Characterizing Major Depressive Disorder (MDD) using alpha-band activity in resting-state electroencephalogram (EEG) combined with MATRICS Consensus Cognitive Battery (MCCB).

BACKGROUND: The diagnosis of major depressive disorder (MDD) is commonly based on the subjective evaluation by experienced psychiatrists using clinical scales. Hence, it is particularly important to find more objective biomarkers to aid in diagnosis and further treatment. Alpha-band activity (7-13 Hz) is the most prominent component in resting electroencephalogram (EEG), which is also thought to be a potential biomarker. Recent studies have shown the existence of multiple sub-oscillations within the alpha band, with distinct neural underpinnings. However, the specific contribution of these alpha sub-oscillations to the diagnosis and treatment of MDD remains unclear. METHODS: In this study, we recorded the resting-state EEG from MDD and HC populations in both open and closed-eye state conditions. We also assessed cognitive processing using the MATRICS Consensus Cognitive Battery (MCCB). RESULTS: We found that the MDD group showed significantly higher power in the high alpha range (10.5-11.5 Hz) and lower power in the low alpha range (7-8.5 Hz) compared to the HC group. Notably, high alpha power in the MDD group is negatively correlated with working memory performance in MCCB, whereas no such correlation was found in the HC group. Furthermore, using five established classification algorithms, we discovered that combining alpha oscillations with MCCB scores as features yielded the highest classification accuracy compared to using EEG or MCCB scores alone. CONCLUSIONS: Our results demonstrate the potential of sub-oscillations within the alpha frequency band as a potential distinct biomarker. When combined with psychological scales, they may provide guidance relevant for the diagnosis and treatment of MDD.

Continuous Versus Intermittent Control Cuff Pressure for Preventing Ventilator-Associated Pneumonia: An Updated Meta-Analysis.

OBJECTIVE: This study aimed to evaluate the effect of continuous control cuff pressure (CCCP) versus intermittent control cuff pressure (ICCP) for the prevention of ventilator-associated pneumonia (VAP) in critically ill patients. METHODS: Relevant literature was searched in several databases, including PubMed, Embase, Web of Science, ProQuest, the Cochrane Library, Wanfang Database and China National Knowledge Infrastructure between inception and September 2022. Randomized controlled trials were considered eligible if they compared CCCP with ICCP for the prevention of VAP in critically ill patients. This meta-analysis was performed using the RevMan 5.3 and Trial Sequential Analysis 0.9 software packages. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework was used to assess the level of evidence. RESULTS: We identified 14 randomized control trials with a total of 2080 patients. Meta-analysis revealed that CCCP was associated with a significantly lower incidence of VAP compared with ICCP (relative risk [RR] = 0.52; 95% confidence interval [CI]: 0.37-0.74; P < 0.001), although considerable heterogeneity was observed (I2 = 71%). Conducting trial sequential analysis confirmed the finding, and the GRADE level was moderate. Subgroup analysis demonstrated that CCCP combined with subglottic secretion drainage (SSD) had a more significant effect on reducing VAP (RR = 0.39; 95% CI = 0.29-0.52; P < 0.001). The effect of CCCP on ventilator-associated respiratory infection (VARI) incidence was uncertain (RR = 0.81; 95% CI = 0.53-1.24; P = 0.34; I2 = 61%). Additionally, CCCP significantly reduced the duration of mechanical ventilation (MV) (mean difference [MD] = -2.42 days; 95% CI = -4.71-0.12; P = 0.04; I2 = 87%). Descriptive analysis showed that CCCP improved the qualified rate of cuff pressure. However, no significant differences were found in the length of intensive care unit (ICU) stay (MD = 2.42 days; 95% CI = -1.84-6.68; P = 0.27) and ICU mortality (RR = 0.86; 95% CI = 0.74-1.00; P = 0.05). CONCLUSION: Our findings suggest that the combination of CCCP and SSD can reduce the incidence of VAP and the duration of MV and maintain the stability of cuff pressure. A combination of CCCP and SSD applications is suggested for preventing VAP.

Efficacy of Endotracheal Tube Cuff Modification in Preventing Ventilator-associated Pneumonia.

The aim of this study was to evaluate the effect of modifying the cuff on preventing ventilator-associated pneumonia (VAP). PubMed, Embase and Cochrane Library were systematically searched from inception to April 2022, for randomised controlled trials (RCTs) that compared the effect of a new type of cuff intubation with traditional cuff intubation on VAP incidence and intensive-care unit (ICU) mortality in mechanically ventilated patients. Nine RCTs with 1937 patients were finally evaluated. The pooled results for the incidence of VAP showed that the modified cuff significantly decreased the morbidity of VAP compared with the traditional cuff (relative ratio (RR) = 0.73, 95% confidence interval (CI) 0.56-0.95, p = 0.02). The subgroup analysis revealed that polyurethane (PU) cuff (RR = 0.82, 95% CI 0.46-1.48, p = 0.52), conical cuff (RR = 0.97, 95% CI 0.73-1.28, p = 0.82) and PU-conical cuff (RR = 1.36, 95% CI 0.85-2.18, p = 0.20) did not decrease the incidence of VAP. Moreover, the improved cuff combined with subglottic secretion drainage (SSD) could significantly reduce the VAP incidence (RR = 0.58, 95% CI 0.44-0.77, p = 0.0001). In terms of ICU mortality, there was no statistically significant difference (RR = 0.83, 95% CI 0.68-1.02, p = 0.08) between the two groups. The modified cuff is superior to the traditional cuff in VAP prevention. In particular, the modified cuff combined with subglottic secretion drainage has more advantages. Key Words: Ventilator-associated pneumonia, Intubation, Endotracheal cuff, Intensive care unit, Meta-analysis.

Periodic Characteristics of Hepatitis Virus Infections From 2013 to 2020 and Their Association With Meteorological Factors in Guangdong, China: Surveillance Study.

BACKGROUND: In the past few decades, liver disease has gradually become one of the major causes of death and illness worldwide. Hepatitis is one of the most common liver diseases in China. There have been intermittent and epidemic outbreaks of hepatitis worldwide, with a tendency toward cyclical recurrences. This periodicity poses challenges to epidemic prevention and control. OBJECTIVE: In this study, we aimed to investigate the relationship between the periodic characteristics of the hepatitis epidemic and local meteorological elements in Guangdong, China, which is a representative province with the largest population and gross domestic product in China. METHODS: Time series data sets from January 2013 to December 2020 for 4 notifiable infectious diseases caused by hepatitis viruses (ie, hepatitis A, B, C, and E viruses) and monthly data of meteorological elements (ie, temperature, precipitation, and humidity) were used in this study. Power spectrum analysis was conducted on time series data, and correlation and regression analyses were performed to assess the relationship between the epidemics and meteorological elements. RESULTS: The 4 hepatitis epidemics showed clear periodic phenomena in the 8-year data set in connection with meteorological elements. Based on the correlation analysis, temperature demonstrated the strongest correlation with hepatitis A, B, and C epidemics, while humidity was most significantly associated with the hepatitis E epidemic. Regression analysis revealed a positive and significant coefficient between temperature and hepatitis A, B, and C epidemics in Guangdong, while humidity had a strong and significant association with the hepatitis E epidemic, and its relationship with temperature was relatively weak. CONCLUSIONS: These findings provide a better understanding of the mechanisms underlying different hepatitis epidemics and their connection to meteorological factors. This understanding can help guide local governments in predicting and preparing for future epidemics based on weather patterns and potentially aid in the development of effective prevention measures and policies.

Status and Risk Factors in Patients Requiring Unplanned Intensive Care Unit Readmission Within 48 Hours: A Retrospective Propensity-Matched Study in China.

Aim: This study investigated the current status and related risk factors of 48-hour unplanned return to the intensive care unit (ICU) to reduce the return rate and improve the quality of critical care management. Methods: Data were collected from 2365 patients discharged from the comprehensive ICU. Multivariate and 1:1 propensity score matching analyses were performed. Results: Forty patients (1.69%) had unplanned readmission to the ICU within 48 hours after transfer. The primary reason for return was respiratory failure (16 patients, 40%). Furthermore, respiratory failure (odds ratio [OR] = 5.994, p = 0.02) and the number of organ failures (OR = 5.679, p = 0.006) were independent risk factors for unplanned ICU readmission. Receiver operating characteristic curves were drawn for the predictive value of the number of organ injuries during a patient's unplanned transfer to the ICU (area under the curve [AUC] = 0.744, sensitivity = 60%, specificity = 77.5%). Conclusion: The reason for patient transfer and the number of organ injuries during the process were independent risk factors for patients who were critically ill. The number of organs damaged had a predictive value on whether the patient would return to the ICU within 48 hours.

Temporal dynamic characteristics of human monkeypox epidemic in 2022 around the world under the COVID-19 pandemic background.

Background: The reemergence of the monkeypox epidemic has aroused great concern internationally. Concurrently, the COVID-19 epidemic is still ongoing. It is essential to understand the temporal dynamics of the monkeypox epidemic in 2022 and its relationship with the dynamics of the COVID-19 epidemic. In this study, we aimed to explore the temporal dynamic characteristics of the human monkeypox epidemic in 2022 and its relationship with those of the COVID-19 epidemic. Methods: We used publicly available data of cumulative monkeypox cases and COVID-19 in 2022 and COVID-19 at the beginning of 2020 for model validation and further analyses. The time series data were fitted with a descriptive model using the sigmoid function. Two important indices (logistic growth rate and semi-saturation period) could be obtained from the model to evaluate the temporal characteristics of the epidemic. Results: As for the monkeypox epidemic, the growth rate of infection and semi-saturation period showed a negative correlation (r = 0.47, p = 0.034). The growth rate also showed a significant relationship with the locations of the country in which it occurs [latitude (r = -0.45, p = 0.038)]. The development of the monkeypox epidemic did not show significant correlation compared with the that of COVID-19 in 2020 and 2022. When comparing the COVID-19 epidemic with that of monkeypox, a significantly longer semi-saturation period was observed for monkeypox, while a significant larger growth rate was found in COVID-19 in 2020. Conclusions: This novel study investigates the temporal dynamics of the human monkeypox epidemic and its relationship with the ongoing COVID-19 epidemic, which could provide more appropriate guidance for local governments to plan and implement further fit-for-purpose epidemic prevention policies.

Exploring the Nursing Factors Related to Ventilator-Associated Pneumonia in the Intensive Care Unit.

Objective: The purpose of this study was to investigate the key nursing factors associated with ventilator-associated pneumonia (VAP) in critical care patients. Methods: Through the quality control platform of Hebei Province, questionnaires were sent to intensive care nurses in 32 tertiary hospitals in Hebei Province, China to collect data concerning the incidence of VAP and the status of the nursing staff. All the data were analyzed using an independent t-test and a one-way analysis of variance (ANOVA). The Pearson correlation coefficient was used to analyse the correlation between the nursing factors and the incidence of VAP. Multivariate logistic regression analysis was used to determine the risk factors affecting VAP. Results: In terms of nursing, the incidence of VAP was affected by the differential nursing strategies. Multivariate logistic regression analysis showed that the incidence of VAP was significantly associated with the following six variables: the ratio of nurses to beds (p = 0.000), the ratio of nurses with a bachelor's degree or higher (p = 0.000), the ratio of specialist nurses (p = 0.000), the proportion of nurses with work experience of 5-10 years (p = 0.04), the number of patients nurses were responsible for at night (p = 0.01) and the frequency of oral care (p = 0.000). Conclusion: The incidence of VAP is closely related to nursing factors. In terms of nursing human resources, even junior nurses (less experienced nurses) can play an essential role in reducing VAP. In addition, to reduce VAP, the number of patients that nurses are responsible for at night should be reduced as much as possible, and improving nursing qualifications.

Attentional selection and suppression in children and adults.

The fundamental role of covert spatial attention is to enhance the processing of attended items while simultaneously ignoring irrelevant items. However, relatively little is known about how brain electrophysiological activities associated with target selection and distractor suppression are involved as they develop and become fully functional. The current study aimed to identify the neurophysiological bases of the development of covert spatial attention, focusing on electroencephalographic (EEG) markers of attentional selection (N2pc) and suppression (PD ). EEG data were collected from healthy young adults and typically developing children (9-15 years old) as they searched for a shape singleton target in either the absence or the presence of a salient-but-irrelevant color singleton distractor. The ERP results showed that a lateral shape target elicited a smaller N2pc in children compared with adults regardless of whether a distractor was present or not. Moreover, the target-elicited N2pc was always followed by a similar positivity in both age groups. Counterintuitively, a lateral salient-but-irrelevant distractor elicited a large PD in children with low behavioral accuracy, whereas high-accuracy children exhibited a small and "adult-like" PD . More importantly, we found no evidence for a correlation between the target-elicited N2pc and the distractor-elicited PD in either age group. Our results provide neurophysiological evidence for the developmental differences between target selection and distractor suppression. Compared with adults, 9-15-year-old children deploy insufficient attentional selection resources to targets but use "adult-like" or even more attentional suppression resources to resist irrelevant distractors. A video abstract of this article can be viewed at: https://www.youtube.com/watch?v=NhWapx0d75I.

Attentional selection predicts rapid automatized naming ability in Chinese-speaking children with ADHD.

Children with attention-deficit/hyperactivity disorder (ADHD) are reported to have a significantly higher risk of showing reading difficulties or disorders. Here, we aimed to identify the relationship between electroencephalographic (EEG) marker of spatial attention and reading ability in Chinese children with ADHD. First, we demonstrated that rapid automatized naming (RAN) is a strong predictor of reading ability in Chinese-speaking children. Then, EEG data of 9-to 15-year-old children with ADHD (n = 38) and typically developing (TD) controls (n = 36) were collected while the children performed a classical visual search task. Children with ADHD showed slower RAN speed than TD children. For event-related potentials (ERPs), children with ADHD showed a reduced target-evoked N2pc component, which predicted their poorer RAN performance. However, in TD children the early occipital P1 amplitude was negatively correlated with their RAN performance. The correlation between decreased N2pc and poor RAN performance in children with ADHD suggests that their reading problems may in part be due to impaired attentional selection. In contrast, in TD children, development in early visual processing co-occurs with improvements in reading ability.

Magnetic solid-phase extraction of phthalate esters (PAEs) in apparel textile by core-shell structured Fe3O4@silica@triblock-copolymer magnetic microspheres.

In this paper, novel core-shell structured magnetic Fe3O4/silica nanocomposites with triblock-copolymer grafted on their surface (Fe3O4@SiO2@MDN) were successfully fabricated by combining a sol-gel method with a seeded aqueous-phase radical copolymerization approach. Owing to the excellent characteristics of the strong magnetic responsivity, outstanding hydrophilicity and abundant π-electron system, the obtained core-shell structured microspheres showed great potential as a magnetic solid phase extraction (MSPE) adsorbent. Several kinds of phthalate esters (PAEs) were selected as model analytes to systematically evaluate the applicability of adsorbents for extraction followed by gas chromatography-mass spectrometry (GC-MS) analyses. Various parameters, including adsorbents amounts, adsorption time, species of eluent, and desorption time were optimized. Under the optimized conditions, Validation experiments such as recovery, reproducibility, and limit of detection were carried on and showed satisfactory results. The analysis method showed excellent linearity with a wide range of 0.2-10mg/kg (R(2)>0.9974) and low limits of detection (LOD) of 0.02-0.09 mg/kg (S/N=3). Ultimately, the novel magnetic adsorbents were successfully employed to detect the PAEs in apparel textile samples. And the results indicated that this novel approach brought forward in the present work offered an attractive alternative for rapid, efficient and sensitive MSPE for PAEs compounds.

Attentional Selection and Suppression in Children With Attention-Deficit/Hyperactivity Disorder.

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder with prominent impairments in directing and sustaining attention. The aim of this study was to identify the neurophysiologic bases of attention deficits in ADHD, focusing on electroencephalography markers of attentional selection (posterior contralateral N2 [N2pc]) and suppression (distractor positivity [PD]). METHODS: The electroencephalography data were collected from 135 children 9-15 years old with and without ADHD while they searched for a shape target in either the absence (experiment 1) or the presence (experiment 2) of a salient but irrelevant color distractor. RESULTS: In experiment 1, the shape target elicited a smaller N2pc in children with ADHD (n = 38) compared with typically developing children (n = 36). The smaller N2pc amplitude predicted higher levels of inattentive symptoms in children with ADHD. Moreover, the target-elicited N2pc was followed by a positivity in typically developing children but not in children with ADHD. In experiment 2, the salient but irrelevant color distractor elicited a smaller PD component in children with ADHD (n = 32) compared with typically developing children (n = 29). The smaller PD predicted higher inattentive symptom severity as well as lower behavioral accuracy in children with ADHD. CONCLUSIONS: The correlation between N2pc/PD amplitudes and ADHD symptom severity suggests that these signals of attentional selection and suppression may serve as potential candidates for neurophysiologic markers of ADHD. Our findings provide a neurophysiologic basis for the subjective reports of attention deficits in children with ADHD and highlight the importance of spatial attention impairments in ADHD.

Quantitative comparison of the hemodynamic activation elicited by cardinal and oblique gratings with functional near-infrared spectroscopy.

Evidence has been accumulated for over a century indicating that the visual system of humans and many animals is more sensitive to contour stimulation at vertical or horizontal orientations than oblique orientations. However, the neural basis for this orientation anisotropy is still a subject of debate. In the present study, we recorded brain activity over the parietal-occipital and frontal lobes with functional near-infrared spectroscopy (fNIRS) when human participants were presented with gratings in different orientations. The oblique gratings induced a much larger change in the oxygenated hemoglobin concentration than vertical and horizontal gratings in the left occipital lobe. However, we did not find any significant orientation anisotropy in the frontal lobe. Our study showed that different quantitative changes in the hemoglobin concentrations occurred in response to differently oriented stimuli in the visual cortex and that fNIRS could potentially be a valuable tool in the assessment of the hemodynamic responses of the visual system.

The N2pc is increased by perceptual learning but is unnecessary for the transfer of learning.

BACKGROUND: Practice improves human performance in many psychophysical paradigms. This kind of improvement is thought to be the evidence of human brain plasticity. However, the changes that occur in the brain are not fully understood. METHODOLOGY/PRINCIPAL FINDINGS: The N2pc component has previously been associated with visuo-spatial attention. In this study, we used event-related potentials (ERPs) to investigate whether the N2pc component changed during long-term visual perceptual learning. Thirteen subjects completed several days of training in an orientation discrimination task, and were given a final test 30 days later. The results showed that behavioral thresholds significantly decreased across training sessions, and this decrement was also present in the untrained visual field. ERPs showed training significantly increased the N2pc amplitude, and this effect could be maintained for up to 30 days. However, the increase in N2pc was specific to the trained visual field. CONCLUSION/SIGNIFICANCE: Training caused spatial attention to be increasingly focused on the target positions. However, this process was not transferrable from the trained to the untrained visual field, which suggests that the increase in N2pc may be unnecessary for behavioral improvements in the untrained visual field.

Comparison of event-related potentials elicited by cardinal and oblique orientations with broad-band noise stimuli.

The experiments described here used event-related potentials (ERPs) to investigate the neural processes of the horizontal effect, in which visual performance is worst for horizontal and best for oblique orientations. EEGs were recorded while human adult subjects performed an orientation identification task with broad-band noise stimuli. The results showed that the difference between cardinal orientations and oblique orientations first occurred at P2 component around 200 ms post-stimulus onset, which is much later than the traditional oblique effect. Additionally, the P3 was much smaller and earlier for oblique orientations than for cardinal orientations. These findings indicated that, compared to the classical oblique effect, the horizontal effect with broad-band noise stimuli might occur at relatively later stages of visual information processing and might involve more complex neural mechanisms.