Novel C4P2 monolayers: forming Z-scheme heterojunction and Janus structure for high-efficiency metal-free photocatalytic water splitting.

Metal-free two-dimensional (2D) semiconductors have garnered significant attention in the realm of photocatalytic water splitting, primarily owing to their inherent clean, stable, and efficient photoresponsive properties. Motivated by it, we have proposed two types of stable C4P2 monolayers with indirect band gaps, mediocre carrier mobility and excellent optical absorption in visible-light and ultraviolet regions. Although the too-low work function of monolayer α-C4P2 and the too-high work function of monolayer ß-C4P2 make them only suitable for single-side redox reaction in photocatalytic water splitting, the creation of an α-C4P2/ß-C4P2 Z-scheme heterojunction, combined with the Janus monolayer γ-C4P2 that integrates features of both α and ß structures, effectively addresses this limitation, fulfilling the prerequisites for comprehensive photocatalytic water splitting. Furthermore, the calculations indicate that the α-C4P2/ß-C4P2 Z-scheme heterojunction and Janus monolayer γ-C4P2 not only demonstrate improved carrier mobility and optical absorption but also feature internal electric fields that effectively enhance driving energy and photo-induced charge separation. Notably, Janus monolayer γ-C4P2 achieves a high electron mobility of ∼105 cm2 V-1 s-1 and an impressive solar-to-hydrogen conversion efficiency of 25.62%.

Development and validation of a novel radiomics-clinical model for predicting post-stroke epilepsy after first-ever intracerebral haemorrhage.

OBJECTIVES: Post-stroke epilepsy (PSE) is associated with increased morbidity and mortality. This study aimed to develop and validate a novel prediction model combining clinical factors and radiomics features to accurately identify patients at high risk of developing PSE after intracerebral haemorrhage (ICH). METHODS: Researchers performed a retrospective medical chart review to extract derivation and validation cohorts of patients with first-ever ICH that attended two tertiary hospitals in China between 2010 and 2020. Clinical data were extracted from electronic medical records and supplemented by tele-interview. Predictive clinical variables were selected by multivariable logistic regression to build the clinical model. Predictive radiomics features were identified, and a Rad-score was calculated according to the coefficient of the selected feature. Both clinical variables and radiomic features were combined to build the radiomics-clinical model. Performances of the clinical, Rad-score, and combined models were compared. RESULTS: A total of 1571 patients were included in the analysis. Cortical involvement, early seizures within 7 days of ICH, NIHSS score, and ICH volume were included in the clinical model. Rad-score, instead of ICH volume, was included in the combined model. The combined model exhibited better discrimination ability and achieved an overall better benefit against threshold probability than the clinical model in the decision curve analysis (DCA). CONCLUSIONS: The combined radiomics-clinical model was better able to predict ICH-associated PSE compared to the clinical model. This can help clinicians better predict an individual patient's risk of PSE following a first-ever ICH and facilitate earlier PSE diagnosis and treatment. KEY POINTS: • Radiomics has not been used in predicting the risk of developing PSE. • Higher Rad-scores were associated with higher risk of developing PSE. • The combined model showed better performance of PSE prediction ability.

Halogen Engineering To Realize Regulable Multipolar Axes, Nonlinear Optical Response, and Piezoelectricity in Plastic Ferroelectrics.

Compared with uniaxial molecular ferroelectrics, multiaxial ferroelectrics have better application prospects because they are no longer subject to the single-crystal form and have been pursued in recent years. Halogen engineering refers to the adjustment of halogens in materials at the atomic level, which can not only explore multiaxial ferroelectrics but also help to improve piezoelectrics, recently. In this work, we successfully synthesized and characterized three multiaxial plastic ferroelectrics through the precise molecular design from I to Cl, confirming the increase of the number of polar axes of ferroelectrics from 3 to 6, the increase of second-harmonic generation density from 2.1 times to nearly 6 times of monopotassium phosphate, and the increase of piezoelectric coefficient by 140%. This systematic work has proved that halogen engineering can not only enrich the family of multiaxial plastic ferroelectrics but also promote the further development of nonlinear optical and piezoelectric materials.

External validation and comparison of clinical scores for predicting late seizures after intracerebral hemorrhage in Chinese patients.

PURPOSE: Clinical scores have been established to predict the probability of late seizures following intracerebral hemorrhage (ICH) for individual patients, including the CAVE, CAVS and LANE scores. The purpose of this study was to compare these prediction scores in the Chinese population and undertake an independent external validation on them. METHODS: At one tertiary hospital in China, we retrospectively recruited consecutive inpatients who had been diagnosed with ICH. Medical records and tele interviews with a modified standardized questionnaire were used to identify late seizures. All the predictors of the prediction scores were collected from patient charts and databases by a standardized data collection protocol. The external validation of the prediction scores was quantified by the area under the curve (AUC), sensitivity, specificity, Youden index (YI), positive predictive value (PPV), and negative predictive value (NPV). RESULTS: 69 (5.4%) of 1276 patients experienced late seizures after ICH. There was no significant difference in the CAVE, CAVS, and LANE scores, which had AUCs of 0.75 (95% CI = 0.70-0.81), 0.74 (95% CI = 0.68-0.80), and 0.76 (95% CI = 0.70-0.82), respectively. At the optimal cutoff score, the LANE score had a lower sensitivity but a higher specificity than the CAVE and CAVS scores. Among the three prediction scores, the LANE score had a higher PPV than the others (0.145 vs. 0.088, 0.083), while the NPV was similar among the three prediction scores (0.989, 0.989, and 0.972). CONCLUSION: Our study showed that the CAVE, CAVS and LANE scores had similar AUCs for the occurrence of late seizures, but the LANE score had a relatively high PPV at the optimal cutoff score. Due to low evidence for using prophylactic antiseizure medications (ASM) in patients with ICH and poor availability of specialist stroke care in China, the LANE score with a cutoff score of 3 could be an applicable prediction tool in Chinese patients with ICH.

Metal-free Janus α- and ß-SiCP4: designing stable and efficient two-dimensional semiconductors for water splitting.

Two-dimensional (2D) semiconductors exhibit exceptional potential in the field of photocatalytic water splitting due to their unique structural characteristics and photoelectric properties. In this study, based on first-principles density functional theory, we theoretically proposed two SiCP4 Janus 2D semiconductors with high stability, namely monolayer α- and ß-SiCP4. By performing the calculation of HSE06 functionals, the band structures of monolayer α- and ß-SiCP4 have been estimated, and the results show that both α- and ß-SiCP4 are direct-band-gap semiconductors with band gaps of 1.64 eV and 1.91 eV, respectively. Meanwhile, the band edge levels of monolayer α- and ß-SiCP4 meet the band structure requirements of photocatalysts in water splitting. Notably, because of the internal build-in electric fields and tiny band gaps, monolayer α- and ß-SiCP4 exhibit separated photogenerated electron-hole pairs and high solar-to-hydrogen (STH) efficiency, reaching up to 33.68% and 23.72%, respectively. Additionally, we also investigate the impact of uniaxial strain on electronic, optical and photocatalytic properties of monolayer α- and ß-SiCP4 considering pH values ranging from 0 to 14. Our results demonstrate that the maximum STH efficiency for α-SiCP4 is achieved under X-direction strain (η) of 2%, Y-direction strain (η) of 8%, and pH values between 2 and 4. Conversely, ß-SiCP4 exhibits the highest STH efficiency under X-direction strain (η) of 8%, Y-direction strain (η) of 6%, and pH values between 2 and 4.

Structure-engineering the stability, electronic, optical and photocatalytic properties of hexagonal C2P2 monolayers.

Structure engineering presents unique opportunities in materials science field, including material design and modification. Herein, we applied structure engineering to double-sublayer hexagonal C2P2 monolayers so as to form two novel non-Janus structures and two new Janus structures. Based on first-principles calculations, the stability, electronic, optical, and photocatalytic properties of the C2P2 monolayers, including the two discovered structures and four new C2P2 monolayers, have been investigated. The results showed that these C2P2 monolayers are highly stable in energetics, dynamics, and thermodynamics. We also found that counterrotating 60° between the top and bottom sublayers could make the C2P2 monolayers become more stable. The calculations of the project band structures indicated that the new C2P2 monolayers were semiconductors with indirect band gaps ranging from 1.02 eV to 2.62 eV. Meanwhile, it was also suggested that the distributions of VBM and CBM in the two Janus C2P2 monolayers were out-of-plane due to their internal electric fields. Moreover, the carrier mobility of the C2P2 monolayers was anisotropic between an armchair and zigzag direction and quite high (reaching 103 cm2 V-1 s-1) in the zigzag direction. Additionally, all the C2P2 monolayers had large exciton binding energies (∼1.0 eV) and considerable absorption in the visible-light region. Furthermore, except for the CP-3 monolayer, all the C2P2 monolayers, including CP-1, CP-2, CP-4, CP-5, and CP-6, have great potential for metal-free visible-light photocatalytic water splitting. Our calculations reveal that structure engineering is particularly applicable to multi-sublayer two-dimensional materials for discovering new members and tuning their properties.

Super-high carrier mobilities and excellent thermoelectric performances of Tri-Tri group-VA monolayers.

High-performance thermoelectric materials in theoretical and experimental research are mostly composed of expensive, scarce, heavy elements and rarely of single light elements, which severely limit their application and development. Based on density functional and semiclassical Boltzmann transport theory, we determine that a stable phosphorene allotrope, named Tri-Tri phosphorene, has super-high electron mobility (23845.29 cm2 V-1 s-1) much higher than those of most two-dimension materials. Moreover, its optimized maximum ZT can reach up to 3.43 at room temperature (4.83 at 500 K and 5.92 at 700 K), exhibiting highly favorable prospects in practical thermoelectric systems. Motivated by the excellent properties of Tri-Tri phosphorene, we further demonstrate the structural stability of Tri-Tri arsenene and Tri-Tri antimonene and predict that the two Tri-Tri structures also have high Seebeck coefficients and electron mobilities. Their lattice thermal conductivities are dramatically decreased compared with Tri-Tri phosphorene. Thus, their predicted thermoelectric performances are also excellent, with maximum ZT values of 4.12 (Tri-Tri arsenene) and 3.54 (Tri-Tri antimonene) at room temperature. The low layer moduli of the three Tri-Tri structures indicate that they have high mechanical flexibility and suitability for current device assemblies. All these desirable properties make Tri-Tri group-VA materials promising for future applications in thermoelectric devices.

External validation of the AntiEpileptic Drug Monitoring in PREgnancy (EMPiRE) model for predicting seizures in pregnant women with epilepsy.

BACKGROUND: The AntiEpileptic Drug Monitoring in PREgnancy (EMPiRE) model is the only available tool for predicting seizures in pregnant women with epilepsy (WWE) using anti-seizure medications (ASMs); however, its predictive performance requires validation. This study aimed to evaluate the predictive ability of this model in pregnant Chinese WWE and its potential usefulness in clinical practice. METHODS: Data of the EMPiRE model were derived from the EMPiRE study, a prospective multicenter cohort study that recruited women on ASM monotherapy (lamotrigine, carbamazepine, phenytoin or levetiracetam) or polytherapy (lamotrigine with either carbamazepine, phenytoin or levetiracetam). Based on the applicable population of the EMPiRE model, we evaluated 280 patients registered in the Wenzhou Epilepsy Follow-up Registry Database from January 1, 2010, to December 31, 2020. A total of 158 eligible patients were included in the validation cohort. We collected data on the baseline characteristics of patients, eight predictors of the EMPiRE model and outcome events. The outcome was the occurrence of tonic-clonic or non-tonic-clonic seizures at any time in pregnancy up to 6 weeks postpartum. We used the equation of the EMPiRE model to obtain the predicted probabilities of seizures. The predictive ability of the EMPiRE model was quantified by the C-statistic (scale 0-1, values > 0.5 show discrimination), GiViTI calibration test and decision curve analysis (DCA). RESULTS: Of 158 eligible patients, 96 patients (60.8%, 96/158) experienced one or more seizures at any time between pregnancy and 6 weeks postpartum. The EMPiRE model showed good discrimination with a C-statistic of 0.76 (95% confidence interval [CI] 0.70-0.84). The GiViTI calibration belt showed that the predicted probabilities, which ranged from 16 to 96% (95% CI), were lower than the actual probabilities. DCA indicated that the highest net proportional benefit was obtained for predicted probability thresholds of 15-18% and 54-96%. CONCLUSIONS: The EMPiRE model could discriminate well between WWE with and without seizures during pregnancy and 6 weeks postpartum, but the risk of seizures may be underestimated. The limitations of the model for specific medication regimens may limit its real-world application. If the model is further improved, it will be incredibly valuable.

Superior mechanical flexibility, lattice thermal conductivity and electron mobility of the hexagonal honeycomb carbon nitride monolayer.

Nitrogen is the nearest neighbor element of carbon and, thus, the hexagonal honeycomb carbon nitride monolayer (CxNy), which consists of a covalent network of carbon and nitrogen atoms, usually has attractive physical and chemical properties similar to those in graphene. Here, we systematically investigate the geometric structure, mechanical properties, thermal transport properties, and plasmon excitation of a new phase, labeled C3N2, and make a detailed comparison with other possible CxNy allotropes. All CxNy have a super-high layer modulus and Young's modulus. But compared with the others, C3N2 exhibits excellent mechanical flexibility, and can withstand a relatively high critical strain up to 20% (18%) along the X(Y) direction. Additionally, C3N2 also has excellent thermal and electronic transport properties, with a super-high lattice thermal conductivity of ∼110.9 W m-1 K-1 and electron mobility of ∼1617.52 cm2 V-1 s-1 at 300 K. By performing time-dependent density functional theory (TDDFT), we obtain the optical absorptions of C3N2 and C3N, and meanwhile analyze their Fourier transforms of induced charge densities at some resonant frequencies. The main optical absorption peaks of the C3N2 nanostructure are located in the ultraviolet region, and its plasmon peaks are far higher than those in C3N. Its excellent mechanical and optical properties, the larger electronic band gap, and the higher electron mobility suggest that C3N2 has great potential for application in nanoelectronics and optoelectronics.

Exploring the photocatalytic properties and carrier dynamics of 2D Janus XMMX' (X = S, Se; M = Ga, In; and X' = Te) materials.

Recently, two-dimensional (2D) Janus structures have been extensively explored because of their robust electron mobility and unique photocatalytic properties. In spite of the increasing interest, the origin of high photocatalytic activities and the behaviors of photoinduced carriers in this kind of materials have not been well understood. Herein, we present a step-by-step protocol based on the first-principles calculations combined with the ab initio non-adiabatic molecular dynamics (NAMD) simulations to unveil the origin of high photocatalytic activity of highly stable typical 2D Janus XMMX' structures (X = S, Se; M = Ga, In; and X' = Te). Their band structures, optical properties, exciton binding energies, carrier effective masses, solar-to-hydrogen efficiency, hot carrier relaxation and recombination times, etc. have been calculated. We find that the difference between X and X' atoms on the two surfaces of the XMMX' monolayer not only builds an out-of-plane electric field, which significantly affects the charge distributions on the valence band maxima (VBM) and the conduction band minima (CBM) and subsequently decreases the exciton binding energy, but also transforms the indirect band structures of XM into the direct ones with well suitable energy gaps for visible-light absorption as well as endows the XMMX' structures with unequal electron and hole mobility, rapid hot carrier relaxation and slow electron-hole recombination processes on a timescale of tens of nanoseconds. The current work suggests that Janus XMMX' monolayers are good photocatalytic materials for overall water splitting and provides a guide to regulate the materials' properties for efficient energy harvesting and optoelectronic applications.

Renin-angiotensin system inhibition reverses the altered triacylglycerol metabolic network in diabetic kidney disease.

OBJECTIVE: Dyslipidemia is a significant risk factor for progression of diabetic kidney disease (DKD). Determining the changes in individual lipids and lipid networks across a spectrum of DKD severity may identify lipids that are pathogenic to DKD progression. METHODS: We performed untargeted lipidomic analysis of kidney cortex tissue from diabetic db/db and db/db eNOS-/- mice along with non-diabetic littermate controls. A subset of mice were treated with the renin-angiotensin system (RAS) inhibitors, lisinopril and losartan, which improves the DKD phenotype in the db/db eNOS-/- mouse model. RESULTS: Of the three independent variables in this study, diabetes had the largest impact on overall lipid levels in the kidney cortex, while eNOS expression and RAS inhibition had smaller impacts on kidney lipid levels. Kidney lipid network architecture, particularly of networks involving glycerolipids such as triacylglycerols, was substantially disrupted by worsening kidney disease in the db/db eNOS-/- mice compared to the db/db mice, a feature that was reversed with RAS inhibition. This was associated with decreased expression of the stearoyl-CoA desaturases, Scd1 and Scd2, with RAS inhibition. CONCLUSIONS: In addition to the known salutary effect of RAS inhibition on DKD progression, our results suggest a previously unrecognized role for RAS inhibition on the kidney triacylglycerol lipid metabolic network.

2-(2-Benzofuranyl)-2-Imidazoline Attenuates the Disruption of the Blood-Brain Barrier in EAE via NMDAR.

Blood-brain barrier (BBB) disruption has been recognized as an early hallmark of multiple sclerosis (MS) pathology. Our previous studies have shown that 2-(2-Benzofuranyl)-2-imidazoline (2-BFI) protected against experimental autoimmune encephalomyelitis (EAE), a classic animal model of MS. However, the potential effects of 2-BFI on BBB permeability have not yet been evaluated in the context of EAE. Herein, we aimed to investigate the effect of 2-BFI on BBB permeability in both an animal model and an in vitro BBB model using TNF-α to imitate the inflammatory damage to the BBB in MS. In the animal model, 2-BFI reduced neurological deficits and BBB permeability in EAE mice compared with saline treatment. The Western blot results indicated that 2-BFI not only alleviated the loss of the tight junction protein occludin caused by EAE but also inhibited the activation of the NR1-ERK signaling pathway. In an in vitro BBB model, 2-BFI (100 µM) alleviated the TNF-α-induced increase in permeability and reduction in expression of occludin in monolayer bEnd.3 cells. Similar protective effects were also observed after treatment with the NMDAR antagonist MK801. The Western blot results showed that the TNF-α-induced BBB breakdown and increase in NMDAR subunit 1 (NR1) levels and ERK phosphorylation could be blocked by pretreatment with 2-BFI or MK801. However, no additional effect was observed on BBB permeability or the expression of occludin and p-ERK after pretreatment with both 2-BFI and MK801. Our study indicates that 2-BFI alleviates the disruption of BBB in the context of inflammatory injury similar to that of MS by targeting NMDAR1, as well as by likely activating the subsequent ERK signaling pathway. These results provide further evidence for 2-BFI as a potential drug for the treatment of MS.

The impact of social factors, especially psychological worries on anxiety and depression in patients with epilepsy.

BACKGROUND: Social factors are believed to affect mental health in patients with epilepsy (PWE). However, there is still a lack of sufficient manifest proof, given the difficulty of exposing PWE to relatively consistent natural social environments with a low or high level of social interaction to study their significant role. METHODS: This single-center, longitudinal study was conducted via online questionnaires during the coronavirus disease 2019. PWE were recruited from downtown Wuhan and surrounding areas. The Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 were used to assess psychological status. RESULTS: We analyzed 588 questionnaires completed by 294 PWE who participated in the dual survey. Under lockdown and reopening, the prevalence of anxiety was 13.6%/22.5%, and the prevalence of depression was 19.4%/34.0%. Raising children and seizure-related characteristics, including uncontrolled seizures, seizure exacerbation, seizure frequency ≥ 2/m, and changes in drug regimen, were risk factors in the first and second surveys. A high education level (OR = 1.946, 95% CI = 1.191-3.182), low life satisfaction (OR = 1.940, 95% CI = 1.007-3.737), worry about unanticipated seizures (OR = 2.147, 95% CI = 1.049-4.309), and worry about purchasing medication outside (OR = 2.063, 95% CI = 1.060-4.016) were risk factors for higher scores after reopening. Worry about unanticipated seizures (OR = 3.012, 95% CI = 1.302-6.965) and in-person medical consultation (OR = 2.319, 95% CI = 1.262-4.261) were related to newly diagnosed patients with psychological disorder after reopening. CONCLUSIONS: We identified an association between social variables and epileptic psychiatric comorbidities.

Monolayered H-Si-P semiconductors: structural stability, electronic structure, optical properties, and prospects for photocatalytic water splitting.

Group IV and V monolayers are promising state-of-the-art two-dimensional (2D) materials owing to their high carrier mobility, tunable bandgaps, and optical linear dichroism along with outstanding electronic and thermoelectric properties. Furthermore, recent studies revealed the stability of free-standing 2D monolayers by hydrogenation. Inspired by this, we systematically predicted and investigated the structure and properties of various hydrogen-saturated silicon phosphide (H-Si-P) monolayers based on first-principles calculations. According to the results, H-Si-P monolayers belong to indirect bandgap semiconductors with a highly stable structure. Their bandgaps and band edge positions assessed using accurate hybrid functional are shown to be effectively adjusted by applying a biaxial strain. Furthermore, the absorption spectra of these monolayers, simulated in the context of time-dependent density functional theory, exhibit their excellent potential for solar energy conversion and visible-light-driven photocatalytic water splitting. In this respect, this work provides valuable guidance for finding more 2D semiconductors and nanostructures for nanoelectronics and optoelectronic applications, as well as for photocatalytic water splitting.

External validation and comparison of two prediction models for seizure recurrence after the withdrawal of antiepileptic drugs in adult patients.

OBJECTIVE: The models currently available for predicting the risk of seizure recurrence after antiepileptic drug (AED) withdrawal in adult epilepsy patients include the prediction model developed by Lamberink et al (Lamberink model, 2017) and the Medical Research Council prediction model (MRC model, 1993). However, there was no external validation for the two models. The purpose of this study was to perform an independent external validation and a comparison of the Lamberink model and the MRC model in adult patients. METHODS: The study population was recruited from the Wenzhou Epilepsy Follow-up Registry Database (WEFURD). All the predictors of the Lamberink and MRC models and the occurrence of seizure recurrence in the participants were collected based on the WEFURD. Participants' predicted probabilities of seizure recurrence were obtained by a Web-based tool and the prognostic index formula. The external validation of the Lamberink model and the MRC model were quantified by discrimination, calibration, and decision curve analysis (DCA). RESULTS: Of 212 patients, 126 (59.4%) had seizure recurrence after AED withdrawal. The Lamberink 2-year model, the Lamberink 5-year model, the MRC 1-year model, and the MRC 2-year model had areas under the curve of 0.71 (95% confidence interval [CI] = 0.64-0.78), 0.68 (95% CI = 0.60-0.76), 0.60 (95% CI = 0.50-0.69), and 0.58 (95% CI = 0.50-0.66), respectively. Additionally, the Lamberink 2-year model had a significantly better integrated discrimination improvement than the MRC 2-year model (P < .001). Regarding calibration, the Lamberink 2-year model (P = .121) and the MRC 1-year model (P = .264) were well calibrated, but the Lamberink 5-year model (P = .022) and the MRC 2-year model (P = .008) were not. In the DCA, the Lamberink 2-year model performed well at threshold probabilities of 30%-65%. SIGNIFICANCE: This external validation shows that the Lamberink 2-year model might be more accurate and has greater clinical benefit than others for guiding drug withdrawal in adult epilepsy clinics.

Comparison of the performance of suicide ideation scales in adult patients with epilepsy in China.

OBJECTIVE: The aims of this study were to evaluate and compare the performance of the Chinese version of the Suicide Ideation Scale-Current (SSI-C) and the Suicide Ideation Scale-Worst (SSI-W) as suicide ideation screening tools in patients with epilepsy (PWE). METHODS: A consecutive sample of Chinese adult PWE recruited from a tertiary hospital completed the SSI-C and SSI-W and the suicidality module of the Chinese version of the Mini International Neuropsychiatric Interview (MINI) Plus 5.0.0. RESULTS: A total of 260 consecutive PWE were recruited. The area under the curve (AUC) for the SSI-C was 0.831, and the optimal cutoff score was >1 (sensitivity 73%, specificity 91%); for the SSI-W, the AUC was 0.958, and the optimal cutoff score was >2 (sensitivity 94.6%, specificity 87.4%). The AUC for the SSI-W was larger than that for the SSI-C, and the two-factor structure was considered significant. CONCLUSION: Our results showed that the SSI-C and SSI-W had good validity as suicidal ideation screening tools in PWE in southern China and can be recommended for clinical suicidal ideation screening. The SSI-W is a better suicidal ideation screening tool than the SSI-C according to the results of our study.

Comparison of the performance of two depression rating scales in patients with epilepsy in southern China.

OBJECTIVE: The aim of this study was to evaluate and compare the performance of the Chinese version of the Neurological Disorder Depression Inventory for Epilepsy (CNDDI-E) with that of the depression subscale of the Hospital Anxiety and Depression Scale (C-HADS-D) as screening tools for depression in the same patients with epilepsy (PWE). METHODS: A total of 213 consecutive PWE were evaluated. Receiver operating characteristic (ROC) analysis was performed using the C-NDDI-E and C-HADS-D as predictors and the Chinese version of the Mini International Neuropsychiatric Interview (C-MINI) as the gold standard. RESULTS: The area under the curve (AUC) for the C-NDDI-E was 0.870, and the optimal cutoff score was >11 (sensitivity 85.71%, specificity 79.78%); for the C-HADS-D, the AUC was 0.804, and the optimal cutoff score was >5 (sensitivity 85.71%, specificity 62.36%). The AUC for the C-NDDI-E was larger than the AUC for the C-HADS-D, but the comparison of the AUCs revealed no significant differences (P = 0.1444). CONCLUSION: Our findings indicate that the C-NDDI-E and C-HADS-D have high validity and support the use of these screening tools for depression in PWE. Moreover, the C-NDDI-E is a better screening scale for diagnosing depression than the C-HADS-D according to the results of this study.

Regulatory role of Golgi brefeldin A resistance factor-1 in amyloid precursor protein trafficking, cleavage and Aß formation.

ß-amyloid peptide (Aß) deposition derived from sequential cleavage of the amyloid precursor protein (APP) through the amyloidogenic pathway is an important characteristic feature of Alzheimer's disease (AD). During this process, cellular trafficking plays a crucial role. A large Sec7-domain containing ADP-ribosylation factor guanine nucleotide exchange factor (ARF-GEF), Golgi brefeldin A resistance factor 1 (GBF1) has been reported to initiate the ADP-ribosylation factor (Arf) activation cascade at trans-Golgi network, which plays a crucial function at the endoplasmic reticulum-Golgi interface. In this study, we investigated the role of GBF1 in APP transmembrane transport and Aß formation. Using APP/PS1 (presenilin 1) overexpressing transgenic mice, we demonstrate that GBF1 has upregulated the expression of APP, indicating a role for GBF1 in APP physiological process. Knocking down of GBF1 using small interfering has significantly increased the intracellular but not the surface expression of APP. In contrast, overexpression of wild-type (WT) and guanine nucleotide exchange factor (GEF) in the activated form but not the GEF deficient mutation induced continuous activation of GBF1, which subsequently increased the surface level of APP. Interestingly, inhibition of GBF1 by c(BFA) also impaired APP trafficking and induced endoplasmic reticulum (ER) stress in SH-SY5Y cells. Our results thus for identified the role of GBF1 in APP trafficking and cleavage, and provide evidence for GBF1 as a possible therapeutic target in AD.

Validation of the Chinese version of the Scale for Suicide Ideation-Worst in adult patients with epilepsy.

OBJECTIVE: The aim of this study was to validate the Chinese version of the Scale for Suicide Ideation-Worst (SSI-W) for screening suicide ideation in Chinese adult patients with epilepsy (PWE). METHOD: A consecutive sample of Chinese adult PWE from a tertiary hospital completed the SSI-W and the suicidality module of the Chinese version of the Mini International Neuropsychiatric Interview (MINI) Plus 5.0.0. RESULTS: A total of 269 PWE completed the scales. According to the MINI, 59 patients (21.9%) had suicidal ideation. The Cronbach's α coefficient for the SSI-W was 0.96. Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) for the SSI-W was 0.957 (95% confidence interval [CI] = 0.935-0.980). With a cutoff score of 2 points, the SSI-W demonstrated the best psychometric properties: a sensitivity of 95.8%, a specificity of 87.3%, a positive predictive value (PPV) of 56.7%, and a negative predictive value (NPV) of 99.0%. The scores for items 11 (Reason for attempt) and 18 (Final acts) were not significantly different (p > 0.05) in patients with suicidal ideation, while the scores for the other items were significantly different between these groups of patients. CONCLUSION: The Chinese version of the SSI-W proved to be a reliable and effective assessment tool for screening suicidal ideation in Chinese adult PWE.

Risk factors for suicidal tendency in adult patients with epilepsy in China.

OBJECTIVE: The major cause of premature mortality in people with epilepsy (PWE) is suicide. Actual data on the risk of suicidal tendency in adult PWE in China are scarce. In our study, associations between possible risk factors and suicidal tendency in adult PWE in China were investigated. METHODS: People with epilepsy (n = 251) were recruited, and their demographic and clinical characteristics were evaluated. Suicide risk was examined using the suicidality module (SM) of the Mini International Neuropsychiatric Interview (MINI) Plus Chinese Version 5.0.0. RESULTS: Suicidal tendency was present in 36 (14.3%) of the 251 PWE. On the basis of the results of univariate analyses, family relationship (P < 0.001), age at epilepsy onset (P = 0.037), seizure-free period (P = 0.041), seizures/month (P = 0.015), depressive disorders (P < 0.001), and number of antiepileptic drugs (AEDs) (P = 0.017) were associated with suicidal tendency. Multivariate analysis revealed that moderate or poor family relationships (odds ratio (OR): 6.468, 95% confidence interval (CI): 2.418-17.300) and depressive disorders (OR: 3.548, 95% CI: 1.575-7.995) were associated with high odds of suicidal tendency. CONCLUSION: Suicidal tendency is common among adult PWE. This study reveals that family relationships and depressive disorders are independent risk factors for suicidal tendency among adult PWE. Therefore, while maintaining treatment of epilepsy, more attention should be directed to the social support and mental state of PWE to prevent suicide.