Do we need to flick the switch? The need for a broader conceptualization of iatrogenic course aggravation in clinical trials of bipolar disorder?

The term ‘switching’ is often used in bipolar disorder when describing polarity changes in bipolar disorder, but this term is ambiguous and imprecise, and is sometimes used interchangeably with the term ‘cycling’. Furthermore, polarity changes in bipolar disorder can be understood in different ways, because their clinical manifestations range from the emergence of subthreshold symptoms to a full episode of the opposite pole. Besides the need to tighten the meaning of the term ‘switching’, this paper also argues that switching does not adequately describe the complex phenomena that occur with course aggravation of bipolar disorder, such as alteration in episode frequency or amplitude. A more-fine grained approach to course aggravation in bipolar disorder is proposed, which incorporates trans-polar switching, index polarity aggravation, as well as alterations in episodic amplitude, episodic duration, and interepisode length. This approach has the potential to capture a broader, more fine-grained and clinically relevant picture of the process of aggravation of the bipolar cycle.

Prospective progression from high-prevalence disorders to bipolar disorder: exploring characteristics of pre-illness stages

BACKGROUND: Identification of risk factors within precursor syndromes, such as depression, anxiety or substance use disorders (SUD), might help to pinpoint high-risk stages where preventive interventions for Bipolar Disorder (BD) could be evaluated.

METHODS: We examined baseline demographic, clinical, quality of life, and temperament measures along with risk clusters among 52 young people seeking help for depression, anxiety or SUDs without psychosis or BD. The risk clusters included Bipolar At-Risk (BAR) and the Bipolarity Index as measures of bipolarity and the Ultra-High Risk assessment for psychosis. The participants were followed up for 12 months to identify conversion to BD. Those who converted and did not convert to BD were compared using Chi-Square and Mann Whitney U tests.

RESULTS: The sample was predominantly female (85%) and a majority had prior treatment (64%). Four participants converted to BD over the 1-year follow up period. Having an alcohol use disorder at baseline (75% vs 8%, χ(2)=14.1, p<0.001) or a family history of SUD (67% vs 12.5%, χ(2)=6.0, p=0.01) were associated with development of BD. The sub-threshold mania subgroup of BAR criteria was also associated with 12-month BD outcomes. The severity of depressive symptoms and cannabis use had high effects sizes of association with BD outcomes, without statistical significance.

CONCLUSIONS AND LIMITATIONS: The small number of conversions limited the power of the study to identify associations with risk factors that have previously been reported to predict BD. However, subthreshold affective symptoms and SUDs might predict the onset of BD among help-seeking young people with high-prevalence disorders.

Instruments that prospectively predict bipolar disorder - a systematic review

BACKGROUND: Identification of earlier stages of Bipolar Disorder (BD), even prior to the first manic episode, may help develop interventions to prevent or delay the onset of BD. However, reliable and valid instruments are necessary to ascertain such earlier stages of BD. The aim of the current review was to identify instruments that had predictive validity and utility for BD for use in early intervention (EI) settings for the prevention of BD. METHODS: We undertook a systematic examination of studies that examined participants without BD I or II at baseline and prospectively explored the predictive abilities of instruments for BD onset over a period of 6 months or more. The instruments and the studies were rated with respect to their relative validity and utility predicting onset of BD for prevention or early intervention. Odds ratios and area under the curve (AUC) values were derived when not reported. RESULTS: Six studies were included, identifying five instruments that examined sub-threshold symptoms, family history, temperament and behavioral regulation. Though none of the identified instruments had been examined in high-quality replicated studies for predicting BD, two instruments, namely the Child Behavioral Checklist - Pediatric BD phenotype (CBCL-PBD) and the General Behavioral Inventory - Revised (GBI-R), had greater levels of validity and utility. LIMITATION: Non-inclusion of studies and instruments that incidentally identified BD on follow-up limited the breadth of the review. CONCLUSION: Instruments that test domains such as subthreshold symptoms, behavioral regulation, family history, and temperament hold promise in predicting BD onset.

Graphene quantum dots directly generated from graphite via magnetron sputtering and the application in thin-film transistors

This work presents a novel method to prepare graphene quantum dots (GQDs) directly from graphite. A composite film of GQDs and ZnO was first prepared using the composite target of graphite and ZnO via magnetron sputtering, followed with hydrochloric acid treatment and dialysis. Morphology and optical properties of the GQDs were investigated using a number of techniques. The as-prepared GQDs are 4-12 nm in size and 1-2 nm in thickness. They also exhibited typical excitation-dependent properties as expected in carbon-based quantum dots. To demonstrate the potential applications of GQDs in electronic devices, pure ZnO and GQD-ZnO thin-film transistors (TFTs) using ZrOx dielectric were fabricated and examined. The ZnO TFT incorporating the GQDs exhibited enhanced performance: an on/off current ratio of 1.7 × 107, a field-effect mobility of 17.7 cm2/Vs, a subthreshold swing voltage of 90 mV/decade. This paper provides an efficient, reproducible and eco-friendly approach for the preparation of monodisperse GQDs directly from graphite. Our results suggest that GQDs fabricated using magnetron sputtering method may envision promising applications in electronic devices.

Indicadores de cálcio e de voltagem codificados geneticamente na detecção de potenciais de ação e inputs sinápticos em cultura de neurônios hipocampais

Recently, genetically encoded optical indicators have emerged as noninvasive tools of high spatial and temporal resolution utilized to monitor the activity of individual neurons and specific neuronal populations. The increasing number of new optogenetic indicators, together with the absence of comparisons under identical conditions, has generated difficulty in choosing the most appropriate protein, depending on the experimental design. Therefore, the purpose of our study was to compare three recently developed reporter proteins: the calcium indicators GCaMP3 and R-GECO1, and the voltage indicator VSFP butterfly1.2. These probes were expressed in hippocampal neurons in culture, which were subjected to patchclamp recordings and optical imaging. The three groups (each one expressing a protein) exhibited similar values of membrane potential (in mV, GCaMP3: -56 ±8.0, R-GECO1: -57 ±2.5; VSFP: -60 ±3.9, p = 0.86); however, the group of neurons expressing VSFP showed a lower average of input resistance than the other groups (in Mohms, GCaMP3: 161 ±18.3; GECO1-R: 128 ±15.3; VSFP: 94 ±14.0, p = 0.02). Each neuron was submitted to current injections at different frequencies (10 Hz, 5 Hz, 3 Hz, 1.5 Hz, and 0.7 Hz) and their fluorescence responses were recorded in time. In our study, only 26.7% (4/15) of the neurons expressing VSFP showed detectable fluorescence signal in response to action potentials (APs). The average signal-to-noise ratio (SNR) obtained in response to five spikes (at 10 Hz) was small (1.3 ± 0.21), however the rapid kinetics of the VSFP allowed discrimination of APs as individual peaks, with detection of 53% of the evoked APs. Frequencies below 5 Hz and subthreshold signals were undetectable due to high noise. On the other hand, calcium indicators showed the greatest change in fluorescence following the same protocol (five APs at 10 Hz). Among the GCaMP3 expressing neurons, 80% (8/10) exhibited signal, with an average SNR value of 21 ±6.69 (soma), while for the R-GECO1 neurons, 50% (2/4) of the neurons had signal, with a mean SNR value of 52 ±19.7 (soma). For protocols at 10 Hz, 54% of the evoked APs were detected with GCaMP3 and 85% with R-GECO1. APs were detectable in all the analyzed frequencies and fluorescence signals were detected from subthreshold depolarizations as well. Because GCaMP3 is the most likely to yield fluorescence signal and with high SNR, some experiments were performed only with this probe. We demonstrate that GCaMP3 is effective in detecting synaptic inputs (involving Ca2+ influx), with high spatial and temporal resolution. Differences were also observed between the SNR values resulting from evoked APs, compared to spontaneous APs. In recordings of groups of cells, GCaMP3 showed clear discrimination between activated and silent cells, and reveals itself as a potential tool in studies of neuronal synchronization. Thus, our results indicate that the presently available calcium indicators allow detailed studies on neuronal communication, ranging from individual dendritic spines to the investigation of events of synchrony in neuronal networks genetically defined. In contrast, studies employing VSFPs represent a promising technology for monitoring neural activity and, although still to be improved, they may become more appropriate than calcium indicators, since neurons work on a time scale faster than events of calcium may foresee

NN scattering: Chiral predictions for asymptotic observables

We assume that the nuclear potential for distances larger than 2.5 fm is given just by the exchanges of one and two pions and, for the latter, we adopt a model based on chiral symmetry and subthreshold pion-nucleon amplitudes, which contains no free parameters. The predictions produced by this model for nucleon-nucleon observables are calculated and shown to agree well with both experiment and those due to phenomenological potentials.

Diverse levels of an inwardly rectifying potassium conductance generate heterogeneous neuronal behavior in a population of dorsal cochlear nucleus pyramidal neurons

Leao RM, Li S, Doiron B, Tzounopoulos T. Diverse levels of an inwardly rectifying potassium conductance generate heterogeneous neuronal behavior in a population of dorsal cochlear nucleus pyramidal neurons. J Neurophysiol 107: 3008-3019, 2012. First published February 29, 2012; doi:10.1152/jn.00660.2011.-Homeostatic mechanisms maintain homogeneous neuronal behavior among neurons that exhibit substantial variability in the expression levels of their ionic conductances. In contrast, the mechanisms, which generate heterogeneous neuronal behavior across a neuronal population, remain poorly understood. We addressed this problem in the dorsal cochlear nucleus, where principal neurons exist in two qualitatively distinct states: spontaneously active or not spontaneously active. Our studies reveal that distinct activity states are generated by the differential levels of a Ba2+-sensitive, inwardly rectifying potassium conductance (K-ir). Variability in K-ir maximal conductance causes variations in the resting membrane potential (RMP). Low K-ir conductance depolarizes RMP to voltages above the threshold for activating subthreshold-persistent sodium channels (Na-p). Once Na-p channels are activated, the RMP becomes unstable, and spontaneous firing is triggered. Our results provide a biophysical mechanism for generating neural heterogeneity, which may play a role in the encoding of sensory information.

The Li-8(p, alpha)He-5 reaction at low energies, and Be-9 spectroscopy around the proton threshold

We present a direct measurement of the low-energy Li-8(p, alpha)He-5 cross section, using a radioactive Li-8 beam impinging on a thick target. With four beam energies, we cover the energy range between E-c.m. = 0.2 and 2.1 MeV. An R-matrix analysis of the data is performed and suggests the existence of two broad overlapping resonances (5/2(+) at E-c.m. = 1.69 MeV and 7/2(+) at E-c.m. = 1.76 MeV). At low energies our data are sensitive to the properties of a subthreshold state (E-x = 16.67 MeV) and of two resonances above threshold. These resonances were observed in previous experiments. The R-matrix fit confirms spin assignments, and provides partial widths. We propose a new Li-8(p, alpha)He-5 reaction rate and briefly discuss its influence in nuclear astrophysics. DOI: 10.1103/PhysRevC.86.064321

Behavior of triple-gate Bulk FinFETs with and without DTMOS operation

In this paper, the combination of the Dynamic Threshold (DT) voltage technique with a non-planar structure is experimentally studied in triple-gate FinFETs. The drain current, transconductance, resistance, threshold voltage, subthreshold swing and Drain Induced Barrier Lowering (DIBL) will be analyzed in the DT mode and the standard biasing configuration. Moreover, for the first time, the important figures of merit for the analog performance such as transconductance-over-drain current, output conductance. Early voltage and intrinsic voltage gain will be studied experimentally and through three-dimensional (3-D) numerical simulations for different channel doping concentrations in triple-gate DTMOS FinFETs. The results indicate that the DTMOS FinFETs always yield superior characteristic; and larger transistor efficiency. In addition, DTMOS devices with a high channel doping concentration exhibit much better analog performance compared to the normal operation mode, which is desirable for high performance low-power/low-voltage applications. (C) 2011 Elsevier Ltd. All rights reserved.

Phase-disorder-induced firing activity in excitable neuronal networks with attractive and repulsive coupling

It has been revealed that the network of excitable neurons via attractive coupling can generate spikes under stimuli of subthreshold signals with disordered phases. In this paper, we explore the firing activity induced by phase disorder in excitable neuronal networks consisting of both attractive and repulsive coupling. By increasing the fraction of repulsive coupling, we find that, in the weak coupling strength case, the firing threshold of phase disorder is increased and the system response to subthreshold signals is decreased, indicating that the effect of inducing neuron firing by phase disorder is weakened with repulsive coupling. Interestingly, in the large coupling strength case, we see an opposite situation, where the coupled neurons show a rather large response to the subthreshold signals even with small phase disorder. The latter case implies that the effect of phase disorder is enhanced by repulsive coupling. A system of two-coupled excitable neurons is used to explain the role of repulsive coupling on phase-disorder-induced firing activity.

Clinical and sociodemographic factors in a sample of older subjects experiencing depressive symptoms

Objectives This study aims to determine the frequency of clinically significant depressive symptoms (CSDS) in a community sample of older Brazilians and to examine their relationship with sociodemographic factors, cognitive and functional impairment (CFI), and medical illness. Methods A total of 1145 subjects aged 60?years or older living in the City of Ribeirao Preto, State of Sao Paulo, Brazil, were interviewed. The following instruments were used: a 10-item scale for screening of depressive symptoms in older people, the mini mental state examination, the Fuld Object Memory Evaluation, the Informant Questionnaire on Cognitive Decline in the Elderly, the Bayer Activities of Daily Living Scale, and a sociodemographic and clinical questionnaire. Results The frequency of CSDS was 15.7%. Logistic regression analysis indicated that being previously depressed, having CFI, having lower level of education, using psychotropics, and not engaging in physical exercise were related to CSDS. On the other hand, being a woman, older, medically ill, employed, or married was not associated with CSDS. Conclusions Consistent with previous reports, lower education, lack of physical activity, and CFI were significantly associated with higher frequencies of CSDS. Further investigations are necessary to clarify the occurrence of depression and possible modifiable factors in developing countries such as Brazil. Copyright (C) 2011 John Wiley & Sons, Ltd.

Signal amplification of active rotators with phase-shifted coupling

In this paper, we study the signal amplification of coupled active rotators with phase-shifted coupling. We find that the system's response to the external subthreshold signal can be significantly affected by each of the two types of phase-shifted couplings: identical and non-identical phase-shifted couplings. Moreover, through both theoretical analysis and numerical simulations, we have figured out the optimal phase shift, at which the largest signal amplification is generated. These results show that the phase-shifted coupling plays an important role in regulating the system's response to the subthreshold signal.

Numerical study of graphene as a channel material for field-effect transistors

Graphene excellent properties make it a promising candidate for building future nanoelectronic devices. Nevertheless, the absence of an energy gap is an open problem for the transistor application. In this thesis, graphene nanoribbons and pattern-hydrogenated graphene, two alternatives for inducing an energy gap in graphene, are investigated by means of numerical simulations. A tight-binding NEGF code is developed for the simulation of GNR-FETs. To speed up the simulations, the non-parabolic effective mass model and the mode-space tight-binding method are developed. The code is used for simulation studies of both conventional and tunneling FETs. The simulations show the great potential of conventional narrow GNR-FETs, but highlight at the same time the leakage problems in the off-state due to various tunneling mechanisms. The leakage problems become more severe as the width of the devices is made larger, and thus the band gap smaller, resulting in a poor on/off current ratio. The tunneling FET architecture can partially solve these problems thanks to the improved subthreshold slope; however, it is also shown that edge roughness, unless well controlled, can have a detrimental effect in the off-state performance. In the second part of this thesis, pattern-hydrogenated graphene is simulated by means of a tight-binding model. A realistic model for patterned hydrogenation, including disorder, is developed. The model is validated by direct comparison of the momentum-energy resolved density of states with the experimental angle-resolved photoemission spectroscopy. The scaling of the energy gap and the localization length on the parameters defining the pattern geometry is also presented. The results suggest that a substantial transport gap can be attainable with experimentally achievable hydrogen concentration.

Resonance properties of different neuronal populations in the immature mouse neocortex

Subthreshold resonance is a characteristic membrane property of different neuronal classes, is critically involved in the generation of network oscillations, and tunes the integration of synaptic inputs to particular frequency ranges. In order to investigate whether resonance properties of distinct neuronal populations in the immature neocortex contribute to these network oscillations, I performed whole-cell patch-clamp recordings from visually identified neurons in tangential and coronal neocortical slices from postnatal day (P) P0-P7 C57Bl/6 and P6-P13 GAD67-GFP knock-in mice. Subthreshold resonance was analyzed by sinusoidal current injection of varying frequency. All Cajal-Retzius cells showed subthreshold resonance with an average frequency of 2.6 ± 0.1 Hz (n=60), which was massively reduced by ZD7288, a blocker of hyperpolarization-activated cation currents. About 65.6% (n=61) of the supragranular pyramidal neurons showed subthreshold resonance with an average frequency of 1.4 ± 0.1 Hz (n=40). Application of 1 mM Ni2+ suppressed subthreshold resonance, suggesting that low-threshold Ca2+ currents contribute to resonance in these neurons. About 63.6% (n=77) of the layer V pyramidal neurons showed subthreshold resonance with an average frequency of 1.4 ± 0.2 Hz (n=49), which was abolished by ZD7288. Only 44.1% (n=59) of the subplate neurons showed subthreshold resonance with an average frequency of 1.3 ± 0.2 Hz (n=26) and a small resonance strength. Finally, 50% of the investigated GABAergic interneurons showed subthreshold resonance with an average frequency of 2.0 ± 0.2 Hz (n=42). Membrane hyperpolarization to –86 mV attenuated the frequency and strength of subthreshold resonance. Subthreshold resonance was virtually abolished in the presence of 1 mM Ni2+, suggesting that t-type Ca2+ currents are critically involved in the generation of resonance, while ZD7288 had no effect. Application of 0.4 µM TTX suppressed subthreshold resonance at depolarized, but not hyperpolarized membrane potential, suggesting that persistent Na+ current contribute to the amplification of membrane resonance. rnIn summary, these results demonstrate that all investigated neuronal subpopulations reveal resonance behavior, with either hyperpolarization-activated cation or low-threshold Ca2+ currents contributing to the subthreshold resonance. GABAergic interneurons also express subthreshold resonance at low frequencies, with t-type Ca2+ and persistent Na+ currents underlying the generation of membrane resonance. The membrane resonance of immature neurons may contribute to the generation of slow oscillatory activity pattern in the immature neocortex and enhance the temporal precision of synaptic integration in developing cortical neurons.rn

The near babylonian speech confusion in early detection of psychosis

It is barely 15 years since, in 1996, the issue theme of Schizophrenia Bulletin (Vol 22, 2) “Early Detection, and Intervention in Schizophrenia” signified the commencement of this field of research. Since that time the field of early detection research has developed rapidly and it may be translated into clinical practice by the introduction of an Attenuated Psychosis Syndrome in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, (DSM-5) (www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=412#). Attenuated psychotic symptoms (APS) had first been suggested as a clinical predictor of first-episode psychosis by the Personal Assessment and Crisis Evaluation (PACE) Clinic group as part of the ultrahigh risk (UHR) criteria.1 The term ultrahigh risk became broadly accepted for this set of criteria for imminent risk of developing psychosis in the late 1990s. The use of the term “prodrome” for a state characterized by at-risk (AR) criteria was criticized as a retrospective concept inevitably followed by the full-blown disorder.1 Although alternative terms have been suggested, prodrome is still used in prospective studies (eg, prodromally symptomatic, potentially or putatively prodromal, prodrome-like state/symptoms). Some alternative suggestions such as prepsychotic state/symptoms, subthreshold psychotic symptoms, early psychosis, subsyndromal psychosis, hypopsychosis, or subpsychosis were short-lived. Other terms still in use include UHR, at-risk mental state (ARMS), AR, high risk, clinical high risk (CHR), or early and late AR state. Further, the term psychotic-like experiences (PLEs) has recently (re-)entered early detection research. …