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Iwamoto H, Nakano S, Tajima R, Kiguchi R, Yoshida Y, Kitanishi Y, Aoki Y. Predicting Workers' Stress: Application of a High-Performance Algorithm Using Working-Style Characteristics. JMIR AI 2024; 3:e55840. [PMID: 39093604 PMCID: PMC11329844 DOI: 10.2196/55840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 04/18/2024] [Accepted: 06/14/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND Work characteristics, such as teleworking rate, have been studied in relation to stress. However, the use of work-related data to improve a high-performance stress prediction model that suits an individual's lifestyle has not been evaluated. OBJECTIVE This study aims to develop a novel, high-performance algorithm to predict an employee's stress among a group of employees with similar working characteristics. METHODS This prospective observational study evaluated participants' responses to web‑based questionnaires, including attendance records and data collected using a wearable device. Data spanning 12 weeks (between January 17, 2022, and April 10, 2022) were collected from 194 Shionogi Group employees. Participants wore the Fitbit Charge 4 wearable device, which collected data on daily sleep, activity, and heart rate. Daily work shift data included details of working hours. Weekly questionnaire responses included the K6 questionnaire for depression/anxiety, a behavioral questionnaire, and the number of days lunch was missed. The proposed prediction model used a neighborhood cluster (N=20) with working-style characteristics similar to those of the prediction target person. Data from the previous week predicted stress levels the following week. Three models were compared by selecting appropriate training data: (1) single model, (2) proposed method 1, and (3) proposed method 2. Shapley Additive Explanations (SHAP) were calculated for the top 10 extracted features from the Extreme Gradient Boosting (XGBoost) model to evaluate the amount and contribution direction categorized by teleworking rates (mean): low: <0.2 (more than 4 days/week in office), middle: 0.2 to <0.6 (2 to 4 days/week in office), and high: ≥0.6 (less than 2 days/week in office). RESULTS Data from 190 participants were used, with a teleworking rate ranging from 0% to 79%. The area under the curve (AUC) of the proposed method 2 was 0.84 (true positive vs false positive: 0.77 vs 0.26). Among participants with low teleworking rates, most features extracted were related to sleep, followed by activity and work. Among participants with high teleworking rates, most features were related to activity, followed by sleep and work. SHAP analysis showed that for participants with high teleworking rates, skipping lunch, working more/less than scheduled, higher fluctuations in heart rate, and lower mean sleep duration contributed to stress. In participants with low teleworking rates, coming too early or late to work (before/after 9 AM), a higher/lower than mean heart rate, lower fluctuations in heart rate, and burning more/fewer calories than normal contributed to stress. CONCLUSIONS Forming a neighborhood cluster with similar working styles based on teleworking rates and using it as training data improved the prediction performance. The validity of the neighborhood cluster approach is indicated by differences in the contributing features and their contribution directions among teleworking levels. TRIAL REGISTRATION UMIN UMIN000046394; https://www.umin.ac.jp/ctr/index.htm.
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Affiliation(s)
| | | | | | | | | | | | - Yasunori Aoki
- Shionogi & Co., Ltd., Osaka, Japan
- Department of Psychiatry, Nippon Life Hospital, Osaka, Japan
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Zielinski JM, Reisert M, Sajonz BEA, Teo SJ, Thierauf-Emberger A, Wessolleck J, Frosch M, Spittau B, Leupold J, Döbrössy MD, Coenen VA. In Search for a Pathogenesis of Major Depression and Suicide-A Joint Investigation of Dopamine and Fiber Tract Anatomy Focusing on the Human Ventral Mesencephalic Tegmentum: Description of a Workflow. Brain Sci 2024; 14:723. [PMID: 39061463 PMCID: PMC11275155 DOI: 10.3390/brainsci14070723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 07/16/2024] [Accepted: 07/17/2024] [Indexed: 07/28/2024] Open
Abstract
Major depressive disorder (MDD) is prevalent with a high subjective and socio-economic burden. Despite the effectiveness of classical treatment methods, 20-30% of patients stay treatment-resistant. Deep Brain Stimulation of the superolateral branch of the medial forebrain bundle is emerging as a clinical treatment. The stimulation region (ventral tegmental area, VTA), supported by experimental data, points to the role of dopaminergic (DA) transmission in disease pathology. This work sets out to develop a workflow that will allow the performance of analyses on midbrain DA-ergic neurons and projections in subjects who have committed suicide. Human midbrains were retrieved during autopsy, formalin-fixed, and scanned in a Bruker MRI scanner (7T). Sections were sliced, stained for tyrosine hydroxylase (TH), digitized, and integrated into the Montreal Neurological Institute (MNI) brain space together with a high-resolution fiber tract atlas. Subnuclei of the VTA region were identified. TH-positive neurons and fibers were semi-quantitatively evaluated. The study established a rigorous protocol allowing for parallel histological assessments and fiber tractographic analysis in a common space. Semi-quantitative readings are feasible and allow the detection of cell loss in VTA subnuclei. This work describes the intricate workflow and first results of an investigation of DA anatomy in VTA subnuclei in a growing naturalistic database.
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Affiliation(s)
- Jana M. Zielinski
- Department of Stereotactic and Functional Neurosurgery, Medical Center of Freiburg University, Breisacher Straße 64, 79106 Freiburg i.Br., Germany
| | - Marco Reisert
- Department of Stereotactic and Functional Neurosurgery, Medical Center of Freiburg University, Breisacher Straße 64, 79106 Freiburg i.Br., Germany
- Medical Faculty of University of Freiburg, 79106 Freiburg, Germany
- Department of Diagnostic and Interventional Radiology, Medical Physics, Medical Center—University of Freiburg, 79106 Freiburg, Germany
| | - Bastian E. A. Sajonz
- Department of Stereotactic and Functional Neurosurgery, Medical Center of Freiburg University, Breisacher Straße 64, 79106 Freiburg i.Br., Germany
- Medical Faculty of University of Freiburg, 79106 Freiburg, Germany
| | - Shi Jia Teo
- Medical Faculty of University of Freiburg, 79106 Freiburg, Germany
- Department of Diagnostic and Interventional Radiology, Medical Physics, Medical Center—University of Freiburg, 79106 Freiburg, Germany
| | - Annette Thierauf-Emberger
- Medical Faculty of University of Freiburg, 79106 Freiburg, Germany
- Institute of Forensic Medicine, Medical Center of Freiburg University, 79104 Freiburg, Germany
| | - Johanna Wessolleck
- Medical Faculty of University of Freiburg, 79106 Freiburg, Germany
- Laboratory of Stereotaxy and Interventional Neurosciences, Department of Stereotactic and Functional, Neurosurgery, Medical Center of Freiburg University, 79106 Freiburg, Germany
| | - Maximilian Frosch
- Medical Faculty of University of Freiburg, 79106 Freiburg, Germany
- Institute of Neuropathology, Medical Center of Freiburg University, 79106 Freiburg, Germany
| | - Björn Spittau
- Medical School OWL, Anatomy and Cell Biology, Bielefeld University, 33501 Bielefeld, Germany
- Institute for Anatomy and Cell Biology, Department of Molecular Embryologie, Faculty of Medicine, Freiburg University, 79104 Freiburg, Germany
| | - Jochen Leupold
- Medical Faculty of University of Freiburg, 79106 Freiburg, Germany
- Department of Diagnostic and Interventional Radiology, Medical Physics, Medical Center—University of Freiburg, 79106 Freiburg, Germany
| | - Máté D. Döbrössy
- Medical Faculty of University of Freiburg, 79106 Freiburg, Germany
- Laboratory of Stereotaxy and Interventional Neurosciences, Department of Stereotactic and Functional, Neurosurgery, Medical Center of Freiburg University, 79106 Freiburg, Germany
- Faculty of Biology, University of Freiburg, 79104 Freiburg, Germany
| | - Volker A. Coenen
- Department of Stereotactic and Functional Neurosurgery, Medical Center of Freiburg University, Breisacher Straße 64, 79106 Freiburg i.Br., Germany
- Medical Faculty of University of Freiburg, 79106 Freiburg, Germany
- Laboratory of Stereotaxy and Interventional Neurosciences, Department of Stereotactic and Functional, Neurosurgery, Medical Center of Freiburg University, 79106 Freiburg, Germany
- Center for Deep Brain Stimulation, Medical Center of Freiburg University, 79106 Freiburg, Germany
- Center for Basics in Neuromodulation, Medical Faculty of Freiburg University, 79106 Freiburg, Germany
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Haapasalo A, Pasternack R, Kautiainen H, Ylianttila L, Snellman E, Partonen T. Influence of ultraviolet A1 exposures on mood states: a randomized controlled study. Photochem Photobiol Sci 2024; 23:1229-1238. [PMID: 38748081 DOI: 10.1007/s43630-024-00587-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/23/2024] [Indexed: 07/05/2024]
Abstract
We investigated the effects of daily ultraviolet A1 (UV-A1, 340-400 nm) exposures on mood states (#R19055, approval on 21 October 2020). Based on our earlier findings of the influence of diurnal preference on mood, we investigated further whether diurnal preference plays a role in the influence of UV-A1 on mood states. Forty-one healthy participants aged 19-55 years were randomized to receive either UV-A1 (n = 21) or control (n = 20) exposures (violet light, 390-440 nm). The irradiations were administered on three consecutive mornings on the skin of the buttocks and middle back. Diurnal preference was assessed with the modified 6-item Morningness-Eveningness Questionnaire (mMEQ). Changes in mood were assessed with Total Mood Disturbance (TMD) score of the 40-item Profile of Mood States (POMS) before the first irradiation, immediately after each irradiation and one week after the last irradiation. Mood improved among those subjected to UV-A1 exposures compared with the controls (p = 0.031). Individuals with more pronounced morningness had mood improvement (p = 0.011), whereas those with more pronounced eveningness did not (p = 0.41). At follow-up of one week after the last irradiation the mood improvement had disappeared.
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Affiliation(s)
- Annina Haapasalo
- Department of Dermatology, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
- Department of Allergology and Dermatology, Tampere University Hospital, Tampere, Finland.
| | - Rafael Pasternack
- Department of Dermatology, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Allergology and Dermatology, Tampere University Hospital, Tampere, Finland
| | - Hannu Kautiainen
- Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | | | - Erna Snellman
- Department of Dermatology, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Allergology and Dermatology, Tampere University Hospital, Tampere, Finland
- Department of Dermatology and Venereology, University of Turku, Turku, Finland
| | - Timo Partonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
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Slominski RM, Chen JY, Raman C, Slominski AT. Photo-neuro-immuno-endocrinology: How the ultraviolet radiation regulates the body, brain, and immune system. Proc Natl Acad Sci U S A 2024; 121:e2308374121. [PMID: 38489380 PMCID: PMC10998607 DOI: 10.1073/pnas.2308374121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Abstract
Ultraviolet radiation (UVR) is primarily recognized for its detrimental effects such as cancerogenesis, skin aging, eye damage, and autoimmune disorders. With exception of ultraviolet B (UVB) requirement in the production of vitamin D3, the positive role of UVR in modulation of homeostasis is underappreciated. Skin exposure to UVR triggers local responses secondary to the induction of chemical, hormonal, immune, and neural signals that are defined by the chromophores and extent of UVR penetration into skin compartments. These responses are not random and are coordinated by the cutaneous neuro-immuno-endocrine system, which counteracts the action of external stressors and accommodates local homeostasis to the changing environment. The UVR induces electrical, chemical, and biological signals to be sent to the brain, endocrine and immune systems, as well as other central organs, which in concert regulate body homeostasis. To achieve its central homeostatic goal, the UVR-induced signals are precisely computed locally with transmission through nerves or humoral signals release into the circulation to activate and/or modulate coordinating central centers or organs. Such modulatory effects will be dependent on UVA and UVB wavelengths. This leads to immunosuppression, the activation of brain and endocrine coordinating centers, and the modification of different organ functions. Therefore, it is imperative to understand the underlying mechanisms of UVR electromagnetic energy penetration deep into the body, with its impact on the brain and internal organs. Photo-neuro-immuno-endocrinology can offer novel therapeutic approaches in addiction and mood disorders; autoimmune, neurodegenerative, and chronic pain-generating disorders; or pathologies involving endocrine, cardiovascular, gastrointestinal, or reproductive systems.
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Affiliation(s)
- Radomir M. Slominski
- Departments of Genetics, the University of Alabama at Birmingham, Birmingham, AL35294
| | - Jake Y. Chen
- Department of Biomedical Informatics and Data Science, the University of Alabama at Birmingham, Birmingham, AL35294
- Comprehensive Cancer Center, Cancer Chemoprevention Program, University of Alabama at Birmingham, Birmingham, AL35294
| | - Chander Raman
- Department of Dermatology, the University of Alabama at Birmingham, Birmingham, AL35294
| | - Andrzej T. Slominski
- Comprehensive Cancer Center, Cancer Chemoprevention Program, University of Alabama at Birmingham, Birmingham, AL35294
- Department of Dermatology, the University of Alabama at Birmingham, Birmingham, AL35294
- Veteran Administration Medical Center, Birmingham, AL35294
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Herbuela VRDM, Karita T, Toya A, Furukawa Y, Senba S, Onishi E, Saeki T. Multilevel and general linear modeling of weather and time effects on the emotional and behavioral states of children with profound intellectual and multiple disabilities. Front Psychiatry 2024; 14:1235582. [PMID: 38250279 PMCID: PMC10797094 DOI: 10.3389/fpsyt.2023.1235582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 11/07/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction Eliciting the emotional and behavioral states of children with severe or profound intellectual disabilities (IDs) and profound intellectual and multiple disabilities (PIMD) due to their complex and atypical developmental trajectories has become increasingly elusive. It is evident that the environment, influenced by weather conditions and time of the day, plays a pivotal role in molding children's behaviors, emotions, and interactions. This underscores the significance of the environment as a critical factor in exploring the communication dynamics of children with PIMD/IDs. Methods Over five months during fall and winter seasons, we conducted 105 video-recorded sessions with 20 children aged 8 to 16 with PIMD/IDs. These sessions aimed to capture the emotional and behavioral states interpreted by caregivers while simultaneously collecting indoor and outdoor weather indices, location, and time data. Using cross-classified multilevel and general linear models adjusted for individual characteristics and location variability with subsequent simple slope analyses, we examined the main and seasonal interaction effects of indoor and outdoor weather indices and time of the day on the emotional and behavioral states of children with PIMD/IDs. Results The models revealed that higher atmospheric pressure (atm), indicative of pleasant and favorable weather conditions, was associated with increased engagement (indoor: p < 0.01; outdoor: p < 0.01) and interest (outdoor: p < 0.01) behaviors. In contrast, engagement levels decreased before lunchtime (p < 0.01; p < 0.001), and inclement or unstable weather conditions characterized by low-pressure systems (p < 0.05) and stronger wind speed (p < 0.05) led to more refusal or disagreement. During winter, children displayed significantly more agreement with their caregivers (p < 0.001). Interestingly, they also engaged more on cloudy days (p < 0.05). Furthermore, simple slope analyses revealed that high atm conditions in fall were linked to more engagement (p < 0.05) while humid conditions predicted more assent behaviors (p < 0.001). However, cloudy weather predicted less attentional focusing (p < 0.05) and interest (p < 0.01) behaviors in winter. Conclusion This study confirms that fluctuations in weather indices, including seasonal changes and time of the day, can provide potential pathway indicators and supplement behavioral observations to elicit the behavioral states of children with PIMD/IDs. These findings highlight the importance of considering these factors when designing meaningful interactions and communication interventions for this population.
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Affiliation(s)
| | - Tomonori Karita
- Center for Inclusive Education, Faculty of Education, Ehime University, Ehime, Japan
| | - Akihiro Toya
- Graduate School of Humanities and Social Sciences, Hiroshima University, Higashihiroshima, Japan
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Merkel T, Navarini A, Mueller S. The impact of phototherapy on itch intensity and itch-related quality of life amongst different skin diseases, skin phototypes and genders - A prospective study with 102 patients. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2024; 40:e12948. [PMID: 38288769 DOI: 10.1111/phpp.12948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 12/21/2023] [Accepted: 12/25/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND Phototherapy is a mainstay to treat itchy conditions. However, only little is known about differences in the antipruritic effect of phototherapy amongst different skin conditions, phototypes and genders. METHODS In this prospective, single-center study, we analyzed the effect of phototherapy on itch intensity and itch-related quality of life amongst these subgroups after a treatment duration of 4 weeks, while on-demand treatment with topical corticosteroids, topical calcineurin inhibitors and/or antihistamines was allowed. RESULTS Of 102 patients (age 53.0 ± 18.7, 56 females [54.9%]), 72 (78.3%) reported a significant reduction of itch intensity by Δ -2.76 on a 0-10 Numerical Rating Scale (NRS), p = <.001, 95% CI [2.2; 3.3] paralleled by a significant improvement of itch-related quality of life as measured by the German version of the ItchyQoL by Δ 7.3, p = <.001, 95% CI [4.4; 11.6]. The best improvement of itch intensity and itch-related QoL was reported by patients with pruritus on non-diseased skin (ΔNRS -3.5; Δ 9.7 Ger-ItchyQoL points), followed by patients with atopic dermatitis and psoriasis. We found no statistical differences in the response to phototherapy amongst Fitzpatrick phototypes I-VI. Women had higher itch intensities at baseline but itch-related quality of life impairment at baseline and phototherapy treatment response did not significantly differ between genders. CONCLUSION Phototherapy appears to induce a meaningful itch reduction in various itchy skin conditions, all phototypes and both genders within 4 weeks that directly translates into improvement of itch-related quality of life.
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Affiliation(s)
- Tamara Merkel
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - Alexander Navarini
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - Simon Mueller
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
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Conte S, Aldien AS, Jetté S, LeBeau J, Alli S, Netchiporouk E, Lagacé F, Lefrançois P, Iannattone L, Litvinov IV. Skin Cancer Prevention across the G7, Australia and New Zealand: A Review of Legislation and Guidelines. Curr Oncol 2023; 30:6019-6040. [PMID: 37489567 PMCID: PMC10377770 DOI: 10.3390/curroncol30070450] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/12/2023] [Accepted: 06/17/2023] [Indexed: 07/26/2023] Open
Abstract
Incidence rates of melanoma and keratinocyte skin cancers have been on the rise globally in recent decades. While there has been a select focus on personal sun protection awareness, to our knowledge, there is a paucity of legislation in place to help support citizens' efforts to protect themselves from the harmful effects of ultraviolet radiation (UVR). Given this, we conducted a comprehensive review of legislation and guidelines pertaining to a variety of sun protection-related topics in countries of the Group of Seven (G7), Australia and New Zealand. Australia was the only country to have banned tanning beds for individuals of all ages, while other select countries have instituted bans for minors. In workplace policy, there is very little recognition of the danger of occupational UVR exposure in outdoor workers, and thus very few protective measures are in place. With regard to sports and recreation, certain dermatological/professional associations have put forward recommendations, but no legislation was brought forward by government bodies outside of Australia and New Zealand. With regard to youth, while there are various guidelines and frameworks in place across several countries, adherence remains difficult in the absence of concrete legislation and standardization of procedures. Finally, only Australia and a few select jurisdictions in the United States have implemented sales tax exemptions for sunscreen products. In light of our findings, we have made several recommendations, which we anticipate will help reduce the rates of melanoma and keratinocyte cancers in years to come. However, minimizing UVR exposure is not without risk, and we, therefore, suggest the promotion of vitamin D supplementation in conjunction with sun protective practices to limit potential harm.
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Affiliation(s)
- Santina Conte
- Faculty of Medicine and Health Sciences, McGill University, Montréal, QC H3G 2M1, Canada
| | - Ammar Saed Aldien
- Faculty of Medicine and Health Sciences, McGill University, Montréal, QC H3G 2M1, Canada
| | - Sébastien Jetté
- Faculty of Medicine and Health Sciences, McGill University, Montréal, QC H3G 2M1, Canada
| | - Jonathan LeBeau
- Faculty of Medicine and Health Sciences, McGill University, Montréal, QC H3G 2M1, Canada
| | - Sauliha Alli
- Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Elena Netchiporouk
- Division of Dermatology, McGill University Health Centre, Montréal, QC H4A 3J1, Canada
| | - François Lagacé
- Division of Dermatology, McGill University Health Centre, Montréal, QC H4A 3J1, Canada
| | - Philippe Lefrançois
- Division of Dermatology, McGill University Health Centre, Montréal, QC H4A 3J1, Canada
| | - Lisa Iannattone
- Division of Dermatology, McGill University Health Centre, Montréal, QC H4A 3J1, Canada
| | - Ivan V Litvinov
- Division of Dermatology, McGill University Health Centre, Montréal, QC H4A 3J1, Canada
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Marx W, Manger SH, Blencowe M, Murray G, Ho FYY, Lawn S, Blumenthal JA, Schuch F, Stubbs B, Ruusunen A, Desyibelew HD, Dinan TG, Jacka F, Ravindran A, Berk M, O'Neil A. Clinical guidelines for the use of lifestyle-based mental health care in major depressive disorder: World Federation of Societies for Biological Psychiatry (WFSBP) and Australasian Society of Lifestyle Medicine (ASLM) taskforce. World J Biol Psychiatry 2023; 24:333-386. [PMID: 36202135 PMCID: PMC10972571 DOI: 10.1080/15622975.2022.2112074] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/24/2022] [Accepted: 08/07/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVES The primary objectives of these international guidelines were to provide a global audience of clinicians with (a) a series of evidence-based recommendations for the provision of lifestyle-based mental health care in clinical practice for adults with Major Depressive Disorder (MDD) and (b) a series of implementation considerations that may be applicable across a range of settings. METHODS Recommendations and associated evidence-based gradings were based on a series of systematic literature searches of published research as well as the clinical expertise of taskforce members. The focus of the guidelines was eight lifestyle domains: physical activity and exercise, smoking cessation, work-directed interventions, mindfulness-based and stress management therapies, diet, sleep, loneliness and social support, and green space interaction. The following electronic bibliographic databases were searched for articles published prior to June 2020: PubMed, EMBASE, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Methodology Register), CINAHL, PsycINFO. Evidence grading was based on the level of evidence specific to MDD and risk of bias, in accordance with the World Federation of Societies for Biological Psychiatry criteria. RESULTS Nine recommendations were formed. The recommendations with the highest ratings to improve MDD were the use of physical activity and exercise, relaxation techniques, work-directed interventions, sleep, and mindfulness-based therapies (Grade 2). Interventions related to diet and green space were recommended, but with a lower strength of evidence (Grade 3). Recommendations regarding smoking cessation and loneliness and social support were based on expert opinion. Key implementation considerations included the need for input from allied health professionals and support networks to implement this type of approach, the importance of partnering such recommendations with behaviour change support, and the need to deliver interventions using a biopsychosocial-cultural framework. CONCLUSIONS Lifestyle-based interventions are recommended as a foundational component of mental health care in clinical practice for adults with Major Depressive Disorder, where other evidence-based therapies can be added or used in combination. The findings and recommendations of these guidelines support the need for further research to address existing gaps in efficacy and implementation research, especially for emerging lifestyle-based approaches (e.g. green space, loneliness and social support interventions) where data are limited. Further work is also needed to develop innovative approaches for delivery and models of care, and to support the training of health professionals regarding lifestyle-based mental health care.
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Affiliation(s)
- Wolfgang Marx
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Sam H Manger
- College of Medicine and Dentistry, James Cook University, Queensland, Australia
- Australasian Society of Lifestyle Medicine, Melbourne, Australia
| | - Mark Blencowe
- Australasian Society of Lifestyle Medicine, Melbourne, Australia
| | - Greg Murray
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
| | - Fiona Yan-Yee Ho
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong SAR
| | - Sharon Lawn
- Lived Experience Australia Ltd, Adelaide, Australia
- Flinders University, College of Medicine and Public Health, Adelaide, Australia
| | - James A. Blumenthal
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham NC 27710
| | - Felipe Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Anu Ruusunen
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland
| | - Hanna Demelash Desyibelew
- Department of Nutrition and Dietetics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | | | - Felice Jacka
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Arun Ravindran
- Department of Psychiatry & Institute of Medical Sciences, University of Toronto. Centre for Addiction and Mental Health, Toronto, Canada
| | - Michael Berk
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Adrienne O'Neil
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
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Liang M, Min M, Ye P, Duan L, Sun Y. Are there joint effects of different air pollutants and meteorological factors on mental disorders? A machine learning approach. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:6818-6827. [PMID: 36008583 DOI: 10.1007/s11356-022-22662-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
Exposure to air pollutants is considered to be associated with mental disorders (MD). Few studies have addressed joint effect of multiple air pollutants and meteorological factors on admissions of MD. We examined the association between multiple air pollutants (PM2.5, PM10, O3, SO2, and NO2), meteorological factors (temperature, precipitation, relative humidity, and sunshine time), and MD risk in Yancheng, China. Associations were estimated by a generalized linear regression model (GLM) adjusting for time trend, day of the week, and patients' average age. Empirical weights of environmental exposures were judged by a weighted quantile sum (WQS) model. A machine learning approach, Bayesian kernel machine regression (BKMR), was used to assess the overall effect of mixed exposures. We calculated excess risk (ER) and 95% confidence interval (CI) for each exposure. According to the effect of temperature on MD, we divided the exposure of all factors into different temperature groups. In the high temperature group, GLM found that for every 10 μg/m3 increase in O3, PM2.5 and PM10 exposure, the ERs were 1.926 (95%CI 0.345, 3.531), 1.038 (95%CI 0.024, 2.062), and 0.780 (95% CI 0.052, 1.512) after adjusting for covariates. Temperature, relative humidity, and sunshine time also reported significant results. The WQS identified O3 and temperature (above the threshold) had the highest weights among air pollutants and meteorological factors. BKMR found a significant positive association between mixed exposure and MD risks. In the low temperature group, only O3 and temperature (below the threshold) showed significant results. These findings provide policymakers and practitioners with important scientific evidence for possible interventions. The association between different exposures and MD risk warrants further study.
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Affiliation(s)
- Mingming Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Min Min
- Anhui Institute of Medical Information (Anhui Medical Association), Hefei, 230061, Anhui, China
| | - Pengpeng Ye
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Leilei Duan
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China.
- Chaohu Hospital, Anhui Medical University, Hefei, 238000, Anhui, China.
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Hwang HJ, Choi YJ, Hong D. The Association between Self-Rated Health Status, Psychosocial Stress, Eating Behaviors, and Food Intake According to the Level of Sunlight Exposure in Korean Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010262. [PMID: 36612583 PMCID: PMC9819439 DOI: 10.3390/ijerph20010262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/17/2022] [Accepted: 12/22/2022] [Indexed: 06/01/2023]
Abstract
Sunlight exposure has been reported to have various beneficial effects on human health. This study investigated the relationship between self-rated health status, psychosocial stress, eating behaviors, and food intake according to sunlight exposure in 948 adults. Sunlight exposure was classified as less than one hour, less than three hours, and greater than three hours. Of the participants, 49.2% had fewer than three hours of daily exposure to sunlight. Regarding participants exposed to sunlight for less than one hour, the largest response was that they did not engage in outdoor activities on weekdays or weekends, and the rate of being outdoors in the shade on sunny days was the highest in this group at 42.7%. Furthermore, the participants exposed to sunlight for less than one hour had a lower health response than the other two groups, and there were significantly more participants classified in the stress risk group. Regarding eating habits, those with less than an hour of exposure to sunlight frequently ate fried foods, fatty foods, added salt, and snacks, and had significantly lower total dietary scores or three regular meals. Additionally, their frequency of consumption of cereals, milk and dairy products, orange juice, and pork was also significantly lower than the other groups. Thus, it is necessary to provide sufficient guidelines for adequate sunlight exposure and food intake because participants with low sunlight exposure may have low vitamin D synthesis and insufficient food intake.
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Affiliation(s)
- Hyo-Jeong Hwang
- Department of Food and Nutrition, Sahmyook University, Seoul 01795, Republic of Korea
| | - Yean-Jung Choi
- Department of Food and Nutrition, Sahmyook University, Seoul 01795, Republic of Korea
| | - Dongwan Hong
- Department of Medical Informatics, College of Medicine, Catholic University of Korea, Seoul 06591, Republic of Korea
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Chang MS, Hartman RI, Trepanowski N, Giovannucci EL, Nan H, Li X. Cumulative Erythemal Ultraviolet Radiation and Risk of Cancer in 3 Large US Prospective Cohorts. Am J Epidemiol 2022; 191:1742-1752. [PMID: 35671977 PMCID: PMC9991893 DOI: 10.1093/aje/kwac101] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 05/20/2022] [Accepted: 06/01/2022] [Indexed: 01/29/2023] Open
Abstract
Ultraviolet radiation (UVR) exposure is the major risk factor for melanoma. However, epidemiologic studies on UVR and noncutaneous cancers have reported inconsistent results, with some suggesting an inverse relationship potentially mediated by vitamin D. To address this, we examined 3 US prospective cohorts, the Health Professionals Follow-up Study (HPFS) (1986) and Nurses' Health Study (NHS) I and II (1976 and 1989), for associations between cumulative erythemal UVR and incident cancer risk, excluding nonmelanoma skin cancer. We used a validated spatiotemporal model to calculate erythemal UVR. Participants (47,714 men; 212,449 women) were stratified into quintiles by cumulative average erythemal UVR, using the first quintile as referent, for Cox proportional hazards regression analysis. In the multivariable-adjusted meta-analysis of all cohorts, compared with the lowest quintile, risk of any cancer was slightly increased across all other quintiles (highest quintile hazard ratio (HR) = 1.04, 95% confidence interval (CI): 1.01, 1.07; P for heterogeneity = 0.41). All UVR quintiles were associated with similarly increased risk of any cancer excluding melanoma. As expected, erythemal UVR was positively associated with risk of melanoma (highest quintile HR = 1.17, 95% CI: 1.04, 1.31; P for heterogeneity = 0.83). These findings suggest that elevated UVR is associated with increased risk of both melanoma and noncutaneous cancers.
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Affiliation(s)
| | | | | | | | | | - Xin Li
- Correspondence to Dr. Xin Li, Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Health Sciences Building, RG 5114, 1050 Wishard Boulevard., Indianapolis, IN 46202 (e-mail: )
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Implication of Melanocortin Receptor Genes in the Familial Comorbidity of Type 2 Diabetes and Depression. Int J Mol Sci 2022; 23:ijms23158350. [PMID: 35955479 PMCID: PMC9369258 DOI: 10.3390/ijms23158350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/22/2022] [Accepted: 07/25/2022] [Indexed: 12/20/2022] Open
Abstract
The melanocortin receptors are G-protein-coupled receptors, which are essential components of the hypothalamic–pituitary–adrenal axis, and they mediate the actions of melanocortins (melanocyte-stimulating hormones: α-MSH, β-MSH, and γ-MSH) as well as the adrenocorticotropin hormone (ACTH) in skin pigmentation, adrenal steroidogenesis, and stress response. Three melanocortin receptor genes (MC1R, MC2R, and MC5R) contribute to the risk of major depressive disorder (MDD), and one melanocortin receptor gene (MC4R) contributes to the risk of type 2 diabetes (T2D). MDD increases T2D risk in drug-naïve patients; thus, MDD and T2D commonly coexist. The five melanocortin receptor genes might confer risk for both disorders. However, they have never been investigated jointly to evaluate their potential contributing roles in the MDD-T2D comorbidity, specifically within families. In 212 Italian families with T2D and MDD, we tested 11 single nucleotide polymorphisms (SNPs) in the MC1R gene, 9 SNPs in MC2R, 3 SNPs in MC3R, 4 SNPs in MC4R, and 2 SNPs in MC5R. The testing used 2-point parametric linkage and linkage disequilibrium (LD) (i.e., association) analysis with four models (dominant with complete penetrance (D1), dominant with incomplete penetrance (D2), recessive with complete penetrance (R1), and recessive with incomplete penetrance (R2)). We detected significant (p ≤ 0.05) linkage and/or LD (i.e., association) to/with MDD for one SNP in MC2R (rs111734014) and one SNP in MC5R (rs2236700), and to/with T2D for three SNPs in MC1R (rs1805007 and rs201192930, and rs2228479), one SNP in MC2R (rs104894660), two SNPs in MC3R (rs3746619 and rs3827103), and one SNP in MC4R genes (Chr18-60372302). The linkage/LD/association was significant across different linkage patterns and different modes of inheritance. All reported variants are novel in MDD and T2D. This is the first study to report risk variants in MC1R, MC2R, and MC3R genes in T2D. MC2R and MC5R genes are replicated in MDD, with one novel variant each. Within our dataset, only the MC2R gene appears to confer risk for both MDD and T2D, albeit with different risk variants. To further clarity the role of the melanocortin receptor genes in MDD-T2D, these findings should be sought among other ethnicities as well.
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Luo CW, Chen SP, Chiang CY, Wu WJ, Chen CJ, Chen WY, Kuan YH. Association between Ultraviolet B Exposure Levels and Depression in Taiwanese Adults: A Nested Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6846. [PMID: 35682430 PMCID: PMC9180491 DOI: 10.3390/ijerph19116846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 05/19/2022] [Accepted: 05/30/2022] [Indexed: 02/06/2023]
Abstract
Depression is a common mental disorder that affects more than 264 million people worldwide. Anxiety, diabetes, Alzheimer's disease, myocardial infarction, and cancer, among other disorders, are known to increase the risk of depression. Exposure to ultraviolet B (UVB) can cause human serotonin levels to increase. The vitamin D pathway is one mechanism through which ultraviolet light absorbed through the skin can affect mood; however, UVB exposure is known to increase the risk of cancer. In this study, we explored the effects of prolonged exposure to UVB on depression. Data were retrieved from the Taiwan National Health Insurance Research Database for 2008 to 2013. Each patient with depression was matched 1:4 with a comparison patient by sex and age (±5 years); thus, the study included 23,579 patients with depression and 94,316 healthy controls for comparison. The patients had been exposed to UVB for at least 1 year to observe the cumulative effect of UVB exposure. Based on the World Health Organization UV index, we divided the observation period data into five UV levels: low, moderate, high, very high, and extreme. A multivariate Poisson regression model was used to assess the risk of depression according to UVB exposure level, adjusting for sex, age, income, urbanization level, month, and comorbidities. The results revealed that the incidence rate ratio (IRR) for patients with depression was 0.889 for moderate levels (95% CI 0.835-0.947), 1.134 for high levels (95% CI: 1.022-1.260), 1.711 for very high levels (95% CI: 1.505-1.945), and 2.785 for extreme levels (95% CI: 2.439-3.180) when compared to low levels. Moderate levels of UVB lowered the risk of depression, while high levels of UVB gradually increased the risk. We propose that UVB at normal concentrations can effectively improve depression. However, exposure to high concentrations of UVB damage DNA results in physical diseases such as skin cancer, which increase the risk of depression.
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Affiliation(s)
- Ci-Wen Luo
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan; (C.-W.L.); (W.-J.W.)
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
| | - Shih-Pin Chen
- Department of Internal Medicine, School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan;
- Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
| | - Chen-Yu Chiang
- Department of Veterinary Medicine, National Chung Hsing University, Taichung 40227, Taiwan; (C.-Y.C.); (W.-Y.C.)
| | - Wen-Jun Wu
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan; (C.-W.L.); (W.-J.W.)
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
| | - Chun-Jung Chen
- Department of Education and Research, Taichung Veterans General Hospital, Taichung 40705, Taiwan;
| | - Wen-Ying Chen
- Department of Veterinary Medicine, National Chung Hsing University, Taichung 40227, Taiwan; (C.-Y.C.); (W.-Y.C.)
| | - Yu-Hsiang Kuan
- Department of Pharmacology, School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
- Department of Pharmacy, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
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Physical Activity, Climate Change and Health-A Conceptual Model for Planning Public Health Action at the Organizational Level. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084664. [PMID: 35457530 PMCID: PMC9025182 DOI: 10.3390/ijerph19084664] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/14/2022] [Accepted: 04/08/2022] [Indexed: 11/28/2022]
Abstract
Climate change is linked to health risks for both professional and amateur athletes. Sports organisations will need to react to these developments. The starting point for this concept paper is a summary of the sport-specific health risks currently under discussion: increasing heatwaves, growing numbers of extreme weather events, rising UV, ozone and allergen levels and the spread of infectious diseases. Based on the current state of research, a conceptual model is developed to reduce these climate-related health risks in sports at organisational level. Given the wide variety of predicted direct and indirect health risks linked to climate change, the “sports, clubs and climate change model” (SC3 model) presented here follows a stepwise risk-specific approach using technical, organisational and person-related measures. The SC3 model also includes cross-cutting measures that have an overarching effect comprising training, warning systems, coordination and evaluation measures. The SC3 model makes it possible to develop prevention plans, both at national level for central associations and at the regional level of local organisations and clubs. It can be applied to typical settings (e.g., training or competition at elite or amateur levels) and target groups (e.g., athletes, spectators, referees and club officials).
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Davis GE, Davis MJ, Lowell WE. The effect of ultraviolet radiation on the incidence and severity of major mental illness using birth month, birth year, and sunspot data. Heliyon 2022; 8:e09197. [PMID: 35368522 PMCID: PMC8969152 DOI: 10.1016/j.heliyon.2022.e09197] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 08/06/2021] [Accepted: 03/22/2022] [Indexed: 11/16/2022] Open
Abstract
Background and objectives The evaluation of the severity of patients afflicted with major mental illness (MMI) has been problematic because of confounding variables and genetic variability. There have been multiple studies that suggest several human diseases, especially schizophrenia, are predisposed to be born in certain months or seasons. This observation implied an epigenetic effect of sunlight, likely ultraviolet radiation (UVR), which is damaging to DNA, especially in an embryo. This paper outlines a method to evaluate the severity of schizophrenia (SZ), bipolar disorder (BPD), and schizoaffective disorder (SZ-AFF) using the month/year of birth of those affected compared to the month/year of birth of the general population (GP). Relevance Our previous research found that more intense UVR (equal to or greater than 90 sunspot number (SSN)) had a negative effect on the average human lifespan. Also, human birth rates vary in frequency by month of birth reflecting variables like availability of food, sunlight, and other unknown epigenetic factors. We wanted to see if the patient month of birth varied from the average birth months of the general population and if UVR has an epigenetic effect promoting these diseases. Methods We obtained the month and year of birth of 1,233 patients admitted over a 15-year period to Maine's largest state psychiatric hospital and counted the months of birth for each diagnosis of SZ, BPD, and SZ-AFF, and compared these results to the general population's birth months of 4,265,555 persons from U. S. Census Year 2006. The number of patients in each month was normalized to August and compared with the normalized birth months of the general population (GP). Plots of the normalized months were considered rates of change (e.g., derivatives) and their respective integrals gave domains of each mental illness relative to the GP. Normalizing the GP to unity was then related to the factor 1.28, e.g., 28% more entropy, deduced from the Sun's fractal dimension imprinted on biological organisms. Results The percent of patients meeting our criterion for severity: SZ = 27%; BPD = 26%; SZ-AFF = 100%. Conclusions High UVR intensity or a rapid increase in UVR in early gestation are likely epigenetic triggers of major mental illness. BPD is more epigenetically affected than SZ or SZ-AFF disorders. We found that 52% of 1,233 patients comprised the core function of a tertiary-care psychiatric hospital. Also, mental illness exacerbated when the median SSN doubled. This work also validates the Kraeplinian dichotomy. What is new in this research This paper offers a new paradigm for evaluating the severity of MMI and supports significant epigenetic effects from UVR.
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Affiliation(s)
- George E Davis
- Riverview Psychiatric Center, 250 Arsenal Street, State House Station #11, Augusta, Maine, 04333-0011, USA
| | - Matthew J Davis
- Riverview Psychiatric Center, 250 Arsenal Street, State House Station #11, Augusta, Maine, 04333-0011, USA
| | - Walter E Lowell
- Riverview Psychiatric Center, 250 Arsenal Street, State House Station #11, Augusta, Maine, 04333-0011, USA
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Ogbonna AC, Chaudhry AS, Asher L. Effect of Dietary Vitamin D3 and Ultraviolet B Light on Growth Performance, Blood Serum Parameters, Gut Histology, and Welfare Indicators of Broilers. FRONTIERS IN ANIMAL SCIENCE 2022. [DOI: 10.3389/fanim.2021.806967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Stressors are commonly encountered by all farmed species, including chickens, but the impact of these stressors on the animal and their productivity can be influenced by the environmental conditions in which they are kept. This study investigated the effects of dietary vitamin D3 (vitD3) and ultraviolet light (UVB) on growth performance, organ weight, serum corticosterone levels (CORT), serum 25-hydroxy vitamin D (25-OH-D3) status, gut histology, and welfare indicators of broiler chickens challenged with social isolation stress. One day (d) old Ross 308 broiler chicks (n = 192) were individually weighed, wing-tagged, and allocated to non-isolated (control) and isolated groups; control birds were never isolated, while isolated birds were subjected to regular sessions of social isolation for about 15-min periods over the course of 3 d a week for 2 weeks starting from d 10 (1.30 h total exposure) with inter treatment interval of 48 h. Birds were treated with either dietary vitD3 at 4,000 IU/kg (HD) or UVB light (UVB). The UVB lamp (24 Watt 12% UVB D3, 55 cm) with wavelength: 280–315 nm, intensity; 28.12 μW/cm2 hung 50 cm above the substrate was used for the broilers in all the treatment groups but were filtered to remove UVB in the HD group. Growth performance measure; body weight gain, feed intake, and feed conversion ratio were estimated at the end of starter (day 10), grower (day 24), and finisher periods (day 38). Broilers were feather and gait scored to measure welfare at 22/35 and 24/37 days of age, respectively. The selected birds were weighed and euthanized to obtain serum to determine 25-OH-D3 and CORT levels, GIT weights, and gut histology. Subjecting the birds to 2-week social isolation (for 15 min, three times per week) increased CORT levels but did not alter GP and 25-OH-D3 levels of broilers. However, UVB-treated broilers demonstrated better welfare, duodenal absorptive capacity, and reduced FCR compared to HD chickens. Results suggest some beneficial effects of UVB lighting on welfare indicators and the potential to support early life growth of commercial broilers reared indoors, which are often challenged with stressors.
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Abstract
Human health is regulated by complex interactions among the genome, the microbiome, and the environment. While extensive research has been conducted on the human genome and microbiome, little is known about the human exposome. The exposome comprises the totality of chemical, biological, and physical exposures that individuals encounter over their lifetimes. Traditional environmental and biological monitoring only targets specific substances, whereas exposomic approaches identify and quantify thousands of substances simultaneously using nontargeted high-throughput and high-resolution analyses. The quantified self (QS) aims at enhancing our understanding of human health and disease through self-tracking. QS measurements are critical in exposome research, as external exposures impact an individual's health, behavior, and biology. This review discusses both the achievements and the shortcomings of current research and methodologies on the QS and the exposome and proposes future research directions.
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Affiliation(s)
- Xinyue Zhang
- Department of Genetics, Stanford University School of Medicine, Stanford, California 94305, USA;
| | - Peng Gao
- Department of Genetics, Stanford University School of Medicine, Stanford, California 94305, USA;
| | - Michael P Snyder
- Department of Genetics, Stanford University School of Medicine, Stanford, California 94305, USA;
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Cui Y, Gong Q, Huang C, Guo F, Li W, Wang Y, Cheng X. The relationship between sunlight exposure duration and depressive symptoms: A cross-sectional study on elderly Chinese women. PLoS One 2021; 16:e0254856. [PMID: 34270627 PMCID: PMC8284632 DOI: 10.1371/journal.pone.0254856] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/05/2021] [Indexed: 11/18/2022] Open
Abstract
Sunlight has been reported to have various beneficial effects on human health. Although research indicates an association between sunlight exposure and depressive symptoms, no study has examined it among the older adult population, especially among elderly Chinese women. This cross-sectional study addresses the aforesaid gap by investigating this association in 1,429 Chinese women aged 60 years and older. Information on their sunlight exposure was collected through a self-reported questionnaire. Depressive symptoms were assessed using the Zung Self-Rating Depression Scale (SDS). The logistic regression models revealed that greater exposure to sunlight is associated with a lower prevalence of depressive symptoms. In the final adjusted model, when the short sunlight exposure category (reference) was compared with the medium and long ones, the odds ratios and 95% confidence intervals for the prevalence of depressive symptoms (SDS cutoff ≥ 45) were 0.84 (0.60, 1.19) and 0.62 (0.43, 0.91), respectively (p-value for trend = 0.01). This significant association did not change when the SDS cutoff points were altered to ≥ 40 and ≥ 50. Findings indicate that an increased sunlight exposure duration is associated with a lower prevalence of depressive symptoms in elderly women.
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Affiliation(s)
- Yufei Cui
- Institute of Exercise Epidemiology and Department of Physical Education, Huaiyin Institute of Technology, Huaian, Jiangsu Province, People’s Republic of China
- Department of Medicine and Science in Sports and Exercise, Tohoku University Graduate School of Medicine, Sendai, Japan
- * E-mail: (YC); (CH)
| | - Qiang Gong
- Department of Medicine and Science in Sports and Exercise, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Cong Huang
- Department of Sports and Exercise Science, College of Education, Zhejiang University, Hangzhou, Zhejiang Province, People’s Republic of China
- * E-mail: (YC); (CH)
| | - Feng Guo
- Institute of Exercise Epidemiology and Department of Physical Education, Huaiyin Institute of Technology, Huaian, Jiangsu Province, People’s Republic of China
| | - Wang Li
- Institute of Exercise Epidemiology and Department of Physical Education, Huaiyin Institute of Technology, Huaian, Jiangsu Province, People’s Republic of China
| | - Yongxiang Wang
- Institute of Exercise Epidemiology and Department of Physical Education, Huaiyin Institute of Technology, Huaian, Jiangsu Province, People’s Republic of China
| | - Xin Cheng
- Institute of Exercise Epidemiology and Department of Physical Education, Huaiyin Institute of Technology, Huaian, Jiangsu Province, People’s Republic of China
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Vashurin I, Barzilai A, Baum S, Ohana O, Pavlotsky F, Greenberger S. The effect of narrow-band ultraviolet B radiation on sleep, happiness, and appetite: A prospective cohort study. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2021; 37:278-284. [PMID: 33351211 DOI: 10.1111/phpp.12648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/09/2020] [Accepted: 12/19/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND The health benefits of sunlight are well documented, including the effects on happiness and sleep. However, only a few studies have investigated the benefits of artificial narrow-band ultraviolet B (NB-UVB) radiation. OBJECTIVES To investigate the effect of NB-UVB on sleep quality, happiness, and appetite. METHODS Patients from a single phototherapy unit were selected, and their epidemiological characteristics were documented. Subjects were asked to complete questionnaires including the Pittsburg Sleep Quality Index (PSQI), Subjective Happiness Scale (SHS), and the Simplified Nutritional Appetite Questionnaire (SNAQ) 4 weeks before and after the initiation of the NB-UVB therapy. The sample consisted of 52 patients. RESULTS Four weeks after the initiation of NB-UVB sessions, sleep quality was significantly improved (the PSQI decreased from 6.5 to 5.23 (t = -3.52, P < .01). In contrast, subjective happiness did not improve (the SHS decreased from baseline 5.5 to 5.2, P > .05). Similarly, appetite did not change (the SNAQ score increased from baseline 14.75 to 15.05, P > .05) and body mass index was not affected by phototherapy. In general, men were found to have better sleep quality before and after UV light therapy. CONCLUSION Our data suggest that NB-UVB exposure over 4 weeks improves sleep quality; however, it does not influence happiness or appetite.
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Affiliation(s)
- Ilan Vashurin
- Department of Dermatology, Sheba Medical Center, Ramat-Gan, Israel
| | - Aviv Barzilai
- Department of Dermatology, Sheba Medical Center, Ramat-Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Sharon Baum
- Department of Dermatology, Sheba Medical Center, Ramat-Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Orly Ohana
- Department of Dermatology, Sheba Medical Center, Ramat-Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Felix Pavlotsky
- Department of Dermatology, Sheba Medical Center, Ramat-Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
- Phototherapy Unit, Sheba Medical Center, Ramat-Gan, Israel
| | - Shoshana Greenberger
- Department of Dermatology, Sheba Medical Center, Ramat-Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
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Moattari CR, Granstein RD. Neuropeptides and neurohormones in immune, inflammatory and cellular responses to ultraviolet radiation. Acta Physiol (Oxf) 2021; 232:e13644. [PMID: 33724698 DOI: 10.1111/apha.13644] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 02/26/2021] [Accepted: 03/02/2021] [Indexed: 12/16/2022]
Abstract
Humans are exposed to varying amounts of ultraviolet radiation (UVR) through sunlight. UVR penetrates into human skin leading to release of neuropeptides, neurotransmitters and neuroendocrine hormones. These messengers released from local sensory nerves, keratinocytes, Langerhans cells (LCs), mast cells, melanocytes and endothelial cells (ECs) modulate local and systemic immune responses, mediate inflammation and promote differing cell biologic effects. In this review, we will focus on both animal and human studies that elucidate the roles of calcitonin gene-related peptide (CGRP), substance P (SP), nerve growth factor (NGF), nitric oxide and proopiomelanocortin (POMC) derivatives in mediating immune and inflammatory effects of exposure to UVR as well as other cell biologic effects of UVR exposure.
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Schmalbach I, Schmalbach B, Zenger M, Berth H, Albani C, Petrowski K, Brähler E. A Brief Assessment of Body Image Perception: Norm Values and Factorial Structure of the Short Version of the FKB-20. Front Psychol 2020; 11:579783. [PMID: 33335498 PMCID: PMC7736636 DOI: 10.3389/fpsyg.2020.579783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 11/02/2020] [Indexed: 12/17/2022] Open
Abstract
The Body Image Questionnaire-20 (FKB-20) is one of the most applied self-report measures in the context of body image assessment in German-speaking regions. A version of the FKB-20 capturing an ideal concept of body image is also available. A special property of the scale is its high sensitivity for individuals suffering from anorexia nervosa. The present research provided a short version of this scale (for both variants) and examined its validity in a representative sample (N = 2,347) of the German population. We utilized factor analysis methods to identify the optimal short scale of the measure, finding excellent model fit and reliability for a two-factor model (FKB-6) for both real and ideal body image. Both versions of the FKB-6 can be considered invariant across sex and age groups. Good reliability indices were shown for both versions of the FKB-6. The reliability indices were similar to those mentioned in previous studies. Our study also revealed, that large discrepancies between the real and an ideal body image are correlated with somatic and body dysmorphic symptoms. Finally, we provided norm values for comparisons of individual scores with the general population. The FKB-6 is a valid and a reliable measure that economizes assessments by clinicians and researchers.
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Affiliation(s)
- Ileana Schmalbach
- Technische Universität Dresden, Carl Gustav Carus Faculty of Medicine, Division of Psychological and Social Medicine and Developmental Neurosciences, Research Group Applied Medical Psychology and Medical Sociology, Dresden, Germany
- Department of Medical Psychology and Medical Sociology, Johannes-Gutenberg University Mainz, Mainz, Germany
| | - Bjarne Schmalbach
- Department of Medical Psychology and Medical Sociology, Johannes-Gutenberg University Mainz, Mainz, Germany
| | - Markus Zenger
- Department of Applied Human Studies, University of Applied Sciences Magdeburg and Stendal, Stendal, Germany
- Integrated Research and Treatment Center (IFB) Adiposity Diseases – Behavioral Medicine, Medical Psychology and Medical Sociology, University of Leipzig Medical Center, Leipzig, Germany
| | - Hendrik Berth
- Technische Universität Dresden, Carl Gustav Carus Faculty of Medicine, Division of Psychological and Social Medicine and Developmental Neurosciences, Research Group Applied Medical Psychology and Medical Sociology, Dresden, Germany
| | - Cornelia Albani
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Katja Petrowski
- Department of Medical Psychology and Medical Sociology, Johannes-Gutenberg University Mainz, Mainz, Germany
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Elmar Brähler
- Integrated Research and Treatment Center (IFB) Adiposity Diseases – Behavioral Medicine, Medical Psychology and Medical Sociology, University of Leipzig Medical Center, Leipzig, Germany
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
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22
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Veleva BI, Caljouw MAA, van der Steen JT, Mertens BJA, Chel VGM, Numans ME. The Effect of Ultraviolet B Irradiation Compared with Oral Vitamin D Supplementation on the Well-being of Nursing Home Residents with Dementia: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051684. [PMID: 32150855 PMCID: PMC7084916 DOI: 10.3390/ijerph17051684] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 02/21/2020] [Accepted: 02/28/2020] [Indexed: 11/16/2022]
Abstract
There are indications that ultraviolet B (UVB) exposure has beneficial effects on well-being through mechanisms other than vitamin D synthesis alone. We conducted a randomized controlled multicenter trial to compare the effects of UVB light and vitamin D supplementation (VD) in terms of the well-being of nursing home residents with dementia. Participants were randomly assigned to the intervention group (UVB group, n = 41; half-body UVB irradiation, twice weekly over 6 months, with 1 standard erythema dose (SED)) or to the control group (VD group, n = 37; 5600 International units (IU) cholecalciferol supplementation once a week). The main outcome was well-being, measured by the Cohen-Mansfield Agitation Inventory (CMAI) and the Cornell scale for depression in dementia at 0, 3, and 6 months. Secondary outcomes were QUALIDEM quality of life domains and biochemical parameters of bone homeostasis. Intention-to-treat analysis with linear mixed modeling showed no significant between-group differences on agitation (p = 0.431) or depressive symptoms (p = 0.982). At six months, the UVB group showed less restless/tense behavior compared to the VD group (mean difference of the mean change scores 2.2, 95% CI 0.8 to 3.6; p = 0.003 for group x time interaction) and lower serum 25(OH)D3 concentration (estimated mean difference - 21.9, 95% CI −32.6 to −11.2; p = 0.003 for group difference). The exposure of nursing home residents with dementia to UVB light showed no positive benefits in terms of wellbeing. UVB treatment may have a positive effect on the restless/tense behavior characteristic of advanced dementia but more research is needed to confirm this finding.
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Affiliation(s)
- Bistra I. Veleva
- Department of Public Health and Primary Care, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands; (M.A.A.C.); (J.T.v.d.S.); (V.G.M.C.); (M.E.N.)
- Woonzorgcentra Haaglanden, Polanenhof 497, 2548 MP Den Haag, The Netherlands
- Correspondence: ; Tel.: +31-71-5268444; Fax: +31-71-5268259
| | - Monique A. A. Caljouw
- Department of Public Health and Primary Care, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands; (M.A.A.C.); (J.T.v.d.S.); (V.G.M.C.); (M.E.N.)
| | - Jenny T. van der Steen
- Department of Public Health and Primary Care, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands; (M.A.A.C.); (J.T.v.d.S.); (V.G.M.C.); (M.E.N.)
| | - Bart J. A. Mertens
- Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands;
| | - Victor G. M. Chel
- Department of Public Health and Primary Care, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands; (M.A.A.C.); (J.T.v.d.S.); (V.G.M.C.); (M.E.N.)
| | - Mattijs E. Numans
- Department of Public Health and Primary Care, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands; (M.A.A.C.); (J.T.v.d.S.); (V.G.M.C.); (M.E.N.)
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Tazawa Y, Liang KC, Yoshimura M, Kitazawa M, Kaise Y, Takamiya A, Kishi A, Horigome T, Mitsukura Y, Mimura M, Kishimoto T. Evaluating depression with multimodal wristband-type wearable device: screening and assessing patient severity utilizing machine-learning. Heliyon 2020; 6:e03274. [PMID: 32055728 PMCID: PMC7005437 DOI: 10.1016/j.heliyon.2020.e03274] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 12/11/2019] [Accepted: 01/17/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE We aimed to develop a machine learning algorithm to screen for depression and assess severity based on data from wearable devices. METHODS We used a wearable device that calculates steps, energy expenditure, body movement, sleep time, heart rate, skin temperature, and ultraviolet light exposure. Depressed patients and healthy volunteers wore the device continuously for the study period. The modalities were compared hourly between patients and healthy volunteers. XGBoost was used to build machine learning models and 10-fold cross-validation was applied for the validation. RESULTS Forty-five depressed patients and 41 healthy controls participated, creating a combined 5,250 days' worth of data. Heart rate, steps, and sleep were significantly different between patients and healthy volunteers in some comparisons. Similar differences were also observed longitudinally when patients' symptoms improved. Based on seven days' data, the model identified symptomatic patients with 0.76 accuracy and predicted Hamilton Depression Rating Scale-17 scores with a 0.61 correlation coefficient. Skin temperature, sleep time-related features, and the correlation of those modalities were the most significant features in machine learning. LIMITATIONS The small number of subjects who participated in this study may have weakened the statistical significance of the study. There are differences in the demographic data among groups although we performed a correction for multiple comparisons. Validation in independent datasets was not performed, although 10-fold cross validation with the internal data was conducted. CONCLUSION The results indicated that utilizing wearable devices and machine learning may be useful in identifying depression as well as assessing severity.
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Affiliation(s)
- Yuuki Tazawa
- Keio University School of Medicine, Tokyo, Japan
| | | | | | | | - Yuriko Kaise
- Keio University School of Medicine, Tokyo, Japan
| | | | - Aiko Kishi
- Faculty of Science and Technology, Keio University, Kanagawa, Japan
| | | | - Yasue Mitsukura
- Faculty of Science and Technology, Keio University, Kanagawa, Japan
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Toledo A, Karppinen T, Miettinen ME, Leppäluoto J, Vuolteenaho O, Ylianttila L, Kautiainen H, Snellman E, Partonen T. Narrow-band ultraviolet B (NB UV-B) exposures improve mood in healthy individuals differently depending on chronotype. Chronobiol Int 2019; 36:1570-1580. [PMID: 31530241 DOI: 10.1080/07420528.2019.1661424] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The evening chronotype is associated with psychological symptoms such as depressed mood, while skin exposure to ultraviolet radiation (UVR) may affect mood and behavior through neural and humoral routes. This pilot study aimed to investigate the impact of whole-body narrow-band (NB) UV-B exposure on current mood state and circulating 25-hydroxyvitamin D3 (25(OH)D3), interleukin-6 (IL-6), cortisol and β-endorphin (β-END) levels in healthy participants. Here, eleven healthy women received full-body NB UV-B exposures on four afternoons, and the chronotype was assessed with a shortened version of Horne and Östberg's Morningness-Eveningness Questionnaire (MEQ). Perceived mood was evaluated using the Visual Analogue Scale (VAS), and serum 25(OH)D3, IL-6, cortisol and β-END concentrations were monitored daily. Decreasing VAS values showed mood to improve significantly over the five days after the four suberythematous NB UV-B exposures (p = .038), and the more the circadian preference was inclined toward eveningness, the greater the improvement in the mood dimension of wellbeing (p = .021). Baseline mood state was correlated with baseline 25(OH)D3 (r = -0.54, 95% CI: -0.86 to -0.09) and with baseline cortisol (r = -0.57, 95% CI: -0.87 to -0.04). During the NB UV-B exposures, 25(OH)D3 increased significantly, as expected, and IL-6 declined significantly by -0.35 (95% CI: -0.69 to -0.07) pg/mL from the initial values of 1.12 ± 0.66 pg/mL (p = .025). In conclusion, in our pilot study, NB UV-B exposure improved mood, especially among those with evening preference for their daily activities, as well as circulating 25(OH)D3 levels, whereas circulating IL-6 levels decreased. Abbreviations: UVR: Ultraviolet radiation; NB UV-B: narrow-band UV-B; VAS: Visual Analogue Scales; β-END: β-endorphin; IL-6: Interleukin-6.
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Affiliation(s)
- Anna Toledo
- Faculty of Medicine and Health Technology, Department of Dermatology and Venereology, Tampere University , Tampere , Finland.,Department of Dermatology and Allergology, Tampere University Hospital , Tampere , Finland
| | - Toni Karppinen
- Faculty of Medicine and Health Technology, Department of Dermatology and Venereology, Tampere University , Tampere , Finland.,Department of Dermatology and Allergology, Tampere University Hospital , Tampere , Finland
| | - Maija E Miettinen
- Department of Public Health Solutions, National Institute for Health and Welfare (THL) , Helsinki , Finland
| | | | | | - Lasse Ylianttila
- STUK - Radiation and Nuclear Safety Authority , Helsinki , Finland
| | - Hannu Kautiainen
- Unit of Primary Health Care, Helsinki University Central Hospital, Department of General Practice, University of Helsinki , Helsinki , Finland.,Unit of Primary Health Care, Kuopio University Hospital , Kuopio , Finland
| | - Erna Snellman
- Faculty of Medicine and Health Technology, Department of Dermatology and Venereology, Tampere University , Tampere , Finland.,Department of Dermatology and Allergology, Tampere University Hospital , Tampere , Finland
| | - Timo Partonen
- Department of Public Health Solutions, National Institute for Health and Welfare (THL) , Helsinki , Finland
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A Review of Daylighting System: For Prototype Systems Performance and Development. ENERGIES 2019. [DOI: 10.3390/en12152863] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Daylighting systems make daylight illuminance possible, and the development of prototype daylighting systems can provide more efficient daylight illuminance. The purpose of this article is to review the development and performance of prototype daylighting systems in the last decade. The passive and active daylighting systems are listed separately and divided into the four categories by the presence and absence of hybrid. Each prototype daylighting system was evaluated in terms of cost and daylight performance and as well as their novel optical design. We evaluated the architecture and daylighting principles of each system by reviewing individual prototype daylighting systems. The cost of prototype systems still poses a challenge to development. How to use passive or active systems in different environments and whether or not electrical lighting assistance is needed is a controversial issue. However, active daylighting systems equipped with solar tracking systems are still mainstream. This research is a valuable resource for daylight researchers and newcomers. It is helpful to understand the advantages of various prototype daylighting systems and commercial daylighting systems that have been developed for many years; moreover, it is also possible to know the research directions suggested by the prototype daylighting systems. These will be of further use in developing innovative and better daylighting systems and designs.
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It is time to investigate integrative approaches to enhance treatment outcomes for depression? Med Hypotheses 2019; 126:82-94. [DOI: 10.1016/j.mehy.2019.03.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 03/11/2019] [Accepted: 03/21/2019] [Indexed: 12/14/2022]
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