Association of nightmares with cardio-cerebrovascular disease, hypertension and hyperlipidemia in older adults: A population-based cross-sectional study.

OBJECTIVE: This cross-sectional study investigated the relationship of nightmares with cardio-cerebrovascular disease (CVD), hypertension and hyperlipidemia which are major preceding diseases of CVD in older adults. METHODS: Participants (n = 2824; mean age 63.6 ± 6.6 years, females 49.3%) completed the Disturbing Dream and Nightmare Severity Index (DDNSI), which was used to divide the sample into either the Nightmare or Non-Nightmare group (cut-off score ≥ 10). Demographic information, history of CVD (cerebrovascular disease, myocardial infarction, congestive heart failure, coronary artery disease, and arrhythmia), hypertension, hyperlipidemia, and self-report questionnaires about stress (Perceived Stress Scale), depression (Beck Depression Inventory), sleep quality (Pittsburgh Sleep Quality Index), and insomnia symptoms were also collected. RESULTS: Among the sample, 379 participants (13.4%) reported experiencing nightmares more than once a year, and 73 participants (2.6%) were classified as having nightmare disorder based on DDNSI scores (≥10). 11.3% of participants (n = 319) reported having more than one CVD. Approximately half of the participants reported a history of hypertension (52.1%, n = 1471) and hyperlipidemia (47.7%, n = 1346). Logistic regression analysis indicated the Nightmare group was 2.04 times at higher risk for hyperlipidemia (OR = 2.04, 95% CI 1.22-3.40, p = .006) after controlling for covariates compared to the Non-Nightmare group. Although non-significant, there was a trend toward a higher risk of hypertension in the Nightmare group (OR = 1.67, 95% CI 0.99-2.84, p = .056). CONCLUSIONS: Results of this study indicate frequent nightmares in older adults may be associated with hyperlipidemia, which are risk factors for CVD. Further studies are needed to explore nightmares' directionality and health consequences in an aging population.

Severe Neurological Manifestation Associated With Coronavirus Disease 2019 in Children During the Omicron Variant-Predominant Period.

BACKGROUND: The Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is known to be more infectious and less severe than the other variants. Despite the increasing number of symptomatic patients, severe neurological complications in children with the Omicron variant have been reported rarely, unlike with wild-type or Delta variants. This study aimed to investigate severe neurological complications in children with Omicron variant infection. METHODS: We conducted a retrospective study of 17 pediatric patients with severe neurological manifestations associated with coronavirus disease 2019 in Korea during the Omicron variant prevalence, from January 1 to April 30, 2022. RESULTS: Among the 17 patients, 11 had pre-existing neurological disabilities and nine met the criteria for multisystem inflammatory syndrome in children (MIS-C). Four of the five vaccine-eligible patients (12 years and older) were unvaccinated. Severe neurological manifestations included acute necrotizing encephalopathy, acute fulminant cerebral edema, acute disseminated encephalomyelitis, basal ganglia encephalitis, unclassified severe encephalopathy/encephalitis, and refractory status dystonicus. Patients with MIS-C and underlying neurological disabilities had longer median hospital and intensive care unit stays compared with those without these conditions. Five patients survived with new neurological deficits at the one-year follow-up, and three died, all of whom had underlying neurological disabilities. CONCLUSIONS: This study shows that severe neurological complications in pediatric patients with the Omicron variant of SARS-CoV-2 occur infrequently but may lead to significant morbidity and mortality, especially among those with pre-existing neurological disabilities and unvaccinated individuals. Continued efforts are necessary to prevent and manage such complications in these vulnerable populations.

Effect of smartphone use on cervical spine stability.

Using a smartphone often involves a sustained head-forward tilt posture, which may deteriorate the mechanism of muscle reaction efficiency or reduce the stiffness of connective tissues of the cervical spine. These changes in muscular and connective tissues can impair cervical spine stability and contribute to developing neck pain symptoms. In this experiment, change in the cervical spine stability associated with a sustained smartphone use posture was evaluated by quantifying the effective stiffness and the reflexive responses of the head to sudden perturbations. Seventeen young smartphone users maintained their heads tilted forward approximately 30° for 30 min while watching videos on their smartphones in sitting. Data show that the measures of cervical spine stability did not change significantly after the smartphone use task despite developing mild to moderate neck and upper body discomfort symptoms. Study findings imply that keeping the head tilt posture for 30 min for smartphone use did not significantly alter spinal stability, rejecting its association with neck discomfort.

Mediating and Moderating Effects of Uncertainty on the Relationship between Family Function, Self-Care, and Depression among Blood Cancer Survivors.

Uncertainty in cancer survivorship poses a substantial challenge to survivors' coping mechanisms and psychological well-being. This study investigated the intricate interplay among family function, uncertainty, self-care, and depression in this context, with a primary focus on discerning the mediating and moderating roles of uncertainty in the relationship between family function, self-care, and depression among blood cancer survivors. Cross-sectional data from 147 survivors in South Korea underwent analysis using descriptive statistics, Pearson's correlations, and the PROCESS macro in SPSS version 26.0. The results revealed that family function significantly predicted both self-care and depression. Notably, uncertainty mediated the relationship between family function and these outcomes. Furthermore, the impact of family function on depression was moderated by uncertainty, indicating a relatively weaker association in survivors facing higher uncertainty levels. This study contributes valuable insights by elucidating the role of uncertainty in regulating how family function influences self-care and depression among survivors of blood cancer. It emphasizes the critical need to enhance family function and alleviate uncertainty for the improved adjustment of cancer survivorship. The findings underscore the importance of targeted support for individuals grappling with different levels of uncertainty, aiming to prevent or mitigate depressive symptoms through the reinforcement of family function.

Parameterization of below-cloud scavenging for polydisperse fine mode aerosols as a function of rain intensity.

The below-cloud aerosol scavenging process by precipitation is one of the most important mechanisms to remove aerosols from the atmosphere. Due to its complexity and dependence on both aerosol and raindrop sizes, wet scavenging process has been poorly treated, especially during the removal of fine particles. This makes the numerical simulation of below-cloud scavenging in large-scale aerosol models unrealistic. To consider the slip effects of submicron particles, a simplified expression for the diffusion scavenging was developed by approximating the Cunningham slip correction factor. The derived analytic solution was parameterized as a simple power function of rain intensity under the assumption of the lognormal size distribution of particles. The resultant approximated expression was compared to the observed data and the results of previous studies including a 3D atmospheric chemical transport model simulation. Compared with the default GEOS-Chem coefficient of 0.00106R0.61 and the observation-based coefficient of 0.0144R0.9268, the coefficient of a and b in Λm = aRb spread in the range of 0.0002- 0.1959 for a and 0.3261- 0.525 for b over a size distribution of GSD of 1.3-2.5 and a geometric mean diameter of 0.01- 2.5 µm. Overall, this study showed that the scavenging coefficient varies widely by orders of magnitude according to the size distribution of particles and rain intensity. This study also demonstrated that the obtained simplified expression could consider the theoretical approach of aerosol polydispersity. Our proposed analytic approach showed that results can be effectively applied for reduced computational burden in atmospheric modeling.

A Neonate with Autosomal Dominant Pseudohypoaldosteronism Type 1 Due to a Novel Microdeletion of the NR3C2 Gene at 4q31.23.

Dehydration with hyponatremia can occur from a variety of causes and can be potentially fatal to infants. Pseudohypoaldosteronism type 1 (PHA1) is a rare disease that can cause severe dehydration along with hyponatremia and hyperkalemia because of renal tubular unresponsiveness to mineralocorticoids. Autosomal dominant PHA1 (ADPHA1, OMIM #177735) is caused by inactivating mutations in the NR3C2 gene, which encodes the mineralocorticoid receptor, and it can lead to renal salt-wasting, dehydration, and failure to thrive during infancy. Here, we report a case of a 20-day-old female neonate who presented as severe dehydration with hyponatremia and polyuria. We suspected that her diagnosis might be PHA1 based on markedly elevated plasma renin activity and serum aldosterone levels. For the genetic diagnosis of PHA1, we performed targeted exome sequencing of all causative genes of PHA1, but the result was negative. We confirmed by chromosomal microarray that a novel heterozygous microdeletion was found in the 4q31.23 region spanning exons 7-9 of the NR3C2 gene, and the patient was diagnosed with ADPHA1. In conclusion, our patient is a case of ADPHA1 that developed into a salt-wasting crisis in the neonatal period due to a microdeletion of the 4q31.23 region inherited from her father.

Characteristics of Bacteriophage Isolates and Expression of Shiga Toxin Genes Transferred to Non Shiga Toxin-Producing E. coli by Transduction.

A risk analysis of Shiga toxin (Stx)-encoding bacteriophage was carried out by confirming the transduction phage to non-Stx-producing Escherichia coli (STEC) and subsequent expression of the Shiga toxin genes. The virulence factor stx1 was identified in five phages, and both stx1 and stx2 were found in four phages from a total of 19 phage isolates with seven non-O157 STEC strains. The four phages, designated as φNOEC41, φNOEC46, φNOEC47, and φNOEC49, belonged morphologically to the Myoviridae family. The stabilities of these phages to temperature, pH, ethanol, and NaClO were high with some variabilities among the phages. The infection of five non-STEC strains by nine Stx-encoding phages occurred at a rate of approximately 40%. Non-STEC strains were transduced by Stx-encoding phage to become lysogenic strains, and seven convertant strains had stx1 and/or stx2 genes. Only the stx1 gene was transferred to the receptor strains without any deletion. Gene expression of a convertant having both stx1 and stx2 genes was confirmed to be up to 32 times higher for Stx1 in 6% NaCl osmotic media and twice for Stx2 in 4% NaCl media, compared with expression in low-salt environments. Therefore, a new risk might arise from the transfer of pathogenic genes from Stx-encoding phages to otherwise harmless hosts. Without adequate sterilization of food exposed to various environments, there is a possibility that the toxicity of the phages might increase.

Prevalence of and factors associated with nightmares in the elderly in a population based cohort study.

OBJECTIVES: Nightmares are extremely unpleasant and vivid recurring dreams that are accompanied with awakening during sleep. However, earlier studies were mostly conducted with children and adults, with very few studies on nightmares in older adults. This population-based study aims to investigate the prevalence of nightmares and its associated factors nightmares in the elderly. METHODS: This study utilized a subsample from the Korean Genome and Epidemiology Study (KoGES). Participants (n = 2940; mean age 63.71 ± 6.73) completed the questionnaires on nightmares (Disturbing Dream and Nightmare Severity Index; DDNSI), depression, suicidal ideation, sleep quality and stress. RESULTS: Among the sample, 2.7% (n = 79) were classified into the nightmare group (NG), which was classified with DDNSI scores. In the age group over 70, prevalence of nightmares was 6.3% (n = 37), which was significantly higher than other age groups. Marital status, employment status and family income were associated with nightmares. Additionally, NG reported significantly more sleep problems, higher suicidal ideation, depression and stress compared to the non-nightmare group (N-NG). Logistic regression analyses results indicated that the NG was 4.35 times at higher risk for depression, and 3.16 higher risks for stress, and 3.45 higher risks for suicidal ideation compared to the N-NG after controlling for covariates. CONCLUSIONS: Our results indicate that psychological and demographic factors are associated with nightmares in the elderly. Furthermore, this population-based cohort study showed the prevalence of nightmares increased after age 70, which suggests the need for further studies of nightmares in older populations.

The relationship between smartphone overuse and sleep in younger children: a prospective cohort study.

STUDY OBJECTIVES: Younger children and adolescents are exposed to various smart devices in the modern world, and their use of smart devices is rapidly increasing worldwide. Although smart devices have often been considered to have negative effects on sleep of children and adolescents, such effects have not been studied among younger children. Sleep is considered particularly important for learning and memory, and also has implications for emotional regulation and behavior. Therefore, this study was conducted to examine the effects of smartphone overuse on sleep in 5- to 8-year-old children. METHODS: Participants were from the Kids Cohort for Understanding of Internet Addiction Risk Factors in Early Childhood (K-CURE) Study, an observational prospective cohort study in Korea. Smartphone screen time and total sleep time were assessed using parental questionnaires. Sleep problems of children were assessed using the Children's Sleep Habits Questionnaire (CSHQ). Analysis of covariance was used to examine the association between smartphone overuse and sleep habits in children. All statistical analyses were conducted using SPSS version 21.0 (IBM Corporation, Armonk, NY). RESULTS: Total sleep time of the smartphone overuse group (smartphone use over 1 hour daily) was shorter than that of the control group (F = 6.362, P < .05). Children in the smartphone overuse group showed statistically significant higher scores in the CSHQ total score and nocturnal awakening subscale score (P < .05). CONCLUSIONS: Excessive smartphone use was related to shorter total sleep time in children. Use of a smartphone was also associated with significant reductions in the quality of sleep in younger children.

A 1.15 µW 200 kS/s 10-b Monotonic SAR ADC Using Dual On-Chip Calibrations and Accuracy Enhancement Techniques.

Herein, we present an energy efficient successive-approximation-register (SAR) analog-to-digital converter (ADC) featuring on-chip dual calibration and various accuracy-enhancement techniques. The dual calibration technique is realized in an energy and area-efficient manner for comparator offset calibration (COC) and digital-to-analog converter (DAC) capacitor mismatch calibration. The calibration of common-mode (CM) dependent comparator offset is performed without using separate circuit blocks by reusing the DAC for generating calibration signals. The calibration of the DAC mismatch is efficiently performed by reusing the comparator for delay-based mismatch detection. For accuracy enhancement, we propose new circuit techniques for a comparator, a sampling switch, and a DAC capacitor. An improved dynamic latched comparator is proposed with kick-back suppression and CM dependent offset calibration. An accuracy-enhanced bootstrap sampling switch suppresses the leakage-induced error <180 µV and the sampling error <150 µV. The energy-efficient monotonic switching technique is effectively combined with thermometer coding, which reduces the settling error in the DAC. The ADC is realized using a 0.18 µm complementary metal⁻oxide⁻semiconductor (CMOS) process in an area of 0.28 mm². At the sampling rate fS = 9 kS/s, the proposed ADC achieves a signal-to-noise and distortion ratio (SNDR) of 55.5 dB and a spurious-free dynamic range (SFDR) of 70.6 dB. The proposed dual calibration technique improves the SFDR by 12.7 dB. Consuming 1.15 µW at fS = 200 kS/s, the ADC achieves an SNDR of 55.9 dB and an SFDR of 60.3 dB with a figure-of-merit of 11.4 fJ/conversion-step.

A Scenario-Based Cognitive Behavioral Therapy Mobile App to Reduce Dysfunctional Beliefs in Individuals with Depression: A Randomized Controlled Trial.

INTRODUCTION: While self-administered mobile app-based cognitive behavioral therapy (CBT) has shown efficiency and effectiveness over the past decade, attempts to address automatic and negative beliefs have been lacking. The purpose of this study was to introduce and verify a mobile app that directly intervenes in dysfunctional thoughts. This app-based treatment includes recognizing automatic and negative thoughts of the protagonist of scenarios, writing advice directly to the main character, and sharing advice provided by other participants. MATERIALS AND METHODS: Thirty-four participants diagnosed with Other Specified Depressive Disorder were recruited and randomly allocated to a CBT-based mobile-app program, the Todac Todac (TT group), or a daily mood chart app program (control group). Participants were asked to use the software for 3 weeks. Assessments for autonomic thoughts and clinical symptoms were administered at baseline and at a follow-up evaluation. RESULTS: After completing the 3-week program, Dysfunctional Attitude Scale (DAS) scores in TT group were lower than they were in the control group. In clinical measures, both TT group and control group showed reduced Beck Depression Inventory-II (BDI-II) scores and situation-dependent trait version of State-Trait Anxiety Inventory (STAI-X2) at follow-up. However, TT group showed significantly reduced STAI-X2 scores compared to control group. For all participants, changes in DAS scores were correlated with BDI-II and STAI-X2 scores. CONCLUSIONS: Our preliminary findings provide promising evidence that scenario-based CBT mobile apps can be used to deliver feasible and efficacious cognitive therapy. Long-term research is needed to determine the impact and effectiveness of this new treatment format.

Morphology Control of Ni(II)-NTA-End-Functionalized Block Copolymer and Bio-Conjugation through Metal-Ligand Complex.

This study demonstrates the synthesis of an amphiphilic block copolymer, Ni2+-nitrilotiracetic acid-end-functionalized-poly(poly(ethylene glycol)methyl ether methacrylate)-block-polystyrene (NTA-p(PEGMA-b-St)), morphology control via their self-assembly behavior and reversible bioconjugation of hexahistidine-tagged green fluorescent protein (His6-GFP) onto the surfaces of polymeric vesicles through nitrilotriacetic acid (NTA)-Ni2+-His interaction. First, the t-boc-protected-NTA-p(PEGMA-b-St) was synthesized by atom transfer radical polymerization. After the removal of the t-boc protecting group, the NTA group of the polymer was complexed with Ni2+. To induce self-assembly, water was added as a selective solvent to the solution of the copolymer in tetrahydrofuran (THF). Varying the water content of the solution resulted in various morphologies including spheres, lamellas and vesicles. Finally, polymeric vesicles decorated with green fluorescent protein (GFP) on their surfaces were prepared by the addition of His6-GFP into the vesicles solution. Reversibility of the binding between vesicles and His6-GFP was confirmed with a fluorescent microscope.

A facile room temperature chemical transformation approach for binder-free thin film formation of Ag2Te and lithiation/delithiation chemistry of the film.

The present work demonstrates a highly controllable, facile and environmentally friendly aqueous solution based synthetic method for oxide contamination-free Ag2Te thin films on desired substrates at room temperature using ion exchange induced chemical transformation of Ag/AgxO thin films. The films before and after chemical transformation reaction are characterized using an energy dispersive X-ray analyzer, field emission scanning electron microscopy, X-ray photoelectron spectroscopy, thin film X-ray diffraction technique, high resolution transmission electron microscopy, and the selected area electron diffraction analysis technique. The as-deposited Ag2Te films show a highly crystalline nature even without thermal treatment. Furthermore, the electrochemistry for lithiation/delithiation of the Ag2Te film is studied for exploring its feasibility in the application as an anode material in a Li-ion battery. The experimentally estimated capacity of the Ag2Te electrode for Li storage is found to be about two and half fold larger than the theoretical capacity of the Ag2Te material. This implies that the binder-free Ag2Te film prepared by the current method could find a potential application in the Li-ion or other similar charge storing devices.