Developing a Multimodal Monitoring System for Geriatric Depression: A Feasibility Study.

The Internet of Medical Things is promising for monitoring depression symptoms. Therefore, it is necessary to develop multimodal monitoring systems tailored for elderly individuals with high feasibility and usability for further research and practice. This study comprised two phases: (1) methodological development of the system; and (2) system validation to evaluate its feasibility. We developed a system that includes a smartphone for facial and verbal expressions, a smartwatch for activity and heart rate monitoring, and an ecological momentary assessment application. A sample of 21 older Koreans aged 65 years and more was recruited from a community center. The 4-week data were collected for each participant (n = 19) using self-report questionnaires, wearable devices, and interviews and were analyzed using mixed methods. The depressive group (n = 6) indicated lower user acceptance relative to the nondepressive group (n = 13). Both groups experienced positive emotions, had regular life patterns, increased their self-interest, and stated that a system could disturb their daily activities. However, they were interested in learning new technologies and actively monitored their mental health status. Our multimodal monitoring system shows potential as a feasible and useful measure for acquiring mental health information about geriatric depression.

Ecological momentary assessment of mental health in adults at suicide risk: An observational study protocol.

AIMS: To describe the research protocol for an ecological momentary assessment (EMA) designed to examine patterns of suicidal ideation and relevant psychosocial stress indicators in adults at risk for suicide. DESIGN: This observational and longitudinal study will collect data for 28 consecutive days. METHODS: A total of 150 adults at risk for suicide will be recruited from a single suicide prevention centre and an outpatient clinic in Korea. Self-report questionnaires will be administrated during weeks 0, 1, 3 and 5. Participants will receive text messages three times a day for 4 weeks prompting them to access an online survey link for daily mood survey including depression, anxiety, stress and suicidal ideation. In addition, for the first 2 weeks, they will wear an actigraphy device designed to collect actigraphic data in terms of sleep patterns and physical activity. Data analyses such as descriptive statistics, independent t-tests, one-way ANOVA, chi-squared statistics and time-series and correlation analyses will be performed using IBM SPSS 26.0 and SAS version 9.3. The study received funding from National Research Foundation of Korea in February 2020. Institutional Review Board approval for our study was obtained in April 2021. DISCUSSIONS: This study will yield fundamental information about daily patterns of suicide ideation and psychosocial stress indicators to develop preventive interventions for adults at risk for suicide. IMPACT: Our study will contribute to the development of EMAs and interventions for adults at risk for suicide aimed at providing timely and individualized mental health services in a community setting. TRIAL REGISTRATION: The trial is registered with the Clinical Research Information Service (CRIS). CRIS Registration Number: KCT0006165.

Impact of Trunk Resistance and Stretching Exercise on Fall-Related Factors in Patients with Parkinson's Disease: A Randomized Controlled Pilot Study.

BACKGROUND: This study aimed to examine the effect of a 12-week progressive trunk resistance and stretching exercise program on fall-related factors in patients with Parkinson's disease (PD). METHODS: A randomized study assessed a progressive trunk resistance and stretching exercise program over a 12-week period. A total of 17 patients with PD participated and wererandomly allocated into an exercise group (n = 10) or a control group (n = 7). Participants in the exercise group completed the exercise program in 60- to 90-min sessions for three days per week. Primary and secondary outcome measures included the trunk mobility scale, functional fitness test, standing balance, and sit-to-walk test. RESULTS: The exercise group showed improvements in functional fitness, trunk mobility, standing balance, and dynamic stability compared with the control group (all p < 0.05). The 2.44 m timed up and go test (odds ratio (OR): 0.125) and the 2 min step test (OR: 10.584) of the functional fitness test, and the first-step length (OR: 3.558) and first-toe clearance height (OR: 4.777) of the sit-to-walk test, were different between the groups following the exercise program. CONCLUSION: This 12-week exercise program improved fall-related factors in patients with PD and may lead to prevention of fall-related injuries.

Postural stability for taekwondo athletes with repetitive ankle sprains during a single-leg stance.

[Purpose] The purpose of this study is to investigate postural stability in such group of taekwondo athletes by measuring the center-of-pressure variables in both the injured limb and uninjured limb during a single-leg stance with eyes closed. [Subjects and Methods] The study includes eleven taekwondo athletes with repetitive ankle sprains (RASs) and eleven healthy taekwondo athletes (the controls) at the college level participating in taekwondo training sessions. For the controls, the "injured" limb was taken to be the left limb. [Results] The postural stability measured in both the anteroposterior and mediolateral directions using center-of-pressure variables was lower in the uninjured limb of the RAS group than in the control group during a single-leg stance with eyes closed. However, for the injured limb, there were no significant differences between the two groups. Furthermore, compared to the RAS group, the control group had higher stability in the injured limb than in the uninjured limb. [Conclusion] Individuals with RASs should ensure improvements in their proprioceptive and neuromuscular functions, as well as muscle strength, through an adequate period of rehabilitation to reduce the risk of re-injury.

Evaluation of the turning characteristics according to the severity of Parkinson disease during the timed up and go test.

BACKGROUND: Patients with Parkinson disease (PD) experience problems such as falls and freezing of gait during walking and turning in daily activities. However, few studies have examined the relationship between simultaneous turning tasks and the severity of PD. AIM: To investigate turning characteristics in patients with PD using three-dimensional (3D) analysis during the timed up and go (TUG) test. METHODS: Thirty individuals performed the TUG test under 3D motion analysis: 10 patients with Hoehn and Yahr (H&Y) stages 2.5 and 3.0 PD (group I), 10 patients with H&Y stage 2.0 PD (group II), and 10 healthy older adult controls. Spatiotemporal and kinematic variables were analyzed during the TUG test with a Vicon 3-D motion analysis system. RESULTS: The walking speed, step length, step length asymmetry index, range of motion of the hip, knee, and shoulder joints, and foot clearance height significantly differed between patients with PD and the controls. The step length and foot clearance height were significantly different between groups I and II. DISCUSSION: The step length and foot clearance are different between the severity levels of PD, and the TUG test may be useful for identifying turning characteristics in patients with PD. CONCLUSIONS: Patients with PD exhibited significant differences in all variables of interest compared to the controls. The step length and foot clearance height as well as the TUG test during the turning phase may be helpful for measuring turning in patients with different severity levels of PD.

Tunable Temperature Response of a Thermochromic Photonic Gel Sensor Containing N-Isopropylacrylamide and 4-Acryloyilmorpholine.

In this study, thermochromic photonic gels were fabricated using 2-hydroxyethyl methacrylate (HEMA) as a hydrogel building block, and 4-Acryloyl morpholine (ACMO) and N-isopropylacrylamide (NIPAAM) as thermoresponsive monomers with different critical solution temperature behaviors. Rapid photopolymerization of opal-templated monomer mixtures of varying ACMO contents formed five individual thermochromic inverse opal photonic gels integrated on a single substrate. With temperature variation from 10 °C to 80 °C, the changes in reflective colors and reflectance spectra of the respective thermochromic gels were noted, and λpeak changes were plotted. Because NIPAAM exhibits a lower critical solution temperature (LCST) at 33 °C, the NIPAAM-only gel showed a steep slope for dλpeak/dT below 40 °C, whereas the slope became flatter at high temperatures. As the ACMO content increased in the thermochromic gel, the curve of dλpeak/dT turned out to be gradual within the investigated temperature range, exhibiting the entire visible range of colors. The incorporation of ACMO in NIPAAM-based thermochromic gels therefore enabled a better control of color changes at a relatively high-temperature regime compared to a NIPAAM-only gel. In addition, ACMO-containing thermochromic gels exhibited a smaller hysteresis of λpeak for the heating and cooling cycle.

Effects of chronic ankle instability and induced mediolateral muscular fatigue of the ankle on competitive taekwondo athletes.

[Purpose] The purpose of this study was to investigate the effects of chronic ankle instability and induced mediolateral muscular fatigue of the ankle on competitive Taekwondo athletes during single-leg drop landing. [Subjects and Methods] Fourteen competitive taekwondo athletes with chronic ankle instability and 14 healthy adults participated, and they performed three single-leg drop landings from a 40-cm height before and after induced fatigue. Ankle angular position, peak vertical ground reaction force, loading rate, eccentric work, and contribution were calculated and analyzed. [Results] Athletes had lower ankle eversion and abduction angle than the controls did at maximum knee flexion both pre- and post-fatigue. Furthermore, athletes had lower eccentric work of the hip than the controls did post-fatigue, and they had lower eccentric work of the knee than controls at both pre- and post-fatigue. The eccentric work of the knee increased while, peak vertical ground reaction force decreased in both, athletes as well as controls post-fatigue. [Conclusion] Taekwondo athletes with chronic ankle instability who participate in a high-intensity training program are continuously exposed to potential injuries of their ankle or knee joints. Therefore, competitive taekwondo athletes with chronic ankle instability should limit their participation in regular training until they complete the rehabilitation process.

Estimation of Local Bone Loads for the Volume of Interest.

Computational bone remodeling simulations have recently received significant attention with the aid of state-of-the-art high-resolution imaging modalities. They have been performed using localized finite element (FE) models rather than full FE models due to the excessive computational costs of full FE models. However, these localized bone remodeling simulations remain to be investigated in more depth. In particular, applying simplified loading conditions (e.g., uniform and unidirectional loads) to localized FE models have a severe limitation in a reliable subject-specific assessment. In order to effectively determine the physiological local bone loads for the volume of interest (VOI), this paper proposes a novel method of estimating the local loads when the global musculoskeletal loads are given. The proposed method is verified for the three VOI in a proximal femur in terms of force equilibrium, displacement field, and strain energy density (SED) distribution. The effect of the global load deviation on the local load estimation is also investigated by perturbing a hip joint contact force (HCF) in the femoral head. Deviation in force magnitude exhibits the greatest absolute changes in a SED distribution due to its own greatest deviation, whereas angular deviation perpendicular to a HCF provides the greatest relative change. With further in vivo force measurements and high-resolution clinical imaging modalities, the proposed method will contribute to the development of reliable patient-specific localized FE models, which can provide enhanced computational efficiency for iterative computing processes such as bone remodeling simulations.

Factors Associated with Poor Quality of Sleep in Construction Workers: A Secondary Data Analysis.

This study aimed to explore factors associated with poor quality of sleep in construction workers. This study was cross-sectional, correlational in design and used secondary data from fatigue instrument development study. We analyzed the data from 206 participants aged over 19 years who worked at construction sites for more than 6 months. We used multivariate binary logistic regression to identify the factors associated with poor quality of sleep. We classified the two sleep quality groups based on the Pittsburgh Sleep Quality Index (PSQI) score, and almost 63% of them were classified as the poor quality of sleep group. Based on multivariate binary logistic regression (Cox and Snell R2 = 0.317, Nagelkerke R2 = 0.429), the poor quality of sleep group tended to sleep for a shorter duration before the working day, and not only showed lower sleep latency and higher levels of daytime dysfunction and discomfort in daily life, but also had more chronic disease, depressive symptoms, and higher physical fatigue. Our study findings support that there are many modifiable factors associated with poor sleep and a high rate of poor quality of sleep occurred in construction workers. Thus, clinicians should consider providing diverse options for applying interventions to ensure better sleep, fatigue management, and depression prevention in construction workers after considering their unique characteristics.

Current Understanding of Religion, Spirituality, and Their Neurobiological Correlates.

Religion and spirituality (R/S) have been prominent aspects of most human cultures through the ages; however, scientific inquiry into this phenomenon has been limited. We conducted a systematic literature review of research on the neurobiological correlates of R/S, which resulted in 25 reports studying primarily R/S with electroencephalography, structural neuroimaging (MRI), and functional neuroimaging (fMRI, PET). These studies investigated a wide range of religions (e.g., Christianity, Buddhism, Islam) and R/S states and behaviors (e.g., resting state, prayer, judgments) and employed a wide range of methodologies, some of which (e.g., no control group, varying measures of religiosity, small sample sizes) raise concerns about the validity of the results. Despite these limitations, the findings of these studies collectively suggest that the experience of R/S has specific neurobiological correlates and that these correlates are distinct from non-R/S counterparts. The findings implicate several brain regions potentially associated with R/S development and behavior, including the medial frontal cortex, orbitofrontal cortex, precuneus, posterior cingulate cortex, default mode network, and caudate. This research may suggest future clinical applications and interventions related to R/S and various disorders, including mood, anxiety, psychotic, pain, and vertiginous disorders. Further studies with more rigorous study designs are warranted to elucidate the neurobiological mechanisms of R/S and their potential clinical applications.

Depression and posture in patients with Parkinson's disease.

BACKGROUND: Depression is an important non-motor symptom of Parkinson's disease (PD) that significantly impacts the daily activities of affected patients. Furthermore, the stooped posture that characterizes patients with PD has also been associated with depression. The purpose of this study was to investigate the relationship between the presence of depressive symptoms and body posture in patients with PD. METHODS: Forty-six patients with mild-to-moderate PD were recruited. The patients were divided into depression and no depression groups based on Beck Depression Inventory scores. All patients underwent kinematic analysis conducted in the upright standing posture with a motion capture system. RESULTS: There were no differences in clinical characteristics between the depression (n = 22) and no depression groups (n = 24). In the standing position, patients with depression showed anterior tilting of the head from the pelvis and an increased distance between head and pelvis. The severity of depression was correlated with the degree of flexion at the lower trunk level and the degree of anterior tilting of the head, neck, and trunk from the pelvis and base of support. CONCLUSIONS: Patients with PD and depression showed increased flexion at pelvis level, which caused the trunk to tilt anteriorly. In addition, the severity of depression was correlated with the degree of anterior tilting of the head and trunk. These findings suggest that stooped posture, especially from the pelvis level, could be a marker of depression in patients with PD.

Impacts of freezing of gait on forward and backward gait in Parkinson's disease.

Freezing of gait (FOG) is a major risk factor for falls and fall-related injuries in patients with Parkinson's disease (PD). The characteristics of gait in PD patients with FOG have been studied but remain controversial. To investigate gait characteristics of FOG in PD, this study analyzed the forward and backward walking of patients with PD. Twenty-six patients with PD were recruited [age: 71.0 ±â€¯6.2 years, Hoehn and Yahr stage: 2-3 (median 2.5)]. Based on responses to the New Freezing of Gait Questionnaire, we classified patients into either the "freezer" or "non-freezer" group. Spatiotemporal and kinematic analyses of forward and backward walking were completed using a three-dimensional motion analysis system over an 8 m walkway in the defined "off" state. There was no difference in demographic and clinical characteristics between the freezers (n = 10) and non-freezers (n = 16). Analysis of forward walking revealed no between-group differences, except for faster walking speed among the non-freezers. During backward walking, the freezers exhibited slower walking speed, shorter stride length, and increased asymmetry of step length. Kinematic analysis of backward walking revealed smaller range of motion in hip and ankle joints and lower step height in freezers. Further investigations of backward walking might expand our understanding of the pathophysiology of FOG in patients with PD.

The effect of knee flexor and extensor fatigue on shock absorption during cutting movements after a jump landing.

BACKGROUND: Sporting situations include instances of continuous and/or integrated movements. However, the effect of fatigue on the performance of these movements remains unclear. PURPOSE: To investigate the effect of knee flexor and extensor fatigue on the shock absorption strategy of the lower limb during cutting movements performed after jump landings. METHODS: Twenty-four healthy participants performed cutting movements following jump landings from two heights - 30cm and 40cm - and under three levels of lower limb fatigue: pre-fatigue (100% peak knee extension torque), and post-fatigue 50% (post-50%) and 30% (post-30%) peak knee extension torque. Fatigue was induced by repeated isokinetic flexion/extension of the knee (60°/s). RESULTS: Compared to the pre-fatigue condition, power and work at the knee joint decreased under both post-50% and post-30% conditions (P<0.001), while the work performed by the ankle (P<0.001) increased significantly. An increase in height from 30cm to 40cm was associated with an increase in the range of motion of the ankle (P<0.001) and knee (P=0.022), peak vertical ground reaction force (P<0.001), rate of loading (P<0.001), knee stiffness (P=0.026) and peak power of the knee (P<0.001), as well as the work performed by the knee (P<0.001) and hip (P<0.001) joints. CONCLUSIONS: Under substantial muscle fatigue the proportion of shock absorption contributed by the knee for cutting movements performed after jump landings from a height of 40cm decreased; there was an adaptive increase in the contribution by the ankle.

Homeostasis-based aging model for trabecular changes and its correlation with age-matched bone mineral densities and radiographs.

PURPOSE: This paper aims (1) to propose a novel bone adaptation model for age-related trabecular changes by adopting two implicit parameters in optimization, (2) to compare the simulated bone volume fraction (BV/TV) with the reported bone mineral density (BMD), and (3) to review the simulated trabecular architectures with the age-matched radiographs. MATERIALS AND METHODS: The proposed model simulated the trabecular changes for an age span of 32-80 years. Quantitative comparison was conducted in terms of BMD and other morphometric indices. Then, two radiologists scored the simulated trabecular architectures using the age-matched radiographs. This protocol was approved by the hospital institutional review board. RESULTS: The simulated BV/TV was well correlated with BMD reported in the literature (R(2)=0.855; p<0.05). In comparison with age-matched radiographs, the consensus scores of agreement of the trabeculae were higher in age groups over the 50s, and the means of the Ward's triangle areas were strongly correlated with those in the age-matched radiographs (R(2)=0.982; p<0.05). CONCLUSION: The proposed model could reflect the targeted trabecular changes in proximal femur with age. With further follow-up measurements, this research would contribute to the development of patient-specific models that assist radiologists in predicting skeletal integrity with aging.