Objectives: The present study analyzed the reciprocal relationships between four common pediatric ophthalmic diseases (i.e., hyperopia, myopia, astigmatism, and strabismus) and attention‐deficit/hyperactivity disorder (ADHD) in children. Methods: This study enrolled 86,028 children with ADHD and 1,798,673 children without ADHD in the Taiwan Maternal and Child Health Database who were born at any time from 2004 to 2017. Cox proportional hazards regression models were used to estimate the bidirectional relationships of the four ophthalmic diseases with ADHD in children after adjusting for age, sex, and gestational age at birth. Survival curves for time-to-event variables were estimated using the Kaplan-Meier method, and the log-rank test was used to compare the curves. Results: The results indicated that ADHD significantly predicted the occurrence of hyperopia, myopia, astigmatism, and strabismus. Furthermore, hyperopia, myopia, astigmatism, and strabismus significantly predicted the occurrence of ADHD. The time between enrollment and ADHD diagnosis was shorter for patients with ophthalmic diseases than for the control group, and the time between enrollment and ophthalmic disease diagnosis was also shorter for ADHD patients than for the control group. Sex differences were found in the associations between ADHD and ophthalmic diseases. Conclusion: Clinicians should monitor children with ADHD for hyperopia, myopia, astigmatism, and strabismus to ensure appropriate treatment, and vice versa.

Abstract The effect of Maillard reaction browning factors on the color enhancement of membrane clarification non-centrifugal cane sugar (M-NCS) in storage was explored. During storage, the color of M-NCS gradually browned and blackened. pH, the contents of glucose, fructose, protein, total amino acids and 5-hydroxymethylfurfural (5-HMF) decreased significantly. Meanwhile, the moisture content, relative percentages of volatile Maillard reaction products (MRPs) and the content of 3-deoxyglucosone (3-DG) increased during storage. The sucrose content remained stable. Correlation analysis shows all browning factors were significantly correlated with color. Multivariate data analysis results demonstrated that the compound effects of volatile MRPs, 3-DG, pH, glucose and total amino acids led to the color change of stored M-NCS. The order of effect on the color change of stored M-NCS was volatile MRPs > 3-DG > pH > glucose > total amino acids.

Abstract Background Mental health disparity in sexual minorities is a crucial clinical and public health issue worldwide. A total of 500 homosexual or bisexual men aged between 20 and 25 years participated in this study. Objectives The aims of the study were to examine the relationships of victimization of traditional and cyber homophobic bullying during childhood and adolescence with problematic internet and smartphone use and activities during early adulthood among sexual minority men in Taiwan. Methods The seveirities of problematic internet and smartphone use and activities in early adulthood were compared between victims and non-victims of bullying. The severities of problematic internet and smartphone use were also compared among the groups of various types of bullying as well as among the groups of various persistence durations of being bullied. Results Victims of traditional and cyber homophobic bullying had more severe problematic internet and smartphone use than non-victims. Victims of multi-type bullying had more severe problematic internet use than victims of single-type bullying. Prolonged victimization was significantly associated with problematic internet and smartphone use. Discussion: Victimization of traditional and cyber homophobic bullying during childhood and adolescence predicts problematic internet and smartphone use during early adulthood among sexual minority men.

Abstract Objectives The aim of the present study was to evaluate the associations of parental bonding and adolescents’ Internet addiction symptoms with depression and anxiety in parents of adolescents with attention deficit/hyperactivity disorder (ADHD). Methods Parental depression and anxiety symptoms, parental bonding, and adolescents’ Internet addiction symptoms were assessed in 46 parent-child dyads using the Center for Epidemiological Studies Depression Scale, State-Trait Anxiety Inventory, Parental Bonding Instrument (PBI), and Chen Internet Addiction Scale, respectively. Forward stepwise multiple regression analysis was used to examine the associations of parental bonding and adolescents’ Internet addiction symptoms with parental depression and anxiety. Results Low care/affection on the PBI was significantly associated with parental depression, and overprotection on the PBI and adolescents’ Internet addiction were significantly associated with parental anxiety. Discussion Parental bonding and adolescents’ Internet addiction are related to depression and anxiety in parents of adolescents with ADHD.

Abstract Background: Homophobic harassment can compromise mental health of sexual minority youths. Objectives: This study examined the rates of persistent and multisite homophobic harassment and their associations with school difficulties during childhood and adolescence among gay and bisexual men in Taiwan. Methods: Participants were recruited through advertisements on the Facebook, Bulletin Board Systems, and the home pages of health promotion and counseling centers for the gay, lesbian, and bisexual community. The experiences of traditional and cyber harassment based on gender role nonconformity and sexual orientation of 500 gay or bisexual men were examined. The associations of multisite and persistent harassment victimization with school difficulties were evaluated. Results: A total of 239 (47.8%) and 131 (26.2%) participants experienced persistent and multisite harassment victimization, respectively. Harassment victimization was significantly associated with low satisfaction with academic performance in any stage of study. Moreover, the participants who were harassed in senior high schools were more likely to miss classes or be truant than those who were not harassed. The victims of multisite harassment at senior high schools were more likely to miss classes or be truant than those of school-only harassment. Discussion: Prevention and intervention programs are warranted to reduce homophobic harassment in sexual minority youths.

Abstract Background A total of 6150 junior and senior high school students aged 11–18 years participated in this study. Their level of pain-related QOL was assessed using the pain subscale of the Taiwanese QOL Questionnaire for Adolescents. The severities of depression, suicidality, anxiety, and alcohol abuse were also examined. Objectives This study examined the associations between pain-related quality of life (QOL) and sociodemographic characteristics and those between pain-related QOL and mental health problems such as depression, suicidality, anxiety, and alcohol abuse. Methods The association of sociodemographic factors with pain-related QOL was examined through multiple regression analysis. The association of pain-related QOL with mental health problems was examined through logistic regression analysis. Results The boys exhibited a higher level of satisfaction with pain-related QOL than did the girls. Older age was significantly associated with a lower level of satisfaction with pain-related QOL. Residential background, parental marital status, and parental education levels were not significantly associated with the level of satisfaction with pain-related QOL. Increased risks of depression, suicidality, anxiety, and alcohol abuse were significantly associated with a low level of satisfaction with pain-related QOL. Discussion A low level of satisfaction with pain-related QOL is significantly associated with the risk of poor mental health. Adolescents with the correlates of low satisfaction with pain-related QOL should be monitored for the risk of mental health problems.

BACKGROUND Stroke is the major cause of adult disability. Selective serotonin reuptake inhibitors (SSRIs) have been used for many years to manage depression. Recently, small trials have demonstrated that SSRIs might improve recovery after stroke, even in people who are not depressed. Systematic reviews and meta-analyses are the least biased way to bring together data from several trials. Given the promising effect of SSRIs on stroke recovery seen in small trials, a systematic review and meta-analysis is needed. OBJECTIVE To determine whether SSRIs improve recovery after stroke, and whether treatment with SSRIs was associated with adverse effects. METHODS Search methods: We searched the Cochrane Stroke Group Trials Register (August 2011), Cochrane Depression Anxiety and Neurosis Group Trials Register (November 2011), Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 8), MEDLINE (from 1948 to August 2011), EMBASE (from 1980 to August 2011), CINAHL (from 1982 to August 2011), AMED (Allied and Complementary Medicine) (from 1985 to August 2011), PsycINFO (from 1967 to August 2011) and PsycBITE (Pyschological Database for Brain Impairment Treatment Efficacy) (March 2012). To identify further published, unpublished and ongoing trials we searched trials registers, pharmaceutical websites, reference lists, contacted experts and performed citation tracking of included studies. Selection criteria: We included randomized controlled trials that recruited stroke survivors (ischaemic or haemorrhagic) at any time within the first year. The intervention was any SSRI, given at any dose, for any period. We excluded drugs with mixed pharmacological effects. The comparator was usual care or placebo. In order to be included, trials had to collect data on at least one of our primary (dependence and disability) or secondary (impairments, depression, anxiety, quality of life, fatigue, healthcare cost, death, adverse events and leaving the trial early) outcomes. Data collection and analysis: We extracted data on demographics, type of stroke, time since stroke, our primary and secondary outcomes, and sources of bias. For trials in English, two review authors independently extracted data. For Chinese papers, one review author extracted data. We used standardized mean differences (SMD) to estimate treatment effects for continuous variables, and risk ratios (RR) for dichotomous effects, with their 95% confidence intervals (CIs). MAIN RESULTS We identified 56 completed trials of SSRI versus control, of which 52 trials (4059 participants) provided data for meta-analysis. There were statistically significant benefits of SSRI on both of the primary outcomes: RR for reducing dependency at the end of treatment was 0.81 (95% CI 0.68 to 0.97) based on one trial, and for disability score, the SMD was 0.91 (95% CI 0.60 to 1.22) (22 trials involving 1343 participants) with high heterogeneity between trials (I2 = 87%; P < 0.0001). For neurological deficit, depression and anxiety, there were statistically significant benefits of SSRIs. For neurological deficit score, the SMD was -1.00 (95% CI -1.26 to -0.75) (29 trials involving 2011 participants) with high heterogeneity between trials (I2 = 86%; P < 0.00001). For dichotomous depression scores, the RR was 0.43 (95% CI 0.24 to 0.77) (eight trials involving 771 participants) with high heterogeneity between trials (I2 = 77%; P < 0.0001). For continuous depression scores, the SMD was -1.91 (95% CI -2.34 to -1.48) (39 trials involving 2728 participants) with high heterogeneity between trials (I2 = 95%; P < 0.00001). For anxiety, the SMD was -0.77 (95% CI -1.52 to -0.02) (eight trials involving 413 participants) with high heterogeneity between trials (I2 = 92%; P < 0.00001). There was no statistically significant benefit of SSRI on cognition, death, motor deficits and leaving the trial early. For cognition, the SMD was 0.32 (95% CI -0.23 to 0.86), (seven trials involving 425 participants) with high heterogeneity between trials (I2 = 86%; P < 0.00001). The RR for death was 0.76 (95% CI 0.34 to 1.70) (46 trials involving 3344 participants) with no heterogeneity between trials (I2 = 0%; P = 0.85). For motor deficits, the SMD was -0.33 (95% CI -1.22 to 0.56) (two trials involving 145 participants). The RR for leaving the trial early was 1.02 (95% CI 0.86 to 1.21) in favour of control, with no heterogeneity between trials. There was a non-significant excess of seizures (RR 2.67; 95% CI 0.61 to 11.63) (seven trials involving 444 participants), a non-significant excess of gastrointestinal side effects (RR 1.90; 95% CI 0.94 to 3.85) (14 trials involving 902 participants) and a non-significant excess of bleeding (RR 1.63; 95% CI 0.20 to 13.05) (two trials involving 249 participants) in those allocated SSRIs. Data were not available on quality of life, fatigue or healthcare costs. There was no clear evidence from subgroup analyses that one SSRI was consistently superior to another, or that time since stroke or depression at baseline had a major influence on effect sizes. Sensitivity analyses suggested that effect sizes were smaller when we excluded trials at high or unclear risk of bias. Only eight trials provided data on outcomes after treatment had been completed; the effect sizes were generally in favour of SSRIs but CIs were wide. AUTHORS' CONCLUSIONS SSRIs appeared to improve dependence, disability, neurological impairment, anxiety and depression after stroke, but there was heterogeneity between trials and methodological limitations in a substantial proportion of the trials. Large, well-designed trials are now needed to determine whether SSRIs should be given routinely to patients with stroke.