Bidirectional motivated bimodal isothermal strand displacement amplifier with a table tennis-like movement for the ultrasensitive fluorescent and colorimetric detection of depression-related microRNA.

An increasing number of studies have highlighted the potential of microRNAs (miRNAs) as physiological indicators of major depressive disorder (MDD). Herein, we developed a bidirectional-motivated bimodal isothermal strand displacement amplifier (BB-ISDA) for the ultrasensitive fluorescent and colorimetric detection of MDD-related miRNA-132. In the BB-ISDA system, a pair of functionalized hairpin probes (HP1 and HP2) with nicking recognition sites are designed to recognize target miRNA. The recognition of target miRNA by HP1 (or HP2) generates copious numbers of nicked triggers by HP1 (or HP2)-based ISDA to recognize HP2 (or HP1) by autonomous strand polymerization, cleavage, and displacement, which in turn induces the subsequent generation of copious numbers of nicked G-quadruplex triggers by HP2 (or HP1)-based ISDA to recognize HP1 (or HP2) along a same line. After many cycles, this bidirectional motivated table-tennis-like movement amplifies the fluorescent signal from HP1 and the colorimetric signal from HP2, simultaneously. The dual-signal output pattern was cross-validated for sensing miRNA-132. Each of the detection modal shows the capability for qualitative and quantitative detection of miRNA-132 with high sensitivity and specificity. The adaptability of the bimodal mechanism was verified via the detection of target miRNA-132 from clinical human blood samples. We envision that this BB-ISDA with dual-signal output for accurate and reliable analysis of miRNA is promising for the molecular diagnosis of human mental diseases.

Improved Safety of Hybrid Electroconvulsive Therapy Compared With Standard Electroconvulsive Therapy in Patients With Major Depressive Disorder: A Randomized, Double-Blind, Parallel-Group Pilot Trial.

Objectives: ECT is a rapid and effective treatment for depression. While efficacy is often remarkable over the initial 3-4 sessions, the efficacy of later sessions is less rapid, and the side-effects, especially cognitive impairment limit its use. To preliminarily compare the efficacy and acceptability of a novel hybrid-ECT (HECT) protocol for patients with major depressive disorder (MDD) with standard ECT, we conducted this pilot trial. Methods: Thirty patients were randomly assigned to ECT or HECT. Both arms received three ECT sessions (phase 1) but, in phase 2, the HECT arm received low-charge electrotherapy instead of ECT. The primary outcome was the change in 24-item Hamilton depression rating scale (HAMD-24) scores between baseline and the end of treatment. Cognitive function was assessed by repeatable battery for the assessment of neuropsychological status (RBANS), Stroop color word, and orientation recovery tests (ORT). Safety was measured by the drop-out rate and adverse events (AEs). Four visits were conducted at baseline, post-phase 1, post-phase 2, and at 1-month follow-up. Trial registration: Chinese Clinical Trial Registry (http://www.chictr.org.cn/), identifier: ChiCTR1900027701. Results: Patients in both arms showed significant within-group improvements in HAMD-24, but the between-group differences were non-significant. Participants in the HECT arm outperformed ECT patients for most cognitive tests at the end of treatment or at follow-up. There was a significantly lower AE rate and shorter ORT in phase 2 of the HECT ar. Conclusion: In this pilot trial, HECT was associated with fewer AEs and better cognitive function including executive and memory function, but its possible similar antidepressive efficacy needs to be further investigated in future.

Comparing performance of iterative and non-iterative algorithms on various feature schemes for arrhythmia analysis.

To evaluate the performance of the classic machine learning algorithms and the effectiveness of various features, the iterative algorithms (i.e., support vector machine (SVM), and least-squares SVM (LS-SVM)) and non-iterative algorithms (i.e., random forest (RF) and naive bayes (NB)) for six feature schemes were performed to classify the ECG recordings. The ECG recordings were initially filtered with a 0.1 Hz - 12 Hz band pass filter. Then 80 features, including 48 time domain, 18 frequency domain, 12 time-frequency and two principle component analysis (PCA) features, were extracted to construct six feature schemes. The RF, SVM, LS-SVM and NB were employed to discern a binary-classification task (i.e., normal and AF ECG recordings) and a tri- classification task (i.e., the normal, AF and ST change ECG recordings) for the six feature schemes. The results revealed that time domain, frequency domain features and PCA features can provide relatively reliable feature combinations to the RF and SVM. In addition, the RF yielded the highest F1-scores (0.8908 and 0.7535) for the binary-classification task and the tri-classification task than the SVM, LS-SVM and NB.

Automatic heartbeat classification using S-shaped reconstruction and a squeeze-and-excitation residual network.

To facilitate the identification of arrhythmia, in this study, an S-shaped reconstruction method was proposed, and a two-dimensional (2-D) 19-layer deep squeeze-and-excitation residual network (SE-ResNet) was used to classify heartbeats. The proposed method has three steps. The first step involves data preprocessing, which includes denoising of the original electrocardiogram (ECG) data, removing of baseline drift, heartbeat extraction, and data balancing using a synthetic minority oversampling technique algorithm. Subsequently, the extracted one-dimensional heartbeat series is transformed into a 2-D matrix by employing the novel S-shaped reconstruction method for determining the relationship between distant points in an ECG series. Finally, the 2-D 19-layer SE-ResNet is used to divide the 2-D heartbeat matrix into five heartbeat categories, namely normal, supraventricular ectopic, ventricular ectopic, fusion, and unknown beats, in accordance with the American National Standards Institute/Advancement of Medical Instrumentation standard, and 10-fold cross-validation is employed to train the 2-D 19-layer SE-ResNet. The accuracy, positive prediction rate, sensitivity, and specificity of the proposed method reached 99.61%, 93.87%, 93.78%, and 99.27%, respectively. The results indicated that the S-shaped reconstruction method can be helpful for acquiring additional information from ECG heartbeat data.

The application of plan, do, check, act (PDCA) quality management in reducing nosocomial infections in endoscopy rooms: It does work.

BACKGROUND: The role of plan, do, check, act (PDCA) cycle quality management in reducing nosocomial infections in endoscopy rooms remains unclear; we aimed to evaluate the effects of PDCA in the nosocomial infections control of endoscopy rooms. METHODS: This present study was a before and after design. The patients treated in our endoscopy room from 1 January 2019 to 31 December 2019 were included in the control group, which were managed according to current department practice. The patients from 1 January 2020 to 31 December 2020 were included in the PDCA group, which were managed according to PDCA cycle quality management including formulation of cleaning and disinfection process, establishment of an infection control team and improvement of inspection standards. The nosocomial infections of patients, the pass rate of medical staff's knowledge on the nosocomial infection and hand hygiene, the pass rate of disinfection of endoscope cavity and surface, the incidence of sharp injury and biological pollution were compared between two groups. RESULTS: A total of 1020 patients were included, with 512 patients in PDCA group and 508 patients in the control group. The incidence of nosocomial infections in PDCA group was significantly lower than that of control group (0.98% vs. 2.76%, P = .002). The pass rate of medical staff's knowledge on the nosocomial infection and hand hygiene was significantly higher than that of control group (all P < .05). The pass rate of disinfection of endoscope cavity in PDCA group was significantly higher than that of control group (P = .037). The incidence of sharp injury and biological pollution in PDCA group were significantly lower than that of control group (all P < .05). CONCLUSIONS: PDCA cycle management is beneficial to reduce the risk of nosocomial infection, enhance the awareness of infection control and reduce the risk of occupational exposure of medical staff in the endoscopy room.

Preliminary study of abnormalities in saccade dynamics in patients with hyperthyroidism with no pre-existing eye damage.

The present study investigated the relationship between hyperthyroidism and thyroid-associated ophthalmopathy by examining saccade dynamics to identify defects in eye tracking in patients with hyperthyroidism with no pre-existing eye damage and sensitive indicators that discriminated eye tracking ability in hyperthyroidism. A total of 33 outpatients with hyperthyroidism and 26 healthy controls participated in visually guided saccade (VGS) analysis. Patients with hyperthyroidism were divided into groups based on their medication status (medicated vs. unmedicated). Main sequence analysis was performed to identify differences in peak velocity and duration, and a general linear model (GLM) was used to identify differences in latency, peak acceleration and peak deceleration among the groups. The present study compared differences in the Spearman's correlation coefficient of the duration of saccades and the acceleration asymmetric index (RAD) among the groups. Vmax values (Vmax was the asymptotic value of the PV of saccades of large amplitude) were significantly different between the healthy control and unmedicated-hyperthyroidism groups. The results of the GLM-based analysis indicated no significant differences in saccade latency among the three groups. Peak acceleration was significantly different between the healthy control and unmedicated-hyperthyroidism groups (P<0.01). Peak deceleration was significantly different between the healthy control, unmedicated- and medicated-hyperthyroidism groups (P<0.01). RAD was significantly different between the healthy control and medicated-hyperthyroidism groups (P=0.004). The results of the present study suggested that patients with hyperthyroidism with no pre-existing eye damage exhibited significantly altered saccade dynamics during VGS. Therefore, RAD may be used as an indicator to monitor the level of eye movement coordination.

Low-Charge Electrotherapy in Geriatric Major Depressive Disorder Patients: A Case Series.

To examine the feasibility of low-charge electrotherapy (LCE) in treating geriatric major depressive disorder (MDD) patients. Bi-temporal LCEs (approximately 25 mC) were performed with an electroconvulsive therapy (ECT) instrument three times per week. We used the Hamilton Depression Scale 17 (HAMD-17) and the Hamilton Anxiety Scale (HAMA) to assess the effects of LCE and the Mini-Mental State Examination (MMSE) to evaluate the cognitive function change before and after LCE. Six visits occurred at the baseline, after LCE sessions 3, 6, and 9, after the last session, and at the end of the one-month follow-up period. Four patients were enrolled in the study. Two patients completed all LCE sessions. Two patients withdrew during the trial, one due to the adverse event of uroschesis potentially caused by atropine and the other due to her own will. All four patients completed the follow-up sessions. The HAMD-17 and HAMA scores were reduced significantly at the last LCE session and the end of the follow-up period compared with the scores at the baseline. As measured by the MMSE, cognitive impairment showed no significant changes at the last LCE session and the end of the follow-up period compared with that at the baseline. In this case series, LCE showed potential as an alternative current-based treatment for treating geriatric MDD patients. Further research is needed to assess the efficiency and safety of LCE.

Low-charge electrotherapy for patients with schizophrenia: A double-blind, randomised controlled pilot clinical trial.

A double-blind, randomised controlled pilot clinical trial was conducted to assess the potential effectiveness and safety of low-charge electrotherapy (LCE) for patients with schizophrenia. Bitemporal LCE (approximately 2.8 Joules) was administered three times a week. The Positive and Negative Syndrome Scale score was set as the outcome measure. Any adverse event (AE) was recorded. Three visits occurred at baseline, post-treatment, and after one month of follow-up. Twelve patients were randomised to the electroconvulsive therapy (ECT) group or LCE group (6 patients in each group). No patient withdrew during the study. The LCE group did not experience seizures during the trial. Patients in both groups showed significant improvements in clinical measures after treatment, and the reduction of all scale scores between the two groups was nonsignificant. The LCE group experienced significantly fewer AEs than the ECT group. Compared with ECT, LCE exerts similar antipsychotic effects while causing fewer AEs. Thus, LCE has the potential to be a safe and effective treatment for patients with schizophrenia, but further research is needed.

Electroconvulsive therapy changes the regional resting state function measured by regional homogeneity (ReHo) and amplitude of low frequency fluctuations (ALFF) in elderly major depressive disorder patients: An exploratory study.

Electroconvulsive therapy (ECT) is the most effective and rapid treatment for severe major depressive disorder (MDD) in elderly patients. The mechanism of ECT is unclear, and studies on ECT in elderly MDD patients by resting-state functional magnetic resonance imaging are rare. Thirteen elderly MDD patients were scanned before and after ECT using a 3.0T MRI scanner. Regional homogeneity (ReHo) and amplitude of low-frequency fluctuations (ALFF) were processed to compare resting-state function before and after treatment. Depression and anxiety symptoms of all patients abated after ECT. Decreased ReHo values in the bilateral superior frontal gyrus (SFG) were observed after ECT, and the values of right SFG significantly correlated with an altered Hamilton depression rating scale score. Increased ALFF values in the left middle frontal gyrus, right middle frontal gyrus, orbital part, and decreased ALFF values in the left midcingulate area, left precentral gyrus, right SFG/middle frontal gyrus after ECT were also observed. These results support the hypothesis that ECT may affect the regional resting state brain function in geriatric MDD patients.

Soluble B7-H2 as a novel marker in early evaluation of the severity of acute pancreatitis.

The clinical usefulness of soluble B7-H2 (sB7-H2) as an early indicator of acute pancreatitis (AP) remains unclear, so we performed the present study to investigate this issue. For our cohort, we recruited 75 patients with AP, 70 patients with other abdominal sepsis, and 20 healthy control individuals. The sB7-H2 levels of AP patients or healthy control individuals were measured by enzyme-linked immunosorbent assay (ELISA). The sB7-H2 levels in patients with AP rather than other patients with abdominal sepsis were significantly higher than those in healthy controls. Hence, we selected AP to study the clinical significance of sB7-H2 in inflammatory conditions. The sB7-H2 level was positively correlated with the white blood cell (WBC) count and the lactate dehydrogenase (LDH), high-sensitivity C-reactive protein (hs-CRP), and lipopolysaccharide LPS levels (P <.05 for each). Receiver operating characteristic (ROC) analysis revealed that sB7-H2 can distinguish moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP) from mildly acute pancreatitis (MAP) with 77.8% sensitivity and 80.0% specificity; and that the levels of sB7-H2 also can distinguish SAP from MSAP and MAP with 92.0% sensitivity and 86.0% specificity. The present results indicate that sB7-H2 might be a useful marker in the clinical diagnosis of AP.

Mindfulness-based stress reduction for chronic insomnia in adults older than 75 years: a randomized, controlled, single-blind clinical trial.

OBJECTIVE: To assess the effectiveness of mindfulness-based stress reduction (MBSR) for chronic insomnia and combined depressive or anxiety symptoms of older adults aged 75 years and over. DESIGN: A randomized, controlled, single-blind clinical trial. PATIENTS AND METHODS: Participants included 60 adults aged 75 years and over with chronic insomnia. Participants were randomly assigned to the eight-week MBSR group or the wait-list control group. Assessments using the Pittsburgh Sleep Quality Index (PSQI), Self-rating Anxiety Sale (SAS), and Geriatric Depression Scale (GDS) were taken at baseline and post-treatment. For each outcome measure, a repeated measures analysis of variance was used to detect changes across assessments. RESULTS: There was a significant time × group interaction for the PSQI global score (P = .006); the MBSR group had a decrease in the PSQI global score (Cohen׳s d = 1.12), while the control group did not (Cohen׳s d = -0.06). Among the PSQI components, there was a significant time × group interaction for daytime dysfunction (P = .048); Cohen׳s d of the MBSR group was 0.76, while Cohen׳s d of control group was -0.04. There was no significant time × group interaction for the SAS score (P = .116), while for the GDS there was a significant time × group interaction (P = .039); the Cohen׳s d value for the MBSR group was 1.20, and it was 0.12 for the control group. CONCLUSION: This study demonstrated that the MBSR program could be a beneficial treatment for chronic insomnia in adults aged 75 years and older.

Teratogenicity of Staphylococcus aureus L-forms using a mouse whole-embryo culture model.

Our previous studies have suggested that Staphylococcus aureus L-forms are able to pass through the placental barrier of mice from the maternal side to the fetal body and affect fetal growth and development, but little is known about the direct influence of S. aureus L-forms on embryos during the critical period of organogenesis. Mouse embryos at gestational day 8.5 were cultured in vitro for 48 h with 0, 50, 100, 200 or 400 c.f.u. S. aureus L-forms ml(-1). At the end of the culture period, the mouse embryos were assessed morphologically for viability, growth and development. Bacteriological and immunohistochemical staining were used to determine the existence of S. aureus L-forms in embryonic tissues. We found that both crown-rump length and head length of mouse embryos exposed to S. aureus L-forms at a concentration of 50 c.f.u. ml(-1) were reduced. When the mouse embryos were exposed to 100, 200 or 400 c.f.u. S. aureus L-forms ml(-1), the total morphological score, number of somites, dry embryo weight, yolk sac diameter, crown-rump length and head length were significantly lower than those of the control group. With the increased concentration of S. aureus L-forms in the culture medium, there were fewer normally developed embryos and more embryos with abnormalities or retardation in growth. S. aureus L-forms detected by Gram-staining and immunohistochemical detection of antigen were found in the tissues of embryos infected by S. aureus L-forms. These data suggest that S. aureus L-forms exert a direct teratogenic effect on cultured mouse embryos in vitro.

[Effect of maternal staphylococcal enterotoxin B administration during pregnancy on CD3⁺ TCR Vß8⁺T cells of adult offspring rats].

OBJECTIVE: To investigate the influence of maternal staphylococcal enterotoxin B (SEB) administration during pregnancy on CD3⁺ TCR Vß8⁺T cells of adult offspring rats. METHODS: Pregnant maternal rats at gestational day (GD) 16 were injected intravenously with 15 µg SEB in 0.2 ml PBS (SEB group), and the control rats receive the same volume of PBS. Flow cytometry was used to determine the levels of CD3⁺ TCR Vß8⁺T cells in both the thymus and peripheral blood of adult offspring rats and the response of these cells to a secondary SEB administration. RESULTS: Maternal SEB administration during pregnancy significantly decreased the percentages of CD3⁺TCR Vß8⁺T cells in the thymus in adult female (1.760-2.714) and male (1.098-2.088) offspring rats (P<0.05). The change of CD3⁺TCR Vß8⁺T cells in the peripheral blood was similar to that in the thymus. In the control adult offspring rats, SEB administration at adulthood significantly reduced the percentages of CD3⁺TCR Vß8⁺T cells in both the thymus and peripheral blood (P<0.05). But in SEB group, a secondary SEB administration in adult offspring rats significantly increased the percentage of CD3⁺TCR Vß8⁺T cells in the peripheral blood (P<0.05) but not in the thymus (P>0.05). CONCLUSION: Maternal SEB administration during pregnancy can change the response of CD3⁺ TCR Vß8⁺T cells of adult offspring rats to a secondary SEB administration.

An autoradiographic study on the pathogenesis of levodopa-induced dyskinesia: regulation of dopamine transporter by levodopa in a rat model of Parkinson's disease.

BACKGROUND: The development of abnormal involuntary movements or dyskinesia is a serious complication of L-3,4-dihydroxyphenylalanine (L-DOPA) therapy for Parkinson's disease (PD). OBJECTIVE: To evaluate the correlation between dopamine transporter (DAT) regulated by L-DOPA and the pathogenesis of dyskinesia in PD rats. METHODS: Thirty rats were used to establish the PD model by injecting 6-hydroxydopamine into the right medial forebrain bundle. The sham surgery rats (n = 4) received 4 µl of physiological saline. Then, 19 rats in which PD has been successfully induced were randomly assigned to the L-DOPA (20 mg/kg/day; n = 15) or model (saline; n = 4) group. After 4 weeks of treatment, (131)I-N-(3-fluoropropyl)-2ß-carbomethoxy-3 ß-(4-iodophenyl)nortropane was injected into the rats, and images of DAT in the brain were acquired using a storage phosphor plate. The levels of DAT-specific radioactivity uptake in the bilateral corpora striata (left/right) were compared. RESULTS: There was no difference in DAT-specific radioactivity uptake between the bilateral corpora striata in the sham surgery rats. The images were clear and symmetrically distributed in the corpora striata. In PD model rats, the DAT-specific radioactivity uptake decreased on the lesioned side and the ratios of uptake between the corpora striata were increased. Accumulation of the radioligand on the lesioned side was sparse. In the L-DOPA group, the average ratio values were significantly increased in dyskinetic rats and reduced in nondyskinetic rats. In addition, the differences between the bilateral corpora striata were reduced in nondyskinetic rats. CONCLUSION: L-DOPA was shown to downregulate DAT in some PD model rats. That process may be involved in the pathogenesis of dyskinesia.