Prolactin Level Changes according to Atypical Antipsychotics Use: A Study Based on Clinical Data Warehouse.

Objective: : Antipsychotic drugs are known as the major cause of non-neoplastic hyperprolactinemia. This study aimed to investigate the levels of serum prolactin depending on the use of antipsychotic drugs in patients through the Clinical Data Warehouse (CDW). Methods: : We conducted a cohort search in the CDW application and got 260 patients' medical records diagnosed with schizophrenia, schizotypal and delusional disorders, manic episodes, and bipolar affective disorders who were taking one of risperidone, blonanserin, amisulpride, and olanzapine. After that, we reviewed the medical data and used the ANCOVA analysis and the post hoc test to compare serum prolactin levels among four antipsychotic drug groups. Results: : Among the 117 subjects included in the analysis, the mean serum prolactin level was 64.6 ± 54.6 ng/ml. Serum prolactin levels were significantly higher in subjects taking risperidone or amisulpride compared to blonanserin and olanzapine. The female subjects who took blonanserin, olanzapine, and risperidone had significantly higher prolactin levels, but there was no difference in serum prolactin levels between sex in the subjects who took amisulpride. Conclusion: : This study suggests the need for regular monitoring of serum prolactin levels in patients who are taking antipsychotics, especially in female patients. And we showed that there is a possibility to conduct more effective and simpler big data research using the CDW. Further studies on the subjects with controlled confounding variables and larger sample groups are needed.

The Change of Suicidal Ideation Over a 12-Week Naturalistic Treatment of Depression: Comparison Between Young People and Older Adults.

OBJECTIVE: We investigated the differences in suicidality between young people and older adults with depression over the course of 12-week naturalistic treatment with antidepressants. METHODS: A total of 565 patients who had moderate to severe depression (Hamilton Depression Rating Scale [HAM-D] score ≥14) and significant suicidal ideation (Beck Scale for Suicide Ideation [SSI-B] score ≥6) were recruited from 18 hospitals. Participants were classified into two groups: the younger group (13-24 years of age, n=82) and the older group (≥25 years of age, n=483). Total scores over time on the SSI-B, HAM-D, and Hamilton Anxiety Rating Scale (HAM-A) were assessed and compared between the two groups. RESULTS: At baseline, the younger group had lower HAM-D scores (21.0 vs. 22.2; p=0.028) but higher SSI-B scores (19.4 vs. 15.6; p<0.001) compared with the older group. The overall 12-week proportion of patients with resolved suicidality was 44.1% in the younger group and 69.2% in the older group. Although the improvement in the HAM-D and HAM-A scores did not differ between the groups, suicidal ideation in the younger group remained more severe than in the older group throughout the treatment. The ratio of the subjects who achieved HAM-D remission or response but did not achieve SSI-B remission was significantly higher in the younger group than in the older group. CONCLUSION: These data suggest that in depressed youths, suicide risk is a serious concern throughout the course of depression even when favorable treatment outcomes are obtained.

Community-based multi-site randomized controlled trial of behavioral activation for patients with negative symptoms of schizophrenia.

BACKGROUND: Negative symptoms are closely related to the poor prognosis of schizophrenia, for which there is no effective treatment to date. Behavioral activation (BA), which is an effective treatment for depression, is a behavioral approach that targets low levels of response-contingent positive reinforcement. This study aimed to explore BA as an effective intervention for relieving the negative symptoms of schizophrenia. METHODS: This was a randomized single-blind controlled trial. Eighty-four patients with schizophrenia were enrolled in community mental health settings. Excluding 14 patients who opted out of the study, 70 were randomly assigned to receive BA in addition to treatment-as-usual (BA + TAU) or treatment-as-usual (TAU) only. Negative symptoms were assessed using the Clinical Assessment Interview for Negative Symptoms (CAINS) and Brief Negative Symptom Scale (BNSS) at baseline, post-treatment, and 6-months follow-up. RESULTS: Significant differences between the BA + TAU and TAU only groups were observed in the measures of negative symptoms post-treatment. The total score of CAINS was significantly decreased after BA treatment (η2 = 0.13). The tendency of the BA + TAU treatment effect was also observed for the BNSS total score and PANSS negative symptom subscale (η2 = 0.10 and η2 = 0.11, respectively). However, the difference between the two groups was not sustained at the six-month follow-up. CONCLUSIONS: Our findings suggest that BA could be a promising time-limited and structured psychosocial intervention for schizophrenia-associated negative symptoms with the merit of easy dissemination. Further studies are needed to examine the factors involved in sustaining improvement.

Does panic disorder increase the risk of cardiovascular diseases in diabetics?: A nationwide population-based study.

BACKGROUND: Several studies have suggested a link between panic disorder (PD) and cardiovascular disease (CVD). However, the extent to which PD confers risk for CVD is still unclear, particularly in diabetics, a group showing high risk for CVD. METHODS: A nationwide population-based cohort of 1,624,718 patients with type 2 diabetes were selected from the National Health Screening Program database covering the years 2009 to 2012. The subjects were divided into two groups: those without panic disorder (non-PD group, n = 1,618,263) and those with newly diagnosed PD (PD-group, n = 6455). Follow-up of subjects for up to 10 years was conducted for evaluation of the incidences of myocardial infarction (MI), stroke, and death. RESULTS: After adjusting for the baseline covariates and diabetes mellitus (DM)-related variables, no difference in the future risk of MI and stroke was observed between the non-PD group and the PD group. Compared with the non-PD group, the PD group showed an increase in the future risk of death. [adjusted hazard ratio (aHR) = 1.120, 95 % confidence interval (CI): 1.039-1.206]. In contrast to the population aged <40 and > 65 years, in the age group of 40-64 years a significantly higher risk of stroke was observed in the PD group compared with the non-PD group (aHR = 1.352, 95%CI: 1.136-1.610). LIMITATION: The diagnoses were based on the diagnostic codes of the claim data. CONCLUSION: The current findings suggested that PD might not contribute to the risk of future MI and stroke in diabetics who have already been at risk of various cardiovascular complications.

Effect of amino acids in the Maillard reaction products generated from the reaction flavors of Tenebrio molitor (mealworm) protein and d-xylose.

In this study, Tenebrio molitor (mealworm) protein and reducing sugar were thermally reacted without (MP-RF) or with amino acids (MPA-RFs, A is then replaced with three-letter abbreviation of amino acid used in the reaction), and their Maillard reaction products (MRPs) and sensory characteristics were compared to explore the amino acids that contributed to desirable meat-related odor attributes in MP-RF. The odor characteristics perceived from MP-RF were changed based on the amino acid that was added to MP-RF and then reacted. Noticeably, a 'dried shrimp-like' attribute, which was the most intense in MP-RF, was weakened in all MPA-RFs. The 'meaty' and 'sulfur-like' odor notes were higher in MP-RF reacted with cysteine (MPCys-RF) than those in MP-RF and most MPA-RFs. In addition, 2-methyl-3-furanthiol and 2-furfurylthiol, which are the most important key odorants in a meat flavoring material, were also found only in MPCys-RF. These results show that the meaty flavoring potential of MP-RF was significantly enhanced when reacted with cysteine.

Association Between Diabetic Retinopathy and Insomnia Risk: A Nationwide Population-Based Study.

Background: Previous studies have suggested a close link between sleep disturbances and diabetic retinopathy (DR). However, to date, no confirmatory findings have been reported. We aimed to explore the risk of insomnia in DR by considering demographic factors and diabetes mellitus (DM)-related variables. Methods: A nationwide population-based cohort of 2,206,619 patients with type 2 diabetes from the Korean National Insurance Service Database was followed up for insomnia incidence. DR, non-proliferative DR (NPDR), and proliferative DR (PDR) were defined according to ICD-10 codes. The interactive effects of sex, age, and DM-related variables were analyzed to evaluate their impact on insomnia risk in DR. Results: Compared with the non-DR group, insomnia risk was increased in the DR [(adjusted hazard ratio (aHR): 1.125, 95% confidence interval (CI):1.108-1.142), NPDR (aHR:1.117, 95% CI:1.099-1.134), and PDR (aHR:1.205, 95% CI: 1.156-1.256), even after controlling for comorbidities, lifestyle factors, and DM-related variables. The men and youngest age groups (<40 years) were most vulnerable to insomnia risk. Sex, age, DM duration, and chronic kidney disease (CKD) status exerted interactive effects with DR status in increasing the insomnia risk. In the PDR group, sex, age, DM duration, insulin therapy status, and CKD status exerted interactive effects that increased the risk of insomnia. Conclusion: Insomnia risk is significantly higher in patients with DR, and clinical attention is warranted.

Mediation Effect of the Coping Strategies on the Relation Between Stress and Sleep Quality.

OBJECTIVE: Recently data has been accumulated regarding the role of coping strategies in the relationship between stress and sleep quality. Therefore, we set out to identify the mediating effects of coping strategies between stress and sleep quality. METHODS: A online-based cross-sectional study was performed using the Perceived Stress Scale-10, the Pittsburgh Sleep Quality Index, and a simplification of the 60-item Coping Orientation to Problems Experienced (Brief COPE) inventory in the nonclinical adult sample. The 24 items of Brief COPE were categorized into four factors (social support, problem solving, avoidance, positive thinking). Then, we used the PROCESS macro to conduct the multiple mediation analysis for the four coping styles as potential mediators in the relationship between stress and sleep quality, and an additional subgroup analysis was examined to identify a gender difference for the mediation effect. RESULTS: As a group, four coping styles mediated significantly the association between perceived stress and poor sleep quality. And avoidance has maintained its significance thought all regression analyses. Finally, this results remained as same in the females. CONCLUSION: The effect of perceived stress on poor sleep quality was mediated by coping strategies, especially by avoidance. Thus, further research should consider the coping styles of individuals to reduce the influence of stress on sleep quality.

An Ultralow Power Mixed Dimensional Heterojunction Transistor Based on the Charge Plasma pn Junction.

Development of a reliable doping method for 2D materials is a key issue to adopt the materials in the future microelectronic circuits and to replace the silicon, keeping the Moore's law toward the sub-10 nm channel length. Especially hole doping is highly required, because most of the transition metal dichalcogenides (TMDC) among the 2D materials are electron-doped by sulfur vacancies in their atomic structures. Here, hole doping of a TMDC, tungsten disulfide (WS2 ) using the silicon substrate as the dopant medium is demonstrated. An ultralow-power current sourcing transistor or a gated WS2 pn diode is fabricated based on a charge plasma pn heterojunction formed between the WS2 thin-film and heavily doped bulk silicon. An ultralow switchable output current down to 0.01 nA µm-1 , an off-state current of ≈1 × 10-14 A µm-1 , a static power consumption range of 1 fW µm-1 -1 pW µm-1 , and an output current ratio of 103 at 0.1 V supply voltage are achieved. The charge plasma heterojunction allows a stable (less than 3% variation) output current regardless of the gate voltage once it is turned on.

Suicide Risk in Patients With Diabetes Varies by the Duration of Diabetes: The Korea National Health and Nutrition Examination Survey (2019).

OBJECTIVE: The objectives of this study were to investigate the suicide risk in diabetes patients and evaluate the variations in suicide risk by the duration of diabetes using a large population sample in South Korea. METHODS: Data from 6,296 adults in the 2019 Korea National Health and Nutrition Examination Survey were included. The suicidal ideation, suicide plans, and suicidal behavior of diabetes patients were compared to the general population. After classifying the patients into ≤1 year, 2 to 9 years, and ≥10 years of diabetes duration, we evaluated the relationship between the duration of diabetes and the suicide risk. RESULTS: Diabetes patients had higher prevalences of suicidal ideation (9.1%, p<0.001) and suicide plans (3.6%, p<0.001) than the general population. After adjusting for potential confounding factors, suicide plans (adjusted odds ratio [aOR]=2.926, 95% confidence interval [CI]=1.325-6.463) were significantly associated with diabetes. In the 2 to 9 years group of diabetes patients, we found an increase in the risk of suicidal ideation (aOR=2.035, 95% CI=1.129-3.670), suicide plans (aOR=3.507, 95% CI=1.538-7.996), and suicidal behavior (aOR=7.130, 95% CI=2.035-24.978) after adjusting for the covariates. However, no increases in suicide risk were observed ≤1 year and ≥10 years after diabetes diagnosis. CONCLUSION: In adults, diabetes is associated with an increase in suicide risk. Suicide risk in diabetes patients showed an inverted U-shaped depending upon the duration of diabetes.

Low-temperature n-type doping of insulating ultrathin amorphous indium oxide using H plasma-assisted annealing.

Low-temperature process compatibility is a key factor in successfully constructing additional functional circuits on top of pre-existing circuitry without corrupting characteristics thereof, a technique that typically requires die-to-die (wafer-to-wafer) stacking and interconnecting. And against thermal annealing, which is mandatory and is possible only globally for activating amorphous oxide semiconductors, the selective control of electrical characteristics of the oxide thin-films for integrated circuit applications is challenging. Here, a low-temperature process that enables n-type doping of the designed region of insulating In2O3thin-film is demonstrated. A short hydrogen plasma treatment followed by low-temperature annealing is used to increase interstitial and substitutional hydrogen associated bond states creating shallow donor levels in the insulating In2O3surface to transform the thin-film into an n-type semiconductor. As a result, an In2O3thin-film transistor with a high on/off current ratio (>108), a field-effect mobility of 3.8 cm2V-1s-1, and a threshold voltage of ∼3.0 V has been developed. Compared to performing just thermal annealing, the H-plasma assisted annealing process resulted in an n-type In2O3thin-film transistor showing similar characteristics, while the processing time was reduced by ∼1/3 and the plasma-untreated area still remained insulating. With further development, the hydrogen plasma doping process may make possible a monolithic planar process technology for amorphous oxide semiconductors.

Community-Based Multi-Site Randomized Controlled Trial of Behavioral Activation for Patients with Depressive Disorders.

Behavioral activation (BA) is a beneficial and relatively cost-effective treatment option for depression. This study utilized a pragmatic randomized controlled research design to investigate whether BA, as compared with treatment as usual (TAU), led to superior treatment effects, when delivered in community mental health settings by retrained community mental health professionals. Patients with depressive disorders (n = 64) were randomly assigned to a 10-session BA (n = 31) or TAU (n = 33) group. The depressive symptoms and behavioral engagement were assessed at the baseline, post-treatment, and a six-month follow-up. Results showed that, as compared to the TAU group, the BA group had: (1) a reduction in depression severity, as evidenced by large effect sizes and greater response rates, and (2) an increase in behavioral engagement. However, the post-treatment gains were not maintained at the six-month follow-up. The implications and limitations of the study are also discussed (KCT0004098, June 27, 2019, retrospectively registered).

Differential characteristics of repeated polysomnography and multiple sleep latency test parameters in narcolepsy type 1 and type 2 patients: a longitudinal retrospective study.

PURPOSE: Narcolepsy is a chronic disorder and its phenotype is dichotomized into narcolepsy type 1 (NT1) and narcolepsy type 2 (NT2). The clinical course and pathophysiological mechanisms of these two clinical entities and their differences are not adequately defined. This study aimed to explore the differential longitudinal patterns of polysomnography (PSG) and multiple sleep latency test (MSLT) in NT1 and NT2. METHODS: In this retrospective study demographic characteristics, PSG, and MSLT parameters at baseline and follow-up were compared between NT1 and NT2 patients. Patients with both follow-up MSLT and PSG were selected for sub-group analysis. Baseline and follow-up MSLT and PSG parameters were compared. RESULTS: Of 55 patients with narcolepsy, mean follow-up periods were 7.4 ± 3.5 years for NT1 and 5.5 ± 2.9 for NT2. Demographic data showed increased body mass index and prevalence of sleep paralysis in NT1. Baseline PSG characteristics between NT1 and NT2 showed decreased sleep latency (p = 0.016) and REM latency (p = 0.046) in NT1 group when compared with NT2. Nocturnal SOREMP on PSG was more prevalent in NT1 (p = 0.017), and half of NT2 patients with nocturnal SOREMP on PSG changed their diagnoses to NT1. On follow-up PSG, NT1 displayed reductions in sleep stage N2 (p = 0.006) and N3 (p = 0.048), while wake after sleep onset (WASO) (p = 0.023) and apnea-hypopnea index (AHI) (p = 0.007) were significantly increased. CONCLUSION: Differential MSLT and PSG characteristics of NT1 and NT2 in at baseline and follow-up indicate that NT1 and NT2 are distinct disease phenotypes, and that they present with a contrasting course of disease.

Tactile Interaction Sensor with Millimeter Sensing Acuity.

In this article we report on a 3 × 3 mm tactile interaction sensor that is able to simultaneously detect pressure level, pressure distribution, and shear force direction. The sensor consists of multiple mechanical switches under a conducting diaphragm. An external stimulus is measured by the deflection of the diaphragm and the arrangement of mechanical switches, resulting in low noise, high reliability, and high uniformity. Our sensor is able to detect tactile forces as small as ~50 mgf along with the direction of the shear force. It also distinguishes whether there is a normal pressure during slip motion. We also succeed in detecting the contact shape and the contact motion, demonstrating potential applications in robotics and remote input interfaces. Since our sensor has a simple structure and its function depends only on sensor dimensions, not on an active sensing material, in comparison with previous tactile sensors, our sensor shows high uniformity and reliability for an array-type integration.

Aroma Characteristics of Raw and Cooked Tenebrio molitor Larvae (Mealworms).

This study compared aroma compositions and sensory aroma attributes of raw and cooked Tenebrio molitor larvae (mealworms). Main sensory aroma attributes of raw mealworms were strong wet-soil-like, and less-intense oily, shrimp-like and sweet-corn-like. Quantitatively, the major aroma components of raw mealworms were hydrocarbons and aldehydes. As cooking proceeded, sweet-corn-like, roasted, and fried-oil-like sensory attributes were increasingly perceived with steaming, roasting, and frying, respectively. Some pyrazines, pyrrolidines, and carbonyls increased or appeared in roasted and fried mealworms. Partial least squares regression also showed differences in raw and cooked mealworms based on aroma components and their sensory attributes. Unlike raw mealworms, steamed mealworms had a relatively strong sweet-corn-like aroma attribute, which was related to 2,4,6-trimethyl-heptane, 2,4-dimethyl-dodecane, and 3,5-dihydroxy-6-methyl-2,3-dihydropyran-4-one. In comparison, roasted and fried mealworms exhibited roasted, shrimp-like, and fried-oil-like aroma attributes, which were associated with intermediates of the Maillard reaction and lipid oxidation, such as pyrazines, alcohols, and aldehydes. This result during thermal reactions was very similar to those of meat and/or seafood. The use of mealworms as a savory-type flavor enhancer can be expected.

Predictors of 1-year rehospitalization in inpatients with bipolar I disorder treated with atypical antipsychotics.

Bipolar disorder (BPD) is debilitating disorder, and patients can experience multiple relapses and subsequent hospitalizations. Since pharmacotherapy is the mainstay of treatment for patients with BPD, investigations on the effects of atypical antipsychotics (AAP) on reducing rehospitalization risk are crucial. The objective of study is to explore predictors of 1-year rehospitalization in patients with bipolar I disorder treated with AAP. A retrospective chart review on inpatients with bipolar I disorder was conducted. All participants were followed up for 1 year, and they were subdivided into three AAP treatment groups (olanzapine, risperidone, and quetiapine group). Kaplan-Meier survival analysis was implemented to detect time to rehospitalization due to any mood episodes within 1 year after discharge. Cox proportional regression model was adopted to find predictors of 1-year hospitalization in patients who experienced rehospitalization. One hundred thirty-eight participants were included in the study, and a 1-year rehospitalization rate was 18.1%. Time to rehospitalization did not differ between three AAP treatment groups. Predictors of rehospitalization due to any episode within 1 year were family history of depression and number of previous admission. Our findings can be conducive to understanding prognosis, and predicting rehospitalization risk in patients with BPD on AAP.

Poly(ε-caprolactone) (PCL) Hollow Nanoparticles with Surface Sealability and On-Demand Pore Generability for Easy Loading and NIR Light-Triggered Release of Drug.

A new system for the easy loading and NIR light-triggered release of drugs is introduced. It consists of poly(ε-caprolactone) (PCL) hollow nanoparticles with surface openings containing a biodegradable fatty acid with phase-change ability and a biocompatible photothermal agent. These openings, which can enhance the connectivity between the interior and the exterior, enable the easy loading of drug molecules into the interior voids, and their successive sealing ensures a stable encapsulation of the drug. Upon exposure to an external NIR light irradiation, the photothermal agent generates heat that raises the local temperature of the hollow particles above the melting point of the fatty acid, leading to the formation of nanopores on their shells, and consequently, the instant release of the encapsulated drug molecules through the pores. The synergistic activity of the hyperthermia effect from the photothermal agent and the NIR-triggered release of the drug molecules results in noticeable anticancer efficacy.

Biomimetic Tactile Sensors with Bilayer Fingerprint Ridges Demonstrating Texture Recognition.

In this article, we report on a biomimetic tactile sensor that has a surface kinetic interface (SKIN) that imitates human epidermal fingerprint ridges and the epidermis. The SKIN is composed of a bilayer polymer structure with different elastic moduli. We improved the tactile sensitivity of the SKIN by using a hard epidermal fingerprint ridge and a soft epidermal board. We also evaluated the effectiveness of the SKIN layer in shear transfer characteristics while varying the elasticity and geometrical factors of the epidermal fingerprint ridges and the epidermal board. The biomimetic tactile sensor with the SKIN layer showed a detection capability for surface structures under 100 µm with only 20-µm height differences. Our sensor could distinguish various textures that can be easily accessed in everyday life, demonstrating that the sensor may be used for texture recognition in future artificial and robotic fingers.

Anxiety and Depression of the Patients with Hematological Malignancies during Hospitalization for Hematopoietic Stem Cell Transplantation.

OBJECTIVE: This study aimed to assess the anxiety and depression in patients undergoing hematopoietic stem cell transplantation (HSCT). METHODS: Eighty-seven adult patients with various hematologic diseases, who were scheduled to receive autologous or allogeneic HSCT, were enrolled. The M.D. Anderson Symptom Inventory and the Hospital Anxiety Depression Scale were applied prospectively at hospital admission (D-14), on the day of transplantation (D day), and at 7 (D7) and 14 days (D14) after transplantation. RESULTS: The severity of both anxiety and depressive symptoms increased over time, with a peak at D7, and then showed a downturn at D14. Physical distresses also started with mild intensity at base line, which were continuously aggravated until D7, and then a partial recovery afterwards. Approximately, 52% of the participants had significantly high anxiety or depression before the start of HSCT. The occurrence of aggravation of pain, nausea, shortness of breath, and lack of appetite was associated with the development of anxiety during isolation period. The patients with significant baseline anxiety had higher scores on fatigue and shortness of breath items at D7 compared to those without. CONCLUSION: Our finding suggests the importance of psychiatric approaches, including preventive measures, for the patients undergoing HSCT.

Layered deposition of SnS2 grown by atomic layer deposition and its transport properties.

In this work, we report on the layered deposition of few-layer tin disulfide (SnS2) using atomic layer deposition (ALD). By varying the ALD cycles it was possible to deposit poly-crystalline SnS2 with small variation in layer numbers. Based on the ALD technique, we developed the process technology growing few-layer crystalline SnS2 film (3-6 layers) and we investigated their electrical properties by fabricating bottom-gated thin film transistors using the ALD SnS2 as the transport channel. SnS2 devices showed typical n-type characteristic with on/off current ratio of ∼8.32 × 106, threshold voltage of ∼2 V, and a subthreshold swing value of 830 mV decade-1 for the 6 layers SnS2. The developed SnS2 ALD technique may aid the realization of two-dimensional SnS2 based flexible and wearable devices.

Highly Sensitive Tactile Shear Sensor Using Spatially Digitized Contact Electrodes.

In this article, we report on a highly sensitive tactile shear sensor that was able to detect minute levels of shear and surface slip. The sensor consists of a suspended elastomer diaphragm with a top ridge structure, a graphene layer underneath, and a bottom substrate with multiple spatially digitized contact electrodes. When shear is applied to the top ridge structure, it creates torque and deflects the elastomer downwards. Then, the graphene electrode makes contact with the bottom spatially digitized electrodes completing a circuit producing output currents depending on the number of electrodes making contact. The tactile shear sensor was able to detect shear forces as small as 6 µN, detect shear direction, and also distinguish surface friction and roughness differences of shearing objects. We also succeeded in detecting the contact slip motion of a single thread demonstrating possible applications in future robotic fingers and remote surgical tools.