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Whether patients with Mycoplasma infection have an increased risk of ocular surface ulcers. Using a nation-wide database, we identified patients with a new diagnosis of Mycoplasma infection between 1997 and 2013, and compared them with age-, sex-, and index year-matched subjects without the infection. Cox proportional regression was performed to compare the risk of corneal diseases between the two cohorts. The incidence of corneal diseases was significantly higher in the 4223 patients with Mycoplasma infection than in the 16,892 patients without (7.28 vs. 5.94 per 1000 person-years, P Mycoplasma infection might be a predisposing factor for patients with keratitis.

Objective Aneurysm volume quantification (AVQ) using the equation of ellipsoid volume is widely used although it is inaccurate. Furthermore, AVQ with 3-dimensional (3D) rendered data has limitations in general use. A novel universal method for AVQ is introduced for any diagnostic modality and application to any shape of aneurysms. Methods Relevant AVQ studies published from January 1997 to June 2019 were identified to determine common methods of AVQ. The basic idea is to eliminate the normal artery volume from 3D model with the aneurysm. After Digital Imaging and Communications in Medicine (DICOM) data is converted and exported to stereolithography (STL) file format, the 3D STL model is modified to remove the aneurysm and the volume difference between the 3D model with/without the aneurysm is defined as the aneurysm volume. Fifty randomly selected aneurysms from DICOM database were used to validate the different AVQ methods. Results We reviewed and categorized AVQ methods in 121 studies. Approximately 60% used the ellipsoid method, while 24% used the 3D model. For 50 randomly selected aneurysms, volumes were measured using 3D Slicer, RadiAnt, and ellipsoid method. Using 3D Slicer as the reference, the ratios of mean difference to mean volume obtained by RadiAnt and ellipsoid method were -1.21±7.46% and 4.04±30.54%, respectively. The deviations between RadiAnt and 3D Slicer were small despite of aneurysm shapes, but those of ellipsoid method and 3D Slicer were large. Conclusion In spite of inaccuracy, ellipsoid method is still mostly used. We propose a novel universal method for AVQ that is valid, low cost, and easy to use.

Background:Increased traumatic brain injury (TBI) risk was found in patients with bipolar disorder (BPD). Whether the medications for BPD and dosage moderate the risk of TBI is not clear.Aim:This study aimed to determine whether an association exists between BPD and TBI and whether the prescription of psychotropics moderates TBI risk.Methods:A total of 5606 individuals who had received diagnoses of BPD between January 1, 1997 and December 31, 2013 and 56,060 matched controls without BPD were identified from Taiwan’s National Health Insurance Research Database. Cases and controls were followed until the date of TBI diagnosis.Results:BPD was associated with a high risk of TBI (adjusted hazard ratio (aHR): 1.85; 95% CI: 1.62–2.11). Patients with BPD, with or without a history of psychiatric hospitalization, had increased risks of TBI (aHR: 1.94, 95% CI: 1.57–2.4 and aHR: 1.82, 95% CI: 1.55–2.1, respectively). The prescription of typical antipsychotics (0 Conclusion:Patients with BPD have a higher risk of TBI. The use of typical antipsychotics, TCAs, or high-dose BZDs increases the risk of TBI in BPD.

Adding protein-bound polysaccharide K (PSK) to adjuvant chemotherapy with mitomycin and fluorouracil after gastrectomy for gastric cancer was demonstrated to improve survival in a previous study in Japan. However, the efficacy of PSK outside Japan and in combination with other adjuvant chemotherapeutic agents remains unclear. The aims of this study were to evaluate the efficacy of PSK. We conducted a population-based historical cohort study using the National Health Insurance Research Database of Taiwan. We performed sensitivity analysis with propensity score matching to control for possible confounders. Patients who used PSK (PSK group) were matched at a 1:4 ratio to those who had never used PSK (control group) after adjusting for covariates including sex, age, urbanization, income and comorbidities. The primary outcome was overall survival. Multivariate hazard ratios from competing risk analysis were calculated by adjusting for demographic data and all confounding factors. From 1999 to 2008, we identified 10,617 patients with gastric cancer received gastrectomy and adjuvant chemotherapy. 1295 patients used PSK (PSK group) and 5180 patients never used PSK (control group) were analyzed after propensity score matching. The median overall survival was 6.49 years (95% confidence interval [CI] 5.22-7.63) in the PSK group and 3.59 years (95% CI 3.38-3.80) in the control group. After adjusting for age, sex, urbanization, income, and comorbidities, adding PSK to adjuvant chemotherapy was the most significant prognostic factor for improved survival (hazard ratio 0.76, P.0001). Adjuvant chemotherapy combined with PSK significantly prolonged overall survival in gastric cancer patients after gastrectomy.

Objectives: Traditional Chinese medicine (TCM) has been shown to reduce insulin resistance and improve beta cell function in previous studies. The aim of this study was to assess whether the use of...

Purpose This study explored and compared the effects of depression and antidepressants on sexual dysfunction in men with diabetes mellitus (DM). Patients and methods Patients older than 18 years who had been newly diagnosed with DM (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] code 250) between 1999 and 2010 were identified from Taiwan's National Health Insurance Research Database and were followed up until 2013. Patients with preexisting depression or sexual dysfunction were excluded. A total of 636,210 patients with DM were enrolled. These patients were divided into two groups: DM with comorbid depression and a matched cohort without depression. The groups were followed up until the end of 2010 for the first diagnosis of sexual dysfunction (ICD-9-CM codes 302.70, 302.71, 302.72, 302.74, 302.75, 302.76, 302.79, 607.84, and V417). A Cox proportional hazard model and a Cox regression model with time-dependent covariates were applied. Results Patients with DM and depression had a higher risk of sexual dysfunction than those with DM without depression (hazard ratio [HR] = 1.44; 95% confidence interval [CI], 1.33-1.55). The risk of sexual dysfunction was lower in the subgroup who used antidepressants (per 28 cumulative defined daily doses [cDDDs]), HR = 0.96; 95% CI, 0.94-0.97). A significantly lower incidence of sexual dysfunction was also associated with the use of selective serotonin reuptake inhibitors (SSRIs, per 28 cDDD). The adjusted HR was 0.95 (95% CI, 0.93-0.97). Subgroup analysis indicated that SSRI use was significantly associated with an amelioration of erectile dysfunction (per 28 cDDD), with an HR of 0.95 (95% CI, 0.92-0.97). Conclusion Male patients with DM and depression are at increased risk of sexual dysfunction. Antidepressant use had a small inverse association with the risk of sexual dysfunction in men with DM and depression. Antidepressants, in particular SSRIs, did not increase the risk of sexual dysfunction in this population.

Needle-free injections are mainly used for administering human or mammalian vaccines or drugs. However, poultry vaccines, in ovo injections to embryos, subcutaneous injections to chickens, and intramuscular injections are administered using needle injections. This article presents a new needle-free in ovo injection device method that uses push-pull solenoids to eject liquid jets, mainly for embryonic eggs of chickens. Furthermore, our study investigated the suitable jet pressures for using this method and the post-injection hatching rates in 18-day-old embryonic eggs. Using this method, we could deliver the liquid to the allantoic and amniotic cavities or the muscle tissue through the egg membrane of the air chamber using a jet pressure of ~6–7 MPa or ~8 MPa. After injecting 0.25 mL of 0.9% saline into 18-day-old Lohmann breed layer embryonic eggs and specific pathogen-free (SPF) embryonic eggs at a jet pressure of ~7 MPa, we observed hatching rates of 98.3% and 85.7%, respectively. This study’s electromagnetic needle-free in ovo injection device can apply vaccine or nutrient solution injection for embryo eggs and serve as a reference for future studies on needle-free in ovo injection automation systems, jet pressure control, and injection pretreatment processes.

Duck eggs are a good source of essential nutrients for the human body. However, transportation, processing, and handling can easily cause cracks in the eggshells. These cracks can lead to microbial contamination, reducing the shelf life and compromising food safety. In this study, a method for the nondestructive testing of cracks in duck eggshells was developed. First, the acoustic emission signals of intact and cracked eggshells were measured, and the most significant frequency features were selected to establish a calibration curve for cracked eggshells. Logistic regression using the frequency features was then adopted to predict intact and cracked eggshells. Then, we establish a set of optimal regression models and used independent samples for verification. The overall accuracy rates of the calibration and prediction models using five frequencies of bandwidth (1500, 5000, 6000, 8500, and 10,000 Hz) were 89.7% and 87.6%, respectively. Sound measurement enables a simple and quantitative method for duck egg crack detection and classification. This nondestructive and cost-effective method can be used for duck egg quality screening and can be integrated into duck egg processing machinery.

Collisions can be classified as completely elastic or inelastic. Collision mechanics theory has gradually developed from elastic to inelastic collision theories. Based on the Hertz elastic collision contact theory and Zener inelastic collision theory model, we derive and explain the Hertz and Zener collision theory model equations in detail in this study and establish the Zener inelastic collision theory, which is a simple and fast calculation of the approximate solution to the nonlinear differential equations of motion. We propose an approximate formula to obtain the Zener nonlinear differential equation of motion in a simple manner. The approximate solution determines the relevant values of the collision force, material displacement, velocity, and contact time.

To determine whether exposure to antidepressants (ATDs) results in improved overall survival (OS) of patients with gastric cancer (GC) after surgery, we conducted a large cohort study and considered confounding factors that might affect the research outcomes. Patients who received a new diagnosis of GC and received surgery and chemotherapy between 1999 and 2008 were recruited and were classified into different groups based on the ATD level used. The association between the OS of patients with GC after surgery with different levels of ATD use, and the hazard ratio with comorbidities at different ATD use levels were compared. According to Kaplan–Meier method, the more of an ATD was taken, the longer the OS and a dose-dependent relationship was discovered in the OS curve; the adjusted HRs were 0.76 (95% confidence interval [CI] = 0.68–0.84) and 0.48 (95% CI = 0.41–0.57) for ATD users taking a cumulative defined daily dose (cDDD) of 28–167 and ≧168, respectively. Sensitivity analyzes were performed to investigate the effect of various comorbidities on OS with different degrees of ATD use and the results remained consistent among the varying models. Additionally, the effect of ATD use still exhibited a dose-dependent relationship in distinct stratifications for sex and age. The OS for patients with GC after surgery and chemotherapy improved with ATD use, and a dose-dependent relationship was discovered in this study. Further studies on the association between OS of GC and ATD use are required.

본 연구는 최근 이슈가 되고 있는 신남방국가들이 현재까지 이루고 있는 경제성장에 대해 다음 요소인 FDI·ODA·TRADE 선정하여 지난 27년간 경제발전에 미치는 영향을 조사하여 분석하였다. 본 연구 방법은 FDI·ODA·TRADE 변수를 통하여 Augmented Dickey-Fuller 단위근 검정 및 Johansen 공적분 검정 추정결과는 벡터오차수정모형을 사용하여 신남방 국가의 경제 성장에 어떤 영향을 미치는지 분석하였다. 1990년~2017년까지 자료를 이용하여 실증 분석한 결과 다음과 같이 결과가 도출되었는데, ODA보다는 FDI가 경제성장에 지대한 영향을 미치는 것으로 확인되었으며, 무역이 FDI보다 경제성장에 더 큰 영향을 준 것으로 확인되었다. 이러한 실증분석 결과를 통해 ODA보다 외국인직접투자 및 수출입이 신남방 국가 성장에 지대한 영향을 준 것으로 확인되며, 무역·투자 증진을 위한 제도적 기반을 강화하여, 신기술 및 신기업의 진출 지원이 경제협력 기반을 구축하는데 중요하다는 시사점을 도출할 수 있다.

Context The effect of antidepressant (ATD) use on mortality in patients with diabetes mellitus (DM) has not yet been sufficiently studied, although comorbid depression is common in this population. Objective To explore the impact of ATDs on mortality among DM patients. Design A retrospective cohort study in a national database. Setting This population-based study used the National Health Insurance Research Database in Taiwan. Since 2000, we identified 53,412 cases of newly diagnosed patients with DM and depression. Patient cases were followed for assessing mortality until 2013. Main Outcome Measure The association between mortality and ATD use was explored adjusting for cumulative dosing. Results Using the time-dependent Cox regression model, ATD use was associated with significantly reduced mortality among patients with DM [in the highest dose group: hazard ratio (HR), 0.65; 95% CI, 0.59 to 0.71]. Further analysis showed that differences in mortality existed across ATD categories: selective serotonin reuptake inhibitors (HR, 0.63; 95% CI, 0.56 to 0.71), serotonin-norepinephrine reuptake inhibitors (HR, 0.58; 95% CI, 0.44 to 0.78), norepinephrine-dopamine reuptake inhibitors (HR, 0.20; 95% CI, 0.07 to 0.63), mirtazapine (HR, 0.60; 95% CI, 0.45 to 0.82), tricyclic/tetracyclic antidepressants (HR, 0.73; 95% CI, 0.54 to 0.97), and trazodone (HR, 0.52; 95% CI, 0.29 to 0.91). However, reversible inhibitor of monoamine oxidase A (RIMA) was found to be associated with an increase, rather than a decrease, in total mortality (HR, 1.48; 95% CI, 1.09 to 1.99). Conclusion Most ATDs, but not RIMA, were associated with significantly reduced mortality among a population with comorbid DM and depression.

The purpose of this study was to investigate whether polymorphisms in five microRNAs (miRNAs), miR-604A&gt, G, miR-608C&gt, G, 631I/D, miR-938G&gt, A, and miR-1302-3C&gt, T, are associated with the risk of idiopathic recurrent pregnancy loss (RPL). Blood samples were collected from 388 patients with idiopathic RPL (at least two consecutive spontaneous abortions) and 227 control participants. We found the miR-604 AG and AG + GG genotypes of miR-604, the miR-938 GA and GA + AA genotypes of miR-938, and the miR-1302-3CT and CT + TT genotypes of miR-1302-3 are less frequent than the wild-type (WT) genotypes, miR-604AA, miR-938GG, and miR-1302-3CC, respectively, in RPL patients. Using allele-combination multifactor dimensionality reduction (MDR) analysis, we found that eight haplotypes conferred by the miR-604/miR-608/miR-631/miR-938/miR-1302-3 allele combination, A-C-I-G-T, A-C-I-A-C, G-C-I-G-C, G-C-I-G-T, G-G-I-G-C, G-G-I-G-T, G-G-I-A-C, G-G-D-G-C, three from the miR-604/miR-631/miR-938/miR-1302-3 allele combination, A-I-G-T, G-I-G-C, G-I-A-T, one from the miR-604/miR-631/miR-1302-3 allele combination, G-I-C, and two from the miR-604/miR-1302-3 allele combination, G-C and G-T, were less frequent in RPL patients, suggesting protective effects (all p &lt, 0.05). We also identified the miR-604A&gt, G and miR-938G&gt, A polymorphisms within the seed sequence of the mature miRNAs and aligned the seed sequences with the 3′UTR of putative target genes, methylenetetrahydrofolate reductase (MTHFR) and gonadotropin-releasing hormone receptor (GnRHR), respectively. We further found that the binding affinities between miR-604/miR-938 and the 3′UTR of their respective target genes (MTHFR, GnRHR) were significantly different for the common (miR-604A, miR-938G) and variant alleles (miR-604G, miR-938A). These results reveal a significant association between the miR-604A&gt, A polymorphisms and idiopathic RPL and suggest that miRNAs can affect RPL in Korean women.

Supplemental material, sj-docx-1-jop-10.1177_02698811211013582 for Effect of medication on risk of traumatic brain injury in patients with bipolar disorder: A nationwide population-based cohort study by Yin-To Liao, Yu-Hui Ku, Hong-Ming Chen, Mong-Liang Lu, Ko-Jung Chen, Yao-Hsu Yang, Jun-Cheng Weng and Vincent Chin-Hung Chen in Journal of Psychopharmacology

Additional file 2. Additional details of molecular testing.

Additional file 1: Supplementary Table 1. Results of bisulfite pyrosequencing.

Supplemental material, sj-docx-1-jop-10.1177_02698811211013582 for Effect of medication on risk of traumatic brain injury in patients with bipolar disorder: A nationwide population-based cohort study by Yin-To Liao, Yu-Hui Ku, Hong-Ming Chen, Mong-Liang Lu, Ko-Jung Chen, Yao-Hsu Yang, Jun-Cheng Weng and Vincent Chin-Hung Chen in Journal of Psychopharmacology

Introduction Patients with hemoglobinopathies have been reported to have higher rates of pulmonary complications. Few studies have investigated the association between thalassemia and asthma in children. Methods We used the data of one million individuals randomly selected from the Registry for Beneficiaries of the National Health Insurance Research Database. One thalassemic child was matched with four control children without thalassemia according to sex, birth year, birth season, prematurity, and previous enteroviral infection. Results A total of 800 hundred thalassemic children and 3200 controls were included. Children with thalassemia had higher rates of developing asthma (41.81 vs 25.70 per 1000 person-years, P < 0.001) than the non-thalassemia controls with an adjusted hazard ratio of 1.37 (95% confidence interval [CI] = 1.19–1.58). Boys in the thalassemia cohort had a significantly higher adjusted incidence hazard ratio (IRR) of asthma than those in the non-thalassemia cohort (adjusted IRR = 1.45, 95% CI = 1.02–1.73). The risk of atopic and nonatopic asthma was higher in the thalassemia cohort than in the non-thalassemia cohort (IRR = 1.3, 1.61, respectively). Conclusions Children with thalassemia were more likely to develop asthma. More attention should be paid to the early diagnosis of asthma and prevention of asthma attacks.

Background:Antidepressants are frequently used to treat depression in patients with dementia. In addition, late-life depression is associated with the incidence of subsequent cognitive impairment or dementia. However, the association between exposure to antidepressants in late-life depression and the development of incident dementia remains understudied.Methods:Through a population-based retrospective cohort design, data were extracted from the Taiwan National Health Insurance Research Dataset of medical claims registered from 1998–2013. We collected data of individuals who had received a new diagnosis of depression between 2000 and 2007. We excluded those who received a diagnosis of depression and were given antidepressants before 2000 and those younger than 60 years. The primary outcome was the occurrence of incident dementia. The time from the prescription of antidepressants or the diagnosis of depression until the outcome or the end of 2013 was calculated as the time to event. A total of 563,918 cases were included and were divided into either antidepressant users or antidepressant nonusers. Cox proportional hazards models were used to calculate the hazard ratio and 95% confidence interval.Results:Exposure to antidepressants did not increase the risk of dementia in patients with late-life depression at either a low exposure dosage (hazard ratio: 1.06, 95% confidence interval: 0.91–1.23) or a high exposure dosage (hazard ratio: 1.07, 95% confidence interval: 0.95–1.20). To confirm the validity of our results, we performed a sensitivity analysis and subgroup analysis, and the post-hoc results were consistent with the main results.Conclusion:Antidepressants did not increase the risk of incident dementia in patients with late-life depression.

Background: Numerous studies have revealed that statins have antitumor effects in vivo and in vitro. However, few studies have explored the relationship between statin use and the mortality of gastric cancer (GC) patients after treatments. This study examines the relationship between statin use and the overall survival (OS) of GC patients after surgery and adjuvant chemotherapy, using data from the nationwide cohort database of Taiwan. Methods: All patients newly diagnosed with GC from 1999 to 2008 in Taiwan were identified from the Registry of Catastrophic Illness Patients Database. Through propensity score matching, statin users were matched to statin non-users at a 1:4 ratio. The relationship between statin use and the OS of patients with GC was estimated through Cox regression models. Results: The study cohort included 1835 patients with GC who had received therapies during the study period. The death numbers among statin users (defined as those who used more than 28 cumulative defined daily doses (cDDDs)) and statin non-users were 138 and 895, respectively. A dose&ndash, response association was noted between statin use and the OS of patients with GC after treatments. The adjusted hazard ratios were 0.62 (95% confidence intervals (CI), 0.50&ndash, 0.78) and 0.34 (95% CI, 0.26&ndash, 0.45) for statin users administered 28&ndash, 167 cDDDs and &gt, 168 cDDDs, respectively, compared with no statin use (&lt, 28 cDDDs). Conclusions: This study highlights that statin use may dose-dependently improve the OS of patients with GC after surgery and adjuvant chemotherapy in Taiwan. Additional studies are required to confirm the efficacy and safety of statin use.

Pei-Lun Chung,1 Chien-Wei Huang,2 Min-Jing Lee,1,3 Yao-Hsu Yang,4,5 Ko-Jung Chen,4 Mong-Liang Lu,6 Jun-Cheng Weng,1,7 Vincent Chin-Hung Chen1,3 1Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan; 2Division of Nephrology, Department of Medicine, School of Medicine, Kaohsiung Veterans General Hospital, and National Yang-Ming University, Taiwan; 3School of Medicine, Chang Gung University, Taoyuan, Taiwan; 4Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan; 5Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan; 6Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; 7Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, TaiwanCorrespondence: Vincent Chin-Hung ChenDepartment of Psychiatry, Chang Gung Memorial Hospital, Chiayi, TaiwanEmail cch1966@gmail.comPurpose: This study explored and compared the effects of depression and antidepressants on sexual dysfunction in men with diabetes mellitus (DM).Patients and Methods: Patients older than 18 years who had been newly diagnosed with DM (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] code 250) between 1999 and 2010 were identified from Taiwan’s National Health Insurance Research Database and were followed up until 2013. Patients with preexisting depression or sexual dysfunction were excluded. A total of 636,210 patients with DM were enrolled. These patients were divided into two groups: DM with comorbid depression and a matched cohort without depression. The groups were followed up until the end of 2010 for the first diagnosis of sexual dysfunction (ICD-9-CM codes 302.70, 302.71, 302.72, 302.74, 302.75, 302.76, 302.79, 607.84, and V417). A Cox proportional hazard model and a Cox regression model with time-dependent covariates were applied.Results: Patients with DM and depression had a higher risk of sexual dysfunction than those with DM without depression (hazard ratio [HR] =  1.44; 95% confidence interval [CI], 1.33– 1.55). The risk of sexual dysfunction was lower in the subgroup who used antidepressants (per 28 cumulative defined daily doses [cDDDs]), HR = 0.96; 95% CI, 0.94– 0.97). A significantly lower incidence of sexual dysfunction was also associated with the use of selective serotonin reuptake inhibitors (SSRIs, per 28 cDDD). The adjusted HR was 0.95 (95% CI, 0.93– 0.97). Subgroup analysis indicated that SSRI use was significantly associated with an amelioration of erectile dysfunction (per 28 cDDD), with an HR of 0.95 (95% CI, 0.92– 0.97).Conclusion: Male patients with DM and depression are at increased risk of sexual dysfunction. Antidepressant use had a small inverse association with the risk of sexual dysfunction in men with DM and depression. Antidepressants, in particular SSRIs, did not increase the risk of sexual dysfunction in this population.Keywords: selective serotonin reuptake inhibitor, SSRI, sexual functioning, diabetes mellitus, depression

본 연구의 목적은 부모자녀 간의 관계증진에 보편적으로 적용 가능한 예방적 프로그램을 개발 적용하고, 프로그램 참여자의 경험을 통해 그 적용 결과를 탐색하기 위함이다. 이를 위해 서울 시내 한 초등학교에 재학 중인 초등학생 6명과 그 어머니를 대상으로 가족관계증진 사회서비스 R&D의 일환으로 개발한 부모자녀 관계증진 프로그램을 9회기 걸쳐 시범 실시하였다. 프로그램의 효과를 분석하기 위해 참여 어머니를 대상으로초점집단면접을 수행하였고 주요 연구결과는 다음과 같다. 먼저, 문제 중심으로 접근하는 기존 프로그램과 달리 성숙한 관계를 형성하고 유지할 수 있는 기초역량 강화 중심의 접근은 친밀한 관계에 대한 이해력 제고에 긍정적으로 작용함을 알 수 있었다. 또한 자녀양육 강의가 아닌 대안적 상호작용 체험 위주의 진행 방식은 부모가 자녀의 특성을 이해하고 관계상의 고민과 문제를 통찰하는데 용이하다는 장점으로 부각되었다. 다음으로, 사회서비스로서 부모자녀 관계증진 프로그램의 공급과 확산을 위한 학교 역할의 중요성을 확인하였으며 참여 어머니들의 프로그램 경험이 자조집단 발달로 이어지는 성과를 관찰하였다. 이러한 연구결과는 보편적이고 예방적 성격의 사회서비스가 부모교육 및 전문상담에 대한 잠재 욕구를 인식하게 하는 계기(screening) 또는 서비스진입점(entry point) 역할을 할 수 있다는 함의를 가진다.

To determine whether exposure to antidepressants (ATDs) results in improved overall survival (OS) of patients with gastric cancer (GC) after surgery, we conducted a large cohort study and considered confounding factors that might affect the research outcomes.Patients who received a new diagnosis of GC and received surgery and chemotherapy between 1999 and 2008 were recruited and were classified into different groups based on the ATD level used. The association between the OS of patients with GC after surgery with different levels of ATD use, and the hazard ratio with comorbidities at different ATD use levels were compared.According to Kaplan-Meier method, the more of an ATD was taken, the longer the OS and a dose-dependent relationship was discovered in the OS curve; the adjusted HRs were 0.76 (95% confidence interval [CI] = 0.68-0.84) and 0.48 (95% CI = 0.41-0.57) for ATD users taking a cumulative defined daily dose (cDDD) of 28-167 and ≧168, respectively. Sensitivity analyzes were performed to investigate the effect of various comorbidities on OS with different degrees of ATD use and the results remained consistent among the varying models. Additionally, the effect of ATD use still exhibited a dose-dependent relationship in distinct stratifications for sex and age.The OS for patients with GC after surgery and chemotherapy improved with ATD use, and a dose-dependent relationship was discovered in this study. Further studies on the association between OS of GC and ATD use are required.

Additional file 3: Table S2. Haplotype analysis of individuals with mutations in the GBAgene.

Additional file 1: Figure S1. Three-dimensional structure of GBA and location of GBAmutations.

Additional file 2: Table S1. The list of 11 short tandem repeat (STR) markers.

Purpose This study explored and compared the effects of depression and antidepressants on sexual dysfunction in men with diabetes mellitus (DM). Patients and Methods Patients older than 18 years who had been newly diagnosed with DM (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] code 250) between 1999 and 2010 were identified from Taiwan’s National Health Insurance Research Database and were followed up until 2013. Patients with preexisting depression or sexual dysfunction were excluded. A total of 636,210 patients with DM were enrolled. These patients were divided into two groups: DM with comorbid depression and a matched cohort without depression. The groups were followed up until the end of 2010 for the first diagnosis of sexual dysfunction (ICD-9-CM codes 302.70, 302.71, 302.72, 302.74, 302.75, 302.76, 302.79, 607.84, and V417). A Cox proportional hazard model and a Cox regression model with time-dependent covariates were applied. Results Patients with DM and depression had a higher risk of sexual dysfunction than those with DM without depression (hazard ratio [HR] = 1.44; 95% confidence interval [CI], 1.33–1.55). The risk of sexual dysfunction was lower in the subgroup who used antidepressants (per 28 cumulative defined daily doses [cDDDs]), HR = 0.96; 95% CI, 0.94–0.97). A significantly lower incidence of sexual dysfunction was also associated with the use of selective serotonin reuptake inhibitors (SSRIs, per 28 cDDD). The adjusted HR was 0.95 (95% CI, 0.93–0.97). Subgroup analysis indicated that SSRI use was significantly associated with an amelioration of erectile dysfunction (per 28 cDDD), with an HR of 0.95 (95% CI, 0.92–0.97). Conclusion Male patients with DM and depression are at increased risk of sexual dysfunction. Antidepressant use had a small inverse association with the risk of sexual dysfunction in men with DM and depression. Antidepressants, in particular SSRIs, did not increase the risk of sexual dysfunction in this population.

Background Hepatitis C virus ( HCV ) infection not only links closely to systemic inflammation but also has numerous extrahepatic manifestations. Chronic inflammation also increases the risk of new‐onset atrial fibrillation (AF). However, little is known regarding the clinical association between HCV infection and new‐onset AF. Methods and Results We conducted a population‐based cohort study using Taiwan's National Health Insurance Research Database during 1997 to 2013. A total of 11 771 HCV ‐infected patients were included in this study, and each of them was matched in a ratio of 1:4. Because of higher mortality among HCV cohorts, we used both Cox proportional hazard regression and competing risk regression models to compute the hazard ratios accompanying 95% CI s after adjustment for relevant confounder. The results demonstrated that the patients with chronic HCV infection had significantly higher incidence rate (332.0 versus 265.8 in 100 000 person‐years, P HCV population. The adjusted hazard ratio of HCV for new‐onset AF was 1.32 (95% CI , 1.20–1.44; P CI, 1.10–1.31; P =0.0001) while calculated with Cox proportional hazard regression model and competing risk model, respectively. Intriguingly, we observed that the patients with HCV treated with antiviral agents had significantly lower incidental AF than those without anti‐ HCV treatment (1.2% versus 6.0%; P Conclusions Chronic HCV infection was associated with an increased risk of incidental AF probably through sharing common pathology of chronic inflammation. Furthermore, a well‐designed study is needed to clarify whether anti‐ HCV therapy can provide protection against the occurrence of AF .

Background: Dementia prevalence is increasing worldwide, and dementia is frequently comorbid with depression during its disease course. Additionally, safety concerns are rising regarding the prescription of psychotropic agents to patients with dementia. Thus, our study assessed the influence of prescribing antidepressants in dementia with depression on mortality risk, and the differences between classes of antidepressants. Methods: This study was a population-based retrospective cohort study that utilized the National Health Insurance (NHI) medical claims data on mental illness in Taiwan between 1998 and 2013. We identified 25,890 cases of newly diagnosed dementia with depression and divided them into two groups: antidepressant users and nonusers. All-cause mortality between the two groups and the effects of different antidepressants were analyzed. Results: Antidepressants reduced all-cause mortality in patients with dementia and depression after adjusting for all covariates. Furthermore, the effect was significant when antidepressant exposure was more than 168 cumulative defined daily dosages, and most classes of antidepressants had this protective effect. Conclusions: Antidepressant treatment showed significant protective effects in all-cause mortality for patients with dementia and depression. Most classes of antidepressants were effective, especially with longer treatment duration or higher dosage.

Background Intracranial aneurysms after radiotherapy (RT) have previously been reported. However, the majority of studies were case reports. Therefore, we performed a nationwide study to explore the risk of radiation-induced intracranial aneurysms. Methods This study included patients diagnosed with head and neck cancer (ICD9: 140–149, 161). Intracranial aneurysms formation was identified using the following ICD9 codes: nonruptured cerebral aneurysm (ICD9:4373), aneurysm clipping (ICD9:3951). Patients who did not receive curative treatment and those with intracranial aneurysms before the diagnosis of head and neck cancer were excluded. Results In total, 70,691 patients were included in the final analysis; they were categorized into the following three groups: nasopharyngeal carcinoma (NPC) with RT, non-NPC with RT, and non-NPC without RT. Patients in the NPC with RT group had the highest risk of developing intracranial aneurysms (hazard ratio (HR) 2.57; P

Objectives: The clinical effect of traditional Chinese medicine (TCM) on survival in patients with advanced lung adenocarcinoma treated with first-line epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) is a major concern and requires more evidence from large-scale clinical studies. Materials and Methods: This population-based cohort study used the Taiwan National Health Insurance Research Database to enroll patients between 2006 and 2012 who had newly diagnosed locally advanced and metastatic lung adenocarcinoma treated with first-line gefitinib or erlotinib. Survival was tracked until 2013. The patients were separated into TCM users and nonusers, and Cox regression models were applied to determine the association between the use of TCM and the survival of patients. Results: A total of 1988 patients receiving first-line gefitinib or erlotinib for the treatment of EGFR-mutated advanced lung adenocarcinoma, with the exclusion of TCM users after tumor progression, were included in this cohort study. Compared with TCM nonuse, TCM use for ≥180 days was associated with a significantly decreased risk of mortality by 68% (adjusted hazard ratio [HR], 0.32 [95% CI, 0.21-0.50], P < .0001). Compared with TCM nonuse, TCM use for ≥180 days was associated with a significantly decreased risk of disease progression by 59% (adjusted HR, 0.41 [95% CI, 0.29-0.58], P < .0001). Conclusion: This cohort study suggests that adjunctive TCM therapy could improve overall survival and progression-free survival in patients with advanced lung adenocarcinoma treated with first-line TKIs. Future randomized, controlled trials are required to validate these findings.

Purpose: In case of existing building, A lot of attempts are being made like changing thermal system or using high efficiency products to decrease energy load and increase energy efficiency. However, (1) Absence of systemed database of green-remodeling technology and products. (2) Absence of comparative analysis system and qualitative/quantitative evaluation method of energy performance and energy reduction cost. (3) Existing remodeling was very hard to access for non-experts. So, in this paper, the authors developed data base for green-remodeling(Impact Table A, Impact Table B) and optimum combination dedication tool for user convenience. Accordingly, purpose of this paper validate usefulness of Impact Table and optimum alternative dedication tool. Method: For validate the usefulness of Impact Table and optimum combination dedication tool, the authors selected five test model office buildings. Next, through research investigation, the authors diagnosed the present state of buildings. In base of diagnosis results, select technologies for remodeling by qualitative comparison (Impact Table A). Next, evaluate quantitative price and performance technologies that selected in Impact Table A (Impact Table B). Lastly, through final evaluation of Impact Taba A and Impact Table B, determine the direction of the green-remodeling. Result: Impact Table and optimum combination dedication tool can use relative indicator for green-remodeling, especially through ROI by detail field.

Additional file 1. Detail and data of chromosomal microarray testing including non-pathogenic CNVs.

BackgroundChronic inflammation is known to be associated with both rotator cuff tears (RCTs) and depression. However, no epidemiological studies with a longitudinal follow-up have been performed to prove this association. We aimed to investigate whether depressed patients had an elevated risk of RCT and subsequent repair surgery compared with those without depression.MethodsThis retrospective cohort study comprised of patients diagnosed with depression between 2000 and 2010 (depression cohort) and patients without depression (non-depression cohort, 1:2 age and sex matched). The risk of RCT and rotator cuff repair surgery were determined during a 13-year follow-up (2000-2013) between these two cohorts.ResultsThis study included 26,868 patients with depression and 53,736 patients without depression. The incidence of RCT was 648 and 438 per 100,000 person-years in the depression and non-depression cohorts, respectively. The adjusted hazard ratio (HR) was 1.46 (95% confidence interval [CI], 1.36-1.57) for depressed patients. The incidence of rotator cuff repair surgery was 28 and 18 per 100,000 person-years in the depression and non-depression cohorts, respectively. Depressed patients also had a significantly increased risk of subsequent rotator cuff repair surgery (adjusted HR = 1.46; 95% CI, 1.04-2.06).ConclusionThe present study showed that depression was associated with an increased risk of rotator cuff tear and rotator cuff repair surgery.

We present three unrelated Korean Shwachman-Diamond syndrome (SDS) patients that carry an incomplete but identical homozygous EFL1 p.Thr1069Ala variant due to a bone marrow-specific mosaic uniparental disomy (UPD) in chromosome 15. This rare variant is found in 0.017% of East Asians and is asymptomatic in a heterozygous status, but harbors a hypomorphic effect, leading to 80S assembly of ribosomal protein (RP) transcripts. We propose a novel somatically-induced pathogenesis mechanism and EFL1 dysfunction that eventually leads to aberrant translational control and ribosomopathy.

High comorbidity of obsessive-compulsive disorder (OCD) has been reported in patients with schizophrenia. The sequence of OCD and schizophrenia onset might clarify the underlying pathophysiological relationships between these two disorders, but available evidence is limited. In this study, we used a population-based cohort to investigate the risk of schizophrenia in people with newly diagnosed OCD. Patients who were first diagnosed with OCD from 2000 to 2013 were selected from the Longitudinal Health Insurance Research Database. The non-OCD group was randomly sampled, and matched with the OCD group by gender, age, urbanization level, and income. Cox regression analyses and competing risk model were used to estimate the risk of schizophrenia, adjusting for potential confounding factors. In total, 2009 patients with OCD and 8036 controls were identified. The crude incidences of schizophrenia in the OCD and non-OCD groups were 876.2 per 100,000 person-years and 28.7 per 100,000 person-years, respectively. After adjustment, a substantially higher risk of schizophrenia was observed in the OCD group (hazard ratio = 30.29, 95% confidence interval = 17.91–51.21). Male gender, age of OCD onset before 20 years, and antipsychotic prescription were associated with schizophrenia. Patients with comorbidity of autistic disorder have higher risk of schizophrenia (hazard ratio = 4.63, 95% confidence interval = 1.58–13.56). In conclusion, OCD diagnosis, male gender, age of OCD onset before 20 years, comorbidity of autistic disorder, and antipsychotic use were associated with higher risk of schizophrenia. It is essential for psychiatrists to note that OCD may be the initial presentation of schizophrenia.

In the past few years numerous studies focused on early detection of Alzheimer's disease (AD). Of various biomarkers, cerebral beta-amyloid (Aβ) is the most important evidence that implicates AD-specific neuropathology, which begins to accumulate decades before the clinical onset of AD. Thus early identification of individuals at high risk of developing AD becomes crucial. Although cerebral Aβ burden can be assessed in-vivo via positron emission tomography (PET), these techniques are expensive and are not commonly available. This study supports that simple and cost-effective methods can predict cerebral Aβ based on neuropsychological test scores with demographics derived from machine learning approaches. Specifically, we applied several well-established and simple machine learning algorithms to Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset. Our study demonstrated that neuropsychological assessment data with demographics using simple machine learning algorithms can be a cost-effective method for predicting amyloid beta compared to magnetic resonance imaging (MRI) data.

The goal of this study was to investigate the gratifications Taiwanese students sought and obtained from Instant Messaging use (IM). This study also examined the relationship among gratifications Taiwanese students obtained, gender, and their frequency of IM use. A 13-motivation with 37 statements scale derived from previous uses and gratifications studies is presented along with the demographic information as an instrument to determine Taiwanese students’ gratifications from IM use. The participants were 406 undergraduate, graduate, and doctoral college students, who are the primary users of this new interactive communication technology. The results indicated there were 10 gratifications sought (Flexibility, Escape, Convenience, Companionship, Socialization, Control, Habit, Identity, Utility, and Surveillance) and nine gratifications obtained (Convenience, Escape, Companionship, Socialization, Mobility, Identity, Surveillance, Control, and Utility) from IM use. Gratifications obtained were positively associated with the frequency of IM use. Gender differences that lead to different gratifications obtained and frequency of IM use per week were also found.