An Unguided, Computerized Cognitive Behavioral Therapy Intervention (TreadWill) in a Lower Middle-Income Country: Pragmatic Randomized Controlled Trial.

BACKGROUND: Globally, most individuals who are susceptible to depression do not receive adequate or timely treatment. Unguided computerized cognitive behavioral therapy (cCBT) has the potential to bridge this treatment gap. However, the real-world effectiveness of unguided cCBT interventions, particularly in low- and middle-income countries (LMICs), remains inconclusive. OBJECTIVE: In this study, we aimed to report the design and development of a new unguided cCBT-based multicomponent intervention, TreadWill, and its pragmatic evaluation. TreadWill was designed to be fully automated, engaging, easy to use, and accessible to LMICs. METHODS: To evaluate the effectiveness of TreadWill and the engagement level, we performed a double-blind, fully remote, and randomized controlled trial with 598 participants in India and analyzed the data using a completer's analysis. RESULTS: The users who completed at least half of the modules in TreadWill showed significant reduction in depression-related (P=.04) and anxiety-related (P=.02) symptoms compared with the waitlist control. Compared with a plain-text version with the same therapeutic content, the full-featured version of TreadWill showed significantly higher engagement (P=.01). CONCLUSIONS: Our study provides a new resource and evidence for the use of unguided cCBT as a scalable intervention in LMICs. TRIAL REGISTRATION: ClinicalTrials.gov NCT03445598; https://clinicaltrials.gov/ct2/show/NCT03445598.

Water mediated dielectric polarizability and electron charge transport properties of high resistance natural fibers.

Recent studies showed that silk and human hair fibers develop thermoelectric properties at optimal water, temperature and light conditions. The nature of charge carriers and the role of water in mediating charge conduction in these fibers is an unexplored issue. By studying four different classes of natural fibers, viz., silk cocoon, human hair, jute and corn silk, we uncover their common electrical transport properties and its dependence on water concentration and temperature. All these fibers uniformly exhibit nonlinear, hysteretic current - voltage characteristics, which scale with water concentration. The optimal electrical conductivity shows thermally activated hopping transport mechanism. Scanning tunneling microscope (STM) and dielectric measurements of silk cocoon fibers showed the electronic density of states and dielectric properties of the hydrated medium enhances with water concentration. Electron paramagnetic resonance (EPR) study reveals that the charge carriers in these membranes are electronic in nature. Our results are explained through the mechanism of hopping of a Polaron, which is an electron surrounded by positive charge fluctuations created by water molecules. The mechanism unravels the peculiar role water plays in mediating electrical activity in these membranes and also opens the possibility for exploring such charge transport mechanism in other biological membranes.

Active Physical Practice Followed by Mental Practice Using BCI-Driven Hand Exoskeleton: A Pilot Trial for Clinical Effectiveness and Usability.

Appropriately combining mental practice (MP) and physical practice (PP) in a poststroke rehabilitation is critical for ensuring a substantially positive rehabilitation outcome. Here, we present a rehabilitation protocol incorporating a separate active PP stage followed by MP stage, using a hand exoskeleton and brain-computer interface (BCI). The PP stage was mediated by a force sensor feedback-based assist-as-needed control strategy, whereas the MP stage provided BCI-based multimodal neurofeedback combining anthropomorphic visual feedback and proprioceptive feedback of the impaired hand extension attempt. A six week long clinical trial was conducted on four hemiparetic stroke patients (screened out of 16) with a left-hand disability. The primary outcome, motor functional recovery, was measured in terms of changes in grip-strength (GS) and action research arm test (ARAT) scores; whereas the secondary outcome, usability of the system was measured in terms of changes in mood, fatigue, and motivation on a visual-analog-scale. A positive rehabilitative outcome was found as the group mean changes from the baseline in the GS and ARAT were +6.38 kg and +5.66 accordingly. The VAS scale measurements also showed betterment in mood ( 1.38), increased motivation (+2.10) and reduced fatigue (0.98) as compared to the baseline. Thus, the proposed neurorehabilitation protocol is found to be promising both in terms of clinical effectiveness and usability.

Soft magnetic memory of silk cocoon membrane.

Silk cocoon membrane (SCM), a solid matrix of protein fiber, responds to light, heat and moisture and converts these energies to electrical signals. Essentially it exhibits photo-electric and thermo-electric properties; making it a natural electro-magnetic sensor, which may influence the pupal development. This raises the question: 'is it only electricity?', or 'it also posses some kind of magnetic memory?' This work attempted to explore the magnetic memory of SCM and confirm its soft magnetism. Fe, Co, Ni, Mn, Gd were found in SCM, in traces, through energy dispersive X-ray analysis (EDX), X-ray photoelectron spectroscopy (XPS) and inductively coupled plasma mass spectrometry (ICP-MS). Presence of iron was ascertained by electron paramagnetic resonance (EPR). In addition, EPR-spectra showed the presence of a stable pool of carbon-centric free radical in the cocoon structure. Carbon-centric free radicals behaves as a soft magnet inherently. Magnetic-Hysteresis (M-H) of SCM confirmed its soft magnetism. It can be concluded that the soft bio-magnetic feature of SCM is due to the entrapment of ferromagnetic elements in a stable pool of carbon centric radicals occurring on the super-coiled protein structure. Natural soft magnets like SCM provide us with models for developing eco-friendly, protein-based biological soft magnets.

The role of photo-electric properties of silk cocoon membrane in pupal metamorphosis: A natural solar cell.

Silkworm metamorphosis is governed by the intrinsic and extrinsic factors. One key intrinsic factor is the temporal electrical firing of the neuro-secretory cells of the dormant pupae residing inside the silk cocoon membrane (SCM). Extrinsic factors are environmental like temperature, humidity and light. The firing pattern of the cells is a function of the environmental factors that eventually controls the pupal development. How does the nervous organization of the dormant pupae sense the environment even while enclosed inside the cocoon shell? We propose that the SCM does this by capturing the incident light and converting it to electricity in addition to translating the variation in temperature and humidity as an electrical signal. The light to electricity conversion is more pronounced with ultraviolet (UV) frequency. We discovered that a UV sensitive fluorescent quercetin derivative that is present on the SCM and pupal body surface is responsible for generating the observed photo current. Based on these results, we propose an equivalent circuit model of the SCM where an overall electrical output transfers the weather information to pupae, directing its growth. We further discuss the implication of this electrical energy conversion and its utility for consumable electricity.