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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.
Non-communicable diseases (NCDs) share common risk factors as poor dietary intakes, especially among low-income populations worldwide. However, the diet-related health burden by country income levels remains unclear. We assessed the current prevalence of NCDs and the association between selected dietary factors and NCDs by income levels. Data were obtained from the World Health Organization, Food and Agriculture Organization, and World Bank, and 151 countries were included in the analysis weighted by the total population size. Linear regression was used to find the association between metabolic risk factors and health-related behaviors by income levels. The prevalence of raised fasting blood glucose and total cholesterol, overweight, and obesity were lowest in lower and middle income countries, but prevalence of raised blood pressure and NCD deaths under age 70 were highest in lower and middle income countries (p for trend < 0.001). The proportion of carbohydrates and alcohol consumer were highest, and vegetable, milk supply, insufficient activity were lowest in lower and middle income countries. In high income countries, raised fasting blood glucose level were negatively associated with vegetable consumption (β = -0⋅05 CI [-0⋅08, -0⋅02]), and alcohol consumption, fat intake (7⋅94 [1⋅82, 14⋅06]), and sugar and sweetener supply (0⋅04 [0⋅01, 0⋅07]) were associated with overweight. In low income countries, overweight was associated with vegetable oil (0⋅03 [0⋅00, 0⋅05]),. In this study, different relationship between diets and NCDs trends were found across country income levels. Appropriate health policies for each group of countries by income are needed to solve the increasing challenges of NCDs.
This work was carried out with the support of “Cooperative Research Program for Agriculture Science and Technology Development (Project No. PJ PJ01317001)” Rural Development Administration, Republic of Korea.
Low rates of bystander cardiopulmonary resuscitation (CPR) were identified as a shortcoming in the “chain of survival” for out-of-hospital cardiac arrest (OHCA) care in the Korean city of Ansan. This study sought to evaluate the effect of an initiative to increase bystander CPR and quality of out-of-hospital resuscitation on outcome from OHCA. The post-intervention data were used to determine the next quality improvement (QI) target as part of the “Plan-Do-Study-Act” (PDSA) model for QI.
The study hypothesis was that bystander CPR, return of spontaneous circulation (ROSC), and survival to discharge after OHCA would increase in the post-intervention period.
This was a retrospective pre/post study. The data from the pre-intervention period were abstracted from 2008–2011 and the post-intervention period from 2012–2013. The effect of the intervention on the odds of ROSC and survival to hospital discharge was determined using a generalized estimating equation to account for confounders and the effect of clustering within medical centers. The analysis was then used to identify other factors associated with outcomes to determine the next targets for intervention in the chain of survival for cardiac arrest in this community.
Rates of documented bystander CPR increased from 13% in the pre-intervention period to 37% in the post-intervention period. The overall rate of ROSC decreased from 18.4% to 14.3% (risk difference −4.1%; 95% CI, −7.1%–1.0%), whereas survival to hospital discharge increased from 3.9% to 5.0% (risk difference 1.1%; 95% CI, −1.8%–3.8%), and survival with good neurologic outcome increased from 0.8% to 1.6% (risk difference 0.8%; 95% CI, −0.8%–2.4%). In multivariable analyses, there was no association between the intervention and the rate of ROSC or survival to hospital discharge. The designated level of the treating hospital was a significant predictor of both survival and ROSC.
In this case study, there were no observed improvements in outcomes from OHCA after the targeted intervention to improve out-of-hospital CPR. However, utilizing the PDSA model for QI, the designated level of the treating hospital was found to be a significant predictor of survival in the post-period, identifying the next target for intervention.
We investigated the extent of delays in the response time of emergency medical services (EMS) as an impact of mass casualty incidences (MCIs) in the same area.
We defined an MCI case as an event that resulted in 6 or more patients being transported by EMS, and prehospital response time as the time from the call to arrival at the scene. We matched patients before and after MCIs by dividing them into categories of 3 hours before, 0-1 hour after, 1-2 hours after, and 2-3 hours after the MCIs. We compared prehospital response times using multiple linear regression.
A total of 33,276 EMS-treated patients were matched. The prehospital response time for the category of 3 hours before the MCIs was 8.8 minutes (SD: 8.2), treated as the reference, whereas that for the category of 0-1 hour after the MCI was 11.3 minutes (P<0.01). The multiple linear regression analysis revealed that prehospital response time increased by 2.5 minutes (95% CI: 2.3-2.8) during the first hour and by 0.3 minutes (95% CI: 0.1-0.6) during the second hour after MCIs.
There were significant delays in the prehospital response time for emergency patients after MCIs, and it lasted for 2 hours as the spillover effect. (Disaster Med Public Health Preparedness. 2018;12:94–100)
Family study can provide estimates of overall genetic influences on a particular trait because family relationships provide accurate measures of average genetic sharing. However, evidence of genetic contributions to skin phenotypes is limited, which may preclude genetic studies to identify genetic variants or to understand underlying molecular biology of skin traits. This study aimed to estimate genetic and environmental contributions to selected dermatologic phenotypes, that is, to melanin index, sebum secretion, and skin humidity level in a Korean twin-family cohort. We investigated more than 2,000 individuals from 486 families, including 388 monozygotic twin pairs and 82 dizygotic twin pairs. Variance component method was used to estimate genetic influences in terms of heritability. Heritability of skin melanin index, sebum secretion, and skin humidity (arm and cheek) were estimated to be 0.44 [95% CI 0.38–0.49], 0.21 [95% CI 0.16–0.26], 0.13 [95% CI 0.07–0.18], and 0.11 [95% CI 0.06–0.16] respectively, after adjusting for confounding factors. Our findings suggest that genetics play a major role on skin melanin index, but only mild roles on sebum secretion and humidity. Sebum secretion and skin humidity are controlled predominantly by environmental factors notably on shared environments among family members. We expect that our findings add insight to determinants of common dermatologic traits, and serve as a reference for biologic studies.
The purpose of this study was to investigate whether there is any association between preeclampsia and eNOS, DDAH, and VEGF gene polymorphisms, and also to search for a possible association between haplotypes in eNOS, DDHA, and VEGF genes and the risk for preeclampsia. DNA was extracted from whole blood of 223 preeclampsia patients and 237 healthy pregnant women. The genotypes were analyzed by a single base primer extension assay using a SNaPShot assay kit. Results were analyzed with the Student's t-test, Chi-square test, and Logistic regression analysis. Haplotype analyses were performed using Haploview 3.2 version. There were no significant differences in genotype or allele frequencies of eNOS, DDAH, and VEGF gene polymorphisms between preeclampsia patients and controls. No increase in the risk of preeclampsia for those genes was observed under any model of inheritance and there were no statistically significant associations between any haplotypes and preeclampsia risk. Polymorphisms in eNOS, DDAH, and VEGF gene do not seem to be risk factors for preeclampsia.
Somatic cell nuclear transfer (SCNT) has emerged as an important tool for producing transgenic animals and deriving transgenic embryonic stem cells. The process of SCNT involves fusion of in vitro matured oocytes with somatic cells to make embryos that are transgenic when the nuclear donor somatic cells carry ‘foreign’ DNA and are clones when all the donor cells are genetically identical. However, in canines, it is difficult to obtain enough mature oocytes for successful SCNT due to the very low efficiency of in vitro oocyte maturation in this species that hinders canine transgenic cloning. One solution is to use oocytes from a different species or even a different genus, such as bovine oocytes, that can be matured easily in vitro. Accordingly, the aim of this study was: (1) to establish a canine fetal fibroblast line transfected with the green fluorescent protein (GFP) gene; and (2) to investigate in vitro embryonic development of canine cloned embryos derived from transgenic and non-transgenic cell lines using bovine in vitro matured oocytes. Canine fetal fibroblasts were transfected with constructs containing the GFP and puromycin resistance genes using FuGENE 6®. Viability levels of these cells were determined by the MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide] assay. Interspecies SCNT (iSCNT) embryos from normal or transfected cells were produced and cultured in vitro. The MTT measurement of GFP-transfected fetal fibroblasts (mean OD = 0.25) was not significantly different from non-transfected fetal fibroblasts (mean OD = 0.35). There was no difference between transgenic iSCNT versus non-transgenic iSCNT embryos in terms of fusion rates (73.1% and 75.7%, respectively), cleavage rates (69.7% vs. 73.8%) and development to the 8–16-cell stage (40.1% vs. 42.7%). Embryos derived from the transfected cells completely expressed GFP at the 2-cell, 4-cell, and 8–16-cell stages without mosaicism. In summary, our results demonstrated that, following successful isolation of canine transgenic cells, iSCNT embryos developed to early pre-implantation stages in vitro, showing stable GFP expression. These canine–bovine iSCNT embryos can be used for further in vitro analysis of canine transgenic cells and will contribute to the production of various transgenic dogs for use as specific human disease models.
Stream development can generate environmental changes that impact fish communities. In temperate streams, the distribution of fish species is associated with environmental gradients. To analyze the relevant factors, large-scale exploration is required. Thus, to evaluate the distribution patterns of fish in Korea, sampling was conducted on a national scale at 720 sites over a 6-week period in 2009. A total of 124 fish species in 27 families were identified; Zacco platypus and Zacco koreanus of the Cyprinidae were the dominant and subdominant species, respectively. Of the species found, 46 (37.1%) were endemic and 4 (3.2%) exotic; of the latter, Micropterus salmoides and Lepomis macrochirus were widely distributed. Upon canonical correspondence analysis (CCA), both altitude and biological oxygen demand (BOD) were highly correlated with CCA axes 1 and 2, respectively. This explained 62.5% of the species–environment relationship. Altitude and stream order were longitudinally related to species distribution. The numbers of both total and endemic species gradually increased as streams grew in size to the fourth–fifth-order, and decreased in sixth-order, streams. Overall, fish communities were stable throughout the entire watershed, whereas some species showed site-specific occurrence patterns due to the paleogeomorphological characteristics of Korean peninsula. However, various anthropogenic activities may negatively affect fish communities. Therefore, both short- and long-term sustainable management strategies are required to conserve native fish fauna.
We evaluate Vickers hardness and true instrumented indentation test (IIT) hardness of 24 metals over a wide range of mechanical properties using just IIT parameters by taking into account the real contact morphology beneath the Vickers indenter. Correlating the conventional Vickers hardness, indentation contact morphology, and IIT parameters for the 24 metals reveals relationships between contact depths and apparent material properties. We report the conventional Vickers and true IIT hardnesses measured only from IIT contact depths; these agree well with directly measured hardnesses within ±6% for Vickers hardness and ±10% for true IIT hardness.
Brain-derived neurotrophic factor (BDNF) signalling via tyrosine kinase B receptors may play an important role in ovarian development and function. It has been reported that metformin elevates the activity of Tyrosine kinase receptors and may amplify BDNF signalling. The objective of this study was to investigate the effect of BDNF during in vitro maturation (IVM) and/or in vitro culture (IVC) (Experiment 1), and to evaluate the collaborative effect of BDNF and metformin treatment on the developmental competence of bovine in vitro fertilized (IVF) embryos (Experiment 2). In Experiment 1, BDNF, which was added to our previously established IVM systems, significantly increased the proportions of MII oocytes at both 10 ng/ml (86.7%) and 100 ng/ml (85.4%) compared with the control (64.0%). However, there was no statistically significant difference in blastocyst development between the control or BDNF-supplemented groups. In Experiment 2, in order to investigate the effect of BDNF (10 ng/ml) and/or metformin (10−5 M) per se, TCM-199 without serum and hormones was used as the control IVM medium. The BDNF (48.3%) and BDNF plus metformin (56.5%) significantly enhanced the proportions of MII oocytes compared with the control (34.4%). Although, BDNF or metformin alone had no effect in embryo development, BDNF plus metformin significantly improved early embryo development to the 8–16-cell stage compared with the control (16.5 vs. 5.5%). In conclusion, the combination of BDNF and metformin may have a collaborative effect during the IVM period. These results could further contribute to the establishment of a more efficient bovine in vitro embryo production system.
Whereas there are numerous reports in the literature relating the impact of maternal nutritional status on subsequent birth outcome, much less is known about the long-term impact on infant growth after birth. Therefore, we conducted a prospective cohort study to investigate the association of maternal micronutrient status (vitamins A, C and E, folate) and oxidative stress status in pregnancy with infant growth during the first year of life.
Prospective cohort study.
Outpatient clinic of obstetrics, Ewha Womans University Hospital, Seoul, South Korea.
Subjects and methods
Two groups were constructed for this study – the Ewha pregnancy cohort (n = 677) and the infant growth cohort comprising follow-up live newborns of all the recruited pregnant women (n = 317). Maternal serum vitamin and urinary oxidative stress levels were collected and infant weights and heights were measured at birth and at 6 and 12 months after birth.
Division of the subjects into folate-deficient and normal groups revealed that infant weight and height at 0, 6 and 12 months were adversely affected by folate deficiency. High maternal vitamin C was associated with increased infant weight and height at birth and after birth.
Our findings indicate the importance of preventing folate deficiency and supplementing vitamin C during pregnancy.
We report on the basic characteristics and gas sensing operation of density controlled single-walled carbon nanotube (SWCNT) thin films on poly(dimethyl siloxane) (PDMS) substrates The vacuum filteration and PDMS mold transfer method allowed the density of SWCNT distributed to have non-local uniformity. The optical transparency of the SWCNT thin films was inversely proportional to SWCNT density and conductivity. The flexible SWCNT thin film showed high mechanical stability with negligible change in conductance after being bent by 180o. We evaluated its gas sensing operation depending on SWCNT density and bias voltage. It was shown that lower SWCNT density thin films had higher sensitivity to NH3 gas, which may be due to higher exposed surface area for lower density SWCNT thin films. Also, we found that lower bias voltage devices showed faster recovery times. The results show that vacuum filteration and mold transfer method produced flexible SWCNT thin films that have stable mechanical and electrical characteristics and also stable gas sensing capabilities making them applicable to future flexible integrated sensors.
Zinc oxide (ZnO) thin films have emerged as one of the most promising oxide materials owing to their optical and electrical properties, together with their high chemical and mechanical stability. Chemical solution deposition (CSD) is attractive technique for obtaining ZnO thin films and has the advantages of easy control of the film composition and easy fabrication of a larger-area thin film at low cost. In this work, epitaxial ZnO thin films on SiC substrate were prepared by using a CSD method with a zinc naphthenate precursor. Precursor films were pyrolyzed at 500°C for 10 min in air and finally annealed at 600°C, 700°C, 800°C and 900°C for 30 min in air. Crystallinity and in-plane alignment of the films were investigated by X-ray diffraction theta-2 theta scan and pole-figure analysis. Scanning electron microscope, scanning probe microscope, and He-Cd laser (325 nm) are used to detect the surface morphology and photoluminescence of the films. The effects of annealing temperature on crystallinity and epitaxy of the films will be fully discussed on the basis of the results of X-ray diffraction analysis.
The role of the size of amorphous silicon quantum dots in the Er luminescence at 1.54 μm was investigated. As the dot size was increased, the more Er ions were located near one dot due to its large surface area and more Er ions interacted with other ones. This Er-Er interaction caused a weak photoluminescence intensity despite the increase in the effective excitation cross section. The critical dot size, needed to take advantage of the positive effect on Er luminescence, is considered to be about 2.0 nm, below which a small dot is very effective in the efficient luminescence of Er.
Silicon nitride–Si2N2O in situ composites were prepared by hot pressing powder mixtures of α–Si3N4, 6 wt% Y2O3, 1 wt% Al2O3, and 0–12 wt% SiO2. X-ray diffraction (XRD) analysis indicated that the volume percents of Si2N2O were 0, 13, 31, and 54 for the composites prepared with 0, 4, 8, and 12 wt% SiO2, respectively. XRD results also indicated that both silicon nitride grains and Si2N2O grains were laid down perpendicular to hot pressing direction. As the volume percent of Si2N2O increased, the width and the amount of elongated silicon nitride grains decreased, but the fracture toughness increased. Young's modulus of the in situ composites decreased as the Si2N2O content was increased. The erosion rate decreased as the Si2N2O content was increased, in part, due to both the increased fracture toughness and the reduced grain size. Erosion of the composites occurred primarily due to the grain dislodgment. The sample without Si2N2O experienced micro-chipping due to transgranular fracture.
A new host-guest electro optic (EO) polymer, in which a chromophore can be reacted with the polymer main chain during poling to give the corresponding side-chain EO polymer, has been prepared for improving EO effect and its thermal stability. Polyisoimide (PII) synthesized from 2, 2-bis (4-aminophenyl) hexafluoropropane and oxydiphthalic anhydride and Disperse Red 1 (DR1) were used as a host and a guest, respectively. A model compound reaction and Infrared spectra of the host-guest film after annealing at various temperatures show that the reaction between the isoimide groups in PII and the hydroxyl groups in DR1 occurs around 140 °C. The glass transition temperatures of the resulting EO polyamic aicd ester-imide copolymer with 0, 10, 20 and 30 wt. % of chromophore concentration were 275, 219, 160, and 124 °C, respectively. The EO coefficient obtained at a wavelength of 1.55 νm was 5.3 and 10.5 pm/V from the EO polymer film with 20 and 30 wt. % DR1. The EO signals exhibited only a slight decay at high temperature due to the chemical reaction between the host and guest during poling.
Histiocytic necrotizing lymphadenitis, or Kikuchi’s disease, is a self-limiting cervical lymphadenitis of unknown origin. Since no specific treatment has been reported for Kikuchi’s disease to date, once a diagnosis of Kikuchi’s disease has been established, the role of the physician has been limited only to treating the symptoms. Sometimes, however, the clinical manifestations of the disease can be very distressing for the patients. Thus, a more aggressive form of treatment may be required for the patients who suffer from severe and persisting symptoms and recurrence. We present three cases of Kikuchi’s disease that benefited significantly from systemic administration of prednisone.
The effects of reactive ion etching damage on the electrical properties of Pt/SBT/Pt capacitors have been investigated. The plasma treated SBT/Pt layers showed a significant decrease in remanent polarization compared with that of the reference sample. The remanent polarization of the plasma treated layers varied with the gas ratios of the Cl2/Ar plasma. XPS analysis of the plasma treated SBT/Pt samples showed that the surface composition was significantly changed as the gas ratios were varied, which resulted in a polarization decrease in the plasma treated samples. Plasma treatment also caused a voltage shift of the hysteresis loops along the voltage axis. The magnitude of the voltage shift was increased for the chlorine-rich plasma. The results of surface analysis revealed that the voltage shift is caused by oxygen deficiency at the SBT surface. Based on our experimental results, reactive ion etching damage was explained in terms of physical and electrical effects of the plasma on the electrical properties of the ferroelectric Pt/SBT/Pt capacitors.