Abstract
Studies from the United States have shown increasing incidence of autism spectrum disorder (ASD) with increasing socioeconomic status (SES), whereas in Scandinavian countries, no such ...relation was identified. We investigated how ASD risk in offspring varied according to parental SES in Taiwan, where there is universal health care. Through linking birth reporting data and data from Taiwan’s national health insurance program, we studied 706,111 singleton births from 2004 to 2007 and followed them until 2015. Parental SES was determined by monthly salary at the time of childbirth, and child neuropsychiatric outcomes were defined using International Classification of Diseases codes. We identified 7,323 ASD cases and 7,438 intellectual disability (ID) cases; 17% of ASD cases had co-occurring ID. In multivariable Cox regression analysis, higher SES was independently associated with higher risk of ASD after we took into account urbanization levels, child sex, parental age, and other covariates. By contrast, higher SES was independently associated with lower risk of ID. Besides the SES disparity in ASD case ascertainment and in the access to health care, findings from Taiwan suggest that other social, environmental, biological, and immunological factors linked with parental SES levels may contribute to the positive relation of SES and ASD risk.
Male infertility affects approximately 50% of all infertile couples. The male-related causes of intracytoplasmic sperm injection failure include the absence of sperm, immotile or immature sperm, and ...sperm with structural defects such as those caused by premature chromosomal condensation and DNA damage. Our previous studies based on a knockout mice model indicated that SEPT12 proteins are critical for the terminal morphological formation of sperm. SEPT12 mutations in men result in teratozospermia and oligozospermia. In addition, the spermatozoa exhibit morphological defects of the head and tail, premature chromosomal condensation, and nuclear damage. However, the molecular functions of SEPT12 during spermatogenesis remain unclear. To determine the molecular functions of SEPT12, we applied a yeast 2-hybrid system to identify SEPT12 interactors. Seven proteins that interact with SEPT12 were identified: SEPT family proteins (SEPT4 and SEPT6), nuclear or nuclear membrane proteins (protamine 2, sperm-associated antigen 4, and NDC1 transmembrane nucleoproine), and sperm-related structural proteins (pericentriolar material 1 and obscurin-like 1). Sperm-associated antigen 4 (SPAG4; also known as SUN4) belongs to the SUN family of proteins and acts as a linker protein between nucleoskeleton and cytoskeleton proteins and localizes in the nuclear membrane. We determined that SEPT12 interacts with SPAG4 in a male germ cell line through coimmunoprecipitation. During human spermiogenesis, SEPT12 is colocalized with SPAG4 near the nuclear periphery in round spermatids and in the centrosome region in elongating spermatids. Furthermore, we observed that SEPT12/SPAG4/LAMINB1 formed complexes and were coexpressed in the nuclear periphery of round spermatids. In addition, mutated SEPT12, which was screened from an infertile man, affected the integration of these nuclear envelope complexes through coimmunoprecipitation. This was the first study that suggested that SEPT proteins link to the SUN/LAMIN complexes during the formation of nuclear envelopes and are involved in the development of postmeiotic germ cells.
Spatial search, and environmental monitoring are key technologies in robotics. These problems can be reformulated as maximal coverage problems with routing constraints, which are NP-hard problems. ...The generalized cost-benefit algorithm (GCB) can solve these problems with theoretical guarantees. To achieve better performance, evolutionary algorithms (EA) boost its performance via more samples. However, it is hard to know the terminal conditions of EA to outperform GCB. To solve these problems with theoretical guarantees and terminal conditions, in this research, the cross-entropy based Monte Carlo Tree Search algorithm (CE-MCTS) is proposed. It consists of three parts: the EA for sampling the branches, the upper confidence bound policy for selections, and the estimation of distribution algorithm for simulations. The experiments demonstrate that the CE-MCTS outperforms benchmark approaches (e.g., GCB, EAMC) in spatial search problems.
The pathogenesis of nephrotic syndrome is unclear. We conducted a nationwide population-based cohort study to examine the associations between preterm births and subsequent development of NS. NS was ...defined as ≥ 3 records with ICD-9-CM codes for NS in hospital admission or outpatient clinic visits. To avoid secondary nephrotic syndrome or nephritis with nephrotic range proteinuria, especially IgA nephropathy, we excluded patients with associated codes. A total of 78,651 preterm infants (gestational age < 37 weeks) and 786,510 matched term infants born between 2004 and 2009 were enrolled and followed until 2016. In the unadjusted models, preterm births, maternal diabetes, and pregnancy induced hypertension were associated with subsequent NS. After adjustment, preterm births remained significantly associated with NS (p = 0.001). The risk of NS increased as the gestational age decreased (p for trend < 0.001). Among the NS population, preterm births were not associated with more complications (Hypertension: p = 0.19; Serious infections: p = 0.63, ESRD: p = 0.75) or a requirement for secondary immunosuppressants (p = 0.61). In conclusion, preterm births were associated with subsequent NS, where the risk increased as the gestational age decreased. Our study provides valuable information for future pathogenesis studies.
BACKGROUND Maternal hypothyroidism during pregnancy can cause adverse effects in the fetus. Scientific evidence has shown that probable thyroid-like function of some phthalates in vitro and in vivo, ...and phthalates exposure, can begin in utero. This study investigated the association between phthalate exposure and thyroid hormones in pregnant women. METHODS Serum and spot urine samples were collected from 76 Taiwanese pregnant women at second trimester. Thyroid hormones, including thyroid-stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4) and free T4 (FT4) were analysed in serum samples, and five urinary phthalate monoesters, including mono butyl phthalate (MBP), monoethyl phthalate (MEP) and mono ethylhexyl phthalate (MEHP), were measured. RESULTS Urinary MBP, MEP and MEHP, the median levels of which were 81.8, 27.7 and 20.6 ng/ml, respectively, were the predominant substances in the urinary phthalate monoesters. Significant mild negative correlations were found between T4 and urinary MBP (R = −0.248, P < 0.05), and between FT4 and urinary MBP (R = −0.368, P < 0.05). After adjusting for age, BMI and gestation, urinary MBP levels showed negative associations with FT4 and T4 (FT4: β = −0.110, P < 0.001; T4: β=−0.112, P = 0.003). CONCLUSIONS Exposure to di-n-butyl phthalate (DBP) may affect thyroid activity in pregnant women, but how DBP affects thyroid function is unclear. Further studies are needed to elucidate the mechanism of action and to investigate whether any other factors related to DBP exposure alter the thyroid function.
•Exposure to DEHP increased the risk of early recurrent pregnancy loss.•Cumulative risks indices of phthalate related to early pregnancy loss.•New approaches of hazard index, relative potency and ...receptor effect posed for female reproduction.
Phthalates, which are commonly used in flexible plastics and consumer products, have been reported to be toxic to reproductive and developmental function in mammals. Past studies have focused on the toxic effects on male reproduction, with only a few studies conducted on the risks that cumulative exposure to phthalates have on the female reproductive system. We recruited 260 patients with recurrent pregnancy loss (RPL) of unknown etiology and 203 controls from the clinics of Obstetrics and Gynecology at a medical center in southern Taiwan from 2013 to 2020. The daily intake of phthalates was estimated from urine samples using the back-calculation method, after which the cumulative risk was determined using multiple hazard indices, including a dose-addition model, a receptor effect model, and a hazard index approach. The patients with RPL had a significantly higher cumulative exposure to phthalates (p < 0.05) than did the controls with a hazard index above one. After adjusted logistic regression analysis, we found that the risk of RPL was strongly related to the higher quartiles of DEHP, the DEHPTEQ for the antiandrogenic effect and adverse effects of the female reproductive system and the ERα binding effect (p < 0.05). Our work suggests that more attentions should be paid to the adverse effects induced by phthalates on female reproduction, especially the effects caused by the cumulative exposure to phthalates in women of reproductive age.
Aim
Recurrent miscarriage is considered a major life event. The main purposes of this study were to compare the differences in stress, anxiety, social support, sleep quality and depressive symptoms ...in couples experiencing recurrent miscarriage compared to peers who experience full‐term normal childbirth in southern Taiwan.
Methods
Convenience sampling and snowball sampling were used respectively to recruit 78 couples with and 80 couples without recurrent miscarriage from October 2014 to July 2015. Five structured questionnaires including Perceived Stress Scale, State‐ Anxiety Inventory, Interpersonal Support Evaluation List, Pittsburgh Sleep Quality Index and Edinburgh Depression Scale were administered.
Results
Women who experienced recurrent miscarriage perceived significantly higher levels of stress, anxiety and depressive symptoms than their husbands. Women in the recurrent miscarriage group reported significantly greater depressive symptoms than women of the other group. A stepwise multiple regression analysis indicated key predictors of depressive symptoms among women of childbearing age, accounting for 62.9% of the variance, were anxiety, stress, social support and history of recurrent miscarriage.
Conclusion
Women with recurrent miscarriage suffer mild to moderate depressive symptoms and a greater incidence of depression than their peers who experienced normal childbirth. Health professionals can use the knowledge gained from these findings to evaluate women with recurrent miscarriage for stress, anxiety and depressive symptoms and develop supportive interventions.
SUMMARY STATEMENT
What is already known about this topic?
Recurrent miscarriage is considered a major life event and, for some, a failure to fulfil a core responsibility for the family lineage.
Research about the differences between genders in both the type and degree of emotional response to a miscarriage is limited.
What this paper adds?
Women with recurrent miscarriage suffer mild to moderate depressive symptoms and a greater incidence of depression than women without recurrent miscarriage.
The key predictors of depressive symptoms among women of childbearing age were anxiety, stress, social support and history of recurrent miscarriage, accounting for 62.9% of the variance.
The implications of this paper:
This study highlights the need to increase healthcare professionals' awareness of the importance of evaluating stress, anxiety and depressive symptoms in women with recurrent miscarriage.
It is recommended that future studies develop and test supportive care protocols for couples experiencing recurrent miscarriage.
A series of anthracene-based organic dyes were prepared via cost-effective synthetic procedures for dye-sensitized cell application. UV–visible and fluorescent spectra, electrochemical properties, ...and photovoltaic performance of the dyes were studied. Under one sun (100 mW/cm2), the AN-3 small cell outperforms others in the series. Under a dim light condition, the AN-3 modules showed PCE comparable to that of the Z907 modules. After optimizing the synthetic procedure, we found that AN-3 can be manufactured at a fairly low price.
Worldwide several studies have examined the associations of fetal sex, paternal age and maternal age with pregnancy outcomes, with the evidence regarding paternal age being less consistent. Although ...in Taiwan we keep good records on birth certificates, these issues have been seldom researched. Our objective was to assess the association of fetal sex and parental age with gestational hypertension/preeclampsia, eclampsia and preterm delivery in the Taiwanese population.
We conducted a nationwide study and included 1,347,672 live births born between 2004 and 2011 in Taiwan. Gestational hypertension/preeclampsia and eclampsia were ascertained based on the International Classification of Diseases codes; preterm delivery (< 37 weeks) was defined according to the gestational age documented by healthcare providers. We implemented logistic regression models with covariates adjusted to assess the association of fetal sex and parental age with pregnancy outcomes.
The prevalence was 2.27% for gestational hypertension/preeclampsia, 0.07% for eclampsia and 6.88% for preterm delivery. After considering other parent's age and covariates, we observed a significantly stepped increase in the risk of both gestational hypertension/preeclampsia and preterm delivery as paternal and maternal age increased. For example, fathers aged ≥50 years were associated with a significantly higher risk of gestational hypertension/preeclampsia (odds ratio OR: 1.60, 95% CI: 1.39, 1.84) and preterm delivery (OR: 1.38, 95% CI: 1.27, 1.51) than fathers aged 25-29 years. Analysis on fetal sex showed that relatively more female births were linked to gestational hypertension/preeclampsia and more male births linked to preterm delivery, compared to the whole population.
We found both paternal and maternal age, as well as fetal sex, were associated with the risk of pregnancy outcomes. Some findings on fetal sex contradicted with previous research using non-Asian samples, suggesting that ethnicity may play a role in the association of fetal sex and pregnancy outcomes. Besides, there is a need to counsel couples who are planning their family to be aware of the influence of both advanced maternal and paternal age on their pregnancy outcomes.
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