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Impact of living with bipolar patients: Making sense of caregivers' burden

World Journal of Psychiatry 2014年第1期4卷 1-12页

作者： Maurizio Pompili Désirée Harnic Xenia Gonda Alberto Forte Giovanni Dominici Marco Innamorati Konstantinos N Fountoulakis Gianluca Serafini Leo Sher Luigi Janiri Zoltan Rihmer Mario Amore Paolo Girardi Department of Neurosciences Mental Health and Sensory Organs Suicide Prevention Center Sant’Andrea Hospital Sapienza University of Rome 00189 Rome Italy Department of Psychiatry Catholic University Medical School 00189 Rome Italy Department of Clinical and Theoretical Mental Health and Department of Pharmacodynamics Semmelweis University H-1086 Budapest Hungary Neuropsychopharmacology and Neurochemistry Research Group National Academy of Sciences and Semmelweis University H-1086 Budapest Hungary National Institute of Psychiatry and Addictions Laboratory for Suicide Research and Prevention H-1135 Buda-pest Hungary 3rd Department of Psychiatry Aristotle University of Thessaloniki GR-54006 Thessaloniki Greece Department of Psychiatry Icahn School of Medicine at Mount Sinai New York NY 10029 United States Department of Clinical and Theoretical Mental Health Semmelweis University H-1125 Budapest Hungary Department of Neuroscience Rehabilitation Ophthalmology Genetics Maternal and Child Health Section of Psychiatry University of Genova I-16146 Genova Italy

The aim of the present review was to examine objective and subjective burdens in primary caregivers(usually family members) of patients with bipolar disorder(BD) and to list which symptoms of the patients are considered more burdensome by the caregivers. In order to provide a critical review about caregiver's burden in patients with bipolar disorder, we performed a detailed Pub Med, Bio Med Central, ISI Web of Science, Psyc INFO, Elsevier Science Direct and Cochrane Library search to identify all papers and book chapters in English published during the period between 1963 and November 2011. The highest levels of distress were caused by the patient's behavior and the patient's role dysfunction(work, education and social relationships). Furthermore, the caregiving role compromises other social roles occupied by the caregiver, becoming part of the heavy social cost of bipolar affective disorder. There is a need to better understand caregivers' views and personal perceptions of the stresses and demands arising from caring for someone with BD in order to develop practical appropriate interventions and to improve the training of caregivers.

关键词： bipolar disorder Caregivers Burden Prevention

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Treatment-adherence in bipolar disorder: A patient-centred approach

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World Journal of Psychiatry 2016年第4期6卷 399-409页

作者： Subho Chakrabarti Department of Psychiatry Postgraduate Institute of Medical Education and Research (PGIMER)

About half of the patients diagnosed with bipolar disorder(BD) become non-adherent during longterm treatment, a rate largely similar to other chronic illnesses and one that has remained unchanged over the years. Non-adherence in BD is a complex phenomenon determined by a multitude of influences. However, thereis considerable uncertainty about the key determinants of non-adherence in BD. Initial research on nonadherence in BD mostly limited itself to examining demographic, clinical and medication-related factors impacting adherence. However, because of inconsistent results and failure of these studies to address the complexities of adherence behaviour, demographic and illness-related factors were alone unable to explain or predict non-adherence in BD. This prompted a shift to a more patient-centred approach of viewing nonadherence. The central element of this approach includes an emphasis on patients' decisions regarding their own treatment based on their personal beliefs, life circumstances and their perceptions of benefits and disadvantages of treatment. Patients' decisionmaking processes are influenced by the nature of their relationship with clinicians and the health-care system and by people in their immediate environment. The primacy of the patient's perspective on non-adherence is in keeping with the current theoretical models and concordance-based approaches to adherence behaviour in BD. Research over the past two decades has further endorsed the critical role of patients' attitudes and beliefs regarding medications, the importance of a collaborative treatment-alliance, the influence of the family, and the significance of other patient-related factors such as knowledge, stigma, patient satisfaction and access to treatment in determining non-adherence in BD. Though simply moving from an illness-centred to a patientcentred approach is unlikely to solve the problem of nonadherence in BD, such an approach is more likely to lead to a better understanding of non-adherence and more likely to yield effective solut

关键词： Non-adherence bipolar disorder Attitudes Health-beliefs Treatment-alliance Familial influences Knowledge Stigma

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Health-care needs of remitted patients with bipolar disorder: A comparison with schizophrenia

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World Journal of Psychiatry 2016年第4期6卷 431-441页

作者： Rajarshi Neogi Subho Chakrabarti Sandeep Grover Department of Psychiatry Postgraduate Institute of Medical Education and Research (PGIMER)

AIM To investigate health-care needs and their correlates among patients with remitted bipolar disorder(BD) compared to patients with remitted schizophrenia. METHODS Outpatients with BD(n = 150) and schizophrenia(n = 75) meeting clearly defined remission criteria were included in the study along with their relatives. Diagnostic ascertainment was carried out using the Mini International Neuropsychiatric Interview. Demographic and clinical details were recorded using structured formats. Residual symptoms were assessed using standardized scales. Health-care needs were assessed on two separate scales. The principal instrument employed to assess health-care needs was the Camberwell Assessment of Need-Research version(CAN-R). To further evaluate health-care needs we felt that an additional instrument, which was more relevant for Indian patients and treatment-settings and designed to cover those areas of needs not specifically covered by the CAN-R was required. This instrument with a structure and scoring pattern similar to the CAN-R was used for additional evaluation of needs. Patients' level offunctioning was assessed using the Global Assessment of Functioning Scale and their quality of life(QOL) using the World Health Organization Quality Of Life-BREF version in Hindi.RESULTS An average of 6-7 needs was reported by patients with BD as well as their relatives. Commonly reported needs were in the areas of economic and welfare needs, informational needs, social needs and the need for treatment. According to the CAN-R, both patients and relatives reported that more than 60% of the total needs were being met. However, over 90% of the needs covered by the additional evaluation were unmet according to patients and relatives. Needs in the areas of economic and welfare-benefits, information, company, daytime activities and physical health-care were largely unmet according to patients and relatives. Total, met and unmet needs were significantly higher for schizophrenia, but the most common types of needs were quite similar to

关键词： Health-care needs bipolar disorder Schizophrenia Remission Patients Relatives

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Memantine: New prospective in bipolar disorder treatment

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World Journal of Psychiatry 2014年第4期4卷 80-90页

作者： Giulia Serra Francesca Demontis Francesca Serra Lavinia De Chiara Andrea Spoto Paolo Girardi Giulio Vidotto Gino Serra Department of Psychiatry Harvard Medical School Boston MA 02115 United States International Consortium for bipolar Disorder Research Mc Lean Hospital Belmont MA 02478 United States NESMOS Department Sant’Andrea Hospital Sapienza University 00185 Rome Italy Centro Lucio Bini Mood Disorder Center 00193 Rome Italy Department of Biomedical Sciences University of Sassari 07100 Sassari Italy Department of General Psychology University of Padua 35122 Padova Italy

We review preclinical and clinical evidences strongly suggesting that memantine, an old drug currently approved for Alzheimer's dementia, is an effective treatment for acute mania and for the prevention of manic/hypomanic and depressive recurrences of manicdepressive illness. Lithium remains the first line for the treatment and prophylaxis of bipolar disorders, but currently available treatment alternatives for lithium resistant patients are of limited and/or questionable efficacy. Thus, research and development of more effective mood stabilizer drugs is a leading challenge for modern psychopharmacology. We have demonstrated that 21 d administration of imipramine causes a behavioural syndrome similar to a cycle of bipolar disorder, i.e., a mania followed by a depression, in rats. Indeed, such treatment causes a behavioural supersensitivity to dopamine D2 receptor agonists associated with an increase sexual activity and aggressivity(mania). The dopamine receptor sensitization is followed, after imipramine discontinuation, by an opposite phenomenon(dopamine receptor desensitization) and an increased immobility time(depression) in the forced swimming test of depression. Memantine blocks the development of the supersensitivity and the ensuing desensitization associated with the depressive like behavior. On the basis of these observations we have suggested the use of memantine in the treatment of mania and in the prophylaxis of bipolar disorders. To test this hypothesis we performed several naturalistic studies that showed an acute antimanic effect and a long-lasting and progressive mood-stabilizing action(at least 3 years), without clinically relevant side effects. To confirm the observations of our naturalistic trials we are now performing a randomized controlled clinical trial. Finally we described the studies reporting the efficacy of memantine in maniclike symptoms occurring in psychiatric disorders other than bipolar. Limitations: A randomized controlled clinical trial is needed to confirm our naturalistic obser

关键词： Memantine bipolar disorder Depression Mood stabilizer Manic symptoms

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Tribotronic bipolar junction transistor for mechanical frequency monitoring and use as touch switch

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Microsystems & Nanoengineering 2018年第1期4卷 65-72页

作者： Fengben Xi Yaokun Pang Wenjian Li Tianzhao Bu Junqing Zhao Guoxu Liu Tong Guo Wenbo Liu Chi Zhang CAS Center for Excellence in Nanoscience Beijing Key Laboratory of Micronano Energy and SensorBeijing Institute of Nanoenergy and NanosystemsChinese Academy of Sciences100083 BeijingChina School of Nanoscience and Technology University of Chinese Academy of Sciences100049 BeijingChina

Tribotronics,a new field that involves the coupling of triboelectricity and semiconductors,has attracted great interest in the nanoenergy and nanoelectronics domains.This paper proposes a tribotronic bipolar junction transistor(TBJT)that incorporates a bipolar junction transistor and a triboelectric nanogenerator(TENG)in the single-electrode mode.When the mobile triboelectric layer slides on the device surface for electrification,a bias voltage is created and applied to the emitter junction,and then the base current from the TENG is amplified.Based on the fabricated TBJT,a mechanical frequency monitoring sensor with high sensitivity and excellent stability and a finger-triggered touch switch were developed.This work demonstrated for the first time a tribotronic device with simultaneously controlled voltage and current voltage/current simultaneously controlled tribotronic device,which has promising potential applications in micro/nano-sensors,human-machine interactions,intelligent instrumentation,wearable electronics,and other applications.

关键词： bipolar transistor junction

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bipolar hemiarthroplasty for femoral neck fracture using the direct anterior approach

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World Journal of Orthopedics 2013年第2期4卷 85-89页

作者： Tomonori Baba Katsuo Shitoto Kazuo Kaneko Department of Orthopedic Surgery Juntendo University School of Medicine Tokyo 113-8421 Japan Department of Orthopedic Surgery Juntendo University Urayasu Hospital Chiba 279-0021Japan

AIM: To evaluate whether walking ability recovers early after bipolar hemiarthroplasty(BHA) using a direct anterior approach.METHODS: Between 2008 and 2010, 81 patients with femoral neck fracture underwent BHA using the direct anterior approach(DAA) or the posterior approach(PA). The mean observation period was 36 mo. The age, sex, body mass index(BMI), time from admission to surgery, length of hospitalization, outcome after discharge, walking ability, duration of surgery, blood loss and complications were compared. RESULTS: There was no significant difference in the age, sex, BMI, time from admission to surgery, length of hospitalization, outcome after discharge, duration of surgery and blood loss between the two groups. Two weeks after the operation, assistance was not necessary for walking in the hospital in 65.0% of the patients in the DAA group and in 33.3% in the PA group(P < 0.05). As for complications, fracture of the femoral greater trochanter developed in 1 patient in the DAA group and calcar crack and dislocation in 1 patient each in the PA group.CONCLUSION: DAA is an approach more useful for BHA for femoral neck fracture in elderly patients than total hip arthroplasty in terms of the early acquisition of walking ability.

关键词： Direct anterior approach bipolar hemiarthroplasty Posterior approach Femoral neck fracture Muscle presentation Walking ability

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Impact of proton-induced alteration of carrier lifetime on single-event transient in SiGe heterojunction bipolar transistor

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Chinese Physics B 2019年第7期28卷 375-380页

作者：魏佳男贺朝会李培李永宏郭红霞 School of Nuclear Science and Technology Xi'an Jiaotong University Xi'an 710049 China State Key Laboratory of Intense Pulsed Irradiation Simulation and Effect Northwest Institute of Nuclear Technology Xi'an 710024 China

This paper presents an investigation into the impact of proton-induced alteration of carrier lifetime on the singleevent transient(SET) caused by heavy ions in silicon–germanium heterojunction bipolar transistor(SiGe HBT).The ioninduced current transients and integrated charge collections under different proton fluences are obtained based on technology computer-aided design(TCAD) simulation.The results indicate that the impact of carrier lifetime alteration is determined by the dominating charge collection mechanism at the ion incident position and only the long-time diffusion process is affected.With a proton fluence of 5 × 1013 cm-2, almost no change is found in the transient feature, and the charge collection of events happened in the region enclosed by deep trench isolation(DTI), where prompt funneling collection is the dominating mechanism.Meanwhile, for the events happening outside DTI where diffusion dominates the collection process, the peak value and the duration of the ion-induced current transient both decrease with increasing proton fluence, leading to a great decrease in charge collection.

关键词： silicon–germanium heterojunction bipolar transistor(SiGe HBT) proton irradiation minority carrier lifetime single-event transient technology computer-aided design(TCAD) simulation

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bipolar electrocoagulation on functional cortex(BCFC)for intractable epilepsy involving eloquent cortex:a review

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Journal of Translational Neuroscience 2018年第1期3卷 17-22页

作者： Xinghui He Guoming Luan Beijing Key Laboratory of Epilepsy Sanbo Brain Hospital Capital Medical University Beijing 100093 China Department of Neurosurgery Epilepsy Center Sanbo Brain Hospital Capital Medical University Beijing 100093 China Institute of Epilepsy Beijing Institute for Brain Disorders Capital Medical University Beijing 100069 China

Twenty percent to forty percent of patients with epilepsy are medically refractory.For these patients,epilepsy surgeries such as resecting the epileptogenic focus may provide an alternative option.However,when the epileptogenic focus is located in the eloquent cortex,the resection of epileptogenic focus may lead to unacceptable functional deficits.bipolar electrocoagulation on functional cortex(BCFC)is a surgical technique that holds the same principles with multiple subpial transections(MST)and aims to benefit patients with epilepsy whose epileptogenic zone is located in the eloquent cortex.It uses thermal injury to interrupt the horizontal fibers in the cortex while mechanical injury is used in MST.Here,we reviewed the rationale,surgical procedure,laboratory research,and clinical application of BCFC.We also discussed the ongoing challenges of BCFC.

关键词： functional cortex epilepsy surgery bipolar electrocoagulation on functional cortex(BCFC)

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bipolar Quantum Logic Gates and Quantum Cellular Combinatorics—A Logical Extension to Quantum Entanglement

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Journal of Quantum Information Science 2013年第2期3卷 93-105页

作者： Wen-Ran Zhang Department of Computer Science College of Engineering and Information Technology Georgia Southern University Statesboro USA

Based on bipolar dynamic logic (BDL) and bipolar quantum linear algebra (BQLA) this work introduces bipolar quantum logic gates and quantum cellular combinatorics with a logical interpretation to quantum entanglement. It is shown that: 1) BDL leads to logically definable causality and generic particle-antiparticle bipolar quantum entanglement;2) BQLA makes composite atom-atom bipolar quantum entanglement reachable. Certain logical equivalence is identified between the new interpretation and established ones. A logical reversibility theorem is presented for ubiquitous quantum computing. Physical reversibility is briefly discussed. It is shown that a bipolar matrix can be either a modular generalization of a quantum logic gate matrix or a cellular connectivity matrix. Based on this observation, a scalable graph theory of quantum cellular combinatorics is proposed. It is contended that this work constitutes an equilibrium-based logical extension to Bohr’s particle-wave complementarity principle, Bohm’s wave function and Bell’s theorem. In the meantime, it is suggested that the result may also serve as a resolution, rather than a falsification, to the EPR paradox and, therefore, a equilibrium-based logical unification of local realism and quantum non-locality.

关键词： bipolar Causal Sets Logically Definable Causality Basis State Quantum Entanglement Generic and Composite Entanglement bipolar Equilibrium bipolar Quantum Logic Gates Quantum Cellular Combinatorics

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bipolar and Schizophrenia Disorders Diagnosis Using Artificial Neural Network

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Neuroscience & Medicine 2018年第4期9卷 209-220页

作者： Mateus Beck Fonseca Renan Soares de Andrades Suelen de Lima Bach Carolina David Wiener Jean Pierre Oses Engineer Center Federal University of Pelotas Pelotas Brazil Department of Health and Behavior Clinical Neuroscience Lab Catholic University of Pelotas Pelotas Brazil Anhanguera Educacional Rio Grande Brazil Department of Electronic Engineering and Computer Catholic University of Pelotas Pelotas Brazil

Motivation: bipolar disorder (BD) and schizophrenia (SZ) has a difficult diagnosis, so the main objective of this article is to propose the use of Artificial Neural Networks (ANNs) to classify (diagnose) groups of patients with BD or SZ from a control group using sociodemographic and biochemical variables. Methods: Artificial neural networks are used as classifying tool. The data from this study were obtained from the array collection from Stanley Neuropathology Consortium databank. Inflammatory markers and characteristics of the sampled population were the inputs variables. Results: Our findings suggest that an artificial neural network could be trained with more than 90% accuracy, aiming the classification and diagnosis of bipolar, schizophrenia and control healthy group. Conclusion: Trained ANNs could be used to improve diagnosis in Schizophrenia and bipolar disorders.

关键词： bipolar Disorder Schizophrenia Disorder Biomarkers Artificial Neural Network

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