Knowledge, attitudes, and practices of adolescent depression among parents of children diagnosed with depression in Ningbo City, eastern China.

Objective: To investigate parental knowledge, attitudes, and practices (KAP) toward adolescent depression. Methods: A cross-sectional survey was conducted between October 2022 and October 2023 at The First Affiliated Hospital of Ningbo University among parents of adolescents diagnosed with depression. A self-administered questionnaire was used to collect the parents' demographic characteristics and KAP toward adolescent depression. Results: A total of 522 questionnaires were collected from parents of depressed adolescents. Among the participants, 383 (73.37%) were female. In addition, 426 participants (81.61%) had children aged 14-18. The mean knowledge, attitude, and practice scores were 9.09 ± 2.37 (possible range: 0-12), 37.04 ± 4.11 (possible range: 11-55), and 31.53 ± 3.84 (possible range: 8-40), respectively. There were significant positive correlations between knowledge and attitude (r = 0.225, p < 0.001), knowledge and practice (r = 0.240, p < 0.001), and attitude and practice (r = 0.381, p < 0.001). The path analysis showed significant direct effects of knowledge on attitude (ß = 0.422, p < 0.001) and practice (ß = 0.283, p < 0.001). There was an indirect effect of knowledge on practice through attitude (ß = 0.131, p = 0.004). Attitude directly impacted practice (ß = 0.311, p < 0.001). Conclusion: Parents of adolescents diagnosed with depression exhibited moderate KAP regarding adolescent depression. The study underscored the importance of targeted interventions to improve parental KAP in supporting adolescents with depression. Moreover, future research should explore additional factors influencing parental attitudes and behaviors toward adolescent depression to develop more effective interventions.

Enhancing Dielectric Properties of (CaCu3Ti4O12 NWs-Graphene)/PVDF Ternary Oriented Composites by Hot Stretching.

Using high-dielectric inorganic ceramics as fillers can effectively increase the dielectric constant of polymer-based composites. However, a high percentage of fillers will inevitably lead to a decrease in the mechanical toughness of the composite materials. By introducing high aspect ratio copper calcium titanate (CaCu3Ti4O12) nanowires (CCTO NWs) and graphene as fillers, the ternary poly(vinylidene fluoride) (PVDF)-based composites (CCTO NWs-graphene)/PVDF with a significant one-dimensional orientation structure were prepared by hot stretching. CCTO NWs and graphene are arranged in a directional manner to form a large number of microcapacitor structures, which significantly improves the dielectric constant of the composites. When the ratio of CCTO NWs and graphene is 0.2 and 0.02, the oriented composites have the highest dielectric constant, which is 19.3% higher than the random composites, respectively. Numerical simulations reveal that the introduction of graphene and the construction of the one-dimensional oriented microstructure have a positive effect on improving the dielectric properties of the composites. This study provides a strategy to improve the dielectric properties of composite materials by structural design without changing the filler content, which has broad application prospects in the field of electronic devices.

Efficacy of Internet-Based Cognitive Behavioral Therapy for Subthreshold Depression Among Older Adults in Institutional Long-Term Care Settings: Pragmatic Randomized Controlled Trial.

BACKGROUND: Subthreshold depression (sD) is prevalent in older populations in long-term care (LTC) settings, but psychological therapy in LTC settings in China is not readily available. Thus, internet-based cognitive behavioral therapy (ICBT) may be suitable for this population, but research on the efficacy of ICBT for older adults with sD, especially those living in LTC settings, is limited. OBJECTIVE: This study aimed to evaluate the efficacy and acceptability of ICBT treatment for sD among LTC residents in China. We also examined whether ICBT is as effective as group-based cognitive behavioral therapy (CBT) for treating sD in this population. METHODS: We conducted a pragmatic randomized controlled trial, which included 18 LTC institutions. A total of 354 participants were randomized to ICBT, group-based CBT, or a waiting list and were followed up for 12 months. The primary outcome was self-reported depressive symptoms on the Center for Epidemiological Studies Depression Scale (CES-D). Secondary outcomes were the scores of the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder 7-Item (GAD-7), and Geriatric Depression Scale (GDS). A mixed-effects model was used to assess the efficacy of ICBT. RESULTS: The ICBT group showed a significant improvement in self-reported depressive symptoms, which was maintained at the 12-month follow-up (all P<.001). The ICBT group exhibited a significantly larger reduction in the scores of the CES-D (Cohen d=0.07, 95% CI 0.04-0.09; P=.01), PHQ-9 (d=0.30, 95% CI 0.28-0.33; P<.001), GDS (d=0.10, 95% CI 0.08-0.13; P<.001), and GAD-7 (d=0.19, 95% CI 0.17-0.22; P<.001) compared with a waiting list at postintervention. ICBT had significantly stronger effects than CBT on the PHQ-9 and GAD-7 at postintervention (d=0.15, 95% CI 0.13-0.17; P<.001 and d=0.21, 95% CI 0.19-0.23; P<.001, respectively), 6-month follow-up (d=0.18, 95% CI 0.16-0.21; P<.001 and d=0.18, 95% CI 0.15-0.21; P<.001, respectively), and 12-month follow-up (d=0.15, 95% CI 0.11-0.19; P<.001 and d=0.18, 95% CI 0.14-0.21; P<.001, respectively). CONCLUSIONS: ICBT is a relatively effective and acceptable intervention for reducing depressive symptoms among Chinese LTC residents with sD. These findings indicate the usefulness of ICBT application for sD in LTC settings. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2000030697; https://www.chictr.org.cn/showproj.aspx?proj=50781.

3D hotspot engineering and analytes strategy enabled ultrasensitive SERS platform for biosensing of depression biomarker.

Nowadays, the diagnose of depression mainly relies on clinical examination while impossible to accurately evaluate the occurrence of depression. Chemical approaches are captivating to analyze stress biomarkers for feedbacking body's endocrine response to stress stimuli. However, it remains challenging in exploring accurate, reliable and sensitive approaches. Herein, we rationally design a newly SERS platform with integrated hotspots engineering and analyte strategy to achieve highly sensitive analysis for estrogen, a typical depression biomarker in adolescent female. On the one hand, the 3D micro/nano plasmonic substrate containing Au-Ag Alloy Nanourchins (AAA-NUs) and arrays-based monolayer films of Au nanoparticles (Au NSs) was constructed to achieve high density and availability of hotspots. On the other hand, the analyte strategy was designed via rapid azotizing reaction to further enhance the scattering cross-section of estrogen in the form of azido compounds. With the synergism of them, the proposed SERS platform displayed high sensitivity for estrogen with a limit of detection down to 10-11 mg/mL. More importantly, the blood estrogen levels of depressed patients were evaluated via the proposed SERS platform and presented high consistence with clinical diagnostic results. This integrated SERS platform paves the way for universal and ultrasensitive biosensing and possess great potential for applying in multi-target detection and disease prediction.

Aberrant resting-state brain activity in Huntington's disease: A voxel-based meta-analysis.

Introduction: Functional neuroimaging could provide abundant information of underling pathophysiological mechanisms of the clinical triad including motor, cognitive and psychiatric impairment in Huntington's Disease (HD). Methods: We performed a voxel-based meta-analysis using anisotropic effect size-signed differential mapping (AES-SDM) method. Results: 6 studies (78 symptomatic HD, 102 premanifest HD and 131 healthy controls) were included in total. Altered resting-state brain activity was primarily detected in the bilateral medial part of superior frontal gyrus, bilateral anterior cingulate/paracingulate gyrus, left insula, left striatum, right cortico-spinal projections area, right inferior temporal gyrus area, right thalamus, right cerebellum and right gyrus rectus area. Premanifest and symptomatic HD patients showed different alterative pattern in the subgroup analyses. Discussion: The robust and consistent abnormalities in the specific brain regions identified in the current study could help to understand the pathophysiology of HD and explore reliable neuroimaging biomarkers for monitoring disease progression, or even predicting the onset of premanifest HD patients.

Benzodiazepine-Receptor Agonist Utilization in Outpatients with Anxiety Disorder: A Retrospective Study Based on Electronic Healthcare Data from a Large General Tertiary Hospital.

Benzodiazepine-receptor agonists (BZRAs), including benzodiazepines (BZDs) and drugs related to BZDs (Z-drugs), are commonly used for anxiety, but often have side effects. We retrospectively investigated the utilization and prescription characteristics of BZRAs for patients with anxiety disorders in a large tertiary care general hospital between 2018 and 2021, based on electronic healthcare records. We also examined the pattern of simultaneous consumption of multiple BZRA drugs, and the diseases coexisting with anxiety that are associated with this. The numbers of patients and BZRA prescriptions increased over the 4 years. Moreover, 7195 prescriptions from 694 patients contained two or more BZRAs, of which 78.08% contained both BZDs and Z-drugs, 19.78% contained multiple BZDs, and 2.14% contained multiple Z-drugs. For anxiety patients with concomitant Alzheimer's disease or Parkinson's disease, and dyslipidemia, they were more likely to consume multiple BZRAs simultaneously, whereas patients with concomitant insomnia, depression, hypertension, diabetes, or tumors were less likely to consume multiple BZRAs (all p < 0.05). Furthermore, older patients who consume multiple BZRAs simultaneously may have higher probabilities of long-term drug use. Better interventions supporting standardized BZD utilization may be needed to minimize the side effects of inappropriate BZRA administration.

Efficacy of an internet-based cognitive behavioral therapy for subthreshold depression among Chinese adults: a randomized controlled trial.

BACKGROUND: Subthreshold depression (sD) negatively impacts well-being and psychosocial function and is more prevalent compared with major depressive disorder (MDD). However, as adults with sD are less likely to seek face-to-face intervention, internet-based cognitive-behavioral therapy (ICBT) may overcome barriers of accessibility to psychotherapy. Although several trials explored the efficacy of ICBT for sD, the results remain inconsistent. This study evaluated whether ICBT is effective in reducing depressive symptoms among Chinese adults with sD. METHODS: A randomized controlled trial was performed. The participants were randomly assigned to 5 weeks of ICBT, group-based face-to-face cognitive-behavioral therapy (CBT), or a waiting list (WL). Assessments were conducted at baseline, post-intervention and at a 6-month follow-up. The primary outcome measured depressive symptoms using the Center for Epidemiological Studies Depression Scale (CES-D). Outcomes were analyzed using a mixed-effects model to assess the effects of ICBT. RESULTS: ICBT participants reported greater reductions on all the outcomes compared to the WL group at post-intervention. The ICBT group showed larger improvement on the Patient Health Questionnaire-9 (PHQ-9) at post-intervention (d = 0.12) and at follow-up (d = 0.10), and with CES-D at post-intervention (d = 0.06), compared to the CBT group. CONCLUSIONS: ICBT is effective in reducing depressive symptoms among Chinese adults with sD, and improvements in outcomes were sustained at a 6-month follow-up. Considering the low rates of face-to-face psychotherapy, our findings highlight the considerable potential and implications for the Chinese government to promote the use of ICBT for sD in China.

Left intermittent theta burst stimulation combined with right low-frequency rTMS as an additional treatment for major depression: A retrospective study.

Background: Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for major depression (MD). We retrospectively analyzed the efficacy of intermittent theta burst stimulation (iTBS) on the left dorsolateral prefrontal cortex (DLPFC) combined with low-frequency rTMS (LF-rTMS) on the right DLPFC as an additional therapy to standard medication treatment. Materials and Methods: The study included 54 patients with MD who completed 10 courses (5 days per week) of rTMS as an add-on therapy. Thirty patients were treated in the combination group (120% resting motor threshold; left DLPFC, iTBS, 600 stimuli + right DLPFC, 1-Hz rTMS, 600 stimuli), while 24 patients were in the high-frequency rTMS (HF-rTMS) group (120% resting motor threshold; left DLPFC, 10-Hz rTMS, 3000 stimuli). The outcome was assessed based on the changes in scores of 24-item Hamilton Depression Scale (HAMD-24) and 14-item Hamilton Anxiety Scale (HAMA-14). Results: Both depression and anxiety were significantly improved after 2 weeks of treatment by rTMS combined with medication. The combination of iTBS and LF-rTMS was significantly superior to HF-rTMS in improving the scores of HAMD-24 (P = 0.041) and HAMA-14 (P = 0.0095), and the response rate (P = 0.027). Conclusion: The pilot study showed that the combination of iTBS and LF-rTMS may hold promise as a potentially effective alternative therapy for MD due to its efficacy and time-saving benefit. The preliminary results shed light on the study of the efficacy and acceptability of the combination of iTBS and LF-rTMS for MD.

Internet-based cognitive behavioral therapy for psychological distress in older adults without cognitive impairment living in nursing homes during the COVID-19 pandemic: A feasibility study.

BACKGROUND: The COVID-19 pandemic has had a detrimental effect on the mental health of older adults living in nursing homes. Very few studies have examined the effects of Internet-based Cognitive Behavioral Therapy (ICBT) on older adults living in nursing homes during the pandemic. We conducted a feasibility study using a single-group design, to explore the effectiveness of ICBT on psychological distress in 137 older adults (without cognitive impairment) from 8 nursing homes in 4 southeast cities in China, between January and March 2020. METHODS: Symptoms of depression, anxiety, general psychological distress, and functional disability were measured at baseline, post-treatment (5 weeks) and at a 1-month follow-up. Mixed-effects model was used to assess the effects of ICBT. RESULTS: Statistically significant changes with large effect sizes were observed from pre- to post-treatment on the PHQ-9 (p < .001, Cohen's d = 1.74), GAD-7 (p < .001, d = 1.71), GDS (p < .001, d = 1.30), K-10 (p < .001, d = 1.93), and SDS (p < .001, d = 2.03). Furthermore, improvements in treatment outcomes were sustained at 1-month follow-up, and high levels of adherence and satisfaction were indicated. CONCLUSION: ICBT was effective in reducing psychological distress in older adults without cognitive impairments living in nursing homes during the COVID-19 pandemic. Thus, it could be applied in improving the mental health of this vulnerable group during the pandemic.

Efficient AoA-Based Wireless Indoor Localization for Hospital Outpatients Using Mobile Devices.

The motivation of this work is to help outpatients find their corresponding departments or clinics, thus, it needs to provide indoor positioning services with a room-level accuracy. Unlike wireless outdoor localization that is dominated by the global positioning system (GPS), wireless indoor localization is still an open issue. Many different schemes are being developed to meet the increasing demand for indoor localization services. In this paper, we investigated the AoA-based wireless indoor localization for outpatients' wayfinding in a hospital, where Wi-Fi access points (APs) are deployed, in line, on the ceiling. The target position can be determined by a mobile device, like a smartphone, through an efficient geometric calculation with two known APs coordinates and the angles of the incident radios. All possible positions in which the target may appear have been comprehensively investigated, and the corresponding solutions were proven to be the same. Experimental results show that localization error was less than 2.5 m, about 80% of the time, which can satisfy the outpatients' requirements for wayfinding.

Mutation screening of the TIA1 gene in Chinese patients with amyotrophic lateral sclerosis/frontotemporal dementia.

Mutations in the low-complexity domain (LCD) of T-cell intracellular antigen-1 (TIA1) have been reported to be associated with amyotrophic lateral sclerosis/frontotemporal dementia (ALS/FTD) in the Caucasian population. In the present study, we aimed to screen mutations in the LCD (exon 11-13) of TIA1 and determine the mutation frequency in Chinese ALS/FTD patients. A total of 740 ALS patients, including 721 sporadic ALS (sALS), 19 familial ALS, 24 FTD patients, and 501 healthy controls, were directly sequenced. A novel variant p.S349P was found in a male sALS patient who presented with mild cognitive decline and a survival time of 1.23 years since onset. No mutation in the LCD of TIA1 was found in the familial ALS and FTD patients. The mutation frequency of TIA1 was 0.14% (1/721) in Chinese sALS patients, which suggests that TIA1 mutation is an uncommon genetic cause for ALS in the Chinese population.

[Study on the effect of Klotho gene interferred by plasmid-mediated short hairpin RNA (shRNA) on sinoatrial node pacing channel gene].

The study was aimed to assess the effect of Klotho gene and sinoatrial node pacing channel gene (HCN4 and HCN2) for studying sick sinus syndrome, with Klotho gene under the interference of Plasmid-mediated short hairpin RNA. Twenty-five C57BL/6J mice were divided into four groups, i. e, plasmid shRNA 24h group, plasmid shRNA 12h group, sodium chloride 24h group and sodium chloride 12h group. Plasmid shRNA 50microL (1microg/microL) and sodium chloride 50microl were respectively injected according to mice vena caudalis into those in plasmid shRNA group and sodium chloride group. After 12h or 24h respectively, all mice were executed and their sinoatrial node tissues were cut. The mRNA of Klotho, HCN4 and HCN2 gene were detected by RT-PCR. The results of RT-PCR showed that Klotho, HCN4 and HCN2 mRNA levels were lower compared with those in sodium chloride 12h group after 12h interference interval. The results indicated that there might be the a certain relationship between Klotho gene and sinoatrial node pacing channel gene.

The prevalence and clinical characteristics of Charles Bonnet syndrome in Chinese patients.

OBJECTIVE: The aim of this study was to investigate the prevalence and characteristics of Charles Bonnet syndrome (CBS) in a group of Chinese older patients and to study whether CBS is associated with rapid eye movement behavior disorder (RBD). METHODS: Four hundred and thirty-two consecutive patients aged 60 years and above were asked a standardized question to determine if they had symptoms of CBS. If they responded positively, a detailed questionnaire was orally administered to inquire into the details of the symptoms. RESULTS: There were 238 men (55.1%) and 194 women (44.9%). Six (1.4%) patients of 432 had hallucinations attributable to CBS. The clinical characteristics of CBS hallucinations are quite variable between patients. No patient was pathologically confirmed to have RBD. CONCLUSION: This is the first report on the epidemiology of CBS in mainland China. CBS is not uncommon in elderly, visually handicapped Chinese patients. The natures of the hallucinations experienced were similar to those previously reported. None of the CBS patients had evidence of RBD. Further studies are needed to investigate the prevalence of CBS in the general population.

Mapping of bioluminescent images onto CT volume surface for dual-modality BLT and CT imaging.

We present a method for mapping the two-dimensional (2D) bioluminescent images (BLIs) onto a three-dimensional (3D) body surface derived from the computed tomography (CT) volume data. This mapping includes two closely-related steps, the spatial registration of the 2D BLIs into the coordinate system of the CT volume data and the light flux recovering on the body surface from BLIs. By labeling markers on the body surface, we proposed an effective registration method to achieve the spatial position alignment. The subsequent light flux recovering is presented based on the inverse process of the free-space light transport model and taking the influence of the camera lens diaphragm into account. Incorporating the mapping procedure into the bioluminescence tomography (BLT) reconstruction, we developed a dual-modality BLT and CT imaging framework to provide both optical and anatomical information. The accuracy of the registration and the light flux recovering methods were evaluated via physical phantom experiments. The registration method was found to have a mean error of 0.41 mm and 0.35 mm in horizontal and vertical direction, and the accuracy of the light flux recovering method was below 5%. Furthermore, we evaluated the performance of the dual-modality BLT/CT imaging framework using a mouse phantom. Preliminary results revealed the potential and feasibility of the dual-modality imaging framework.

Endothelialization and in-stent restenosis on the surface of glycoprotein IIIa monoclonal antibody eluting stent.

Since the percutaneous transtuminal coronary angioplasty was introduced into China in 1984, this procedure has become widely accepted as an important step in coronary revascularization. This study shows the effect of the monoclonal antibody (mAb) on the platelet glycoprotein IIIa receptor during endothelialization and in-stent restenosis by implanting the mAb-eluting stents into iliac arteries of rabbits. The hard tissue cross sections of the stent-implanted arterial segments were made by polymethylmethacrylate embedding. Arterial intima proliferation was observed and analyzed. The endothelialization of the stent surface was observed using scanning electron microscope, whereas the ultrastructure of the neointima was observed using transmission electron microscope. After one month of stent implantation, the surfaces of both groups were covered by intact endothelial layers, but the neointimal areas and the ratio of stenosis were significantly lesser in the mAb-eluting stent group (p < 0.01). After 3 months, the ratio of stenosis in the mAb-eluting stent group was 14.67 ± 0.79, whereas that of the bare stent group was 21.58 ± 1.76 (p < 0.01). Therefore, the mAb eluting from the stent surface has the potential to accelerate endothelialization, prevent thrombosis formation due to the interaction of stent with blood, and decrease the stenosis ratio by inhibiting neointima proliferation.

Sparse regularization-based reconstruction for bioluminescence tomography using a multilevel adaptive finite element method.

Bioluminescence tomography (BLT) is a promising tool for studying physiological and pathological processes at cellular and molecular levels. In most clinical or preclinical practices, fine discretization is needed for recovering sources with acceptable resolution when solving BLT with finite element method (FEM). Nevertheless, uniformly fine meshes would cause large dataset and overfine meshes might aggravate the ill-posedness of BLT. Additionally, accurately quantitative information of density and power has not been simultaneously obtained so far. In this paper, we present a novel multilevel sparse reconstruction method based on adaptive FEM framework. In this method, permissible source region gradually reduces with adaptive local mesh refinement. By using sparse reconstruction with l(1) regularization on multilevel adaptive meshes, simultaneous recovery of density and power as well as accurate source location can be achieved. Experimental results for heterogeneous phantom and mouse atlas model demonstrate its effectiveness and potentiality in the application of quantitative BLT.

Sparse reconstruction for quantitative bioluminescence tomography based on the incomplete variables truncated conjugate gradient method.

In this paper, we present an incomplete variables truncated conjugate gradient (IVTCG) method for bioluminescence tomography (BLT). Considering the sparse characteristic of the light source and insufficient surface measurement in the BLT scenarios, we combine a sparseness-inducing (ℓ1 norm) regularization term with a quadratic error term in the IVTCG-based framework for solving the inverse problem. By limiting the number of variables updated at each iterative and combining a variable splitting strategy to find the search direction more efficiently, it obtains fast and stable source reconstruction, even without a priori information of the permissible source region and multispectral measurements. Numerical experiments on a mouse atlas validate the effectiveness of the method. In vivo mouse experimental results further indicate its potential for a practical BLT system.

Truncated total least squares method with a practical truncation parameter choice scheme for bioluminescence tomography inverse problem.

In bioluminescence tomography (BLT), reconstruction of internal bioluminescent source distribution from the surface optical signals is an ill-posed inverse problem. In real BLT experiment, apart from the measurement noise, the system errors caused by geometry mismatch, numerical discretization, and optical modeling approximations are also inevitable, which may lead to large errors in the reconstruction results. Most regularization techniques such as Tikhonov method only consider measurement noise, whereas the influences of system errors have not been investigated. In this paper, the truncated total least squares method (TTLS) is introduced into BLT reconstruction, in which both system errors and measurement noise are taken into account. Based on the modified generalized cross validation (MGCV) criterion and residual error minimization, a practical parameter-choice scheme referred to as improved GCV (IGCV) is proposed for TTLS. Numerical simulations with different noise levels and physical experiments demonstrate the effectiveness and potential of TTLS combined with IGCV for solving the BLT inverse problem.

A source reconstruction algorithm based on adaptive hp-FEM for bioluminescence tomography.

As a novel modality of molecular imaging, bioluminescence tomography (BLT) is used to in vivo observe and measure the biological process at cellular and molecular level in small animals. The core issue of BLT is to determine the distribution of internal bioluminescent sources from optical measurements on external surface. In this paper, a new algorithm is presented for BLT source reconstruction based on adaptive hp-finite element method. Using adaptive mesh refinement strategy and intelligent permissible source region, we can obtain more accurate information about the location and density of sources, with the robustness, stability and efficiency improved. Numerical simulations and physical experiment were both conducted to verify the performance of the proposed algorithm, where the optical data on phantom surface were obtained via Monte Carlo simulation and CCD camera detection, respectively. The results represent the merits and potential of our algorithm for BLT source reconstruction.