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It has been suggested that schizophrenia involves dysconnectivity between functional brain regions and also the white matter structural disorganisation. Thus, diffusion tensor imaging (DTI) has widely been used for studying schizophrenia. However, most previous studies have used the region of interest (ROI) based approach. We, therefore, performed the probabilistic tractography method in this study to reveal the alterations of white matter tracts in the schizophrenia brain.
Methods:
A total of four different datasets consisted of 189 patients with schizophrenia and 213 healthy controls were investigated. We performed retrospective harmonisation of raw diffusion MRI data by dMRIharmonisation and used the FMRIB Software Library (FSL) for probabilistic tractography. The connectivities between different ROIs were then compared between patients and controls. Furthermore, we evaluated the relationship between the connection probabilities and the symptoms and cognitive measures in patients with schizophrenia.
Results:
After applying Bonferroni correction for multiple comparisons, 11 different tracts showed significant differences between patients with schizophrenia and healthy controls. Many of these tracts were associated with the basal ganglia or cortico-striatal structures, which aligns with the current literature highlighting striatal dysfunction. Moreover, we found that these tracts demonstrated statistically significant relationships with few cognitive measures related to language, executive function, or processing speed.
Conclusion:
We performed probabilistic tractography using a large, harmonised dataset of diffusion MRI data, which enhanced the statistical power of our study. It is important to note that most of the tracts identified in this study, particularly callosal and cortico-striatal streamlines, have been previously implicated in schizophrenia within the current literature. Further research with harmonised data focusing specifically on these brain regions could be recommended.
Fe-rich smectite is ubiquitous in soil environments and closely linked to the fate and mobility of hazardous trace metals and particularly to the variations in the biogeochemical redox reactions of structural Fe that determine the sorption and desorption properties of clay minerals. The biotic/abiotic redox reactions of a Fe-rich smectite, nontronite (NAu-1), were performed at various reaction times using the Fe-reducing bacterium Shewanella oneidensis MR-1 at 30°C and Na-dithionite (Na2S2O4), respectively. The extent of biotic Fe-reduction of NAu-1 after 30 days of incubation reached up to 10.7% of total Fe and the range of abiotic Fe-reduction varied from 4.9–46.6% at reaction times of 5 min, 30 min, 1 h, and 4 h. The biotically and abiotically Fe-reduced NAu-1 samples were spiked with Pb concentrations of 0.07, 0.2, 0.5, and 1.0 mg/kg and incubated under aerobic or anaerobic conditions for 24 h.
The amounts of Pb in the supernatants were analyzed using an Inductively Coupled Plasma Mass Spectrometer (ICP-MS) and Multi-collector (MC)-ICP-MS. The amounts of Pb removed from the supernatants were negatively related to the extent of Fe(III) reduction in the abiotically Fe-reduced NAu-1 samples. In contrast, less Pb (~15%) was removed from the biotically Fe-reduced NAu-1 samples with a similar extent of Fe(III) reduction. Changes in the isotopic 208/204Pb ratio indicated that the lighter 204Pb isotope was preferentially adsorbed to the NAu-1 samples with less Fe reduction and indicated that variations in the net layer charge affected isotopic fractionation. Significant differences in the 208/204Pb ratios for NAu-1 samples that were biotically Fe-reduced under anaerobic conditions were measured and indicate that the reversibility of the structural/chemical modifications that occur under redox conditions can affect Pb removal and, thus, isotope fractionation. These results collectively infer that the biogeochemical properties of clay minerals should be considered in order to understand the fate of trace metals in natural environments.
Although disconnectivity among brain regions has been one of the main hypotheses for schizophrenia, the superficial white matter (SWM) has received less attention in schizophrenia research than the deep white matter (DWM) owing to the challenge of consistent reconstruction across subjects.
Methods:
We obtained the diffusion magnetic resonance imaging (dMRI) data of 223 healthy controls and 143 patients with schizophrenia. After harmonising the raw dMRIs from three different studies, we performed whole-brain two-tensor tractography and fibre clustering on the tractography data. We compared the fractional anisotropy (FA) of white matter tracts between healthy controls and patients with schizophrenia. Spearman’s rho was adopted for the associations with clinical symptoms measured by the Positive and Negative Syndrome Scale (PANSS). The Bonferroni correction was used to adjust multiple testing.
Results:
Among the 33 DWM and 8 SWM tracts, patients with schizophrenia had a lower FA in 14 DWM and 4 SWM tracts than healthy controls, with small effect sizes. In the patient group, the FA deviations of the corticospinal and superficial–occipital tracts were negatively correlated with the PANSS negative score; however, this correlation was not evident after adjusting for multiple testing.
Conclusion:
We observed the structural impairments of both the DWM and SWM tracts in patients with schizophrenia. The SWM could be a potential target of interest in future research on neural biomarkers for schizophrenia.
Birds in flight are prone to collide with various transparent or reflective structures. While bird–window collision has been recognised as a critical conservation issue, collision with other transparent structures has been less understood. Noise barriers made of transparent materials are considered critical hazards for birds; however, little is known about the bird mortality they cause. We conducted the first nationwide-scale estimates of bird-collision mortality caused by transparent noise barriers (TNBs) along roads in the Republic of Korea. The total length of existing roadside transparent noise barriers was estimated at 1,416 km nationwide (as of 2018), and it had been increasing exponentially. Based on carcass surveys at 25 sites, daily mortality at the observed barriers was 0.335 ± 1.132 birds/km on average, and no difference in observed mortality was detected between both sides of a single barrier and between road types (i.e. local roads and motorways). Finally, we estimated that approximately 186,000 birds (95% confidence interval: 162,465–204,812 birds) are killed annually by collisions with roadside TNBs. As privately installed barriers were not considered in this study, the actual mortality is likely be higher than our estimates. Thus, collision with TNBs could become an emerging threat to avian conservation, especially in developing and urbanising regions around the world. As such structures are not formally recognised as conservation issues of importance, more systematic surveys aided by citizen science, both for the status of TNBs and bird-collision mortality, are needed in addition to management and mitigation policies.
We compared the pregnancy and live birth rates following transfer of early-stage embryos or blastocysts produced by somatic cell nuclear transfer using in vitro-matured oocytes. In total 102 ovaries were collected from dromedary camels at a local abattoir; from these 1048 cumulus–oocytes complexes (COCs) were aspirated and cultured for 42 h in a commercial maturation medium. Metaphase II oocytes were subjected to nuclear transfer. Somatic cell nuclear transfer-derived embryos were cultured in a commercial embryo medium for 2 or 7 days. Next, 71 early-stage embryos were surgically transferred to the left fallopian tube of 28 recipients and 47 blastocysts were transferred to the left uterine horn of 26 recipients. Early pregnancy was detected by serum progesterone (P4), and pregnancy was confirmed using ultrasonography on days 30 and 90 after embryo transfer. Pregnancy rate based on P4 level was 17.86% (5/28) and 11.54% (3/26) for early-stage embryo and blastocyst transfer, respectively. In the early-stage embryo group, out of five recipients, one recipient had lost the pregnancy by the first ultrasonography on day 30; two other recipients aborted at 14 and 24 weeks, and two recipients gave live births. In the blastocyst group, out of three recipients, one lost the pregnancy at an early stage and two recipients gave live births. Therefore, for dromedary camels, we recommend transvaginal blastocyst transfer from the standpoint of the pregnancy and live birth rate, ease of the transfer procedure, and comfort and safety of the recipients.
Clozapine is generally considered as the treatment of choice for patients with treatment-resistant schizophrenia (TRS). However, its superiority has recently been questioned because olanzapine has been suggested as non-inferior to clozapine in its effectiveness.
Aims
We aimed to investigate the current status of clozapine prescriptions to identify any disparity between clinical guidelines and real-world practices.
Method
In this study, we utilised the Health Insurance Review Agency database in the Republic of Korea to investigate the real-world effectiveness of clozapine for patients with TRS. We compared differences in patient variables before and after clozapine administration, and we also performed survival analyses for both psychiatric admissions and emergency room visits among patients who used clozapine or olanzapine.
Results
This study investigated an incident cohort of 64 442 patients, and 2338 patients have been prescribed clozapine. Of these, 998 patients had TRS. In survival analysis, clozapine showed a worse survival rate for psychiatric admissions than olanzapine (hazard ratio 0.615). We also identified that clinicians tended to try a number of antipsychotics, as recommended, before starting patients on clozapine.
Conclusions
In conclusion, we found that olanzapine led to higher survival rates for psychiatric admissions than clozapine. Thus, considering the risk of serious adverse effects, clozapine may be used conservatively. Considering several studies advocating superior efficacy of clozapine, further studies with extensive data are recommended.
Current evidence on antipsychotic treatment and risk of psychiatric hospitalization in first-episode schizophrenia (FES) is largely based on the findings from randomized clinical trials (RCTs). However, the generalization of the findings to real-world patients is limited due to inherent caveats of the RCT. We aimed to investigate the treatment discontinuation and risk of psychiatric hospitalization using a nationwide population database.
Methods
The Health Insurance Review Agency database in South Korea was obtained, and the observation period started from 1 January 2009 to 31 December 2016. We defined the maintenance period as the period from 6-month after the diagnosis of schizophrenia, which is utilized for the main results. For a total of 44 396 patients with FES, a within-individual Cox regression model was used to compare the risk of the treatment discontinuation and psychiatric hospitalization.
Results
In group comparison, a long-acting injectable (LAI) antipsychotic group was associated with the lowest risk of the treatment discontinuation (0.64, 0.55–0.75) and psychiatric hospitalization (0.29, 0.22–0.38) in comparison with a typical antipsychotic group and no use, respectively. Among individual antipsychotics, the lowest risk of the treatment discontinuation was observed in LAI paliperidone (0.46, 0.37–0.66) compared to olanzapine. Clozapine was found to be the most effective antipsychotic in lowering the risk of psychiatric hospitalization as monotherapy compared to no use (0.23, 0.18–0.31).
Conclusions
In real-world patients with FES, LAI paliperidone and clozapine were associated with low treatment discontinuation and better effectiveness in lowering the risk of psychiatric hospitalization.
The efficiency of halide perovskite solar cells has progressed rapidly through a series of major breakthroughs. Currently, a certified efficiency of 25.2% has been achieved for a solar cell using a polycrystalline thin film. This is the result of having reached 75% of the Shockley–Queisser limit for single-junction solar cells. However, for further improvements, new breakthrough technologies are required. This article reviews the impact of previous breakthrough technologies on the efficiency of halide perovskite solar cells, based on certified efficiencies. We clarify the current status of halide perovskite solar cells and introduce photon recycling as the next technological innovation for higher efficiencies. Photon recycling keeps the photon concentration inside the light-harvesting layer high, and consequently, leads to open-circuit voltages close to the theoretical value. Although photon recycling has not yet been implemented in real halide perovskite solar cells, three key technologies for implementing it are examined.
Objectives: Rotator cuff tear is the leading cause of the decline in quality of life for older adults, but comparative evidence on treatment effectiveness is lacking. This study systematically reviewed the effects of various rotator cuff tear treatments through a Bayesian meta-analysis of the related randomized clinical trials (RCTs).
Methods: We searched nine electronic databases for RCTs evaluating rotator cuff tear treatments from their inception through June 2017. A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the National Institute for Health and Care Excellence-Decision Support Unit guidelines (Supplementary Table 1). Outcomes included functional improvement, pain one year after surgical treatment, and tendon structural integrity. The Bayesian network meta-analysis was applied for functional improvement and pain, based on an assumption of consistency and similarity. Tendon integrity was reported descriptively.
Results: Fifteen RCTs were selected. Patients undergoing physiotherapy after open surgery showed statistically significant functional improvements compared with those undergoing physiotherapy only (mean differences, 9.1 [credible interval, 0.9–17.4]). Open surgery with physiotherapy was associated with a decrease in pain 1 year after treatment compared with when physiotherapy was combined with arthroscopic rotator cuff surgery, mini open surgery, platelet-rich plasma therapy, or physiotherapy alone (absolute value of mean difference 1.2 to 1.4). The tendon integrity results were inconsistent.
Conclusions: Some surgical treatments were associated with significant improvement in function and pain, but evidence regarding their comparative effectiveness is still lacking. A well-designed RCT discussing functional and structural treatment outcomes is needed in future.
It has not been well established whether dietary folate intake reduces the risk of diabetes development. We aimed to clarify the prospective association between dietary folate intake and type 2 diabetes (T2D) risk among 7333 Korean adults aged 40 years or older who were included in the Multi-Rural Communities Cohort. Dietary folate intake was estimated from all 106 food items listed on a FFQ, not including folate intake from supplements. Two different measurements of dietary folate intake were used: the baseline consumption and the average consumption from baseline until just before the end of follow-up. The association between folate intake and T2D risk was determined through a modified Poisson regression model with a robust error estimator controlling for potential confounders. For 29 745 person years, 319 cases of diabetes were ascertained. In multivariable analyses, dietary folate intake was inversely associated with risk of T2D for women, not for men. For women, the incidence rate ratio of diabetes in the third tertile compared with the first tertile was 0·57 (95 % CI 0·38–0·87, Pfor trend=0·0085) in the baseline consumption model and 0·64 (95 % CI 0·43–0·95, Pfor trend=0·0244) in the average consumption model. These inverse associations was found in both normal fasting blood glucose group and impaired fasting glucose group among women. Among non-users of multinutrients and vitamin supplements, the significant inverse association remained. Thus, higher dietary intake of folate is prospectively associated with lower risk of diabetes for women.
The aim of this study is to develop predictive models to predict organ at risk (OAR) complication level, classification of OAR dose-volume and combination of this function with our in-house developed treatment decision support system.
Materials and methods
We analysed the support vector machine and decision tree algorithm for predicting OAR complication level and toxicity in order to integrate this function into our in-house radiation treatment planning decision support system. A total of 12 TomoTherapyTM treatment plans for prostate cancer were established, and a hundred modelled plans were generated to analyse the toxicity prediction for bladder and rectum.
Results
The toxicity prediction algorithm analysis showed 91·0% accuracy in the training process. A scatter plot for bladder and rectum was obtained by 100 modelled plans and classification result derived. OAR complication level was analysed and risk factor for 25% bladder and 50% rectum was detected by decision tree. Therefore, it was shown that complication prediction of patients using big data-based clinical information is possible.
Conclusion
We verified the accuracy of the tested algorithm using prostate cancer cases. Side effects can be minimised by applying this predictive modelling algorithm with the planning decision support system for patient-specific radiotherapy planning.
Confucianism has been considered mainly to have had a negative influence on capitalistic development since Max Weber's theory on non-Western societies became widespread. However, in this article, we champion the positive role of Confucianism and attempt to explain Confucianism as providing fundamental “significance” to social development by imbuing it with religious significance. We present the self-sacrificing work ethic and zeal for education that characterizes Confucianism as having become the foundation for Korea's economic growth. In particular, we examine the religious significance inherent in the Confucian value of “filial piety” and illustrate how the value came to be a powerful economic motivator during the process of industrialization. The religious tendency of filial piety, which attempts to “remember” and “represent” one's ancestors, acted as an important spiritual ethos in Korea's social development centered on economic growth. Filial piety did not stop at being an ethical standard; it was the fundamental basis for macrosocial dynamism that was closely linked to the development of capitalism in Korea.
The aim of this study is to examine a relationship between a change in social activity and depression among Koreans aged 45 years or more.
Methods:
Data came from the Korean Longitudinal Study of Aging (KLoSA) (2006–2010), with 5,327 participants aged 45 years or more. The generalized estimating equation (GEE) with the logit link was used to investigate an association between a change in social activity during 2006–2008 (or 2008–2010) and depression among respondents in year 2008 (or Y2010). Depression was measured by Center for Epidemiological Studies Depression scale (CES-D10) and a change in social activity was classified with four categories, i.e. “consistent participation”, “consistent non-participation”, “participation to non-participation”, and “non-participation to participation”. Social activity was divided into various elements and the same analysis was conducted for each of these elements.
Results:
Those with consistent non-participation and from participation to non-participation were more likely to be depressed than those with consistent participation and from non-participation to participation in social activities (OR 1.44 [95% CI 1.22–1.71], OR 1.35 [95% CI 1.15–1.58] vs. OR 1.00 [Reference], OR 1.27 [95% CI 1.09–1.48]). In addition, the strength of the negative association between consistent or new participation in social activity and depression was different across different elements of social activity. The negative association was particularly strong for leisure, culture or sports clubs, and for family or school reunion.
Conclusion:
For improving the mental health of the population aged 45 years or more, the promotion of their continued or new participations in leisure/culture clubs and family/school reunion might be needed in South Korea.
A 44-year-old man developed sudden non-fluent aphasia and right hemiplegia due to left striatocapsular infarction (Figure). Neurologic examination revealed gaze deviation to the right with eyes closed, but not with eyes open (Video). There was no spontaneous or gaze-evoked nystagmus, even after elimination of visual fixation. Leftward pursuit was impaired in a craniotopic frame of reference, and horizontal saccades were hypometric in both directions. Head impulse test was normal in the horizontal plane and there were no visual field defects. The contralesional gaze deviation with eye closure persisted for ten days.
This study aimed to investigate the influences of age, education, and gender on the two total scores (TS-I and TS-II) of the Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological assessment battery (CERAD-NP) and to provide normative information based on an analysis for a large number of elderly persons with a wide range of educational levels.
Methods:
In the study, 1,987 community-dwelling healthy volunteers (620 males and 1,367 females; 50–90 years of age; and zero to 25 years of education) were included. People with serious neurological, medical, and psychiatric disorders (including dementia) were excluded. All participants underwent the CERAD-NP assessment. TS-I was generated by summing raw scores from the CERAD-NP subtests, excluding Mini-Mental State Examination and Constructional Praxis (CP) recall subtests. TS-II was calculated by adding CP recall score to TS-I.
Results:
Both TS-I and TS-II were significantly influenced by demographic variables. Education accounted for the greatest proportion of score variance. Interaction effect between age and gender was found. Based on the results obtained, normative data of the CERAD-NP total scores were stratified by age (six overlapping tables), education (four strata), and gender.
Conclusions:
The normative information will be very useful for better interpretation of the CERAD-NP total scores in various clinical and research settings and for comparing individuals’ performance of the battery across countries.
We demonstrate that the size and crystallinity of grains in individual ZnO nanofibers greatly influence their sensing properties for CO. The sensing properties, including sensitivity, response and recovery times of a sensor fabricated with ZnO nanofibers composed of large grains are much superior to those of a sensor fabricated with nanofibers of small grains. The crystallinity, improved by the longer calcination time, is likely to be responsible for the higher sensitivity in the large-grained nanofibers. The facilitated occupancy and desorption of CO molecules at grain boundaries in the large-grained nanofibers are the most probable causes of the shorter response and recovery times in detecting CO, respectively. This work suggests not only that electrospinning-synthesized ZnO nanofibers hold promise for realizing sensitive and reliable gas sensors but also that the size as well as the crystallinity of the grains existing in individual nanofibers need to be optimized to obtain the best sensing properties.
Background: Low education and illiteracy are associated with an increased risk of dementia. This study aimed to develop a neuropsychological test battery applicable to both illiterate and literate elderly and to assess its reliability and validity for a diagnosis of dementia.
Methods: We developed the Literacy Independent Cognitive Assessment (LICA), which consists of 13 subtests assessing memory, language, visuoconstruction, executive function, attention and calculation. We investigated its reliability and validity on 152 patients with dementia, 66 with mild cognitive impairment and 639 normal controls.
Results: The subtests were found to be applicable to most of the illiterate normal controls (97.3%) and were found to have high inter-rater reliabilities (r = 0.85–1.00, p < 0.001) and moderate to high test-retest reliabilities (r = 0.50–0.86, p < 0.001). The LICA performed well in discriminating participants across Clinical Dementia Rating stages and showed excellent internal consistency and good concurrent validity with the Korean Mini-mental State Examination in both literate and illiterate participants. The area under the curve of the receiver operating characteristic was 0.985 in each of the two literacy groups. Sensitivity and specificity of the LICA to make a diagnosis of dementia was 91.9% and 91.8% at the cutoff point of 186.0 in the literate subjects and 96.2% and 91.1% at the cutoff point of 154.5 in the illiterate subjects. The battery was factored into two separate factors consisting of verbal memory tests and tests for other cognitive domains.
Conclusion: The LICA is a valid and reliable instrument for a diagnosis of dementia in both illiterate and literate elderly.
This study aimed to investigate whether aquaporin 3 (Aqp3) mRNAs are expressed in immature oocytes and altered during in vitro maturation process. Five- to 6-week-old female ICR mice were primed by gonadotropin for 24 and 48 h. Immature oocytes obtained 48 h after priming were also matured in vitro for 17 to 18 h. In vivo matured oocytes were obtained after 48 h priming followed by hCG injection. Total RNAs were extracted from 80 to 150 oocytes in each experimental group, and the levels of Aqp3 mRNA were quantified by real-time reverse transcriptase polymerase chain reaction. The experiments were repeated twice using different oocytes. The Aqp3 mRNA was expressed in immature oocytes, as well as in in vitro and in vivo matured oocytes. The expression level was higher in immature oocytes obtained 48 h after priming (17.2 ± 8.6, mean ± SD) than those with no priming (5.7 ± 0.8) or obtained 24 h after priming (2.5 ± 0.8). The expression of Aqp3 mRNA decreased after in vitro maturation (1.2 ± 0.5), which was similar to in vivo matured oocytes (1.0 ± 0.0). Our work demonstrated that Aqp3 mRNA expression increased during the development of immature oocyte but decreased after completion of in vitro maturation. The results indicate that AQP3 is certainly needed for the acquisition of immature oocytes’ full growing potential within antral follicles.
A novel route to organic-inorganic composites was described based on biomineralization of poly(ethylene glycol) (PEG)-based hydrogels. The 3-dimensional hydrogels were synthesized by radical crosslinking polymerization of poly(ethylene glycol fumarate) (PEGF) in the presence of ethylene glycol methacrylate phosphate (EGMP) as an apatite-nuclating monomer, acrylamide (AAm) as a composition-modulating comonomer, and potassium persulfate (PPS) as a radical initiator. We used the urea-mediated solution precipitation technique for biomineralization of hydrogels. The apatite grown on the surface and interior of the hydrogel was similar to biological apatites in the composition and crystalline structure. Powder x-ray diffraction (XRD) showed that the calcium phosphate crystalline platelets on hydrogels are preferentially aligned along the crystallographic c-axis direction. Inductively-coupled plasma mass spectroscopy (ICP-MS) analysis showed that the Ca/P molar ratio of apatites grown on the hydrogel template was found to be 1.60, which is identical to that of natural bones. In vitro cell experiments showed that the cell adhesion/proliferation on the mineralized hydrogel was more pronounced than on the pure polymer hydrogel.