Efficacy of deep brain stimulation for Tourette syndrome and its comorbidities: A meta-analysis.

Tourette Syndrome (TS) is a neurodevelopmental disorder characterized by multiple motor and vocal tics, often accompanied by comorbid disorders. Optional treatments for patients with TS include behavioral therapy, pharmacotherapy, and neurostimulation techniques. Deep brain stimulation (DBS) has been considered a therapeutic approach for refractory TS and its comorbid symptoms. However, systematic comparison is necessary to understand the therapeutic effect of DBS among patients with TS with various comorbid symptoms, demographic characteristics, or stimulation targets. Consequently, our research aimed to assess the clinical efficacy of DBS in alleviating the symptoms of TS and its comorbidities. A systematic literature search was conducted across five databases: PubMed, Web of Science, MEDLINE, Embase, and PsycINFO. The primary outcome was the mean change in the global score of the Yale Global Tic Severity Scale (YGTSS), which assesses the severity of tics. The secondary outcomes included mean improvement of comorbid symptoms, such as obsessive-compulsive behaviors (OCB), depression symptoms and anxiety symptoms. In total, 51 studies with 673 participants were included in this meta-analysis. Overall, the DBS led to a significant improvement in tic symptoms (p â€‹< â€‹0.001), as well as the comorbid obsessive-compulsive, depression, and anxiety symptoms with effect sizes of 1.88, 0.88, 1.04, and 0.76 accordingly. In the subgroup analysis, we found that striatum stimulation led to a more significant improvement in OCB in patients with TS compared to that observed with thalamic stimulation (p â€‹= â€‹0.017). The relationship between sex, age, and target with the improvement of tics, depression, and anxiety was not statistically significant (p â€‹= â€‹0.923, 0.438, 0.591 for different male proportions; p â€‹= â€‹0.463, 0.425, 0.105 for different age groups; p â€‹= â€‹0.619, 0.113, 0.053 for different targets). In conclusion, DBS is an efficient treatment option for TS, as well as the comorbid OCB, depression symptoms, and anxiety symptoms. It is important to highlight that stimulating the striatum is more effective in managing obsessive-compulsive symptoms compared to stimulating the thalamus.

Comparison of the Clancy Autism Behavior Scale and Autism Behavior Checklist for Screening Autism Spectrum Disorder.

PURPOSE: To make early detection of individuals with autism spectrum disorder (ASD), caregiver-report instruments remain an efficient and adaptable option for the preliminary assessment. This study aimed to compare the psychometric properties of the Clancy Autism Behavior Scale (CABS) and Autism Behavior Checklist (ABC) as screening tools for ASD by caregivers. METHODS: The data were collected from 154 pairs of children and their parents, who sought medical attention for suspected autism at Peking University Sixth Hospital. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, Youden index, and area under the receiver operating characteristics curves (AUC) of the CABS and ABC were calculated and compared using recommended cut-off values from initial papers. The optimal cut-off values for CABS and ABC were determined according to the maximum Youden index. RESULTS: The ABC performed better than the CABS in screening autistic persons. Specifically, the ABC demonstrated higher sensitivity than the CABS in identifying children with ASD, while the CABS exhibited superior specificity compared to the ABC. According to the maximum Youden index, the optimal cut-off value was determined to be 13 for CABS and 62 for ABC. CONCLUSION: The ABC exhibits higher sensitivity and overall performance in screening individuals with ASD compared to the CABS. The ABC is more suitable as a screening tool for caregivers in both domestic and clinical settings, while the CABS may be utilized when evaluation time or medical resources are limited due to its shorter completion time and fewer items.

Diagnostic efficiency and psychometric properties of CBCL DSM-oriented scales in a large sample of Chinese school-attending students aged 5-16.

BACKGROUND: Children and adolescents are vulnerable to various psychiatric disorders during the critical phase of individual development. In China, the child behavior checklist (CBCL) is a widely employed psychometric questionnaire for assessing children and adolescents. However, further validation of the psychometric properties and diagnostic effectiveness of the CBCL DSM-oriented scales is necessary. These scales were developed based on DSM diagnosis and require evaluation using a substantial sample of Chinese individuals. METHODS: This study involved the analysis of a substantial dataset consisting of 72,109 samples collected from five provinces in China. Data was gathered using the CBCL (Parent Rating Scale), and rigorous assessments of reliability and validity were conducted. The mini-international neuropsychiatric interview for children and adolescents (MINI-KID) and the diagnostic and statistical manual of mental disorders-IV (DSM-IV) interview were employed to diagnose the participants. To ensure the accuracy of the diagnoses, receiver operating characteristic curve (ROC curves) were utilized, and the Youden Index was calculated to determine the appropriate diagnostic cut-off point for each specific target diagnosis. RESULTS: The study included a total sample of 72,109 cases, out of which 19,782 cases underwent MINI-KID assessment and structured or semi-structured interviews based on DSM-IV to clarify the diagnosis. Reliability and validity analyses showed that the reliability of the subscales and total scales was good, except for Anxiety Problems. The Cronbach's alpha for the CBCL DSM-oriented scales was 0.92. In addition, the validity of all scales was good (CFI = 0.80). For the sample with a clear diagnosis, all five subscales of the CBCL DSM-oriented scales showed fair diagnostic efficiency for the target diagnosis. Among them, the area under curves (AUC) of Mood disorder, Anxiety, Attention deficit and hyperactivity disorder (ADHD), Oppositional defiant disorder (ODD) and Conduct disorder (CD) are 0.80, 0.74, 0.75, 0.74, 0.74. Among the three sample groups, the highest diagnostic efficiency was found in Affective Problems to Mania. The diagnostic cut-off point for each subscale on target diagnoses was clearly defined. CONCLUSION: Overall, the reliability, validity and diagnostic efficiency of CBCL DSM-oriented scales in Chinese children and adolescents were within acceptable limits. In addition, we used ROC curves and cut-off points to predict the cut-off values of common child and adolescent psychiatric disorders mentioned in the CBCL DSM-oriented scales. This provides an important reference for the clinical application of the CBCL DSM-oriented scales in Chinese samples.

Prevalence and risk factor for long COVID in children and adolescents: A meta-analysis and systematic review.

BACKGROUND: Millions of COVID-19 pediatric survivors are facing the risk of long COVID after recovery from acute COVID-19. The primary objective of this study was to systematically review the available literature and determine the pooled prevalence of, and risk factors for long COVID among the pediatric survivors. METHODS: Studies that assessed the prevalence of, or risk factors associated with long COVID among pediatric COVID-19 survivors were systematically searched in PubMed, Embase, and Cochrane Library up to December 11th, 2022. Random effects model was performed to estimate the pooled prevalence of long COVID among pediatric COVID-19 patients. Subgroup analyses and meta-regression on the estimated prevalence of long COVID were performed by stratification with follow-up duration, mean age, sex ratio, percentage of multisystem inflammatory syndrome, hospitalization rate at baseline, and percentage of severe illness. RESULTS: Based on 40 studies with 12,424 individuals, the pooled prevalence of any long COVID was 23.36 % ([95 % CI 15.27-32.53]). The generalized symptom (19.57 %, [95 % CI 9.85-31.52]) was reported most commonly, followed by respiratory (14.76 %, [95 % CI 7.22-24.27]), neurologic (13.51 %, [95 % CI 6.52-22.40]), and psychiatric (12.30 %, [95% CI 5.38-21.37]). Dyspnea (22.75 %, [95% CI 9.38-39.54]), fatigue (20.22 %, [95% CI 9.19-34.09]), and headache (15.88 %, [95 % CI 6.85-27.57]) were most widely reported specific symptoms. The prevalence of any symptom during 3-6, 6-12, and> 12 months were 26.41 % ([95 % CI 14.33-40.59]), 20.64 % ([95 % CI 17.06-24.46]), and 14.89 % ([95 % CI 6.09-26.51]), respectively. Individuals with aged over ten years, multisystem inflammatory syndrome, or had severe clinical symptoms exhibited higher prevalence of long COVID in multi-systems. Factors such as older age, female, poor physical or mental health, or had severe infection or more symptoms were more likely to have long COVID in pediatric survivors. CONCLUSIONS: Nearly one quarter of pediatric survivors suffered multisystem long COVID, even at 1 year after infection. Ongoing monitoring, comprehensive prevention and intervention is warranted for pediatric survivors, especially for individuals with high risk factors.

Optic nerve injury-induced regeneration in the adult zebrafish is accompanied by spatiotemporal changes in mitochondrial dynamics.

Axonal regeneration in the central nervous system is an energy-intensive process. In contrast to mammals, adult zebrafish can functionally recover from neuronal injury. This raises the question of how zebrafish can cope with this high energy demand. We previously showed that in adult zebrafish, subjected to an optic nerve crush, an antagonistic axon-dendrite interplay exists wherein the retraction of retinal ganglion cell dendrites is a prerequisite for effective axonal repair. We postulate a 'dendrites for regeneration' paradigm that might be linked to intraneuronal mitochondrial reshuffling, as ganglion cells likely have insufficient resources to maintain dendrites and restore axons simultaneously. Here, we characterized both mitochondrial distribution and mitochondrial dynamics within the different ganglion cell compartments (dendrites, somas, and axons) during the regenerative process. Optic nerve crush resulted in a reduction of mitochondria in the dendrites during dendritic retraction, whereafter enlarged mitochondria appeared in the optic nerve/tract during axonal regrowth. Upon dendritic regrowth in the retina, mitochondrial density inside the retinal dendrites returned to baseline levels. Moreover, a transient increase in mitochondrial fission and biogenesis was observed in retinal ganglion cell somas after optic nerve damage. Taken together, these findings suggest that during optic nerve injury-induced regeneration, mitochondria shift from the dendrites to the axons and back again and that temporary changes in mitochondrial dynamics support axonal and dendritic regrowth after optic nerve crush.

Leisure Activities and the Risk of Dementia: A Systematic Review and Meta-Analysis.

OBJECTIVES: Leisure activities are major components of modifiable and healthy lifestyles and are proposed to help prevent the development of dementia. This study aimed to assess the effects of different types of leisure activities, including cognitive, physical, and social activities, on the incidence of all-cause dementia (ACD), Alzheimer's disease (AD), and vascular dementia (VD). METHODS: We performed a systematic review and meta-analysis of the Cochrane, PubMed, Embase, and Web of Science databases to identify longitudinal studies that examined associations between leisure activities and dementia. Relative risks (RRs) and 95% confidence intervals (95% CI) were pooled using random-effects meta-analysis. Subgroup analyses were used to estimate potential effect modifiers. The study was registered with PROSPERO (CRD42019116857). RESULTS: A total of 38 longitudinal studies, with 2154818 participants at baseline, 74700 ACD cases, 2848 AD cases, and 1423 VD cases during follow-up, were included in the meta-analysis. The subgroup analyses showed that physical (RR = 0.83, 95% CI: [0.78-0.88]), cognitive (RR = 0.77 [0.68-0.87]), and social (RR = 0.93 [0.87-0.99]) activities were inversely associated with incidence of ACD. In addition, physical (RR = 0.87 [0.78-0.96]) and cognitive (RR = 0.66 [0.52-0.85]) activities were related with a reduced risk of AD. Physical activity (RR = 0.67 [0.53-0.85]) was associated with a lower incidence of VD. CONCLUSION: Our findings suggest that leisure activities are inversely associated with risk of ACD, AD and VD.

A systematic review and meta-analysis on prevalence of and risk factors associated with depression, anxiety and insomnia in infectious diseases, including COVID-19: a call to action.

Infectious disease epidemics have become more frequent and more complex during the 21st century, posing a health threat to the general public and leading to psychological symptoms. The current study was designed to investigate the prevalence of and risk factors associated with depression, anxiety and insomnia symptoms during epidemic outbreaks, including COVID-19. We systematically searched the PubMed, Embase, Web of Science, OVID, Medline, Cochrane databases, bioRxiv and medRxiv to identify studies that reported the prevalence of depression, anxiety or insomnia during infectious disease epidemics, up to August 14th, 2020. Prevalence of mental symptoms among different populations including the general public, health workers, university students, older adults, infected patients, survivors of infection, and pregnant women across all types of epidemics was pooled. In addition, prevalence of mental symptoms during COVID-19 was estimated by time using meta-regression analysis. A total of 17,506 papers were initially retrieved, and a final of 283 studies met the inclusion criteria, representing a total of 948,882 individuals. The pooled prevalence of depression ranged from 23.1%, 95% confidential intervals (95% CI: [13.9-32.2]) in survivors to 43.3% (95% CI: [27.1-59.6]) in university students, the pooled prevalence of anxiety ranged from 25.0% (95% CI: [12.0-38.0]) in older adults to 43.3% (95% CI: [23.3-63.3]) in pregnant women, and insomnia symptoms ranged from 29.7% (95% CI: [24.4-34.9]) in the general public to 58.4% (95% CI: [28.1-88.6]) in university students. Prevalence of moderate-to-severe mental symptoms was lower but had substantial variation across different populations. The prevalence of mental problems increased over time during the COVID-19 pandemic among the general public, health workers and university students, and decreased among infected patients. Factors associated with increased prevalence for all three mental health symptoms included female sex, and having physical disorders, psychiatric disorders, COVID infection, colleagues or family members infected, experience of frontline work, close contact with infected patients, high exposure risk, quarantine experience and high concern about epidemics. Frequent exercise and good social support were associated with lower risk for these three mental symptoms. In conclusion, mental symptoms are common during epidemics with substantial variation across populations. The population-specific psychological crisis management are needed to decrease the burden of psychological problem and improve the mental wellbeing during epidemic.

Connectivity-Based Brain Network Supports Restricted and Repetitive Behaviors in Autism Spectrum Disorder Across Development.

Introduction: Autism spectrum disorder (ASD) is a lifelong condition. Autistic symptoms can persist into adulthood. Studies have reported that autistic symptoms generally improved in adulthood, especially restricted and repetitive behaviors and interests (RRBIs). We explored brain networks that are related to differences in RRBIs in individuals with ASDs among different ages. Methods: We enrolled 147 ASD patients from the Autism Brain Imaging Data Exchange II (ABIDEII) database. The participants were divided into four age groups: children (6-9 years old), younger adolescents (10-14 years old), older adolescents (15-19 years old), and adults (≥20 years old). RRBIs were evaluated using the Repetitive Behaviors Scale-Revised 6. We first explored differences in RRBIs between age groups using the Kruskal-Wallis test. Associations between improvements in RRBIs and age were analyzed using a general linear model. We then analyzed RRBIs associated functional connectivity (FC) links using the network-based statistic method by adjusting covariates. The association of the identified FC with age group, and mediation function of the FC on the association of age-group and RRBI were further analyzed. Results: Most subtypes of RRBIs improved with age, especially stereotyped behaviors, ritualistic behaviors, and restricted behaviors (p = 0.012, 0.014, and 0.012, respectively). Results showed that 12 FC links were closely related to overall RRBIs, 17 FC links were related to stereotyped behaviors. Among the identified 29 FC links, 15 were negatively related to age-groups. The mostly reported core brain regions included superior occipital gyrus, insula, rolandic operculum, angular, caudate, and cingulum. The decrease in FC between the left superior occipital lobe and right angular (effect = -0.125 and -0.693, respectively) and between the left insula and left caudate (effect = -0.116 and -0.664, respectively) might contribute to improvements in multiple RRBIs with age. Conclusion: We identified improvements in RRBIs with age in ASD patients, especially stereotyped behaviors, ritualistic behaviors, and restricted behaviors. The decrease in FC between left superior occipital lobe and right angular and between left insula and left caudate might contribute to these improvements. Our findings improve our understanding of the pathogenesis of RRBIs and suggest potential intervention targets to improve prognosis in adulthood.

Early Prediction Model of Acute Aortic Syndrome Mortality in Emergency Departments.

Purpose: Acute aortic syndrome is a constellation of life-threatening medical conditions for which rapid assessment and targeted intervention are important for the prognosis of patients who are at high risk of in-hospital death. The current study aims to develop and externally validate an early prediction mortality model that can be used to identify high-risk patients with acute aortic syndrome in the emergency department. Patients and Methods: This retrospective multi-center observational study enrolled 1088 patients with acute aortic syndrome admitted to the emergency departments of two hospitals in China between January 2017 and March 2021 for model development. A total of 210 patients with acute aortic syndrome admitted to the emergency departments of Peking University Third Hospital between January 2007 and December 2021 was enrolled for model validation. Demographics and clinical factors were collected at the time of emergency department admission. The predictive variables were determined by referring to the results of previous studies and the baseline analysis of this study. The study's endpoint was in-hospital death. To assess internal validity, we used a fivefold cross-validation method. Model performance was validated internally and externally by evaluating model discrimination using the area under the receiver-operating characteristic curve (AUC). A nomogram was developed based on the binary regression results. Results: In the development cohort, 1088 patients with acute aortic syndromes were included, and 88 (8.1%) patients died during hospitalization. In the validation cohort, 210 patients were included, and 20 (9.5%) patients died during hospitalization. The final model included the following variables: digestive system symptoms (OR=2.25; P=0.024), any pulse deficit (OR=7.78; P<0.001), creatinine (µmol/L)(OR=1.00; P=0.018), lesion extension to iliac vessels (OR=4.49; P<0.001), pericardial effusion (OR=2.67; P=0.008), and Stanford type A (OR=10.46; P<0.001). The model's AUC was 0.838 (95% CI 0.784-0.892) in the development cohort and 0.821 (95% CI 0.750-0.891) in the validation cohort, and the Hosmer-Lemeshow test showed p=0.597. The fivefold cross-validation demonstrated a mean accuracy of 0.94, a mean precision of 0.67, and a mean recall of 0.13. Conclusion: This risk prediction tool uses simple variables to provide robust prediction of the risk of in-hospital death from acute aortic syndrome and validated well in an independent cohort. The tool can help emergency clinicians quickly identify high-risk acute aortic syndrome patients, although further studies are needed for verifying the prospective data and the results of our study.

Mental Health in Children in the Context of COVID-19: Focus on Discharged Children.

Introduction: To date, the mental health consequences of children hospitalized with COVID-19 remain unclear. We aimed to assess mental health status in children in the context of COVID-19, with a focus on discharged children. Methods: We recruited discharged children who recovered from COVID-19 and healthy controls between July and September 2020 in Wuhan Children's Hospital. Post-traumatic stress disorder (PTSD), anxiety, depression, and sleep problems were assessed in these children using questionnaires. Univariable and multivariable logistic and linear regressions were conducted to identify risk factors. Results: Totally, there were 152 children (61 discharged children and 91 healthy controls) aged 7-18 years old in our study. An increasing trend in the prevalence of PTSD, anxiety, and depression was observed in the discharged children compared with healthy controls (PTSD: 8.20 vs. 2.20%, anxiety: 22.95 vs. 13.19%; depression: 47.54 vs. 32.97%). Discharged children tended to report more depressive symptoms (ß = 0.39) and less sleep problems (ß = -0.37). Discharged children who lived in nuclear families and had longer hospital stays were more likely to report depression [odds ratio (OR) = 3.68 and 1.14, respectively]. Anxiety symptoms and the severity of sleep problems of discharged children were positively associated with caregivers' depression and PTSD symptoms (OR = 21.88 and 31.09, respectively). Conclusion: In conclusion, PTSD, anxiety, and depression symptoms were common among recovered children 4 months after COVID-19 hospitalization. Children from nuclear family and those had longer hospital stays need special attention. In addition, parental mental health had a significant impact on their children's mental resilience and recovery.

Influencing Factors of Environmental Risk Perception during the COVID-19 Epidemic in China.

The spread of COVID-19 is having a serious impact on socioeconomic development, and increased environmental risk perception (ERP). ERP provide new ideas for the orderly recovery of society. However, there have been studies that often pay attention to individual factors, and less concerned about the external environment. In fact, ERP will be affected by the external environment and individual factors. We used a Python script to collect 65,277 valid Weibo comments during the COVID-19 epidemic in China to assess urban residents' environmental risk perception (ERP). SnowNLP emotion analysis was used to measure the ERP of 366 urban in China, and the structural proportion characteristics and spatial-temporal differentiation of ERP were analyzed. Then, an order logistic regression model was used to investigate the relationship between economic level, social security, medical facilities and ERP. The study investigated the Chinese cities have a higher ERP during the COVID-19 period, and it shows marked fluctuations. As COVID-19 spreads, the ERP shows a distribution pattern of "high in the southeast and low in the northwest" with Hu line as the boundary and "from high to low" with Wuhan as the high value center. COVID-19 serves as catalysts for ERP, the impact of COVID-19 is enhanced after socioeconomic factors are considered. The economic level effectively regulates ERP, except the stage of accelerating diffusion. ERP is effectively stabilized by social security and medical facilities. After considering all the variables simultaneously, we found that the mitigation effect of social security and medical facilities on ERP has improved.

Prevalence of posttraumatic stress disorder after infectious disease pandemics in the twenty-first century, including COVID-19: a meta-analysis and systematic review.

Pandemics have become more frequent and more complex during the twenty-first century. Posttraumatic stress disorder (PTSD) following pandemics is a significant public health concern. We sought to provide a reliable estimate of the worldwide prevalence of PTSD after large-scale pandemics as well as associated risk factors, by a systematic review and meta-analysis. We systematically searched the MedLine, Embase, PsycINFO, Web of Science, CNKI, WanFang, medRxiv, and bioRxiv databases to identify studies that were published from the inception up to August 23, 2020, and reported the prevalence of PTSD after pandemics including sudden acute respiratory syndrome (SARS), H1N1, Poliomyelitis, Ebola, Zika, Nipah, Middle Eastern respiratory syndrome coronavirus (MERS-CoV), H5N1, and coronavirus disease 2019 (COVID-19). A total of 88 studies were included in the analysis, with 77 having prevalence information and 70 having risk factors information. The overall pooled prevalence of post-pandemic PTSD across all populations was 22.6% (95% confidence interval (CI): 19.9-25.4%, I2: 99.7%). Healthcare workers had the highest prevalence of PTSD (26.9%; 95% CI: 20.3-33.6%), followed by infected cases (23.8%: 16.6-31.0%), and the general public (19.3%: 15.3-23.2%). However, the heterogeneity of study findings indicates that results should be interpreted cautiously. Risk factors including individual, family, and societal factors, pandemic-related factors, and specific factors in healthcare workers and patients for post-pandemic PTSD were summarized and discussed in this systematic review. Long-term monitoring and early interventions should be implemented to improve post-pandemic mental health and long-term recovery.

Functional connectivity of thalamus in children with primary nocturnal enuresis: results from a resting-state fMRI study.

Primary nocturnal enuresis (PNE) is characterized by a low cure rate and a high reoccurrence rate, since its underlying mechanism remains unclear. Based on the recent studies that thalamus plays an important role in waking up a sleeping person, here we further investigate the functional connectivity (FC) information between thalamus and other brain regions, in order to make better understanding of the PNE's pathogenesis. In this study, we enrolled 30 children diagnosed with PNE and 30 typically developing children that are age and sex matched, the thalamus-based FC estimates were extracted at the resting-state. Experiments showed that for children with PNE, there were four brain regions found with a reduced connection efficiency with thalamus, that were cerebellum posterior lobe, frontal lobe, parietal lobe and precentral gyrus. It can be concluded that these relevant regions might induce an arousal disorder, and therefore further lead to PNE. This finding also provides a new insight in the pathophysiology of PNE.

Epilepsy and Autism Spectrum Disorder: An Epidemiological Study in Shanghai, China.

Autism spectrum disorder (ASD) is a neurodevelopmental disease that may involve various brain abnormalities. However, there are few large epidemiological studies on the relation between epilepsy and ASD in terms of different genders and ages. This study aimed to evaluate the relation between epilepsy and ASD based on 74,251 Chinese children aged 3-12 years who were recruited from kindergartens and primary schools in China. ASD was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-V), and verification of epilepsy was based on medical records. The enrolled children diagnosed with ASD were examined by magnetic resonance imaging (MRI) and took genetic tests to rule out other neurological and congenital diseases. The raw odds ratio (OR) was 60.53 [95% confidence interval (CI) = 37.80-96.92, P < 0.01] for epilepsy and ASD, and the adjusted OR was 38.99 (95% CI = 20.70-73.41, P < 0.01) after controlling for the confounders. Moreover, the adjusted OR was significantly higher in girls (OR = 45.26, 95% CI = 16.42-124.76, P < 0.01) than in boys (OR = 32.64, 95% CI = 14.33-74.34, P < 0.01). Among children with younger age, the adjusted OR was the highest (OR = 75.12, 95% CI = 22.80-247.48.16, P < 0.01). These findings suggest that epilepsy might be closely linked to the development of ASD, especially for early-onset epilepsy and among girls.

[Abnormal brain structure in preschool and school-aged children with autism spectrum disorder].

OBJECTIVE: To investigate the prevalence and type of abnormal brain structure in preschool and school-aged children with autism spectrum disorder (ASD). METHODS: A total of 74 252 preschool and school-aged children aged 3-12 years in Shanghai were enrolled as subjects. A questionnaire survey was performed to collect basic information, and their parents and teachers completed the Social Communication Questionnaire (SCQ) based on the children's conditions. ASD was diagnosed by specialist physicians according to the DSM-5 criteria. Brain magnetic resonance imaging (MRI) was performed according to their parents' desires. RESULTS: The overall prevalence rate of ASD was 2.59‰ (192/74 252) in the preschool and school-aged children. Brain MRI data were collected from 73 children with ASD and 185 healthy children. Among the 73 children with ASD, 40 (55%) had abnormal brain structure, and the most common types were unilateral or bilateral ventriculomegaly in 32 children (80%) and unilateral or bilateral deep frontotemporal sulci in 12 children (30%). Children with ASD showed lower white matter signal in bilateral ventricular and unilateral or bilateral deep frontotemporal sulci, compared to their normal peers (P<0.05). CONCLUSIONS: There is a high prevalence rate of abnormal brain structure in preschool and school-aged children with ASD, with major types of unilateral or bilateral ventriculomegaly and unilateral or bilateral deep frontotemporal sulci. It is speculated that abnormal brain structure might be associated with the pathogenesis of ASD, and further studies are needed to clarify the association between abnormal brain structure and symptoms in children with ASD.

Nocturnal enuresis in obese children: a nation-wide epidemiological study from China.

Childhood obesity increases the risk of obstructive sleep apnea syndrome, type 2 diabetes mellitus, cardiovascular abnormalities, and psychological and behavioral disorders. But it is unclear whether obesity is associated with childhood nocturnal enuresis (NE). This study aimed to assess the relationship between childhood obesity and NE in a nationally representative large sample in China. Subjects were enrolled from Urumqi, Chengdu, Xi'an, Hohhot, Wuhan, Canton, Shanghai, and Harbin cities in China in November and December 2005. The survey included 20,987 children aged 5-12 years and they and their caregivers completed questionnaires. Height and weight were measured by school teachers trained in healthcare. According to the WHO child growth standards, obesity was defined as a body mass index >95th percentile of peers with the same age and gender. NE was defined as bed wetting for more than twice a week for 3 consecutive months. Demographic variables were compared among different groups. The prevalence of obesity, asthma, attention-deficit/hyperactivity disorder (ADHD), depressive moods, and snoring were different between the NE and without-NE groups (P < 0.05). The raw odds ratio (OR) for NE and obesity was 1.36 (95%CI = 1.07-1.74; P = 0.013) and the adjusted OR was 1.42 (95%CI = 1.11-1.82; P = 0.005) in the multivariable analysis. When adjusting for co-occurring conditions, the results showed that asthma did not affect the risk of NE (OR = 1.42, 95%CI = 1.11-1.82; P = 0.005), but ADHD (OR = 1.41; 95%CI = 1.10-1.81; P = 0.006) and depressive moods (OR = 1.34; 95%CI = 1.07-1.76; P = 0.012) slightly weakens the association between NE in children and obesity, while snoring weakens the association between obesity and NE and the risk became non-significant (OR = 1.21; 95%CI = 0.94-1.56; P = 0.138). In conclusion, obese children were at a higher risk of incurring NE compared to non-obese children. This association was weaker in children who either snored, had ADHD, or had depressive mood.

Fully Printed All-Solid-State Organic Flexible Artificial Synapse for Neuromorphic Computing.

Nonvolatile, flexible artificial synapses that can be used for brain-inspired computing are highly desirable for emerging applications such as human-machine interfaces, soft robotics, medical implants, and biological studies. Printed devices based on organic materials are very promising for these applications due to their sensitivity to ion injection, intrinsic printability, biocompatibility, and great potential for flexible/stretchable electronics. Herein, we report the experimental realization of a nonvolatile artificial synapse using organic polymers in a scalable fabrication process. The three-terminal electrochemical neuromorphic device successfully emulates the key features of biological synapses: long-term potentiation/depression, spike timing-dependent plasticity learning rule, paired-pulse facilitation, and ultralow energy consumption. The artificial synapse network exhibits an excellent endurance against bending tests and enables a direct emulation of logic gates, which shows the feasibility of using them in futuristic hierarchical neural networks. Based on our demonstration of 100 distinct, nonvolatile conductance states, we achieved a high accuracy in pattern recognition and face classification neural network simulations.

Abnormal neural responses to emotional stimuli in children with primary monosymptomatic nocturnal enuresis.

Nocturnal enuresis (NE) is a common disorder in school-aged children that has been reported to affect nearly 10% of 7-year-old children and affects both the children and their families. Previous studies have shown that the risk of psychosocial difficulties in children with enuresis is elevated. Thus, children with NE may experience negative effects on psychosocial health or emotion processing. Therefore, the aim of this study was to investigate the potential disturbance in emotional processing in children with NE using functional magnetic resonance imaging (fMRI). In this work, we used fMRI and an affective picture task to evaluate brain response changes in children with NE. Two groups, one consisting of 22 children with primary monosymptomatic NE and one with 23 healthy controls, were scanned using fMRI. Compared to the healthy subjects, children with NE mainly showed increased activation when viewing negative vs. neutral pictures in the bilateral medial superior frontal gyrus that extended to the anterior cingulate cortex. Our results demonstrated that children with primary monosymptomatic NE showed abnormal neural responses to emotional stimuli and overactivation in the medial prefrontal and anterior cingulate cortices suggested that children with primary monosymptomatic NE may be hypersensitive in their sensory perception of negative pictures.

Room-Temperature Pressure Synthesis of Layered Black Phosphorus-Graphene Composite for Sodium-Ion Battery Anodes.

Sodium-ion batteries offer an attractive option for grid-level energy storage due to the high natural abundance of sodium and low material cost of sodium compounds. Phosphorus (P) is a promising anode material for sodium-ion batteries, with a theoretical capacity of 2596 mAh/g. The red phosphorus (RP) form has worse electronic conductivity and lower initial Coulombic efficiency than black phosphorus (BP), but high material cost and limited production capacity have slowed the development of BP anodes. To address these challenges, we have developed a simple and scalable method to synthesize layered BP/graphene composite (BP/rGO) by pressurization at room temperature. A carbon-black-free and binder-free BP/rGO anode prepared with this method achieved specific charge capacities of 1460.1, 1401.2, 1377.6, 1339.7, 1277.8, 1123.78, and 720.8 mAh/g in a rate capability test at charge and discharge current densities of 0.1, 0.5, 1, 5, 10, 20, and 40 A/g, respectively. In a cycling performance test, after 500 deep cycles, the capacity of BP/rGO anodes stabilized at 1250 and 640 mAh/g at 1 and 40 A/g, respectively, which marks a significant performance improvement for sodium-ion battery anodes.