Factors Related to Caregivers' Intention to Vaccinate Their Elderly Family Members with Major Neurocognitive Disorders against COVID-19.

Vaccination helps reduce the risk of coronavirus disease 2019 (COVID-19) infection in elderly individuals with major neurocognitive disorders (MNDs). However, some caregivers are hesitant to have their elderly family members with MNDs vaccinated against COVID-19. This study explored the factors influencing caregivers' intentions to vaccinate elderly family members with MNDs against COVID-19. A total of 232 caregivers of elderly family members with MNDs participated in this study. In this survey, data regarding COVID-19 vaccination acceptance, fear, side effects, family members' attitudes toward vaccination, mental health status, neuropsychiatric symptoms, and cognitive impairments were collected from the elderly participants with MNDs. The associations between these variables and the caregivers' intention to vaccinate their elderly family members with MNDs against COVID-19 were examined using a multivariable linear regression analysis model. The results revealed that caregivers' perceived familial support for vaccination, the perceived value of vaccination, and autonomy to vaccinate elder family members were positively correlated with caregivers' intention to vaccinate elderly family members with MNDs, whereas elderly family members' age was negatively correlated with caregiver intentions. This study demonstrated that caregiver factors (perceived familial support, value of vaccination, and autonomy) and elderly family members' age were correlated with caregiver intention. These factors should be considered in developing interventions to enhance caregivers' intentions to vaccinate their elderly family members with MNDs against COVID-19.

Factors Related to Mpox-Vaccine Uptake among Men Who Have Sex with Men in Taiwan: Roles of Information Sources and Emotional Problems.

An mpox outbreak occurred suddenly and rapidly spread worldwide in 2022. Research has demonstrated a link between the sexual behavior of men who have sex with men (MSM) and the contraction of mpox. This study assessed the factors related to mpox-vaccine uptake among MSM in Taiwan, focusing on the roles of information sources and emotional problems. In total, 389 MSM participated in an online survey. Data on the participants' vaccination statuses; anxiety symptoms, which were assessed using the State-Trait Anxiety Inventory; depressive symptoms, which were assessed using the Center for Epidemiologic Studies Depression Scale; and risk perceptions of contracting mpox were collected. Factors related to mpox-vaccine uptake were examined using a multivariable logistic regression model. The results revealed that MSM who were older (p < 0.001), perceived a higher risk of contracting mpox (p = 0.040), and received mpox information from health-care providers (p < 0.001) were more likely to receive mpox vaccination, whereas MSM who reported a greater severity of depression (p = 0.017) were less likely to receive mpox vaccination. However, age did not moderate the associations of perceiving a higher risk of contracting mpox, receiving mpox information from health-care providers, and depression with having an mpox vaccination. Health-care providers should consider these factors when developing intervention programs for enhancing mpox-vaccine uptake among MSM.

Predicting risk of dementia among the elderly with major depressive disorder in remission: A prospective study.

OBJECTIVES: Cognitive impairment and change are a focus of research into late-life depression. The aims of this 5-year prospective study were (1) to observe cognitive status change; (2) to investigate the rate and risk ratio of dementia or cognitive decline; and (3) to examine the cognitive domain predictors for conversion to dementia within 5 years among a clinical cohort with remitted major depressive disorder (MDD). METHODS: The study cohort included 130 elderly persons with late-life remitted MDD and 100 normal controls. Comprehensive neuropsychological tests were conducted to determine cognitive domain status. Diagnoses of mild cognitive impairment (MCI) and dementia were made at baseline and at a follow-up visit at the 5-year point. In total, 98 cases and 55 normal controls completed the 5-year follow-up assessment. RESULTS: Of the study cohort with late-life remitted MDD, 28.6% had MCI and 25.5% developed dementia within 5 years. Patients with late-life remitted MDD had an approximate 3 times higher risk of subsequent cognitive decline as compared with the normal controls. Information-processing speed (p = 0.009) and memory (p = 0.041) could predict subsequent progression to dementia within 5 years among patients with MDD. CONCLUSIONS: This study demonstrated that compared with the general elderly population, elderly patients with depression have more significant impairment in cognitive function after 5 years. Further, we found that in depressed patients, deficits in information-processing speed and memory domains were highly suggestive of progression to dementia within 5 years.

Molecular Engineering and Confinement Effect Powered Ultrabright Nanoparticles for Improving Sensitivity of Lateral Flow Immunoassay.

The application of traditional lateral flow immunoassay (LFIA)-based gold nanoparticles (AuNPs) to measure traces of target chemicals is usually challenging. In this study, we developed an integrated strategy based on molecular engineering and the spatial confinement of nanoparticles (NPs) to obtain ultrahigh quantum yields (QYs) of aggregation-induced emission (AIE) fluorescence NPs and employed them for the highly sensitive detection of T-2 toxin on the LFIA platform. Tetraethyl-4,4',4″,4‴-(ethene-1,1,2,2-tetrayl)tetrabenzoate (TCPEME), an AIE luminogen, was designed using molecular engineering to lower the energy gap, achieving higher QYs (26.26%) than previous AIEgens (13.02%). Subsequently, TCPEME-doped fluorescence NPs (TFNPs) achieved ultrahigh QYs, up to 84.55%, which were generated from the strong restriction of the NP state, efficiently suppressing nonradiative relaxation channels verified by ultrafast electron dynamics. On the LFIA platform, the sensitivity of the designed TFNP-based LFIA (TFNP-LFIA) was 10.4-fold and 4.3-fold more sensitive than that of the AuNP-LFIA and TPENP-LFIA for detecting the T-2 toxin, respectively. In addition, TFNP-LFIA was used for detecting T-2 toxin in samples and showed satisfactory recoveries (79.5 to 122.0%) with CV (1.49 to 11.75%), which implied excellent application potential for TFNP-LFIA. Overall, dual improvement of the molecule in fluorescence performance originating from the molecular engineering and spatial confinement of NPs could be an efficient tool for promoting the development of high-performance reporters in LFIA.

Predictors of problematic smartphone use among young adult lesbian, gay and bisexual individuals during the COVID-19 pandemic: a four-year follow-up study.

BACKGROUND: This 4-year follow-up study was conducted to evaluate the predictive effects of prepandemic individual and environmental factors on problematic smartphone use (PSU) among young adult lesbian, gay, and bisexual (LGB) individuals during the COVID-19 pandemic. METHODS: Data on prepandemic PSU, demographics, sexual stigma (e.g., perceived sexual stigma from family members, internalized sexual stigma, and sexual microaggression), self-identity confusion (e.g., disturbed identity, unconsolidated identity, and lack of identity), anxiety, depression, and family support were collected from 1,000 LGB individuals between August 2018 and June 2019. The participants' PSU was surveyed again after 4 years (between August 2022 and June 2023). The associations of prepandemic individual and environmental factors with PSU at follow-up were analyzed through linear regression. RESULTS: In total, 673 (67.3%) participants completed the follow-up assessment. The severity of PSU significantly decreased after 4 years (p = .001). Before the incorporation of PSU at baseline into the analysis model, the results of the model revealed that high levels depressive symptoms (p < .001), disturbed identity (p < .001), and perceived sexual stigma from family members (p = .025) at baseline were significantly associated with PSU at follow-up. After the incorporation of PSU at baseline into the analysis model, the results of the model revealed that high levels PSU (p < .001) and depressive symptoms (p = .002) at baseline were significantly associated with PSU at follow-up. CONCLUSION: Interventions aimed at reducing the severity of PSU among LGB individuals should be designed considering the predictors identified in our study.

Left Ventricular Pressure Strain Loops for Evaluation of Myocardial Work in Type 2 Diabetic Patients with Hypertension.

BACKGROUND: Type 2 diabetes mellitus (T2DM) and hypertension (HT) are the two most common underlying diseases worldwide, and they often coexist. The long-term existence of both may lead to left ventricular dysfunction. Therefore, evaluating the cardiac function of T2DM patients with HT is vital to guide treatment and improve prognosis. Left ventricular pressure strain loops (LVPSL) combine left ventricular strain and afterload, which can quantify left ventricular energy expenditure and detect left ventricular subclinical systolic dysfunction. Many studies have focused on myocardial work (MW) in uncomplicated T2DM patients or simple HT patients, but a few have focused on T2DM patients with HT. OBJECTIVE: The study aimed to evaluate the MW changes in T2DM patients with HT using LVPSL and to find independent related factors of MW parameters. METHODS: 40 T2DM patients, 35 HT patients, 40 T2DM patients with HT (T2DM+HT group), and 35 controls were enrolled. The differences between clinical data, conventional ultrasound parameters, and MW parameters were analyzed among the four groups. RESULTS: The global longitudinal strain (GLS) of the T2DM group, HT group, and T2DM+HT group was lower than the control group (P<0.05). The global work index (GWI) and global constructive work (GCW) in the T2DM group were lower than other groups (P<0.05). The GWI of the HT group was higher than other groups (P<0.05), while GCW was only higher than the T2DM group and T2DM+HT group (P<0.05). The GWI and GCW of the T2DM+HT group were higher than the T2DM group and were lower than the HT group(P<0.05), while there was no significant difference with the control group. HT group and T2DM+HT group had higher global work waste (GWW) (P<0.05). The global work efficiency (GWE) of the T2DM+HT group was lower than other groups (P<0.05). Systolic blood pressure (SBP) and glycosylated hemoglobin (HbA1c) were independent factors of each MW parameter. CONCLUSION: LVPSL can recognize left ventricular subclinical systolic dysfunction early in patients with T2DM and HT. Compared to simple T2DM or HT, the combination of T2DM and HT had greater damage to left ventricular systolic function. SBP and HbA1c are two factors that have a considerable impact on MW parameters. The impact of afterload on MW parameters should be paid more attention to.

A 4-year prospective investigation of predictive effects of prepandemic sexual stigma, affective symptoms, and family support on fear of COVID-19 among lesbian, gay, and bisexual individuals.

Aim: This prospective study examined whether prepandemic sexual stigma, affective symptoms, and family support can predict fear of coronavirus disease 2019 (COVID-19) among lesbian, gay, and bisexual (LGB) individuals. Methods: Data of 1,000 LGB individual on prepandemic sociodemographic characteristics, sexual stigma (familial sexual stigma [FSS] measured by the Homosexuality-Related Stigma Scale, internalized sexual stigma [ISS] measured by the Measure of Internalized Sexual Stigma for Lesbians and Gay Men, and sexual orientation microaggression [SOM] measured by the Sexual Orientation Microaggression Inventory), affective symptoms (i.e., depression measured by the Center for Epidemiologic Studies-Depression Scale and anxiety measured by the State-Trait Anxiety Inventory-State version), and family support measured by the Adaptability, Partnership, Growth, Affection, and Resolve Index were collected. Four years later, the fear of COVID-19 was assessed using the Fear of COVID-19 Scale and the associations of prepandemic sexual stigma, affective symptoms, and perceived family support on fear of COVID-19 4 years later were analyzed using multiple linear regression analysis. Results: In total, 670 (67.3%) participants agreed and completed the follow-up assessment. Greater prepandemic FSS, ISS, SOM, affective symptoms, and perceived family support were significantly associated with a greater fear of COVID-19 at follow-up. Conclusion: The identified predictors should be considered when designing interventions aimed at preventing and reducing the fear of COVID-19 in LGB individuals.

Association between Self-Stigma and Suicide Risk in Individuals with Schizophrenia: Moderating Effects of Self-Esteem and Perceived Support from Friends.

This cross-sectional study assessed the moderating effects of self-esteem and perceived support from friends on the association between self-stigma and suicide risk in individuals with schizophrenia. We included 300 participants (267 with schizophrenia and 33 with schizoaffective disorder). Suicide risk was assessed using items adopted from the suicide module of the Mini-International Neuropsychiatric Interview; self-stigma was assessed using the Self-Stigma Scale-Short; perceived support from friends was assessed using the Friend Adaptation, Partnership, Growth, Affection, and Resolve Index; and self-esteem was assessed using the Rosenberg Self-Esteem Scale. A moderation analysis was performed to examine the moderating effects of self-esteem and perceived support from friends on the association between self-stigma and suicide risk. The results indicated that self-stigma was positively associated with suicide risk after the effects of other factors were controlled for. Both perceived support from friends and self-esteem significantly reduced the magnitude of suicide risk in participants with self-stigma. Our findings highlight the value of interventions geared toward ameliorating self-stigma and enhancing self-esteem in order to reduce suicide risk in individuals with schizophrenia.

A Newly Developed Scale for Assessing Experienced and Anticipated Sexual Stigma in Health-Care Services for Gay and Bisexual Men.

Gay and bisexual men's experiences and worries of sexual stigma by health-care providers may delay them from seeking health-care assistance. Our study developed the Experienced and Anticipated Sexual Stigma Scale in Health-care Services (EASSSiHS) and examined its psychometric properties. The six-item EASSSiHS was first developed on the basis of the results of focus group interviews with 24 participants. Parallel analysis was used to determine the number of factors. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to examine the factor structure. The internal consistency was examined using McDonald's omega coefficient. Concurrent validity was examined using Pearson correlations with perceived sexual stigma from family and friends, depression, anxiety, and loneliness. The results of parallel analysis and EFA indicated that the factor structure of the EASSSiHS included two factors: experienced stigma and anticipated stigma. The result of CFA further confirmed the two-factor structure. The EASSSiHS had good internal consistency and acceptable concurrent validity. The anticipated stigma factor had stronger associations with perceived sexual stigma from family members and friends, depression, anxiety, and loneliness, when compared with the experienced stigma factor. The results of this study supported the psychometric properties of the EASSSiHS for assessing experienced and anticipated sexual stigma in health-care services among gay and bisexual men. The experience and worry of sexual stigma in health-care services were not rare among gay and bisexual men; therefore, interventions to enhance the cultural competency of health-care workers are urgently required.

Validation and Comparison of the Informant-Rated and Self-Rated Versions of the Mild Behavioral Impairment Checklist.

BACKGROUND: The Mild Behavioral Impairment Checklist (MBI-C) has been developed to assess mild behavioral impairment (MBI). However, no study has validated the use of MBI-C using a promising translation method in Taiwan. Thus, consistency and discrepancy between informant-rated and self-rated scores have not been extensively researched. OBJECTIVE: This study validated and compared the informant- and self-rated versions of the MBI-C among community-dwelling people in Taiwan. METHOD: We recruited 202 pairs of individuals without dementia aged ≥50 years and their cohabitating informants. The participants completed the MBI-C (MBI-C-self), and the informants completed the MBI-C (MBI-C-informant) and the Neuropsychiatric Inventory Questionnaire (NPI-Q) independently. Internal consistency, inter-rater reliability, and convergent validity were examined. RESULTS: Both MBI-C-self and MBI-C-informant exhibited satisfactory Cronbach's α values (0.92 and 0.88, respectively). The MBI-C-informant total scorewas correlated with the NPI-Q total score (r = 0.83, p < 0.001). Inter-rater reliability between the two versions, as represented by the inter-rater correlation coefficient, was 0.57 (p < 0.001). The prevalence of MBI based on the MBI-C-informant scores was 1.5% higher than that based on the MBI-C-self scores according to the suggested cut-off score of 8.5. The affective dysregulation domain score of MBI-C-informant was significantly lower than that of MBI-C-self. CONCLUSION: MBI-C-informant exhibited both high reliability and validity. Discrepancies between MBI-C-informant and MBI-C-self related to the detection rates and affective dysregulation domain scores were noted. The level of consistency and discrepancy between these two versions provide implications for the use of MBI-C in clinical practice and future research.

Comparing the Psychometric Properties among Three Versions of the UCLA Loneliness Scale in Individuals with Schizophrenia or Schizoaffective Disorder.

The UCLA Loneliness Scale (Version 3; UCLA-LSV3) is widely used for assessing loneliness. Nevertheless, the validity of this scale for assessing loneliness in individuals with schizophrenia or schizoaffective disorder has not been determined. Additionally, studies validating the eight-item and three-item versions of UCLA-LSV3 have not included individuals with severe mental illness; therefore, whether the short versions are comparable to the full 20-item version of UCLA-LSV3 for this population is unclear. The present study examined the unidimensional structure, internal consistency, concurrent validity, and test-retest reliability of the Chinese versions of UCLA-LSV3 (i.e., 20-item, 8-item, and 3-item versions) to determine which version is most appropriate for assessing loneliness in individuals with schizophrenia or schizoaffective disorder in Taiwan. A total of 300 participants (267 with schizophrenia and 33 with schizoaffective disorder) completed the scales, comprising UCLA-LSV3, the Center for Epidemiological Studies Depression Scale (CES-D), the suicidality module of the Kiddie Schedule for Affective Disorders and Schizophrenia-Epidemiological Version (K-SADS-E), and the family and peer Adaptation, Partnership, Growth, Affection, and Resolve (APGAR) index. Construct validity was evaluated through confirmatory factor analysis. The three versions of UCLA-LSV3 were compared with the CES-D, the suicidality module of the K-SADS-E, and the family and peer APGAR index to establish concurrent validity. The results indicated that all three versions of UCLA-LSV3 exhibited acceptable to satisfactory psychometric properties in terms of unidimensional constructs, concurrent validity, and test-retest reliability. The full version of UCLA-LSV3 had the best performance, followed by the eight-item version and the three-item version. Moreover, the three versions had relatively strong associations with each other. Therefore, when deliberating which version of UCLA-LSV3 is the best choice for assessing loneliness in individuals with schizophrenia or schizoaffective disorder, healthcare providers and therapists should consider time availability and practicality.

Nitrobenzoate-Derived Compound X8 Impairs Vascular Development in Zebrafish.

Proper growth and patterning of blood vessels are critical for embryogenesis. Chemicals or environmental hormones may interfere with vascular growth and cause developmental defects. Nitrobenzoate-based compounds have been demonstrated to have a wide range of biological and pharmacological functions, leading to the development of numerous 4-nitrobenzoate derivatives for clinical application. In this study, we tested a novel nitrobenzoate-derived compound, X8, and investigated its effects on vascular development using zebrafish as a model organism. We first determined the survival rate of embryos after the addition of exogenous X8 (0.5, 1, 3, 5, and 10 µM) to the fish medium and determined a sublethal dose of 3 µM for use in further assays. We used transgenic fish to examine the effects of X8 treatment on vascular development. At 25-32 h postfertilization (hpf), X8 treatment impaired the growth of intersegmental vessels (ISVs) and caudal vein plexuses (CVPs). Moreover, X8-treated embryos exhibited pericardial edema and circulatory defects at 60-72 hpf, suggesting the effects of X8 in vasculature. Apoptosis tests showed that the vascular defects were likely caused by the inhibition of proliferation and migration. To investigate the molecular impacts underlying the defects in the vasculature of X8-treated fish, the expression levels of vascular markers, including ephrinb2, mrc1, and stabilin, were assessed, and the decreased expression of those genes was detected, indicating that X8 inhibited the expression of vascular genes. Finally, we showed that X8 treatment disrupted exogenous GS4012-induced angiogenesis in Tg(flk:egfp) zebrafish embryos. In addition, vascular defects were enhanced during cotreatment with X8 and the VEGFR2 inhibitor SU5416, suggesting that X8 treatment causes vascular defects mediated by disruption of VEGF/VEGFR2 signaling. Collectively, our findings indicate that X8 could be developed as a novel antiangiogenic agent.

Cardiac Autonomic and Cardiac Vagal Control During and After Depressive and Happiness Autobiographical Memories in Patients With Major Depressive Disorder.

Background: Heart rate variability (HRV) and respiratory sinus arrhythmia (RSA) are indices of cardiac autonomic and cardiac vagal control (CVC), both of which are markers of emotional regulation and physical health. This study examined (1) the differences in cardiac autonomic regulation and CVC during baseline, depressive, and happiness autobiographical memory tasks between participants with major depressive disorder (MDD group) and healthy controls (HC group); (2) the associations between depressive symptoms and cardiac autonomic and CVC; and (3) the reactivity and recovery of cardiac autonomic and CVC between the MDD and HC groups. Methods: A total of 168 and 178 participants were included in the MDD and HC groups, respectively. Demographic data and the Beck Depression Inventory-II were collected before the experimental procedure. Lead II electrocardiograph (ECG) was measured during baseline, depressive, and happiness autobiographical memory tasks, and then interbeat intervals from ECG were converted to the time and frequency domains of HRV and RSA. Results: The participants in the MDD group showed lower HRV (including standard deviation of normal to normal intervals, low frequency, the natural logarithm of low frequency, and the natural logarithm of high frequency) and CVC (RSA and lnRSA) than those in the HC group. Depressive symptoms were positively correlated with heart rate and negatively correlated with the indices of cardiac autonomic and CVC. There was significantly increased reactivity and recovery of cardiac autonomic and CVC during and after depressive and happiness autobiographical memory tasks in the HC group, but not in the MDD group. Discussion: Participants with MDD had cardiac autonomic and CVC dysregulation, decreased reactivity, and did not recover to baseline after emotional provocations. These results can be the theoretical basis for clinical intervention by using HRV biofeedback to restore cardiac autonomic regulation and CVC during and after emotional events in the future.

Problematic Smartphone Use and Its Associations with Sexual Minority Stressors, Gender Nonconformity, and Mental Health Problems among Young Adult Lesbian, Gay, and Bisexual Individuals in Taiwan.

Smartphones are a necessity for many people; however, problematic smartphone use (PSU) may negatively influence people's mental health. Using multivariate linear regression analysis, the study examined the associations of sexual minority stressors [namely perceived sexual stigma from family members, sexual orientation microaggressions (SOMs), and internalized sexual stigma] and gender nonconformity with PSU severity as well as the associations of PSU with depression and anxiety in young adult lesbian, gay, and bisexual (LGB) individuals. This cross-sectional survey study recruited 1000 young adult LGB individuals (500 men and 500 women). PSU severity was assessed using the Smartphone Addiction Inventory. The experiences of perceived sexual stigma from family members, SOMs, and internalized sexual stigma and the levels of gender nonconformity, depression, and anxiety were assessed. The results indicated that perceived sexual stigma from family members, SOMs, internalized sexual stigma in the dimensions of social discomfort and identity and gender nonconformity were significantly associated with PSU severity in LGB individuals. Moreover, PSU was significantly associated with depression and anxiety in LGB individuals. The findings highlight the significance of developing strategies for the prevention and early detection of PSU and sexual minority stress in LGB individuals.

Application of Contrast-enhanced Ultrasound and Bosniak Classification to the Diagnosis of Cystic Renal Masses.

BACKGROUND: The Bosniak classification system based on contrast-enhanced computed tomography (CECT) is commonly used for the differential diagnosis of cystic renal masses. Contrastenhanced ultrasound (CEUS) is a relatively novel technique, which has gradually played an important role in the diagnosis of cystic renal cell carcinoma (CRCC) due to its safety and lowest price. OBJECTIVE: The aim of the study is to investigate the application value of CEUS and Bosniak classification into the diagnosis of cystic renal masses. METHODS: 32 cystic masses from January 2018 to December 2019 were selected. The images of conventional ultrasound (US), CEUS and CECT from subjects confirmed by surgical pathology were retrospectively analyzed. The Bosniak classification system of cystic renal masses was implemented using CEUS and CECT, and the diagnostic ability was compared. RESULTS: For the 32 cystic masses, postoperative pathology confirmed 11 cases of multilocular CRCC, 15 cases of clear cell carcinoma with hemorrhage, necrosis and cystic degeneration, 5 cases of renal cysts, and 1 case of renal tuberculosis. The Bosniak classification based on CEUS was higher than that based on CECT, and the difference was statistically significant (P = .024). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CEUS were comparable to CECT. There was no significant difference observed in the diagnosis of CRCC (P >.05). CONCLUSION: CEUS combined with Bosniak classification greatly improves the diagnosis of CRCC. CEUS shows a comparable diagnostic ability to CECT. In daily clinical routine, patients who require multiple examinations and present contraindications for CECT can particularly benefit from CEUS.

One-kilojoule pulsed-power generator for laboratory space sciences.

This paper reports on the assembly of a compact, low-cost, pulsed-power facility used for plasma studies. The construction uses two modules placed on opposite sides of the test chamber to minimize the system impedance and improve access to test samples. The stored energy is 1  kJ with a peak current of 135  kA and a 1592  ns quarter-period time. Up until now, an imploding conical-wire array has been studied by using time-integrated (visible) imaging, and time-resolved laser imaging, providing a measure of the plasma jet speed in the range of 170  km/s. Our future plans will continue to investigate high-energy-density plasmas that are relevant to the space environment, fusion, and spectroscopy.

Contrast-enhanced Ultrasound for Diagnosis of Renal Cystic Mass.

BACKGROUND: Cystic Renal Cell Carcinoma (CRCC) is often difficult to differentiate from complex cysts with sonographic manifestations of renal carcinoma. Contrast-Enhanced Ultrasound (CEUS) is a new technology, and its clinical utility in the diagnosis of renal cystic mass has not been established. OBJECTIVE: The objective of this study is to analyze the characteristics of CEUS of renal cystic masses and to explore the clinical significance and value of CEUS in the diagnosis of CRCC. METHODS: This study was a retrospective study. A total of 32 cystic masses from January 2018 to December 2019 were selected. The images of conventional Ultrasound (US) and CEUS were confirmed via surgical pathology. Routine US was used to observe the location, shape, size, boundary, cyst wall, internal echo, and blood supply of each cystic mass. CEUS observed contrast enhancement of the cyst wall, cystic septa, and solid nodules of cystic masses. RESULTS: There were 26 cases of CRCC, 5 cases of renal cysts, and 1 case of renal tuberculosis. The enhancement pattern, degree of enhancement, and pseudocapsular sign by CEUS in benign and malignant masses had statistically significant differences (P<.05). In the diagnosis of CRCC, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 92.3%, 83.3%, 90.6%, 96.0%, and 71.4% for CEUS; 57.6%, 66.7%, 59.3%, 88.2%, and 26.7% for conventional US, respectively. CEUS had a higher sensitivity and accuracy than the conventional US (P<.05), although the diagnostic specificity, positive predictive value and negative predictive value of the two methods were not significantly different (P>.05). CONCLUSION: CEUS is more accurate in the diagnosis of renal cystic masses, and it can be used as an effective imaging method.

Neuropsychiatric symptoms and mortality among patients with mild cognitive impairment and dementia due to Alzheimer's disease.

BACKGROUND: Neuropsychiatric symptoms (NPS) could increase mortality risk in people with dementia due to Alzheimer's disease (AD). However, whether NPS affects mortality risk in people with mild cognitive impairment (MCI) and whether any specific syndrome of NPS influences this risk are still unclear. METHODS: In total, 984 participants with dementia due to AD, 338 with MCI, and 365 controls were enrolled. Over a mean of 5-year follow-up, cause of death data were obtained from the Ministry of Health and Welfare in Taiwan. NPS were assessed using Neuropsychiatric Inventory Questionnaire (NPI-Q), and psychosis, mood, and frontal domain scores were determined. Survival analyses were conducted to determine the hazard ratio (HR) of death. RESULTS: In controlled analyses, HR of death for AD was 2.19 (95% confidence interval [CI] = 1.29-3.71) compared with the control group, whereas no statistical significance was noted for the MCI group. A high NPI-Q score (above the median score) increased mortality risk for both the MCI and AD groups, with HRs of 2.32 (95% CI = 1.07-5.03) and 2.60 (95% CI = 1.51-4.47), respectively. Among NPI-Q domain scores, only high mood domain, but not psychosis or frontal domain, scores increased death risk for both the MCI (HR = 2.89, 95% CI = 1.00-8.51) and AD (HR = 2.59, 95% CI = 1.47-4.55) groups. CONCLUSION: Mortality risk is high for patients with AD. Not only for AD, patients with MCI presenting with NPS, particularly mood symptoms, have high death risk.

Prefrontal Lobe and Posterior Cingulate Cortex Activations in Patients with Major Depressive Disorder by Using Standardized Weighted Low-Resolution Electromagnetic Tomography.

BACKGROUND: The differences in brain activity between patients with major depressive disorder (MDD) and healthy adults have been confirmed by functional magnetic resonance imaging (fMRI), positron emission tomography (PET), and electroencephalography (EEG). The prefrontal lobe and posterior cingulate cortex (PCC) are related to emotional regulation in patients with MDD. However, the high cost and poor time resolution of fMRI and PET limit their clinical application. Recently, researchers have used high time resolution of standardized weighted low-resolution electromagnetic tomography (swLORETA) to investigate deep brain activity. This study aimed to convert raw EEG signals into swLORETA images and explore deep brain activity in patients with MDD and healthy adults. METHODS: BrainMaster EEG equipment with a 19-channel EEG cap was used to collect resting EEG data with eyes closed for 5 min. NeuroGuide software was used to remove the EEG artifacts, and the swLORETA software was used to analyze 12,700 voxels of current source density (CSD) for 139 patients with MDD and co-morbid anxiety symptoms (mean age = 43.08, SD = 13.76; 28.78% were male) and 134 healthy adults (mean age = 40.60, SD = 13.52; 34.33% were male). Deep brain activity in the frontal lobe and PCC at different frequency bands was analyzed, including delta (1-4 Hz), theta (5-7 Hz), alpha (8-11 Hz), beta (12-24 Hz), beta1 (12-14 Hz), beta2 (15-17 Hz), beta3 (18-24 Hz), and high beta (25-29 Hz). RESULTS: There was lower delta and theta and higher beta, beta1, beta2, beta3, and high-beta activity at the prefrontal lobe (dorsal medial prefrontal cortex [dmPFC], ventral medial prefrontal cortex [vmPFC], and dorsal lateral prefrontal cortex [dlPFC], ventral lateral prefrontal cortex [vlPFC], orbital frontal cortex [OFC]) and PCC in MDD patients compared with healthy adults. There was no significant difference in alpha activity between the two groups. CONCLUSION: This study indicates brain hyperactivity in the right prefrontal lobe (dlPFC and vmPFC) and PCC in patients with MDD with co-morbid anxiety symptoms, and the dlPFC and PCC were also related to emotion regulation in MDD. Inhibiting high-beta activity or restoring delta and theta activity to the normal range in the right frontal lobe and PCC may be possible in z-score neurofeedback protocols for patients with MDD in future studies.

Rail-gap switch with a multistep high-voltage triggering system.

A rail-gap switch with a multistep triggering system was developed. The rail-gap switch consisted of two rail-like electrodes and a knife-edge electrode parallel to each other. It was assembled from many pieces and filled with unpressurized-flowing dry air. Good alignments between all electrodes were achieved by using a special jig and the knife-edge electrode as the spatial reference. Furthermore, to trigger the rail-gap switch, a multistep triggering system was used. The triggering system consisted of three components: an optical trigger-pulse generator, a slow high-voltage trigger-pulse generator using an ignition coil for a car, and finally, a fast high-voltage trigger-pulse generator using a three-stage Marx generator. The triggering system generated a negative high-voltage trigger pulse of less than -40 kV with a falling speed of -6.6 ± 0.4 kV/ns. The falling speed was fast enough to initiate multichannel discharges in the rail-gap switch. Finally, the rail-gap switch was tested using a test bench consisting of a 0.5-µF capacitor bank charged to 20 kV. The rail-gap switch was triggered by the multistep triggering system robustly with a delay of 180 ns. The delay between the time, when the peak current of the test bench occurred, and the trigger pulse was 890 ns with a jitter of 20 ns, i.e., ∼2% uncertainty in time. The inductance of the rail-gap switch was ∼80 nH obtained from the discharge tests. The rail-gap switch with the multistep high-voltage triggering system is suitable for any pulsed-power systems with current rise times in the order of 1 µs.