Solar farm policy and farmland price - A land zoning perspective.

Photovoltaic or solar energy is recognized as a significant source of renewable energy on a global scale. The utilization of ground-mounted solar panels is closely associated with the use of farmland, as solar power generation typically requires vast expanses of farmland. While previous studies have explored the use of price incentives to regulate the adoption of solar panels, little is known about the impact of land zoning policies on farmland prices. The relationship between farmland use policies and farmland prices is well-documented, with policies often capitalizing into the value of the land across various countries. The deployment of ground-mounted solar panels has raised concerns about the potential loss of farmland and the degradation of the farming environment. However, the policy debate has largely overlooked the price capitalization effect of solar panel installations. In an effort to mitigate the adverse effects of solar panels on agriculture, the Taiwanese government implemented revised zoning regulations that impose stricter limitations on small-scale ground-mounted type solar panels installed on farmland. As a result of this policy reform, solar panels are no longer permitted on farmland areas measuring less than 660 square meters. While it is expected that the installation of solar panels will slow down, the resulting price effects on farmland remain poorly understood. This paper measures the impact of the land zoning regulation on farmland prices in Taiwan. By utilizing nationwide data on farmland transactions and employing the difference-in-differences method, we discover that the tightened regulations pertaining to solar panel installation have led to a 21.8% reduction in farmland prices. Furthermore, the negative price effect is found to be least pronounced in high-productivity farmland. We also find that the decline in prices commenced two months after the reform and continued to intensify over time. Additionally, we identify a distributional effect concerning price, whereby farmland with higher prices per hectare experiences the most significant impact. Consequently, our study contributes an empirical analysis that confirms the substantial price capitalization effects of land zoning policies on farmland.

Is decompressive craniectomy necessary in malignant posterior reversible encephalopathy syndrome with brain edema caused uncal herniation? A case report of reversible coma without surgical decompression.

BACKGROUND: Posterior reversible encephalopathy syndrome (PRES) is considered a benign entity and is usually reversible with only medical management, but persistent neurologic deficits and disability or death can occur without adequate treatment. Favorable outcomes have been associated with surgical decompression in malignant-type PRES in which hemorrhagic transformation or brain stem compression has developed. CASE DESCRIPTION: Here we report a case of malignant PRES in a 61-year-old female of Asian descent in which the disease rapidly progressed to coma and a near-fatal condition with uncal herniation caused by severe brain edema; however, this patient achieved a dramatic recovery without surgical decompression. CONCLUSION: After reviewing previous reports regarding malignant PRES, we propose that hemorrhagic transformation is a crucial indicator for surgical decompression and an important prognostic factor in malignant PRES.

Patient-Specific Three-Dimensional Printing Guide for Single-Stage Skull Bone Tumor Surgery: Novel Software Workflow with Manufacturing of Prefabricated Jigs for Bone Resection and Reconstruction.

OBJECTIVE: To describe a novel system workflow to design and manufacture patient-specific three-dimensional (3D) printing jigs for single-stage skull bone tumor excision and reconstruction and to present surgical outcomes of 14 patients. METHODS: A specific computer-aided design/computer-aided manufacturing software and hardware system was set up, including a virtual surgical planning subsystem and a 3D printing-associated manufacturing subsystem. Computed tomography data of the patient's skull were used for 3D rendering of the skull and tumor. The output of patient-specific designing included a 3D printing guide for tumor resection and a 3D printing model of the bone defect after tumor excision. A polymethyl methacrylate implant was fabricated preoperatively and used for repair. RESULTS: The specific 3D printing guide was used to design intraoperative jigs and implants for 14 patients (age range, 1-72 years) with skull bone tumors. In all cases, the cutting jig allowed precise excision of tumor and bone, and implants were exact fits for the defects created. All operative results were successful, without intraoperative or postoperative complications. Postoperative computed tomography scans were obtained for analysis. Postoperative 3D measurement of the skull symmetry index (cranial vault asymmetry index) showed significant improvement of head contour after surgery. CONCLUSIONS: The computer-aided design/computer-aided manufacturing system described allows definitive preoperative planning and fabrication for treatment of skull bone tumors. Apparent benefits of the method include more accurate determination of surgical margins and better oncological outcomes.

Decreased Risk of Influenza in Child and Adolescent Patients with Attention-Deficit Hyperactivity Disorder Following Methylphenidate Treatment: A Nationwide Cohort Study in Taiwan.

BACKGROUND: Young individuals with attention-deficit hyperactivity disorder (ADHD) may have an elevated risk of influenza because of the difficulty in complying with the behavioral procedures that help protect against influenza. Moreover, the effects of sufficient methylphenidate treatment on influenza have received little attention. OBJECTIVE: This study evaluated the association between ADHD medication usage and influenza and assessed the effect of duration of ADHD treatment on the risk of influenza using a nationwide population-based database. METHODS: This study investigated methylphenidate usage and the risk of influenza among children and adolescents with ADHD. We identified 5259 young individuals aged less than 18 years who were diagnosed as having ADHD between 1996 and 2013 from the National Health Insurance Research Database of Taiwan, and we tested whether methylphenidate use affects influenza risk using Cox proportional hazard models. RESULTS: After controlling for confounding factors, the results indicated that influenza risk significantly reduced in the group of ADHD patients who were prescribed methylphenidate for 90 days and more (hazard ratio [HR]: 0.62, 95% confidence interval [CI]: 0.52-0.75, p<0.001), demonstrating a 38% reduction in the risk of influenza in this group. However, this was not observed in the group of ADHD patients who used methylphenidate for 1-90 days (HR: 0.69, 95% CI: 0.89-1.05, p=0.12). CONCLUSION: The lower incidence of influenza observed in the group prescribed with methylphenidate for a longer period highlights the importance of compliance to medication and psychoeducation with regard to ADHD management.

New Use for Old Drugs: The Protective Effect of Risperidone on Colorectal Cancer.

Background: The potential of old drugs in novel indications is being greatly valued. We propose a triple-model study involving population-based, cell, and animal studies to investigate the effects of risperidone, a type of second-generation antipsychotic (SGA) drug, on colorectal cancer. Methods: We used data from Taiwan's National Health Insurance Research Database between 1997 and 2013 to compare 101,989 patients with colorectal cancer and 101,989 controls. Conditional logistic regression analyses were used to explore the association between SGA exposure and the risk of colorectal cancer. The following bench studies were performed to evaluate the findings of the population-based study. Results: We found that SGAs had been less commonly used in colorectal cancer patients than in controls. The colorectal cancer risk was reduced with an increase in the cumulative defined daily dose (cDDD) of SGAs. The adjusted odds ratio of antipsychotic use for cDDD days was 0.32 (95% CI: 0.25-0.42). Risperidone exhibited the most prominent tumor inhibition effect in a cell screen study. Bench data revealed that risperidone significantly induced apoptosis and elevated intracellular ROS in human SW480 cells and suppressed the proliferation of the xenografted SW480 tumor in nude mice. Conclusion: This triple-model study demonstrates the association between risperidone usage and a lower risk of colorectal cancer.

Antipsychotic use is inversely associated with gastric cancer risk: A nationwide population-based nested case-control study.

OBJECTIVE: The association between antipsychotic use and gastric cancer risk remains unclear. Therefore, this study aimed to determine the association between antipsychotic exposure and the incidence of gastric cancer. METHODS: Using a nested case-control design, a total of 34 470 gastric cancer patients and 163 430 nongastric cancer controls were identified from Taiwan's National Health Insurance Research Database between 1 January 1997 and 31 December 2013. We analyzed the data using a conditional logistic regression model to adjust for possible confounding variables. RESULTS: Antipsychotic use was independently inversely associated with gastric cancer risk after controlling for potential confounding factors including income, urbanization, medications, physical and medical illness, aspirin use, nonsteroidal anti-inflammatory drug use and triple therapy. In addition, dose-dependent trends against gastric cancer risk were also shown with individual antipsychotic compounds including thioridazine, haloperidol, sulpiride, clozapine, olanzapine, quetiapine, amisulpride, and risperidone. A sensitivity analysis showed that second-generation antipsychotics had significant dose-dependent effects in reducing the risk of gastric cancer risk in patients with and without peptic ulcer disease. CONCLUSIONS: Antipsychotic use was inversely associated with gastric cancer risk, and dose-dependent effects against gastric cancer were also seen with several individual antipsychotic compounds.

De Novo Formation of Pial Arteriovenous Fistulas: Systematic Review of Acquired Lesions and Their Clinical Differences Compared with Primary Lesions.

OBJECTIVE: Acquired pial arteriovenous fistula (pAVF) is an extremely rare intracranial vascular malformation, with few case reports in the English literature. This study presents a thorough review and analysis of all acquired pAVF cases from the literature in addition to an illustrated case. METHODS: We report a case with de novo development of intracranial pAVF after craniotomy. A medical literature database search between 1975 and 2018, including the Medline, Ovid, and PubMed databases, was performed to identify all reports with possible acquired lesions. Differences between these acquired lesions and previously reported primary lesions were evaluated. RESULTS: A total of 8 patients with de novo formation of acquired pAVF were included in this series. Most of these pAVFs were fed and drained via a similar arteriovenous pattern, from distal/cortical branches of the middle cerebral artery (6/8, 75%) to the superficial middle cerebral vein (6/8, 75%). Compared with a previously reported primary pAVF series, acquired pAVF tended to be asymptomatic (P < 0.0001) and found essentially in adults (P = 0.0061). Fewer venous varices (P = 0.0049) and associated intracranial mass effect (P = 0.0189) were found in the cases of acquired pAVF. All 4 reported acquired pAVFs that were treated microsurgically resulted in complete angiographic obliteration (4/4, 100%). The overall outcome was good or stable even with observation only (7/8, 87.5%). CONCLUSIONS: Acquired pAVF is highly correlated with sentinel neurosurgical procedures or venous occlusion events. These lesions should be regarded as a different disease entity from primary pAVF because of the relatively low-flow shunting and benign clinical course.

GLP-1 Analogue Liraglutide Attenuates Mutant Huntingtin-Induced Neurotoxicity by Restoration of Neuronal Insulin Signaling.

Huntington's disease (HD) is a progressive and fatal neurodegenerative disease caused by CAG repeat expansion in the coding region of huntingtin (HTT) protein. The accumulation of mutant HTT (mHTT) contributes to neurotoxicity by causing autophagy defects and oxidative stress that ultimately lead to neuronal death. Interestingly, epidemiologic studies have demonstrated that the prevalence of type-2 diabetes, a metabolic disease mainly caused by defective insulin signaling, is higher in patients with HD than in healthy controls. Although the precise mechanisms of mHTT-mediated toxicity remain unclear, the blockade of brain insulin signaling may initiate or exacerbate mHTT-induced neurodegeneration. In this study, we used an in vitro HD model to investigate whether neuronal insulin signaling is involved in mHTT-mediated neurotoxicity. Our results demonstrated that mHTT overexpression significantly impairs insulin signaling and causes apoptosis in neuronal cells. However, treatment with liraglutide, a GLP-1 analogue, markedly restores insulin sensitivity and enhances cell viability. This neuroprotective effect may be attributed to the contribution of the upregulated expression of genes associated with endogenous antioxidant pathways to oxidative stress reduction. In addition, liraglutide stimulates autophagy through AMPK activation, which attenuates the accumulation of HTT aggregates within neuronal cells. Our findings collectively suggest that liraglutide can rescue impaired insulin signaling caused by mHTT and that GLP-1 may potentially reduce mHTT-induced neurotoxicity in the pathogenesis of HD.

Suicide risk reduction in youths with attention-deficit/hyperactivity disorder prescribed methylphenidate: A Taiwan nationwide population-based cohort study.

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) youths have increased suicide risk. Nevertheless, the beneficial effects of methylphenidate (MPH) on suicide attempt have received relatively little attention. AIMS: To investigate the MPH usage and the risk of suicide attempt among ADHD youths. METHODS: We identified 84,898 youths less than 18 years old with ADHD diagnosis between 1997 and 2013 from National Health Insurance, and examined whether MPH use affected suicide attempt risk using Cox proportional-hazards models. OUTCOME AND RESULTS: Among ADHD youths, reduction of suicide risk was found in patients prescribed 90-180days of MPH after adjusting for confounding factors (hazard ratio (HR): 0.41, 95% confidence interval (CI): 0.19-0.90) and a greater reduction in those prescribed more than 180days of MPH (HR: 0.28, 95% CI: 0.17-0.48). CONCLUSIONS AND IMPLICATIONS: We observed a 59% suicide attempt risk reduction among ADHD youths prescribed between 90 and 180days and a 72% risk reduction in those prescribed more than 180days of MPH. The protective benefit observed by the group prescribed MPH for longer duration underscores the importance of psychoeducation and compliance enhancement as part of ADHD management. Indication bias is identified as a limitation of this study, and future self-case control study to investigate the association between suicide attempt and ADHD medication is suggested. WHAT THIS PAPER ADDS: This nationwide population-based cohort study showed that among ADHD youths, reduction of suicide risk was observed in patients prescribed MPH for duration 90days and longer, underscoring the importance of appropriate ADHD pharmacotherapy and enhancing drug compliance.

Prediction of traumatic carotid-cavernous sinus fistula via noncontrast computed tomography by fracture pattern and abnormality of venous system.

BACKGROUND: Traumatic carotid-cavernous sinus fistula (tCCF) is infrequent but with high morbidity if delayed diagnosed or managed. Because of the lack of screening criteria and requirement of advanced and invasive radiological examinations, diagnosis is often delayed or underdiagnosed. METHODS: A matched case-control study with univariate and multivariate analyses was conducted to predict tCCFs. Forty-six patients diagnosed with tCCFs were included and matched with 138 patients of craniofacial trauma without tCCF as control at a ratio of 1:3. RESULTS: The diagnostic diameter of superior ophthalmic vein (SOV) in tCCF was 4 mm with area under curve of 0.89. In multivariate analysis, engorgement of SOV and cavernous sinus (odds ratio [OR], 35.39; 95% confidence interval [CI], 13.56-104.84; p < 0.001) and lateral impact (ipsilateral temporal and sphenoid sinus fractures) (OR, 3.96; 95% CI, 1.10-14.91; p = 0.028) were identified significant, whereas basilar skull fracture (OR, 1.58; 95% CI, 0.53-4.75; p = 0.300) and injuries to ocular nerves (cranial nerves III, IV, and VI) (OR, 1.77; 95% CI, 0.38-7.88; p = 0.055) were insignificant. CONCLUSION: Presence of SOV or cavernous sinus engorgement on noncontrast computed tomography and lateral impact were demonstrated as independent predictors to tCCF and warrant further radiological evaluation. Injury to ocular nerves is not predictive but as an essential differential diagnosis with reversible outcome. LEVEL OF EVIDENCE: Diagnostic, level III.

Depression and family support in breast cancer patients.

BACKGROUND: Breast cancer is the most common cancer in women. Among the survivors, depression is one of the most common psychiatric comorbidities. This paper reports the point prevalence of major depressive disorder among breast cancer patients and the association between family support and major depressive disorder. METHODS: Clinical data were collected from a breast cancer clinic of a general hospital in central Taiwan. Participants included 300 patients who were older than 18 years and diagnosed with breast cancer. Among these individuals, we used Mini International Neuropsychiatric Interview (a structural diagnostic tool for psychiatric disorders) to ascertain if they had major depressive disorder. We also used the Family Adaptability, Partnership, Growth, Affection, and Resolve score to assess the family support. RESULTS: The point prevalence of major depressive disorder among breast cancer patients was 8.33%, and this was positively associated with insomnia, psychiatric family history, pain severity, and radiotherapy and negatively associated with menopause, cancer duration, hormone therapy, and family support. Family support (adjusted odds ratio =0.87, 95% CI: 0.78-0.98) was found to be an associated factor for major depressive disorder in breast cancer patients after controlling for potential risk factors. CONCLUSION: Major depressive disorder is a common comorbidity among breast cancer patients. Family support is an important associated factor for these patients. Health care professionals should evaluate mood problems and family support while treating these patients.

Correction: The association between methylphenidate treatment and the risk for fracture among young ADHD patients: A nationwide population-based study in Taiwan.

[This corrects the article DOI: 10.1371/journal.pone.0173762.].

The association between methylphenidate treatment and the risk for fracture among young ADHD patients: A nationwide population-based study in Taiwan.

Attention-deficit hyperactivity disorder (ADHD) is associated with higher risk for fracture. Whether the medical treatment for ADHD would mitigate the risk remains unclear. In this study, we sought to investigate the effect of methylphenidate treatment on risk for fracture, as well the moderational role of treatment duration on the risk of fracture, in a large national sample. Cases less than 18 years old were identified from Taiwan's National Health Insurance Research Database with a new primary diagnosis of ADHD (ICD-9:314) between 1996 and 2013. A total of 6201 cases with ADHD were included as the study cohort. The cases were divided into 3 groups according to the duration of methylphenidate treatment (0, 1-180, and more than 180 days). All groups were followed until the end of 2013 for first diagnoses of fracture (ICD-9 codes 800 to 829). Cox proportional hazards models were applied. Compared to the group without methylphenidate treatment, the risk for fracture was lower among the group treated for more than 180 days. The adjusted hazard ratio was 0.77 (95% Confidence interval: 0.63-0.94). The groups treated for 180 days or fewer had no significant difference in the risk for fracture. In conclusion, methylphenidate treatment was associated with lower risk for fracture among ADHD patients. The association was evident only in the cohort treated for more than 180 days.

Effective Steroid Treatment in Traumatic Cervical Spinal Epidural Hematoma Presenting with Delayed Tetraparesis: Two Case Reports and Literature Review.

BACKGROUND: Traumatic spinal epidural hematoma (TSEH) is a rare neurosurgical condition that according to conventional treatment requires prompt surgical decompression. Recent reports, however, suggest that conservative management within the acute phase after trauma also can lead to similar long-term functional outcomes without the need for immediate neurosurgical intervention. CASE DESCRIPTION: In the present paper, we describe 2 cases of TSEH located in the ventral upper cervical spine, which presented with delayed neurologic deficits. In both cases, conservative management with steroid treatment was initiated before neurosurgical decompression, resulting in improved neurologic outcomes. CONCLUSIONS: Urgent surgical decompression may not be necessary acutely in patients with TSEH who respond well to conservative therapy. Although there is currently no consensus for the initial management strategies, steroid treatment could individually tailored and applied according to the clinical condition and evolving symptoms.

Systematic Analysis of the Risk Factors Affecting the Recurrence of Traumatic Carotid-Cavernous Sinus Fistula.

OBJECTIVE: The current therapies for traumatic carotid-cavernous sinus fistula (tCCF) yield a variable rate of recurrence and produce different results. We analyzed factors among traumatic head injury to identify the risk factors in recurrent tCCFs. METHODS: We retrospectively reviewed patients who were diagnosed with tCCFs from January 2004 to December 2014 in a tertiary referral center. The factors that were analyzed included age, sex, associated injury, clinical presentation, interval from injury to interventions, interventions for tCCFs, and pathologic characters of tCCFs under digital subtraction angiography. RESULTS: A total of 55 patients with 56 tCCFs (1 bilateral tCCF) were included. Thirty-nine patients (40 tCCFs) were treated successfully in single session of a procedure, whereas 16 patients (16 tCCFs) experienced a recurrence of tCCF. In multivariate analysis, we found that the involvement of C2 or C4 segments (Debrun classification) of intracavernous internal carotid artery is an independent risk factor (hazard ratio [HR] 2.95, 95% confidence interval [95% CI] 1.34-6.52; P < 0.01) for the recurrence of tCCFs. Endovascular coil embolization demonstrated superior efficacy in successful interventions of tCCFs compared with detachable balloons (HR 2.63, 95% CI 1.06-6.57; P < 0.05) and other modalities (HR 3.06, 95% CI: 1.27-7.37; P < 0.05). CONCLUSIONS: A detachable coil is a favorable approach in the management of tCCFs when considering the rate of recurrence. In addition, the involvement of C2 or C4 segments (Debrun classification) served as an independent risk factor of the recurrence of tCCFs.

Asthma and self-harm: a population-based cohort study in Taiwan.

OBJECTIVE: Few studies have investigated the relationship between asthma and suicidality-related outcomes in the world. We sought to investigate the association between asthma and risk of non-fatal self-harm in a large national sample. METHODS: Cases aged 10years and over were identified from Taiwan's National Health Insurance Research Database with a new primary diagnosis of asthma (ICD-9:493) between 2000 and 2008. Case status required the presence of any inpatient diagnosis of asthma and/or at least two recorded diagnoses and 1year duration of asthma in outpatient services. These 27,781 cases were compared to 138,905 sex- and age-matched controls and both groups were followed until end of 2008 for instances of self-harm, defined as ICD-9 codes E950-E959 (self-harm causes) and E980-E989 (undetermined causes). Competing risk adjusted Cox regression analyses were applied, adjusting for sex, age, residence (urban/rural), insurance premium, episode of psychiatric disease, montelukast, Charlson comorbidity index and mortality. RESULTS: Of the 166,686 subjects, 445 carried out self-harm during a mean (SD) follow-up period of 5.84 (2.35) years. Asthma (hazard ratio=1.70, 95% CI: 1.35-2.14), age, residence, episode of psychiatric disease and Charlson comorbidity index were independent risks on self-harm in the fully adjusted model. CONCLUSIONS: Asthma was associated with increased risk of self-harm in this population, independent of a number of potential confounding factors including montelukast use. This reinforces the need to consider mental health in routine asthma care, and to consider asthma as a potentially important stressor in people with comorbid mental disorder.

Association of asthma and bipolar disorder: a nationwide population-based study in Taiwan.

BACKGROUND: The relationship between asthma and bipolar disorder has received little research. We sought to investigate this in a large national sample. Previous studies have found mood changes after prednisone use in asthma patients, and we therefore also investigated this exposure in relation to bipolar disorder. METHODS: Cases were identified from Taiwan׳s National Health Insurance Research Database with a new primary diagnosis of asthma (ICD-9:493) between 2000 and 2007. Case status required the presence of any inpatient diagnosis of asthma and/or at least one year diagnosis of asthma in outpatient service. These 46,558 cases were compared to 46,558 sex-, age-, residence- and insurance premium-matched controls and both groups were followed until the end of 2008 for first diagnosis of bipolar disorder (ICD-9 codes 296.0 to 296.16, 296.4 to 296.81 and 296.89). Competing risk adjusted Cox regression analyses were applied, adjusting for sex, age, residence, insurance premium, prednisone, hyperthyroidism, COPD (chronic obstructive pulmonary disease), Charlson comorbidity index, and hospital admission days for any disorder. RESULTS: Of the 93,116 subjects, 161 were ascertained as having bipolar disorder during a mean (SD) follow-up period of 5.7 (2.2) years. Asthma was an independent risk for bipolar disorder in the fully adjusted model. Higher daily dose of prednisone was a risk factor in asthma cases. LIMITATIONS: The severity of asthma and bipolar disorder, and the route/duration of prednisone treatment were not evaluated. CONCLUSIONS: Asthma was associated with increased risk of bipolar disorder. Higher daily dose of prednisone was associated with a further increased risk.

Use of barrier protection for sexual activity among women who have sex with women.

OBJECTIVE: To assess the frequency and associations of barrier protection use during sexual activity in a population of women who have sex with women (WSW). METHODS: WSW were invited to participate in an international internet-based survey. Information regarding ethnodemographics, sexual health, and barrier use during sexual activities was collected. RESULTS: The study cohort comprised 1557 participants. Barrier use was least prevalent during digital genital stimulation (11.3% ever used barriers) and most prevalent during stimulation with a sex toy (34.4% ever used barriers). Univariate analysis revealed that women in non-monogamous relationships were more likely than monogamous women to always use barrier protection for sexual activity (14.3% vs 3.5%). On multivariate analysis, there was no association between barrier use and frequency of casual sexual activity or history of sexually transmitted infection. Small associations were noted between barrier use and certain sexual activities, age, race, and number of partners. CONCLUSION: Many WSW do not use barrier protection during sexual activity, even in the context of potentially risky sexual behaviors. Safer-sex practices among WSW merit increased attention from healthcare providers and public health researchers.