The NEVERMIND e-health system in the treatment of depressive symptoms among patients with severe somatic conditions: A multicentre, pragmatic randomised controlled trial.

Background: This study assessed the effectiveness of the NEVERMIND e-health system, consisting of a smart shirt and a mobile application with lifestyle behavioural advice, mindfulness-based therapy, and cognitive behavioural therapy, in reducing depressive symptoms among patients diagnosed with severe somatic conditions. Our hypothesis was that the system would significantly decrease the level of depressive symptoms in the intervention group compared to the control group. Methods: This pragmatic, randomised controlled trial included 425 patients diagnosed with myocardial infarction, breast cancer, prostate cancer, kidney failure, or lower limb amputation. Participants were recruited from hospitals in Turin and Pisa (Italy), and Lisbon (Portugal), and were randomly assigned to either the NEVERMIND intervention or to the control group. Clinical interviews and structured questionnaires were administered at baseline, 12 weeks, and 24 weeks. The primary outcome was depressive symptoms at 12 weeks measured by the Beck Depression Inventory II (BDI-II). Intention-to-treat analyses included 425 participants, while the per-protocol analyses included 333 participants. This trial is registered in the German Clinical Trials Register, DRKS00013391. Findings: Patients were recruited between Dec 4, 2017, and Dec 31, 2019, with 213 assigned to the intervention and 212 to the control group. The sample had a mean age of 59·41 years (SD=10·70), with 44·24% women. Those who used the NEVERMIND system had statistically significant lower depressive symptoms at the 12-week follow-up (mean difference=-3·03, p<0·001; 95% CI -4·45 to -1·62) compared with controls, with a clinically relevant effect size (Cohen's d=0·39). Interpretation: The results of this study show that the NEVERMIND system is superior to standard care in reducing and preventing depressive symptoms among patients with the studied somatic conditions. Funding: The NEVERMIND project received funding from the European Union's Horizon 2020 Research and Innovation Programme under grant agreement No. 689691.

Decoding of semantic categories of imagined concepts of animals and tools in fNIRS.

Objective.Semantic decoding refers to the identification of semantic concepts from recordings of an individual's brain activity. It has been previously reported in functional magnetic resonance imaging and electroencephalography. We investigate whether semantic decoding is possible with functional near-infrared spectroscopy (fNIRS). Specifically, we attempt to differentiate between the semantic categories of animals and tools. We also identify suitable mental tasks for potential brain-computer interface (BCI) applications.Approach.We explore the feasibility of a silent naming task, for the first time in fNIRS, and propose three novel intuitive mental tasks based on imagining concepts using three sensory modalities: visual, auditory, and tactile. Participants are asked to visualize an object in their minds, imagine the sounds made by the object, and imagine the feeling of touching the object. A general linear model is used to extract hemodynamic responses that are then classified via logistic regression in a univariate and multivariate manner.Main results.We successfully classify all tasks with mean accuracies of 76.2% for the silent naming task, 80.9% for the visual imagery task, 72.8% for the auditory imagery task, and 70.4% for the tactile imagery task. Furthermore, we show that consistent neural representations of semantic categories exist by applying classifiers across tasks.Significance.These findings show that semantic decoding is possible in fNIRS. The study is the first step toward the use of semantic decoding for intuitive BCI applications for communication.

Potential pitfalls of widely used implementations of common spatial patterns.

We have uncovered serious flaws in handling EEG signals with a decreased rank in implementations of the common spatial patterns (CSP). The CSP algorithm assumes covariance matrices of the signal to have full rank. However, preprocessing techniques, such as artifact removal using independent component analysis, may decrease the rank of the signal, leading to potential errors in the CSP decomposition. We inspect what could go wrong when CSP implementations do not take this into consideration on a binary motor imagery classification task. We review CSP implementations in open-source toolboxes for EEG signal analysis (FieldTrip, BBCI Toolbox, BioSig, EEGLAB, BCILAB, and MNE). We show that unprotected implementations decreased mean classification accuracy by up to 32%, with spatial filters resulting in complex numbers, for which corresponding spatial patterns do not have a clear interpretation. We encourage researchers to check their implementations and analysis pipelines.

Achieving Dental Analgesia with the Erbium Chromium Yttrium Scandium Gallium Garnet Laser (2780 nm): A Protocol for Painless Conservative Treatment.

OBJECTIVE: The aim of this research is to evaluate those techniques and optimal parameters of Erbium Chromium Yttrium Scandium Gallium Garnet (Er,Cr:YSGG) laser use in delivering predictable painless (or with very limited discomfort) restorative cavity preparation without the aid of injected local anesthesia. MATERIAL AND METHODS: This study was conducted on 30 patients (26 adults and 4 youth 9-16 years old; average age, 37) treated in a private practice. For each patient, a single cavity was prepared using the Er,Cr:YSGG laser (2780 nm). An Electric Pulp Tester (EPT) was used to monitor the changes in pulp sensibility threshold. The patient experience was tested before and after the treatment using a modified Visual Analogue Scale (VAS) and Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) to evaluate pain and anxiety. RESULTS: Pain analysis indicated that 80% of patients (24 out of 30) felt no pain and no discomfort, or only a very slight sensation. None of the 30 patients requested anesthesia. EPT was found to be unreliable in evaluating pulpal pain threshold levels. A tendency was noted wherein greater discomfort was felt by anxious patients. On average, the older the patient, the less discomfort was felt. The factors that have a greater tendency to promote discomfort were: posterior teeth, greater caries depth, greater use of higher power levels and ablation time. CONCLUSIONS: Using the Er,Cr:YSGG laser, it was possible to avoid local anesthesia during cavity preparation with a bur. The treatment was effective in a high number of cases (80%), leading to reduction in the anxiety frequently associated with dental care.