Optimizing Therapeutic Hypothermia Depths in Acute Type A Aortic Dissection Repair.

INTRODUCTION: Existing evidence regarding the impact of hypothermic circulatory arrest (HCA) depth in acute type A aortic dissection (ATAAD) repair lacks robustness concerning blood loss and mortality. We aimed to assess whether using mild and moderate HCA (MMHCA) versus deep and profound HCA (DPHCA) in ATAAD repair is associated with reduced bleeding risk, lower in-hospital mortality, and improved long-term survival. METHODS: This retrospective cohort study spanned from 2003 to 2023. ATAAD repair patients were identified from hospital records, with exclusion criteria applied to those who died before surgery, those with symptoms lasting longer than 14 d, and those who operated on without HCA. Patients in the DPHCA group underwent surgery with HCA (T ≤ 20°C), while those in the MMHCA group had temperatures ranging from 34°C to 20.1°C. RESULTS: Out of 549 eligible ATAAD patients, the MMHCA group exhibited a reduced rate of chest re-exploration for bleeding (39% versus 14%, P < 0.005), decreased blood loss after surgery (1637 mL versus 1045 mL, P < 0.005), and lower volumes for red blood cell transfusions (1375 mL versus 903 mL, P < 0.005) compared with the DPHCA group. Additionally, the MMHCA group had lower crude and age- and sex-adjusted in-hospital mortality rates, with a mortality rate ratio of 0.65 (P = 0.003). Cox regression analysis revealed a 25% reduction in long-term mortality for the MMHCA group compared with the DPHCA group (hazard ratio = 0.75; P = 0.045). CONCLUSIONS: ATAAD repair using MMHCA and antegrade cerebral perfusion is associated with lower blood loss and improved immediate and long-term survival.

Systematic Review and Meta-Analysis Confirm the Moderate Efficacy of High-Frequency r-TMS in Alzheimer's Disease: Mediating Effects of Anhedonia-Apathy and Add-On Motor-Cognitive Excersizes.

OBJECTIVES: Alzheimer's disease (AD) presents a major global health issue of significant socio-economic impact. Pharmacological treatments for AD have limited efficacy, prompting the exploration of alternative therapies, such as repetitive transcranial magnetic stimulation (rTMS), a promising non-invasive technique to enhance cognitive function in AD patients. Our systematic review and meta-analysis aim to evaluate the efficacy of rTMS in relation to cognitive function in AD patients, identify optimal rTMS stimulation parameters, and understand the underlying neural mechanisms. METHODS: We conducted a comprehensive literature search in PubMed using predefined search terms to identify original research articles investigating the effects of rTMS on cognitive function in AD patients. We selected only randomized controlled trials (RCTs) with sufficient quantitative data for comparing active rTMS to the sham-coil treatment, and then performed a random effects meta-analysis using standardized mean differences (SMDs) to synthesize the effects across studies. RESULTS: The systematic review included 22 studies, among which 14 RCTs met our criteria for meta-analysis. High-frequency rTMS, particularly targeting the dorsolateral prefrontal cortex (DLPFC), evoked significant cognitive improvements in AD patients, with a moderate positive effect size of rTMS on cognitive function (Hedges' g=0.580, 95% CI [0.268, 0.892], p<0.001), albeit with substantial heterogeneity (I²=59%). Funnel plot asymmetry and Egger's test suggested a potential publication bias, but fail-safe N analysis indicated a robust finding. Moreover, anhedonia-apathy symptoms and motor-cognitive exercises mediated the efficacy of tTMS in ameliorating cognitive functioning across several studies. CONCLUSION: rTMS demonstrates moderate efficacy in improving cognitive function in AD-patients, most distinctly with high-frequency rTMS stimulation protocols targeting the DLPFC area. The meta-analysis support rTMS as a viable therapeutic intervention for cognitive enhancement in AD. Future promising research should focus on personalized treatment strategies targeting mediating factors, baseline connectivity patterns, and TMS-induced neuroplasticity in AD.

Interpersonal Psychotherapy in Russia: Remembering Past Losses of the Heart, Keeping Mindful of the Culture of Melancholy, and Reconnecting with a Supportive Social Environment.

BACKGROUND: The dissolution of the Soviet Union brought economic instability and variety of social changes, resulting in fluctuating suicide rates and highlighting the national phenomenon of a melancholy cultural trait across the general population. The socio-political changes in Russia post-1991 led to increased rates of depressive and stress-related disorders, as well as opening avenues for integrating foreign psychotherapeutic methods, including Interpersonal Psychotherapy (Klerman-Weissman IPT), into the treatment of mental disorders. This narrative review explores the adaptation and efficacy of IPT in Russia, particularly for depressive and stress-related disorders. MATERIAL AND METHODS: We assembled key PhD theses related to the topic of IPT use in Russia. One such study involved 120 female patients aged 23-45 years with adjustment disorders, treated at the Omsk Rehabilitation Treatment Hospital. Participants were divided into an IPT group (n=80) and a control group (n=40) receiving treatment as usual (TAU). The IPT group underwent 12-16 individual sessions, each lasting 60 minutes, held twice a week. The main study group was further divided into four sub-groups based on specific interpersonal problems: loss of loved ones, interpersonal conflicts, social role changes, and social isolation. RESULTS: Both groups showed improvement in anxiety, dyssomnia, and motor retardation, with the IPT group demonstrating more sustained improvement. At the 8-week endpoint, full recovery from depression was observed in 50% of the IPT group, compared to only 20% in the TAU group. The IPT group also showed significant improvements in coping strategies, with a notable decrease in avoidance behaviors and an increase in problem-solving strategies, also targeting melancholy national phenomenon via training acceptance skills and practicing an active life position to aware the self-responisbility and achieve a of well-being state of emotional balance. The group IPT method was also experimentally combined with the person-oriented (reconstructive) psychotherapy, which has a long and successful history of within the group format, and has enabled shortening of the standard course of person-oriented reconstructive treatment. CONCLUSIONS: IPT method has proven efficacy in treating depressive and stress-related disorders in Russia, by addressing deeper pathogenetic levels of mental and behavioral formations. The Russian Society of Psychiatrists and Russian Psychotherapy Association have recommended its broader implementation in Russian mental health institutions, and has included IPT in the Russian National Guidelines for Psychiatry.

Depression and Anxiety Among COVID-19 Patients Admitted to a "Red Zone" Intensive Care Unit: Do the Factors of Self-Awareness of Somatic Health, Anxiety, and Depression Contribute to the Course of Sars-Cov-2 Infection?

BACKGROUND: The prevalence of depressive disorders in the general population increased significantly during the COVID-19 pandemic. The aim of this study is to examine the relationship between history of anxiety and depressive disorders and COVID-19 outcome, hospitalization and severity of anxiety and depression, and whether such relationships are explicable by direct impact of the disease. SUBJECTS AND METHODS: We conducted a questionnaire survey among 98 inpatients in the Department of Infectious Diseases of the Clinics of Samara State Medical University. The self-report questionnaire consisted of 120 items, including socio-demographic characteristics of participants, State-Trait Anxiety Inventory, and the Center for Epidemiologic Studies Depression Scale, with items reflecting subjective feelings about the COVID-19 pandemic. We used one-factor analysis of variance to compare between groups for those indicators that conformed to a normal distribution, and the chi-square test (χ2) or Fisher's exact test to analyze group differences in the distribution of categorical variables was used. RESULTS: The mean (SD) total score on the STAI anxiety scale among hospitalized patients (51 (10.1)) significantly exceeded that of the COMET-G control group (44.9 (11.7) (H=22.8, p<0.001). There was a similar difference in the severity of depression as measured by the CES-D scale (23.4 (12.6) versus 18.0 (11.8), H=15.2 and p<0.001). In contrast to the general population, there were no statistically significant differences in anxiety and depression severity in the matched samples 52 subjects fulfilling the criteria of age, gender, and general perception of health condition. CONCLUSIONS: Anxiety and depression scores among ICU (red zone) inpatients significantly exceeded the scores observed in the COMET-G general population group. Our study did not confirm expected relationship between symptoms of anxiety and depression (based on questionnaire response) and the risk of severe course of COVID-19 (e.g. hospitalization) in matched samples, but proved that the factor of self-awareness of health state may be related to the COVID-19 course severity. Future research would benefit from clinical interview of inpatients and follow-up monitoring of affective disorders to specify whether anxiety and particular type of depression (e.g., anxious) are selectively related to the severity of COVID-19 course and risks of affective disorders persistence after somatic recovery. The accumulation of mental disorders with age, and the bidirectional association of mood disorders and infectious diseases should be considered when assessing the risk factors.

The Population Typology of Conspiracy Beliefs About Sars-Cov-2 Origin in Russia Based on Predictive Modelling of COMET-G Study Data: Incoherent Attitude Indicator as a Predisposing Factor for Developing Mental Disturbances.

BACKGROUND: We examined the prevalence and spread of conspiracy beliefs about the origins of the COVID-19 pandemic among representatives of the Russian population. Our study aimed to identify belief clusters and develop predictive models to understand the factors that influence conspiracy beliefs, particularly in the context of how they might evolve in response to socio-political events and cause mental disturbances, thus in relation to specific pathways of the infodemic and psychodemic waves that spread among vulnerable population groups. METHODS: Data respondents to the international COMET-G study living in Russia during pandemic period (n=7,777) were analyzed using descriptive statistics, K-means clustering, and various machine learning models, including gradient boosting. We identified distinct populations depending on predominant beliefs about COVID-19 pandemic origins, and applied game theory (Shapely additive explanations) to determine the most influential variables in predicting cluster membership. RESULTS: Four distinct belief clusters emerged, which we designate as Naturalists, Conspiracists, COVID-Sceptics, and the Incoherent Attitude groups. The Incoherent Attitude cluster constituted 20.8% of the sample, and was particularly associated with mental health signs such as sleep disturbances and the use of psychotropic medications. Internet use and mental health-related factors, as well as the respondents' education level, were key predictors of mental disturbances with mediating effects of the conspiracy views across all clusters. Conspiracy beliefs about COVID-19 origin were highly fluid/variable, often being shaped by external sociopolitical factors rather than objective health data. CONCLUSIONS: The cluster with Incoherent Attitude regarding COVID-pandemic origins, which had an association with psychoticism, showed a greater predisposition for mental health problems, than did the Conspiracist, Naturalist and Sceptic clusters. We suppose that underlying psychoticism bears a relation to their sleep problems and resorting to use of psychotropic medications. These results emphasizes the global health need for implementing target-focused and selective strategies that address public misinformation and promote the adoption of critical thinking skills to mitigate the impact of conspiracy theories, considering the factors of education level and pre-existing mental disorders.

Self-Harm Behavior and Suicidality Among Adolescents in Samara Region.

INTRODUCTION: Self-harm behavior is a significant global concern, with Russia among the countries with high prevalence rates. Adolescents and young adults (15-29 years old) are particularly vulnerable, with suicide being the fourth leading cause of death in this age group. Our objective was to present statistics on suicidality and non-suicidal self-harm behavior (NSSH) among adolescents in the Samara region and to identify psychosocial differences between patients hospitalized for the first time and those hospitalized repeatedly. SUBJECTS AND METHODS: This study is a retrospective chart analysis of adolescents hospitalized due to suicidal ideation or attempts in 2023. Data were collected from hospital records, comprising a diverse sample of adolescents. RESULTS: The sample included 76 adolescents, with a significant gender imbalance, as 84.2% were female. Chronic family conflicts presumably were the most influential factor, rather than family composition. Data on hereditary predisposition were subjective and presumably did not correlate with the number of hospitalizations. Fetal hypoxia was the only notable perinatal pathology. Self-harm behavior was more common in readmissions, while suicidal thoughts were present in similar proportions in both initial and repeat hospitalizations. The main reasons for self-harm behavior were the desire to gain control over life or to relieve emotional pain. Only 2.6% of cases were directly aimed at suicide. CONCLUSIONS: Identified risk factors for suicidal behavior among adolescents included female gender, an unfavorable family environment, and NSSH, which, although not directly suicidal, increased the risk of future suicidal behavior. These factors should be considered in the diagnosis and prevention of suicidal behavior.

Risk Assessment Suicidality Scale (RASS)-Based On-Line Calculator Targeting Early Prevention of Suicides in General Population: from COMET-G Study Results Towards Integration of the Screening Tool into Routine Clinical Practice.

BACKGROUND: Suicide is a major global health concern, particularly among young people. This study evaluates an online suicide risk calculator based on the Risk Assessment of Suicidality Scale (RASS), which is designed to enhance accessibility and early detection of suicide risk. METHODS: The study involved 444 participants who completed the RASS via an online calculator. Results were compared with data from the COMET-G study's Russian sample (n=7572). Descriptive statistics, correlation analysis, and two-way ANOVA were used to analyze the data. RESULTS: The mean age of participants was 22.71 years (SD=7.94). The mean total RASS standardized score was 837.7 (SD=297.8). There was a significant negative correlation between age and RASS scores (r=-0.463, p<0.0001). The online calculator sample showed significantly higher RASS scores compared to the COMET-G sample, with 71% of online users scoring above the 90th percentile of the COMET-G sample. CONCLUSION: Our study demonstrated the advantage of the on-line suicidality risk calculator based on the RASS scale as a sensitive tool in detecting suicidal behaviours and measuring the severity of suicidality risks, offering a capability for broad reach and immediate assessment during clinical conversation between doctor and patient. Moreover, the RASS on-line psychometric instrument, when being freely distributed among the general population over internet sources, enabled to attract vulnerable groups of respondents with significantly higher suicidality risks. Future research should focus on integrating such tools into comprehensive suicide prevention programs and developing appropriate follow-up monitoring strategies for high risk-cases.

Mind Language Disturbances and PET-Signs of Depression vs Alzheimer's Disease: Are There Any Common Patterns Identified?

BACKGROUND: There is a broad appreciation that a diagnosis of depression (D) in the elderly is a strong risk factor for incident dementia, particularly Alzheimer's disease (AD). Indeed, the two disorders might constitute a dyad, although their causal relationship is uncertain, given the likely bidirectional and compounding effects of social withdrawal and loss of previous activities, and the manifestation of language disturbances, cognitive dysfunction, and social disruption that are typical of both conditions. We argue that language declines in D and AD share common patterns and biological underpinnings, and that D/AD patients might benefit from intensive language remediation training aiming to improve the functioning of neural networks that are linked to similar cognitive impairments. METHODS: A literature search in PubMed database included topics of language disturbances, cognitive impairments, and molecular brain imaging by positron emission tomography (PET) to identify common patterns in D and AD regarding language decline and its neurobiological underpinnings. RESULTS: Language disturbances show a particular commonality in the two disorders, manifesting in simplified language and particular speech markers (e.g., lexical and semantic repetitions, arguably due to ruminations in D and memory deficits in AD). PET can reveal abnormal protein deposits that are practically diagnostic of AD, but cerebrometabolic deficits to PET with the glucose tracer FDG show a certain commonality in D and AD. Typical findings of hypometabolism in the frontal lobes doubtless underlie the executive function deficits, where frontal hypometabolism in prodromal D increases with AD progression. This may reflect overlapping changes in noradrenaline and other neurotransmitter (e.g. serotonin) changes. Cerebrometabolic deficits associated with language dysfunction may inform targeted language remediation treatments in the D/AD progression. CONCLUSIONS: Language remediation techniques targeting specific language disturbances might present an important complimentary treatment strategy along with an adjusted pharmacotherapy approach and standard psychosocial rehabilitation interventions. We see a need for investigations of language remediation informed by the overlapping pathologies and language disturbances in D and AD.

Virtual Reality (VR) Device with Integrated Biofeedback Sensors (ReViSide) to Cope with Emotional Burnout State Among Employees Experiencing Stress at Workplace: Problem Overview and Action Plan.

INTRODUCTION: In this study we examine the issue of employee burnout, caused by long-term exposure to workplace stressors, considering its complex phenomenology in the context of contemporary psychological and psychiatric views. Towards the development of innovative technologies to correct burnout in the context of psychosocial rehabilitation, we present our study protocol involving the ReViSide virtual reality (VR) and biofeedback intervention, including monitoring of respiratory rates and EEG rhythms. METHODS: The randomized controlled trial protocol includes adult participants aged 18 to 65 years (n=140) who exhibit emotional burnout in the workplace. The intervention group will undergo a course of VR correction (ReViSide), while the control group receives a standard psychocorrection. The primary endpoint will be level of emotional burnout to the Maslach Burnout Inventory (MBI). We shall also assess anxiety, depression, asthenia and subjective improvement in condition using validated scales (HADS, HARS, HDRS, VAS-A, PGI-C). RESULTS: We shall test our hypothesis that the VR-correction group will show significant improvements in MBI scores, particularly in emotional exhaustion, depersonalization, and personal accomplishment, compared to the control group. Secondary outcome measures are likewise expected to demonstrate more prominent improvements in the VR group, correlating with the magnitude of burnout reduction to MBI. Analysis of EEG data may reveal changes in alpha rhythm patterns during VR sessions, potentially correlating with reduced distress levels. CONCLUSIONS: We designed this study to test the integration of an interdisciplinary approach for treating burnout, highlighting the ReViSide technology. Confirming the efficacy of this approach for psychosocial rehabilitation targeting burnout states among employees should improve their stress resilience, daily motivation, and work productivity in the context of the modern high working pressure environment and demanding corporate culture.

Virtual Reality / Augmented Reality (VR/AR) Approach to Develop Social and Communication Skills in Children and Adolescents with Autism Spectrum Disorders Without Intellectual Impairment.

BACKGROUND: Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder that affects a significant proportion of the world's population, particularly children and adolescents. The sensory processing issues can be an evidence-based target for therapeutic/corrective interventions by controlling the intensity and targeted replacement of maladaptive sensory stimuli with neutral stimuli using virtual reality or augmented reality. SUBJECTS AND METHODS: We searched for articles on Pubmed. The search query included ((VR or virtual reality) or (AR or augmented reality)) and (children or adolescents) and (ASD or autism spectrum disorder or autism). RESULTS: Our criteria were met by 25 articles. 19 articles used VR, 5 articles used AR and 1 article used MR. Most interventions offer children and adolescents with ASD individualized tasks. Immersive VR games developed collaborative skills. Other systems encourage and teach directed facial gaze. Evaluation of the effectiveness of learning in VR/AR environment is carried out by means of different scales, qualitative analysis of surveys, questionnaires and interviews, studying the number and duration of eye contacts between the participant and the avatar. It should be noted that almost all studies were conducted on small samples, so their results allow us to draw only preliminary conclusions about the effectiveness of VR /AR. CONCLUSIONS: The following key areas of VR/AR technologies for children and adolescents with high-functioning ASD can be identified: communicating with an avatar, including answering its questions, tracking the child's gaze and encouraging the child to look at the face, placing it in social situations close to real life, practicing common everyday situations, learning to recognize emotions. A VR/AR-based therapy approach may help children with autism spectrum disorder without cognitive impairment to develop higher levels of adaptation in terms of social and communication skills. However, more research is needed to evaluate the effectiveness of different methods.

Broadband infrared imaging governed by guided-mode resonance in dielectric metasurfaces.

Nonlinear metasurfaces have experienced rapid growth recently due to their potential in various applications, including infrared imaging and spectroscopy. However, due to the low conversion efficiencies of metasurfaces, several strategies have been adopted to enhance their performances, including employing resonances at signal or nonlinear emission wavelengths. This strategy results in a narrow operational band of the nonlinear metasurfaces, which has bottlenecked many applications, including nonlinear holography, image encoding, and nonlinear metalenses. Here, we overcome this issue by introducing a new nonlinear imaging platform utilizing a pump beam to enhance signal conversion through four-wave mixing (FWM), whereby the metasurface is resonant at the pump wavelength rather than the signal or nonlinear emissions. As a result, we demonstrate broadband nonlinear imaging for arbitrary objects using metasurfaces. A silicon disk-on-slab metasurface is introduced with an excitable guided-mode resonance at the pump wavelength. This enabled direct conversion of a broad IR image ranging from >1000 to 4000 nm into visible. Importantly, adopting FWM substantially reduces the dependence on high-power signal inputs or resonant features at the signal beam of nonlinear imaging by utilizing the quadratic relationship between the pump beam intensity and the signal conversion efficiency. Our results, therefore, unlock the potential for broadband infrared imaging capabilities with metasurfaces, making a promising advancement for next-generation all-optical infrared imaging techniques with chip-scale photonic devices.

Discovery of the novel HLA-B*35:611 allele, a variant of the HLA-B*35:64:01 allele.

Five nucleotide substitutions in exon 3 of HLA-B*35:64:01 results in the novel allele, HLA-B*35:611.

Two novel HLA class II alleles identified by next-generation sequencing.

Two novel HLA class II, HLA-DRB1*13:357 and HLA-DQB1*03:525, characterised in Russian individuals.

Identification of eight new HLA class I alleles by next-generation sequencing.

Eight novel HLA class I alleles detected by next-generation sequencing.

Polaritonic states trapped by topological defects.

The miniaturization of photonic technologies calls for a deliberate integration of diverse materials to enable novel functionalities in chip-scale devices. Topological photonic systems are a promising platform to couple structured light with solid-state matter excitations and establish robust forms of 1D polaritonic transport. Here, we demonstrate a mechanism to efficiently trap mid-IR structured phonon-polaritons in topological defects of a metasurface integrated with hexagonal boron nitride (hBN). These defects, created by stitching displaced domains of a Kekulé-patterned metasurface, sustain localized polaritonic modes that originate from coupling of electromagnetic fields with hBN lattice vibrations. These 0D higher-order topological modes, comprising phononic and photonic components with chiral polarization, are imaged in real- and Fourier-space. The results reveal a singular radiation leakage profile and selective excitation through spin-polarized edge waves at heterogeneous topological interfaces. This offers impactful opportunities to control light-matter waves in their dimensional hierarchy, paving the way for topological polariton shaping, ultrathin structured light sources, and thermal management at the nanoscale.

Characterisation of two new HLA-A alleles: HLA-A*01:454 and HLA-A*31:229.

HLA-A*01:454 and HLA-A*31:229, two novel HLA-A alleles detected during routine typing by next-generation sequencing.

Pseudo-spin switches and Aharonov-Bohm effect for topological boundary modes.

Topological boundary modes in electronic and classical-wave systems exhibit fascinating properties. In photonics, topological nature of boundary modes can make them robust and endows them with an additional internal structure-pseudo-spins. Here, we introduce heterogeneous boundary modes, which are based on mixing two of the most widely used topological photonics platforms-the pseudo-spin-Hall-like and valley-Hall photonic topological insulators. We predict and confirm experimentally that transformation between the two, realized by altering the lattice geometry, enables a continuum of boundary states carrying both pseudo-spin and valley degrees of freedom (DoFs). When applied adiabatically, this leads to conversion between pseudo-spin and valley polarization. We show that such evolution gives rise to a geometrical phase associated with the synthetic gauge fields, which is confirmed via an Aharonov-Bohm type experiment on a silicon chip. Our results unveil a versatile approach to manipulating properties of topological photonic states and envision topological photonics as a powerful platform for devices based on synthetic DoFs.

Identification of a new HLA-B allele, HLA-B*35:594.

A novel HLA-B*35 allele, officially designated HLA-B*35:594, was identified by next-generation sequencing.

Water-Wave Vortices and Skyrmions.

Topological wave structures-phase vortices, skyrmions, merons, etc.-are attracting enormous attention in a variety of quantum and classical wave fields. Surprisingly, these structures have never been properly explored in the most obvious example of classical waves: water-surface (gravity-capillary) waves. Here, we fill this gap and describe (i) water-wave vortices of different orders carrying quantized angular momentum with orbital and spin contributions, (ii) skyrmion lattices formed by the instantaneous displacements of the water-surface particles in wave interference, and (iii) meron (half-skyrmion) lattices formed by the spin-density vectors, as well as (iv) spatiotemporal water-wave vortices and skyrmions. We show that all these topological entities can be readily generated in linear water-wave interference experiments. Our findings can find applications in microfluidics and show that water waves can be employed as an attainable playground for emulating universal topological wave phenomena.