, four hybrid ZOR patches with shorting pins form a metasurface which is fed by slot coupling. Different from some reported designs which have more high-frequency elements than low-frequency ones, the whole array is composed of 4 $$\times$$ × 4 hybrid ZOR patches operating in C band (4.74–5.12 GHz) and 2 $$\times$$ × 2 MAs working in Ku band (13.0–14.0 GHz). Such a layout brings that the designed array has the benefit to reduce Ku-band loss. Measure results validate the dual-band operation and show that the antenna has its peak gains of 12.7 dBi and 17.2 dBi in these two bands, respectively, which can support vehicle-to-base station and vehicle-to-satellite communications.

Summary: Background: Adult preventive health checkups with depression screening were launched in August 2011 in Taiwan; however, its impact has not yet been evaluated. This study aimed to use real-world data to assess the effectiveness of depression screening among middle-aged and older adults. Methods: A total of 4,972,228 adults aged 40 years and above who participated in a health checkup with depression screening between 2013 and 2019 and the same number of unscreened counterparts were included. The target trial emulation study was conducted to estimate the hazard ratios (HRs) for newly treated depression, psychiatric hospitalisation, and suicide. The changes in HRs during the study period were assessed using interval Cox models. Findings: The screening group had a higher rate of newly treated depression (HR 1.63 [95% CI 1.62, 1.64]) and a lower risk of psychiatric hospitalisation (HR 0.93 [95% CI 0.91, 0.95]). There was a null association between depression screening and suicide; however, a higher suicide risk was found in screened older adults aged 65 years and above. Only 10.8% received depression treatment during the study period among the screen-positive individuals. Interpretation: Health checkups with depression screening could potentially promote depression treatment and reduce the risk of psychiatric hospitalisation; however, there was no effect on suicide. The treatment rate for depression remained low after screening for depression. Further attention to enhance referral and treatment is required. Funding: The study was funded by the National Health Research Institutes, Taiwan.

The Garzê–Yushu fault is a large active NW-trending strike-slip fault on the Tibetan Plateau, along which strong earthquakes have frequently occurred historically. Together with the Xianshuihe fault, the Garzê–Yushu fault constitutes the northern boundary of the Sichuan–Yunnan block, and it is also the boundary between the Bayan Har and Qiangtang blocks. The Abuduo fault is a near E–W-trending fault on the southern side of the Garzê–Yushu fault. Through remote sensing image interpretation and field seismic geological investigations, this study found a series of left-lateral displacement landforms and well-preserved seismic surface rupture zones along the Abuduo fault, extending over a distance of approximately 65 km from Abuduo through Yushu and Qinghai to Selikou Village. According to the geological and geomorphological evidence, the Abuduo fault is considered a left-lateral strike-slip fault with Holocene activity, which has tectonic conditions suitable for breeding and generating strong earthquakes. Additionally, the eastward extension of the Abuduo fault is likely to intersect the Garzê–Yushu fault and thereby decompose its horizontal sliding deformation.

Research with adults has increasingly moved beyond the focus on a small set of allegedly basic emotions, each associated with a signature facial expression. That expansion has been accompanied by a greater emphasis on the potential variability of emotion concepts across different cultural settings. In this conceptual review of children's understanding of emotion, we argue that it is also important in developmental research to look beyond the small set of emotions associated with distinctive facial expressions. At the same time, we caution against any premature rejection of a universalist approach to children's understanding of emotion. We review three different lines of evidence in support of this stance: (1) children's ability to appropriately cite situational elicitors for emotions beyond the basic set; (2) their developing understanding of the relations between emotions and other mental processes; and (3) their realization that a person's facially expressed emotion may not indicate their felt emotion. In each of these three domains, we target studies that have included children from a variety of cultures to assess how far they respond similarly or differently. We conclude that there is robust evidence for similar conceptual progress in children's understanding of emotion across a range of cultural settings.

Abstract Background Diabetes with co-existing bone fragility or osteoporosis is common in elderly patients, whereas is frequently underestimated. Methods We conducted dual-energy x-ray absorptiometry (DXA) with 7-site skinfold (SF) and dominant hand grip strength measurements among patients with type 2 diabetes (T2DM) to assess their gender-specific associations. A total of 103 patients with T2DM (60 females and 43 males), aged between 50 and 80 years (median 68.0 years) were enrolled and 45 non-DM females were also included to compare with T2DM females. Results Our results revealed osteoporosis was negatively correlated with grip strength in both genders, negatively correlated with lean mass solely in males and negatively correlated with fat mass (particular the gynoid fat mass and thigh SF thickness) in females. Via performing multivariable stepwise logistic regression, we identified grip strength in both genders and thigh SF thickness in females as predictors for osteoporosis. Receiver operating characteristic curve analysis further disclosed 20.5 mm female thigh skinfold thickness, 18.1 kg female grip strength and 29.0 kg male grip strength as reasonable cutoff levels for predicting osteoporosis in the Taiwanese patients with T2DM. Conclusions Patients with T2DM presented gender-specific associations between osteoporosis, body composition and grip strength. Grip strength and thigh SF thickness might serve as predictors for detection of osteoporosis in patients with T2DM.

Abstract Testing of concrete panels subjected to pure in-plane shear loading is necessary to elucidate the shear behavior of concrete. However, available data for predicting the shear capacity and behavior of steel fiber-reinforced concrete are rather limited. This study aims to evaluate the shear capacity and behavior of fiber-reinforced concrete made of highly flowable strain hardening fiber-reinforced concrete (HF-SHFRC) experimentally and analytically, respectively, using a panel tester loaded under pure shear and modified compression field theory (MCFT). The test was conducted using a panel test machine at the University of Toronto. The test results of the HF-SHFRC demonstrated strain hardening behavior at tension after the first crack, as indicated by the increase in the shear stress after the first crack in the HF-SHFRC panel. An analysis procedure is proposed for predicting the shear strength of steel fiber-reinforced concrete (SFRC) based on experimental data of the SFRC panels to obtain reliable results. A comparison of results obtained from the proposed analysis procedure and experiments show that it accurately predicted the response of the HF-SHFRC. The proposed MCFT-based analysis procedure can provide valuable insight for understanding the behavior of the SFRC panels under shear loading.

Abstract Identifying the relevant factors for suicidality in individuals with conduct problems is a public health concern, especially if they were under the influence of mood disorders later in life. This study investigates the relationship between youth conduct problems and mood disorders and adulthood suicidality, and to further explore the mediating effects of personality on this relationship. A retrospective cohort study was administered to 308 individuals aged 20–65 years, with or without mood disorders diagnosed by psychiatrists. The Composite International Diagnosis Interview was used to evaluate conduct problems in youth and suicidality (i.e., suicide plan and suicide attempt) in the past year. Personality traits were assessed using Eysenck Personality Questionnaire-Revised for extraversion and neuroticism. Multiple-mediator analysis was used to investigate the mediation effects of personality traits on the relationship between conduct problems and suicidality. The average age of enrolled participants was 31.6 years, and 42.5% of them were female. 39.2% reported suicidality and 43.2% reported conduct problems in youth. Participants who were diagnosed with mood disorders (p

Abstract Background Emerging evidence suggests that DNA methylation can be affected by physical activities and is associated with cardiac fibrosis. This translational research examined the implications of DNA methylation associated with the high-intensity interval training (HIIT) effects on cardiac fibrosis in patients with heart failure (HF). Methods Twelve HF patients were included and received cardiovascular magnetic resonance imaging with late gadolinium enhancement for cardiac fibrosis severity and a cardiopulmonary exercise test for peak oxygen consumption ( $$\normalsize \tt V$$ V O2peak). Afterwards, they underwent 36 sessions of HIIT at alternating 80% and 40% of $$\normalsize \tt V$$ V O2peak for 30 min per session in 3–4 months. Human serum from 11 participants, as a means to link cell biology to clinical presentations, was used to investigate the exercise effects on cardiac fibrosis. Primary human cardiac fibroblasts (HCFs) were incubated in patient serum, and analyses of cell behaviour, proteomics (n = 6) and DNA methylation profiling (n = 3) were performed. All measurements were conducted after completing HIIT. Results A significant increase (p = 0.009) in $$\normalsize \tt V$$ V O2peak (pre- vs. post-HIIT = 19.0 ± 1.1 O2 ml/kg/min vs. 21.8 ± 1.1 O2 ml/kg/min) was observed after HIIT. The exercise strategy resulted in a significant decrease in left ventricle (LV) volume by 15% to 40% (p

This study investigates the impact of small water bodies on outdoor temperatures in their vicinity, using a campus located in the subtropical region of Taichung City, Taiwan, as the research subject. By employing on-site measurements and Computational Fluid Dynamics (CFD) simulations, we examined their temporal and spatial influence, as well as comparisons between actual measurements and software predictions. Key findings include the following: (1) Small water bodies exhibit discernible temperature-regulating effects on their surrounding areas. While the influence diminishes with distance, this attenuation is not stark, and is potentially constrained by the water body’s patch size. (2) Regulatory effects vary between day and night. In summer, temperature reductions of up to 3.5 °C (simulated) and 3.2 °C (measured) were observed. Conversely, in winter, daytime temperatures around water bodies may rise by up to 3.9 °C. (3) Discrepancies between CFD simulations and actual measurements, influenced by fluctuations in Global Horizontal Irradiation (GHI), range from +2.5 °C to −1.8 °C. During high GHI periods, measured values surpass simulations, whereas during low or zero GHI conditions, simulations exceed measurements. Moreover, high regression analysis R2 values validate the feasibility of CFD simulations for predicting water body-induced temperature changes. Insights from this study offer valuable guidance for urban planners and policymakers seeking sustainable urban climate management strategies.

Abstract Heart rate variability (HRV) is often considered as a biomarker reflecting well‐being, but the clinical meaning of short‐term resting‐state HRV is not sufficiently defined. We assume that combining several common HRV indices as “HRV patterns” and using the patterns for screening purposes are meaningful approaches. Resting‐state 5‐min HRV data of 424 subjects were analyzed. Four of the most commonly used HRV indices were considered: standard deviation of normal–to–normal RR intervals, low‐frequency power, high‐frequency power and the ratio of low‐frequency to high‐frequency power. According to these indices, four HRV patterns were defined: normal pattern, low HRV pattern, relatively high sympathetic pattern, and relatively high vagal pattern. The associations between the demographics, lifestyles, personality traits, psychological states, and HRV patterns were explored: the low HRV pattern was positively associated with age, body mass index, and depression; the relatively high sympathetic pattern was positively associated with age and negatively associated with exercise habit; and the relatively high vagal pattern was negatively associated with having a steady job and novelty seeking. The pattern perspective may provide a convenient and evidence‐based way to interpret resting‐state HRV for patients with affective disorders.

Background/Purpose: The number of psychiatrists working in community clinics in Taiwan has increased dramatically in the recent decade. This study aimed to investigate the trend of prevalence and incidence of depressive disorders and assess the quality of depression care between 2007 and 2016 in Taiwan. Methods: We used the claims database derived from Taiwan's National Health Insurance (NHI) program, in which approximately 23.0 million individuals were enrolled, translating to a coverage rate of 99%. Patients with depressive disorders were identified based on International Classification of Diseases codes. The process indicators of depression care quality included visit, duration, and dose adequacy. The outcome indicators included the rate of psychiatric hospitalisation, emergency visit, self-harm hospitalisation, and suicide. Results: The prevalence of treated depressive disorders increased from 1.61% in 2007 to 1.92% in 2016, i.e., a 25% increase, whereas the incidence of first-ever or recurrent depressive disorder did not change significantly. The number of patients treated by psychiatrists and in community clinics also increased. The quality of depression care improved, the proportion of patients receiving minimum psychiatric clinic follow-up and adequate medication increased, and the rate of emergency visits, psychiatric hospitalisation, and self-harm hospitalisation declined. Conclusion: The community-based psychiatric services increased and the quality indicators of depression care in Taiwan improved during 2007–2016. The causality warrants further investigations.

Background: Functional somatic syndromes (such as chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome) are often comorbid. Whether these syndromes are distinct constructs and whether they have different psychological features are interesting questions. We perform a cluster analysis based on a nationwide survey in Taiwan to answer these questions. Methods: A score of at least 5 on the Patient Health Questionnaire-15 (PHQ-15, measuring somatic symptoms) indicated somatic syndromes and the data of 550 subjects were included. According to the gastrointestinal, pain–fatigue and cardiovascular subdimension scores of the PHQ-15, we performed a two-step cluster analysis. The demographic data and the cluster scores of the Health Anxiety Questionnaire and the Patient Health Questionnaire-4 (measuring depression and anxiety) were compared. Multinomial logistic and multiple linear regression analyses were used to clarify the associations between clusters/somatic symptoms and demographics/psychological features. Results: Four clusters were generated and named according to their somatic features: “high gastrointestinal symptoms”, “high pain-fatigue and comorbid somatic symptoms”, “middle to high pain–fatigue symptoms” and “high cardiovascular symptoms”. The high pain–fatigue and comorbid somatic symptom cluster had the highest levels of extent to which symptoms interfere with a person's life, depression and anxiety. The high cardiovascular symptom cluster was featured by high excessive worry over health and illness and low educational level. The high gastrointestinal symptom cluster had relatively low psychopathologies. Conclusion: The results of this population-based analysis supported the existence of distinct somatic syndromes that are not parts of a single whole somatic syndrome and have different psychological features.

In this study, two numerical schemes with second-order accuracy in time for a modified Ericksen–Leslie model are constructed. The highlight is based on a novel convex splitting method for dealing with the nonlinear potentials, which is integrated with the second-order backward differentiation formula (BDF2) and leap frog method for temporal discretization and the finite element method for spatial discretization. The unconditional energy stability of both schemes is further demonstrated. Finally, several numerical examples are presented to demonstrate the efficiency and accuracy of the proposed schemes.

Negative Pressure Wound Therapy (NPWT) is a commonly employed clinical strategy for wound healing, yet its early-stage mechanisms remain poorly understood. To address this knowledge gap and overcome the limitations of human trials, we establish an NPWT C57BL/6JNarl mouse model to investigate the molecular mechanisms involved in NPWT. In this study, we investigate the intricate molecular mechanisms through which NPWT expedites wound healing. Our focus is on NPWT’s modulation of inflammatory immune responses and the concurrent orchestration of multiple signal transduction pathways, resulting in shortened coagulation time and reduced inflammation. Notably, we observe a significant rise in dickkopf-related protein 1 (DKK-1) concentration during NPWT, promoting the differentiation of Hair Follicle Stem Cells (HFSCs) into epidermal cells, expediting wound closure. Under negative pressure, macrophages express and release DKK-1 cytokines, crucial for stimulating HFSC differentiation, as validated in animal experiments and in vitro studies. Our findings illuminate the inflammatory dynamics under NPWT, revealing potential signal transduction pathways. The proposed framework, involving early hemostasis, balanced inflammation, and macrophage-mediated DKK-1 induction, provides a novel perspective on enhancing wound healing during NPWT. Furthermore, these insights lay the groundwork for future pharmacological advancements in managing extensive wounds, opening avenues for targeted therapeutic interventions in wound care.

Background/purpose: Suicide is a huge global health burden. High suicide rates with a low prevalence of major depressive disorder were reported in East Asia. This study aimed to investigate the prevalence of suicidal behaviors in relation to the demographic characteristics and major depressive disorder in Taiwan. Methods: This study was based on the Taiwan Psychiatric Morbidity Survey, conducted between 2003 and 2005, a survey of common psychiatric disorders in a nationally representative sample of non-institutionalized civilians aged 18 or above. Demographic data, major depressive disorder, and suicidal behaviors were ascertained by a face-to-face interview using the paper version of the World Mental Health Survey Composite International Diagnostic Interview. Results: According to the total sample of 10,135 participants, the lifetime prevalence of suicidal ideation, plans and attempts was 7.52% (S.E = 0.46%), 1.31% (S.E. = 0.16%) and 1.29% (S.E. = 0.16%), respectively. Among suicide ideators, the conditional probability of making a suicide plan was 17.39% (S.E. = 1.92%), and a suicide attempt 17.16% (S.E. = 2.15%). Age ≤ 40, female sex, and major depressive disorder were related to a higher risk of suicidal behaviors in the general population; the former two were associated with further developing suicide attempts and the latter one developing plans among ideators. Conclusion: Despite low prevalence, major depressive disorder remained a significant risk factor for suicidal behaviors in Taiwan.

BackgroundSubjective sleep quality may reflect the mental well-being of migrant care workers; however, the related occupational factors remain unclear. This study examines the association between the characteristics of care labor and the subjective sleep quality of female migrants.MethodsIn this cross-sectional study, Southeast Asian migrant care workers in Taiwan were recruited using convenience sampling. Data on working conditions, including workplace setting, wage, working hours, psychiatric symptoms of care recipients, and sleep quality measured using the Pittsburgh Sleep Quality Index (PSQI), were collected through computer-assisted personal interviews. Multiple linear regression analyses were performed to determine the independent relationship between working conditions and the PSQI global score.ResultsThere were 220 institution-(47.7%) and home-based (52.3%) care workers, and 47.7% had a PSQI score higher than 5. After controlling for covariates, the lowest tertile of wages and daily working hours (> 8 h) were independently correlated with poor sleep quality. Moreover, in the stepwise regression model, wage and working hours remained the most explainable correlates of poor sleep quality.ConclusionThis study lent support to the notion that low wages and long working hours are significant occupational factors that negatively impact the subjective sleep quality of female Southeast Asian migrant care workers in Taiwan.