Sex differences in the factors that affect medical lethality in elderly suicide attempters

ObjectivesThis study aimed to identify sex differences in the factors that affect medical lethality in elderly suicide attempters.MethodsA total of 253 elderly suicide attempters and 351 middle-aged attempters (comparison group) who visited the emergency room at a general hospital were included. The sociodemographic and clinical characteristics of the patients were investigated. The Chi-squared test and logistic regression analysis were performed. And Spearman’s correlation coefficient was calculated.ResultsIn older males, the risk of high lethality was lower when attempting suicide due to the loss of family members [adjusted odds ratio (AOR): 0.08]. The risk increased as the intent to die became more certain (some AOR: 11.31, certain AOR: 28.75), and this association became more pronounced with age (rho middle-aged: 0.329; young-old: 0.387; old-old: 0.415). In older females, the risk was lower when employed (AOR: 0.28). The method of suicide attempt also affected lethality (agricultural chemicals AOR: 3.71; psychiatric medication AOR: 0.31).ConclusionSex differences in the factors that affect medical lethality were identified among elderly suicide attempters. In particular, medical lethality can be predicted by the degree of suicide intention in older males. These findings will help to establish more efficient preventive strategies with specific targets

Extending a structural model of somatization to South Koreans: Cultural values, somatization tendency, and the presentation of depressive symptoms

Background: Somatization refers to the tendency to emphasize somatic symptoms when experiencing a psychiatric disturbance. This tendency has been widely reported in patients from East Asian cultural contexts suffering from depression. Recent research in two Chinese samples have demonstrated that the local cultural script for depression, involving two aspects—the experience and expression of distress (EED) and conceptualization and communication of distress (CCD)—can be evoked to help explain somatization. Given the beliefs and practices broadly shared across Chinese and South Korean cultural contexts, the current study seeks to replicate this explanatory model in South Koreans. Methods: Our sample included 209 psychiatric outpatients from Seoul and Wonju, South Korea. Self-report questionnaires were used to assess somatization tendency, adherence to traditional values, and psychological and somatic symptoms of depression. Results: Results from SEM showed that the EED and CCD factors of somatization tendency were differently associated with cultural values and somatic symptoms, replicating our previous findings in Chinese outpatients. Limitations: The reliance on a brief self-report measure of somatization tendency, not originally designed to assess separate EED and CCD factors, highlights the need for measurement tools for the assessment of cultural scripts in cross-cultural depression research. Conclusions: The replication of the Chinese structural model of somatization in South Korealends empirical support to the view that somatization can be understood as the consequence of specific cultural scripts. These scripts involve the experience and expression of distress as well as culturally meaningful ways in which this distress is conceptualized and communicated to other

Alcohol Dependence, Mortality, and Chronic Health Conditions in a Rural Population in Korea

To determine the effects of excessive drinking and alcohol dependency on mortality and chronic health problems in a rural community in South Korea, this study represents a nested case-control study. In 1998, we conducted the Alcohol Dependence Survey (ADS), a population survey of a village in Korea. To measure the effects of alcohol on chronic health conditions and mortality over time, in 2004, we identified 290 adults from the ADS sample (N=1,058) for follow-up. Of those selected, 145 were adults who had alcohol problems, either alcohol dependence as assessed in the ADS by the Severity of Alcohol Dependence Questionnaire (N=59), or excessive drinking without dependency (N=86). Further 145 nondrinkers were identified, matching those with alcohol problems in age and sex. We revisited the village in 2004 and completed personal interviews with them. In multivariate logistic regressions, the rates of mortality and morbidity of chronic health conditions were three times greater for alcohol dependents compared with the rate for nondrinkers. Importantly, however, excessive drinking without dependency was not associated with the rates of either mortality or morbidity. Future investigations would benefit by attending more specifically to measures for alcohol dependence as well as measures for alcohol consumption

The Inner-Shelf Dynamics Experiment

17 USC 105 interim-entered record; under review.The article of record as published may be found at http://dx.doi.org/10.1175/BAMS-D-19-0281.1The inner shelf, the transition zone between the surfzone and the midshelf, is a dynamically complex region with the evolution of circulation and stratification driven by multiple physical processes. Cross-shelf exchange through the inner shelf has important implications for coastal water quality, ecological connectivity, and lateral movement of sediment and heat. The Inner-Shelf Dynamics Experiment (ISDE) was an intensive, coordinated, multi-institution field experiment from September–October 2017, conducted from the midshelf, through the inner shelf, and into the surfzone near Point Sal, California. Satellite, airborne, shore- and ship-based remote sensing, in-water moorings and ship-based sampling, and numerical ocean circulation models forced by winds, waves, and tides were used to investigate the dynamics governing the circulation and transport in the inner shelf and the role of coastline variability on regional circulation dynamics. Here, the following physical processes are highlighted: internal wave dynamics from the midshelf to the inner shelf; flow separation and eddy shedding off Point Sal; offshore ejection of surfzone waters from rip currents; and wind-driven subtidal circulation dynamics. The extensive dataset from ISDE allows for unprecedented investigations into the role of physical processes in creating spatial heterogeneity, and nonlinear interactions between various inner-shelf physical processes. Overall, the highly spatially and temporally resolved oceanographic measurements and numerical simulations of ISDE provide a central framework for studies exploring this complex and fascinating region of the ocean.U.S. Office of Naval Research (ONR)ONR Departmental Research Initiative (DRI)Inner-Shelf Dynamics Experiment (ISDE

Wave energy resource characterization and classification for the United States & numerical simulation of coastal circulation near Point Sal, California

This thesis contains two different topics: 1) Wave energy resource assessments, characterizations, and classifications for US coastal waters, 2) Numerical studies for three-dimensional circulation during coastal upwelling favorable winds on the inner shelf near Point Sal, California. Ocean waves are a largely abundant and untapped renewable source of energy with limited environmental impact and high energy density. Although ocean waves have significant energy potential, the technology is in early stages of development due to high costs from lower conversion efficiencies as well as risks to operations, maintenance and survival. This study characterizes and classifies the wave energy resource by performing a comprehensive resource assessment of the wave energy for the US. The work for this portion includes three parts. The first part focuses on describing the wave energy resource parameters or metrics for characterization, e.g., wave energy potential, dominant frequency, directional and temporal variability. Partitioned wave parameters generated from a 30-year WaveWatch III model hindcast are used to estimate the total wave energy potential as an annual available energy (AAE), which is a theoretical annual energy production per unit energy capture length without considering energy conversion efficiencies. The distribution of AAE by peak period, wave direction, month, and year are important attributes of the wave energy resource that can be quantified using simple summary metrics (indices), including spectral width, energy-weighted period, directionality coefficient, and direction of maximum directionally resolved AAE. These metrics are used to characterize long-term AAE trends, including inter-annual and seasonal variability. These temporal attributes of the wave energy resource can be parameterized by simple indices as measures of the variability, or constancy, of the resource, which can affect the capacity factor and annual energy production of a wave energy generation project. Geographical distributions of the AAE and these seven resource parameters delineate distinct wave climates and wave energy resource regions within US coastal waters, which supports regional energy planning and project development. The second part uses these parameters to delineate and describe eleven distinct US wave climates or wave energy resource regions based on the key attributes of the resource, wave energy potential, resource attributes, assessed from the part 1. In order to gain a high-level wave resource characteristics, marginal and joint energy distributions of the wave energy in terms of the peak period, wave direction and month, and corresponding resource parameters are provided. The frequency dependence, directional and temporal variability of the conditional wave energy resources at each region is characterized, e.g., the spectral width of the wave energy from a particular direction or month, directionality coefficient of the wave energy within a particular frequency or month. These assessments and characteristics of the conditional wave energy resources can contribute to WEC industries by providing the resource quality of all wave systems and recommending target wave systems for energy generation at each region. Detailed characteristics of energetic wave systems contributing to the total energy at each region are identified and described by linking global and local wind climates. Finally, representative characteristics of the wave energy resources for the eleven regions are summarized. In the third part, wave energy resource classification systems for the US is developed based on wave power and its distribution with peak period. Energy resource classification systems are useful assessment tools that support energy planning and project development, e.g., siting and feasibility studies. They typically establish standard classes of power, a measure of the opportunity for energy resource capture. As the operating resonant period bandwidth of a wave energy converter (WEC) technology is an important design characteristic, the dominant period band containing the largest energy content is identified among three peak period band classes. The classification systems, comprised of four power classes and three peak period band classes, are based on the total wave power or the partitioned wave power in the dominant peak period band. This work establishes a framework for investigating the feasibility of a compatible wave climate (design load) conditions and WEC technology classification system to reduce design and manufacturing costs. The circulation during coastal upwelling events near Pt. Sal, a 5km headland in southern California, is considered complex not only due to the complex bathymetry and coastline but a confluence of distinct alongshore currents, e.g., California Undercurrent, coastal jets, and upwelling plumes. The wind stresses and alongshore currents drive geostrophic flows and Ekman transports simultaneously and alongshore variabilities of coastline orientations and a promontory complicate the circulation by creating pressure gradients at the coast. In order to understand the coastal circulations around Pt. Sal, a numerical model, Regional Ocean Modeling System (ROMS) is used for simulations during upwelling favorable wind periods, June-July 2015 and July-September 2017. The coastal upwelling events on 15 July 2015 and 22 July 2017 are identified and three-dimensional particle trajectories are calculated to analyze the circulation pattern on these periods. As a result, characteristics of the coastal circulations, circulation boundary, upwelling front, convergence/divergence, and stratifications, are described. Basic driving forces influencing the circulation during the detected periods, e.g., alongshore/cross-shore wind stresses, California Undercurrent, coastal jet, upwelling plumes, and bathymetry are discussed. The circulation pattern is diagnosed by linking the forcing mechanisms with three-dimensional momentum balances at different locations. Finally, the dominant forcing mechanisms acting on the different regions are identified and two coastal upwelling circulations are compared.Ph.D

A Noise-Shaped Signaling Method for Vehicle-to-Everything Security

This paper presents a method to improve the Vehicle-to-Everything (V2X) security. With the recent rapid development of communication technology and traffic applications, V2X is recently commercialized and has been growing as a fundamental system for future applications. Because of the high mobility of the vehicles, V2X requires a low latency and high-reliability. However, previous security methods demand a large computational burden and generate high latency owing to complex operations and long additional data bits for ensuing security. To resolve such constraints, an advanced security method ensuring lower latency and higher reliability is required. We propose a noise-shaped signaling method that provides high-level security with low latency for reliable V2X communication. The proposed method encrypts original data symbols to noise-like symbols by applying a noise envelope that consists of Chaotic Random Magnitude Sequence (CRMS) and Chaotic Random Phase Sequences (CRPS). Our method simplifies the sequence sharing process between a sender and an intended receiver by adapting the characteristics of a chaotic dynamic system. Moreover, the proposed method does not demand additional data bits and generate delay because the method only uses simple multiplication and division procedure for data encryption in the physical layer. We analyze our method in depth using extensive simulations and various viewpoints such as error rate, probability of modulation identification. From the simulations, we demonstrate that a malicious adversary cannot comprehend the transmitted symbols and always has the maximum error rate under various network environments and conditions. We also demonstrate how the adversary cannot infer the modulation scheme from the symbols applying the proposed method. After these analyses, we confirm that the noise-shaped signaling method is high-level of secure method with a low latency for V2X communication

Wireless Torque and Power Transfer Using Multiple Coils with LCC-S Topology for Implantable Medical Drug Pump

In this paper, we propose a method of wirelessly torque transfer (WTT) and power (WPT) to a drug pump, one of implantable medical devices. By using the magnetic field generated by the WPT system to transfer torque and power to the receiving coil at the same time, applications that previously used power from the battery can be operated without a battery. The proposed method uses a receiving coil with magnetic material as a motor, and can generate torque in a desired direction using the magnetic field from the transmitting coil. The WPT system was analyzed using a topology that generates a constant current for stable torque generation. In addition, a method for detecting the position of the receiving coil without using additional power was proposed. Through simulations and experiments, it was confirmed that WTT and WPT were possible at the same time, and in particular, it was confirmed that WTT was stably possible

Association between high adolescent smartphone use and academic impairment, conflicts with family members or friends, and suicide attempts.

This study aims to evaluate the association between smartphone use and suicide attempts, independent of possible confounders, including conflicts with family/friends and poor academic performance due to smartphone use. Data were obtained from the 2017 Korea Youth Risk Behavior Web-based Survey, a nationally representative survey of middle- and high-school students (N = 62,276). Time spent using a smartphone was divided into four categories: less than 1 h, 1-2 h, 3-4 h, and 5 h or more a day. The association of conflicts with family due to smartphone use, conflicts with friends due to smartphone use, and poor academic performance due to smartphone use with suicide attempts and time spent using a smartphone were analyzed using multiple and binary logistic regression analyses, respectively. The relationship between time spent on a smartphone and suicide attempts was analyzed using a multiple logistic regression analysis. All analyses were also stratified according to the main purpose of smartphone use (process purposes/social purposes). Conflicts with family/friends due to smartphone use was significantly associated with suicide attempts (P <0.001). The variables of conflicts with family, conflicts with friends and poor academic performance were also proportionally related to higher smartphone use (P <0.001). The use of a smartphone was significantly associated with suicide attempts in a multiple logistic regression analysis (adjusted odds ratio for smartphone use 5 h or more a day 2.16; 95% CI 2.07-2.26; P <0.001), and the association was more prominent with smartphone use for process purposes. Conflicts with family, conflicts with friends, poor academic performance, and suicide attempts were related to higher smartphone use in Korean adolescents. Time spent on a smartphone was positively related to suicide attempts, even after adjusting for conflicts with family members or friends and poor academic performance due to smartphone use

Impact of psychotic symptoms on clinical outcomes in delirium.

Delirium is an acute disturbance in attention and awareness in response to one or more physiological stressors that is closely related to poor clinical outcomes. The aim of this study is to investigate whether delirium patients with psychotic symptoms (PS) would have unique clinical characteristics and outcomes. A retrospective chart review was performed on the patients with delirium due to general medical conditions to assess clinical characteristics and outcomes. All patients were assessed by Delirium Rating Scale-revised-98 and classified as having PS when scored two or more on at least one of the psychotic symptom items (perceptual disturbances, delusions, and thought process abnormalities). Of 233 patients with delirium, 116 (49.8%) manifested PS. Patients with PS were younger, more likely to use antipsychotics to manage delirium, and had more hyperactive motor subtype than patients without PS. Logistic regression analysis showed that odds ratio of psychotic symptoms for having in-hospital mortality was 0.27 (95% CI = 0.08-0.94) after controlling age, sex, disease severity, comorbidity, number of medications, etiologies, motor subtypes, delirium severity and use of antipsychotics. The present study demonstrated that PS of delirium was associated with unique clinical characteristics and may affect the clinical course in a psychiatry-referral sample