Validation of Electronic Health Record Phenotyping of Bipolar Disorder Cases and Controls

Objective: The study was designed to validate use of elec-tronic health records (EHRs) for diagnosing bipolar disorder and classifying control subjects. Method: EHR data were obtained from a health care system of more than 4.6 million patients spanning more than 20 years. Experienced clinicians reviewed charts to identify text features and coded data consistent or inconsistent with a diagnosis of bipolar disorder. Natural language processing was used to train a diagnostic algorithm with 95% specificity for classifying bipolar disorder. Filtered coded data were used to derive three additional classification rules for case subjects and one for control subjects. The positive predictive value (PPV) of EHR-based bipolar disorder and subphenotype di- agnoses was calculated against diagnoses from direct semi- structured interviews of 190 patients by trained clinicians blind to EHR diagnosis. Results: The PPV of bipolar disorder defined by natural language processing was 0.85. Coded classification based on strict filtering achieved a value of 0.79, but classifications based on less stringent criteria performed less well. No EHR- classified control subject received a diagnosis of bipolar dis- order on the basis of direct interview (PPV=1.0). For most subphenotypes, values exceeded 0.80. The EHR-based clas- sifications were used to accrue 4,500 bipolar disorder cases and 5,000 controls for genetic analyses. Conclusions: Semiautomated mining of EHRs can be used to ascertain bipolar disorder patients and control subjects with high specificity and predictive value compared with diagnostic interviews. EHRs provide a powerful resource for high-throughput phenotyping for genetic and clinical research.

Seasonality Shows Evidence for Polygenic Architecture and Genetic Correlation With Schizophrenia and Bipolar Disorder

OBJECTIVE: To test common genetic variants for association with seasonality (seasonal changes in mood and behavior) and to investigate whether there are shared genetic risk factors between psychiatric disorders and seasonality. METHOD: Genome-wide association studies (GWASs) were conducted in Australian (between 1988 and 1990 and between 2010 and 2013) and Amish (between May 2010 and December 2011) samples in whom the Seasonal Pattern Assessment Questionnaire (SPAQ) had been administered, and the results were meta-analyzed in a total sample of 4,156 individuals. Genetic risk scores based on results from prior large GWAS studies of bipolar disorder, major depressive disorder (MDD), and schizophrenia were calculated to test for overlap in risk between psychiatric disorders and seasonality. RESULTS: The most significant association was with rs11825064 (P = 1.7 × 10⁻⁶, β = 0.64, standard error = 0.13), an intergenic single nucleotide polymorphism (SNP) found on chromosome 11. The evidence for overlap in risk factors was strongest for schizophrenia and seasonality, with the schizophrenia genetic profile scores explaining 3% of the variance in log-transformed global seasonality scores. Bipolar disorder genetic profile scores were also associated with seasonality, although at much weaker levels (minimum P value = 3.4 × 10⁻³), and no evidence for overlap in risk was detected between MDD and seasonality. CONCLUSIONS: Common SNPs of large effect most likely do not exist for seasonality in the populations examined. As expected, there were overlapping genetic risk factors for bipolar disorder (but not MDD) with seasonality. Unexpectedly, the risk for schizophrenia and seasonality had the largest overlap, an unprecedented finding that requires replication in other populations and has potential clinical implications considering overlapping cognitive deficits in seasonal affective disorders and schizophrenia.

Diketopyrrolopyrrole derivatives for bulk heterojunction and dye sensitised solar cells

This thesis describes the synthesis and characterisation of a series of molecules for use in bulk heterojunction and dye sensitised solar cells. The target molecules were based on a central diketopyrrolopyrrole subunit. Molecules based on diketopyrrolopyrrole have a conjugated structure, allowing for π-π interaction. Diketopyrrolopyrrole molecules also have relatively low lying HOMO and LUMO levels and high absorption coefficients and exhibit efficient charge transport properties. Furthermore, their electron withdrawing properties have warranted their use as promising organic photovoltaic materials. A number of molecules were successfully synthesised and sent to collaborators for testing in organic photovoltaic devices and development of this series of molecules continues to be of interest within the research group.

Doença bipolar de início tardio: caso clínico

Introdução: A perturbação bipolar afecta aproximadamente 1% da população, com o diagnóstico geralmente estabelecido durante a adolescência/início da idade adulta e sendo apenas feito em 0.1% da população geriátrica. A perturbação bipolar de início tardio é heterogénea e a sua etiopatogenia é complexa. A idade de início tem um impacto significativo na natureza e curso desta doença. Objectivos: As autoras apresentam um caso de perturbação bipolar de início tardio, aos 76 anos, sem que esteja identificada uma causa orgânica subjacente. Conclusão: Este caso demonstra a importância de um amplo diagnóstico diferencial e manejo farmacológico, quando se abordam sintomas maniformes/depressivos de novo em doentes geriátricos.

Pronóstico a largo plazo del trastorno bipolar con episodios mixtos.

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O tratamento do doente bipolar na consulta de medicina dentária: um caso clínico

Dissertação para obtenção do grau de Mestre no Instituto Superior de Ciências da Saúde Egas Moniz

Organic materials for active layers in transistors: Study of the electrical stability properties

Field effect transistors based on several conjugated organic materials were fabricated and assesed in terms of electrical stability. The device characteristics were studied using steady state measurements as well as techniques for addressing trap states. Temperature-dependent measurements show clear evidence for an electrical instability occurring above 200 K that is caused by an electronic trapping process. It is suggested that the trapping sites are created by a change in the organic conjugated chain, a process similar to a phase transition.

Effect of oxygen on the electrical characteristics of field effect transistors formed from electrochemically deposited films of poly(3-methylthiophene)

Field effect devices have been formed in which the active layer is a thin film of poly(3-methylthiophene) grown electrochemically onto preformed source and drain electrodes. Although a field effect is present after electrochemical undoping, stable device characteristics with a high modulation ratio are obtained only after vacuum annealing at an elevated temperature, and only then if the devices are held in vacuo. The polymer is shown to be p type and the devices operate in accumulation only. The hole mobility in devices thermally annealed under vacuum is around 10 -3 cm 2 V -1 s -1. On exposure to ambient laboratory air, the device conductance increases by several orders of magnitude. This increase may be reversed by subjecting the device to a further high-temperature anneal under vacuum. Subsidiary experiments show that these effects are caused by the reversible doping of the polymer by gaseous oxygen.

Organic materials for active layers in transistors: Study of the electrical stability properties

Field effect transistors based on several conjugated organic materials were fabricated and assesed in terms of electrical stability. The device characteristics were studied using steady state measurements as well as techniques for addressing trap states. Temperature-dependent measurements show clear evidence for an electrical instability occurring above 200 K that is caused by an electronic trapping process. It is suggested that the trapping sites are created by a change in the organic conjugated chain, a process similar to a phase transition.

Electrical characterization of organic based transistors: stability issues

An investigation into the stability of metal insulator semiconductor (MIS) transistors based on alpha-sexithiophene is reported. In particular the kinetics of the threshold voltage shift upon application of a gate bias has been determined. The kinetics follow a stretched-hyperbola type behavior, in agreement with the formalism developed to explain metastability in amorphous-silicon thin film transistors. Using this model, quantification of device stability is possible. Temperature-dependent measurements show that there are two processes involved in the threshold voltage shift, one occurring at T approximate to 220 K and the other at T approximate to 300 K. The latter process is found to be sample dependent. This suggests a relation between device stability and alpha-sexithiophene deposition parameters. Copyright (c) 2005 John Wiley A Sons, Ltd.

Effect of oxygen on the electrical characteristics of field effect transistors formed from electrochemically deposited films of poly(3-methylthiophene)

Field effect devices have been formed in which the active layer is a thin film of poly(3-methylthiophene) grown electrochemically onto preformed source and drain electrodes. Although a field effect is present after electrochemical undoping, stable device characteristics with a high modulation ratio are obtained only after vacuum annealing at an elevated temperature, and only then if the devices are held in vacuo. The polymer is shown to be p type and the devices operate in accumulation only. The hole mobility in devices thermally annealed under vacuum is around 10 -3 cm 2 V -1 s -1. On exposure to ambient laboratory air, the device conductance increases by several orders of magnitude. This increase may be reversed by subjecting the device to a further high-temperature anneal under vacuum. Subsidiary experiments show that these effects are caused by the reversible doping of the polymer by gaseous oxygen.

Electronic transport in field-effect transistors of sexithiophene

The electronic conduction of thin-film field-effect-transistors (FETs) of sexithiophene was studied. In most cases the transfer curves deviate from standard FET theory; they are not linear, but follow a power law instead. These results are compared to conduction models of "variable-range hopping" and "multi-trap-and-release". The accompanying IV curves follow a Poole-Frenkel (exponential) dependence on the drain voltage. The results are explained assuming a huge density of traps. Below 200 K, the activation energy for conduction was found to be ca. 0.17 eV. The activation energies of the mobility follow the Meyer-Neldel rule. A sharp transition is seen in the behavior of the devices at around 200 K. The difference in behavior of a micro-FET and a submicron FET is shown. (C) 2004 American Institute of Physics.

Bias-induced threshold voltages shifts in thin-film organic transistors

An investigation into the stability of metal-insulator-semiconductor (MIS) transistors based on alpha-sexithiophene is reported. In particular, the kinetics of the threshold voltage shift upon application of a gate bias has been determined. The kinetics follow stretched-hyperbola-type behavior, in agreement with the formalism developed to explain metastability in amorphous-silicon thin-film transistors. Using this model, quantification of device stability is possible. Temperature-dependent measurements show that there are two processes involved in the threshold voltage shift, one occurring at Tapproximate to220 K and the other at Tapproximate to300 K. The latter process is found to be sample dependent. This suggests a relation between device stability and processing parameters. (C) 2004 American Institute of Physics.

Detection of explosive vapors using organic thin-film transistors

Field effect transistors (FETs) based on organic materials were investigated as sensors for detecting 2,4,6-trinitrotoluene (TNT) vapors. Several FET devices were fabricated using two types of semiconducting organic materials, solution processed polymers deposited by spin coating and, oligomers (or small molecules) deposited by vacuum sublimation. When vapors of nitroaromatic compounds bind to thin films of organic materials which form the transistor channel, the conductivity of the thin film increases and changes the transistor electrical characteristic. The use of the amplifying properties of the transistor represents a major advantage over conventional techniques based on simple changes of resistance in polymers frequently used in electronic noses.