Mobile Phone-Based Unobtrusive Ecological Momentary Assessment of Day-to-Day Mood: An Explorative Study

Background

Ecological momentary assessment (EMA) is a useful method to tap the dynamics of psychological and behavioral phenomena in real-world contexts. However, the response burden of (self-report) EMA limits its clinical utility.

Objective

The aim was to explore mobile phone-based unobtrusive EMA, in which mobile phone usage logs are considered as proxy measures of clinically relevant user states and contexts.

Methods

This was an uncontrolled explorative pilot study. Our study consisted of 6 weeks of EMA/unobtrusive EMA data collection in a Dutch student population (N=33), followed by a regression modeling analysis. Participants self-monitored their mood on their mobile phone (EMA) with a one-dimensional mood measure (1 to 10) and a two-dimensional circumplex measure (arousal/valence, –2 to 2). Meanwhile, with participants’ consent, a mobile phone app unobtrusively collected (meta) data from six smartphone sensor logs (unobtrusive EMA: calls/short message service (SMS) text messages, screen time, application usage, accelerometer, and phone camera events). Through forward stepwise regression (FSR), we built personalized regression models from the unobtrusive EMA variables to predict day-to-day variation in EMA mood ratings. The predictive performance of these models (ie, cross-validated mean squared error and percentage of correct predictions) was compared to naive benchmark regression models (the mean model and a lag-2 history model).

Results

A total of 27 participants (81%) provided a mean 35.5 days (SD 3.8) of valid EMA/unobtrusive EMA data. The FSR models accurately predicted 55% to 76% of EMA mood scores. However, the predictive performance of these models was significantly inferior to that of naive benchmark models.

Conclusions

Mobile phone-based unobtrusive EMA is a technically feasible and potentially powerful EMA variant. The method is young and positive findings may not replicate. At present, we do not recommend the application of FSR-based mood prediction in real-world clinical settings. Further psychometric studies and more advanced data mining techniques are needed to unlock unobtrusive EMA’s true potential.

Crystal structures of human gephyrin and plant Cnx1 G domains: comparative analysis and functional implications

The molybdenum cofactor (Moco) consists of a unique and conserved pterin derivative, usually referred to as molybdopterin (MPT), which coordinates the essential transition metal molybdenum (Mo). Moco is required for the enzymatic activities of all Mo-enzymes, with the exception of nitrogenase and is synthesized by an evolutionary old multi-step pathway that is dependent on the activities of at least six gene products. In eukaryotes, the final step of Moco biosynthesis, i.e. transfer and insertion of Mo into MPT, is catalyzed by the two-domain proteins Cnx1 in plants and gephyrin in mammals. Gephyrin is ubiquitously expressed, and was initially found in the central nervous system, where it is essential for clustering of inhibitory neuroreceptors in the postsynaptic membrane. Gephyrin and Cnx1 contain at least two functional domains (E and G) that are homologous to the Escherichia coli proteins MoeA and MogA, the atomic structures of which have been solved recently. Here, we present the crystal structures of the N-terminal human gephyrin G domain (Geph-G) and the C-terminal Arabidopsis thaliana Cnx1 G domain (Cnx1-G) at 1.7 and 2.6 A resolution, respectively. These structures are highly similar and compared to MogA reveal four major differences in their three-dimensional structures: (1) In Geph-G and Cnx1-G an additional alpha-helix is present between the first beta-strand and alpha-helix of MogA. (2) The loop between alpha 2 and beta 2 undergoes conformational changes in all three structures. (3) A beta-hairpin loop found in MogA is absent from Geph-G and Cnx1-G. (4) The C terminus of Geph-G follows a different path from that in MogA. Based on the structures of the eukaryotic proteins and their comparisons with E. coli MogA, the predicted binding site for MPT has been further refined. In addition, the characterized alternative splice variants of gephyrin are analyzed in the context of the three-dimensional structure of Geph-G.

Mapping of brain stem neuronal circuitry active during swallowing

A poorly understood neural circuit in the brain stem controls swallowing. This experiment studied the swallowing circuit in the rat brain stem by means of fos immunocytochemistry. The fos protein is a marker of activated neurons, and under experimental conditions, repetition of a behavior causes the fos protein to be produced in the neurons involved in that behavior. The fos technique has been successfully used to delineate neural circuits involved in reflex glottic closure, cough, and vocalization; however, the technique has not been used to map the swallowing circuit. Nine rats were used in this study. Swallows were evoked in anesthetized rats for 1 hour, then, after a 4-hour delay to allow maximum fos production, the rats were painlessly sacrificed by perfusion. The brain stems were removed and sectioned in the frontal plane, and every fourth section was immunoreacted for fos protein. All sections were examined by light microscopy, and cells positive for fos were marked on drawings of brain stem structures for different levels throughout the brain stem. Control animals underwent sham experiments. After subtraction of the areas of fos labeling seen in controls, all experimental rats showed fos-labeled neurons in very discrete and localized areas, including practically all regions implicated by prior neurophysiology studies of swallowing. The distribution of labeled neurons was more dispersed through the brain stem than current theories of swallowing would suggest. Specifically, recent studies of swallowing control have focused on the nucleus of the solitary tract (NST) and the region surrounding the nucleus ambiguus (periambigual area) just rostral to the obex. These areas contained fos-labeled neurons, but unexpectedly, heavy labeling was found in the same areas caudal to the obex. Areas containing the heaviest labeling were specific subnuclei of the NST and surrounding reticular formation; the periambigual area; and the intermediate reticular zone in the pons and caudal medulla. Interestingly, none of these anatomic structures had uniform fos labeling; this finding suggests that the unlabeled areas are involved in other oromotor behaviors, or that the specific protocol did not activate the full population of swallowing-related neurons. A notable finding of this study is a candidate for the central pattern generator (CPG) of swallowing. Careful lesioning studies in cats strongly suggest that a region in the rostral-medial medulla contains the CPG for swallowing, although the exact location of the CPG was never pinpointed. In the homologous region of the rat brain stem, fos labeling was only found in a small group of neurons within the gigantocellular reticular formation that may be a candidate for the CPG. In summary, correlation with prior physiology experiments suggests that this experiment appears to have delineated many, if not all, of the components of the swallowing circuit for the first time in any mammal. In addition, other areas were found that might also be swallowing-related. One notable example is a small group of fos-labeled cells that may be the CPG for swallowing. Further studies are required to clarify the specific roles of the fos-labeled neurons seen in this study.

Soluble human interleukin-4 receptor is produced by activated T cells under the control of metalloproteinases

BACKGROUND

Soluble interleukin 4 receptors (sIL-4R) are present in biological fluids. In contrast to mice, in man no distinct mRNA coding for sIL-4R has been described, suggesting that human sIL-4R is exclusively produced by proteolytic cleavage of the cell surface receptor. It is not known whether human sIL-4R is actively produced during an immune response.

METHODS

Human purified T cells, CD4+, CD8+, CD45RA+ and CD45R0+ T cell subpopulations were activated in vitro. sIL-4R was determined in the supernatants, cell surface IL-4R was measured by flow cytometry and RT-PCR.

RESULTS

Recombinant sIL-4R inhibited IL-4-mediated proliferation and IL-5 upregulation by T cells. sIL-4R could be detected at low levels in supernatants of nonactivated T cells, but at high levels following TCR engagement. This response was paralleled by enhanced transcription and de novo synthesis of the human cell surface IL-4R. Both, activated naive CD45RA+ and memory CD45R0+ T cells, produced sIL-4R with long-lasting kinetics. IL-4 increased sIL-4R production by activated CD45RA+, but there was less of an increase by CD45R0+ T cells. In addition, interferon-gamma enhanced sIL-4R production. Cycloheximide and dexamethasone inhibited sIL-4R production by activated T cells, but did not abolish constitutive release of sIL-4R. Phosphoramidon and 1,10-phenanthroline dose-dependently inhibited shedding of the IL-4R, even in nonactivated T cells.

CONCLUSION

The production of human sIL-4R by T cells is regulated by TCR stimuli, IL-4 and IFN-gamma and needs the activity of metalloproteinases. Thus, sIL-4R should be regarded as inducible and due to its IL-4-antagonizing activity an immunoregulatory molecule.

[Hemodynamic effects of a single intravenous administration of prostaglandin E1 in a patient sample with chronic NYHA-stage II/III heart failure]

We investigated the hemodynamic effects of a single infusion of PGE1 (60 micrograms infused over a period of 2 h--this is the single dose used in courses of treatment for peripheral occlusive arterial disease) in patients with chronic heart failure NYHA class II-III. The ejection fraction of these patients was < 55%, their average age was 58.4 years (standard deviation 10 years), and their condition was stable. Nineteen of the patients had coronary heart disease and one patient had myocarditis. The hemodynamic data were obtained invasively by catheterization of the right and left heart. Blood pressure and pulse rate were measured manually. Intravenous infusion of 60 micrograms PGE1 over a period of 2 hours did not significantly alter contractility or hemodynamics. Dp/dtmax, dp/dtmax/p, and dp/dt DP40, which are parameters of left ventricular contractility, determined with the aid of a catheter-tip manometer, did not differ significantly over time from those in the placebo control group. Similarly, the other data furnished no evidence that administration of PGE1 had any hemodynamic or myocardial effects. Hence, it is reasonable to state that it is safe to administer PGE1 to patients with peripheral occlusive arterial disease.

Hemodynamic effects of a single intravenous infusion of prostaglandin E1 in patients with clinically moderate to severe chronic heart failure

In a placebo-controlled, double-blind study, we investigated the hemodynamic effects of a single infusion of prostaglandin E ( 1 ) (PGE ( 1 ); 60 microg infused over a period of 2 hours, the unit dosage used in courses of treatment for peripheral occlusive arterial disease) in 20 patients with moderate to severe chronic heart failure (New York Heart Association functional class II or III). Ejection fraction before therapy was less than 55%, and average age was 58.4 +/- 10 years in these clinically stable patients. Nineteen patients had coronary heart disease and one patient had had myocarditis underlying heart failure. Hemodynamic data were obtained by right- and left-heart catheterization and by Doppler echocardiography. Blood pressure and pulse rate were measured manually. Intravenous infusion of 60 microg PGE ( 1 ) over a period of 2 hours did not significantly alter contractility or hemodynamics. Dp/dt max, dp/dt max/p and dp/dt DP40, measures of left ventricular contractility determined with a catheter-tip manometer, did not differ significantly over time in PGE ( 1 ) -treated patients and those who received placebo. Other measures also failed to reveal PGE ( 1 ) -induced myocardial effects. We conclude that it is safe to administer PGE ( 1 ) to patients with peripheral occlusive arterial disease irrespective of heart failure.