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Mood disorders require consistent management of symptoms to prevent recurrences of mood episodes. Circadian rhythm (CR) disruption is a key symptom of mood disorders to be proactively managed to prevent mood episode recurrences. This study aims to predict impending mood episodes recurrences using digital phenotypes related to CR obtained from wearable devices and smartphones.
The study is a multicenter, nationwide, prospective, observational study with major depressive disorder, bipolar disorder I, and bipolar II disorder. A total of 495 patients were recruited from eight hospitals in South Korea. Patients were followed up for an average of 279.7 days (a total sample of 75 506 days) with wearable devices and smartphones and with clinical interviews conducted every 3 months. Algorithms predicting impending mood episodes were developed with machine learning. Algorithm-predicted mood episodes were then compared to those identified through face-to-face clinical interviews incorporating ecological momentary assessments of daily mood and energy.
Two hundred seventy mood episodes recurred in 135 subjects during the follow-up period. The prediction accuracies for impending major depressive episodes, manic episodes, and hypomanic episodes for the next 3 days were 90.1, 92.6, and 93.0%, with the area under the curve values of 0.937, 0.957, and 0.963, respectively.
We predicted the onset of mood episode recurrences exclusively using digital phenotypes. Specifically, phenotypes indicating CR misalignment contributed the most to the prediction of episodes recurrences. Our findings suggest that monitoring of CR using digital devices can be useful in preventing and treating mood disorders.
Firefighters are frequently exposed to stressful situations and are at high risk of developing post-traumatic stress disorder (PTSD). Hyperresponsiveness to threatening and emotional stimuli and diminishment of executive control have been suggested as manifestations of PTSD.
To examine brain activation in firefighters with PTSD by conducting an executive control-related behavioural task with trauma-related interferences.
Twelve firefighters with PTSD and 14 healthy firefighters underwent functional magnetic resonance imaging (fMRI) while performing a Stroop match-to-sample task using trauma-related photographic stimuli. Seed-based functional connectivity analysis was conducted using regions identified in fMRI contrast analysis.
Compared with the controls, the participants with PTSD had longer reaction times when the trauma-related interferences were presented. They showed significantly stronger brain activation to interfering trauma-related stimuli in the left insula, and had weaker insular functional connectivity in the supplementary motor area and the anterior cingulate cortex than the controls. They also showed a significant correlation between left insula–supplementary motor area connectivity strength and the hyperarousal subscale of the Clinician-Administered PTSD Scale.
Our findings indicate that trauma-related stimuli elicit excessive brain activation in the left insula among firefighters with PTSD. Firefighters with PTSD also appear to have weak left insular functional connectivity with executive control-related brain regions. This aberrant insular activation and functional connectivity could be related to the development and maintenance of PTSD symptoms in firefighters.
Network approach has been applied to a wide variety of psychiatric disorders. The aim of the present study was to identify network structures of remitters and non-remitters in patients with first-episode psychosis (FEP) at baseline and the 6-month follow-up.
Participants (n = 252) from the Korean Early Psychosis Study (KEPS) were enrolled. They were classified as remitters or non-remitters using Andreasen's criteria. We estimated network structure with 10 symptoms (three symptoms from the Positive and Negative Syndrome Scale, one depressive symptom, and six symptoms related to schema and rumination) as nodes using a Gaussian graphical model. Global and local network metrics were compared within and between the networks over time.
Global network metrics did not differ between the remitters and non-remitters at baseline or 6 months. However, the network structure and nodal strengths associated with positive-self and positive-others scores changed significantly in the remitters over time. Unique central symptoms for remitters and non-remitters were cognitive brooding and negative-self, respectively. The correlation stability coefficients for nodal strength were within the acceptable range.
Our findings indicate that network structure and some nodal strengths were more flexible in remitters. Negative-self could be an important target for therapeutic intervention.
Progenitors of Type Ib and Ic supernovae (SNe) are stripped envelope stars and provide important clues on the mass-loss history of massive stars. Direct observations of the progenitors before the supernova explosion would provide strong constraints on the exact nature of SN Ib/Ic progenitors. Given that stripped envelope massive stars can have an optically thick wind as in the case of Wolf-Rayet stars, the influence of the wind on the observational properties needs to be properly considered to correctly infer progenitor properties from pre-SN observations. Non-LTE stellar atmosphere models indicate that the optical brightness could be greatly enhanced with an optically thick wind because of lifting-up of the photosphere from the stellar surface to the wind matter, and line and free-free emissions. So far, only a limited number of SN Ib/Ic progenitor candidates have been reported, including iPTF13bvn, SN 2017ein and SN 2019yvr. We argue that these three candidates are a biased sample, being unusually bright in the optical compared to what is expected from typical SN Ib/Ic progenitors, and that mass-loss enhancement during the final evolutionary stage can explain their optical properties.
We recently reported an association between TAAR6 (trace amine associated receptor 6 gene) variations and schizophrenia (SZ). We now report an association of a set of TAAR6 variations and clinical presentation and outcome in a sample of 240 SZ Korean patients. Patients were selected by a Structured Clinical Interview, DSM-IV Axis I disorders – Clinical Version (SCID-CV). Other psychiatric or neurologic disorders, as well as medical diseases, were exclusion criteria. To assess symptom severity, patients were administered the CGI scale and the PANSS at baseline and at the moment of discharge, 1 month later on average. TAAR6 variations rs6903874, rs7452939, rs8192625 and rs4305745 were investigated; rs6903874, rs7452939 and rs8192625 entered the statistical investigation after LD analysis. Rs8192625 G/G homozygosis was found to be significantly associated both with a worse clinical presentation at PANSS total and positive scores and with a shorter period of illness before hospitalization. No haplotype significant findings were found. The present study stands for a role of the TAAR6 in the clinical presentation of SZ. Moreover, our results show that this genetic effect may be counteracted by a correct treatment. Haplotype analysis was not informative in our sample, probably also because of the incomplete SNPs' coverage of the gene we performed. Further studies in this direction are warranted.
To propose a new anthropometric index that can be employed to better predict percent body fat (PBF) among young adults and to compare with current anthropometric indices.
All measurements were taken in a controlled laboratory setting in Seoul (South Korea), between 1 December 2015 and 30 June 2016.
Eighty-seven young adults (18–35 years) who underwent dual-energy x-ray absorptiometry (DXA) were used for analysis. Multiple regression analyses were conducted to develop a body fat index (BFI) using simple demographic and anthropometric information. Correlations of DXA measured PBF (DXA_PBF) with previously developed anthropometric indices and the BFI were analysed. Receiver operating characteristic curve analyses were conducted to compare the ability of anthropometric indices to identify obese individuals.
BFI showed a strong correlation with DXA_PBF (r = 0·84), which was higher than the correlations of DXA_PBF with the traditional (waist circumference, r = 0·49; waist to height ratio, r = 0·68; BMI, r = 0·36) and alternate anthropometric indices (a body shape index, r = 0·47; body roundness index, r = 0·68; body adiposity index, r = 0·70). Moreover, the BFI showed higher accuracy at identifying obese individuals (area under the curve (AUC) = 0·91), compared with the other anthropometric indices (AUC = 0·71–0·86).
The BFI can accurately predict DXA_PBF in young adults, using simple demographic and anthropometric information that are commonly available in research and clinical settings. However, larger representative studies are required to build on our findings.
Twelve evidence-based profiles of roles across the translational workforce and two patients were made available through clinical and translational science (CTS) Personas, a project of the Clinical and Translational Science Awards (CTSA) Program National Center for Data to Health (CD2H). The persona profiles were designed and researched to demonstrate the key responsibilities, motivators, goals, software use, pain points, and professional development needs of those working across the spectrum of translation, from basic science to clinical research to public health. The project’s goal was to provide reliable documents that could be used to inform CTSA software development projects, educational resources, and communication initiatives. This paper presents the initiative to create personas for the translational workforce, including the methodology, engagement strategy, and lessons learned. Challenges faced and successes achieved by the project may serve as a roadmap for others searching for best practices in the creation of Persona profiles.
To investigate the impacts of depression screening, diagnosis and treatment on major adverse cardiac events (MACEs) in acute coronary syndrome (ACS).
Prospective cohort study including a nested 24-week randomised clinical trial for treating depression was performed with 5–12 years after the index ACS. A total of 1152 patients recently hospitalised with ACS were recruited from 2006 to 2012, and were divided by depression screening and diagnosis at baseline and 24-week treatment allocation into five groups: 651 screening negative (N), 55 screening positive but no depressive disorder (S), 149 depressive disorder randomised to escitalopram (E), 151 depressive disorder randomised to placebo (P) and 146 depressive disorder receiving medical treatment only (M).
Cumulative MACE incidences over a median 8.4-year follow-up period were 29.6% in N, 43.6% in S, 40.9% in E, 53.6% in P and 59.6% in M. Compared to N, screening positive was associated with higher incidence of MACE [adjusted hazards ratio 2.15 (95% confidence interval 1.63–2.83)]. No differences were found between screening positive with and without a formal depressive disorder diagnosis. Of those screening positive, E was associated with a lower incidence of MACE than P and M. M had the worst outcomes even compared to P, despite significantly milder depressive symptoms at baseline.
Routine depression screening in patients with recent ACS and subsequent appropriate treatment of depression could improve long-term cardiac outcomes.
To evaluate the bidirectional relationship between blood pressure (BP) and depressive symptoms using a large prospective cohort study.
Prospective cohort study was performed in 276 244 adults who participated in a regular health check-up and were followed annually or biennially for up to 5.9 years. BP levels were categorised according to the 2017 American College of Cardiology and American Heart Association hypertension guidelines. Depressive symptoms were assessed using Centre for Epidemiologic Studies-Depression (CESD) questionnaire and a cut-off score of ≥25 was regarded as case-level depressive symptoms.
During 672 603.3 person-years of follow-up, 5222 participants developed case-level depressive symptoms. The multivariable-adjusted hazard ratios (HRs) [95% confidence interval (CI)] for incident case-level depressive symptoms comparing hypotension, elevated BP, hypertension stage 1 and hypertension stage 2 to normal BP were 1.07 (0.99–1.16), 0.93 (0.82–1.05), 0.89 (0.81–0.97) and 0.81 (0.62–1.06), respectively (p for trend <0.001). During 583 615.3 person-years of follow-up, 27 787 participants developed hypertension. The multivariable-adjusted HRs (95% CI) for incident hypertension comparing CESD 16–24 and ⩾25 to CESD < 16 were 1.05 (1.01–1.11) and 1.12 (1.03–1.20), respectively (p for trend <0.001) and in the time-dependent models, corresponding HRs (95% CI) were 1.12 (1.02–1.24) and 1.29 (1.10–1.50), respectively (p for trend <0.001).
In this large cohort study of young and middle-aged individuals, higher BP levels were independently associated with a decreased risk for developing case-level depressive symptoms and depressive symptoms were also associated with incident hypertension. Further studies are required to elucidate the mechanisms underlying the bidirectional association between BP levels and incident depression.
A new design method of an ultra-wideband circularly-polarized planar multiple-input-multiple-output (MIMO) antenna is presented in this paper. The proposed MIMO antenna consists of four unit cell antennas, being comprised of a microstrip feed line and a square slotted ground plane. In the proposed unit cell design, a circular stub is protruded from the ground plane strip for achieving circular polarization. The unit cell of the MIMO antenna is optimized by adjusting design parameters. The compact four-port MIMO antenna prototype is designed on the FR4 substrate with the overall dimensions of 45 × 45 × 1.6 mm3. The proposed four-port MIMO antenna design provides an impedance bandwidth (S11 < −10 dB) of 112% (3.1–11 GHz) and a 3 dB axial ratio bandwidth of 36% (4.8–6.9 GHz). The performance of the fabricated MIMO antenna shows good agreement between the EM simulation and measurement results.
Cosmopolitan habitat-forming taxa of algae such as the genus Corallina provide an opportunity to compare patterns of biodiversity over wide geographic scales. Nematode assemblages inhabiting Corallina turves were compared between the south coasts of the British Isles and South Korea. A fully nested design was used with three regions in each country, two shores in each region and replicate samples taken from three patches on each shore to compare differences in the taxonomic and biological trait composition of nematode assemblages across scales. A biological traits approach, based on functional diversity of nematodes, was used to make comparisons between countries, among regions, between shores and among patches. The taxonomic and biological trait compositions of nematode assemblages were significantly different across all spatial scales (patches, shores, regions and countries). There is greater variation amongst nematode assemblages at the scale of shore than at other spatial scales. Nematode assemblage structure and functional traits are influenced by the local environmental factors on each shore including sea-surface temperature, the amount of sediment trapped in Corallina spp. and tidal range. The sea-surface temperature and the amount of sediment trapped in Corallina spp. were the predominant factors determining nematode abundance and composition of assemblages and their functional diversity.
In order to investigate the origin of multiple populations in globular clusters (GCs), we have constructed new chemical evolution models for proto-GCs where the supernova blast waves undergo blowout without expelling the ambient gas. Chemical enrichments in our models are then dictated by the winds of massive stars together with the asymptotic-giant-branch stars ejecta. We find that the observed Na-O anti-correlation can be reproduced when multiple episodes of starburst and enrichment are allowed to continue in proto-GCs. The “mass budget problem” is mostly resolved by our models without ad-hoc assumptions on star formation efficiency, initial mass function, and significant loss of first-generation stars. Interestingly, ages and chemical abundances predicted by this chemical evolution model are in good agreements with those independently obtained from our stellar evolution model for the horizontal-branch. We also discuss observational evidence for the GC-like multiple populations in the Milky Way bulge.
Recent analyses of Lee et al. (2018, 2019) have confirmed that Galactic bulge consists of stellar populations originated from Milky Way globular clusters (MWGCs). Motivated by this, here we present the evolutionary population synthesis (EPS) for the Galactic bulge and early-type galaxies (ETGs) with the realistic treatment of individual variations in light elements observed in the MWGCs. We have utilized our model with GC-origin populations to explain the CN spread observed in ETGs, and the results show remarkable matches with the observations. We further employ our model to estimate the age of ETGs, which are considered as good analogs for the MW bulge. We find that, without the effect of our new treatments, EPS models will almost always underestimate the true age of ETGs. Our analysis indicates that the EPS with GC-origin populations is an essential constraint in determining the ETG formation epoch and is closely related to understanding the evolution of the Universe.
Highly ordered wrinkling morphologies of liquid crystalline polymer films are demonstrated based on simple multi-rubbing. The spontaneous pattern formation of periodic wrinkling morphology is achieved through utilizing plasma treatment on a predefined alignment layer. The multi-directional ordering on the alignment layer obtained through selectively covering the alignment layer with a protective layer, which is chemically inert and keeps alignment properties during another rubbing process. The ordering of the wrinkle pattern can be tailored through a molecular orientation of liquid crystal (LC) and a process condition, including film thickness, plasma treatment, and rubbing. The proposed methods enable the spontaneous pattern formation of well-aligned one- or two-dimensionally periodic microstructures over a large area, without an additional template or patterning steps. Since the LC polymer incorporated the optical anisotropic mesogenic groups into polymer chains, it has an optical birefringence in the film and it can be utilized for optical devices requiring a microstructure on a surface.
Cashew nut shell liquid (CNSL) is an economically important by-product obtained from the cashew nut Anacardium occidentale L. The liquid has been found to be versatile with a wide range of uses, including as a raw material in the polymer industry, in the development of drugs (antioxidants) and in pest control. One important chemical component of CNSL known for its bioactivity is cardanol. We isolated (8Z,11Z)-3-(8,11,14-pentadecatrienyl)phenol, a cardanol from CNSL, and determined its insecticidal and progeny growth and development inhibition activities against Tribolium castaneum Hebst. We used a bioassay-guided approach for the isolation. Exposure to cardanol produced 80% mortality of adult T. castaneum in the insecticidal bioassay. In the progeny growth and development inhibition bioassay, 46.7% of larvae were killed, and only 20.7% of adults emerged without deformities after the cardanol treatment. The amount of isolated cardanol from the 1 g equivalent/ml extracted CNSL was found to be 36.55 mg with LC50 value of 47.88 mg/ml and 13.28 mg/ml against adult T. castaneum and its larvae, respectively. We conclude that cardanol can potentially be useful in managing stored product insect pests, especially T. castaneum, but with the prerequisite that one should take much care when handling and when applying the compound.
Our aim was to examine the prevalence, correlates, and association of depressive and anxiety disorders with quality of life (QoL) and such other outcomes as the need for psychosocial services in cancer patients.
A total of 400 patients participated in a multicenter survey involving five cancer centers located throughout Korea. The Short-Form Health Survey, the MD Anderson Symptom Inventory, the Mini-Mental Adjustment to Cancer (MINI-MAC), and Mini-International Neuropsychiatric Interview were administered.
The prevalence rates for depressive and anxiety disorders were 16 and 17.1%, respectively. Younger age and poor Eastern Cooperative Oncology Group performance status, and all physical symptoms, as well as helplessness/hopelessness, anxious preoccupation (AP), and cognitive avoidance (CA) on the MINI-MAC were found to be significantly related to depressive disorder (DD) in a univariate logistic regression analysis. Metastases, the symptoms of disturbed sleep, dry mouth, and numbness or tingling, as well as AP and CA were significantly correlated with anxiety disorder (AD) in the univariate analysis. In the multivariate analyses, only AP was significant for AD (odds ratio = 2.94, p < 0.001), while none reached statistical significance for DD. Psychiatric comorbidity status had a detrimental effect on various dimensions of QoL. Patients with DD or AD reported a significantly higher need for professional psychosocial services.
Significance of results:
Given the substantial prevalence and pervasive impact of DD and AD on various aspects of QoL, its assessment and care should be integrated as a regular part of oncological care throughout the cancer continuum.