Subthreshold Levels Research Articles

The contribution of vulnerability to emotional contagion to the expression of psychological distress in older adults

This study examines the differential weight of a wide range of factors—sociodemographic factors, indicators of autonomy, social support, coping styles, vulnerability to emotional contagion, and empathy—in the presence of two profiles of psychological distress and in their absence. This cross-sectional study included 170 older adults. As assessed by the Hospital Anxiety and Depression Scale (HADS), 65.9% of the individuals in the sample had a clinical or subthreshold level of anxiety and depression (score > 1). Based on the HADS’s clinical cutoff scores for the anxiety and depression subscales, three profiles were created for the no distress, anxiety, and anxious depression groups. The profiles did not differ on demographic indicators except for sex. Vulnerability to emotional contagion, satisfaction with the social network and coping styles emerged as factors weighing the likelihood of being in either of the psychological distress groups relative to individuals with no distress. After controlling for adversity and psychotropic treatment, vulnerability to emotional contagion had the strongest relationship with both psychological distress profiles. Future research, such as a prospective longitudinal study, may provide an opportunity to explain the direction of the relationship between psychological distress and the factors studied, particularly vulnerability to emotional contagion.

A study of a PERMA-based positive psychological intervention programme in subthreshold depressed patients with newly diagnosed breast cancer: formulation and application.

Depression seriously affects the quality of life of breast cancer patients and even hinders treatment and recovery after diagnosis. Subthreshold depression should be worthy of attention, and the risk of subthreshold depression developing into depression increases if timely intervention is not available. However, there is limited research on interventions for subthreshold depression, especially for newly diagnosed breast cancer patients. Exploring the efficacy of a PERMA-based positive psychological intervention programme in newly diagnosed breast cancer patients with subthreshold depression. Using PERMA as a framework, we constructed the intervention programme through a literature review and expert discussion approach, and revised the programme using the Delphi method. Then we selected 84 newly diagnosed breast cancer patients for a randomised controlled trial. The control group received conventional care (primary care, specialist care, psychological care, etc.), and the observation group received a PERMA-based positive psychological intervention programme. Patient data were collected before and after the intervention, and the dataset consisted of patient responses to general information, the Depression Screening Scale (CES-D), the Hamilton Depression Inventory (HAMD-17), and the Questionnaire on Psychosocial Adjustment in Breast Cancer Patients. A total of 79 patients completed the study (38 patients in the observation group and 41 patients in the control group), and before the intervention, there were no statistical differences in the comparison of general information, subthreshold depression scores, and psychosocial adaptation scores between the two groups (p > 0.05). After the intervention, the subthreshold depression (CES-D and HAMD-17 scores) scores of the observation group were lower than those of the control group (p < 0.01), and the psychosocial adaptation scores were significantly higher than those of the control group (p < 0.01). A positive psychological intervention programme using PERMA as a framework was more effective in reducing subthreshold depression levels and promoting levels of psychosocial adjustment in newly diagnosed breast cancer patients. Interventions for subthreshold depression are not limited to the traditional aftercare model, but rather from a positive psychology perspective. Especially for patients newly diagnosed with breast cancer, this is a new endeavour that has important implications for them. Because, instead of focusing on their negative emotions, we help them gradually adapt to their new identity and treatment process from a positive aspect during their most difficult period, thus reducing their subthreshold depression level and preventing it from developing into a more severe depression.

Identification of Compounds That Contribute to Consumer Aroma Liking of Roasted American-European Hybrid Hazelnuts.

New interspecific hybrid hazelnut crosses between American (Corylus americana) and European (Corylus avellana) hazelnuts are being developed to support a commercial industry in the Midwest region of the United States. In this study, volatile compounds that impact consumer aroma liking of roasted hybrid hazelnuts (C. americana × C. avellana) were investigated by targeted and nontargeted GC/MS flavoromics. Chemical profiles from 10 roasted hybrid hazelnut samples were modeled with consumer aroma liking scores by orthogonal partial least-squares with good fit and predictive performance (R2 ≥ 0.92, Q2 ≥ 0.82, RMSECV = 0.2). Top ranked predictors positively correlated with liking included 12 aroma compounds and 4 profiled volatiles for the targeted and nontargeted methods, respectively. Sensory recombination testing of hazelnut samples with addition of the 12 predictive odorants was preferred by consumers (p < 0.001, Δ aroma liking = 2.2 on 9-point scale) and perceived as more roasty, nutty, and sweet compared to the control (p < 0.05). Addition of the 4 predictive volatiles at subthreshold levels also was preferred (p = 0.02) and perceived as less earthy and mushroom like than the control (p < 0.05).

Understanding the Contributions of the Hippocampus

The hippocampus plays an important role in human memory, with its anterior portion contributing to coarse-grained representations and its posterior portion contributing to fine-grained ones (Poppenk et al., 2013). My USRA project is focused on understanding the role of the hippocampus in a potential third type of memory representation; a general synthesis of stimuli. Beyond memory, the hippocampus has also been hypothesize to influence clinical disorders. For instance, preliminary research in our lab has found meta-cognitive memory abilities to be organized into factors resembling clinical disorders, when organized by variance in brain structure. My USRA project also aims to understand the contribution of the hippocampus to clinical disorders. My role in this project has been to develop administrative and experimental structure for the protocol, which involves extensive testing. Participants will complete approximately 27 hours of memory tasks, designed to evaluate the nature of their memory, and whether it is oriented towards detail, gist, or a synthesis of all stimuli. To do so, I have developed an extensive task of reading and evaluating reviews, as well as a recall task of lab-generated stories. Participants will also complete approximately 3-4 hours of online questionnaires, administered through Qualtrics. Over the summer, I conducted research to identify validated questionnaires that assess metacognitive abilities, in the domains of memory, attention, language, motor control, social cognition and perception. Results on these questionnaires will be used to validate preliminary findings on the relationship between metacognitive memory, brain variance and sub-threshold levels of clinical disorders, and to investigate whether these findings expand to other forms of metacognition. Finally, participants will complete a number of structural and functional MRI scans (including DTI). This work may help us understand the pure science of the function of human memory, as well as the nature of clinical disorders.

Beyond the Descriptive: A Comprehensive, Multidomain Validation of Symptom Trajectories for Individuals at Clinical High Risk for Psychosis

BackgroundAlthough the clinical high risk for psychosis (CHR-P) criteria are widely used to ascertain individuals at heightened risk for imminent onset of psychosis, it remains controversial whether CHR-P status defines a diagnostic construct in its own right. In a previous study, CHR-P nonconverters were observed to follow 3 distinct trajectories in symptoms and functioning: remission, partial remission, and maintenance of symptoms and functional impairments at subthreshold levels of intensity. MethodsHere, we utilized the NAPLS3 (North American Prodrome Longitudinal Study phase 3) sample (N = 806) to determine whether 1) the same trajectory groups can be detected when assessing symptoms at 2-month intervals over an 8-month period and 2) the resulting trajectory groups differ from each other and from healthy control participants and converting CHR-P cases in terms of risk factors, comorbidities, and functional outcomes. ResultsThree distinctive subgroups within the CHR nonconverters were identified, largely paralleling those observed previously. Importantly, these extracted groups, together with non-CHR control participants and CHR converters, differed from each other significantly on putative etiological risk factors (e.g., predicted risk scores, physiological and self-report measures of stress), affective comorbidities, and functional outcomes, thus providing converging evidence supporting the validity of the identified trajectory groups. ConclusionsThis pattern, together with the fact that even the subgroup of CHR-P nonconverters who showed a remission trajectory deviated from healthy control participants, supports treating the CHR-P syndrome not only as a status that denotes risk for onset of full psychosis but also as a marker of ongoing distress for a population that is in need of interventions.

Key saltiness-enhancing substances in Maillard reaction products derived from chicken breast hydrolysate: Identification, saltiness-enhancing ability and mechanism

This work employs a saltiness-guided separation combined with UPLC-QTOF-MS to identify the key saltiness-enhancing substances in Maillard reaction products derived from chicken breast hydrolysate (CBH–MRPs). Thirteen compounds in the U3 fraction exhibited significant saltiness-enhancing abilities, which increased the saltiness intensity of NaCl (3 g/L) from 2.80 to 3.35–3.88. Interactions between the compounds and NaCl were evaluated using the S-curve method. The results showed that five compounds (5′-GMP, 5′-IMP, L-glutamic acid, L-lactic acid, and L-carnosine) and one compound (glutamine) exhibited synergistic and additive effects with NaCl, respectively, at tested concentrations. Notably, 5′-GMP/5′-IMP/glutamine and L-carnosine/L-lactic acid demonstrated better saltiness-enhancing abilities at their suprathreshold and subthreshold levels, respectively. Molecular docking results showed that hydrogen bonding was the key force for docking. Residues Cys475, Glu378, and Trp236 were the primary binding sites of the transmembrane channel-like protein 4 (TMC4). These results contribute to a better understanding of the saltiness modulating mechanisms of CBH–MRPs.

A Comprehensive Review of Power Consumption in Digital Logic Circuits at Ultra-Low Subthreshold CMOS Levels

In the anticipated spectrum, a lot of work has gone into managing the trade-offs between power, location, and efficiency in the moderate efficiency, moderate power region. However, research into the extremities of this spectrum remains restricted. In particular, there hasn't been enough research done on the extremes of extraordinarily low power consumption with appropriate efficiency and extraordinary efficiency with energy that is within realistic bounds. In this work, very low subthreshold power levels are used to study the power consumption characteristics of digital logic circuits in static Complementary Metal-Oxide-Semiconductor (CMOS) devices. The study shows that operating transistors below their threshold voltage might result in significant energy savings. This research emphasises the significance of subthreshold design strategies for contemporary electronic circuits that aspire for low-power operation without sacrificing efficiency. The results highlight the potential for significant progress in energy-efficient circuit design and highlight the delicate balance between preserving performance and cutting power usage. As a result, this research adds to our understanding of low-power electronics and provides information that may lead to the development of future technologies that are more efficient and sustainable. Keywords— Power consumption analysis, Digital logic circuits, Ultra-low power, Subthreshold operation, Static CMOS gates

Plasma Phosphorylated Tau 217 and Aβ42/40 to Predict Early Brain Aβ Accumulation in People Without Cognitive Impairment

Phase 3 trials of successful antiamyloid therapies in Alzheimer disease (AD) have demonstrated improved clinical efficacy in people with less severe disease. Plasma biomarkers will be essential for efficient screening of participants in future primary prevention clinical trials testing antiamyloid therapies in cognitively unimpaired (CU) individuals with initially low brain β-amyloid (Aβ) levels who are at high risk of accumulating Aβ. To investigate if combining plasma biomarkers could be useful in predicting subsequent development of Aβ pathology in CU individuals with subthreshold brain Aβ levels (defined as Aβ levels <40 Centiloids) at baseline. This was a longitudinal study including Swedish BioFINDER-2 (enrollment 2017-2022) and replication in 2 independent cohorts, the Knight Alzheimer Disease Research Center (Knight ADRC; enrollment 1988 and 2019) and Swedish BioFINDER-1 (enrollment 2009-2015). Included for analysis was a convenience sample of CU individuals with baseline plasma phosphorylated tau 217 (p-tau217) and Aβ42/40 assessments and Aβ assessments with positron emission tomography (Aβ-PET) or cerebrospinal fluid (CSF) Aβ42/40. Data were analyzed between April 2023 and May 2024. Baseline plasma levels of Aβ42/40, p-tau217, the ratio of p-tau217 to nonphosphorylated tau (%p-tau217), p-tau231, and glial fibrillary acidic protein (GFAP). Cross-sectional and longitudinal PET and CSF measures of brain Aβ pathology. This study included 495 (BioFINDER-2), 283 (Knight ADRC), and 205 (BioFINDER-1) CU participants. In BioFINDER-2, the mean (SD) age was 65.7 (14.4) with 261 females (52.7%). When detecting abnormal CSF Aβ-status, a combination of plasma %p-tau217 and Aβ42/40 showed better performance (area under the curve = 0.949; 95% CI, 0.929-0.970; P <.02) than individual biomarkers. In CU participants with subthreshold baseline Aβ-PET, baseline plasma %p-tau217 and Aβ42/40 levels were significantly associated with baseline Aβ-PET (n = 384) and increases in Aβ-PET over time (n = 224). Associations of plasma %p-tau217 and Aβ42/40 and their interaction with baseline Aβ-PET (%p-tau217: β = 2.77; 95% CI, 1.84-3.70; Aβ42/40: β = -1.64; 95% CI, -2.53 to -0.75; %p-tau217 × Aβ42/40: β = -2.14; 95% CI, -2.79 to -1.49; P < .001) and longitudinal Aβ-PET (%p-tau217: β = 0.67; 95% CI, 0.48-0.87; Aβ42/40: β = -0.33; 95% CI, -0.51 to -0.15; %p-tau217 × Aβ42/40: β = -0.31; 95% CI, -0.44 to -0.18; P < .001) were also significant in the models combining the 2 baseline biomarkers as predictors. Similarly, baseline plasma p-tau217 and Aβ42/40 were independently associated with longitudinal Aβ-PET in Knight ADRC (%p-tau217: β = 0.71; 95% CI, 0.26-1.16; P = .002; Aβ42/40: β = -0.74; 95% CI, -1.26 to -0.22; P = .006) and longitudinal CSF Aβ42/40 in BioFINDER-1 (p-tau217: β = -0.0003; 95% CI, -0.0004 to -0.0001; P = .01; Aβ42/40: β = 0.0004; 95% CI, 0.0002-0.0006; P < .001) in CU participants with subthreshold Aβ levels at baseline. Plasma p-tau231 and GFAP did not provide any clear independent value. Results of this cohort study suggest that combining plasma p-tau217and Aβ42/40 levels could be useful for predicting development of Aβ pathology in people with early stages of subthreshold Aβ accumulation. These biomarkers might thus facilitate screening of participants for future primary prevention trials.

Effect of Noisy Galvanic Vestibular Stimulation on Spatial Learning and Memory of Rats

Background and Aim: Previous studies have shown promising findings on effectiveness of noisy Galvanic Vestibular Stimulation (nGVS) in various cognitive disorders. The connections of the vestibular system with the hippocampus has been proven. Here we investigated the effect of vestibular galvanic stimulation on the improvement of spatial learning and memory of rats. Methods: Twelve Wistar rats were randomly divided into control and nGVS groups. The nGVS group underwent 30-minute sessions of stimulation at sub-threshold levels for a duration of fourteen days. Following the intervention, both groups underwent assessments of cognitive indices through the Morris water maze task, hippocampal neuronal spike rate by Single-Unit Recording (SUR) and the concentrations of c-fos protein in the hippocampus were measured using ELISA device. Results: The nGVS group exhibited a significant difference compared to the control group in both the time taken to reach the target platform and the percentage of time spent in the goal quarter during the Morris water maze test. The nGVS treatment significantly enhanced spike rate of hippocampal dentate gyrus (p&lt;0.01) compared to the control group. Additionally, c-fos protein concentrations were increased in the nGVS (5.833) than the control group (4.126), (p&lt;0.001). Conclusion: According to the obtained results, nGVS plays a role in improving spatial memory, and a longer duration of intervention is suggested to achieve more obvious improvement results. Keywords: Galvanic vestibular stimulation; spatial cognition; single-unit recording; hippocampus; rat

Exploring the Relationships Between Bacterial Community, Taste-Enhancing Peptides and Aroma in Thai Fermented Fish (Pla-ra).

As a traditional Thai condiment, Pla-ra is used to add flavor and richness to dishes. Nine treatment combinations of Pla-ra formulations created from 3 types of fish (Mor fish, Kradee fish, and Mor + Kradee fish) and 4 different carbohydrate sources (none, rice bran, roasted rice, and rice bran─roasted rice mixture) were studied through a 12 month fermentation period (1, 3, 5, 7, 8, 9, 10, 11, and 12 months). 16S rRNA Next Generation Sequencing (NGS) and LC-MS/MS techniques were used to analyze the microbial diversity and identify taste-enhancing peptides. Descriptive sensory analysis was performed on the extracts of the 108 Pla-ra samples mixed in a model broth. Koku perception and saltiness-enhancing attributes were clearly perceived and dominant in all samples, even though glutamyl peptides, including γ-Glu-Val-Gly, were found at subthreshold levels. The samples from mixed fish and Mor fish fermented with roasted ground rice and rice bran for 12 months had the most typical Pla-ra odors and tastes and had high taste-enhancing activities. NGS analysis revealed the presence of bacteria containing a large number of protease and aminopeptidase genes in the samples. Bacillus spp., Gallicola spp., and Proteiniclasticum spp. correlated well with the generation of glutamyl and arginyl peptides and typical odors in the samples. These results confirmed the typical sensory quality of Pla-ra depended on protein sources, carbohydrate sources, and bacteria communities. Further optimization of the microbial composition found could lead to the development of starter cultures to control and promote flavor development in fermented fish products.

Input Voltage-Level Driven Split-Input Inverter Level Shifter for Nanoscale Applications

A level shifter (LS) appears to be highly efficient and effective in solving voltage contentions between deep sub-threshold and core voltage levels. An input voltage-level driven split-input inverter that can create common unconnected PMOS and NMOS transistors for the input inverter is proposed, which is powered and used at the input stage to achieve maximum conversion efficiency. Layout and simulation results across different corners have demonstrated that the proposed LS is highly useful for cutting-edge nanoscale applications. It can up-convert voltage from 0.2 V to 1.2 V and down-convert from 1.2 V to 0.2 V @ 1 MHz input pulse, with a level-up or level-down mean switching delay of 1.3 ns, and a power of 9.5 nW. Moreover, the LS occupies an area of 8 μm2, which is a reasonably compact size compared to the typical LS designs. Overall, the proposed voltage LS design is an efficient and effective solution that could have an ample range of applications in IoT and biomedical, wireless sensor networks.

Exploring sub-threshold food addiction in adult patients with severe obesity: a cross-sectional analysis

Background Most studies on Food Addiction (FA) used the strict classical diagnosis approach without quantifying sub-threshold symptoms (i.e. uncontrolled/excessive food intake, negative affect, craving, tolerance, withdrawal, and continued use despite harm) nor indicating where they stand on the “three-stage addiction cycle” modeling the transition from substance use to addiction. Objectives (1) to estimate the proportion of clinically significant episodes of distress/impairment in severely obese patients without FA, and (2) to assess their associations with FA symptoms at the subthreshold level. Methods The modified Yale Food Addiction Scale 2.0 (mYFAS 2.0) assesses 11 symptoms (diagnostic criteria) plus clinically significant impairment and distress (clinical significance criterion). We used this tool to diagnose FA (≥ 2 criteria plus clinical significance) in adult patients with severe obesity, but included only those below the threshold in the analyses. Demographics, clinical features, and obesity complications were collected. Results Only 18% of the 192 participants (women n = 148, 77.1%; mean age: 43.0 ± 13.2) reported a total absence of FA symptoms, while one in four reported recurrent episodes of clinically significant distress (24%) or impairment (25%) in social, occupational, or other important areas of functioning. The most common recurrent symptoms were first-stage symptoms (binge/intoxication), while second- (withdrawal/negative affect) and third-stage (preoccupation/anticipation) symptoms affected nearly one patient in five for tolerance and craving, and one in ten for withdrawal. In multivariate analysis, impairment was positively related to withdrawal and tolerance, while distress was positively related to failure in role obligations. Conclusion Many patients with severe obesity experience recurrent episodes of FA symptoms at the subthreshold level. Prospective studies will examine whether these symptoms may play a causal role in symptoms progression toward a full-blown FA and obesity outcomes.

The problem gambling measure: a revision of the problem & pathological gambling measure to better predict at-risk and chronic gambling

ABSTRACT Most problem gambling (PG) assessment instruments classify individuals with subthreshold levels of problem gambling symptomatology as ‘at-risk’, implying a future risk of developing more serious problems. However, this convention lacks empirical support. The present study aimed to develop an empirically supported revision of the Problem and Pathological Gambling Measure (PPGM) that (1) better assesses the risk of future gambling-related harm (GRH) and PG as well as (2) better predicts cases in which PG persists. Data from the Alberta Gambling Research Institute’s National Project Baseline and Follow-up Online Panel Surveys (n = 4676) were used to identify predictors of future GRH and PG. Five variables maximized prediction power: PPGM total score, problem perception, rated importance of gambling as a leisure activity, largest single day gambling loss, and breadth of monthly gambling involvement. A 16-point scale was produced based on the relative risk of developing GRH and PG and Receiver Operating Characteristic (ROC) analyses found that scores of 1, 4, and 8 best captured a gradient of risk for future GRH or PG. Regarding chronicity, a total score of 7 and higher was found to be most parsimoniously predictive of chronic PG. The revised instrument was renamed the Problem Gambling Measure (PGM).

Biomarkers for neurodegeneration impact cognitive function: a longitudinal 1-year case–control study of patients with bipolar disorder and healthy control individuals

BackgroundAbnormalities in cerebrospinal fluid (CSF)-amyloid-beta (Aβ)42, CSF-Aβ40, CSF-Aβ38, CSF-soluble amyloid precursor proteins α and β, CSF-total-tau, CSF-phosphorylated-tau, CSF-neurofilament light protein (NF-L), CSF-neurogranin, plasma-Aβ42, plasma-Aβ40, plasma-total-tau, plasma-NF-L and, serum-S100B during affective episodes may reflect brain changes that could impact cognitive function in patients with bipolar disorder (BD). The study aimed to investigate the association between these biomarkers indicative of Alzheimer’s disease and those reflecting neurodegeneration alongside their impact on cognitive function in patients with BD and healthy control individuals (HC). The primary hypothesis was that GL and VL would increase with increasing levels of CSF-Aβ42 based on data from T0 and T3 in BD and HC jointly.MethodsIn a prospective, longitudinal case–control study euthymic patients with BD (N = 85) and HC (N = 44) were evaluated with clinical assessment and neuropsychological testing at baseline (T0) and during euthymia after a year (T3). Patients’ affective states were recorded weekly as euthymic, subthreshold level, major depression, or (hypo)mania. If an episode occurred during follow-up, the patient was also assessed in post-episode euthymia. Cognitive performance was measured as a global cognitive score (GL) for four cognitive domains including verbal learning and memory (VL).ResultsEstimated in a linear mixed model GL increased with 0.001 for each increase of 1 pg/ml of CSF-Aβ42 (97.5%, CI 0.00043–0.0018, adjusted-p = 0.0005) while VL increased by 0.00089 (97.5%, CI 0.00015–0.0018, adjusted-p = 0.045) in BD and HC jointly. The association was weak, however stronger in patients with BD compared to HC. Associations between other biomarkers including CSF-neurogranin, and cognitive domains were overall weak, and none remained significant after adjustment for multiple testing.LimitationsModest sample size. A complete data set regarding both CSF-AB-42 and cognitive test scores was obtained from merely 61 patients with BD and 38 HC individuals.ConclusionCSF-Aβ42 may be associated with cognitive dysfunction in patients with BD and HC individuals. The association appeared to be stronger in BD but with overlapping confidence intervals. Hence it remains uncertain whether the association is a general phenomenon or driven by BD.

The mediating effect of after-midnight use of digital media devices on the association of internet-related addictive behavior and insomnia in adolescents.

There is evidence that overexposure to digital media devices (DMD) can not only lead to addictive patterns of internet use, but also cause insomnia symptoms. The aim of this cross-sectional study among adolescents is to provide an estimate of the prevalence of sleep impairments and to explore the mediating role of after-midnight use of DMD between internet-related addictive behavior (IRAB) and insomnia. 2,712 school students from Styrian schools participated in a population-representative online survey in a supervised school setting in spring 2022. School students were screened using established and validated scales. Data analysis was carried out using multiple imputation, linear multilevel regression and mediation analysis. Prevalence estimation indicates high proportions of clinically relevant moderate [12.6% (11.3%; 14.1%)] and severe [3.6% (2.9%; 4.4%)] insomnia, with an additional 30.6% (29.0%; 32.2%) at subthreshold level. DMD are typically used after midnight an average of 1.66 (1.58; 1.75) evenings with subsequent school day per school week. Linear multilevel regression analysis shows significant associations for sleep disparities as outcome variable e.g., with generalized anxiety [b = 0.329 (0.287; 0.371)], after-midnight use of DMD [b = 0.470 (0.369; 0.572)] and IRAB [b = 0.131 (0.097; 0.165)]. Mediation analysis shows a mediated proportion of 18.2% (13.0%; 25.0%) of the association of IRAB and insomnia by after-midnight use of DMD [Indirect effect: b = 0.032 (0.023; 0.040), direct effect: b = 0.127 (0.083; 0.170)]. Although the cross-sectional nature of this study limits causal inference, the results indicate a need for policies, which are already in preparation in Styria as part of a respective action plan.

The Effect of Stimulation Intensity, Sampling Frequency, and Sample Synchronization in TMS-EEG on the TMS Pulse Artifact Amplitude and Duration.

Transcranial magnetic stimulation (TMS) coupled with electroencephalography (EEG) possesses diagnostic and therapeutic benefits. However, TMS provokes a large pulse artifact that momentarily obscures the cortical response, presenting a significant challenge for EEG data interpretation. We examined how stimulation intensity (SI), EEG sampling frequency (Fs) and synchronization of stimulation with EEG sampling influence the amplitude and duration of the pulse artifact. In eight healthy subjects, single-pulse TMS was administered to the primary motor cortex, due to its well-documented responsiveness to TMS. We applied two different SIs (90% and 120% of resting motor threshold, representing the commonly used subthreshold and suprathreshold levels) and Fs (conventional 5 kHz and high frequency 20 kHz) both with TMS synchronized with the EEG sampling and the conventional non-synchronized setting. Aside from removal of the DC-offset and epoching, no preprocessing was performed to the data. Using a random forest regression model, we identified that Fs had the largest impact on both the amplitude and duration of the pulse artifact, with median variable importance values of 1.444 and 1.327, respectively, followed by SI (0.964 and 1.083) and sampling synchronization (0.223 and 0.248). This indicated that Fs and SI are crucial for minimizing prediction error and thus play a pivotal role in accurately characterizing the pulse artifact. The results of this study enable focusing some of the study design parameters to minimize TMS pulse artifact, which is essential for both enhancing the reliability of clinical TMS-EEG applications and improving the overall integrity and interpretability of TMS-EEG data.

Effects of the COVID-19 Pandemic on Depressive Symptoms, Including Clinical and Subthreshold Levels, and Eating Behaviors in First-Year University Students

Introduction: During the coronavirus disease 2019 (COVID-19) pandemic, university students experienced unusual environmental stresses, and the number of university students with depressive symptoms increased. The pandemic had a profoundly negative impact on the mental health of first-year students because they were not prepared to face academic and social stresses. The purpose of this study was to investigate the effect of the COVID-19 pandemic on depressive symptoms, eating behaviors, and stress-coping ability among first-year university students. Methods: A total of 8,424 first-year students, 2,043 males and 1,636 females who entered university in Japan in 2021–2022 (during the pandemic) and 2,912 males and 1,833 females who entered university in Japan in 2018–2019 (before the pandemic), participated. We investigated the differences in depressive symptoms (using Beck Depression Inventory II [BDI-II]), eating behaviors (using Eating Attitudes Test-26 [EAT-26] and Bulimic Inventory Test, Edinburgh [BITE]), and stress coping (using Coping Inventory for Stressful Situations [CISS], which has three subscales) between first-year students before and during the pandemic. We divided the students into three categories (clinical, subthreshold, and nonsymptomatic) according to depressive symptoms and eating behaviors based on BDI-ll and EAT-26 scores and compared the frequencies of the three categories at two time points. Results: First-year students during the pandemic showed a higher percentage of depressive symptoms, including clinical and subthreshold levels, than first-year students before the pandemic but did not show disordered eating behaviors. Additionally, the CISS task-oriented score was significantly lower for students with depressive symptoms, including clinical and subthreshold levels, during the pandemic than before the pandemic in females. Conclusions: This study suggests that it may be important to provide first-year university students with more information about depressive symptom awareness, including clinical and subthreshold levels, and to provide appropriate ways for stress coping from many angles and early support in pandemic conditions.

Prospective study of antidepressant treatment of psychiatric patients with depressive disorders: treatment adequacy and outcomes

BackgroundDespite numerous national depression care guidelines (DCGs), suboptimal antidepressant treatment may occur. We examined DCG concordance and depression treatment outcomes in psychiatric settings.MethodsWe evaluated treatment received and outcomes of 128 psychiatric out- and inpatients participating in the PEGAD (Pharmacoepidemiology and Pharmacogenetics of Antidepressant Treatment for Depressive Disorders) study at baseline, two weeks, and eight weeks using interviews and questionnaires. Inclusion criteria were ICD-10 diagnosis of a depressive disorder, a Patient Health Questionnaire-9 symptom (PHQ-9) score ≥ 10, and a new antidepressant prescribed. The primary outcome of the study was within-individual change in PHQ-9 scores.ResultsAt baseline, patients had predominately recurrent (83%) and in 19% treatment-resistant depression (TRD). The median preceding duration of the current episode was 6.5 months. At eight weeks, 85% of the patients (n = 107) used a DCG-concordant antidepressant dose. However, due to the scarcity of antidepressant combinations and augmentations, fewer TRD than non-TRD patients (25% vs. 84%, p < 0.005) received adequate antidepressant treatment. Additionally, one-third of the patients received inadequate follow-up. Overall, only 53% received treatment compatible with DCG recommendations for adequate pharmacotherapy and follow-up. The mean decline in PHQ-9 scores (-3.8 ± SD 5.7) was significant (p < 0.0005). Nearly 40% of the patients reached a subthreshold level of depression (PHQ-9 < 10), predicted by a lower baseline PHQ-9 score, recurrent depression, and female sex. However, 45% experienced no significant clinical improvement (PHQ-9 score reduction < 20%).ConclusionsOur findings suggest that inadequate treatment continues to occur in psychiatric care settings, particularly for TRD patients.

Better renewable with economic growth without carbon growth: A comparative study of impact of turbine, photovoltaics, and hydropower on economy and carbon emission

The pursuit of sustainable development has become a prevalent goal in numerous countries. Therefore, renewable energy development is deemed the prime alternative, as it not only curtails CO2 emissions but also stimulates economic prosperity. Hence, there is a need to investigate rational options for renewable energy development. This paper utilises a research framework that combines linear and non-linear modelling. The specific results are as follows. The study's findings reveal that wind, solar and hydro energy can each promote economic growth and lower carbon emissions. Nevertheless, wind energy exhibits the most effective reduction in emissions, followed by solar energy, and lastly, hydro energy. When it comes to promoting economic development, hydro energy proves to be the most effective, followed by wind energy and then solar energy. Additionally, a panel threshold model is utilised to assess further the CO2 reduction for solar, wind, and hydro energy across a range of economic levels. The results indicate a double threshold effect for wind energy, whereby the effectiveness of CO2 suppression initially increases and then decreases as the economic level rises. In contrast, the use of solar power displays a sole threshold effect that incentivizes CO2 emissions at sub-threshold economic levels, yet significantly curbs them beyond it. Similarly, hydro energy also demonstrates a single threshold effect, but lacks statistical significance below the established threshold and actually heightens carbon emissions above it. Our observations can assist in creating sustainable renewable energy development strategies.

Compulsive digital use among school-age children and association with escapism and feeling of loneliness: A call for action

PurposeThis study aimed to investigate the relationship between Compulsive Digital Use (CDU), escapism, and loneliness among school-age children. Design and methodsA quantitative, non-experimental, descriptive correlational study was conducted at 16 governmental preparatory schools affiliated with the Ministry of Education in Alexandria, Egypt. A simple random sampling of 300 school-age children participated in the study after obtaining the informed consent from the parents/guardians and assent from children. ResultsThe main study findings showed that 74% of school-age children had a subthreshold level of CDU, and 21.7% demonstrated a pathological/ addictive level. Compulsive digital use showed a significant positive correlation with both total escapism and loneliness scores (r = 0.689, p < 0.001 and r = 0.329, p = 0.005, respectively). ConclusionChildren spend more than the recommended daily duration online. They reported having sleeping problems, especially insomnia, and poor academic achievement due to internet overuse. Most children had subthreshold level of CDU and one-quarter of them reached the addictive level. They reported that internet use helped them escape from the world of reality, unpleasant and worrisome things, as well as problems and pressures. Children reported loneliness and felt that people were around but not with them. Female gender and the employment of both parents were significantly associated with developing CDU. Escapism and loneliness among children were positively correlated with CDU. Practical implicationsAwareness-raising campaigns regarding internet usage should be launched for school-age children and their parents to address its emerging psychosocial risks and challenges.