Symptom clusters and network analysis of patients with intermediate and advanced liver cancer treated with targeted immunotherapy.

BACKGROUND: This study aims to identify symptom clusters in patients with intermediate and advanced liver cancer receiving targeted immunotherapy, focusing on core and bridge symptoms to establish a foundation for precise symptom management. METHODS: This study used a cross-sectional survey and utilized convenience sampling from May 2023 to January 2024 at a third-class hospital in Shanghai, China. The severity of symptoms in liver cancer patients during treatment was evaluated using the Memorial Symptom Assessment Scale. Network analysis was employed to depict the interrelation of symptom clusters and identify core and bridge symptoms. RESULTS: The symptoms were classified by severity into five clusters: oral, gastrointestinal, fatigue-related, body image, and pain-sleep. Within the symptom network, the core symptoms were pain, "I don't look like myself," and nausea, while the critical bridge symptoms included pain, itching, and feeling bloated. The strongest connections were observed between nausea and vomiting, followed by taste changes and dry mouth, as well as weight loss and "I don't look like myself." CONCLUSION: In patients receiving targeted immunotherapy for intermediate and advanced liver cancer, multiple symptoms can emerge simultaneously, forming interconnected clusters. By identifying and intervening in core and bridge symptoms, personalized management strategies can be developed to relieve other symptoms and disrupt connections between symptom clusters, thereby enhancing symptom management efficacy. This study has significant clinical and research implications, offering new insights to improve patients' quality of life and treatment outcomes.

Pre-hospital symptom clusters and symptom network analysis in decompensated cirrhotic patients: A cross-sectional study.

AIMS: To generate pre-hospital symptom networks, explore core, bridge and sentinel symptoms, identify pre-hospital symptom clusters and analyse relationship between influencing factors and symptom clusters in decompensated cirrhosis patients. DESIGN: A cross-sectional study design using the Strengthening the Reporting of Observational Studies in Epidemiology checklist. METHODS: Demographical, physiological, psychological and sociological characteristics and the pre-hospital symptoms of 292 decompensated cirrhotic patients were collected from October 2021 to March 2023 in China. Frequencies, percentages, means, standard deviations, independent samples t-tests, one-way analysis of variance, exploratory factor analysis, multiple stepwise regression analysis and network analysis were used for data analysis. RESULTS: 'I don't look like myself' and itching were core and bridge symptoms, while bloating and lack of energy were sentinel symptoms in decompensated cirrhotic patients. Monthly family income, anxiety, depression, social support and disease duration influenced the neuropsychological symptom cluster, with worrying as the strongest predictor symptom. Influential factors for cirrhosis-specific symptom cluster included Child-Pugh class, monthly family income, disease duration, anxiety and depression, with itching being the strongest predictor symptom. Monthly family income, disease duration and depression were influential factors for gastrointestinal symptom cluster, with loss of appetite as the strongest predictor symptom. CONCLUSIONS: Neuropsychological, cirrhosis-specific and gastrointestinal symptom clusters were formed in decompensated cirrhotic patients. Through network analysis, direct connections between symptoms, symptom clusters and their influencing factors were revealed, thereby offering clinicians a foundation for effectively managing patients' pre-hospital symptoms. IMPACT: Decompensated cirrhosis patients commonly have multiple symptoms, while the management of pre-hospital symptoms is often suboptimal. This study identified neuropsychological, cirrhosis-specific, gastrointestinal symptom clusters and recognized core, bridge and sentinel symptoms in these patients. It also revealed the most prominent symptoms within each cluster. This provides insight into the hierarchy of symptoms, improving symptom management in decompensated cirrhosis. PATIENT AND PUBLIC INVOLVEMENT: There was no patient or public involvement.

The core symptom in multiple myeloma patients undergoing chemotherapy: a network analysis.

BACKGROUND: During chemotherapy for multiple myeloma, symptoms include those related to the disease, as well as adverse effects of the treatment. Few studies have explored the relationships between these symptoms. Network analysis could identify the core symptom in the symptom network. OBJECTIVE: The aim of this study was to explore the core symptom in multiple myeloma patients undergoing chemotherapy. METHODS: This was a cross-sectional study in which sequential sampling was used to recruit 177 participants from Hunan, China. Demographic and clinical characteristics were surveyed using a self-developed instrument. The symptoms of chemotherapy-treated multiple myeloma, including pain, fatigue, worry, nausea, and vomiting, were measured using a questionnaire with good reliability and validity. The mean ± SD, frequency, and percentages were used as descriptive statistics. Network analysis was used to estimate the correlation between symptoms. RESULTS: The results showed that 70% of multiple myeloma patients using chemotherapy exhibited pain. In the network analysis, worrying was the dominant symptom, and the strongest relationship was between nausea and vomiting in chemotherapy-treated multiple myeloma patients' symptoms. CONCLUSION: Worrying is the core symptom of multiple myeloma patients. Interventions could be most effective if there is a symptom management focus on worrying when providing care to chemotherapy-treated multiple myeloma patients. Nausea combined with vomiting could be better managed, which would decrease the cost of health care. Understanding the relationship between the symptoms of multiple myeloma patients undergoing chemotherapy is beneficial for precise symptom management. IMPLICATIONS FOR PRACTICE: Nurses and health care teams should be a priority to intervene in the worrying for chemotherapy-treated multiple myeloma patients to maximize the effectiveness of an intervention. Except, nausea and vomiting should be managed together in a clinical setting.

An Overview of Pharmacotherapy in the Management of Children with Autism Spectrum Disorder at a Public Hospital in KwaZulu-Natal.

This study presents an overview of prescribing patterns and provides insight into the current management practice for the core symptoms and comorbidities of ASD in children. A quantitative retrospective study was conducted at a public hospital in KwaZulu-Natal, South Africa by reviewing patient files of children diagnosed with ASD and meeting the inclusion criteria for the study. A descriptive analysis of data was done to identify treatment trends and patient therapeutic outcomes. A total of 181 children met the inclusion criteria of the study. Risperidone was the most frequently prescribed drug (88%) for the management of comorbidities and/or core symptoms of ASD. Drugs prescribed to manage ASD comorbidities included methylphenidate, melatonin, sodium valproate, risperidone, oxybutynin, carbamazepine, and others. Except for risperidone, there were no additional drugs that targeted the core symptoms of ASD. Non-pharmacological therapies were often used collaboratively with medication to manage ASD symptoms. In 41% of patients, there were improvements in their symptoms.

Core Symptom Index (CSI): testing for bifactor model and differential item functioning.

OBJECTIVES: The Core Symptom Index (CSI) is designed to measure anxiety, depression and somatization symptoms. This study examined the construct validity of CSI using confirmatory factor analysis (CFA) including a bifactor model and explored differential item functioning (DIF) of the CSI. The criterion and concurrent validity were evaluated. METHODS: In all, 803 elderly patients, average age 69.24 years, 70% female, were assessed for depressive disorders and completed the CSI and the geriatric depression scale (GDS). A series involving CFA for ordinal scale was applied. Factor loadings and explained common variance were analyzed for general and specific factors; and Omega was calculated for model-based reliability. DIF was analyzed using the Multiple-Indicator Multiple-Cause model. Pearson's correlation, ANOVA, and ROC analysis were used for associations and to compare CSI and GDS in predicting major depressive disorders (MDD). RESULTS: The bifactor model provided the best fit to the data. Most items loaded on general rather than specific factors. The explained common variance was acceptable, while Omega hierarchical for the subscale and explained common variance for the subscales were low. Two DIF items were identified; 'crying' for sex items and 'self-blaming' for education items. Correlation among CSI and clinical disorders and the GDS were found. AUC for the GDS was 0.83, and for the CSI was 0.81. CONCLUSION: CSI appears sufficiently unidimensional. Its total score reflected a single general factor, permitting users to interpret the total score as a sufficient reliable measure of the general factors. CSI could serve as a screening tool for MDD.

Core and bridge symptoms of demoralization in Chinese female cancer patients: a network analysis.

Objective: In this study, we explore the core and bridge symptoms of demoralization in female cancer patients in China, and provide a basis for precise psychological intervention among female cancer patients. Methods: This study used a cross-sectional survey. Participants were recruited from three third-class hospitals in Jiangsu Province from June 2022 to June 2023 using the convenience sampling method. The severity of each symptom of demoralization was investigated in female cancer patients using the Demoralization Scale (DS). Network analysis was performed using the R language to identify core and bridge symptoms in the network and further explore some characteristic edge connections in the network. Results: The network structure model of demoralization had strong accuracy and stability. In the network, the symptoms with the highest strength centrality were "Discouragement" (C3, strength=2.19), "No self-worth" (A3, strength=1.21), "Don't want to live" (A5, strength=1.20), "Hopeless" (D4, strength=0.81), and "Vulnerability" (B3, strength=0.74), respectively. The bridge strength analysis identified "Hopeless" (D4, bridge strength=0.92), "Discouragement" (C3, bridge strength=0.85), "No self-worth" (A3, bridge strength=0.75), "Poor spirits" (E2, bridge strength=0.71), and "Vulnerability" (B3, bridge strength=0.69) as the bridge symptoms. The strongest edge connections of all dimensions were "No self-worth" and "Worthless" (A3-E6, edge weighting=0.27), "Poor spirits" and "Loss of emotional control" (E2-D1, edge weighting=0.22), "Discouragement" and "Vulnerability" (C3-B3, edge weighting=0.14), and "Hopeless" and "No meaning of survival" (D4-A4, edge weighting=0.12). Conclusion: "Discouragement (C3)", "No self-worth (A3)", "Hopeless (D4)", and "Vulnerability (B3)" are both core symptoms and bridge symptoms. These symptoms can not only trigger a patient's demoralization but also stimulate more severe symptom clusters through interactions. The early recognition of and intervention regarding these symptoms could be important for the prevention and treatment of demoralization among female cancer patients.

The weighed core symptom scale and prediction of ADHD in adults - objective measures of remission and response to treatment with methylphenidate.

OBJECTIVE: Two measures of the response rate and the optimal treatment response for adult ADHD were evaluated using methylphenidate. The hypotheses were that Prediction of ADHD (PADHD) defines remission, the Weighed Core Symptom (WCS) scale registers direct effects of medication and that WCS may indicate the optimal dose level during titration. DESIGN: PADHD and WCS were analyzed at baseline and after intake of low doses of either short-acting or modified-release formulations of methylphenidate, MPH (Study I), during titration with modified-release formulations of MPH (18/27, 36, 54, 72 mg) and at three months follow-up (Study II). PATIENTS: Study I consisted of 63 participants (32 females) and Study II consisted of 10 participants (6 females) diagnosed with ADHD and who was to start with treatment. OUTCOME MEASURES: Prediction of ADHD (PADHD) indicates the occurrence of ADHD (No, Yes) and the Weighed Core Symptom scale (WCS) quantifies ADHD from 0 to 100 (max-min). RESULTS: The number of clinical cases of ADHD decreased after methylphenidate treatment according to PADHD. WCS increased (p < 0.001) from 9.75 (SD = 12.27) to 47.50 (SD = 29.75) with about 10 mg of methylphenidate (N = 63). During titration, symptoms improved after 18/27 mg and 36 mg of methylphenidate and baseline-follow up comparisons showed WCS increments (p = 0.005) from 31.00 (N = 10, SD = 26.85) to 69.00 (N = 10, SD = 22.34). CONCLUSIONS: PADHD defined remission and WCS measured therapeutic effects of methylphenidate in adult ADHD.

Correlation and predictive ability of sensory characteristics and social interaction in children with autism spectrum disorder.

Background: Individuals with autism spectrum disorder (ASD) often have different social characteristics and particular sensory processing patterns, and these sensory behaviors may affect their social functioning. The objective of our study is to investigate the sensory profiles of children with ASD and their association with social behavior. Specifically, we aim to identify the predictive role of sensory processing in social functioning. Methods: The Short Sensory Profile (SSP) was utilized to analyze sensory differences between ASD children and their peers. The Social Responsiveness Scale (SRS) and other clinical scales were employed to assess the social functioning of children with ASD. Additionally, the predictive ability of sensory perception on social performance was discussed using random forest and support vector machine (SVM) models. Results: The SSP scores of ASD children were lower than those of the control group, and there was a significant negative correlation between SSP scores and clinical scale scores (P < 0.05). The random forest and SVM models, using all the features, showed higher sensitivity, while the random forest model with 7-feature factors had the highest specificity. The area under the receiver operating characteristic (ROC) curve (AUC) for all the models was higher than 0.8. Conclusion: Autistic children in our study have different patterns of sensory processing than their peers, which are significantly related to their patterns of social functioning. Sensory features can serve as a good predictor of social functioning in individuals with ASD.

Gray matter asymmetry atypical patterns in subgrouping minors with autism based on core symptoms.

Abnormal gray matter (GM) asymmetry has been verified in autism spectrum disorder (ASD), which is characterized by high heterogeneity. ASD is distinguished by three core symptom domains. Previous neuroimaging studies have offered support for divergent neural substrates of different core symptom domains in ASD. However, no previous study has explored GM asymmetry alterations underlying different core symptom domains. This study sought to clarify atypical GM asymmetry patterns underlying three core symptom domains in ASD with a large sample of 230 minors with ASD (ages 7-18 years) and 274 matched TD controls from the Autism Brain Imaging Data Exchange I (ABIDE I) repository. To this end, the scores of the revised autism diagnostic interview (ADI-R) subscales were normalized for grouping ASD into three core-symptom-defined subgroups: social interaction (SI), verbal communication (VA), and restricted repetitive behaviors (RRB). We investigated core-symptom-related GM asymmetry alterations in ASD resulting from advanced voxel-based morphometry (VBM) by general linear models. We also examined the relationship between GM asymmetry and age and between GM asymmetry and symptom severity assessed by the Autism Diagnostic Observation Schedule (ADOS). We found unique GM asymmetry alterations underlying three core-symptom-defined subgroups in ASD: more rightward asymmetry in the thalamus for SI, less rightward asymmetry in the superior temporal gyrus, anterior cingulate and caudate for VA, and less rightward asymmetry in the middle and inferior frontal gyrus for RRB. Furthermore, the asymmetry indexes in the thalamus were negatively associated with ADOS_SOCIAL scores in the general ASD group. We also showed significant correlations between GM asymmetry and age in ASD and TD individuals. Our results support the theory that each core symptom domain of ASD may have independent etiological and neurobiological underpinnings, which is essential for the interpretation of heterogeneity and the future diagnosis and treatment of ASD.

Do the core symptoms play key roles in the development of problematic smartphone use symptoms.

Aims: Previous research determined the core symptoms (loss of control and being caught in the loop) of problematic smartphone use (PSU), which are of great importance to understand the structure and potential intervention targets of PSU. However, the cross-sectional design fails to reveal causality between symptoms and usually conflates the between- and within-subjects effects of PSU symptoms. This study aims to determine whether the core symptoms of PSU, indeed, dominate the future development of PSU symptoms from longitudinal between- and within-subjects levels. Materials and methods: In this study, 2191 adolescents were surveyed for 3 years for PSU symptoms. A cross-lagged panel model (CLPM) was used to explore longitudinal between-subjects causal relationships between symptoms, and a graphic vector autoregressive model (GVAR) was used to separate the between- and within-subjects effects and detect the longitudinal effect at the within-subject level. Results: The results of CLPM indicated that the core symptoms (both loss of control and being caught in the loop) of PSU, indeed, dominate the future development of PSU symptoms at a longitudinal between-subjects level. From T1 to T2, the cross-lagged model showed that both the loss of control (out-prediction = 0.042) and being caught in the loop (out-prediction = 0.053) at T1 have the highest out-prediction over other symptoms at T2. From T2 to T3, the loss of control (out-prediction = 0.027) and being caught in the loop (out-prediction = 0.037) at T2 also have the highest out-prediction over other symptoms of PSU at T3. While, after separating the between- and within-subjects effects, only being caught in the loop at T1 played a key role in promoting the development of other PSU symptoms at T3 at the within-subjects level. The contemporaneous network showed intensive connection, while the cross-sectional between-subjects network is very sparse. Conclusion: These findings not only confirm and extend the key roles of core symptoms in the dynamic aspect of PSU symptoms and PSU itself but also suggest that interventions should consider the core symptoms of PSU, individual- and group-level effects and that individualized intervention programs are needed in future.

Cariprazine alleviates core behavioral deficits in the prenatal valproic acid exposure model of autism spectrum disorder.

RATIONALE: Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by deficits in social communication and interaction and restricted, repetitive behaviors. The unmet medical need in ASD is considerable since there is no approved pharmacotherapy for the treatment of these deficits in social communication, interaction, and behavior. Cariprazine, a dopamine D3-preferring D3/D2 receptor partial agonist, is already approved for the treatment of schizophrenia and bipolar I disorder in adults; investigation in patients with ASD is warranted. OBJECTIVES: The aim of this study was to investigate the effects of cariprazine, compared with risperidone and aripiprazole, in the rat prenatal valporic acid (VPA) exposure model on behavioral endpoints representing the core and associated symptoms of ASD. METHODS: To induce the ASD model, time-mated Wistar rat dams were treated with VPA during pregnancy. Male offspring were assigned to groups and studied in a behavioral test battery at different ages, employing social play, open field, social approach-avoidance, and social recognition memory tests. Animals were dosed orally, once a day for 8 days, with test compounds (cariprazine, risperidone, aripiprazole) or vehicle before behavioral assessment. RESULTS: Cariprazine showed dose-dependent efficacy on all behavioral endpoints. In the social play paradigm, only cariprazine was effective. On the remaining behavioral endpoints, including the reversal of hyperactivity, risperidone and aripiprazole displayed similar efficacy to cariprazine. CONCLUSIONS: In the present study, cariprazine effectively reversed core behavioral deficits and hyperactivity present in juvenile and young adult autistic-like rats. These findings indicate that cariprazine may be useful in the treatment of ASD symptoms.

A network analysis of problematic smartphone use symptoms in a student sample.

BACKGROUND AND AIMS: Previous research has established risk factors for problematic smartphone use (PSU), but few studies to date have explored the structure of PSU symptoms. This study capitalizes on network analysis to identify the core symptoms of PSU in a large sample of students. METHODS: This research investigated 26,950 grade 4 students (male = 13,271) and 11,687 grade 8 students (male = 5,739) using the smartphone addiction proneness scale (SAPS). The collected data were analyzed using a network analysis method, which can provide centrality indexes to determine the core symptoms of PSU. The two networks from the different groups were compared using a permutation test. RESULTS: The results indicated that the core symptoms of students' problematic smartphone use were the loss of control and continued excessive use across the two samples. DISCUSSION AND CONCLUSIONS: These findings suggest that loss of control is a key feature of problematic smartphone use. The results also provide some evidence relevant to previous research from the perspective of network analysis and some suggestions for future treatment or prevention of students' problematic smartphone use.

Symptom Distribution Regularity of Insomnia: Network and Spectral Clustering Analysis.

BACKGROUND: Recent research in machine-learning techniques has led to significant progress in various research fields. In particular, knowledge discovery using this method has become a hot topic in traditional Chinese medicine. As the key clinical manifestations of patients, symptoms play a significant role in clinical diagnosis and treatment, which evidently have their underlying traditional Chinese medicine mechanisms. OBJECTIVE: We aimed to explore the core symptoms and potential regularity of symptoms for diagnosing insomnia to reveal the key symptoms, hidden relationships underlying the symptoms, and their corresponding syndromes. METHODS: An insomnia dataset with 807 samples was extracted from real-world electronic medical records. After cleaning and selecting the theme data referring to the syndromes and symptoms, the symptom network analysis model was constructed using complex network theory. We used four evaluation metrics of node centrality to discover the core symptom nodes from multiple aspects. To explore the hidden relationships among symptoms, we trained each symptom node in the network to obtain the symptom embedding representation using the Skip-Gram model and node embedding theory. After acquiring the symptom vocabulary in a digital vector format, we calculated the similarities between any two symptom embeddings, and clustered these symptom embeddings into five communities using the spectral clustering algorithm. RESULTS: The top five core symptoms of insomnia diagnosis, including difficulty falling asleep, easy to wake up at night, dysphoria and irascibility, forgetful, and spiritlessness and weakness, were identified using evaluation metrics of node centrality. The symptom embeddings with hidden relationships were constructed, which can be considered as the basic dataset for future insomnia research. The symptom network was divided into five communities, and these symptoms were accurately categorized into their corresponding syndromes. CONCLUSIONS: These results highlight that network and clustering analyses can objectively and effectively find the key symptoms and relationships among symptoms. Identification of the symptom distribution and symptom clusters of insomnia further provide valuable guidance for clinical diagnosis and treatment.

Models of poststroke depression and assessments of core depressive symptoms in rodents: How to choose?

Our previous studies have indicated that depression and declined cognition have been involved in some neurodegenerative diseases including Stroke, Parkinson's diseases and Vascular Parkinsonism. Post-stroke depression (PSD) is the most common psychiatric disorder following a stroke and has high morbidity and mortality. Studies on PSD are increasingly common, but the specific mechanisms remain unknown. Current research mainly includes clinical and animal aspects. Questionnaires and peripheral blood examination are two of the most common methods used to study clinical PSD. The results of questionnaires are influenced by multiple factors such as disease history, education background, occupation, economic status, family relationships and social support. There are certain limitations to blood sample testing; for example, it is influenced by cerebrovascular diseases and some other disruptions of the internal environment. It is difficult for either method to fully clarify the pathophysiological mechanism of PSD. Animal models provide alternative methods to further understand the pathophysiological mechanisms of PSD, such as the involvement of neuronal circuits and cytokines. More than ten animal models of PSD have been developed, and new models are constantly being introduced. Therefore, it is important to choose the appropriate model for any given study. In this paper, we will discuss the characteristics of the different models of PSD and comment on the advantages and disadvantages of each model, drawing from research on model innovation. Finally, we briefly describe the current assessment methods for the core symptoms of PSD models, point out the shortcomings, and present the improved sucrose preference test as a rational evaluation of anhedonia.

Status quo and its influencing factors of social anxiety in school-age children with attention deficit hyperactivity disorder / 中国儿童保健杂志

【Objective】 To investigate the current situation of social anxiety in children with attention deficit hyperactivity disorder (ADHD), and to analyze the factors influencing social anxiety in ADHD children, in order to provide reference for improving the clinical management of ADHD children. 【Methods】 A total of 206 school-age children with ADHD were selected from the Children′s Psychology Clinic of Mianyang Central Hospital from January 2020 to January 2023. The relevant clinical data of the children were collected through the general data questionnaire. Children′s Social Anxiety Scale (SASC) was used to assess social anxiety, and the Social Response Scale (SRS) was used to assess social ability. The Chinese version of Swanson,Nolan and Pelham Rating Scale Ⅳ (SNAP-Ⅳ) was used to assess core symptoms. Multivariate Logistic regression analysis was used to determine influencing factors of social anxiety in children with ADHD. 【Results】 There were 128(62.14%) cases detected with social anxiety among 206 children with ADHD. The score of SASC was 14.02±4.06. The proportions of girls (χ2=6.057), comorbid autism spectrum disorder(ASD) (χ2=4.929), and main caregivers with junior high school education or below (χ2=13.345), the total score of SRS(t=5.842) and SNAP-Ⅳ(t=7.848) and the scores of all dimensions were significantly higher than those in the non-anxious group (P<0.05). Multivariate Logistic regression analysis showed that higher SRS total score(OR=5.217, 95%CI: 2.309 - 11.791), higher SNAP-Ⅳ total score(OR=4.150, 95%CI: 1.974 - 8.722), girls(OR=2.268, 95%CI: 1.423 - 3.616), primary caregivers with junior high school education or below (OR=1.527, 95%CI: 1.162 - 2.005), and comorbid ASD (OR=1.551, 95%CI: 1.209 - 1.990) were risk factors for social anxiety in ADHD children (P<0.05). 【Conclusions】 Children with ADHD have a higher prevalence rate of social anxiety. Cognitive behavioral therapy and psychological intervention should be strengthened for high-risk children to improve social ability and reduce the risk of social anxiety.

Research Ideas and Methods for Standardization of Traditional Chinese Medicine Syndrome Differentiation / 中医杂志

Syndrome differentiation and treatment is a unique mode of diagnosis in traditional Chinese medicine （TCM）. The establishment of scientific and standardized syndrome diagnosis standards is an important link to evaluate the clinical efficacy of TCM objectively and systematically， and also a prerequisite for the promotion and development of TCM to obtain international recognition. This article reviewed the basic modes and existed problems of the current syndrome diagnosis criteria， and proposed to construct a multidimensional core information set integrating the minimized core symptoms， the artificial intelligence signs， the multi-modal laboratory indicators， and multi-omics specific markers， so as to present syndrome characteristics from multiple perspectives systematically. This paper also described the basic mode， constructure， as well as the process and methodology to be adopted in the establishment of the standardized diagnostic research method. The core information set of diagnostic symptoms not only took into account the specificity of the disease， but also improved the inconsistency due to the complexity and subjectivity of the syndrome differentiation， thereby providing a methodological basis for the standardization of TCM syndrome differentiation in clinical research.

Inpatient treatment has no impact on the core thoughts and perceptions in adolescents with anorexia nervosa.

AIM: Examine changes in core perceptions and thoughts during the weight restoration phase of inpatient treatment for adolescents with anorexia nervosa. METHOD: Forty-four adolescents with anorexia nervosa consecutively admitted (2009-2012) to an inpatient paediatric-psychiatric unit specializing in eating disorders. The programme consisted of a complete inpatient intervention combining weight restoration by structured supervised meals with individual and group cognitive-behavioural therapy, parental training/family intervention and educational activities, followed by a half-way day-treatment weight-stabilizing phase and progressive reintroduction to the community. The study focused on changes from hospital admission to discharge in patients' responses to self-report questionnaires on eating disorder symptoms, depression, anxiety and suicidal ideation. RESULTS: No significant changes in core anorexic thoughts and perceptions as Body dissatisfaction, Drive for thinness, Weight concern and Shape concern were noted. However, a reduction in the general severity of eating disorder symptoms (including Restraint and Eating concern) was observed, mainly related to the treatment structure. Levels of depression significantly decreased but remained within pathological range. We also found a concerning increase in suicidal ideation not correlated with a concomitant increase in depressive symptomatology. CONCLUSIONS: Inpatient treatment of anorexia nervosa in adolescents does not significantly modify core anorexic thoughts and perceptions. This may explain the high relapse rates. Changes in core beliefs may be crucial for recovery and prevention of relapse in anorexia nervosa at this critical age. This study may have clinical implications for the development of better treatment strategies to target the gap between disturbed thoughts and distorted perceptions - the core aspects of anorexia nervosa and physical recovery during and after the weight restoration phase.

Effect of aerobic exercise on core symptoms and executive function in children with attention deficit hyperactivity disorder / 中国康复理论与实践

ObjectiveTo observe the effect of aerobic exercise on core symptoms and executive function in children with attention deficit hyperactivity disorder (ADHD). MethodsFrom June, 2020 to December, 2021, 64 children with ADHD at outpatient in Dushu Lake Hospital were randomly divided into control group (n = 32) and observation group (n = 32). The control group sat down and watched the cartoon for 20 minutes, and the observation group performed cycling exercise while watching the cartoon, for twelve weeks. The core symptoms were assessed with Conners Parent Symptom Questionnaire (PSQ), while the inhibition, conversion and refresh functions were assessed with the psychological test software E-Prime 2.0 system. ResultsAfter twelve weeks of treatment, the PSQ factor scores decreased in the observation group (t > 4.775, P < 0.001), and were lower than that of the the control group (t > 3.184, P < 0.001). The response time and accuracy of inhibition, conversion, and refresh functions decreased in the observation group (t > 2.259, P < 0.05), and were lower than that of the control group (t > 2.007, P < 0.05). ConclusionAerobic exercise could reduce the core symptoms of poor attention and hyperactivity impulsivity, and improve the executive functioning in children with ADHD.

Detection of suicide among the elderly in a long term care facility.

PURPOSE: The aim of this study was to establish the level of correlation between the suicide item contained within the Core Symptom Index (CSI), and the presence of suicidal thoughts as assessed by the Mini-International Neuropsychiatric Interview (MINI) and the Cornell Scale of Depression in Dementia (CSDD). PATIENTS AND METHODS: Seventy elderly residents in a long term care facility were included in this study. All of these patients completed a CSI and a geriatric depression scale (GDS), plus were interviewed using CSDD, MINI (suicide module), and MMSE. Test characteristics of item two of the CSI (suicidal thoughts) and MINI were compared. Gwet's AC1 and Cohen's Kappa were also used to test the level of agreement between raters, and univariate analysis was used to determine predictors for the severity of any suicidal thoughts present. RESULTS: There was found to be a significant correlation between suicidal ideation, as assessed by item two of the CSI, and the suicidal ideation score as assessed by MINI and CSDD (r=0.773 and r=0.626, P<0.001, respectively). The level of agreement across all three instruments was good (Gwet's AC1 =0.907). The CSI yielded a high level of sensitivity (100%) and specificity (90.32%) for suicidal thoughts as measured by MINI, with an area under the curve of 97%. When assessing predictors of the severity of suicidal thoughts, only item two of the CSI predicted severity, while the depression, GDS, and total scores obtained from the CSI did not. CONCLUSION: CSI item two has the ability to detect suicidal ideation, regardless of whether the patient has cognitive impairment and/or depression or not, and is currently the best predictor of its presence. Therefore, it shows promise as a measure for screening the presence of suicidal thoughts among the elderly in long term care facilities.