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BackgroundUsing Minnesota Multiphasic Personality Inventory-2 (MMPI-2) clinical scales to evaluate clinical symptoms in schizophrenia is a well-studied topic. Nonetheless, research focuses less on how these clinical scales interact with each other.AimsInvestigates the network structure and interaction of the MMPI-2 clinical scales between healthy individuals and patients with schizophrenia through the Bayesian network.MethodData was collected from Wuhan Psychiatric Hospital from March 2008 to May 2018. A total of 714 patients with schizophrenia and 714 healthy subjects were identified through propensity score matching according to the criteria of the International Classification of Diseases (ICD-11). Separated MMPI-2 clinical scales Bayesian networks were built for healthy subjects and patients with schizophrenia, respectively.ResultsThe Bayesian network showed that the lower 7 scale was a consequence of the correlation between the lower 2 scale and the greater 8 scale. A solely lower 7 scale does yield neither a lower 2 scale nor a higher 8 scale. The proposed method showed 72% of accuracy with 78% area under the ROC curve (AUC), similar to the previous studies.LimitationsThe proposed method simplified the continuous Bayesian network to predict binary outcomes, including other categorical data is not explored. Besides, the participants might only represent an endemic as they come from a single hospital.ConclusionThis study identified MMPI-2 clinical scales correlation and built separated Bayesian networks to investigate the difference between patients with schizophrenia and healthy people. These differences may contribute to a better understanding of the clinical symptoms of schizophrenia and provide medical professionals with new perspectives for diagnosis.

Background Clinical mobility and balance assessments identify older adults who have a high risk of falls in clinics. In the past two decades, sensors have been a popular supplement to mobility and balance assessment to provide quantitative information and a cost-effective solution in the community environment. Nonetheless, the current sensor-based balance assessment relies on manual observation or motion-specific features to identify motions of research interest. Objective The objective of this study was to develop an automatic motion data analytics framework using signal data collected from an inertial sensor for balance activity analysis in community-dwelling older adults. Methods In total, 59 community-dwelling older adults (19 males and 40 females; mean age = 81.86 years, SD 6.95 years) were recruited in this study. Data were collected using a body-worn inertial measurement unit (including an accelerometer and a gyroscope) at the L4 vertebra of each individual. After data preprocessing and motion detection via a convolutional long short-term memory (LSTM) neural network, a one-class support vector machine (SVM), linear discriminant analysis (LDA), and k-nearest neighborhood (k-NN) were adopted to classify high-risk individuals. Results The framework developed in this study yielded mean accuracies of 87%, 86%, and 89% in detecting sit-to-stand, turning 360°, and stand-to-sit motions, respectively. The balance assessment classification showed accuracies of 90%, 92%, and 86% in classifying abnormal sit-to-stand, turning 360°, and stand-to-sit motions, respectively, using Tinetti Performance Oriented Mobility Assessment-Balance (POMA-B) criteria by the one-class SVM and k-NN. Conclusions The sensor-based approach presented in this study provided a time-effective manner with less human efforts to identify and preprocess the inertial signal and thus enabled an efficient balance assessment tool for medical professionals. In the long run, the approach may offer a flexible solution to relieve the community’s burden of continuous health monitoring.

Counting the repetition of human exercise and physical rehabilitation is a common task in rehabilitation and exercise training. The existing vision-based repetition counting methods less emphasize the concurrent motions in the same video. This work presents a vision-based human motion repetition counting applicable to counting concurrent motions through the skeleton location extracted from various pose estimation methods. The presented method was validated on the University of Idaho Physical Rehabilitation Movements Data Set (UI-PRMD), and MM-fit dataset. The overall mean absolute error (MAE) for mm-fit was 0.06 with off-by-one Accuracy (OBOA) 0.94. Overall MAE for UI-PRMD dataset was 0.06 with OBOA 0.95. We have also tested the performance in a variety of camera locations and concurrent motions with conveniently collected video with overall MAE 0.06 and OBOA 0.88. The proposed method provides a view-angle and motion agnostic concurrent motion counting. This method can potentially use in large-scale remote rehabilitation and exercise training with only one camera.

Background Obligate brood parasites exert strong selective pressure on target hosts. In response, hosts typically evolve anti-parasitism strategies, of which egg recognition is one of the most efficient. Generally, host egg-recognition capacity is determined using model eggs. Previous studies have shown that some host species, which are capable of detecting parasite eggs, do not reject model eggs. However, it is unknown that whether the reaction to model eggs varies among distinct populations of the same host in relation to the degree of parasitism pressure. Results Here, we compared the rejection frequencies of model eggs and real eggs between mainland and island populations of the plain prinia (Prinia inornata), which are respectively sympatric and allopatric with their brood parasite, the common cuckoo (Cuculus canorus). Our results indicated that the mainland and island populations rejected real eggs at similar rates, but rejected model eggs, which were similar in size to real eggs but heavier, at significantly different rates: the island population rejected fewer model eggs, possibly because the rejection motivation of this population was lower due to absence of parasitism. Conclusions Our results indicated that some factors affecting the decision to reject, such as rejection motivation, varied according to the degree of parasitism pressure, and thus influenced the frequency of egg rejection. Furthermore, our results suggested that model eggs should be used with caution in comparative studies of egg recognition abilities among species or populations subjected to different intensities of brood parasitism. That is, model eggs may fail to accurately detect egg recognition in host populations with little to no risk of parasitism.

Significance It is a tenet of modern biology that species adapt through natural selection to cope with the ever-changing environment. By comparing genetic variants between the island and mainland populations of a passerine, we inferred the related age of genetic variants across its entire genome and suggest that preexisting standing variants played the predominant role in local adaptation. Our findings not only resolve a long-standing fundamental problem in biology regarding the genetic sources of adaptation, but imply that the evolutionary potential of a population is highly associated with its preexisting genetic variation., What kind of genetic variation contributes the most to adaptation is a fundamental question in evolutionary biology. By resequencing genomes of 80 individuals, we inferred the origin of genomic variants associated with a complex adaptive syndrome involving multiple quantitative traits, namely, adaptation between high and low altitudes, in the vinous-throated parrotbill (Sinosuthora webbiana) in Taiwan. By comparing these variants with those in the Asian mainland population, we revealed standing variation in 24 noncoding genomic regions to be the predominant genetic source of adaptation. Parrotbills at both high and low altitudes exhibited signatures of recent selection, suggesting that not only the front but also the trailing edges of postglacial expanding populations could be subjected to environmental stresses. This study verifies and quantifies the importance of standing variation in adaptation in a cohort of genes, illustrating that the evolutionary potential of a population depends significantly on its preexisting genetic diversity. These findings provide important context for understanding adaptation and conservation of species in the Anthropocene.

Recently, perovskites have attracted intense attention due to their high potential in optoelectronic applications. Employing perovskites as the emissive materials of light-emitting electrochemical cells (LECs) shows the advantages of simple fabrication process, low-voltage operation, and compatibility with inert electrodes, along with saturated electroluminescence (EL) emission. Unlike in previously reported perovskite LECs, in which salts are incorporated in the emissive layer, the ion-transport layer was separated from the emissive layer in this work. The layer of ionic transition metal complex (iTMC) not only provides mobile ions but also serves as an electron-injection/transport layer. Orthogonal solvents are used in spin coating to prevent the intermixing of stacked perovskite and iTMC layers. The blue iTMC with high ionization potential is effective in blocking holes from the emissive layer and thus ensures EL color saturation. In addition, the carrier balance of the perovskite/iTMC LECs can be optimized by adjusting the iTMC layer thickness. The optimized external quantum efficiency of the CsPbBr3 /iTMC LEC reaches 6.8 %, which is among the highest reported values for perovskite LECs. This work successfully demonstrates that, compared with mixing all components in a single emissive layer, separating the layer of ion transport, electron injection and transport from the perovskite emissive layer is more effective in adjusting device carrier balance. As such, solution-processable perovskite/iTMC LECs open up a new way to realize efficient perovskite LECs.

To support various network services, routers have to classify packets based on header fields and a set of filters. Each filter contains several fields to specify ranges of header values, and an associated action, which specifies how to handle the packet matching the filter. If two filters overlap and the actions defined in the filters conflict, it may lead to a false classification. In this paper, we propose a fast bit-vector-based algorithm for conflict detection. Experimental results show that our algorithm can reduce the average detection time per filter by 22.6% to 77.9% compared to the scalable bit vector (SBV) algorithm. Moreover, our algorithm does not consume significant extra memory and pre-computation time.

Summary1. Niche evolution underpins the generation and maintenance of biological diversity, butniche conservatism, in which niches remain little changed over time in closely related taxa,and the role of ecology in niche evolution are continually debated.2. To test whether climate niches are conserved in two closely related passerines in East Asia– the vinous-throated (Paradoxornis webbianus) and ashy-throated (P. alphonsianus) parrot-bills – we established their potential allopatric and sympatric regions using ecological nichemodels and compared differences in their climate niches using niche overlap indices in back-ground tests and multivariate statistical analyses. We also used polymorphism data on 44nuclear genes to infer their divergence demography.3. We found that these two parrotbills occupy different climate niches, in both their allopat-ric and potential sympatric regions. Because the potential sympatric region is the area pre-dicted to be suitable for both parrotbills based on the ecological niche models, it can serve asa natural common garden. Therefore, their observed niche differences in this potential sympa-try were not simply rendered by phenotypic plasticity and probably had a genetic basis.4. Our genetic analyses revealed that the two parrotbills are not evolutionarily independentfor the most recent part of their divergence history. The two parrotbills diverged c.856 000 years ago and have had substantial gene flow since a presumed secondary contact c.290 000 years ago.5. This study provides an empirical case demonstrating that climate niches may not behomogenized in nascent species in spite of substantial, ongoing gene flow, which in turn sug-gests a role for ecology in promoting and maintaining diversification among incipient species.Key-words: divergence with gene flow, ecological niche modelling, niche evolution, parapa-try, secondary contact, speciationIntroduction

Aim Coronary artery calcium (CAC) score has a role in stratifying cardiovascular risk in patients with diabetes. Cardio-ankle vascular index (CAVI) is also a useful method to detect coronary artery calcification. This study compares CAC score with CAVI in the prediction of cardiovascular events in patients with diabetes. Methods From August 2006 to June 2008, a total of 626 patients with diabetes who received CAC score assessment with concomitant tests of ankle-brachial index and CAVI were included in this study. Results During 4 years of follow-up, 98 participants developed cardiovascular events. There is an increased incidence of coronary revascularization and total cardiovascular events with higher categories of CAC score (P ＜ 0.05 when CAC score ≥ 100). The logistic regression analyses revealed pooled odd ratios for coronary revascularization, and total cardiovascular events were 1.25 [95% confidence interval (CI) 1.03- 1.51, P =0.021] and 1.23 (95% CI 1.07-1.42, P = 0.005), respectively, for high versus low CAVI (CAVI ≥ 9.0 vs CAVI ＜ 9.0). The logistic regression model revealed that a CACscore of ≥ 1000 rather than a CAVI of ≥ 9.0 had a higher predictive value for total cardiovascular events. Conclusions A CAC score of ≥ 100 or a CAVI of ≥ 9.0 predicts future total cardiovascular events in asymptomatic patients with type 2 diabetes. Considering the advantages of CAVI, it can be used as one of the screening tools to reflect coronary atherosclerosis in these patients.

Background A variety of human diseases transmitted by arthropod vectors, including ticks, are emerging around the globe. Birds are known to be hosts of ticks and can disperse exotic ticks and tick-borne pathogens. In Taiwan, previous studies have focused predominantly on mammals, leaving the role of birds in the maintenance of ticks and dissemination of tick-borne pathogens undetermined. Methods Ticks were collected opportunistically when birds were studied from 1995 to 2013. Furthermore, to improve knowledge on the prevalence and mean load of tick infestation on birds in Taiwan, ticks were thoroughly searched for when birds were mist-netted at seven sites between September 2014 and April 2016 in eastern Taiwan. Ticks were identified based on both morphological and molecular information and were screened for potential tick-borne pathogens, including the genera Anaplasma, Babesia, Borrelia, Ehrlichia and Rickettsia. Finally, a list of hard tick species collected from birds in Taiwan was compiled based on past work and the current study. Results Nineteen ticks (all larvae) were recovered from four of the 3096 unique mist-netted bird individuals, yielding a mean load of 0.006 ticks/individual and an overall prevalence of 0.13%. A total of 139 ticks from birds, comprising 48 larvae, 35 nymphs, 55 adults and one individual of unknown life stage, were collected from 1995 to 2016, and 11 species of four genera were identified, including three newly recorded species (Haemaphysalis wellingtoni, Ixodes columnae and Ixodes turdus). A total of eight tick-borne pathogens were detected, with five species (Borrelia turdi, Anaplasma sp. clone BJ01, Ehrlichia sp. BL157-9, Rickettsia helvetica and Rickettsia monacensis) not previously isolated in Taiwan. Overall, 16 tick species of five genera have been recorded feeding on birds, including nine species first discovered in this study. Conclusion Our study demonstrates the paucity of information on ticks of birds and emphasizes the need for more research on ticks of birds in Taiwan and Southeast Asia. Moreover, some newly recorded ticks and tick-borne pathogens were found only on migratory birds, demonstrating the necessity of further surveillance on these highly mobile species. Electronic supplementary material The online version of this article (10.1186/s13071-017-2535-4) contains supplementary material, which is available to authorized users.

Birds are capable of seeing the ultraviolet light (UV) spectrum and as a consequence have evolved UV-reflective structures with signalling functions. Avian eggs also reflect in the UV spectrum but the importance of UV egg matching in egg rejection decisions has been equivocal. Here we conducted egg rejection experiments in the congeneric and sympatrically breeding Yellow-bellied Prinia Prinia flaviventris and Plain Prinia Prinia inornata in Taiwan to assess the role of UV as a cue in egg discrimination. Yellow-bellied Prinia is a host of Oriental Cuckoo Cuculus optatus, whereas Plain Prinia is not. We coated one prinia egg in the experimental clutches with a cream containing a UV-blocking agent, while the rest of the eggs were coated with cream only. We also experimentally parasitized prinias with non-mimetic model eggs with reduced UV reflectance. Yellow-bellied Prinia and Plain Prinia rejected their own UV-blocked eggs in 18.2 and 8.3% of the experiments, respectively, and the difference was not significant. However, Yellow-bellied Prinia rejected 100% of the non-mimetic eggs, whereas the Plain Prinia rejected only 5%. Hence, UV reflectance alone is a cue in egg discrimination, but the importance of reflectance outside the UV spectrum in these two prinia species is much more responsive to selection as a consequence of brood parasitism. This is the pre-peer reviewed version of the following article: [UV reflectance as a cue in egg discrimination in two Prinia species exploited differently by brood parasites in Taiwan], which has been published in final form at [http://onlinelibrary.wiley.com/doi/10.1111/ibi.12043/abstract]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.

In recent years, an increasing number of people suffer from sleep disorders. Polysomnography (PSG) is commonly used in hospitals or sleep centers to diagnose sleep disorders because it continuously and simultaneously records multiple physiological signals during sleep. However, the excessive number of wired connections for conventional PSG is often a problem that leads to sleep disturbance. Due to the high cost and bulky body, traditional PSG systems are not suitable for sleep recording at home. This paper proposes the design and implementation of a modularized and distributed PSG system that is more convenient and has potential for recording at home. It is composed of multiple, tiny, low-cost, and wireless-synchronized signal acquisition nodes, and each node acquires specific physiological signals within a small body region to reduce sleep disturbance as a result of recording wires. To evaluate accuracy, the system and a commercial PSG system were mounted on subjects to simultaneously perform overnight recording, and the recorded data were compared. A two-phase sleep experiment was also performed to compare the comfortableness of these two systems. The results show that, in addition to high consistency (>; 93%) with the reference system, due to the reduction of the disturbance from recording wires, the proposed system has better comfortableness performance in terms of several objective and subjective sleep indices.

We developed six new microsatellite markers containing tetranucleotide repeat motifs (GATA/CTAT) for Lanyu scops owl (Otus elegans botelensis) from an enriched partial library. All these loci are polymorphic and conform to Hardy–Weinberg equilibrium. We cross-species tested these and 12 other microsatellite primer pairs previously developed from O. elegans on four other species of owls (O. lettia, O. spilocephalus, O. scops, and Ninox scutulata). Results showed that the degree of polymorphism decreased with increasing phylogenetic distance to O. elegans. Most loci (66.7, 83.3, and 100%) were polymorphic in the three Otus owls but only five (27.8%) were polymorphic in N. scutulata. These microsatellites should be very useful genetic markers in studying the mating system, population genetics, and conservation of other little studied Old World Otus owls.

The genetic mating system is known for only a few species of owls. Most of them are genetically monogamous. The Lanyu scops owl Otus elegans botelensis breeds in high density in the forests of Lanyu (Orchid Island), southeast of Taiwan. Because extra-pair copulations (EPCs) have frequently been observed, we suspected a high degree of extra-pair fertilizations (EPFs). Through intensive field observations we quantified both within-pair and extra-pair copulations of this owl, and used a set of microsatellite loci to assign the parentage of 200 offspring from 108 families collected between 1999 and 2004. Among copulations for which we could identify both participants, 19.77% were EPC. However, no EPC was observed in the period just before egg laying. We found only two cases of parentage mismatch among 108 broods. The first case was most likely a case of brood usurpation, which would be the first case reported in the Strigidae. The second case was an EPF resulting in one offspring. Our study found that parentage mismatch in the Lanyu scops owls to be extremely low, therefore reproductive success can be estimated accurately by simply counting chicks in nests.

Background All-trans retinoic acid (RA), the oxidative metabolite of vitamin A, is essential for normal development. In addition, high levels of RA are teratogenic in many species. We have previously shown that excess RA results in immediate effects on the preimplantation embryo and on blastocyst development. This study was conducted to clarify the long-term survival of mouse blastocyst and the effect of RA on gene expression. Methods and results Using an in vitro model, we identified the immediate adverse impact of RA on mouse blastocyst development. This involved an inhibition of cell proliferation and growth retardation. Using an in vivo model, we also identified the resorption of postimplanted blastocysts that had been treated with excess RA. Analysis of RA-mediated gene induction was also included. The retinoic acid receptors RARalpha and RARgamma were constitutively expressed in the blastocyst and the inner cell mass, whereas RARbeta was induced upon RA treatment. Conclusions This is the first evidence to show the impacts of RA on mouse blastocysts in vitro and any carry-over effects in the uterus. There is a retardation of early postimplantation blastocyst development and then subsequent blastocyst death. Our findings also show that there is some degree of selective induction of retinoic acid receptors when excess RA is administered to the blastocysts.

This is the first evidence that excess retinoic acid has a direct cellular response from proliferation to cell death (apoptosis) and affects in vitro development in mouse inner cell mass.

We isolated and characterized nine polymorphic microsatellite loci from a partial genomic library enriched for tetranucleotide repeats in the hoopoe (Upupa epops). A panel of up to 34 adult individuals with unknown relationship was used to characterize polymorphism of these loci. The number of alleles per locus ranged from 5 to 11 and the observed heterozygosity of each locus ranged from 0.250 to 0.853. Only one locus deviated from Hardy–Weinberg equilibrium, with the excess of homozygote. By using five of the nine loci, we conducted paternity analysis on a population of hoopoe on Kinmen Island. The probability of false parent exclusion is 0.984 for the set of loci. In 20 clutches containing parents and juveniles, only one young was sired by extra-pair copulation. In addition to paternity analysis, these microsatellite markers should be useful in population studies for this widely distributed species.

Eight new tetramicrosatellite loci for Eurasian otter ( Lutra lutra ) were designed. Polymorphism of these eight loci in 29 otter individuals was tested. The results indicated that the allele numbers of each of loci ranged from three to five and the observed heterozygosity from 0.483 to 0.828. These new loci can be useful for population genetic research on otters and help improve the resolution of individual identification using noninvasive method.

Conspecific brood parasitism (CBP) is common in a variety of animal taxa, including birds. In coots (Fulica spp.), and the closely related moorhens (Gallinula spp.), such parasitism is especially common, and hosts experience considerable costs through increased chick competition soon after hatching. Hence, these birds have evolved egg recognition and rejection abilities, e.g., egg counting, burying the foreign eggs, assigning them suboptimal positions within the mixed clutch, or deserting parasitized clutches. For common moorhens (Gallinula chloropus) it has been shown that desertion of parasitized nests pays most at the early egg laying stage. Later on, the costs of desertion exceed the costs of brood parasitism and acceptance is favoured. Here we tested moorhen egg discrimination behaviour during the incubation stage when acceptance of foreign eggs is expected. Four treatments were applied: (1) single added non-mimetic pale blue egg, (2) single added non-mimetic white chicken egg, (3) four foreign conspecific eggs added to the clutch and (4) four foreign conspecific eggs exchanged for four host eggs. Moorhens responded by egg destruction (47%) only to the increased clutch size but not to foreign egg colour and size match. In three nests where egg destruction occurred, all the eggs in the mixed clutch were destroyed by pecking, in two other nests one of the foreign eggs were pecked, while two other nests were deserted. These results are puzzling since moorhens have been shown to possess refined egg recognition abilities. To our knowledge, such destruction of parasitized clutches by moorhens during incubation has not previously been reported. We suggest that after clutch completion, moorhens use increase in clutch size as a cue to determine if they have been parasitized, and some individuals choose to reject parasitic eggs by deserting or destroying the whole clutch. © Brill Academic Publishers. This is the authors’ accepted and refereed manuscript to the article.

From a genomic library enriched for GATA/CTAT and GAAA/CTTT repeats, 12 polymorphic microsatellite markers were developed for the Lanyu scops owl ( Otus elegans botelensis ). Polymorphism of these loci was evaluated in a sample of 58 adult individuals of unknown relationship. The allele numbers of each locus were from five to 25 and the observed heterozygosity of each locus ranges from 0.707 to 0.914. When using these loci in parentage assignment, the probability of false parent exclusion is greater than 0.999. All loci conformed to Hardy–Weinberg expectations.

Background Adaptive divergence driven by environmental heterogeneity has long been a fascinating topic in ecology and evolutionary biology. The study of the genetic basis of adaptive divergence has, however, been greatly hampered by a lack of genomic information. The recent development of transcriptome sequencing provides an unprecedented opportunity to generate large amounts of genomic data for detailed investigations of the genetics of adaptive divergence in non-model organisms. Herein, we used the Illumina sequencing platform to sequence the transcriptome of brain and liver tissues from a single individual of the Vinous-throated Parrotbill, Paradoxornis webbianus bulomachus, an ecologically important avian species in Taiwan with a wide elevational range of sea level to 3100 m. Results Our 10.1 Gbp of sequences were first assembled based on Zebra Finch (Taeniopygia guttata) and chicken (Gallus gallus) RNA references. The remaining reads were then de novo assembled. After filtering out contigs with low coverage (P. w. bulomachus genome. Of 7,779 contigs retained for a top-hit species distribution analysis, the majority (about 86%) were matched to known Zebra Finch and chicken transcripts. We also annotated 6,365 contigs to gene ontology (GO) terms: in total, 122 GO-slim terms were assigned, including biological process (41%), molecular function (32%), and cellular component (27%). Many potential genetic markers for future adaptive genomic studies were also identified: 8,589 single nucleotide polymorphisms, 1,344 simple sequence repeats and 109 candidate genes that might be involved in elevational or climate adaptation. Conclusions Our study shows that transcriptome data can serve as a rich genetic resource, even for a single run of short-read sequencing from a single individual of a non-model species. This is the first study providing transcriptomic information for species in the avian superfamily Sylvioidea, which comprises more than 1,000 species. Our data can be used to study adaptive divergence in heterogeneous environments and investigate other important ecological and evolutionary questions in parrotbills from different populations and even in other species in the Sylvioidea.

Background: Echocardiographic parameters could be implicated in the development of apical asynergy (characterized by apical sequestration or apical aneurysm) and worse cardiovascular outcome in patients with apical hypertrophic cardiomyopathy (ApHCM). Hypothesis: Echocardiographic parameters and morphological patterns of left ventriculograms are associated with cardiovascular morbidity and mortality in patients with ApHCM. Methods: We followed 47 cases with echocardiographically documented ApHCM. Echocardiographic findings of the extent and degree of hypertrophy, sustained cavity obliteration, and paradoxical diastolic jet flow were measured. All patients underwent a cardiac catheterization except for the cases whose informed consent was not acquired. The clinical manifestations were assessed and recorded by the attending physicians during 35.4 ± 23.7 months follow-up. Results: Among the 47 patients with ApHCM, 30 patients presented as the “pure” form and 17 patients present as the “mixed” form. Seventeen of 28 patients with sustained cavity obliteration showed paradoxical flow by echocardiography. Thirty-one underwent left ventriculograms and showed morphological abnormalities, including “ace-of-spades” configuration (15/31), apical sequestration (12/31), and apical aneurysm (4/31). The results demonstrated that cardiovascular morbidities occurred in 21 of 47 patients and were closely related to the presence of mixed form ApHCM, cavity obliteration, and paradoxical flow by univariate and multivariate Cox analysis. During the period of follow-up, 4 patients (9.5%) died, and among them 3 had concomitant apical aneurysm. Conclusions: We concluded that detection of cavity obliteration and paradoxical flow and discrimination of pure form from mixed form by echocardiography, as well apical sequestration from apical aneurysm in ApHCM patients, is warranted. © 2011 Wiley Periodicals, Inc. This work was supported in part by grants from Lo-Tung Poh-Ai Hospital. The authors have no other funding, financial relationships, or conflicts of interest to disclose.

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Purpose: Marriage has long been considered protective against suicide, but shifting social norms since 2000 in Hong Kong raise doubts regarding whether this is still the case. This study investigates the changing association between suicide and marital status in Hong Kong between 2002 and 2020. Methods: Suicide death case reports issued between January 1, 2002 and December 31, 2020 were obtained from the Hong Kong Coroner’s Court. Suicide rates were calculated for each year in the study period by gender, age group, and marital status (married, never-married, widowed, divorced/separated). Suicide risk ratios for each marital status cohort by gender and age group, as well as interactions between year and marital status, were estimated using Poisson regression models. Results: Suicide risk decreased significantly over time for men and women of all ages. People who were never-married, or divorced/separated, had significantly higher suicide risks than their married counterparts. Increasing suicide risks over time were observed for never-married men aged between 20 and 49 years, never-married women aged 35–49 years, and divorced/separated men aged 20–34 years. Widowed men and women of any age had higher suicide risks compared with previous studies in Hong Kong. Conclusion: Despite rapidly changing social contexts in Hong Kong during the study period, marriage remains a strong protective factor against suicide for men and women of all ages. The protective effect is particularly evident for younger people. Increasing suicide rates for divorced/separated, never-married, or widowed people suggest that they may require more psychosocial support.