The effectiveness of a smartphone intervention targeting suicidal ideation in young adults : randomized controlled trial examining the influence of loneliness

Background: Loneliness is commonly reported by young people and has been shown to contribute to the rapid onset and escalation of depression and suicidal ideation during adolescence. Lonely people may also be particularly susceptible to disengaging from treatment early given the likelihood of their more complex clinical profiles leading to cognitive fatigue. While a smartphone intervention (LifeBuoy) has been shown to effectively reduce suicidal ideation in young adults, poor engagement is a well-documented issue for this therapeutic modality and has been shown to result in poorer treatment outcomes. Objective: This study aims to determine whether loneliness affects how young people experiencing suicidal ideation engage with and benefit from a therapeutic smartphone intervention (LifeBuoy). Methods: A total of 455 community-based Australian young adults (aged 18-25 years) experiencing recent suicidal ideation were randomized to use a dialectical behavioral therapy–based smartphone intervention (LifeBuoy) or an attention-matched control app (LifeBuoy-C) for 6 weeks. Participants completed measures of suicidal ideation, depression, anxiety, and loneliness at baseline (T0), post intervention (T1), and 3 months post intervention (T2). Piecewise linear mixed models were used to examine whether loneliness levels moderated the effect of LifeBuoy and LifeBuoy-C on suicidal ideation and depression across time (T0 to T1; T1 to T2). This statistical method was then used to examine whether app engagement (number of modules completed) influenced the relationship between baseline loneliness and suicidal ideation and depression across time. Results: Loneliness was positively associated with higher levels of overall suicidal ideation (B=0.75, 95% CI 0.08-1.42; P=.03) and depression (B=0.88, 95% CI 0.45-1.32; P<.001), regardless of time point or allocated condition. However, loneliness did not affect suicidal ideation scores across time (time 1: B=1.10, 95% CI –0.25 to 2.46; P=.11; time 2: B=0.43, 95% CI –1.25 to 2.12; P=.61) and depression scores across time (time 1: B=0.00, 95% CI –0.67 to 0.66; P=.99; time 2: B=0.41, 95% CI –0.37 to 1.18; P=.30) in either condition. Similarly, engagement with the LifeBuoy app was not found to moderate the impact of loneliness on suicidal ideation (B=0.00, 95% CI –0.17 to 0.18; P=.98) or depression (B=–0.08, 95% CI –0.19 to 0.03; P=.14). Conclusions: Loneliness was not found to affect young adults’ engagement with a smartphone intervention (LifeBuoy) nor any clinical benefits derived from the intervention. LifeBuoy, in its current form, can effectively engage and treat individuals regardless of how lonely they may be

High-voltage vertical Ga\u3csub\u3e2\u3c/sub\u3eO\u3csub\u3e3\u3c/sub\u3e power rectifiers operational at high temperatures up to 600 K

This work presents the temperature-dependent forward conduction and reverse blocking characteristics of a high-voltage vertical Ga2O3 power rectifier from 300 K to 600 K. Vertical β-Ga2O3 Schottky barrier diodes (SBDs) were fabricated with a bevel-field-plated edge termination, where a beveled sidewall was implemented in both the mesa and the field plate oxide. The Schottky barrier height was found to increase from 1.2 eV to 1.3 eV as the temperature increases from 300 K to 600 K, indicating the existence of barrier height inhomogeneity. The net donor concentration in the drift region shows little dependence on the temperature. The reverse leakage current up to 500 V was found to be limited by both the thermionic-field electron injection at the Schottky contact and the electron hopping via the defect states in the depletion region. At 300-500 K, the leakage is first limited by the electron injection at low voltages and then by the hopping in depleted Ga2O3 at high voltages. At temperatures above 500 K, the thermionic field emission limits the device leakage over the entire voltage range up to 500 V. Compared to the state-of-the-art SiC and GaN SBDs when blocking a similar voltage, our vertical Ga2O3 SBDs are capable of operating at significantly higher temperatures and show a smaller leakage current increase with temperature. This shows the great potential of Ga2O3 SBDs for high-temperature and high-voltage power applications

Enhanced interlayer neutral excitons and trions in trilayer van der Waals heterostructures

Vertically stacked van der Waals heterostructures constitute a promising platform for providing tailored band alignment with enhanced excitonic systems. Here we report observations of neutral and charged interlayer excitons in trilayer WSe2-MoSe2-WSe2 van der Waals heterostructures and their dynamics. The addition of a WSe2 layer in the trilayer leads to significantly higher photoluminescence quantum yields and tunable spectral resonance compared to its bilayer heterostructures at cryogenic temperatures. The observed enhancement in the photoluminescence quantum yield is due to significantly larger electron-hole overlap and higher light absorbance in the trilayer heterostructure, supported via first-principle pseudopotential calculations based on spin-polarized density functional theory. We further uncover the temperature- and power-dependence, as well as time-resolved photoluminescence of the trilayer heterostructure interlayer neutral excitons and trions. Our study elucidates the prospects of manipulating light emission from interlayer excitons and designing atomic heterostructures from first-principles for optoelectronics.Comment: 25 pages, 5 figures(Maintext). 9 pages, 7 figures(Supplementary Information). - Accepted for publication in npg: 2D materials and applications and reformatted to its standard. - Updated co-authors and references. - Title and abstract are modified for clarity. - Errors have been corrected, npg: 2D materials and applications (2018

TCAD-Machine learning framework for device variation and operating temperature analysis with experimental demonstration

This work, for the first time, experimentally demonstrates a TCAD-Machine Learning (TCAD-ML) framework to assist the analysis of device-to-device variation and operating (ambient) temperature without the need of physical quantities extraction. The ML algorithm used in this work is the Principal Component Analysis (PCA) followed by third order polynomial regression. After calibrated to limited \u27expensive\u27 experimental data, \u27low cost\u27 TCAD simulation is used to generate a large amount of device data to train the ML model. The ML was then used to identify the root cause of device variation and operating temperature from any given experimental current-voltage (I-V) characteristics. We applied this framework to study the ultra-wide-bandgap gallium oxide (Ga2O3) Schottky barrier diode (SBD), an emerging device technology that holds great promise for temperature sensing, RF, and power applications in harsh environments. After calibration, over 150,000 electrothermal TCAD simulations are performed with random variation of physical parameters (anode effective work function, drift layer doping, and drift layer thickness) and operating temperature. An ML model is trained using these TCAD data and we found 1,000-10,000 TCAD data can train an accurate machine. We show that without physical quantities extraction, performing PCA is essential for the TCAD trained ML model to be applicable to analyze experimental characteristics. The physical parameters and temperatures predicted by the ML model show good agreement with experimental analysis. Our TCAD-ML framework shows great promise to accelerate the development of new device technologies with a significantly more efficient process of material and device experimentation

Exciton-photon complexes and dynamics in the concurrent strong-weak coupling regime of singular site-controlled cavity quantum electrodynamics

We investigate the exciton complexes photoluminescence, dynamics and photon statistics in the concurrent strong weak coupling regime in our unique site controlled singular inverted pyramidal InGaAs/GaAs quantum dots photonic crystal cavities platform. Different from a clear boundary between strong and weak QD cavity coupling, we demonstrate the strong and weak coupling can coexist dynamically, as a form of intermediate regime mediated by phonon scattering. The detuning dependent microphotoluminescence spectrum reveals concurrence of exciton cavity polariton mode avoided crossing, as a signature of Rabi doublet of the strong coupled system, the blue shifting of coupled exciton cavity mode energy near zero detuning ascribed to the formation of collective states mediated by phonon assisted coupling, and their partial out of synchronization linewidth narrowing linked to their mixed behavior. By detailing the optical features of strongly confined exciton-photon complexes and the quantum statistics of coupled cavity photons, we reveal the dynamics and antibunching/bunching photon statistical signatures of the concurrent strong weak intermediate coupled system at near zero-detuning. This study suggests our device has potential for new and subtle cavity quantum electrodynamical phenomena, cavity enhanced indistinguishable single photon generation, and cluster state generation via the exciton-photon complexes for quantum networks

The VCAM1-ApoE pathway directs microglial chemotaxis and alleviates Alzheimer\u27s disease pathology

In Alzheimer\u27s disease (AD), sensome receptor dysfunction impairs microglial danger-associated molecular pattern (DAMP) clearance and exacerbates disease pathology. Although extrinsic signals, including interleukin-33 (IL-33), can restore microglial DAMP clearance, it remains largely unclear how the sensome receptor is regulated and interacts with DAMP during phagocytic clearance. Here, we show that IL-33 induces VCAM1 in microglia, which promotes microglial chemotaxis toward amyloid-beta (Aβ) plaque-associated ApoE, and leads to Aβ clearance. We show that IL-33 stimulates a chemotactic state in microglia, characterized by Aβ-directed migration. Functional screening identified that VCAM1 directs microglial Aβ chemotaxis by sensing Aβ plaque-associated ApoE. Moreover, we found that disrupting VCAM1-ApoE interaction abolishes microglial Aβ chemotaxis, resulting in decreased microglial clearance of Aβ. In patients with AD, higher cerebrospinal fluid levels of soluble VCAM1 were correlated with impaired microglial Aβ chemotaxis. Together, our findings demonstrate that promoting VCAM1-ApoE-dependent microglial functions ameliorates AD pathology

It's time to address fear of cancer recurrence in family caregivers: usability study of an virtual version of the Family Caregiver—Fear Of Recurrence Therapy (FC-FORT)

BackgroundFamily caregivers of cancer survivors experience equal or greater levels of fear of cancer recurrence (FCR) than survivors themselves. Some interventions have demonstrated their ability to reduce FCR among cancer survivors and dyads (patient and caregivers). However, to date, no validated intervention exists to focus solely on family caregiver's FCR.ObjectivesThis study aimed to (1) adapt the evidence-based in-person Fear Of Recurrence Therapy (FORT) for family caregivers (referred here in as FC-FORT) and to a virtual delivery format and (2) test its usability when offered virtually.MethodsThe adaptation of FC-FORT was overseen by an advisory board and guided by the Information Systems Research Framework. Following this adaptation, female family caregivers and therapists were recruited for the usability study. Participants took part in 7 weekly virtual group therapy sessions, a semi-structured exit interview and completed session feedback questionnaires. Therapists were offered a virtual training and weekly supervision. Fidelity of treatment administration was assessed each session. Quantitative data were analyzed using descriptive statistics. Exit interviews were transcribed verbatim using NVivo Transcription and coded using conventional content analysis. Results were presented back to the advisory board to further refine FC-FORT.ResultsThe advisory board (n = 16) met virtually on 7 occasions to adapt FC-FORT (i.e., patient manuals, virtual format) and discuss recruitment strategies. Minor (e.g., revised text, adapted materials to virtual format) and major adaptations (e.g., added and rearranged sessions) were made to FC-FORT and subsequently approved by the advisory board. Four family caregivers and three therapists took part in the first round of the usability testing. Six family caregivers and the same three therapists took part in the second round. Overall, participants were very satisfied with FC-FORT's usability. Qualitative analysis identified 4 key themes: usability of FC-FORT, satisfaction and engagement with content, group cohesion, and impact of FC-FORT. All participants indicated that they would recommend FC-FORT to others as is.ConclusionsUsing a multidisciplinary advisory board, our team successfully adapted FC-FORT and tested its usability using videoconferencing. Results from this study indicate that the efficacy and acceptability of FC-FORT are now ready to be tested in a larger pilot study

Multi-Family Psycho-Education Group for Assertive Community Treatment Clients and Families of Culturally Diverse Background: A Pilot Study

This study evaluates the incorporation of Multi-Family Psycho-education Group (MFPG) to an Assertive Community Treatment Team developed to serve culturally diverse clients who suffers from severe mental illness. Participants included Chinese and Tamil clients and their family members. Family members’ well-being, perceived burden, and acceptance of clients were assessed before and after the intervention. Focus group interviews with clinicians were conducted to qualitatively examine MFPG. Family members’ acceptance increased after MFPG. Regular attendance was associated with reduction in perceived family burden. Culturally competent delivery of MFPG enhanced family members’ understanding of mental illness and reduced stress levels and negative feelings towards clients

Targeting of the Human Coagulation Factor IX Gene at rDNA Locus of Human Embryonic Stem Cells

BACKGROUND: Genetic modification is a prerequisite to realizing the full potential of human embryonic stem cells (hESCs) in human genetic research and regenerative medicine. Unfortunately, the random integration methods that have been the primary techniques used keep creating problems, and the primary alternative method, gene targeting, has been effective in manipulating mouse embryonic stem cells (mESCs) but poorly in hESCs. METHODOLOGY/PRINCIPAL FINDINGS: Human ribosomal DNA (rDNA) repeats are clustered on the short arm of acrocentric chromosomes. They consist of approximately 400 copies of the 45S pre-RNA (rRNA) gene per haploid. In the present study, we targeted a physiological gene, human coagulation factor IX, into the rDNA locus of hESCs via homologous recombination. The relative gene targeting efficiency (>50%) and homologous recombination frequency (>10(-5)) were more than 10-fold higher than those of loci targeted in previous reports. Meanwhile, the targeted clones retained both a normal karyotype and the main characteristics of ES cells. The transgene was found to be stably and ectopically expressed in targeted hESCs. CONCLUSION/SIGNIFICANCE: This is the first targeting of a human physiological gene at a defined locus on the hESC genome. Our findings indicate that the rDNA locus may serve as an ideal harbor for transgenes in hESCs

Pharmacological treatment of first episode non affective psychosis, are typical doses of haloperidol for Caucasians appropriate for Asians?

grantor: University of TorontoThis study investigates possible Asian-Caucasian differences with respect to the metabolism and central nervous system (CNS) effect of haloperidol in the treatment of first episode non-affective psychosis. The two part study involved a 4-week active treatment phase and a 9-month follow-up. An attempt was made to control for other identified differences such as initial impairment, tolerance of symptoms, compliance and medication side effects. Fifteen Asians and sixteen Caucasians participated in the four-week trial of treatment phase. Subjects were maintained on low oral doses of haloperidol (2mg./day) for the first week of treatment. Doses were increased weekly to 5mg., 10 mg. and finally 20 mg./day until the 'optimal therapeutic dose' was achieved. This was defined as the point at which subjects: (a) experienced significant clinical improvement; or, (b) developed extrapyramidal side effects. On average, the same dose--5 mg./day--was optimal for both Asian and Caucasian subjects. At a fixed dose of 2 mg haloperidol, Caucasian males had significantly lower plasma haloperidol levels than Asian males. No differences in plasma haloperidol levels were found between Asian and Caucasian females. There was no ethnicity effect or gender effect on plasma prolactin levels (change from baseline) after one week of treatment, implying that there were no differential prolactin response secondary to neuroleptic use. At the end of 4 weeks, Asian subjects were responding less well to treatment than Caucasians. Covariance analysis demonstrated that this difference in initial improvement could be attributed to longer duration of illness onset, and greater proclivity to side-effects secondary to neuroleptic treatment among Asian subjects. At 9-month open drug follow-up, Asian patients had unproved to the point where their therapeutic gains matched those of the Caucasian subjects. In conclusion, the study demonstrated Asian and Caucasian differences with respect to the metabolism of haloperidol in the treatment of first episode non-affective psychosis. There were no statistically significant ethnic differences in central nervous system (CNS) effect of haloperidol.Ph.D