Depression and anxiety one month after stroke

Depression and anxiety after stroke negatively affect patient outcomes; however, health care professionals may overlook poststroke depression and anxiety while they focus on the physical disabilities of patients soon after a stroke. The purpose of this study was to investigate the prevalence and predictors of depression, anxiety, or both concurrently at one month after stroke. We conducted a cross-sectional, descriptive study in a sample of 231 hospitalized patients with ischemic stroke in Korea. Data were collected by interviews using a series of structured questionnaires in addition to clinical data retrieved from patients’ medical records. More than 70% were identified as depressed, 45.9% experienced anxiety, and 43.7% had concurrent depression and anxiety. Using a multiple logistic regression analysis, we identified anxiety as a predictor of depression; depression as a predictor of anxiety; and female sex, headaches, and swallowing difficulty as predictors of the comorbidity of depression and anxiety. Periodical screenings for poststroke depression and anxiety from an early stage in a hospital to years after stroke in a community are recommended to provide better chances for early identification of patients at risk because depression and anxiety may manifest at any stage of recovery. Special attention should be given to individuals with culture-bound somatic symptoms in addition to female patients and those who have difficulty swallowing among Korean stroke patients

Association between Participation in a Rehabilitation Program and 1-Year Survival in Patients Requiring Prolonged Mechanical Ventilation

Background The present study evaluated the association between participation in a rehabilitation program during a hospital stay and 1-year survival of patients requiring at least 21 days of mechanical ventilation (prolonged mechanical ventilation [PMV]) with various respiratory diseases as their main diagnoses that led to mechanical ventilation. Methods Retrospective data of 105 patients (71.4% male, mean age 70.1±11.3 years) who received PMV in the past 5 years were analyzed. Rehabilitation included physiotherapy, physical rehabilitation, and dysphagia treatment program that was individually provided by physiatrists. Results The main diagnosis leading to mechanical ventilation was pneumonia (n=101, 96.2%) and the 1-year survival rate was 33.3% (n=35). One-year survivors had lower Acute Physiology and Chronic Health Evaluation (APACHE) II score (20.2±5.8 vs. 24.2±7.5, p=0.006) and Sequential Organ Failure Assessment score (6.7±5.6 vs. 8.5±2.7, p=0.001) on the day of intubation than non-survivors. More survivors participated in a rehabilitation program during their hospital stays (88.6% vs. 57.1%, p=0.001). The rehabilitation program was an independent factor for 1-year survival based on the Cox proportional hazard model (hazard ratio, 3.513; 95% confidence interval, 1.785 to 6.930; p<0.001) in patients with APACHE II scores ≤23 (a cutoff value based on Youden’s index). Conclusion Our study showed that participation in a rehabilitation program during hospital stay was associated with an improvement of 1-year survival of PMV patients who had less severe illness on the day of intubation

A logical network-based drug-screening platform for Alzheimer’s disease representing pathological features of human brain organoids

Developing effective drugs for Alzheimer’s disease (AD), the most common cause of dementia, has been difficult because of complicated pathogenesis. Here, we report an efficient, network-based drug-screening platform developed by integrating mathematical modeling and the pathological features of AD with human iPSC-derived cerebral organoids (iCOs), including CRISPR-Cas9-edited isogenic lines. We use 1300 organoids from 11 participants to build a high-content screening (HCS) system and test blood–brain barrier-permeable FDA-approved drugs. Our study provides a strategy for precision medicine through the convergence of mathematical modeling and a miniature pathological brain model using iCOs. © 2021, The Author(s).1

Treatment shortening of drug-sensitive pulmonary tuberculosis using high-dose rifampicin for 3 months after culture conversion (Hi-DoRi-3): a study protocol for an open-label randomized clinical trial

Background : The standard treatment regimen for drug-sensitive tuberculosis (TB), comprising four companion drugs, requires a minimum duration of 6 months, and this lengthy treatment leads to poor adherence and increased toxicity. To improve rates of adherence, reduce adverse events, and lower costs, a simplified and shortened treatment regimen is warranted. Methods : This study is a multicenter, open-label randomized clinical trial of non-inferiority design that compares a new regimen with the conventional regimen for drug-sensitive pulmonary TB. The investigational group will use a regimen of high-dose rifampicin (30 mg/kg/day) with isoniazid and pyrazinamide, and the treatment will be maintained for 12 weeks after the achievement of negative conversion of sputum culture. The control group will be treated for 6 months with a World Health Organization-endorsed regimen consisting of isoniazid, rifampicin (10 mg/kg/day), ethambutol, and pyrazinamide. The primary endpoint is the proportion of unfavorable outcomes at 18 months after randomization. Secondary outcomes include time to unfavorable treatment outcome, time to culture conversion on liquid medium, treatment success rate at the end of treatment, proportion of recurrence at 18 months after randomization, time to recurrence after treatment completion, and adverse events of grade 3 or higher during the treatment. We predict a 10% unfavorable outcome for the control group, and 0% difference from the investigational group. Based on 80% verification power and a 2.5% one-sided significance level for a non-inferiority margin of 6%, 393 participants per group are required. Considering the 15% dropout rate, a total of 926 participants (463 in each group) will be recruited. Discussion : This study will inform on the feasibility of the treatment regimen using high-dose rifampicin with a shortened and individualized treatment duration for pulmonary TB. Trial registration : ClinicalTrials.gov NCT04485156.Registered on July 24, 2020.This work was supported by a grant from the Korea National Institute of Health (2020-ER5201-01), Republic of Korea. High-dose rifampicin tablets and capsules were donated from Yuhan (Seoul, Republic of Korea) for this study. The funder and donor had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript

A database of 5305 healthy Korean individuals reveals genetic and clinical implications for an East Asian population

Despite substantial advances in disease genetics, studies to date have largely focused on individuals of European descent. This limits further discoveries of novel functional genetic variants in other ethnic groups. To alleviate the paucity of East Asian population genome resources, we established the Korean Variant Archive 2 (KOVA 2), which is composed of 1896 whole-genome sequences and 3409 whole-exome sequences from healthy individuals of Korean ethnicity. This is the largest genome database from the ethnic Korean population to date, surpassing the 1909 Korean individuals deposited in gnomAD. The variants in KOVA 2 displayed all the known genetic features of those from previous genome databases, and we compiled data from Korean-specific runs of homozygosity, positively selected intervals, and structural variants. In doing so, we found loci, such as the loci of ADH1A/1B and UHRF1BP1, that are strongly selected in the Korean population relative to other East Asian populations. Our analysis of allele ages revealed a correlation between variant functionality and evolutionary age. The data can be browsed and downloaded from a public website (https://www.kobic.re.kr/kova/). We anticipate that KOVA 2 will serve as a valuable resource for genetic studies involving East Asian populations

Modeling of Bond Stress–Slip Relationships of a Strand in Concrete during Steam Curing

Abstract The restrained thermal expansion of a pretensioned strand causes thermal prestress loss during steam curing until sufficient bond strength develops. The amount of thermal prestress loss is directly related to the characteristics of the interfacial bond stress–slip relationship at different maturity phases of concrete. For a rational assessment, the bond stress–slip relationship needs to be investigated experimentally at different maturity phases. In this study, a total of 12 pull-out tests were performed using seven-wire strand of 12.7 mm diameter, at different concrete equivalent ages of 7.8, 23.5, 53.8 and 85.2 h. Based on the test results, an empirical model of the bond stress–slip relationship was developed. The model comprised four segments: a curvilinear ascending region, a constant maximum region, a linearly descending region, and a region of constant frictional bond stress. The characteristic values in the model were expressed as functions of equivalent age. The model was able to predict the test results with reasonable accuracy

Factors Influencing the Accuracy of Shallow Snow Depth Measured Using UAV-Based Photogrammetry

Factors influencing the accuracy of UAV-photogrammetry-based snow depth distribution maps were investigated. First, UAV-based surveys were performed on the 0.04 km2 snow-covered study site in South Korea for 37 times over the period of 13 days under 16 prescribed conditions composed of various photographing times, flight altitudes, and photograph overlap ratios. Then, multi-temporal Digital Surface Models (DSMs) of the study area covered with shallow snow were obtained using digital photogrammetric techniques. Next, the multi-temporal snow depth distribution maps were created by subtracting the snow-free DSM from the multi-temporal DSMs of the study area. Then, snow depth in these UAV-Photogrammetry-based snow maps were compared to the in situ measurements at 21 locations. The accuracy of each of the multi-temporal snow maps were quantified in terms of bias (median of residuals, QΔD) and precision (the Normalized Median Absolute Deviation, NMAD). Lastly, various factors influencing these performance metrics were investigated. The results are as follows: (1) the QΔD and NMAD of the eight surveys performed at the optimal condition (50 m flight altitude and 80% overlap ratio) ranged from −2.30 cm to 5.90 cm and from 1.78 cm to 4.89 cm, respectively. The best survey case had −2.30 cm of QΔD and 1.78 cm of NMAD; (2) Lower UAV flight altitude and greater photograph overlap lower the NMAD and QΔD; (3) Greater number of Ground Control Points (GCPs) lowers the NMAD and QΔD; (4) Spatial configuration and accuracy of GCP coordinates influenced the accuracy of the snow depth distribution map; (5) Greater number of tie-points leads to higher accuracy; (6) Smooth fresh snow cover did not provide many tie-points, either resulting in a significant error or making the entire photogrammetry process impossible

Long-Range Acoustic Communication Using Differential Chirp Spread Spectrum

Here, we propose a new modulation method using chirp spread spectrum (CSS) modulation to indicate the result of long-range acoustic communication (LRAC). CSS modulation had outstanding matched filter characteristics even though the channel was complex. The performance of the matched filter depends on the time&ndash;bandwidth product. We studied the method of using the same modulation method while increasing the amount of the time&ndash;bandwidth product. When differential encoding is applied, the de-modulation is made using the difference between the current symbol and the previous symbol. If the matched filter is applied using both the current and the previous symbol, such as the use of two symbols, the amount of the time&ndash;bandwidth product can be doubled, and this method can make the output of the matched filter larger. The proposed method was verified in lake and sea experiments, in which the experimental environment was analyzed and compared with the result using the channel impulse response (CIR) of the lake and sea. The lake experiment was conducted over a distance of about 100&ndash;300 m between the transmitter and receiver and at a depth of ~40 m. As a result of the communication, the conventional method&rsquo;s bit error rate (BER) was 1.22&times;10&minus;1, but the proposed method&rsquo;s BER was 1.98&times;10&minus;2. The sea experiment was conducted over a distance of ~90 km and at a depth of ~1 km, and the conventional method BER in this experiment was 1.83&times;10&minus;4, while the proposed method&rsquo;s BER was 0

The use of bedaquiline to treat patients with multidrug-resistant tuberculosis and end-stage renal disease: A case report

The use of bedaquiline to treat patients with multidrug-resistant tuberculosis (MDR-TB) and end-stage renal disease (ESRD) may raise safety concerns. Currently, no clinical information is available on the use of bedaquiline to treat MDR-TB patients with ESRD. We report the use of bedaquiline to treat two patients with MDR-TB and ESRD. This report highlights the safety and tolerability of bedaquiline as well as the treatment outcome. The use of bedaquiline in patients with ESRD is also discussed. Keywords: Bedaquiline, Tuberculosis, Multidrug resistance, End-stage renal diseas

Treatment outcomes and factors affecting treatment outcomes of new patients with tuberculosis in Busan, South Korea: a retrospective study of a citywide registry, 2014–2015

Abstract Background This study investigated the treatment outcomes, and factors affecting the outcomes, of new tuberculosis (TB) patients in Busan, South Korea. Methods We retrospectively analysed the citywide TB registry data (collected for the Korean National TB Surveillance System) of new TB patients registered in Busan from January 2014 to December 2015. Results A total of 4732 patients were included in this study (mean age, 52.5 ± 19.9 years; 58.4% male). The overall treatment success rate was 83.9% (cured, 20.2%; completed, 63.7%); 8.0% of patients died, and 3.6% were lost to follow-up. In multivariate analyses, a higher rate of loss to follow-up was associated with foreign nationality, registered as TB-positive at least twice, and being in Q4 (fourth quintile) or Q5 (fifth quintile) of the regional deprivation index. Conversely, a lower rate of loss to follow-up was associated with female gender, smear-positive for pulmonary TB (PTB), and the treatment outcome being reported by a public health centre. Higher mortality was associated with old age (≥ 75 years), smear-positive PTB, treatment outcome being reported by the hospital, and being registered as TB-positive twice. Lower mortality was associated with female gender, treatment outcome being reported by a public health centre or clinic, and Q5 of the regional deprivation index. Conclusions Treatment outcomes of new TB patients were sub-optimal in Busan. TB control programs should maintain close monitoring and provide greater socioeconomic support to patients at high risk of poor treatment outcomes