Comparative efficacy and safety of Chinese patent medicines of acute ischemic stroke: A network meta-analysis.

BACKGROUND: Acute ischemic stroke (AIS) is characterized by high morbidity, disability, mortality, recurrence, and economic burden. Clinical trials have demonstrated that the clinical efficacy of combining oral Chinese patent medicines (CPMs) with chemical drugs (CDs) is better than that of CDs alone. In this study, we performed a network meta-analysis (NMA) of RCTs to assess the efficacy of different CPMs in combination with CDs in the treatment of AIS. METHODS: Search 6 databases from the beginning to January 10, 2023. The Cochrane Risk of Bias tool assessed the methodological quality of the included studies. The NMA was then performed using the STATA 13.0 program. The surface under the cumulative ranking curve (SUCRA) probability values were applied to rank the studied treatments, and cluster analysis was used to compare the effects of CPMs between 2 different outcomes. RESULTS: A total of 94 eligible RCTs, involving 9581 participants, were included in this analysis. Nine CPMs, including Nao-mai-li granule (NML), Nao-mai-tai granule (NMT), Qi-long granule (QL), Long-sheng-zhi capsule (LSZ), Nao-xin-tong capsule (NXT), Nao-xue-shu oral liquid (NXS), Tong-xin-luo capsule (TXL), Xiao-shuan-chang-rong capsule (XSCR), and Xue-shuan-xin-mai-ning capsule (XSXMN) were included. Regarding the clinical effective rate, all types of CPMs + CDs treatments were significantly better than CDs treatments alone, with significant differences among the 9 selected CPMs. Compared with CDs, results showed that NXS + CDs performed best in improving clinical effective rate [OR = 4.73; 95% CI: 1.26-17.78; (SUCRA: 76.1%)]. TXL + CDs showed the most effective effect in alleviating National Institutes of Health Stroke Scale (NIHSS) [MD = -3.84; 95% CI: -5.23, -2.45; (SUCRA: 81.6%)]; NXT + CDs were most effective in improving Barthel index [MD = 13.05; 95% CI: 3.98-22.12; (SUCRA: 63.5%)]. Combined with other outcome indicators and the results of cluster analysis, NXS + CDs may assist in the potential optimal treatment regimen for AIS. CONCLUSION: In conclusion, CPMs were found to be beneficial as adjuvant therapy in patients with AIS. Taking into account the clinical effective rate and other outcomes, NXS + CDs may be the most effective option to improve the condition of AIS patients.

Development and performance validation of a low-cost algorithms-based hyperspectral imaging system for radiodermatitis assessment.

Whilst radiotherapy (RT) is widely used for cancer treatment, radiodermatitis caused by RT is one most common severe side effect affecting 95% cancer patients. Accurate radiodermatitis assessment and classification is essential to adopt timely treatment, management and monitoring, which all depend on reliable and objective tools for radiodermatitis grading. We therefore, in this work, reported the development and grading performance validation of a low-cost (∼2318.2 CNY) algorithms-based hyperspectral imaging (aHSI) system for radiodermatitis assessment. The low-cost aHSI system was enabled through Monte Carlo (MC) simulations conducted on multi-spectra acquired from a custom built low-cost multispectral imaging (MSI) system, deriving algorithms-based hyper-spectra with spectral resolution of 1 nm. The MSI system was based on sequentially illuminated narrow-band light-emitting diodes (LEDs) and a CMOS camera. Erythema induced artificially on healthy volunteers was measured by the aHSI system developed, with algorithms-based hyper-spectra and skin layer resolved physiological parameters (i.e., the blood volume fraction (BVF) and the oxygen saturation of hemoglobin in blood, et. al.) derivation using MC simulations. The MC simulations derived BVF and the oxygen saturation of hemoglobin in blood showed significant (P < 0.001, analysis of variance: ANOVA) increase with erythema. Further 1D-convolution neural network (CNN) implemented on the algorithms-based hyper-spectra leads to an overall classification accuracy of 93.1%, suggesting the great potential of low-cost aHSI system developed for radiodermatitis assessment.

Thermoelectric Characteristics of Self-Supporting WSe2-Nanosheet/PEDOT-Nanowire Composite Films.

Conducting polymer poly(3,4-ethylenedioxythiophene) nanowires (PEDOT NWs) were synthesized by a modified self-assembled micellar soft-template method, followed by fabrication by vacuum filtration of self-supporting exfoliated WSe2-nanosheet (NS)/PEDOT-NW composite films. The results showed that as the mass fractions of WSe2 NSs increased from 0 to 20 wt % in the composite films, the electrical conductivity of the samples decreased from ∼1700 to ∼400 S cm-1, and the Seebeck coefficient increased from 12.3 to 23.1 µV K-1 at 300 K. A room-temperature power factor of 44.5 µW m-1 K-2 was achieved at 300 K for the sample containing 5 wt % WSe2 NSs, and a power factor of 67.3 µW m-1 K-2 was obtained at 380 K. The composite film containing 5 wt % WSe2 NSs was mechanically flexible, as shown by its resistance change ratio of 7.1% after bending for 500 cycles at a bending radius of 4 mm. A flexible thermoelectric (TE) power generator containing four TE legs could generate an output power of 52.1 nW at a temperature difference of 28.5 K, corresponding to a power density of ∼0.33 W/m2. This work demonstrates that the fabrication of inorganic nanosheet/organic nanowire TE composites is an approach to improve the TE properties of conducting polymers.

Relationship between health information literacy and health promoting lifestyle among first-degree relatives of patients with colorectal cancer in China: the mediating effect of health belief.

Background: History of first-degree relatives with colorectal cancer is one of the most important and common risk factors for colorectal cancer in China. Most chronic diseases, such as malignancies, are preventable by adopting health-promoting behaviors and other approaches. However, the relationships among factors affecting the health-promoting lifestyles of first-degree relatives with colorectal cancer have not been sufficiently studied. This study aimed to test the mediation effects of Health belief in the relationship between health-promoting lifestyle and health information literacy among first-degree relatives with colorectal cancer. Methods: A cross-sectional descriptive design was conducted using convenience sampling of 856 first-degree relatives of CRC patients attending three tertiary care hospitals in Nanchong and Deyang of China from December 2020 to December 2022. Questionnaires were used to collect data on the participants' demographic information, the colorectal cancer health beliefs, the health promotion lifestyle, and the health information literacy. Data were analyzed with descriptive statistics, one-way ANOVA, Pearson's correlation coefficients, and mediation analysis using SPSS 25.0 program and its macro-program PROCESS. Results: The findings indicated health information literacy was less, health belief was at the medium level, and performance of health promotion behavior was average for first-degree relatives of colorectal cancer. Whereas first-degree relatives of colorectal cancer health-promotion lifestyle had a positive correlation with health beliefs (r = 0.376, p < 0.01) and health information literacy (r = 0.533, p < 0.01), health beliefs had a positive correlation with health information literacy (r = 0.337, p < 0.01). Health beliefs mediated the positive effect of health information literacy on health-promoting lifestyles (ß =0.420, 95% CI, 0.288-0.581), and indirect effects accounted for 14.0% of the total effect. Conclusion: Health information literacy and health beliefs are key factors associated with a health-promoting lifestyle among first-degree relatives with colorectal cancer. These factors have direct and indirect effects on each other and on health-promoting lifestyles. To enhance health-promoting lifestyles among first-degree relatives with colorectal cancer, interventions that strengthen health beliefs and provide health information literacy should be developed.

Acceptability and initial promise of trainings for community stakeholders serving refugee and immigrant families.

Cumulative traumatic migration experiences are compounded by escalating chronic distress related to the current sociopolitical climate for refugee and immigrant children and families. The aim of this open trial was to conduct a preliminary evaluation of You're Not Alone, a rapidly mounted, strengths-based, community-focused capacity building training initiative for stakeholders interacting with refugee and immigrant children and families in the Chicago area. Trainings, based on Trauma-Informed Care (TIC) and psychological first aid frameworks, adapted education and universal health promotion strategies for population-specific chronic traumatic stress. Two groups of participants (N = 948), who attended either mandatory (n = 659 educators) or voluntary (n = 289 community stakeholders) trainings, completed surveys at pretraining, post-training, and 6-week follow-up. Outcome indices included participant satisfaction, acceptability of training model, and changes in knowledge, attitudes, and behaviors. Over 90% of participants reported satisfaction and acceptability of trainings. For educators, hierarchical linear modeling analyses demonstrated significant increases in trauma knowledge, refugee and immigrant-specific knowledge, positive attitudes toward TIC over time, and a decrease in negative attitudes toward immigrants. Over 95% of participants indicated that they learned and intended to use new strategies to help serve refugee and immigrant children and families. At follow-up, over 80% of those who completed the survey had utilized at least one strategy, and over 55% indicated that they were using resources that they learned about in the training. This study demonstrates that capacity-building trainings swiftly developed and disseminated to community stakeholders can produce positive change in knowledge, attitudes, and practices. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Reproducible metabolic topographies associated with multiple system atrophy: Network and regional analyses in Chinese and American patient cohorts.

PURPOSE: Multiple system atrophy (MSA) is an atypical parkinsonian syndrome and often difficult to discriminate clinically from progressive supranuclear palsy (PSP) and Parkinson's disease (PD) in early stages. Although a characteristic metabolic brain network has been reported for MSA, it is unknown whether this network can provide a clinically useful biomarker in different centers. This study was aimed to identify and cross-validate MSA-related brain network and assess its ability for differential diagnosis and clinical correlations in Chinese and American patient cohorts. METHODS: We included 18F-FDG PET scans retrospectively from 128 clinically diagnosed parkinsonian patients (34 MSA, 34 PSP and 60 PD) and 40 normal subjects in China and in the USA. Using PET images from 20 moderate-stage MSA patients of parkinsonian subtype and 20 normal subjects in both centers, we reproduced MSA-related pattern (MSAPRP) of spatial covariance and estimated its reliability. MSAPRP scores were evaluated in assessing differential diagnosis among moderate- and early-stage MSA, PSP or PD patients and clinical correlations with disease severity. Regional metabolic differences were detected using statistical parameter mapping analysis. MSA-related network and regional topographies of metabolic abnormality were cross-validated between the Chinese and American cohorts. RESULTS: We generated a highly reliable MSAPRP characterized by decreased loading in inferior frontal cortex, striatum and cerebellum, and increased loading in sensorimotor, parietal and occipital cortices. MSAPRP scores discriminated between normal, MSA, PSP and PD subjects and correlated with standardized ratings of clinical stages and motor symptoms in MSA. High similarities in MSAPRPs, network scores and corresponding maps of metabolic abnormality were observed between two different cohorts. CONCLUSION: We have demonstrated reproducible metabolic topographies associated with MSA at both network and regional levels in two independent patient cohorts. Moreover, MSAPRP scores are sensitive for evaluating disease discrimination and clinical correlates. This study supports differential diagnosis of MSA regardless of different patient populations, PET scanners and imaging protocols.

You're not alone: A public health response to immigrant/refugee distress in the current sociopolitical context.

Recent political events and policy changes in the United States have fueled antirefugee/immigrant rhetoric and an increase of xenophobic harassment and intimidation, which together present a significant threat to the physical and mental health of refugee/immigrant children and families. This article aims to provide an overview of how the current sociopolitical context threatens the public health of refugee and immigrant communities and to describe the role of psychologists in advocating for social justice and responding to this urgent public health need through interprofessional collaboration and translation of scientific knowledge into multilevel intervention development. The case study of the You're Not Alone (YNA) initiative describes swiftly mobilized advocacy efforts (e.g., press conference, webinars, resources development and dissemination) and participatory development and roll-out of community capacity-building trainings to address the needs of refugee/immigrant children and families. Trainings aimed to raise awareness of the refugee/immigrant experience and to equip refugee/immigrant community members and providers across a variety of public sectors to implement culturally responsive and trauma-informed strategies to promote resilience, respond to distress, and prevent mental health crises. Between March 2017 and June 2018, a total of 1,642 individuals attended 48 training events. The role of psychologists in future policy and advocacy efforts to promote mental health among refugee/immigrant families is discussed as well as implications for how other marginalized communities affected by the current sociopolitical climate might benefit from broadening the scope of this public health response. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Assessment and Management of Tic Disorders in Pediatric Primary Care Settings.

PURPOSE OF REVIEW: Pediatricians and other primary care providers are often the first and sole healthcare clinicians of patients who present with tics. However, limited primary care pediatric training in neuropsychiatric concerns, as well as perceived lack of comfort and preparation, make it challenging for these clinicians to confidently identify and manage tic disorders. RECENT FINDINGS: Current empirical findings of tic disorder management relevant to pediatric physicians, including assessment, psychoeducation, behavioral interventions, psychotropic medications, and alternative treatments are reviewed. SUMMARY: This article discusses neuropsychiatric and medical complexities of tic disorder assessment, with particular emphasis on differential and comorbid diagnoses. Tiered referral recommendations, based on symptom severity, impairment, and consideration of comorbid conditions, are provided. Future directions for tic management, including dissemination of evidence-based treatments of tic disorders and multidisciplinary teams within pediatric primary care settings, are included.

Diversity in randomized clinical trials of depression: A 36-year review.

Historically, authors reporting the results of randomized clinical trials (RCTs) to address mental health problems have insufficiently described sample characteristics pertaining to the ethnic/racial, linguistic, socioeconomic, and immigrant backgrounds of participants. RCTs have also had inadequate representation of participants from diverse backgrounds. This study reports on the trends in the reporting and representation of various sample demographic characteristics in RCTs of psychotherapy and other psychosocial interventions for depression over a 36-year period, and on the extent to which ethnicity, in particular, is considered in the analyses of treatment effects. A total of 342 trials (85.1% comprised of adult samples), representing 61,283 participants, are summarized in the review. Reporting for ethnicity and socioeconomic indicators improved over time, and RCTs for depression have also increasingly included significant numbers of ethnic minority and low-income groups. However, trials are far more likely to exclude, rather than include, linguistic minorities, and have not enrolled a meaningful number of Asian American, Native Hawaiian/Pacific Islander, Native American/Native Alaskan and multi-ethnic participants. Finally, treatment effects are almost never presented separately across racial/ethnic groups and ethnicity moderation analyses are only sporadically conducted. These findings have implications for generalizability, policy, journal reporting guidelines, and dissemination and implementation.

Identification and analysis of the human sex-biased genes.

Tremendous differences between human sexes are universally observed. Therefore, identifying and analyzing the sex-biased genes are becoming basically important for uncovering the mystery of sex differences and personalized medicine. Here, we presented a computational method to identify sex-biased genes from public gene expression databases. We obtained 1407 female-biased genes (FGs) and 1096 male-biased genes (MGs) across 14 different tissues. Bioinformatics analysis revealed that compared with MGs, FGs have higher evolutionary rate, higher single-nucleotide polymorphism density, less homologous gene numbers and smaller phyletic age. FGs have lower expression level, higher tissue specificity and later expressed stage in body development. Moreover, FGs are highly involved in immune-related functions, whereas MGs are more enriched in metabolic process. In addition, cellular network analysis revealed that MGs have higher degree, more cellular activating signaling and tend to be located in cellular inner space, whereas FGs have lower degree, more cellular repressing signaling and tend to be located in cellular outer space. Finally, the identified sex-biased genes and the discovered biological insights together can be a valuable resource helpful for investigating sex-biased physiology and medicine, for example sex-biased disease diagnosis and therapy, which represents one important aspect of personalized and precision medicine.

Does Depression Screening in Schools Reduce Adolescent Racial/Ethnic Disparities in Accessing Treatment?

Although placing mental health services in schools increases access to care, racial/ethnic disparities persist within the scope of school-based mental health services. Universal mental health screening is a potential strategy to increase problem detection and reduce disparities in care provision. However, no study has experimentally tested the effect of universal screening on patterns of service utilization across racial groups and the potential to reduce disparities. Using a cluster randomized design, we compared service linkage patterns among 7th- and 8th-grade Asian American and Latino students (N = 2,494; Mage = 13.65) in schools that either conducted or did not conduct universal depression screening. Multilevel analyses showed that enrollment in a universal screening school, Latino ethnicity, and low academic performance were associated with greater likelihood of referral. However, these factors were not related to caregiver consent or treatment initiation. Screening-triggered referrals were less likely to result in caregiver consent compared to routine referrals. Furthermore, universal screening did not result in a statistically significant reduction in racial/ethnic disparities in treatment referral. Implications for engaging ethnic minority families beyond the point of problem recognition and referral are discussed.

Odor Identification Test in Idiopathic REM-Behavior Disorder and Parkinson's Disease in China.

BACKGROUND: Olfactory dysfunction is common in Parkinson's disease (PD) and idiopathic rapid eye movement sleep behavior disorder (iRBD), which is a risk factor in the development of PD. However, a few studies have conflicting results when comparing dysosmia in the patients with iRBD and PD. There is no study investigating the olfactory function in Chinese patients with iRBD. Additionally, the Sniffin' Sticks screening 12 test (SS-12) contains several odors that are not familiar to people in different cultures. METHODS: Odor identification was evaluated in iRBD patients (n = 54), PD patients (n = 54) and healthy controls (n = 54). With the identification data, a brief odor identification test was established and then validated in other subjects. RESULTS: Odor identification scores in iRBD patients were significantly higher than those in PD patients (P<0.001) but lower than those in controls (P<0.001). At the cut-off value of 7.5, the Sniffin' Sticks clearly differentiated iRBD and PD patients from the controls, and the brief test could increase the specificity in diagnosing PD. Neither the Sniffin' Sticks nor the brief test could clearly differentiate PD and iRBD patients from each other. CONCLUSIONS: Olfaction is more impaired in PD patients than in iRBD patients, possibly due to the heterogeneity of iRBD patients. The Sniffin' Sticks could be a useful tool for differentiating iRBD patients from the healthy population, and it could be useful for screening people at high-risk of PD in China, especially when combined with polysomnography. To reduce the expense and time required for the Sniffin' Sticks test, this study shows that a brief test is feasible.

Bringing Wellness to Schools: Opportunities for and Challenges to Mental Health Integration in School-Based Health Centers.

OBJECTIVE: School-based health centers (SBHCs) reduce access barriers to mental health care and improve educational outcomes for youths. This qualitative study evaluated the innovations and challenges of a unique network of SBHCs in a large, urban school district as the centers attempted to integrate health, mental health, and educational services. METHODS: The 43 participants sampled included mental health providers, primary care providers, and care coordinators at 14 SBHCs. Semistructured interviews with each participant were audio recorded and transcribed. Themes were identified and coded by using Atlas.ti 5.1 and collapsed into three domains: operations, partnership, and engagement. RESULTS: Interviews revealed provider models ranging from single agencies offering both primary care and mental health services to colocated services. Sites where the health agency provided at least some mental health services reported more mental health screenings. Many sites used SBHC wellness coordinators and coordination team meetings to facilitate relationships between schools and health agency and community mental health clinic providers. Partnership challenges included confidentiality policies and staff turnover. Participants also highlighted student and parent engagement through culturally sensitive services, peer health advocates, and "drop-in" lunches. CONCLUSIONS: Staffing and operational models are critical in the success of integrating primary care, mental health care, and education. Among the provider models observed, the combined primary care and mental health provider model offered the most integrated services. Despite barriers, providers and schools have begun to implement novel solutions to operational problems and family engagement in mental health services.

Cerebral Metabolic Differences Associated with Cognitive Impairment in Parkinson's Disease.

PURPOSE: To characterize cerebral glucose metabolism associated with different cognitive states in Parkinson's disease (PD) using 18F-fluorodeoxyglucose (FDG) and Positron Emission Tomography (PET). METHODS: Three groups of patients were recruited in this study including PD patients with dementia (PDD; n = 10), with mild cognitive impairment (PD-MCI; n = 20), and with no cognitive impairment (PD-NC; n = 30). The groups were matched for age, sex, education, disease duration, motor disability, levodopa equivalent dose and Geriatric Depression Rating Scale (GDS) score. All subjects underwent a FDG-PET study. Maps of regional metabolism in the three groups were compared using statistical parametric mapping (SPM5). RESULTS: PD-MCI patients exhibited limited areas of hypometabolism in the frontal, temporal and parahippocampal gyrus compared with the PD-NC patients (p < 0.01). PDD patients had bilateral areas of hypometabolism in the frontal and posterior parietal-occipital lobes compared with PD-MCI patients (p < 0.01), and exhibited greater metabolic reductions in comparison with PD-NC patients (p < 0.01). CONCLUSIONS: Compared with PD-NC patients, hypometabolism was much higher in the PDD patients than in PD-MCI patients, mainly in the posterior cortical areas. The result might suggest an association between posterior cortical hypometabolism and more severe cognitive impairment. PD-MCI might be important for early targeted therapeutic intervention and disease modification.

Adolescents' stigma attitudes toward internalizing and externalizing disorders: Cultural influences and implications for distress manifestations.

OBJECTIVE: This study examined predictors of stigma attitudes toward common youth emotional behavioral problems to test the hypothesis that interdependent cultural values would be associated with differential stigma towards externalizing versus internalizing disorders. Furthermore, we examined whether problem-specific stigma attitudes would predict adolescent's own self-reported manifestations of distress. METHOD: 1224 Vietnamese American and European American adolescents completed measures of social distance stigma attitudes in response to vignettes depicting youth with internalizing (depression, social anxiety, somatization) and externalizing (alcohol use, aggressive behaviors, delinquency) disorders. A subset of 676 youth also provided self-reports on their own adjustment prospectively over six months. RESULTS: Measurement models revealed clear separation of negatively correlated factors assessing stigma toward externalizing versus internalizing problems. Values related to family interdependence were significantly associated with greater tolerance of internalizing disorders and lower tolerance of externalizing disorders. Stigma towards internalizing disorders was associated with lower concurrent self-reported internalizing symptoms, whereas stigma towards externalizing symptoms was associated with lower concurrent externalizing symptoms and greater decreases in externalizing symptoms over time. CONCLUSIONS: The results of the study suggest that stigma attitudes are differentiated by problem type and may represent one cultural factor shaping distress manifestations.

Inhibition of Rho-kinase by Fasudil protects dopamine neurons and attenuates inflammatory response in an intranasal lipopolysaccharide-mediated Parkinson's model.

Microglia activation and inflammatory factors in brain microenvironment are associated with degeneration of neurons in the substantia nigra (SN) of Parkinson's disease (PD) patients and various PD models. There is increasing evidence that the Rho/ROCK (Rho kinase) signalling pathway may play a critical role in the inflammatory response, and ROCK inhibitor has been reported to have neuroprotective effects. In this study, we examined the neuroprotective potential and possible mechanism of ROCK inhibitor Fasudil in an intranasal lipopolysaccharide (LPS)-induced PD model. ROCK was activated with LPS stimulation and inhibited by Fasudil treatment in this PD model. Behavioural tests demonstrated a clear improvement in motor performance after Fasudil treatment. Furthermore, Fasudil resulted in a significant attenuation of dopamine cell loss, α-synuclein accumulation and inflammatory response with the reversion of inflammatory M1 to anti-inflammatory M2 microglia, decreased NF-кB activation, and IL-12 and TNF-α generation in the SN and olfactory bulb in this model. This study establishes a role for Fasudil in protecting against LPS-mediated dopamine degeneration and provides a therapeutic strategy for the treatment of PD.

Linkages between mental health need and help-seeking behavior among adolescents: Moderating role of ethnicity and cultural values.

Risk of developing emotional and behavioral mental health problems increases markedly during adolescence. Despite this increasing need, most adolescents, particularly ethnic minority youth, do not seek professional help. Informed by conceptual models of health behavior, the current study examined how cultural values are related to help seeking among adolescents from 2 distinct racial/ethnic groups. Using a prospective survey design, 169 Vietnamese American and European American youth in 10th and 11th grade reported on their mental health need, as measured by emotional/behavioral mental health symptoms and stressful life events, with participants reporting on their help-seeking behavior at 6-month follow-up assessments. Multinomial logistic regression analyses indicated that mental health need interacted with cultural values and ethnicity to predict help-seeking behavior. Specifically, associations between symptoms and stressful life events, and help-seeking behavior were smaller among Vietnamese American adolescents, and among adolescents with strong family obligation values. These results underscore the complex sociocultural factors influencing adolescents' help-seeking behavior, which have important implications for engaging youth in needed mental health care.

Effects of electroacupuncture therapy for Bell's palsy from acute stage: study protocol for a randomized controlled trial.

BACKGROUND: Although many patients with facial paralysis have obtained benefits or completely recovered after acupuncture or electroacupuncture therapy, it is still difficult to list intuitive evidence besides evaluation using neurological function scales and a few electrophysiologic data. Hence, the aim of this study is to use more intuitive and reliable detection techniques such as facial nerve magnetic resonance imaging (MRI), nerve electromyography, and F waves to observe changes in the anatomic morphology of facial nerves and nerve conduction before and after applying acupuncture or electroacupuncture, and to verify their effectiveness by combining neurological function scales. METHODS/DESIGN: A total of 132 patients with Bell's palsy (grades III and IV in the House-Brackmann [HB] Facial Nerve Grading System) will be randomly divided into electroacupuncture, manual acupuncture, non-acupuncture, and medicine control groups. All the patients will be given electroacupuncture treatment after the acute period, except for patients in the medicine control group. The acupuncture or electroacupuncture treatments will be performed every 2 days until the patients recover or withdraw from the study. The primary outcome is analysis based on facial nerve functional scales (HB scale and Sunnybrook facial grading system), and the secondary outcome is analysis based on MRI, nerve electromyography and F-wave detection. All the patients will undergo MRI within 3 days after Bell's palsy onset for observation of the signal intensity and facial nerve swelling of the unaffected and affected sides. They will also undergo facial nerve electromyography and F-wave detection within 1 week after onset of Bell's palsy. Nerve function will be evaluated using the HB scale and Sunnybrook facial grading system at each hospital visit for treatment until the end of the study. The MRI, nerve electromyography, and F-wave detection will be performed again at 1 month after the onset of Bell's palsy. TRIAL REGISTRATION: Chinese Clinical Trials Register identifier: ChiCTR-IPR-14005730. Registered on 23 December 2014.

Building the gateway to success: an appraisal of progress in reaching underserved families and reducing racial disparities in school-based mental health.

School-based mental health (SBMH) services hold the promise of reducing barriers to care among underserved children and families in need, which can in turn reduce racial disparities in care. Yet, questions remain about the potential of SBMH for equitably reaching diverse communities. In particular, reaching Asian American youth in SBMH may remain a challenge even compared with other immigrant and ethnic minority groups, such as Latinos. This article describes the development and evaluates the service capacity of a SBMH platform in a medium-sized public school district serving predominantly low-income Latino and Asian American families. Service capacity was built through the creation and coordination of a system of community partnerships. Analyses of needs assessment and service referral and utilization patterns revealed no significant racial/ethnic differences in overall rates of mental health need between Latino and Asian American students; yet, Asian Americans were underrepresented in referrals to SBMH. However, once referred to care, there was no difference in the likelihood that Asian American and Latino students received treatment. Although there was an increase in capacity to link students to care, work remains to improve processes of identification to reduce unmet need across diverse groups.