Substance abuse in adolescence in Taiwan Focus on ketamine

Ketamine is an anesthetic and analgesic agent but has been identified to have abuse potential in recent years. Ketamine abuse is found to be rapidly increasing especially among adolescents and early adults for its relative low cost and lack of immediate severe side effects. Ketamine is a NMDA antagonist and has acute antidepressant effects from recent pharmacological research. The association between abuse potential and antidepressant effects is still uncertain. Though there are no obvious physical withdrawal symptoms of ketamine, strong cravings were noted from chronic ketamine abusers. On the other hand, ketamine can cause severe damage to the urinary system. “Ketamine-induced uropathy” was proposed in recent years, with presentation of severe lower tract urinary symptoms (LUTS; including frequency, urgency, dysuria and hematuria) and urinary system damage. Similar to patients with other substance abuse, ketamine abusers have higher incidence of co-morbid psychiatric diseases. Currently there is still lack of specific medical treatment for managing ketamine abuse, but psychosocial intervention plays an important role especially for adolescents. In this brief review, we hope to call more attention to this emerging problem

Technology Anxiety and Implicit Learning Ability Affect Technology Leadership to Promote the use of Information Technology at Elementary Schools

Abstract“Oversold & underused” is a criticism by Cuban (2001) of the investment of information technology (IT) in the classroom. Recently, Taiwan's educational administration has provided considerable financial support to IT in elementary schools, but few reports have provided evidence of its successful use. The present study aims to identify the personal factors that affect principals’ beliefs about the promotion of IT in their schools. 331 data were collected and analyzed with AMOS 19.0. The results of this study indicated that greater technology anxiety was negatively associated with perceived ease of using (PEU) IT, whereas implicit learning ability was positively correlated with perceived usefulness of IT. Technology leadership increased significantly with PEU and perceived usefulness (PU), it is also associated with the intention to overcome difficulties in promoting information technology in schools. The implications of this study may contribute to the reduction of principals’ technology anxiety, increasing their implicit learning ability and therefore fostering the future implementation of IT in schools, changing the myth of technology as “oversold & underused”

A reduced risk of stroke with lithium exposure in bipolar disorder: a population‐based retrospective cohort study

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/115969/1/bdi12336.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/115969/2/bdi12336_am.pd

High body fat percentage and low consumption of dairy products were associated with vitamin D inadequacy among older women in Malaysia

Background: Serum vitamin D insufficiency is a public health issue, especially among older women. Sun exposure is fundamental in the production of vitamin D, but older women have less optimal sun exposure. Therefore, factors such as body composition and diet become more essential in sustaining sufficient serum levels of vitamin D. The objective of the current study is to determine factors contributing towards serum vitamin D insufficiency among 214 older women. Methods: The respondents had their body weight, height, waist circumference and body fat percentage measured, as well as interviewed for their socio-demographic characteristics, sun exposure and dietary intake. Fasting blood samples were obtained from the respondents to measure their serum 25-hydroxyvitamin D [25(OH)D] concentration. Results: There were 82.7% (95% CI: 77.6%, 87.8%) of the respondents that had serum vitamin D insufficiency (< 50 nmol/L) with an average of 37.4 ± 14.3nmol/L. In stepwise multiple linear regression, high percentage of body fat (ß = -0.211, p <0.01) and low consumption of milk and dairy products (ß = 0.135, p <0.05) were the main contributors towards insufficient serum vitamin D levels, but not socio-demographic characteristics, other anthropometric indices, sun exposure and diet quality. Conclusion: Older women with high body fat percentage and low dairy product consumption were more likely to have serum vitamin D insufficiency. Older women should ensure their body fat percentage is within a healthy range and consume more milk and dairy products in preventing serum vitamin D insufficiency

Predicting the catalytic sites of isopenicillin N synthase (IPNS) related non-haem iron-dependent oxygenases and oxidases (NHIDOX) through a structural superimposition and molecular docking approach

Isopenicillin N synthase (IPNS) related Non-haem iron-dependent oxygenases and oxidases (NHIDOX) demonstrated a striking structural conservativeness, even with low protein sequence homology. It is evident that these enzymes have an architecturally similar catalytic centre with active ligands lining the reactive pocket. Deacetoxycephalosporin C synthase (DAOCS), isopenicillin N synthase (IPNS), deacetylcephalosporin C synthase (DACS), clavaminate synthase 1 and 2 (CAS1 and 2) are important bacterial enzymes that catalyze the formation of β-lactam antibiotics belonging to this enzyme family. Most plant enzyme members within this subfamily namely flavonol synthase (FLS), leucoanthocyanidin dioxygenase (LDOX), anthocyanidin synthase (ANS), 1-aminocyclopropane-1-carboxylic acid oxidase (ACCO), gibberellin 20-oxidase (G20O), desacetoxyvindoline-4-hydroxylase (D4H), flavanone 3β-hydroxylase (F3H), and hyoscyamine 6β-hydroxylase (H6H) are involved in catalyzing the biosyntheses of plant secondary metabolites. With the advancement of protein structural analysis software, it is possible to predict the catalytic sites of protein that shared a structural resemblance. By exploiting the superimposition model of DAOCS-IPNS, DAOCS-IPNS-CAS, G20O-LDOX, FLS-LDOX, ACCO-LDOX, D4H-LDOX, F3H-LDOX and H6H-LDOX model; a computational protocol for predicting the catalytic sites of proteins is now made available. This study shows that without the crystallized or nuclear magnetic resonance (NMR) structures of most NHIDOX enzyme, the plausible catalytic sites of protein can be forecasted using this structural bioinformatics approach.Keywords: Enzyme, catalytic sites, isopenicillin N synthase, ligand

Pretreatment carcinoembryonic antigen level is a risk factor for para-aortic lymph node recurrence in addition to squamous cell carcinoma antigen following definitive concurrent chemoradiotherapy for squamous cell carcinoma of the uterine cervix

<p>Abstract</p> <p>Background</p> <p>To identify pretreatment carcinoembryonic antigen (CEA) levels as a risk factor for para-aortic lymph node (PALN) recurrence following concurrent chemoradiotherapy (CCRT) for cervical cancer.</p> <p>Methods</p> <p>From March 1995 to January 2008, 188 patients with squamous cell carcinoma (SCC) of the uterine cervix were analyzed retrospectively. No patient received PALN irradiation as the initial treatment. CEA and squamous cell carcinoma antigen (SCC-Ag) were measured before and after radiotherapy. PALN recurrence was detected by computer tomography (CT) scans. We analyzed the actuarial rates of PALN recurrence by using Kaplan-Meier curves. Multivariate analyses were carried out with Cox regression models. We stratified the risk groups based on the hazard ratios (HR).</p> <p>Results</p> <p>Both pretreatment CEA levels ≥ 10 ng/mL and SCC-Ag levels < 10 ng/mL (<it>p </it>< 0.001, HR = 8.838), SCC-Ag levels ≥ 40 ng/mL (<it>p </it>< 0.001, HR = 12.551), and SCC-Ag levels of 10-40 ng/mL (<it>p </it>< 0.001, HR = 4.2464) were significant factors for PALN recurrence. The corresponding 5-year PALN recurrence rates were 51.5%, 84.8%, and 27.5%, respectively. The 5-year PALN recurrence rate for patients with both low (< 10 ng/mL) SCC and CEA was only 9.6%. CEA levels ≥ 10 ng/mL or SCC-Ag levels ≥ 10 ng/mL at PALN recurrence were associated with overall survival after an isolated PALN recurrence. Pretreatment CEA levels ≥ 10 ng/mL were also associated with survival after an isolated PALN recurrence.</p> <p>Conclusions</p> <p>Pretreatment CEA ≥ 10 ng/mL is an additional risk factor of PALN relapse following definitive CCRT for SCC of the uterine cervix in patients with pretreatment SCC-Ag levels < 10 ng/mL. More comprehensive examinations before CCRT and intensive follow-up schedules are suggested for early detection and salvage in patients with SCC-Ag or CEA levels ≥ 10 ng/mL.</p