Familial aggregation and heritability of schizophrenia and co-aggregation of psychiatric illnesses in affected families

Strong familial aggregation of schizophrenia has been reported but there is uncertainty concerning the degree of genetic contribution to the phenotypic variance of the disease. This study aimed to examine the familial aggregation and heritability of schizophrenia, and the relative risks (RRs) of other psychiatric diseases, in relatives of people with schizophrenia using the Taiwan National Health Insurance Database. The study population included individuals with affected first-degree or second-degree relatives identified from all beneficiaries (n = 23 422 955) registered in 2013. Diagnoses of schizophrenia made by psychiatrists were ascertained between January 1, 1996 and December 31, 2013. Having an affected co-twin, first-degree relative, second-degree relative, or spouse was associated with an adjusted RR (95% CI) of 37.86 (30.55-46.92), 6.30 (6.09-6.53), 2.44 (1.91-3.12), and 1.88 (1.64-2.15), respectively. Compared with the general population, individuals with one affected first-degree relative had a RR (95% CI) of 6.00 (5.79-6.22) and those with 2 or more had a RR (95% CI) of 14.66 (13.00-16.53) for schizophrenia. The accountability for the phenotypic variance of schizophrenia was 47.3% for genetic factors, 15.5% for shared environmental factors, and 37.2% for non-shared environmental factors. The RR (95% CI) in individuals with a first-degree relative with schizophrenia was 3.49 (3.34-3.64) for mood disorders and 3.91 (3.35-4.57) for delusional disorders. A family history of schizophrenia is therefore associated with a higher risk of developing schizophrenia, mood disorders, and delusional disorders. Heritability and environmental factors each account for half of the phenotypic variance of schizophrenia

Edge states in a two-dimensional honeycomb lattice of massive magnetic skyrmions

We study the collective dynamics of a two-dimensional honeycomb lattice of magnetic skyrmions. By performing large-scale micromagnetic simulations, we find multiple chiral and non-chiral edge modes of skyrmion oscillations in the lattice. The non-chiral edge states are due to the Tamm-Shockley mechanism, while the chiral ones are topologically protected against structure defects and hold different handednesses depending on the mode frequency. To interpret the emerging multiband nature of the chiral edge states, we generalize the massless Thiele's equation by including a second-order inertial term of skyrmion mass as well as a third-order non-Newtonian gyroscopic term, which allows us to model the band structure of skrymion oscillations. Theoretical results compare well with numerical simulations. Our findings uncover the importance of high order effects in strongly coupled skyrmions and are helpful for designing novel topological devices.Comment: 6 pages,4 figures,accepted by Physical Review B as a Rapid Communicatio

Action Research on Applying Compound Stimulus Approach to Improve Empathetic Communication: The Case of Physical Therapy Students

(1) Background: Empathetic communicative skills are the first step in establishing a good therapeutic relationship. The purpose of this study is to understand the effectiveness of improving the empathetic communicative skills applied to obtain accurate and precise information from patients via compound stimulus-drama in education. (2) Methods: A cross-sectional, one-group, pre- and post-test design was used for this study. In the two-day workshop, four clinical physiotherapists acted as tutors for the “Compound Stimulus-Drama in Education” module and assessed students’ performances. The Standard Patient Rating Scale (SPRS), Objective Structured Clinical Examination Scale (OSCES), Professional and Communication Self-Assessment Scale (PCSS), Patients’ Information (PI), and the Jefferson Scale of Empathy (JSE) were used to assess the students’ empathy scores and communication skills, before and after the course. (3) Results: Fifty-seven students participated in this study. The results showed that there were significant improvements in the SPRS, OSCES, PCSS, PI, and JSE (p < 0.05). Both the quantitative data and the participants’ reflection feedback suggest that this novel module was more helpful than traditional clinical practice courses for improving clinical empathy communication skills. (4) Conclusions: This study provided an innovative teaching model and assessment tools for learning clinic empathetic communicative skills in future education training

Gene expression profiles in peripheral blood mononuclear cells of asian obstructive sleep apnea patients

Background: Obstructive sleep apnea (OSA) syndrome is a complicated disease involving several pathogenic mechanisms. Microarray technology provides a high-throughput means of identifying differentially expressed genes in patients with OSA. Methods: An Affymetrix U133A gene chip was used to globally analyze the transcriptome of peripheral blood mononuclear cells (PBMC) in patients with OSA and nonapneic control participants after overnight polysomnography. Results: Several genes were differentially expressed in patients with OSA compared with control participants. These genes included disintegrin and metalloproteinase domain 29 (ADAM29), solute carrier family 18 (vesicular acetylcholine) member 3 (SLC18A3), cyclin-dependent kinase inhibitor 2C (CDKN2C), and fibronectin-like domain-containing leucine-rich transmembrane protein 2 (FLRT2). Among these genes, the expression levels of ADAM29 (p = 0.00003), FLRT2 (p < 0.0001), and SLC18A3 (p = 0.0006) were found to be possible markers of severe OSA [respiratory disturbance index (RDI) > 30]. Conclusion: Our data suggest that PCMC expression of ADAM29, FLRT2, and SLC18A3 could be assessed as part of a routine screen to help identify individuals at risk of severe OSA in Asian populations

Relative Efficacy of Weight Management, Exercise, and Combined Treatment for Muscle Mass and Physical Sarcopenia Indices in Adults with Overweight or Obesity and Osteoarthritis: A Network Meta-Analysis of Randomized Controlled Trials

Aging and osteoarthritis are associated with high risk of muscle mass loss, which leads to physical disability; this loss can be effectively alleviated by diet (DI) and exercise (ET) interventions. This study investigated the relative effects of different types of diet, exercise, and combined treatment (DI+ET) on muscle mass and functional outcomes in individuals with obesity and lower-limb osteoarthritis. A comprehensive search of online databases was performed to identify randomized controlled trials (RCTs) examining the efficacy of DI, ET, and DI+ET in patients with obesity and lower-extremity osteoarthritis. The included RCTs were analyzed through network meta-analysis and risk-of-bias assessment. We finally included 34 RCTs with a median (range/total) Physiotherapy Evidence Database score of 6.5 (4–8/10). DI plus resistance ET, resistance ET alone, and aerobic ET alone were ranked as the most effective treatments for increasing muscle mass (standard mean difference (SMD) = 1.40), muscle strength (SMD = 1.93), and walking speed (SMD = 0.46). Our findings suggest that DI+ET is beneficial overall for muscle mass in overweight or obese adults with lower-limb osteoarthritis, especially those who are undergoing weight management

The Lived Experiences of Aboriginal Adolescent Survivors of Childhood Cancer During the Recovering Process in Taiwan: A Descriptive Qualitative Research

PURPOSE: The purpose of this study was to understand the experiences of Taiwanese aboriginal adolescent survivors of childhood cancer during the process of recovery. METHOD: A snowball sampling strategy was used to recruit participants from the pediatrics unit of a medical center in the eastern region of Taiwan. In-depth interviews were conducted with 11 aboriginal adolescent childhood cancer survivors. The data were analyzed using content analysis. RESULTS: The results revealed three major themes with subthemes within each theme. The three major themes are: roots of resilience, transformation and growth, and meaning of traditional rituals for resilience. The three subthemes within roots of resilience include: feeling secure through company of family, care and financial support , receiving support from the important others and religion and learning to self-adjust . The three subthemes revealed within transformation and growth are: restructuring the relationship with peers, appreciating parents\u27 hard work , and learning to seize the moment . The two subthemes within meaning of traditional rituals to resilience include: feeling blessed with the power of ancestral spirits and strengthening ethnic identity . CONCLUSION: This study provided insight into the experiences of aboriginal adolescents as they recovered from childhood cancer. The experiences made positive impacts by inspiring growth in maturity and consolidating aboriginal ethnic identity. The adolescents were empowered by support from family, friends and clansmen, and by their participation in aboriginal rituals. As healthcare professionals care for the aboriginal adolescents, it is critical to consider this culturally and ethnically specific knowledge/experience of surviving cancer to improve quality of care