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The basal ganglia represents a key component of the pathophysiological model for obsessive-compulsive disorder (OCD). This brain region is part of several neural circuits, including the orbitofronto-striatal circuit and dorsolateral prefronto-striatal circuit. There are, however, no published studies investigating those circuits at a network level in non-medicated patients with OCD. Resting state functional magnetic resonance imaging scans were obtained from 20 non-medicated patients with OCD and 23 matched healthy volunteers. Voxelwise statistical parametric maps testing strength of functional connectivity of three striatal seed regions of interest (ROIs) with remaining brain regions were calculated and compared between groups. We performed additional correlation analyses between strength of connectivity and the severity scores for obsessive-compulsive symptoms, depression, and anxiety in the OCD group. Positive functional connectivity with the ventral striatum was significantly increased (Pcorrected <.05) in the orbitofrontal cortex, ventral medial prefrontal cortex and dorsal lateral prefrontal cortex of subjects with OCD. There was no significant correlation between measures of symptom severity and the strength of connectivity (Puncorrected <.001). This is the first study to investigate the corticostriatal connectivity in non-medicated patients with OCD. These findings provide the first direct evidence supporting a pathophysiological model involving basal ganglia circuitry in OCD.
There is paucity of published literature on antidepressants in a cost-consequence study design.
Measuring clinical outcomes of pharmacotherapy.
Costs and consequences determination in depressive episode acute medical care.
Cost-consequence analysis;Setting-Serbian tertiary university clinic(2010-2012). Patient visits to attending psychiatrists:baseline, 3,8 weeks. HDRS-17 and Q-LES-Q-SF scale were applied in each of control visits. Resource use patterns and costs were evidenced for up to 14 weeks from study entry. Micro-costing approach allowed for most direct and indirect costs measurement. Costs were expressed in national currency-Central Serbian Dinar(1€≈115.85CSD;2012). Societal perspective and 14 weeks time horizon were adopted. Random selection of 65 depressive patients was based on clinical criteria and their assignment to either one of three different treatment protocols.5 patients were lost to follow up.
There was no statistically significant difference in terms of therapeutic response by the HDRS scores before and after introducing treatment groups(χ2=4.339; ?=0.362). QALY value increased by 11.77(SSRI group);8.93(SNRI)and 12.54 (heterocyclics). Mean cost per QALY was 9,937.51 CSD for SSRI; 7,138.27 CSD in SNRI; and 6,164.96 CSD for heterocyclics. There were 28.69 depression with free days in SSRI, 21.78 days in SNRI, and 30.59 days in heterocyclic group. Cost-effectiveness assessment was was 346.38 CSD per day(SSRI); 327.74 CSD(SNRI), and 201.54 CSD(heterocyclics).
Heterocyclic antidepressants provide highest'value for money' in terms of QALY in depressive episode treatment and its treatment is most cost effective. Cost-consequence evaluations have heavier impact to clinical decision making with regards to major depressive disorder treatment in the absence of clear clinical superiority of any major pharmacological protocol.
The primary goal of this study is to examine the effectiveness of a community-based multimodal intervention program for suicide prevention in regions where the suicide rate was relatively high compared to control regions. The secondary goal was to explore the effectiveness of a community-based multimodal intervention program for suicide prevention in highly populated regions.
NOCOMIT-J is a community-based large-scale non-randomized controlled trial, involving seven intervention regions with accompanying control regions, all with populations of statistically sufficient size. The program consists of
1) Establishing social support networks in the public health system for suicide prevention and mental health promotion;
2) A primary prevention measures of awareness campaign for the public and key personnel;
3) Secondary prevention measures for screening, counseling and outreach services for high-risk individuals;
4) After-care for individuals bereaved by suicide;
5) Suicide prevention measures especially for individuals with mental illness and work-related problems.
This study protocol was reviewed and approved by the Central Ethics Committee of the J-MISP. Additionally, the regional leaders obtained written authorization from the local governors.
The intervention started in July 2006, and continued for 3.5 years. Participants are Japanese and foreign residents living in the intervention and control regions, a total of population of 2,120,000 individuals.
Because treatment and prevention of suicide are complex and encompass many factors, success will need multi-sector collaboration. We hope that the results of NOCOMIT-J will help to develop effective strategies to reduce future suicide rate. (ClinicalTrials.gov: NCT00737165)
Reduced white matter integrity in the corpus callosum (CC) has been reported in treatment-resistant depression (TRD). rTMS is assumed to have remote effect on interconnected area with the stimulation site, and this effect is speculated to be one of the therapeutic mechanisms of rTMS treatment. In this preliminary study, we examined changes of callosal fiber integrity in 5 segments of the CC before and after rTMS treatment for TRD.
The subjects were 2 patients with treatment-resistant unipolar depression and 1 patient with treatment-resistant bipolar depression, and 24 healthy controls (HC group). The patients underwent 4-week high frequency rTMS to their left DLPFC. In diffusion tensor imaging (DTI) tractography, the CC was divided into 5 segments (orbital, frontal, parietal, temporal, and occipital) based on their cortical projection zones, and fractional anisotropy (FA) value of each segment was estimated. We compared FA in the CC between the patients and the HC groups, and examined changes of FA in the CC after rTMS treatment in the patients.
The patients showed reduced FA in the frontal, parietal, temporal, and occipital-callosal segments compared to the HC group. All patients responded to the rTMS treatment, and FA in the orbital, frontal, parietal, temporal-callosal segments increased after the rTMS treatment.
Our results suggest that white matter integrity in the CC is reduced in TRD and that increased white matter integrity in the CC might be related with the therapeutic mechanisms of rTMS treatment.
A history of previous suicide attempt is a potent risk factor for suicide later on. Crisis intervention initiated at emergency medical facilities for suicide attempters are considered important components for suicide prevention. The primary aim of this trial is to examine the effectiveness of an extensive intervention for suicide attempters in prevention of recurrent suicidal behavior, as compared with standard intervention.
ACTION-J is a single blinded randomized controlled trial. In this trial, case management intervention were provided at 19 emergency medical facilities in Japan. After psychiatric evaluation and psychological education, subjects were randomly assigned to either a group receiving continuous case management or standard care. Suicidal ideation, depressive symptoms, and general health condition were evaluated as secondary measures. The stratified logrank test based on allocation factors will be performed for all eligible participants in the intent-to-treat analysis. The study protocol was reviewed and approved by the Central Ethics Committee of the J-MISP. The protocol was also reviewed and approved by the On-site Research Ethics Committee at each participating hospital.
The intervention was initiated in July 2006. By December 2009, 914 subjects were randomized. Subject follow-up continued for 1.5 to 5 years, till the end of June 2011. ACTION-J would provide valuable information on suicide attempters and may develop effective case management to reduce future risk for suicide attempters. (ClinicalTrials.gov: NCT00736918.)
In bipolar disorder (BD), reduced white matter (WM) integrity in the corpus callosum has been reported, but its detailed localization difference has not been clarified. In this study, we examined fiber integrity in 7 segments of the corpus callosum and their relationships with clinical symptoms in BD.
Patients with BD (BD group, n = 17) and age-matched healthy controls (HC group, n = 24) were examined using diffusion tensor imaging tractography. The corpus callosum was divided into 7 segments (orbital frontal, anterior frontal, superior frontal, superior parietal, posterior parietal, temporal, and occipital) based on their cortical projection zones, and fractional anisotropy (FA) value of each segment was estimated. Differences in FA of each segment between the groups were examined using ANOVA with repeated measures. Correlations between FA of each segment and clinical symptoms (HAM-D, YMRS) were assessed using Spearman's rank correlation test in the BD group.
The BD group showed reduced FA in the orbital frontal, superior frontal, and posterior parietal-callosal segments compared to the HC group. In addition, the BD group showed a significant negative correlation between FA in the orbital frontal-callosal segment and HAM-D scores.
Our results suggest that WM integrity in the anterior part of the corpus callosum is reduced in BD and that orbital frontal-callosal disintegrity may be related with severity of bipolar depression.
Measurements in the infrared wavelength domain allow direct assessment of the physical state and energy balance of cool matter in space, enabling the detailed study of the processes that govern the formation and evolution of stars and planetary systems in galaxies over cosmic time. Previous infrared missions revealed a great deal about the obscured Universe, but were hampered by limited sensitivity.
SPICA takes the next step in infrared observational capability by combining a large 2.5-meter diameter telescope, cooled to below 8 K, with instruments employing ultra-sensitive detectors. A combination of passive cooling and mechanical coolers will be used to cool both the telescope and the instruments. With mechanical coolers the mission lifetime is not limited by the supply of cryogen. With the combination of low telescope background and instruments with state-of-the-art detectors SPICA provides a huge advance on the capabilities of previous missions.
SPICA instruments offer spectral resolving power ranging from R ~50 through 11 000 in the 17–230 μm domain and R ~28.000 spectroscopy between 12 and 18 μm. SPICA will provide efficient 30–37 μm broad band mapping, and small field spectroscopic and polarimetric imaging at 100, 200 and 350 μm. SPICA will provide infrared spectroscopy with an unprecedented sensitivity of ~5 × 10−20 W m−2 (5σ/1 h)—over two orders of magnitude improvement over what earlier missions. This exceptional performance leap, will open entirely new domains in infrared astronomy; galaxy evolution and metal production over cosmic time, dust formation and evolution from very early epochs onwards, the formation history of planetary systems.
Rabies was eliminated from Japan in 1957. In the 60 years since elimination, vaccination coverage has declined and dog ownership habits have changed. The purpose of this study was to assess the current risk of rabies spread in Japan. A spatially explicit transmission model was developed at the 1 km2 grid scale for Hokkaido and Ibaraki Prefectures. Parameters associated with dog movement and bite injuries were estimated using historical records from Japan, and were used with previously published epidemiological parameters. The final epidemic size, efficacy of rabies contingency plans and the influence of dog owner responses to incursions were assessed by the model. Average outbreak sizes for dog rabies were 3.1 and 4.7 dogs in Hokkaido and Ibaraki Prefectures, respectively. Average number of bite injury cases were 4.4 and 6.7 persons in Hokkaido and Ibaraki Prefectures, respectively. Discontinuation of mandatory vaccination increased outbreak sizes in these prefectures. Sensitivity analyses showed that higher chance of unintentional release of rabid dogs by their owners (from 0.5 to 0.9 probability) increased outbreak size twofolds. Our model outputs suggested that at present, incursions of rabies into Japan are very unlikely to cause large outbreaks. Critically, the reaction of dog owners to their dogs developing rabies considerably impacts the course of outbreaks. Contingency measures should therefore include sensitisation of dog owners.
IR spectroscopy in the range 12–230 μm with the SPace IR telescope for Cosmology and Astrophysics (SPICA) will reveal the physical processes governing the formation and evolution of galaxies and black holes through cosmic time, bridging the gap between the James Webb Space Telescope and the upcoming Extremely Large Telescopes at shorter wavelengths and the Atacama Large Millimeter Array at longer wavelengths. The SPICA, with its 2.5-m telescope actively cooled to below 8 K, will obtain the first spectroscopic determination, in the mid-IR rest-frame, of both the star-formation rate and black hole accretion rate histories of galaxies, reaching lookback times of 12 Gyr, for large statistically significant samples. Densities, temperatures, radiation fields, and gas-phase metallicities will be measured in dust-obscured galaxies and active galactic nuclei, sampling a large range in mass and luminosity, from faint local dwarf galaxies to luminous quasars in the distant Universe. Active galactic nuclei and starburst feedback and feeding mechanisms in distant galaxies will be uncovered through detailed measurements of molecular and atomic line profiles. The SPICA’s large-area deep spectrophotometric surveys will provide mid-IR spectra and continuum fluxes for unbiased samples of tens of thousands of galaxies, out to redshifts of z ~ 6.
Japan has been free from rabies since 1958. A strict import regimen has been adopted since 2004 consisting of identification of an animal with microchip, two-time rabies vaccination, neutralizing antibody titration test and a waiting period of 180 days. The present study aims to quantitatively assess the risk of rabies introduction into Japan through the international importation of dogs and cats and hence provide evidence-based recommendations to strengthen the current rabies prevention system. A stochastic scenario tree model was developed and simulations were run using @RISK. The probability of infection in a single dog or cat imported into Japan is estimated to be 2·16 × 10−9 [90% prediction interval (PI) 6·65 × 10−11–6·48 × 10−9]. The number of years until the introduction of a rabies case is estimated to be 49 444 (90% PI 19 170–94 641) years. The current import regimen is effective in maintaining the very low risk of rabies introduction into Japan and responding to future changes including increases in import level and rabies prevalence in the world. However, non-compliance or smuggling activities could substantially increase the risk of rabies introduction. Therefore, policy amendment which could promote compliance is highly recommended. Scenario analysis demonstrated that the waiting period could be reduced to 90 days and the requirement for vaccination could be reduced to a single vaccination, but serological testing should not be stopped.
In order to investigate the distinguishability about the progenitors of FeCCSNe and ECSNe, we calculate the luminosities and spectra of their pre-SN neutrinos and estimate the number of events at neutrino detectors.
It is now firmly established that a small anisotropy of the galactic cosmic rays exists, observable from Earth as a variation of intensity in sidereal time. The problem now is to determine more clearly the characteristics of the anisotropy and, in particular, its detailed spatial structure and how it depends upon the energy and composition of the cosmic rays. This is a very difficult task and, in the final analysis, may not be fully achievable from Earth-based observations. The purpose of the present paper is to describe briefly an installation now operating in Tasmania to provide further information on the spatial structure of the anisotropy.
Two alternative chemical etchings (aqueous solution of bromine and bromine methanol solution) have been here tested to replace the KCN etching step in Cu-rich CuInSe2 based solar cells fabrication process. This new oxidative etch aims also at smoothing and thinning the as-grown films. This directly affects the interface between the absorber and the CdS buffer, interface which causes problems for Cu-rich solar cells. We present here the effect of these two alternative etchings on both the absorber surface and the solar cells parameters: whereas the bromine methanol etching destroys the solar cell, the aqueous solution of bromine leads to an improvement of the device through reduced interface and tunneling enhanced recombination.
In this work, we report on development of one-dimensional reaction-diffusion simulator needed to understand the kinetics of Cu-related metastabilities observed in CdTe PV devices. Evolution of intrinsic and Cu-related defects in CdTe solar cells has been studied in time-space domain self-consistently with free carrier transport. Resulting device performance was simulated as a function of stress time, thus showing pronounced effect that the evolution of associated acceptor and donor states can cause on device characteristics. Although 1D simulation has intrinsic limitations when applied to poly-crystalline films, the results presented confirm the validity and the potential of the approach presented in better understanding of the performance and metastabilities of CdTe photovoltaic devices.
The goal of this research is to synthesize novel linear and hyperbranched polythiophene derivatives containing diketopyrrolopyrrole (DPP) as linking groups, and to investigate thermal, optical, electrochemical, and photovoltaic properties of those derivatives. Polymers with high regioregularity were synthesized via the Universal Grignard metathesis polymerization. Those linear or hyperbranched polythiophenes containing DPP bridging moieties showed higher molecular weights and better thermal stability compared with normal P3HT. The UV-vis absorption spectra of the DPP-containing polymers are similar to that of P3HT in film state, while they show distinct attenuation in fluorescent emission. Finally, all polymers were blended with PC61BM and used as active layers for fabrication of inverted solar devices. The devices based on those DPP-containing polythiophenes revealed the open-circuit voltage (VOC) of 0.55–0.58 V, the short-circuit current (JSC) of 8.62–16.21 mA/cm2, the fill factor (FF) of 36–41%, and the power conversion efficiency (PCE) of 1.73–3.74%.
In current transparent Si based photovoltaic (PV) module fabrication, green or infrared laser is the most common used band frequency to wipe off the silicon and back contact layer in perpendicular direction of cells. However, this method would result in more power loss than calculation value due to the side effects during the process such as constructional damage of module and shunt effect. A new method is presented here which focus on wiping off more silicon layer by employing green pulsed laser(532 nm wavelength) along the parallel direction of Pattern2, and it shows higher efficiency and more attractive appearance.