The Comparative Efficacy of Treatments for Children and Young Adults with Internet Addiction/Internet Gaming Disorder: An Updated Meta-Analysis

[[abstract]]Internet gaming disorder (IGD) is a formal mental disorder leading to bad outcomes for children and adolescents. This study comprehensively compared the estimated effect of various pharmacotherapy and psychosocial interventions for IGD from randomized controlled trials (RCT) through updated meta-analysis, using meta-regression. A search of PubMed/MEDLINE, Cochrane Library, and Airiti Library between 2000 and 2017 was conducted for various IA/IGD intervention modalities. A total of 124 studies from 29 selected papers involving 5601 children and young adults with IA/IGD were found. Meta-analyzing the pooled standardized mean difference (SMD) revealed a preliminary random effect of 1.399 with a 95% confidence interval of 1.272–1.527, suggesting highly effective treatment of IA/IGD. After adjusting for the confounding risks of age, publication year, type of subjects, and type of study, this study revealed that combining pharmacotherapy with cognitive behavioral therapy (CBT) or multi-level counseling (MLC) was the most effective treatment option. Using a scale of time spent online or a severity of IA symptoms scale was a more effective measurement, with p-values = 0.006 and 0.002, respectively. IA/IGD patients with comorbid depression showed worse outcomes than youth with another comorbidity. The corresponding model goodness-of-fit indices were τ2 = 1.188; I2-Residual = 89.74%; and Adjusted-R2 = 16.10%. This systematic review indicates that pharmacotherapy combined with CBT or MLC might be an effective therapeutic strategy for youth with gaming disorder.[[notice]]補正完

Increasing Early Awareness of Hazard of Children with ADHD's ODD and Aggression by Structural Equation Modeling (SEM)

Background: The hazard of children with Attention Deficit Hyperactivity Disorder (ADHD) occurring Oppositional Defiant Disorder (ODD) (shorten as ADHD's ODD) and aggression is not well understood. This study employs structural equation modeling (SEM) to operationalize aggression as joined symptoms on children with ADHD's ODD by analyzing how aggression symptom transact the symptom severity of ADHD's ODD. Methods:ADHD children and adolescents received clinical diagnosis and inattention (ADHD-I), hyperactivity/impulsivity (ADHD-H/I), and ODD subscale of Swanson, Nolan, and Pelham, version IV scale (SNAP-IV-C) and child behaviour check list (CBCL). SEM was applied to associate ADHD-I, ADHD-H/I, and ODD subscale to aggression. Results: Significantly aggressive symptom on CBCL interact with symptom of ADHD, ODD on SNAP; the standardized direct effect of ADHD symptom by SNAP on behavior symptom by CBCL is 0.57 and the standardized total (direct and indirect) effect of ODD symptom on behavior symptom is 0.34. Children with ADHD's ODD symptom share similar characteristic symptom as symptom of ADHD children with deficient emotional self-regulation (DESR). The aggression is highly correlated with ODD (0.607). Conclusions: On ADHD symptom, the likelihood of symptom severity is predicted by the symptom of ADHD-I, ADHD-H/I, and ODD. On ODD symptom, ODD is associated with aggression and anxiety/depression symptom. There is a need to regard child with symptom of ADHD's ODD and aggression as a child with heavy genetic loading and predictor of disruptive behavior disorder

Elderly Patients with Laryngeal and Hypopharyngeal Cancer Undergoing Total Pharyngolaryngectomy with a Radial Forearm, Free Flap-reconstructed Phonation Tube

SummaryBackgroundThe radial forearm, free-flap (RFFF)-reconstructed phonation tube was developed for functional restoration of voice after total pharyngolaryngectomy. We aimed to report the efficacy of RFFF phonation tube after pharyngolaryngectomy with radiotherapy (RT) or concurrent chemoradiation therapy (CCRT) with intensity-modulated radiotherapy (IMRT) for elderly.Materials and methodsTen patients with laryngeal and hypopharyngeal cancer underwent total pharyngolaryngectomy and one-stage reconstruction with an RFFF-accompanied phonation tube, followed by RT or CCRT. Voice restoration was achieved with the RFFF-reconstructed phonation tube. Functional outcomes of phonation and speech were evaluated and scored.ResultsPercentages of stage III and stage IV patients among all participants were 10% and 90%, respectively. The median follow-up time was 31 months (range, 4–67 months). Almost 9 out of 10 (90%) patients experienced phonation efficacy greater than 80%. The maximal phonation time per breath was 70% longer than 3 sec. The graded as mild of wet voice was 90%. Percentage of mild decreased loudness was 60% and that of low and high pitch was 80%. Of the 10 patients, 40% could count more than 10 and 70% could pronounce more than 1 to 5 words per breath. After RT or CCRT, of patients had moderately good to excellent speech intelligibility.ConclusionThe RFFF phonation tube that was used after pharyngolaryngectomy with RT or CCRT with IMRT provided acceptable complications and functional restoration of voice for elderly patients

Estimating quality weights for EQ-5D (EuroQol-5 dimensions) health states with the time trade-off method in Taiwan

Background/PurposeEQ-5D (EuroQol-5 dimensions) is a preference-based measure of health, which is widely used in cost–utility analyses. It has been suggested that each country should develop its own value set. We therefore sought to develop the quality weights of the EQ-5D health states with the time trade-off (TTO) method in Taiwan.MethodsA total of 745 respondents consisting of employees and volunteers in 17 different hospitals were recruited and interviewed. Each of them valued 13 of 73 EQ-5D health states using the TTO method. Based on the three exclusion criteria for valuation data, only 456 (61.21%) respondents were considered eligible for data analysis. The quality weights for all EQ-5D health states were modeled by generalized estimating equations (GEEs).ResultsOver half of the responses were given negative values, and the medical personnel seemed to have a significantly higher TTO value (+0.1) than others after controlling for other predictors. The N3 model (level 3 occurred within at least 1 dimension) yielded an acceptable fit for the observed OTT data [mean absolute error (MAE) = 0.056, R2 = 0.35]. The magnitude of mean absolute differences (MADs) between Taiwan data and those from the UK, Japan, and South Korea ranged from 0.146 to 0.592, but the rank correlation coefficients were all above 0.811.ConclusionThis study reaffirms the differences in health-related preference values across countries. The high proportion of negative values might indicate that we have also partially measured the intensity of fear in addition to the utility of different health states

Rapid identification of Mycobacterium tuberculosis infection by a new array format-based surface plasmon resonance method

Tubercle bacillus [TB] is one of the most important chronic infectious diseases that cause millions of deaths annually. While conventional smear microscopy and culture methods are widely used for diagnosis of TB, the former is insensitive, and the latter takes up to 6 to 8 weeks to provide a result, limiting the value of these methods in aiding diagnosis and intermediate decisions on treatment. Therefore, a rapid detection method is essential for the diagnosis, prognosis assessment, and recurrence monitoring. A new surface plasmon resonance [SPR] biosensor based on an array format, which allowed immobilizing nine TB antigens onto the sensor chip, was constructed. Simultaneous determination of multiple TB antibodies in serum had been accomplished with this array-based SPR system. The results were compared with enzyme-linked immunosorbent assay, a conventional immunological method. Array-based SPR showed more advantages in providing label-free and real-time detection. Additionally, the high sensitivity and specificity for the detection of TB infection showed its potential for future development of biosensor arrays for TB diagnosis

The 2005 Ilan earthquake doublet and seismic crisis in northeastern Taiwan: evidence for dyke intrusion associated with on-land propagation of the Okinawa Trough

Northern Taiwan underwent mountain building in the early stage of the Taiwan orogeny but is currently subjected to post-collisional crustal extension. It may be related to gravitational collapse or to the rifting of the Okinawa Trough, which lies offshore northeastern Taiwan. The Ilan Plain, northeastern Taiwan, which is bounded by the normal fault systems and filled up with thick Pliocene–Pleistocene sedimentary sequences, formed under such an extension environment. Over there on 2005 March 5 two earthquakes with about the same magnitude (M_L = 5.9) occurred within 68 s and produced intense aftershocks activity according to the records of Central Weather Bureau Seismic Network of Taiwan. We relocated the earthquake sequence by the three-dimension earthquake location algorithm with the newly published 3-D Vp and Vp/Vs velocity model, and determined the first-polarity focal mechanisms of the earthquake doublet. One major cluster of aftershocks which trends E–W and dips steeply to the south can be identified and picked up as a potential fault plane. The focal mechanisms of the two main shocks are both classified as normal type by first-polarity but strike-slip by centroid moment tensor inversion; however two methods both yield consistent E–W strike. Static coseismic deformation was additionally determined from Global Positioning System (GPS) daily solutions at a set of continuous GPS stations and from strong-motion seismographs. These data show NW–SE extension at high angle to the fault plane, which cannot be explained from a simple strike-slip double-couple mechanism. On the other hand, the small vertical displacements and steep fault plane cannot be explained from a simple normal event as well. We present from elastic dislocation modelling that the geodetic data are best explained by significant component of tensile source with centimetre-scale of opening on a 15-km-long fault extending from 1 to 13 km depth. We therefore interpret the crisis as the result of dyke intrusion at the very tip of the Okinawa Trough, which is reasonably driven by backarc spreading

Effects of Moderate Exercise on Relieving Mental Load of Elementary School Teachers

Long-term endurance exercise could increase activity of parasympathetic nervous and decrease activity of sympathetic nervous at rest. However, previous studies all focused on the effect of endurance training on heart rate variability (HRV) for athletes or sedentary subjects. In Taiwan, elementary school teachers teaching and processing the children’s and administrative problems always stand and walk. They will sit down only when they review and correct the students’ home work. Thus, the goal of this study was to elucidate the beneficial effect of moderate intensity exercise on relieving mental load of elementary school teachers. There were 20 participants in the exercise group and another 20 participants in the nonexercise group. The exercising teachers performed 12 weeks of moderate intensity exercise training for an average of 30 minutes per day, 3 times per week. HRV was measured before and after the 4th, 6th, and 12th weeks. The time and frequency domain parameters of HRV all had significant increases between the beginning and after 12 weeks of training. However, the time and frequency domain parameters of HRV in the nonexercise group had significant decreases between the beginning and after 12 weeks of training. The long-term moderate exercises can relieve mental load of elementary school teachers. Moreover, age was the considerable factor affecting HRV in this study