Psychological interventions for depression in adolescent and adult congenital heart disease.

BACKGROUND: Despite improvements in medical care, the quality of life of adults and adolescents with congenital heart disease remains strongly affected by their condition, often leading to depression. Psychotherapy, cognitive behavioural therapy, and other talking therapies may be effective in treating depression in both adults and young adults with congenital heart disease. The aim of this review was to assess the effects of treatments, such as psychotherapy, cognitive behavioural therapies, and talking therapies for treating depression in this population. OBJECTIVES: To evaluate the effects (both harms and benefits) of psychological interventions for reducing symptoms of depression in adolescents (aged 10 to 17 years) and adults with congenital heart disease. Psychological interventions include cognitive behavioural therapy, psychotherapy, or 'talking/counselling' therapy for depression. SEARCH METHODS: We updated searches from the 2013 Cochrane Review by searching CENTRAL, four other databases, and Conference Proceedings Citation Index to 7 March 2023, and two clinical trial registers to February 2021. We applied no language restrictions. SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing psychological interventions to no intervention in the congenital heart disease population, aged 10 years and older, with depression. DATA COLLECTION AND ANALYSIS: Two review authors independently screened titles and abstracts, and independently assessed full-text reports for inclusion. Further information was sought from the authors if needed. Data were extracted in duplicate. We used standard Cochrane methods. Our primary outcome was a change in depression. Our secondary outcomes were: acceptability of treatment, quality of life, hospital re-admission, non-fatal cardiovascular events, cardiovascular behavioural risk factor, health economics, cardiovascular mortality, all-cause mortality. We used GRADE to assess the certainty of evidence for our primary outcome only. MAIN RESULTS: We identified three new RCTs (480 participants). Participants were adults with congenital heart disease. Included studies varied in intervention length (90 minutes to 3 months) and follow-up (3 to 12 months), with depression assessed post-intervention and at follow-up. Risk of bias assessment identified an overall low risk of bias for the main outcome of depression. Psychological interventions (talking/counselling therapy) may reduce depression more than usual care at both three-month (mean difference (MD) -1.07, 95% confidence interval (CI) -1.84 to -0.30; P = 0.006; I2 = 0%; 2 RCTs, 156 participants; low-certainty evidence), and 12-month follow-up (MD -1.02, 95% CI -1.92 to -0.13; P = 0.02; I2 = 0%; 2 RCTs, 287 participants; low-certainty evidence). There was insufficient evidence to draw conclusions about the impact of psychological interventions on quality of life. None of the included studies reported on our other outcomes of interest. Due to the low number of studies included, we did not undertake any subgroup analyses. One study awaits classification. AUTHORS' CONCLUSIONS: Psychological interventions may reduce depression in adults with congenital heart disease compared to usual care. However, the certainty of the evidence is low. Further research is needed to establish the role of psychological interventions in this population, defining the optimal duration, method of administration, and number of sessions required to obtain the greatest benefit.

Investigating the Effectiveness of Novel Support Vector Neural Network for Anomaly Detection in Digital Forensics Data.

As criminal activity increasingly relies on digital devices, the field of digital forensics plays a vital role in identifying and investigating criminals. In this paper, we addressed the problem of anomaly detection in digital forensics data. Our objective was to propose an effective approach for identifying suspicious patterns and activities that could indicate criminal behavior. To achieve this, we introduce a novel method called the Novel Support Vector Neural Network (NSVNN). We evaluated the performance of the NSVNN by conducting experiments on a real-world dataset of digital forensics data. The dataset consisted of various features related to network activity, system logs, and file metadata. Through our experiments, we compared the NSVNN with several existing anomaly detection algorithms, including Support Vector Machines (SVM) and neural networks. We measured and analyzed the performance of each algorithm in terms of the accuracy, precision, recall, and F1-score. Furthermore, we provide insights into the specific features that contribute significantly to the detection of anomalies. Our results demonstrated that the NSVNN method outperformed the existing algorithms in terms of anomaly detection accuracy. We also highlight the interpretability of the NSVNN model by analyzing the feature importance and providing insights into the decision-making process. Overall, our research contributes to the field of digital forensics by proposing a novel approach, the NSVNN, for anomaly detection. We emphasize the importance of both performance evaluation and model interpretability in this context, providing practical insights for identifying criminal behavior in digital forensics investigations.

The use of a non-medicated dressing for superficial-partial thickness burns in children: a case series and review.

BACKGROUND: Cutimed® Sorbact® is a dressing marketed as having antimicrobial properties and easy application without the threat of antibiotic resistance and difficult accessibility. There is little evidence on the clinical outcomes of the use of Cutimed® Sorbact® in adults and currently no evidence of use of Cutimed® Sorbact® on superficial-partial thickness burn injuries in children. OBJECTIVE: To summarise the clinical outcome of burn wounds in children with superficial-partial thickness burns in which Cutimed® Sorbact® was used. METHOD: An observational case series was conducted in Edendale Hospital, Pietermaritzburg, South Africa over the course of four weeks. Patients where included if they were aged < 10 years and had a ⩽ 15% superficial-partial burn. The primary outcome measure was time to 95% re-epithelialisation. Secondary outcome measures included wound complications, adverse healing and number of dressing changes. RESULTS: Ten patients (five girls, five boys; age range = 11 months-8 years) were included in this case series. All participants had a type VI Fitzpatrick skin type and 80% of burns were hot water burns. Of all patients treated with Cutimed® Sorbact®, 50% healed within seven days, 70% within 14 days and 100% within 21 days. There was only one wound complication noted in this study and there was no adverse healing in any burn wounds. The mean number of dressing changes was 1.4 (range = 1-2) and length of hospital stay was in the range of 0-11 days (mean = 5.1 days). CONCLUSION: Cutimed® Sorbact® is a safe, useful and cost-effective dressing that should be used as an alternative for superficial-partial burns in children.