Shared genetic architectures of educational attainment in East Asian and European populations.

Educational attainment (EduYears), a heritable trait often used as a proxy for cognitive ability, is associated with various health and social outcomes. Previous genome-wide association studies (GWASs) on EduYears have been focused on samples of European (EUR) genetic ancestries. Here we present the first large-scale GWAS of EduYears in people of East Asian (EAS) ancestry (n = 176,400) and conduct a cross-ancestry meta-analysis with EduYears GWAS in people of EUR ancestry (n = 766,345). EduYears showed a high genetic correlation and power-adjusted transferability ratio between EAS and EUR. We also found similar functional enrichment, gene expression enrichment and cross-trait genetic correlations between two populations. Cross-ancestry fine-mapping identified refined credible sets with a higher posterior inclusion probability than single population fine-mapping. Polygenic prediction analysis in four independent EAS and EUR cohorts demonstrated transferability between populations. Our study supports the need for further research on diverse ancestries to increase our understanding of the genetic basis of educational attainment.

Analysis across Taiwan Biobank, Biobank Japan, and UK Biobank identifies hundreds of novel loci for 36 quantitative traits.

Genome-wide association studies (GWASs) have identified tens of thousands of genetic loci associated with human complex traits. However, the majority of GWASs were conducted in individuals of European ancestries. Failure to capture global genetic diversity has limited genomic discovery and has impeded equitable delivery of genomic knowledge to diverse populations. Here we report findings from 102,900 individuals across 36 human quantitative traits in the Taiwan Biobank (TWB), a major biobank effort that broadens the population diversity of genetic studies in East Asia. We identified 968 novel genetic loci, pinpointed novel causal variants through statistical fine-mapping, compared the genetic architecture across TWB, Biobank Japan, and UK Biobank, and evaluated the utility of cross-phenotype, cross-population polygenic risk scores in disease risk prediction. These results demonstrated the potential to advance discovery through diversifying GWAS populations and provided insights into the common genetic basis of human complex traits in East Asia.

Boosting the power of genome-wide association studies within and across ancestries by using polygenic scores.

Genome-wide association studies (GWASs) have been mostly conducted in populations of European ancestry, which currently limits the transferability of their findings to other populations. Here, we show, through theory, simulations and applications to real data, that adjustment of GWAS analyses for polygenic scores (PGSs) increases the statistical power for discovery across all ancestries. We applied this method to analyze seven traits available in three large biobanks with participants of East Asian ancestry (n = 340,000 in total) and report 139 additional associations across traits. We also present a two-stage meta-analysis strategy whereby, in contributing cohorts, a PGS-adjusted GWAS is rerun using PGSs derived from a first round of a standard meta-analysis. On average, across traits, this approach yields a 1.26-fold increase in the number of detected associations (range 1.07- to 1.76-fold increase). Altogether, our study demonstrates the value of using PGSs to increase the power of GWASs in underrepresented populations and promotes such an analytical strategy for future GWAS meta-analyses.

Fine-mapping across diverse ancestries drives the discovery of putative causal variants underlying human complex traits and diseases.

Genome-wide association studies (GWAS) of human complex traits or diseases often implicate genetic loci that span hundreds or thousands of genetic variants, many of which have similar statistical significance. While statistical fine-mapping in individuals of European ancestries has made important discoveries, cross-population fine-mapping has the potential to improve power and resolution by capitalizing on the genomic diversity across ancestries. Here we present SuSiEx, an accurate and computationally efficient method for cross-population fine-mapping, which builds on the single-population fine-mapping framework, Sum of Single Effects (SuSiE). SuSiEx integrates data from an arbitrary number of ancestries, explicitly models population-specific allele frequencies and LD patterns, accounts for multiple causal variants in a genomic region, and can be applied to GWAS summary statistics. We comprehensively evaluated SuSiEx using simulations, a range of quantitative traits measured in both UK Biobank and Taiwan Biobank, and schizophrenia GWAS across East Asian and European ancestries. In all evaluations, SuSiEx fine-mapped more association signals, produced smaller credible sets and higher posterior inclusion probability (PIP) for putative causal variants, and captured population-specific causal variants.

Factors Associated With Hyperphagic Behavior in Patients With Dementia Living at Home.

OBJECTIVE: To investigate the prevalence and patterns of and factors associated with hyperphagic behavior in Taiwanese patients with dementia living at home. METHODS: A cross-sectional and correlational design was used. A total of 104 patients with dementia and their primary caregivers were recruited from the geriatric, neurology, and memory clinics of a regional hospital, a medical center and two day-care centers in central Taiwan. The data related to hyperphagic behavior, functional abilities, medical conditions, body weight, and demographic characteristics of patients as well as the demographic characteristics of their primary caregivers were collected between January and May 2013. RESULTS: Based on a strict criterion (a median score of 3 for the hyperphagic subscale), the prevalence of hyperphagia in patients with dementia was 53.8%. Specific hyperphagic patterns exhibited included increased food intake (49% of patients with dementia), hoarding (8.7%), oral exploration (6.8%), and pica (3.9%). Years of education of the patient, the use of antipsychotics in patients, and the age of primary caregivers explained 16.3% of the variance in hyperphagic behavior subscale scores (F = 6.47, p < .001). CONCLUSIONS: For the early identification and treatment of hyperphagic behavior in patients with dementia in home care or in clinic services provided by health professionals, specific attention should be paid to the usual eating behaviors of patients with lower levels of education or who are taking antipsychotic medication or those who have a female primary caregiver.

Perceived knowledge and clinical comfort with genetics among Taiwanese nurses enrolled in a RN-to-BSN program.

BACKGROUND: Advances in genetics have had a profound impact on health care. Yet, many nurses, as well as other health care providers, have limited genetic knowledge and feel uncomfortable integrating genetics into their practice. Very little is known about perceived genetic knowledge and clinical comfort among Taiwanese nurses enrolled in a Registered Nurse to Bachelor of Science in Nursing program. OBJECTIVES: To examine perceived knowledge and clinical comfort with genetics among Taiwanese nurses enrolled in a Registered Nurse to Bachelor of Science in Nursing program and to assess how genetics has been integrated into their past and current nursing programs. The study also sought to examine correlations among perceived knowledge, integration of genetics into the nursing curriculum, and clinical comfort with genetics. DESIGN: A descriptive, cross-sectional study. SETTINGS: Taiwanese nurses enrolled in a Registered Nurse to Bachelor of Science in Nursing program were recruited. METHODS: A total of 190 of 220 nurses returned the completed survey (86.36% response rate). Descriptive statistics and the Pearson product-moment correlation were used for data analysis. RESULTS: Most nurses indicated limited perceived knowledge and clinical comfort with genetics. Curricular hours focused on genetics in a current nursing program were greater than those in past nursing programs. The use of genetic materials, attendance at genetic workshops and conferences, and clinically relevant genetics in nursing practice significantly related with perceived knowledge and clinical comfort with genetics. However, there were no correlations between prior genetic-based health care, perceived knowledge, and clinical comfort with genetics. CONCLUSIONS: This study demonstrated the need for emphasizing genetic education and practice to ensure health-related professionals become knowledgeable about genetic information. Given the rapidly developing genetic revolution, nurses and other health care providers need to utilize genetic discoveries to optimize health outcomes.

Measuring brain temperature while maintaining brain normothermia in patients with severe traumatic brain injury.

The aim of this study was to evaluate the relationship between superficial temporal artery temperature (Tt), rectal temperature (Tr) and intracranial temperature (ICT) when attempting to keep the brain in a normothermic condition in patients with severe traumatic brain injury (TBI). We also compared the incidence of temperature gradient reversal in patients who survived (survivors) and patients who did not (non-survivors) and the difference in temperature gradient reversal between survivors and non-survivors. Tr is normally lower than and ICT and temperature gradient reversal, when Tr exceeds ICT, has been demonstrated to be an early sign of brain death. A total of 28 patients with severe TBI were enrolled retrospectively in our study between November 2008 and February 2010. Each patient's Tt, Tr and ICT was recorded every hour for 4 days. Our results show that the frequency of brain hyperthermia in our participants (ICT>38°C) was 17.7%. Using a paired t-test and Bland-Altman plots, it was shown that a significant temperature difference existed between Tt, Tr and ICT (p<0.001). The use of Spearman's correlation method revealed that Tt, Tr and ICT were positively correlated (p<0.001). Brain death occurred in five patients at a mean of 9.6 hours (range: 8-12 hours) after a temperature gradient reversal between Tt, Tr and ICT. Fisher's exact test showed that there was a significant difference in the incidence of temperature gradient reversal between Tt, Tr and ICT in survivors and non-survivors (p<0.001). We conclude that a significant temperature difference exists between Tt, Tr and ICT when maintaining brain normothermia. The daily practice of non-invasive Tt measurement may cause doctors to underestimate ICT; reversal of the ICT and Tt and/or Tr temperatures could be an early marker of a poor prognosis for patients with severe TBI.

Taiwanese nursing students' perceived knowledge and clinical comfort with genetics.

PURPOSE: To examine perceived knowledge and clinical comfort with genetics among Taiwanese undergraduate nursing students. Information about the integration of genetics into the nursing curriculum was also assessed. DESIGN: A descriptive, cross-sectional study. METHODS: A self-report survey designed to assess perceived knowledge and clinical comfort with genetics was distributed to 501 Taiwanese undergraduate nursing students; 434 returned the completed survey. The survey also included questions concerning the integration of genetics in the nursing curriculum. Descriptive statistics and a one-way analysis of variance were used for data analysis. FINDINGS: Perceptions of genetic knowledge differed significantly among the different levels of nursing students; juniors had the highest genetic knowledge mean scores, followed by seniors, sophomores, and freshmen. Juniors also reported receiving the greatest number of hours of genetic content in lecture. Clinical comfort with genetics did not vary significantly among the different levels of nursing students. The majority of nursing students considered lectures to be the most effective method for learning genetic information. CONCLUSIONS: Findings reinforced evidence that perceived knowledge and clinical comfort with genetics among Taiwanese undergraduate nursing students are limited. It is imperative for practicing nurses and nursing students to promote the use of genetic information and technologies as a central science in the context of health care. More effort must be made to integrate genetic content into the Taiwanese nursing school curricula. CLINICAL RELEVANCE: With the increasing pace of the genomic revolution, nursing students are required to integrate genetic information into the art of nursing practice with the goal of promoting the health of individuals, families, and communities.

[Equipping nurses with psychiatric mental health nursing skills for the 21st century].

In the fast changing environment of 21st century, life can be difficult to manage and personal relationships and interaction more complicated. They cause life stress. Hardiness of personality is therefore more important than before. Nurses are members of society. If nurses are under stress for long periods of time without efficient coping methods, they will become unconsciously fatigued and that will affect not only their occupational life but also their nursing competencies, their own making it difficult help patients and their families to relieve stress and improve their quality of life. Through literature review, this paper will explore how to help nurses to adopt elements of psychiatric mental health nursing and strengthen their physical and mental health in order to improve their personal health and professional skills.

[Future trends in nursing education in Taiwan in the light of globalization].

The twenty-first century is the era of the knowledge-based economy. Its information networks developing rapidly, Taiwan has already entered an age of liberalization, diversity and globalization. Competition and change will be the norm. As globalization continues it will pose substantial problems for nursing education. Nursing is a service-oriented activity which has to develop constantly to meet the changing demands of the public as people start to live longer, society becomes more multi-cultural, the nature of diseases and other health problems changes and public policy, such as that on National Health Insurance, is modified. This article outlines the problems currently facing nursing education (i.e., the complexity of the educational system, shortcomings in the learning environment, curriculum design, the quality of faculty, evaluation methods, and the quality of students' English and Mathematics) to predict likely difficulties (i.e. student recruitment, the running of schools and the quality of clinical nurses) and trends in nursing education. (i.e. changes in the way schools are run in line with the impact of globalization, new teaching methods; faculty training and development, lifelong learning, and the internationalization of education.) The article should be of interest to nursing educators.

[Adult health problems and coping at life turning points].

At important life turning points, middle-aged adults face many physiological changes (e.g., aging, changes in hormone levels) and alterations in family structure (e.g., children growing up and leaving home). In addition to facing these changes and their impacts, adults must also take on challenges in terms of self-concept, body image, life goals, and life meaning. Illnesses that commonly occur during this life stage include menopausal depression, substance abuse, and anxiety. Traditional treatment models are medical-oriented, but curative effects are limited and hospital visits still occur at high frequencies, resulting in increased medical expenses and disruptions in family life. The authors review the current literature on curative models in this area, and discuss the potential of a combination of physical therapy, cognitive, and existential-humanistic therapy to improve patients' physical strength, self-concept, self-esteem, and self-confidence in an effort to overcome physio-psycho-social disorders and to increase vitality.

Gene cloning and characterization of a soybean (Glycine max L.) LEA protein, GmPM16.

Late embryogenesis abundant (LEA) proteins, present in abundance in seeds during the late stages of development, are associated with desiccation tolerance. In the present work, we characterize a soybean LEA protein, GmPM16, with low molecular weight, high pI value, and an unusual amino acid residue distribution along the protein. The transcripts were detected in cotyledon mesophyll cells but not in the vascular system of mature or pod-dried soybean seeds. Circular dichroism (CD) analysis and Fourier transfer infrared (FTIR) spectroscopy indicated that the GmPM16 protein in solution was highly unordered, possessing only partial alpha-helical structures. However, the protein in sodium dodecyl sulfate (SDS) or trifluoroethanol (TFE) solution or in a dry state exhibited a conformation of abundant alpha-helical structures. As well, the GmPM16 protein interacts with sugar and forms tightly glassy matrixes in the dry state. The protein may play a role in reducing cellular damage in drying seeds by changing the protein conformation and forming tight cellular glasses.