Onset Patterns Research Articles

Stereoelectroencephalographic exploration and surgical outcome in Lennox-Gastaut syndrome.

Lennox-Gastaut syndrome (LGS) is typically characterized by drug-resistant epilepsy and subsequent cognitive deterioration. Surgery is a rare but viable option for the control of seizures in a subset of patients with LGS. This study aimed to describe the organization of the epileptogenic zone network (EZN) in patients with LGS using stereoelectroencephalography (SEEG) and to report the outcome of post-SEEG treatment. A quantitative SEEG signal analysis was conducted in 14 consecutive patients with LGS, in whom a potentially localized EZN was suggested based on a comprehensive noninvasive evaluation. The EZN and the irritative zone network were identified using relevant biomarkers during ictal (epileptogenicity index and connectivity epileptogenicity index) and interictal (spikes and high-frequency oscillations) recordings. The applied post-SEEG treatments were assessed, including SEEG-guided radiofrequency thermocoagulation (RF-TC), surgery, and neurostimulation. The seizure onset patterns showed some specificity by seizure type, with 84% of tonic seizures involving low-voltage fast activity. The EZN of patients with LGS was often, but not always, complex and extensive, involving two or more lobes (79%) and both hemispheres (64%). The lateral neocortical structures, particularly the lateral premotor and dorsolateral prefrontal cortices, were identified as being most frequently involved in the EZN. Among the explored subcortical structures, only the pulvinar, central-lateral thalamic nucleus, and hypothalamic hamartoma belonged to the EZN. Twelve patients (86%) underwent SEEG-guided RF-TC, with 50% experiencing a >50% reduction in baseline seizure frequency. Four patients (29%) underwent curative surgery for significant involvement of a lesion in the EZN, and one case achieved an Engel class I outcome. This is the first quantitative SEEG study in patients with LGS to demonstrate the utility of SEEG in identifying patients who may benefit from surgery and to perform SEEG-guided RF-TC. Nevertheless, the indications for SEEG should be carefully assessed, as localized EZN is uncommon in LGS.

Management and investigation of high myopia in infants and young children

A growing array of behavioral, pharmacological, and optical interventions are now available. These interventions have typically been tested on children aged 6 to 16 who exhibit a typical pattern of myopia onset and progression. In such instances, myopia begins to develop after the age of 5 or 6 and progresses variably until stabilizing during the teenage years or early adulthood. However, there is a much rarer pattern of myopia where children exhibit very high levels of myopia in infancy or early childhood, often exceeding the ‐6D threshold of high myopia. In these cases, numerous diagnostic, health, and visual challenges must be addressed. Managing these issues may initially take higher clinical priority than treating observed progression.High myopia in infants also poses challenges for optical correction to ensure normal visual development and prevent amblyopia. High myopia combined with significant behavioral or developmental issues can be particularly difficult, as uncorrected myopia or contact lens intolerance can exacerbate the behavioral issues of these children. The visual impairment from uncorrected refractive errors can negatively affect both their behavior and development. For instance, the inability to see faces and read emotions can be profoundly isolating, sometimes described as "visual autism" due to the impact of visual isolation.The aim of this presentation is to provide an overview of this complex and multifaceted topic, offering recommendations for the identification, investigation, and management of high myopia in infants and young children. These patients may initially present to primary eye care services where specialist multidisciplinary investigation and management are not available. In such settings, a thorough clinical history, comprehensive examination, and recognition of the unusual features of these children are critical to facilitate prompt and appropriate referral.This patient group is commonly referred to hospital‐based eye clinics. Here, the initial challenge is to correctly identify cases that require detailed investigation and to ensure that the appropriate clinical and diagnostic services are utilized. Management can be wide‐ranging, including advanced ocular imaging, electrophysiology, genetic investigations, involvement of pediatricians and clinical geneticists, genetic counseling, optical correction strategies, and appropriate follow‐up protocols for high‐risk children.

Predictors of the Short-Term Outcomes of Guillain-Barré Syndrome: Exploring Electrodiagnostic and Clinical Features.

Guillain-Barré syndrome (GBS), an acute inflammatory disorder of the peripheral nervous system, is characterized by muscle weakness and paralysis. Prompt identification of patients at a high risk of poor outcomes is crucial for timely intervention. In this study, we combined clinical data with nerve conduction study and electromyography data to identify the predictors of GBS outcomes. We retrospectively analyzed the data of patients with GBS who had received treatment at Chang Gung Memorial Hospital, Taiwan, between 1998 and 2022. Comprehensive clinical and electrophysiological data were collected. Statistical analyses were performed to identify the predictors of poor outcomes. The patients were stratified into two groups by their scores on the GBS Disability Scale: good (score ≤ 2) and poor (score > 2) outcome groups. The study finally included 24 GBS patients (mean age: 53.0 ± 20.9 years; female-to-male ratio: 2.3; good outcome group: 13; poor outcome group: 11). Compared with the good outcome group, the poor outcome group was old (43.0 ± 20.4vs. 64.0 ± 15.7, p = 0.011), had a short time-to-treatment period (12.9 ± 7.8vs. 6.5 ± 5.4 days, p = 0.033), exhibited more prevalent mechanical ventilation use (0vs. 36.4%, p = 0.017), and had a prolonged hospitalization duration (14.7 ± 10.2vs. 53.1 ± 20.0 days, p < 0.001). Poor outcomes were associated with low compound muscle action potential (CMAP), slow motor nerve conduction velocity (MNCV), abnormal F-wave latency, and more conduction block and temporal dispersion. In the subgroup of acute inflammatory demyelinating polyradiculoneuropathy (AIDP), there were 19 patients, out of which 10 had good outcomes, while nine had poor outcomes. The clinical features that differentiate between good and poor outcomes in the AIDP subgroup were similar to those observed in all GBS patients. Notably, the motor conduction features, including distal and proximal CMAP and MNCV of the median and tibial nerves (all p < 0.05), were particularly important electrodiagnostic features of outcome discrimination in the AIDP subgroup. Combining clinical data with nerve conduction study and electromyography data can assist in predicting outcomes of both GBS patients and the AIDP subgroup. Poor outcomes are associated with older age, a more abrupt onset pattern, low CMAP, and slow nerve conduction, and abnormal tibial F responses can predict poor outcomes. Early identification of high-risk patients facilitates tailored interventions. This highlights the importance of combining clinical and electrophysiological data in GBS management.

Fast activity chirp patterns in focal seizures from patients and animal models.

Time-frequency analysis of focal seizure electroencephalographic signals performed with depth electrodes in human temporal lobe structures has revealed the occurrence at onset of oscillations at approximately 30-100 Hz that feature a monotonic rapid decay in frequency content. This seizure onset pattern, referred to as chirp, has been identified as a highly specific and sensitive marker of focal seizures that are characterized by low-voltage fast activity. We report that this chirp pattern is also observed in animal models of temporal lobe epilepsy in both invivo and invitro preparations. We propose here that chirps mirror the involvement of synchronous interneuron firing that is known to represent a specific cellular mechanism leading to the initiation of focal seizures, in particular those characterized by low-voltage fast activity.

Daily activity is repeatable but varies across the breeding season in female great tits

Abstract Wild animals typically organize activity around a 24-hour day and daily timing across the year is optimized for both survival and reproductive success. Among-individual variation in chronotype, where individuals differ in when they begin or end their active day relative to a cue such as photoperiod, often exists within a population. Both intrinsic and extrinsic factors contribute to this variation and activity patterns may change across and within different life history stages as energetic investment changes. Here we describe population level changes in free-living female great tit (Parus major) activity patterns of onset and offset of activity as well as assess variation and repeatability in daily activity both within- and across-breeding stages. We fitted individual females with accelerometers to track activity prior to nest building through chick rearing. Prior to clutch initiation females began their active day before sunrise, however in the days prior to laying their first egg, activity was delayed until after sunrise. Females ended activity prior to sunset across the monitoring period and earliest during egg laying and incubation. Additionally, females exhibited greater among- and within-individual variance in activity during parental care. Female daily activity was moderately repeatable within breeding stages and strongly covaried across several breeding stages. These findings expand our understanding of individual variation in activity patterns during reproduction and the potential fitness implications of chronotype in wild animals.

Circadian rhythm pattern of symptom onset in patients with ST-segment elevation myocardial infarction in the Chinese population

BackgroundThe peak incidence of cardiovascular diseases (CVD) usually occurs in the morning. This study aimed to investigate the exact distribution pattern of peak incidence of ST-segment elevation myocardial infarction (STEMI) in the Chinese population, and to explore whether it is associated with the prognosis.MethodsThis study included 7,805 patients with STEMI from the multicenter, prospective AMI cohort in China, for whom had a definite time of symptom onset. In the overall population and the predefined subgroup populations, the circadian rhythms of STEMI onset were statistically analyzed. Then patients were divided into four groups based on the time of onset (6 h interval) to assess the association of symptom onset time and major adverse cardiovascular and cerebrovascular events (MACCE) after discharge.ResultsThe onset of STEMI had a bimodal distribution: a well-defined primary peak at 8:38 AM [95% confidence interval (CI): 7:49 to 9:28 AM], and a less well-defined secondary peak at 12:55 PM (95% CI: 7:39 AM to 18:10 PM) (bimodal: P &amp;lt; 0.001). A similar bimodal circadian rhythm pattern was observed in subgroups of patients with STEMI defined with respect to day of the week, age, sex, and coronary risk factors. Notedly, the two peaks on Sunday were significantly later than other days, and the secondary peaks became clear and concentrated. In addition, no significant difference was found in MACCE among the four groups (P = 0.905).ConclusionsIn the Chinese population, the onset of STEMI exhibited a bimodal circadian rhythm pattern, with a clear primary peak and a less clear secondary peak. One-year clinical outcomes were unrelated to the timing of STEMI onset.

Interplay of serum BDNF levels and childhood adversity in predicting earlier-onset post-traumatic stress disorder: A two-year longitudinal study

This longitudinal study explored the intricate relationships between serum Brain-Derived Neurotrophic Factor (sBDNF) levels, exposure to childhood adversities, and the subsequent development of Post-Traumatic Stress Disorder (PTSD), distinguishing between earlier- and delayed-onset forms over a two-year follow-up period in individuals sustaining physical injuries. We recruited patients presenting with moderate to severe physical injuries at a trauma center, conducting baseline assessments of sBDNF levels and childhood adversities through the Adverse Childhood Experiences (ACE) questionnaire. Additionally, detailed socio-demographic and clinical data were compiled. The Clinician-Administered PTSD Scale for DSM-5 was employed to diagnose PTSD at 3, 6, 12, and 24 months post-injury. Binary and multinomial logistic regression analyses were applied to elucidate the interactions between sBDNF levels, childhood adversities, and PTSD onset patterns. Among 895 participants, PTSD was diagnosed in 107 individuals (11.9 %), with 76 (8.4 %) exhibiting symptoms indicative of earlier-onset PTSD and 31 (3.5 %) demonstrating delayed-onset PTSD. Significantly, lower sBDNF levels were associated with a higher risk of earlier-onset PTSD specifically in the context of childhood adversities. This association was not observed in individuals without childhood adversities or in those with delayed-onset PTSD. The findings suggest a complex and critical interplay between neurobiological factors, specifically sBDNF levels, and early life adversities in influencing the timing of PTSD onset, potentially deepening the understanding of PTSD etiology.

A universal method for seizure onset zone localization in focal epilepsy using standard deviation of spike amplitude

BackgroundPrecisely localizing the seizure onset zone (SOZ) is critical for focal epilepsy surgery. Existing methods mainly focus on high-frequency activities in stereo-electroencephalography, but often fail when seizures are not driven by high-frequency activities. Recognized as biomarkers of epileptic seizures, ictal spikes in SOZ induce epileptiform discharges in other brain regions. Based on this understanding, we aim to develop a universal algorithm to localize SOZ and investigate how ictal spikes within the SOZ induce seizures. MethodsWe proposed a novel metric called standard deviation of spike amplitude (SDSA) and utilized channel-averaged SDSA to describe seizure processes and detect seizures. By integrating SDSA values in specific intervals, the score for each channel located within SOZ was calculated. Channels with high SOZ scores were clustered as SOZ. The localization accuracy was asserted using area under the receiver operating characteristic (ROC) curve. Further, we analyzed early ictal signals from SOZ channels and investigated factors influencing their duration to reveal the seizure inducing conditions. ResultsWe analyzed data from 15 patients with focal epilepsy. The channel-averaged SDSA successfully detected all 28 seizures without false alarms. Using SDSA integration, we achieved precise SOZ localization with an average area under ROC curve (AUC) of 0.96, significantly outperforming previous methods based on high-frequency activities. Further, we discovered that energy of ictal spikes in SOZ was concentrated at a specific frequency distributed in [6, 12 Hz]. Additionally, we found that the higher the energy per second in this frequency band, the faster ictal spikes could induce seizures. ConclusionThe SDSA metric offered precise SOZ localization with robustness and low computational cost, making it suitable for clinical practice. By studying the propagation patterns of ictal spikes between the SOZ and non-SOZ, we suggest that ictal spikes from SOZ need to accumulate energy at a specific central frequency to induce epileptic spikes in non-SOZ, which may have significant implications for understanding the seizure onset pattern.

Retinopathy in Mucopolysaccharidoses.

PurposeTo determine the pattern(s) of onset, variation, and progression of retinopathy in patients with Mucopolysaccharidosis (MPS). DesignProspective, longitudinal, observational study. ParticipantsBetween November 2015 and March 2023, individuals with MPS were recruited from Ophthalmology clinics at the Manchester Royal Eye Hospital, United Kingdom. MethodsParticipants underwent assessment of visual acuity, corneal clouding, intraocular pressure, along with fundoscopy, ultra-widefield (UWF) colour fundus photography, fundus autofluorescence (FAF) imaging, optical coherence tomography (OCT), and electroretinography (ERG), where feasible. Main Outcome MeasuresEvaluation of findings from clinical examination, retinal imaging, and electroretinogram studies, to ascertain the presence and patterns of retinopathy. ResultsData was collected for 75 patients, including 45 MPS I, 9 MPS II, 13 MPS IVA, and 8 MPS VI, aged 3-58 years. Fundus photography was conducted in 65 patients, FAF in 61, OCT in 58, and electrodiagnostic studies in 36 participants. Retinopathy was defined as signs of retinal disease evident through retinal examination or fundus photography such as depigmentation, bone-spicule pigmentation, vascular tortuosity, retinal pigment epithelium (RPE) mottling/other changes, macular atrophy/puckering/epiretinal membranes, FAF findings such as a central hyperautofluorescent dot, hyperautofluorescent parafoveal ring, hypoautofluorescent lesions around fovea (double bull’s eye), areas of hyper/hypoautofluorescence, and extrafoveal changes, OCT imaging features such as central external limiting membrane (ELM) thickening, RPE disturbance, photoreceptor layer loss, parafoveal retinal atrophy, and outer retinal/intrachoroidal cavities, or electroretinogram studies revealing rod-mediated retinopathy or rod-cone dystrophy. Retinopathy was confirmed in 32 patients, including 25 MPS I, 4 MPS II, 1 MPS IVA, and 2 MPS VI. Five participants were first diagnosed with retinopathy with clinical examination, while 31 participants were identified on UWF colour fundus photography supported by FAF and OCT. 21 patients exhibited ERG abnormalities consistent with retinopathy. Fifteen of the total 32 participants described symptoms of nyctalopia. The onset of retinopathy varied substantially, with initial detection between 2 and 53 years of age. ConclusionsMPS patients as young as 2 may develop retinopathy, diagnosed through fundus examination, ophthalmic imaging, or ERG. Emerging treatments, including gene therapy, may prevent or stabilise retinopathy. Phenotypic data and natural history of MPS-related retinopathy are thus of paramount importance.

Patterns of ictal surface EEG in occipital seizures: A simultaneous scalp and intracerebral recording study

ObjectiveTo describe the ictal scalp EEG patterns of occipital seizures (OS) and their spatiotemporal correlations with intracerebral occipital ictal discharges derived from simultaneous SEEG-EEG recordings. MethodsPatients with SEEG confirmed OS (14 OS from 8 patients) were selected from an epilepsy surgery center and were monitored 3–10 days using simultaneous scalp EEG and SEEG recordings. ResultsOn scalp EEG, the most common onset patterns were background activity suppression (28.6 %) and high amplitude slow wave corresponding to intracerebral DC-shift (28.6 %) and occurred with a median delay of 0 s after intra-cerebral onset. The initial discharge involved occipital electrodes in only 50 % of the seizures (7/14) with additional basal temporal (8/14) or parietal electrodes (5/14). The onset was ipsilateral to the intra-cerebral onset zone in 71.4 % of seizures and bilateral in the remaining (28.6 %). The most common propagation pattern was either unilateral (50 %) or bilateral (50 %) and a rhythmic slow activity (66.7 %). Different OS subtypes display distinct scalp EEG patterns. ConclusionScalp EEG accurately determines intra-cerebral seizure onset time in OS and has good lateralizing value. However, initial scalp modification does not always involves occipital electrodes and the second modification is well lateralizing in only 50 % of seizures. SignificanceThis study describes will help clinicians to better identify OS during video EEG and better plan intra-cerebral explorations for epilepsy surgery.

Sleep patterns in adolescents and associations with substance use

ObjectivesGood sleep during adolescence is crucial for maintaining physical and psychological health; however, sleep disturbance during this period may contribute to health risks, such as substance use. This study aimed to identify the latent sleep patterns across male and female adolescents, and their association with drug use. MethodA cross-sectional study was conducted involving 1391 high school students (aged 15-17; 56.4% female). Participants completed the brief Pittsburgh Sleep Quality Index alongside other sleep measures, and the Timeline Follow-Back and Drug Use History Questionnaire to measure substance use. A multiple-group latent class analysis was used to identify sleep patterns across sexes, and pairwise Logistic Regression models to compare their association with substance use. ResultsFour sleep patterns were identified with varying degrees of sleep difficulties: "Good Sleep" (43.3%), "Night Awakenings" (31.8%), "Poor Efficiency and Sleep Onset" (9.4%), and "Poor Sleep" (15.5%). Female adolescents were more likely to belong to Poor Sleep and Poor Efficiency and Sleep Onset patterns, and male adolescents to Good Sleep. Likewise, binge drinking and using alcohol for a longer period were associated with experiencing Poor Efficiency and Sleep Onset (OR=1.03 and 2.3, respectively); smoking tobacco within the past month was linked to Night Awakenings (OR=2.2); and using cannabis or illegal drugs to the Poor Sleep pattern (OR=2.4 and 2.6, respectively). ConclusionsVaried sleep difficulties exist among adolescents that significantly correlate with different aspects of drug use. Targeted interventions that address both sleep and drug prevention are recommended.

Clinical ocular prediction model of postoperative ametropic amblyopia in patients with congenital ectopia lentis.

Despite prompt and appropriate surgical management, a considerable proportion of patients with congenital ectopia lentis (CEL) suffer from postoperative ametropic amblyopia. To predict and identify at-risk patients early, and ensure timely amblyopia treatment, we conducted a thorough investigation into the onset and progression patterns of postoperative amblyopia in patients with CEL. Moreover, an ocular prediction model was constructed for amblyopia. In this prospective cohort study, amblyopia analysis was conducted to reveal the prevalence of postoperative amblyopia at different time points of follow-up. Comparative analysis and logistic regression analysis were performed for the development of an amblyopia prediction model. Receiver Operating Characteristic (ROC) analysis, calibration plots, and decision curve analysis (DCA) were used to evaluate the performance of the model. A nomogram was created to determine the probability of postoperative amblyopia. Amblyopia was diagnosed according to the most recent edition of the Amblyopia Preferred Practice Pattern. A total of 889 eyes from 677 patients operated for CEL were enrolled in this study. In the pediatric cohort, the prevalence of amblyopia showed a decreasing trend with follow-up time from 1 month to 3.5 years. A prediction model based on preoperative best-corrected visual acuity (BCVA) and cardiac phenotype was established to predict postoperative amblyopia. For effective individual prediction, a nomogram was created. With great calibration, discrimination, and clinical usefulness, the prediction model demonstrated good performance. The findings underscore that the prevalence of ametropic amblyopia in pediatric CEL patients who underwent lens surgery exhibited a marked decline over time. The prediction model established with preoperative BCVA and cardiac phenotype can provide accurate and individualized predictions of postoperative amblyopia, and it has the potential to assist ophthalmologists in rapidly identifying high-risk patients.

Patterns of intrinsic capacity trajectory and onset of activities of daily living disability among community-dwelling older adults.

Global population ageing has brought about new challenges for elderly care. Exploring intrinsic capacity (IC) over time, which is designed as a composite measure of an individual's physical and mental capabilities, is essential for promoting healthy ageing and preventing dependency, such as that emerging from disability in activities of daily living (ADL). We aimed to identify and examine the differences between classes of IC trajectory and onset of ADL disability. We conducted an observational study using data from three waves (2011-15) of the China Health and Retirement Longitudinal Study, comprising 2609 participants with 6034 observations. IC was measured by five domains, including locomotion, cognition, psychological, sensory capacities, and vitality. We used joint latent class modelling to identify distinct classes with similar patterns of IC trajectory and onset of ADL disability, as well as to explore the variation in IC trajectory and predict five-year risks of ADL disability considering the heterogeneity in the elderly population. The average baseline IC score was 7.15 (range: 0-15). We observed that IC scores slowly decreased with age, with 17.25% of participants developing ADL disability. We identified three classes of IC, which could be described as moderate health (class 1: n = 1634, 62.63%), at-risk (class 2: n = 716, 27.44%; had the highest risk of ADL disability), and optimal health (class 3: n = 259, 9.93%; had the lowest baseline risk of ADL disability). The probability of being in the moderate health class was decreased the most by emotional problems (odds ratio (OR) = 0.219; P < 0.001). Having a self-rated poor standard of living substantially reduced the chances of moderate (OR = 0.308; P = 0.001) and optimal health (OR = 0.110; P < 0.001). Observing IC trajectories and the onset of ADL disability can stratify the elderly into heterogeneous groups, as well as provide data for implementing person-centred care plans to reverse the trend and delay the adverse outcomes in clinical practice.

Development of a stereo-EEG based seizure matching system for clinical decision making in epilepsy surgery.

Objective.The proportion of patients becoming seizure-free after epilepsy surgery has stagnated. Large multi-center stereo-electroencephalography (SEEG) datasets can allow comparing new patients to past similar cases and making clinical decisions with the knowledge of how cases were treated in the past. However, the complexity of these evaluations makes the manual search for similar patients impractical. We aim to develop an automated system that electrographically and anatomically matches seizures to those in a database. Additionally, since features that define seizure similarity are unknown, we evaluate the agreement and features among experts in classifying similarity.Approach.We utilized 320 SEEG seizures from 95 consecutive patients who underwent epilepsy surgery. Eight international experts evaluated seizure-pair similarity using a four-level similarity score. As our primary outcome, we developed and validated an automated seizure matching system by employing patient data marked by independent experts. Secondary outcomes included the inter-rater agreement (IRA) and features for classifying seizure similarity.Main results.The seizure matching system achieved a median area-under-the-curve of 0.76 (interquartile range, 0.1), indicating its feasibility. Six distinct seizure similarity features were identified and proved effective: onset region, onset pattern, propagation region, duration, extent of spread, and propagation speed. Among these features, the onset region showed the strongest correlation with expert scores (Spearman's rho = 0.75,p< 0.001). Additionally, the moderate IRA confirmed the practicality of our approach with an agreement of 73.9% (7%), and Gwet's kappa of 0.45 (0.16). Further, the interoperability of the system was validated on seizures from five centers.Significance.We demonstrated the feasibility and validity of a SEEG seizure matching system across patients, effectively mirroring the expertise of epileptologists. This novel system can identify patients with seizures similar to that of a patient being evaluated, thus optimizing the treatment plan by considering the results of treating similar patients in the past, potentially improving surgery outcome.

Seasonality in mood disorders: Probing association of accelerometer-derived physical activity with daylength and solar insolation

Mood disorders are the leading cause of disability worldwide. Up to 30 percent of individuals with major depressive disorder (MDD) and bipolar disorder (BD) display a seasonal pattern of onset, a phenomenon now recognized in the official diagnostic manuals (DSM-5 and ICD-11). Very little is known about the influence of day length (photoperiod) and sunlight intensity (solar insolation) on seasonal patterns in MDD and BD. Here we report a quantitative approach to examine the relationship between sunlight measures and objectively measured motor activity patterns to understand environmental factors driving seasonality in MDD and BD. Our generalized linear model (GLM) assessment of the Depresjon dataset, which includes short-term (up to two weeks) motor activity recordings of 23 unipolar and bipolar depressed patients and 32 healthy controls recruited to the study at the University of Bergen Norway (60.4° N latitude, 5.3° E longitude), revealed significant association of accelerometer-derived daytime physical activity with participant’s depressed state (p&lt;0.001), photoperiod (p&lt;0.001), and solar insolation (p&lt;0.001). Our study presents a generalizable strategy to decipher the complex interplay between sunlight, physical activity, and depressed state using open-source digital tools. The ability to identify mood disturbances, particularly in seasonally susceptible individuals, using passive digital biomarker data offers great promise in informing next-generation predictive, personalized diagnostics in mental health.

The development of depression and social anxiety symptoms in adolescents and the negative impact of the COVID-19 pandemic and desire for peer contact.

Adolescence is a dynamic developmental phase in which contact with peers is crucial for socio-emotional development and wellbeing. Depression and social anxiety show patterns of high onset during this period, and more for girls than boys. Here we examine this development among Dutch adolescents, as well as how desire for more peer contact as a result of social distancing measures during the COVID-19 pandemic contributed to this increase. We used a longitudinal three-wave design to examine 406 typically developing Dutch adolescents across two consecutive cohorts; Cohort 1: 2016-2019 (N = 138, 53.6% girls, age at T0 M = 13.00, SD = 0.42), Cohort 2: 2017-2020 (N = 268, 63.1% girls, age at T0 M = 13.05, SD = 0.39), final wave during spring 2020 during the first COVID-19 lockdown. Self-report questionnaires were used to measure depression and social anxiety symptoms, desire for change in the amount of peer contact during lockdowns, and emotion regulation. Parallel process dual latent growth models and autoregressive cross-lagged models were used to test the hypotheses. Results showed that symptoms of both depression and social anxiety increase during adolescence. Gender analysis reveal a higher initial level and increase in depression symptoms for girls, while levels for boys decreased. Adolescents exposed to the pandemic showed a steeper increase in depression but not in social anxiety. Desire for more peer contact was related to an increase in depression and social anxiety, though only in girls. No evidence was found for moderation of emotion regulation skills concerning COVID evoked emotions on the association between desire for peer contact and anxiety and depression symptom development. Symptoms of social anxiety increased during adolescence in boys and girls. Symptoms of depression increased for girls, but decreased for boys. The increase in depression was greater in a cohort who experienced the COVID-19 pandemic. For girls, a desire for more peer contact was associated with an increase of depression and social anxiety symptoms in times of social restrictions.

Examining the onset and cessation patterns of active smoking among college students: an interpretative analysis

Smoking is a prevalent global issue, with a significant risk factor for various non-communicable diseases necessitating prolonged, costly, and potentially devastating medical treatments. In addition, infectious diseases such as tuberculosis, COVID-19, and pneumonia in toddlers are often associated with active and passive smoking habits. The correlation is evident across diverse demographics, encompassing individuals of varying ages, professions, and genders. Therefore, this research aimed to explore and describe behavior of active smokers among campus members at various universities, focusing on the initiation, cessation, and influencing factors associated with smoking.A qualitative research design was used with a hermeneutic phenomenological approach, where information was provided by five active smoker informants.These individuals started smoking as teenagers, and the fluctuating patterns were influenced by health concerns or a perceived lack of significance attributed to smoking. However, the periods of abstinence were only temporary due to the pervasive influence of social and environmental factors. The initiation of smoking commonly started from the influence of close acquaintances, such as family members. Meanwhile, the process of quitting encountered numerous obstacles, primarily from potent social factors outweighing personal intentions.The implementation of smoking cessation strategies posed challenges due to the profound impacts of addiction, requiring unwavering determination, comprehensive plans, and diligent efforts.

Common molecular basis of aging and cancer dynamics: complex interactions among age, diseases, external stressors, and environmental factors

There are incremental efforts to understand the multifaceted aspects of aging, particularly focusing on its biological interplay with various environmental stressors and diseases such as cancer. The concept of biological age, which is distinct from chronological age, and its importance in predicting disease onset and mortality patterns are emphasized. Furthermore, exploration of the reversible nature of biological aging under different stress conditions, such as surgery, pregnancy, and diseases such as cancer and coronavirus disease 2019, is intriguing. This narrative review attempts to address the potential impact of viral infections such as severe acute respiratory syndrome coronavirus 2 and the altered landscape of diseases such as cancer on biological aging and their interconnected relationships. Additionally, it also touches upon the influence of emerging technologies, particularly artificial intelligence-driven machines, on aging dynamics, prompting further research in this area. This article may provide insight into a comprehensive framework for interdisciplinary research to better understand the complex interactions among age-related dynamics, diseases, external stressors, and environmental factors, with implications for future interventions and healthcare strategies.

Analysis of Atypical Antipsychotics-Induced Adverse Events Related to Diabetes Mellitus in Patients With Dementia Using the Japanese Adverse Drug Event Report Database.

Patients with dementia are prescribed low-dose atypical antipsychotics (AAPs) to treat psycho-behavioral symptoms. Although AAPs are known to cause diabetes mellitus-related adverse events (DMAEs), information regarding AAPs-induced DMAEs experienced by patients with dementia is lacking. To use the Japan Adverse Drug Event Report (JADER) database to assess the onset tendencies and patterns of DMAEs attributable to AAPs prescribed to patients with dementia. We performed an analysis using dementia cases from the JADER database that were registered from April 2004 to December 2022. Data in the JADER database are completely anonymized; thus, we did not require institutional review board approval for using the JADER database in our study. The reporting odds ratio and proportional reporting ratio (PRR) were used to assess the onset tendencies of DMAEs with AAPs. In addition, Weibull shape parameters were used to assess the patterns of DMAEs that occur with the use of AAPs. We identified AAPs associated with DMAEs. In particular, low doses of quetiapine showed the potential to induce DMAEs. An analysis of the onset of DMAEs showed the early failure patterns for AAPs (median onset = 38 days). The AAPs may cause DMAEs in patients with dementia. Low doses of quetiapine may induce DMAEs. Health care workers should focus on the development of DMAEs during the early administration period of AAPs. These results may assist with the safe management of patients with dementia who use AAPs.

Floral ontogeny reveals potential synapomorphies for Senegalia sect. Monacanthea p.p. (Leguminosae).

Senegalia was recently described as non-monophyletic; however, its sections exhibit robust monophyletic support, suggesting a potential reclassification into separate genera-Senegalia sect. Monocanthea p.p. is the largest section. It contains 164 species of pantropical distribution and includes all of the current 99 neotropical species of Senegalia; however, no morphological characteristics are available to differentiate this section. To characterize this section, we examined floral developmental traits in four species of Senegalia sect. Monocanthea p.p. These traits were previously considered as potentially distinguishing features within Acacia s.l. and include the onset patterns of the androecium, the timing of calyx union, the origin of the staminal disc, and the presence of stomata on the petals. Furthermore, we analyzed previously unexplored traits, such as corolla union types, inflorescence development, and micromorphological features related to the indumentum, as well as the presence and location of stomata. The characteristics proposed as potential synapomorphies of the group include the postgenital fusion of the corolla and the presence of a staminal disc formed at the base of the filaments. The other analyzed floral characteristics were not informative for the characterization of the group. Future studies of floral ontogeny will help to establish more precise patterns, mainly whether corolla union and staminal tube formation occur similarly in African and Asian sections of Senegalia.