A new perspective for evaluating the efficacy of tACS and tDCS in improving executive functions: A combined tES and fNIRS study.

BACKGROUND: Executive function enhancement is considered necessary for improving the quality of life of patients with neurological or psychiatric disorders, such as attention-deficit/hyperactivity disorder, obsessive-compulsive disorder and Alzheimer's disease. Transcranial electrical stimulation (tES) has been shown to have some beneficial effects on executive functioning, but the quantification of these improvements remains controversial. We aimed to explore the potential beneficial effects on executive functioning induced by the use of transcranial alternating current stimulation (tACS)/transcranial direct current stimulation (tDCS) on the right inferior frontal gyrus (IFG) and the accompanying brain function variations in the resting state. METHODS: We recruited 229 healthy adults to participate in Experiments 1 (105 participants) and 2 (124 participants). The participants in each experiment were randomly divided into tACS, tDCS, and sham groups. The participants completed cognitive tasks to assess behavior related to three core components of executive functions. Functional near-infrared spectroscopy (fNIRS) was used to monitor the hemodynamic changes in crucial cortical regions in the resting state. RESULTS: Inhibition and cognitive flexibility (excluding working memory) were significantly increased after tACS/tDCS, but there were no significant behavioral differences between the tACS and tDCS groups. fNIRS revealed that tDCS induced decreases in the functional connectivity (increased neural efficiency) of the relevant cortices. CONCLUSIONS: Enhancement of executive function was observed after tES, and the beneficial effects of tACS/tDCS may need to be precisely evaluated via brain imaging indicators at rest. tDCS revealed better neural benefits than tACS during the stimulation phase. These findings might provide new insights for selecting intervention methods in future studies and for evaluating the clinical efficacy of tES.

The role of ventral tegmental area orexinergic afferents in depressive-like behavior in a chronic unpredictable mild stress (CUMS) mouse model.

Orexin has been implicated in comorbid diseases of depression, making it a promising target for anti-depression treatment. Although orexin neurons exhibit abnormal activity in depression, the neurocircuit mechanism of orexin remains unclear. As one of the important downstream factors of orexin neurons, the ventral tegmental area (VTA) is considered crucial to the mechanism of depression. However, the role of VTA orexinergic afferents in depression remains unclear. In this study, we applied a combination of opto/chemogenetic and neuropharmacology methods to investigate whether the VTA orexinergic afferents participate in the pathogenesis of depression in a chronic unpredictable mild stress (CUMS) mouse model. We found that c-Fos expression in these VTA-projecting orexin neurons specifically decreased in CUMS-treated mice. Optogenetic and chemogenetic activation of orexin terminals in the VTA significantly reversed depressive behavior. Microinjection of orexin-A, but not orexin-B, into the VTA significantly improved depressive-like behavior. Our study provided direct evidence that the VTA orexinergic afferents participate in the mechanism of depression, and the orexin-1 receptor plays a major role.

Relationship between meaning in life and death anxiety in the elderly: self-esteem as a mediator.

BACKGROUND: Death anxiety is a common phenomenon in all societies. Older adults may be more prone to death anxiety than their younger counterparts; however, death anxiety among older adults is not well understood. This study explores the relationship between meaning in life, self-esteem, and death anxiety in senior citizens in China. METHODS: A total of 283 older adults participated in this study; data were collected via the Meaning in Life Questionnaire, the Rosenberg Self-Esteem Scale, and the Death Anxiety Scale. RESULTS: Results show that the dimensions of meaning in life, presence of meaning (r = - 0.43, p < 0.01), search for meaning (r = - 0.31, p < 0.01), and self-esteem (r = - 0.54, p < 0.01) were each negatively correlated with death anxiety. Regression analysis reveals that meaning in life significantly predicted self-esteem and death anxiety (F = 45.70, p < 0.01; R2 = 0.33). Path analysis indicated that self-esteem either completely or partially mediated the effects of meaning in life on death anxiety in older adults. CONCLUSIONS: Overall, meaning in life appears to be significantly correlated with death anxiety in older adults, and self-esteem can mediate this effect.

Information processing under high and low distractions using eye tracking.

The previous studies found the differences of eye movements between systematic and heuristic processing were inconsistent. To bridge this gap, we manipulated both systematic and heuristic processings (using high vs. low distractions) and argument quality (using strong vs. weak), and measured both eye movements and self-reported attitude. The results suggested that low distraction induced larger differentiation of post-message attitude between strong and weak arguments compared to high distraction, indicating the successful operation of both processings. More importantly, low distraction enabled more fixations and shorter saccade lengths independent of argument quality. However, no differentiations were found involving fixation duration, regressions, and reading speed. In addition, argument quality influenced eye movements, i.e., less fixation and faster reading speed were found in strong arguments. Our results explain why distractions reduce the efficiency of information processing from an eye tracking perspective and why fixation duration results were inconsistent in the previous studies.

Sample size determination for mediation analysis of longitudinal data.

BACKGROUND: Sample size planning for longitudinal data is crucial when designing mediation studies because sufficient statistical power is not only required in grant applications and peer-reviewed publications, but is essential to reliable research results. However, sample size determination is not straightforward for mediation analysis of longitudinal design. METHODS: To facilitate planning the sample size for longitudinal mediation studies with a multilevel mediation model, this article provides the sample size required to achieve 80% power by simulations under various sizes of the mediation effect, within-subject correlations and numbers of repeated measures. The sample size calculation is based on three commonly used mediation tests: Sobel's method, distribution of product method and the bootstrap method. RESULTS: Among the three methods of testing the mediation effects, Sobel's method required the largest sample size to achieve 80% power. Bootstrapping and the distribution of the product method performed similarly and were more powerful than Sobel's method, as reflected by the relatively smaller sample sizes. For all three methods, the sample size required to achieve 80% power depended on the value of the ICC (i.e., within-subject correlation). A larger value of ICC typically required a larger sample size to achieve 80% power. Simulation results also illustrated the advantage of the longitudinal study design. The sample size tables for most encountered scenarios in practice have also been published for convenient use. CONCLUSIONS: Extensive simulations study showed that the distribution of the product method and bootstrapping method have superior performance to the Sobel's method, but the product method was recommended to use in practice in terms of less computation time load compared to the bootstrapping method. A R package has been developed for the product method of sample size determination in mediation longitudinal study design.

Regulatory focus and burnout in nurses: The mediating effect of perception of transformational leadership.

This correlation study investigated the relationship between nurses' regulatory focus and burnout, as mediated by their perceptions of transformational leadership, using a cross-sectional research design with anonymous questionnaires. In July-August 2012, data were collected from 378 nurses from three hospitals in Shaanxi Province, China, using self-report questionnaires for measuring the nurses' regulatory focus, their level of burnout and their perception of whether the leadership of their supervisor was transformational. Structural equation modelling and bootstrapping procedures were used to identify the mediating effect of their perceptions of transformational leadership. The results supported our hypothesized model. The type of regulatory focus emerged as a significant predictor of burnout. Having a perception of transformational leadership partially mediated the relationship between regulatory focus and burnout. Having a promotion focus reduced burnout when the participants perceived transformational leadership, whereas having a prevention focus exhibited the opposite pattern. The mediating effect of the perception of transformational leadership suggests that a promotion focus may help diminish burnout, directly and indirectly. Nurse managers must be aware of the role of a regulatory focus and cultivate promotion focus in their followers.

Visual MMN elicited by orientation changes of faces.

Faces are socially very important visual objects and the detection of a change in faces is an essential evolutionary skill. To investigate whether configural computation of faces automatically occurs under non-attentional condition, visual mismatch negativity (vMMN) elicited by deviant orientation (90° vs. 0°) of faces was analyzed using the equi-probable paradigm which eliminated the low-level refractory effects. Fourteen participants were tested and schematic face stimuli were used. In comparison with control face stimuli, the deviant orientation of faces elicited larger N170 and smaller P2. During the time range between 100-300 ms post stimulus onset, face orientation changes elicited occipital-temporal distributed vMMN. The source analysis of face-MMN showed that it was generated in both temporal and frontal lobes. These data supported the hypotheses that the disruption of facial configuration processing caused by inverted faces is relatively independent of attentional resources.

Network analysis of depressive and anxiety symptoms in older Chinese adults with diabetes mellitus.

Background: The move away from investigating mental disorders as whole using sum scores to the analysis of symptom-level interactions using network analysis has provided new insights into comorbidities. The current study explored the dynamic interactions between depressive and anxiety symptoms in older Chinese adults with diabetes mellitus (DM) and identified central and bridge symptoms in the depression-anxiety network to provide potential targets for prevention and intervention for depression and anxiety. Methods: This study used a cross-sectional design with data from the 2017-2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). A regularized partial correlation network for depressive and anxiety symptoms was estimated based on self-reported scales completed by 1685 older adults with DM aged 65 years or older. Depressive and anxiety symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) and the Seven-Item Generalized Anxiety Disorder Scale (GAD-7), respectively. Expected influence (EI) and bridge expected influence (BEI) indices were calculated for each symptom. Results: According to cutoff scores indicating the presence of depression and anxiety, the prevalences of depression and anxiety in our sample were 52.9% and 12.8%, respectively. The comorbidity rate of depression and anxiety was 11.5%. The six edges with the strongest regularized partial correlations were between symptoms from the same disorder. "Feeling blue/depressed", "Nervousness or anxiety", "Uncontrollable worry", "Trouble relaxing", and "Worry too much" had the highest EI values. "Nervousness or anxiety" and "Everything was an effort" exhibited the highest BEI values. Conclusion: Central and bridge symptoms were highlighted in this study. Targeting these symptoms may be effective in preventing the comorbidity of depressive and anxiety symptoms and facilitate interventions in older Chinese adults with DM who are at risk for or currently have depressive and anxiety symptoms.

Rosmarinic acid ameliorates depressive-like behaviors in a rat model of CUS and Up-regulates BDNF levels in the hippocampus and hippocampal-derived astrocytes.

Rosmarinic acid (RA), a primary constituent of a Chinese herbal medicine, has been shown to have some therapeutic effects in an animal model of depression, but its underlying mechanisms are poorly understood. Sprague-Dawley rats were exposed to chronic unpredictable stress (CUS) for 21 days, and received RA for 14 days from the last week of CUS, then the behavioral changes, hippocampal pERK1/2 and BDNF levels were observed. Rats were further treated with U0126 (an ERK1/2 phosphorylation inhibitor) 30 min before RA treatment to assess the effects of RA and ERK1/2 signaling in depressive-like behavior and hippocampal BDNF levels. In addition, brains of newly born Sprague-Dawley rats were used to harvest and expand hippocampal astrocytes. Cells were exposed to different concentrations of RA (sham, 1, 5, 10, 20, and 40 µg/mL) or U0126 (2 µM as a final concentration) + RA (sham, 1, 5, 10, 20, and 40 µg/mL) for 48 h, and the pERK1/2 and BDNF levels were assessed by western and ELISA assays. RA administration (10 mg/kg daily) reversed depressive-like behaviors in rats exposed to a chronic unpredictable stress paradigm and restored pERK1/2 protein expression and hippocampal brain-derived neurotrophic factor (BDNF). Moreover, in vitro experiments revealed that 20 µg/mL RA increased pERK1/2 and BDNF levels in cultured astrocytes. Interestingly, the effects of RA were inhibited by U0126. RA might be a useful treatment for depression and the changes in ERK1/2 signaling and BDNF levels may play a critical role in the pharmacological action of RA.

Questionnaires based on natural language processing elicit immersive ruminative thinking in ruminators: Evidence from behavioral responses and EEG data.

Rumination is closely related to mental disorders and can thus be used as a marker of their presence or a predictor of their development. The presence of masking and fabrication in psychological selection can lead to inaccurate detection of psychological disorders. Human language is considered crucial in eliciting specific conscious activities, and the use of natural language processing (NLP) in the development of questionnaires for psychological tests has the potential to elicit immersive ruminative thinking, leading to changes in neural activity. Electroencephalography (EEG) is commonly used to detect and record neural activity in the human brain and is sensitive to changes in brain activity. In this study, we used NLP to develop a questionnaire to induce ruminative thinking and then recorded the EEG signals in response to the questionnaire. The behavioral results revealed that ruminators exhibited higher arousal rates and longer reaction times, specifically in response to the ruminative items of the questionnaire. The EEG results showed no significant difference between the ruminators and the control group during the resting state; however, a significant alteration in the coherence of the entire brain of the ruminators existed while they were answering the ruminative items. No differences were found in the control participants while answering the two items. These behavioral and EEG results indicate that the questionnaire elicited immersive ruminative thinking, specifically in the ruminators. Therefore, the questionnaire designed using NLP is capable of eliciting ruminative thinking in ruminators, offering a promising approach for the early detection of mental disorders in psychological selection.

A new psychological intervention: "512 Psychological Intervention Model" used for military rescuers in Wenchuan Earthquake in China.

OBJECTIVE: We sought to compare the efficacy of the "512 Psychological Intervention Model" (that is, "512 PIM", a new psychological intervention) with debriefing on symptoms of post-traumatic stress disorder (PTSD), anxiety and depression of Chinese military rescuers in relation to a control group that had no intervention. METHOD: We conducted a randomized controlled trial with 2,368 military rescuers 1 month after this event and then at follow-up 1, 2 and 4 months later to evaluate changes in symptoms of PTSD, anxiety and depression based on DSM-IV criteria, respectively. RESULTS: Baseline analysis suggested no significant differences between the study groups. Severity of PTSD, anxiety and depression decreased over time in all three groups, with significant differences between the groups in symptoms of PTSD (P < 0.01). Compared with the debriefing and control group, significant lower scores of PTSD and positive efficacy in improving symptoms of re-experiencing, avoidance and hyperarousal were found in the "512 PIM" group. CONCLUSION: "512 PIM" was an effective psychological intervention for military rescuers in reducing symptoms of PTSD, anxiety and depression after a crisis.

Trait anxiety among undergraduates according to the Implicit Association Test.

Trait anxiety, which includes stress and anxiety, affects mental health. However, early studies using the Implicit Association Test-Anxiety (IAT-Anxiety) did not consider the participants' trait anxiety. In the present study, the hypothesis that trait anxiety would influence the results of the IAT-Anxiety was tested. A total of 148 healthy undergraduates were assessed with the Profile of Mood State (POMS) test and the State-Trait Anxiety Inventory (STAI) to test explicit anxiety; they were then assessed for implicit anxiety with the IAT-Anxiety. High trait anxiety was positively correlated with negative mood; low trait anxiety tended to be associated with greater vigor and higher self-esteem. Significant main effects were found for both critical block and group among participants who received the IAT-Anxiety. Future studies of the IAT-Anxiety should consider trait anxiety as a within-subject factor for group matching to enhance the persuasiveness of the results.

Current study on the influence of psychological factors on returning to sports after ACLR.

It is considered that psychological factors are important in determining exercise regression outcomes of patients with anterior cruciate ligament reconstruction (ACLR). This review summarizes the definition and research progress of current undefined psychological factors related to returning to sports (RTS) after ACLR, as well as the application of corresponding measuring scales, and common psychological interventions in the field. The aim is to understand and clarify the impact of psychological factors in the ACL injury and rehabilitation, and to provide a theoretical basis for the application of psychological evaluation and intervention in the later stage. It is believed that there are still many prospects for the research in this field.

Trait anxiety affects attentional bias to emotional stimuli across time: A growth curve analysis.

Many studies have illustrated the close relationship between anxiety disorders and attentional functioning, but the relationship between trait anxiety and attentional bias remains controversial. This study examines the effect of trait anxiety on the time course of attention to emotional stimuli using materials from the International Affective Picture System. Participants with high vs. low trait anxiety (HTA vs. LTA) viewed four categories of pictures simultaneously: dysphoric, threatening, positive, and neutral. Their eye-movements for each emotional stimulus were recorded for static and dynamic analysis. Data were analyzed using a mixed linear model and growth curve analysis. Specifically, the HTA group showed a greater tendency to avoid threatening stimuli and more pupil diameter variation in the early period of stimulus presentation (0-7.9 s). The HTA group also showed a stronger attentional bias toward positive and dysphoric stimuli in the middle and late period of stimulus presentation (7.9-30 s). These results suggest that trait anxiety has a significant temporal effect on attention to emotional stimuli, and that this effect mainly manifests after 7 s. In finding stronger attentional avoidance of threatening stimuli and more changes in neural activity, as well as a stronger attentional bias toward positive stimuli, this study provides novel insights on the relationship between trait anxiety and selective attention.

Fish consumption and the risk of gastric cancer: systematic review and meta-analysis.

BACKGROUND: Gastric cancer is the fourth most frequently occurring malignancy after lung, breast, and colorectal cancer, and the second most common cause of death from cancer worldwide. Epidemiologic studies have examined the possible association between fish consumption and gastric cancer, but the results were inconclusive. We conducted a systematic review and meta-analysis to examine the association between fish intake and the risk of gastric cancer. METHODS: PubMed was searched for studies published in English-language journals from 1991 through 2009. We identified 17 epidemiologic studies (15 case-control and 2 cohort studies) that included relative risks (RRs) or odds ratios (ORs) estimates with 95% confidence intervals (CIs) of the relationship between gastric cancer and fish consumption. Data were extracted using standardized data forms. Summary RRs or ORs for the highest versus non/lowest fish consumption levels were calculated using random-effects model. Heterogeneity among studies was examined using Q and I2 statistics. RESULTS: In this study, 5,323 cases of gastric cancer and over 130,000 non-cases were included. The combined results from all studies indicated that the association between high fish consumption and reduced gastric cancer risk was not statistically insignificant (RR = 0.87, 95% CI = 0.71-1.07). CONCLUSIONS: Current evidence indicated that the association between fish consumption and risk of gastric cancer remains unclear.

Guided imagery, anxiety, heart rate, and heart rate variability during centrifuge training.

BACKGROUND: Centrifuge training is an important method of improving the hypergravity tolerance of pilots, cosmonauts, and Chinese astronauts. However, the concomitants of tension or anxiety often impede training. Guided imagery (GI), a mind-body relaxation technique, provides a behavioral and cognitive means whereby individuals are able to exert control over the focus of attention. This study aims to investigate the immediate effects of GI for reducing stress in centrifuge training. METHODS: There were 12 healthy young men who were randomly assigned to a GI group or music group. We measured changes in heart rate during centrifuge training, in heart rate variability before and after centrifuge training, and also evaluated relaxation and anxiety in three phases: before intervention, after intervention, and following centrifuge training. RESULTS: The change in the pattern of anxiety was different in the two groups over the three phases. Anxiety (measured by State Anxiety Inventory) in the GI group changed from 31.7 +/- 5.9 to 26.8 +/- 2.6 and 27.8 +/- 4.1, whereas for the music group this changed from 32.2 +/- 7.6 to 31.2 +/- 8.3 and 26.8 +/- 6.8. During centrifuge training, the maximal HR for the GI group (101.2 +/- 8.8) was lower than that of the music group (123.0 +/- 19.1). In addition GI showed a decrease in low frequency (LF, 0.04-0.15 Hz) components and an increase in high frequency (HF, 0.15-0.4 Hz) components before and after centrifuge training. CONCLUSION: GI was capable of decreasing tension, anxiety, and sympathetic nervous system activity pre- or post-centrifugation.

Radical treatment of severe open fractures of extremities by orthoplastic surgery: a 10-year retrospective study.

OBJECTIVE: This study aimed to retrospectively analyze clinical data of a series of patients with severe open fractures of extremities (Gustilo IIIb or IIIc), who achieved a satisfactory outcome through radical orthoplastic surgery, so as to provide a reference for determining the treatment of severe open fractures of extremities. METHODS: The clinical data of 41 consecutive patients with severe open fracture (Gustilo IIIb or IIIc) of the limb, who underwent successful surgical debridement, fixation, and soft tissue reconstruction in one stage between January 2008 and January 2019, were retrospectively reviewed. Postoperative indicators, including infection rate and union time, were acquired by a regular follow-up and analyzed. RESULTS: The mean (±SD) age of the patients was 38 ± 16 years. A total of 90 open fractures and severe soft tissue damages were analyzed. The soft tissue cover was achieved within 72 h. The overall rate of infection was 14.6% (6/41). Sex and the Mangled Extremity Severity Score were associated with infection. The median union time of 40 patients (one amputation) was 32 weeks. CONCLUSION: The overall rate of infection exhibited a lower tendency in this study compared with previous studies on high-grade open fractures following a two-stage orthopedic approach. The consequence of infection rate and union time was similar to that in previous studies. These results indicated that the single-stage radical orthoplastic treatment was an effective and reliable option for reconstructing severe open fractures.

Event-related potential based evidence of cognitive dysfunction in patients during the first episode of depression using a novelty oddball task.

Studies using event-related potentials (ERP) to investigate cognitive dysfunction associated with depression have generated variable findings. The differences among reported results are typically attributed to the disparity of the samples. To eliminate the effects of factors such as medication and comorbidity with other psychiatric disorders, first-episode unmedicated patients suffering from depression were recruited in this study. Both depressed patients and matched controls performed an auditory novelty oddball task and ERPs were recorded. The depression group exhibited an increased P2 to standard tones. For the target tones, depressed subjects showed reduced N2 at anterior regions and reduced target P3 in the right hemisphere. In response to novel stimuli, there was a reduced amplitude of the novelty P3 component at the fronto-central region in depressed patients. Our findings suggest that patients with depression in the initial stages show an impaired ability in voluntary and involuntary attention and exhibit frontal lobe and right-hemisphere dysfunctions.

Operational method of reliability and content-validity analysis: Taking "trait-symptoms" screening of individuals at high-risk for OCD as an example.

A well-designed self-reported scale is highly applicable to current clinical and research practices. However, the problems with the scale method, such as quantitative analysis of content validity and test-retest reliability analysis of state-like variables are yet to be resolved. The main purpose of this paper is to propose an operational method for solving these problems. Additionally, it aims to enhance understanding of the research paradigm for the scale method (excluding criterion-related validity). This paper used a study that involved screening of high-risk groups for OCD (Obsessive-Compulsive Disorder), conducted 5 rounds of tests, and developed scales, reliability, and validity analysis (using sample sizes of 496, 610, 600, 600 and 990). The operational method we propose is practical, feasible, and can be used to develop and validate a scale.