Trends in the prevalence of intellectual disability among children in Taiwan.

BACKGROUND: Intellectual disability (ID) is a major developmental disability. However, data on changes in the prevalence over time at the national level are limited. METHOD: Using data from the national disability registry, we conducted an ecological study to evaluate the time trends of ID among children in Taiwan. We calculated the prevalence of ID by age, sex and severity, from 2000 to 2011, and assessed the time trends. RESULTS: During the study period, the overall prevalence of ID in children aged 3-17 years increased from 3.60 to 5.91 per 1000 (ß = 0.22, P < 0.001, r2  = 0.97). The prevalence of mild ID (MID, intelligence quotient: 50-69) increased from 1.30 to 3.60 per 1000 (ß = 0.21, P < 0.001, r2  = 0.98). However, the prevalence of severe ID (SID, intelligence quotient: <50) was relatively constant, between 2.22 and 2.38 per 1000 (ß = 0.01, P = 0.076, r2  = 0.96). Boys had a higher prevalence than girls, and the average boy-to-girl prevalence ratio was 1.42 for MID and 1.31 for SID. The boy-to-girl prevalence ratios of MID and SID decreased over time (ß = -0.01, P < 0.001, r2  = 0.99 for MID; ß = -0.01, P < 0.001, r2  = 1.00 for SID). CONCLUSION: The prevalence of ID in Taiwanese children increased from 2000 to 2011 and was largely attributable to increases in MID. Boys had a higher prevalence of ID and were more likely to have MID.

High-power structured laser modes: manifestation of quantum Green's function.

The distributions of resonant frequencies in an astigmatic cavity are theoretically confirmed to be analogously equivalent to the quantum energy structures of two-dimensional commensurate harmonic oscillators. In the first part [Opt. Lett.45, 4096 (2020)OPLEDP0146-959210.1364/OL.399251] of this two-part series study, the lasing modes were verified to reveal a variety of vortex array structures. Here, in the second part of this two-part series study, the lasing modes are confirmed to agree very well with the quantum Green's functions that correspond to a bundle of Lissajous figures in the high-order regime.

High-power structured laser modes: direct generation of a vortex array.

The frequency degeneracy induced by the astigmatism in a nearly hemispherical cavity is originally exploited to generate vortex array laser modes with the output power up to 300 mW. The inhomogeneous Helmholtz equation is employed to derive the wave function for manifesting the characteristics of the lasing modes. The theoretical wave function explicitly reveals the role of the Gouy phase in the formation of vortex arrays. Numerical analyses are further performed to confirm that the thermal lensing effect in the laser crystal assists the lasing transverse order to increase with increasing pump power. It is believed that the high efficiency enables the present laser modes to be useful in the applications of structured vortex beams.

The presence probability of mandibular lingla and antilingula.

PURPOSE: The lingula and antilingula are crucial surgical landmarks for mandibular setback surgery. The purpose of study was to investigate the correlation of presence probability between lingual and antilingula. MATERIALS AND METHODS: A total of 180 cone-beam computed tomography sides were collected from 90 patients. The probability of absence of the lingula and antilingula was recorded with respect to the gender, mandible (unilateral and bilateral), and skeletal patterns (Class I, II, III); in addition, the correlations between these variables were analysed. RESULTS: Of the 180 sides, 9 sides showed the absence of the lingula (5%) and 34 sides showed the absence of the antilingula (18.9%). Pearson's test revealed that the presence of the lingula and antilingula differed nonsignificantly with respect to gender and skeletal patterns, respectively. The bilateral presence of the lingula was observed in 16 sides (91.1%), and that of the antilingula was observed in 122 sides (67.8%). Pearson's test verified a significant correlation between the presence of the left and right lingula (P<0.05). By contrast, gender and skeletal patterns were nonsignificantly correlated with the presence of the lingula and antilingula. The presence of the lingula was also nonsignificantly correlated with that of the antilingula. CONCLUSION: Gender and skeletal patterns were nonsignificantly correlated with the presence of the lingula and antilingula, respectively. The presence of the lingula was also nonsignificantly correlated with that of the antilingula. Consequently, lingula and antilingula cannot serve as the absolute standards for mandibular setback surgery.

Improvement in lip appearance (lateral and frontal aspects) following mandibular setback surgery.

INTRODUCTION: The post-operative facial profile is critical for patients who undergo orthognathic surgery. The present study investigated the improvement in lip appearance (lateral and frontal aspects) following mandibular setback surgery. MATERIAL AND METHODS: Thirty-one patients with mandibular prognathism underwent mandibular setback surgery. Lateral and posteroanterior cephalograms were obtained before surgery (T0) and more than 1 year after surgery (T1). The landmarks (soft and hard tissues) and linear distances were compared by statistical analysis. RESULTS: The lateral cheilion (Ch), point B (B), and pogonion (Pog) were significantly setbackin the horizontal plane: 5.59, 11.49, and 12.35 mm, respectively. In the vertical plane, B and Pog did not move significantly. The Ch moved significantly downward by 3.23 mm on average. The setback ratios of soft tissue/hard tissue, soft tissue of B/B, and soft tissue of Pog/Pog were 0.96. The Ch/Pog ratio was 0.45. The width of the frontal Ch was significantly reduced by 3.17 mm. CONCLUSIONS: The relationship between the corresponding soft and hard tissues of the chin was approximately 1. The relationship between the lip corner and chin bone was nearly 50%. The width of the lip corner was also significantly reduced.

Correlation between changes in the gonial area and postoperative stability in the treatment of mandibular prognathism.

INTRODUCTION: The present study was to investigate the relationship between the post-operative area of the gonial region (lateral and frontal) and post-operative relapse. MATERIAL AND METHODS: Thirty-seven patients, treated for mandibular prognathism were followed with serial lateral cephalograms [pre-operatively (T1), immediately after surgery (T2), and at least 2 years post-operatively (T3)]. The surgical changes (T21), post-operative stability (T32) and 2-year surgical change (T31) were evaluated by the Student's t-test. Pearson's correlation coefficient analysis was used to determine the correlations between the cephalometric parameters. Multiple linear regression analysis was used to assess the association between the risk factors and post-operative relapse. RESULTS: The immediate post-operative changes (T21), mean setback of the Me was 12.3 mm and the frontal gonial area (T2) was increased by 138.7 mm2. The final post-operative changes (T31), lateral gonial area was significantly reduced by 190.5 mm2. CONCLUSION: Relapse was significantly correlated with the amount of setback. However, changes in the area of the gonial region (lateral and frontal) showed weak correlation with relapse. Multiple regression analysis also showed poor predictability of relapse. In conclusion, the results of this study showed that significant changes in the area of the gonial region (lateral and frontal) did not affect the maintenance of post-operative stability.

Appearance on face reading (cheek line) after orthognathic surgery.

The cheek line (face reading) is an aesthetic element of the facial profile. The purpose of our study was to investigate the changes in the cheek line after mandibular setback surgery. Forty patients (20 female and 20 male, mean (SD) age 22 (5) years) were diagnosed with mandibular prognathism and treated by intraoral vertical ramus osteotomy alone. Cephalograms were obtained before operation (T1), at least a year postoperatively (T2), and final surgical changes over a year (T2-T1). The cheek line and landmarks (soft and hard tissues) were compared using the paired t test. The hypothesis was that the cheek line did not change significantly after mandibular setback. At the time of the final follow-up (T2-T1), the mean (SD) horizontal setback of pogonion (Pog) was 12.3 (3.5) mm for women and 11.7 (4.3) mm for men. The ratios of soft:hard tissue, labrale inferius:incisor inferius, labiomental sulcus:point B, soft tissue Pog:Pog, and cheek point:Pog in women were 0.96, 0.98, 0.98, and 0.08, and in men 0.91, 1.01, 0.94, and 0.13, respectively. The nasolabial and cervicomental angles in women were significantly increased by 11.1° and 11.4°, respectively, and in men the nasolabial angle was significantly increased by 11.1° and the mentolabial angle reduced by 9.9°. The cheek line (T2-T1) was moved significantly forwards. The hypothesis was therefore rejected. In conclusion, the cheek line was advanced significantly after isolated mandibular setback.

Factors related to skeletal relapse in the two-jaw surgery treatment of mandibular prognathism.

This study identified factors contributing to skeletal relapse in the two-jaw surgery treatment of mandibular prognathism. A set of three standardized lateral cephalograms (T1: before surgery, T2: immediately after surgery, T3: final follow-up after surgery) were obtained from 35 patients. The surgical changes were defined as follows: postsurgical immediate change (T2-T1), postoperative stability (T3-T2) and the final surgical change (T3-T1). The occlusal plane and gonial angles were also measured. Relapse was defined as the reverse movements of the menton point (Me) and point A, with the null hypothesis stating that Me and point A do not significantly change at the postoperative stability (T3-T2). A paired t test and Pearson's correlation were used for statistical analysis. The immediate postoperative changes (T2-T1) in Me and point A were significant, and were measured to be 8.5mm backward and 3.0mm forward, respectively. Additionally, the occlusal plane and gonial angles significantly increased by 2° and decreased by 2°, respectively. The final postoperative changes (T3-T1) in Me and point A were also significant, and were measured to be 5.2mm backward and 2.5 forward, respectively; the occlusal plane and gonial angles also increased nonsignificantly by 0.6° and 0.7°, respectively. Upon investigating postoperative stability (T3-T2), Me was measured to be significantly 3.3mm forward and 1.4mm upward, whereas point A was measured to be nonsignificantly 0.5mm backward and 0.9mm upward. Therefore, the null hypothesis was rejected. Pearson's correlation showed that horizontal Me (T3-T2) and point A (T3-T2) were significantly correlated with the amounts of setback Me (T2-T1) and advancement A (T2-T1), respectively. In conclusion, skeletal relapses are significantly correlated with the amounts of mandibular setback and maxillary advancement.

Loss of labelling efficiency caused by carotid stent in pseudocontinuous arterial spin labelling perfusion study.

AIM: To elucidate the cause of cerebral hypoperfusion on the stent placement side after carotid artery stent placement (CAS) measured by pseudocontinuous arterial spin labelling (PCASL) perfusion imaging. MATERIALS AND METHODS: Consecutive patients with symptomatic internal carotid artery stenosis receiving CAS were included in the study. Cerebral blood flow (CBF) was measured by PCASL perfusion imaging at 3 T magnetic resonance imaging (MRI) the day before and 3 days after the procedure. Changes in cerebral haemodynamics after CAS were assessed. RESULTS: Twenty-two patients were included; 17 patients had increased or stationary CBF after CAS and five patients had significantly reduced CBF on the stenting side after CAS whereas CBF increased on the contralateral side. High stent position was noticed in the five patients. After labelling plane adjustment to avoid labelling on the stent, no more cerebral hypoperfusion was noticed. CONCLUSION: When using PCASL perfusion imaging to monitor post-stenting CBF, the stent may cause an artefact that leads to a low CBF in the territory of the stented vessel. Routinely adding a fast T2 star gradient-echo echo-planar-imaging covering the upper neck region before PCASL perfusion imaging to identify the stent position and avoid the stent-related artefact is recommended.

Different spontaneous breathing trials in patients with atrial fibrillation.

INTRODUCTION: Weaning from mechanical ventilation is one of the most important and challenging problems for most intensive care unit (ICU) patients. Spontaneous breathing trial (SBT) is the most common method used to evaluate patients' ability to breathe by themselves and plays an important role in decision making for weaning. The aim of our study was to investigate the effect of different methods of SBT in respiratory care unit (RCU) patients with atrial fibrillation (AF) on weaning outcome. METHODS: We retrospectively analyzed different methods of SBT in patients with and without AF. We enrolled RCU patients who required mechanical ventilation and had undergone transthoracic echocardiography from January 2011 to January 2012. RESULTS: There was a higher SBT passing rate among AF patients who received pressure support ventilation (PSV) trial than in those who received T-piece trail (92.5% vs. 73.1%, p=0.041). The weaning rates between these two groups were not significantly different (83.8% vs. 94.7%, p=0.403). Total ventilator days were longer in T-piece group than in PSV group (median 40.0, IQR: 18.2-125.1 days vs. 33.0, IQR: 29.6-51.0 days respectively, p=0.580), but this difference was not statistically significant. These results were not found in patients without AF. CONCLUSIONS: The use of PSV trial might be considered first instead of T-piece trial for SBT when AF patients were ready to wean.

Control of metamorphic buffer structure and device performance of In(x)Ga(1-x)As epitaxial layers fabricated by metal organic chemical vapor deposition.

Using a step-graded (SG) buffer structure via metal-organic chemical vapor deposition, we demonstrate a high suitability of In0.5Ga0.5As epitaxial layers on a GaAs substrate for electronic device application. Taking advantage of the technique's precise control, we were able to increase the number of SG layers to achieve a fairly low dislocation density (∼10(6) cm(-2)), while keeping each individual SG layer slightly exceeding the critical thickness (∼80 nm) for strain relaxation. This met the demanded but contradictory requirements, and even offered excellent scalability by lowering the whole buffer structure down to 2.3 µm. This scalability overwhelmingly excels the forefront studies. The effects of the SG misfit strain on the crystal quality and surface morphology of In0.5Ga0.5As epitaxial layers were carefully investigated, and were correlated to threading dislocation (TD) blocking mechanisms. From microstructural analyses, TDs can be blocked effectively through self-annihilation reactions, or hindered randomly by misfit dislocation mechanisms. Growth conditions for avoiding phase separation were also explored and identified. The buffer-improved, high-quality In0.5Ga0.5As epitaxial layers enabled a high-performance, metal-oxide-semiconductor capacitor on a GaAs substrate. The devices displayed remarkable capacitance-voltage responses with small frequency dispersion. A promising interface trap density of 3 × 10(12) eV(-1) cm(-2) in a conductance test was also obtained. These electrical performances are competitive to those using lattice-coherent but pricey InGaAs/InP systems.

Prevalence and genotype of Giardia duodenalis from faecal samples of stray dogs in Hualien city of eastern Taiwan.

Giardia duodenalis is a zoonotic protozoan parasite that causes diarrhea through waterborne transmission or fecal-oral infection. The cysts are chlorine-resistant and, therefore, can pollute drinking water and induce a pandemic disease. In this study, we aimed to detect G. duodenalis infection in stray dogs in Hualien, Taiwan. We collected faecal samples from 118 dogs and amplified DNA sequences of the ß-giardin gene by nested polymerase chain reactions (nested PCR). Eleven of the 118 faecal samples tested positive for the parasite. The genotype analysis of the 11 samples indicated that 7 samples belonged to assemblage C and four samples belonged to assemblage D. Our study provided a better understanding of the infection rate and genotypes of G. duodenalis in dogs from Hualien City, and human infection could not be induced by this zoonotic infection pathway in Hualien City.

Neuronal nitric oxide synthase activation is involved in insulin-mediated cardiovascular effects in the nucleus tractus solitarii of rats.

Neuronal nitric oxide synthases (nNOS) is distributed throughout the central nervous system (CNS) and has been proposed to modulate neuronal activity in the nucleus tractus solitarii (NTS). Here, we investigated whether the activation of nNOS is involved in insulin-induced cardiovascular responses in the NTS. Insulin (100 IU/ml) was unilaterally microinjected into the NTS, and the cardiovascular effects were evaluated before and after microinjection of the nNOS inhibitors 7-nitroindazole (7-NI) (5 pmol) and N(5)-(1-imino-3-butenyl)-l-ornithine (vinyl-L-NIO) (600 pmol). Western blot and immunohistochemical analyses were performed to determine nNOS phosphorylation levels after insulin or phosphoinositide 3-kinase (PI3K) inhibitor LY294002 microinjection into the NTS. Unilateral microinjection of insulin into the NTS produced prominent depressor and bradycardic effects in WKY rats. Pretreatment with the nNOS inhibitors 7-NI and Vinyl-L-NIO attenuated the cardiovascular response evoked by insulin in Wistar-Kyoto (WKY) rats. Moreover, Western blot analysis showed a significant increase in nNOS (16.5+/-0.4-fold; P<0.05; n=4) phosphorylation after insulin injection, whereas the PI3K inhibitor LY294002 abolished the insulin-induced effects. In situ nNOS phosphorylation was found to be increased in the NTS after insulin injection. Furthermore, co-immunoprecipitation assay showed Akt and nNOS can bind to each other as detected by phospho-Akt(S473) and phospho-nNOS(S1416) antibodies. In vitro kinase assay showed insulin activated Akt can directly phosphorylate nNOS(S1416). These results demonstrated that nNOS may couple with the activation of the insulin receptor, via the liberation of NO, in order to participate in central cardiovascular regulation of WKY rats.

Regulation of protein expression and function of octn2 in forskolin-induced syncytialization in BeWo Cells.

Placental OCTN2 is a high-affinity carnitine transporter that can interact with a number of therapeutic agents. The process of syncytialization is associated with the expression of a variety of genes. However, the association between syncytialization and OCTN2 expression is not yet clear. Given that forskolin induces BeWo cells to undergo biochemical and morphological differentiation, the purpose of the present study was to investigate whether the function and expression of OCTN2 are influenced by forskolin treatment during syncytialization. The forskolin-induced differentiation of BeWo cells was validated by secretion of beta-human chorionic gonadotropin (beta-hCG) and syncytin expression. Cellular localization of OCTN2 was analyzed by confocal microscopy. Expression of OCTN2 and the modular proteins PDZK1, PDZK2, NHERF1 and NHERF2 was analyzed by Western blotting and carnitine uptake by BeWo cells was estimated and the kinetic properties of uptake measured. The results showed that forskolin treatment increased beta-hCG secretion and syncytin expression, suggesting induction of syncytialization. Confocal images of BeWo cells showed the localization of OCTN2 in the brush-border membrane. OCTN2 protein expression was upregulated in isolated brush-border membranes by long-term forskolin treatment, but the V(m) for carnitine uptake was unchanged, although the K(m) increased. PDZK1, NHERF1 and NHERF2 protein expression in the brush-border membrane was downregulated by forskolin treatment, whereas PDZK2 levels remained unchanged. In conclusion, protein expression and function of OCTN2 in BeWo cells can be regulated by forskolin treatment. While the presence of forskolin results in an increase in OCTN2 protein expression, the increase in uptake capacity may be compensated by the decreased expression of PDZK1, NHERF1 or NHERF2.

Simple technique to achieve a natural head position for cephalography.

The cephalometric measurement of the face in terms of aesthetics can be difficult and misleading due to the variability of the intra-cranial reference lines according to diversity of head posture. Natural head position (NHP) has been proposed as a preferred reference position for assessing facial morphology. Even though natural head position is more proper and valid, it is still abandoned by reasons of time-consumption and additional and necessary complex equipment. Hence, we developed a modified level laser approach to acquire the natural head position. This method was a simple and straightforward technique which may be of value as and adjunct to routine orthognathic planning.

Interdisciplinary management of unfavorable posterior intermaxillary space.

The patient was a case of severe dentoalveolar extrusion of the right maxillary posterior segment due to early loss of mandibular molars. Therefore, it is difficult to replace the missing teeth with either fixed or removable prostheses. Her occlusion was Angle Class II malocclusion and no mandibular molars for anchorage on the right side. A posterior maxillary subapical osteotomy was utilized for reestablishing the intermaxillary space. A titanium alloy miniplate placed in the right mandible provide skeletal anchorage to distalize the anterior mandibular teeth. Dental implants were placed to restore masticatory function.

Effects of inulin/oligofructose on the thermal stability and acid-induced gelation of soy proteins.

Differential scanning calorimetry (DSC) and dynamic oscillatory shear testing were performed to study the influence of inulin (Raftiline HP-gel and Raftiline ST-gel) and oligofructose (Raftilose P95) on the thermal stability and gelation (using glucono-delta-lactone [GDL] as a coagulant) of soy protein isolate (SPI) dispersions. Addition of 10% (w/v) inulin/oligofructose or sucrose increased (P < 0.05) the peak denaturation temperatures (T(m)) of 7S and 11S soy proteins in SPI dispersion (5%[w/v], pH 7.0) by an average of 1.9 and 2.3 degrees C, respectively. GDL induced SPI thermal gelation, and the gel rheology was affected by both the pH decline and the specific temperature of heating. Addition of inulin/oligofructose (8%, w/v) improved the gelling properties of preheated SPI dispersion (8%, w/v) coagulated with GDL, showing 14.4 to 45.6% increase (P < 0.05) in gel rigidity (G' value) at the end of heating (81 degrees C). Microstructural examination revealed a denser protein cross-linking structure and reduced pore sizes in SPI gels containing inulin/oligofructose. In general, inulin was more capable of improving SPI gelation than oligofructose, suggesting that the degree of fructose polymerization in the fructans was of thermal and rheological importance.

Pyrazinoindolone inhibitors of MAPKAP-K2.

Optimization of pyrazinoindolone inhibitors of MAPKAP-K2 (MK2) provides a reasonable balance of cellular potency and physicochemical properties. Mechanistic studies support the inhibition of MK2 which is responsible for the sub-micromolar cellular efficacy.

Instrument for x-ray magnetic circular dichroism measurements at high pressures.

An instrument has been developed for x-ray magnetic circular dichroism (XMCD) measurements at high pressures and low temperatures. This instrument couples a nonmagnetic copper-beryllium diamond anvil cell featuring perforated diamonds with a helium flow cryostat and an electromagnet. The applied pressure can be controlled in situ using a gas membrane and calibrated using Cu K-edge x-ray absorption fine structure measurements. The performance of this instrument was tested by measuring the XMCD spectra of the Gd(5)Si(2)Ge(2) giant magnetocaloric material.