Rating Scale Research Articles

Effect of quantitative consciousness index on seizure parameters during electroconvulsive therapy in patients with major depressive disorder

BACKGROUND Electroconvulsive therapy (ECT) is both an effective treatment for patients with major depressive disorder (MDD) and a noxious stimulus. Although some studies have explored the effect of sedation depth on seizure parameters in ECT, there is little research on the noxious stimulation response to ECT. In this study, we used two electroencephalography (EEG)-derived indices, the quantitative consciousness (qCON) index and quantitative nociceptive (qNOX) index, to monitor sedation, hypnosis, and noxious stimulation response in patients with MDD undergoing acute ECT. AIM To evaluate the effect of anesthesia depth based on the qCON and qNOX indices on seizure parameters. METHODS Patients with MDD (n = 24) underwent acute bilateral temporal ECT under propofol anesthesia. Before ECT, the patients were randomly divided into three groups according to qCON scores (qCON60-70, qCON50-60, and qCON40-50). Continuous qCON monitoring was performed 3 minutes before and during ECT, and the qCON, qNOX, vital signs, EEG seizure parameters, and complications during the recovery period were recorded. The 24-item Hamilton Rating Scale for Depression, Zung’s Self-rating Depression Scale, and Montreal Cognitive Assessment scores were evaluated before the first ECT session, after the fourth ECT session, and after the full course of ECT. RESULTS A total of 193 ECT sessions were performed on 24 participants. The qCON index significantly affected the EEG seizure duration, peak mid-ictal amplitude, and maximum heart rate during ECT (P < 0.05). The qNOX index significantly affected the post-ictal suppression index (P < 0.05). Age, number of ECT sessions, and anesthetic-ECT time intervals also had a significant effect on EEG seizure parameters (P < 0.05). However, there were no significant differences in complications, 24-item Hamilton Rating Scale for Depression scores, Zung’s Self-rating Depression Scale scores, or Montreal Cognitive Assessment scores among the three groups (P > 0.05). CONCLUSION Electrical stimulation at a qCON index of 60-70 resulted in better EEG seizure parameters without increasing complications in patients with MDD undergoing bilateral temporal ECT under propofol anesthesia.

Shugan Jieyu capsule effects on peripheral blood micro-124, micro-132, and brain-derived neurotrophic factor in patients with mild to moderate depression

BACKGROUND To assess the effectiveness of Shugan Jieyu capsules on peripheral blood miR-124, miR-132, and brain-derived neurotrophic factor (BDNF) levels in patients with mild to moderate depression following coronary artery intervention [percutaneous coronary intervention (PCI)] for coronary heart disease. AIM To evaluate the therapeutic efficacy of Shugan Jieyu capsules and their effects on the peripheral blood levels of miR-124, miR-132, and BDNF in patients with mild to moderate depression following PCI for coronary heart disease. METHODS Patients with mild-to-moderate depression of the liver-qi stagnation type after PCI for coronary heart disease at the 305th Hospital of the People’s Liberation Army were enrolled from June 2022 to November 2023 and randomly assigned to two groups: Experimental (treated with Shugan Jieyu capsules) and control (treated with escitalopram oxalate tablets). This study compared the antidepressant effects of these treatments using 17-item Hamilton Rating Scale for Depression (HAMD-17) scores, metabolic equivalents, low-density lipoprotein cholesterol, BDNF, high-sensitivity C-reactive protein levels, miR-124 and miR-132 levels, distribution of immune-related lymphocyte subsets, and traditional Chinese medicine syndrome scores before and after 6 weeks of treatment. RESULTS No significant difference was observed in any index between the two groups before treatment (P > 0.05). After treatment, the total efficacy rates were 93.33% and 90.00% in the experimental and control groups, respectively. Experimental group had significantly lower scores for the main and secondary syndromes compared to the control group (P < 0.05). No significant difference was observed in the metabolic equivalents between the two groups before and after treatment (P > 0.05). The levels of low-density lipoprotein cholesterol, high-sensitivity C-reactive protein, and miR-132 were significantly lower, whereas those of miR-124, BDNF, CD3+T lymphocytes, CD3+CD4+T helper lymphocytes, and CD3+CD4+/CD3+CD8+ cells were significantly higher in the experimental group compared to the control group (P < 0.05). The incidence of adverse reactions during experimental group was significantly lower than that in control group (P < 0.05). CONCLUSION Shugan Jieyu capsules have good efficacy in patients with mild-to-moderate depression after PCI, and its mechanism may contribute to the regulation of miR-124, miR-132, BDNF levels, and lymphoid immune cells.

Predictive effect of lipopolysaccharide-stimulated inflammatory cytokines on symptoms of generalized anxiety disorder

BACKGROUND Generalized anxiety disorder (GAD) is a relatively common mental disorder. Recently, inflammation, an important factor for the development of depression, has attracted increasing attention. Several studies have shown that inflammatory cytokines can affect the pathophysiological processes of several nervous system diseases. We hypothesized that there is a correlation between the levels of lipopolysaccharide (LPS)-stimulated inflammatory cytokines and the clinical symptoms of GAD. AIM To investigate the predictive effect of LPS-stimulated inflammatory cytokines on symptoms of GAD. METHODS This was a cross-sectional study in which 89 patients with GAD diagnosed at The First Hospital of Hebei Medical University from January 2022 to December 2022 and 70 individuals without anxiety and depression (controls) during the same period were included. Fasting venous blood was collected from all the subjects in heparin tubes, and another 3 ml of blood was supplemented with LPS (10 ng/ml). The plasma levels of 12 cytokines [Interleukin (IL)-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, tumor necrosis factor (TNF)-α, interferon (IFN)-γ, IL-17A, IL-12p70, and IFN-α] were detected. RESULTS Post-LPS stimulation, the levels of IL-1β, IL-6, IL-8, IL-10, and TNF-α in both the control and GAD groups were significantly elevated above those in the nonstimulated groups, with IL-6 and IL-8 showing marked increases. Increases in IL-8 and TNF-α were statistically significant in the GAD group (P < 0.05). IL-1β, IL-6, IL-8, IL-10, and TNF-α were found to be significantly correlated with Hamilton Anxiety Rating Scale (HAMA) scores (P < 0.05). A negative correlation was observed between IL-10 levels and HAMA scores. Further analysis revealed that TNF-α was associated with mental anxiety, whereas IL-1β, IL-8, and IL-10 were associated with physical anxiety symptoms, with IL-10 showing a negative correlation with physical anxiety. IL-6 was associated with both mental and physical aspects of anxiety. CONCLUSION The physical symptoms of GAD are related to inflammatory factors. IL-1β, IL-8, IL-10, and TNF-a can be used as predictors of physical or mental anxiety in patients with GAD.

The impact of animated video cartoons as a distraction technique on anticipatory anxiety levels among children during class I GIC restoration procedures.

Investigating the effect of visual distraction using animated video cartoons (AVCs) on anxiety of children during class I class I glass-ionomer cement (GIC) restoration procedures. This randomized clinical trial, 42 children between the ages of 5-6years were enrolled. These participants were divided into two groups: Group 1, consisting of 21 individuals (AVCs), who were exposed to a cartoon as a visual distraction tool, and Group 2, a control group with 21 participants who did not receive any form of distraction during their first visit. Both groups underwent class I GIC restoration procedures that were conducted in a consistent manner. To evaluate the anxiety levels of the children, measurements of their pulse rate (PR) were taken at the beginning and end of the treatment. Additionally, patient behavior was assessed using the Frankl behavior rating scale (FBRS) as well as validated self-reported dental anxiety scale, the Visual Analog Scale - Anxiety (VAS-A) score. In the control group, postoperative PR increased significantly, while the AVC group experienced a decrease compared to their preoperative PR levels. Additionally, audio-visual distraction had a notable impact on FBRS scores compared to the standard approach. Similarly, the VAS-A score displayed a significant reduction when patients received audio-visual distraction compared to the control condition. Subgroup analysis by gender showed that girls tended to be more responsive to AVCs than boys when evaluated by PR and FBRS, but such findings were not observed using VAS-A. Patients with deeper caries had higher VAS-A scores than those with shallower ones. Despite the caries depth, those who received AVC seemed to be calmer, especially to those with deeper lesions, as indicated lower postoperative VAS-A scores compared to their preoperative levels, unlike the control group. Our study suggests that the use of AVCs can be an effective method for reducing anxiety in children undergoing class I GIC restoration procedures.

Clinical correlates of medication adherence in individuals with bipolar disorder and comorbid hypertension.

Individuals with bipolar disorder (BD) have high rates of suboptimal medication adherence, medical illness, and premature mortality, largely from cardiovascular causes. This analysis examined the association between adherence to antihypertensive and BD medications and clinical symptoms in patients with BD and comorbid hypertension (HTN) from an ongoing trial to optimize adherence. Inclusion criteria were a BD diagnosis, treatment with antihypertensives, adherence challenges, and poorly controlled HTN. Adherence was measured via self-report using the Tablets Routine Questionnaire and using eCAP, an electronic pillcap which captures openings. Average systolic blood pressure (SBP) was calculated from 12 readings over 1week. The Montgomery-Asberg Depression Rating Scale (MADRS) and the Brief Psychiatric Rating Scale (BPRS) assessed BD symptoms. A total of 83 participants with BD and HTN were included. Adherence to BD and antihypertensive medications were positively correlated. eCAP openings showed more missed doses than self-reported antihypertensive adherence. BD medication adherence was positively correlated with BPRS at baseline; antihypertensive adherence was negatively correlated with SBP at screening. Antihypertensive adherence improved and SBP decreased between screening and baseline. Adherence levels fluctuated over time and differed based on measurement method in people with comorbid BD and HTN. Self-reported BD adherence was positively related to global psychiatric symptoms and antihypertensive adherence was related to better SBP control. Monitoring both medication and blood pressure led to change in self-reported adherence. BD symptom severity may indicate poor adherence in patients with BD and should be considered in treatment planning.

Effects and safety of monoamine oxidase-B inhibitors for early Parkinson's disease: a network meta-analysis.

To evaluate the effects and safety of monoamine oxidase B inhibitors (MAO-B inhibitors) for early Parkinson's disease. All studies assessed the efficacy of MAO-B inhibitors in patients with early Parkinson's disease were searched. Publications were screened and data were extracted according to predefined criteria. Rev Man 5.4 and Stata 14.0 software were used for statistical analysis. Outcomes assessed included change of Unified Parkinson's Disease Rating Scale (UPDRS) total score, UPDRS Part II score, UPDRS Part III score and the incidence of adverse events. Thirty trials were identified and included in this meta-analysis. Compared with placebo, rasagiline, selegiline, safinamide and zonisamide were significantly more effective, with a standardized mean difference (SMD) of -0.41, 95% confidence interval (CI) = -0.64 to -0.18, SMD =-0.38 (95% CI= -0.51 to -0.24), SMD=-0.37 (95%CI= -0.54 to -0.21) and SMD=-0.31 (95%CI= -0.57 to -0.05) on the UPDRS III score change respectively. The surface under the cumulative ranking (SUCRA) results showed that rasagiline ranked first in improving UPDRS II and UPDRS III, respectively. For safety outcomes, safinamide combination with dopaminergic treatment had lower risk of incurring any adverse events (risk ratio=0.1 95% CI= 0.01 to 0.2), no statistical difference in incidence of adverse events was observed amongst other MAO-B inhibitor regimes and placebo. In conclusion, rasagiline, selegiline, safinamide and zonisamide were effective compared to placebo in the treatment of early Parkinson's disease, but rasagiline was the most effective drug. As for safety, safinamide combination with dopaminergic treatment had lower risk of incurring any adverse events.

Menopausal symptoms and utilization of menopausal hormone therapy among women aged 40–60 years in Addis Ababa, Ethiopia: a cross-sectional study

BackgroundThe onset of menopause leads to diminished estrogen exposure, resulting in a high morbidity burden related to menopausal symptoms. Menopausal hormonal therapy is an effective therapy that offers more advantages than disadvantages for women aged less than 60 years or who have had menopause for less than 10 years.ObjectiveThis study aimed to assess the prevalence of menopausal symptoms, identify factors associated with menopausal symptoms, and assess the use of menopausal hormone therapy among women aged 40–60 who visited the gynecological clinics of three hospitals in Addis Ababa, Ethiopia.MethodsA facility-based cross-sectional study was conducted from January 2022 to June 2022 at Gandhi Memorial Hospital, Tikur Anbessa Hospital, and Zewditu Memorial Hospital on 296 middle-aged women. Data were collected using an interviewer-administered structured questionnaire and analyzed for sociodemographic factors, utilization of menopausal hormone therapy, and prevalence of menopausal symptoms using the menopause rating scale. Data were analyzed using SPSS version 25. Bivariate and multivariate logistic regression analyses were performed to identify independent predictors of each subscale of menopausal symptoms. The strength of the association was measured using odds ratios with 95% confidence intervals, and statistical significance was set at a value of P < 0.05.ResultThe prevalence of menopausal symptoms was 89.9%. According to the menopausal rating scale, the frequency of reported symptoms was hot flushes (54.7%), muscle and joint pain (32.1%) on the somatic subscale; physical and mental exhaustion (55.1%), irritability (48.6%) on psychological subscale; and sexual problems (41.3%), bladder problems (39.2%) on urogenital subscale. This study also showed that the age of women [aOR: 0.317, 95%CI (0.102, 0.990)], and monthly family income [aOR = 0.182, 95% CI (0.041, 0.912)] were significantly associated with somatic menopausal symptoms. There was no utilization of menopausal hormonal therapy to treat menopausal symptoms and to prevent complications.ConclusionThe prevalence of menopausal symptoms is high; however, the utilization of individualized administration of menopausal hormone therapy according to symptoms is negligible. It appears essential for these institutions to work on service availability and delivery of menopausal hormone therapy for those in need of wider benefits for their clients.

Influence of fungicide on soybean seed quality from delayed harvest and environment

AbstractField studies in 2019–2020 evaluated the influence of fungicide application on seed quality from delayed harvest (approx. 20, 30, and 44 days after optimum harvest timing, i.e., 13% seed moisture). Treatments included nofungicide, pydiflumetofen plus difenoconazole (13.7 fl oz/acre Miravis Top, Syngenta), or mefentrifluconazole plus pyraclostrobin plus fluxapyroxad (8 fl oz/acre Revytek, BASF). Effect of environment was investigated in both field (natural rainfall events) and environmentally controlled growth chambers (79°F or 90°F with 30% or 100% relative humidity and exposed for 48 or 96 h) for potential impacts on soybean [Glycine max (L.) Merr.] seed quality. Seed quality was based on a rating scale of 1 to 10 with 1 being seeds in good condition and 10 being seeds in poor condition, based on USDA reference images. Fungicide application had no effect on seed quality from delayed harvest or a saturated environment (100% relative humidity). Delaying harvest beyond approximately 20 days past optimum timing can result in reduced seed quality regardless of fungicide application (1.0 to 2.0 vs 4.0 to 8.1 rating). In addition, seedpod exposure averaged across temperature and relative humidity environments for as little as 96 h after optimum harvest timing can result in deteriorating seed quality issues (3.2 vs 1.4 rating) regardless of fungicide application. Results indicate that soybean harvest delayed 20 days after optimum timing and subjected to seasonal rainfall events or seedpods exposed to completely saturated conditions for 96 h associated with a tropical weather event will result in soybean seed quality deterioration regardless of fungicide application.

Disrupted brain functional asymmetry at rest in patients with major depressive disorder associated with sleep disturbances.

Sleep disturbances (SD) are common in major depressive disorder (MDD) patients. Brain functional asymmetry is crucial for understanding MDD pathophysiology. Previous studies using the parameter of asymmetry (PAS) approach have found brain functional asymmetry disruption in MDD. However, this has not been explored in MDD patients with SD. This study examined 26 MDD patients with SD, 34 MDD patients without SD, and 34 healthy controls using resting-state functional magnetic resonance imaging scans. SD symptoms were quantified using the 17-item Hamilton Rating Scale for Depression. PAS approach was used to evaluate functional asymmetry. MDD patients with SD displayed increased PAS in the left middle frontal gyrus (MFG)/inferior frontal gyrus (IFG) and decreased PAS in the left parahippocampal gyrus (PHG) compared to MDD patients without SD. Increased PAS in the left MFG/IFG was positively correlated with SD severity, and a negative correlation was found between decreased PAS in the left PHG and SD scores in all MDD patients. Receiver operating characteristic analysis indicated that increased PAS in the left MFG/IFG and decreased PAS in the left PHG may serve as potential neuroimaging markers to differentiate MDD patients with SD from those without SD with Area Under Curve values of 0.8157 and 0.8068, respectively. These results highlighted that increased PAS in the left MFG/IFG and decreased PAS in the left PHG may be considered a prominent feature associated with SD symptoms of MDD patients, potentially serving as imaging markers to discriminate between MDD patients with and without SD.

The effect of lung-recruitment maneuver on postoperative shoulder pain in patients undergoing laparoscopic cholecystectomy: a randomized controlled trial.

Lung-recruitment maneuvers (LRM) have been shown to reduce postoperative pain after laparoscopic surgery. This study aimed to investigate the association of LRM with the incidence of shoulder pain after laparoscopic cholecystectomy. A randomized controlled study was conducted with 110 patients undergoing elective laparoscopic cholecystectomy from July 2022 to March 2023. Participants were randomized to receive either routine exsufflation or LRM at pneumoperitoneum release. The postoperative shoulder pain and abdominal pain were assessed at 1, 4, 6, 12, and 24h after surgery using a numeric rating scale. Analgesic consumption and postoperative nausea or vomiting (PONV) were evaluated during the first 24h after surgery. The incidence of shoulder pain during the first 24h after surgery was significantly lower in the LRM group compared to the control group (26.9 vs. 59.3%; P = 0.001). The median [interquartile range] score of worst shoulder pain was significantly lower compared to the control group (3 [2-3] vs 4 [3-5.5]; P = 0.003). Participants in the LRM group showed reduced abdominal pain at rest at 4 and 24h after surgery, and experienced significantly lower intensities of abdominal pain during mobilization at all time points over 24h after surgery. There were no significant differences in opioid consumption or the incidence of PONV between the groups. LRM reduces both the incidence and intensity of shoulder pain during 24h after laparoscopic cholecystectomy. Additionally, LRM was associated with reduced intensity of abdominal pain during mobilization over the study period.

Coping model, personality traits, social support and clinical outcomes in patients undergoing continuous ambulatory peritoneal dialysis: a post-hoc analysis of a randomized trial.

Carrying out dialysis at home brings non-medical factors, including social support, or caretaker relationship, and internal features relevant to personality into the forefront. Inthis study, we aimed to explore the relationship between coping strategies of patients undergoing continuous ambulatory peritoneal dialysis (CAPD) and health outcomes. Our post-hoc analysis was based on one previous randomized controlled trial that enrolled 150 incident patients who started CAPD from December 2010 to June 2016. All patients were followed until withdrawal from PD or May 4, 2023. Medical Coping Modes Questionnaire (MCMQ) was examined, evaluating the dominant method of coping (avoidance, acceptance-resignation, or confrontation) demonstrated by patients, in addition to Social Support Rating Scale (SSRS) and Eysenck Personality Questionnaire (EPQ). Among the three mechanisms of coping, avoidance, at both the continuous and categorical variable levels, was significantly predictive of all-cause mortality. This relationship remained unchanged after adjustmentfor clinical covariates. Meanwhile, the high tertile of acceptance-resignation and other scores of confrontation independently predicted lower death risks after adjustment of the aforementioned variables. Avoidance and confrontation levels also independently predicted first-episode peritonitis. No associations between coping modes and transfer to hemodialysis were observed. Social support and personality were found to be confounders for the predictive effect of coping on all-cause mortality and first-episode peritonitis. Coping models were independently related to all-cause mortality and first-episode peritonitis among CAPD patients, confounded by their associations with social support and personality. Our findings strengthen the need to integrate coping strategies into the practice of patient-centered care.

Necessity of posterior osteotomies for mild flexible cervical deformity correction.

Correction of mild flexible cervical deformity (CD) via the posterior approach has been described with and without the use of posterior osteotomies (POs), despite a lack of clarity regarding their necessity or risks. The purpose of this study was to determine whether the use of POs when correcting mild flexible CD leads to improved clinical or radiographic outcomes, as well as defining the relative risks in utilizing them. A prospective multicenter registry of operative CD patients was analyzed. Inclusion criteria were cervical kyphosis > 10°, cervical scoliosis > 10°, cervical sagittal vertical axis (cSVA) > 4 cm, or chin-brow vertical angle > 25°. Mild deformity was defined by a cSVA of 3-5 cm and/or kyphosis < 15°. Flexibility was defined by a C2-7 angular change > 5° on preoperative flexion/extension radiographs. Patients who received a posterior column osteotomy (PCO) (Ames grades 1 and 2) were compared with patients who did not undergo a PCO (noPCO) as well as those who underwent a three-column osteotomy (3CO) (Ames grades 3-6). Ninety-five patients (33 PCO, 49 noPCO, 13 3CO) met the inclusion criteria. Both the number of levels fused (9.2 vs 7.7, p = 0.001) and the estimated blood loss (EBL) (1027 vs 486 mL, p = 0.012) were higher in the PCO cohort. Patients in the noPCO group were more likely to have a cervical apex of kyphosis (71.1%, p = 0.046), while those undergoing 3COs were more likely to have a thoracic apex (58.3%, p = 0.005). Preoperative cSVA (PCO vs noPCO: 45.4 vs 37.9 cm, p = 0.084), T1 slope (32.5° vs 29.6°, p = 0.376), C2-7 lordosis (-8.9° vs -9.2°, p = 0.942), and modified Japanese Orthopaedic Association (mJOA) score (13.4 vs 13.5, p = 0.854) were similar; however, both Neck Disability Index (NDI) (55.6 vs 42, p = 0.002) and numeric rating scale (NRS) neck (7.2 vs 5.8, p = 0.028) scores were higher in the PCO group before surgery. When adjusting for the use of an anterior approach, there was no significant difference in 1-year postoperative cSVA (35.7 and 35.6 cm, respectively; p = 0.969), C2-7 lordosis (13.7° and 10.1°, respectively; p = 0.393), and patient-reported outcome measures (NRS, NDI, and mJOA) between the PCO and noPCO groups. Two-year radiographic outcomes were largely similar, except for C2 slope, which was higher in the PCO group (29.1° vs 18°, p = 0.026). The overall complication rates progressively increased with more complex osteotomy use (noPCO 68.8% vs PCO 71.9% vs 3CO 75%) but did not reach significance (p = 0.063). The use of POs for mild flexible adult CD may not be necessary to achieve desirable radiographic correction. They are associated with greater EBL and fusion burden. Further studies are needed to fully delineate the risks of adverse events for various types of osteotomies.

Perfecting the pour: A novel co-axial technique with sequential injections for optimising cement delivery during sacroplasty.

Percutaneous sacroplasty is an effective treatment for painful sacral fractures and tumours, however there is no accepted optimal technique for performing this procedure. This study investigated a novel approach to sacroplasty combining co-axial sacral access, sequential cement injections and hypothermic cement manipulation to improve cement delivery. This retrospective study analysed 11 patients who underwent co-axial sacroplasty between April 2023 and March 2024 for treatment of painful insufficiency fractures (n = 5) or malignant sacral tumours (n = 6). All cases were performed using biplane fluoroscopy with conebeam CT navigation for planning and monitoring percutaneous access. Procedural details, technical outcomes, and clinical outcomes including Numerical Rating Scale (NRS) pain and analgesic utilisation on a six-point scale were analysed pre-procedure and at follow-up. Technical success of was achieved in all cases using this technique. The mean injected cement volume was 20.5 ± 6.4 ml. Median pre-procedural NRS pain scores of 8 (IQR 7.25-8) significantly decreased to 0 (IQR, 0-0.25) at follow-up (p <.01). The median preprocedural analgesic utilisation score reduced from 3 (IQR, 2-3) to 0 (IQR, 0-2.5) at follow-up (p <.01). Cement leakage occurred during two cases without associated adverse clinical sequelae. There were no major adverse events. Co-axial sequential injection sacroplasty is a safe and effective technique which allows facilitates controlled delivery of cement. Improved control of cement delivery, including around high-risk structures for cement leakage, offers a potential safety advantage over conventional sacroplasty techniques. Further research comparing technical and clinical outcomes to conventional techniques is warranted.

Residual Depressive Symptoms in Treatment-Resistant Bipolar Depression Following Short-Term Ketamine Administration.

Residual symptoms are frequently observed in a significant number of patients with depression, indicating an unmet need for effective management strategies to achieve functional recovery. This observational study aimed to evaluate the impact of ketamine infusions on depressive symptoms in patients with bipolar disorder who continued their baseline psychotropic and chronic somatic treatments. Datasets of the two consecutive real-world registries (NCT04226963 for 2019-2022; NCT05565352 from 2023 onward) for the tertiary reference center for psychiatry at the Medical University of Gdańsk (Poland) for the safety and tolerability of ketamine use in mood and anxiety disorders were retrospectively analyzed. Depressive symptoms were assessed using the Inventory of Depressive Symptomatology Self-Report 30 (IDS-SR30). Residual symptoms were identified in patients who achieved a treatment response, defined as a 50% or greater reduction in Montgomery-Åsberg Depression Rating Scale (MADRS) scores from baseline to the seventh infusion. Overall, 14 out of 22 patients met the criteria for response. The most commonly persistent depressive symptoms included sad mood (85.7%), view of my future (78.6%), difficulty falling asleep, and leaden paralysis/physical energy (both 71.4%), with the most severe being difficulty falling asleep (64.3%) and sad mood (42.9%). This observational post hoc analysis indicates that the most frequently observed residual depressive symptoms were low mood, altered view of future, sleep disturbances, and low energy levels. This study should be treated with caution as causality does not apply, however, it reports on a real-world population of subjects with treatment-resistant bipolar depression. Establishing standardized definitions for residual symptoms could enhance the quality and comparability of future research in this area.

Assessment of Eye Care Apps for Children and Adolescents Based on the Mobile App Rating Scale: Content Analysis and Quality Assessment.

In China, the current situation of myopia among children and adolescents is very serious. Prevention and control of myopia are inhibited by the lack of medical resources and the low awareness about eye care. Nevertheless, mobile apps provide an effective means to solve these problems. Since the health app market in China is still immature, it has become particularly important to conduct a study to assess the quality of eye-care apps to facilitate the development of better eye-care service strategies. This study aimed to evaluate the quality, functionality, medical evidence, and professional background of eye-care apps targeting children and adolescents in the Chinese app stores. A systematic search on iOS and Android app stores was performed to identify eye-care apps for children and adolescents. The general characteristics, development context, and functional features of the apps were described. Quality assessment of the apps was completed by 2 independent researchers using the Mobile App Rating Scale. This study included 29 apps, of which 17 (59%) were developed by commercial organizations and 12 (41%) had a design with relevant scientific basis. The main built-in functions of these apps include self-testing (18/29, 62%), eye exercises (16/29, 55%), and eye-care education (16/29, 55%). The mean overall quality of eye-care apps was 3.49 (SD 0.33), with a score ranging from 2.89 to 4.39. The overall Mobile App Rating Scale score exhibited a significant positive correlation with the subscale scores (r=0.81-0.91; P<.001). In addition, although most apps provided basic eye-care features, there are some deficiencies. For example, only a few apps were developed with the participation of medical organizations or professional ophthalmologists, and most of the apps were updated infrequently, failing to provide the latest eye-care information and technology in a timely manner. In general, the quality of eye-care apps for children and teenagers in Chinese app stores is good. These apps fulfill users' needs for eye-care services to a certain extent, but they still suffer from insufficient medical background, low user engagement, and untimely updates. In order to further improve the effectiveness of eye-care apps, cooperation with medical institutions and professional ophthalmologists should be strengthened to enhance the scientific and authoritative nature of the apps. At the same time, interactive features and regular updates should be added to enhance user participation and the continuity of the apps. This study provides a reference for future development or improvement of eye-care apps, which can help promote myopia prevention and control.

Relationship between physical exercise, bullying, and being bullied among junior high school students: the multiple mediating effects of emotional management and interpersonal relationship distress

ObjectiveThis paper investigates the relationships between physical activity (PA), school bullying, emotion regulation self-efficacy (ERS), and interpersonal relationship distress (IRD) among junior high school students. It also examines the underlying mechanisms of school bullying to provide insights into reducing adolescent bullying and to lay the groundwork for preventing and controlling aggressive behaviors.MethodsA survey was conducted on 484 students (240 males, 12.18 ± 0.8 years) from 4 secondary schools using the Physical Activity Rating Scale (PARS), Emotional Management Self-Efficacy Scale (EMSS), Interpersonal Relationship Distress Scale (IRDS), and Campus Bullying Scale (CBS) to examine the effects among the variables. A stratified random sampling method was used to select the sample, and data were collected with a structured questionnaire. The data were analyzed using SPSS 24.0 and AMOS 24.0 statistical software. The analysis included Pearson correlation analysis, structural equation modeling, and bias-corrected percentile Bootstrap methods.Results(1) PA negatively predicts IRD, which in turn has an indirect effect on bullying (PA → IRD → Bullying), ES = -0.063. Additionally, EM and IRD act as mediators between PA and school bullying (PA → EM → IRD → Bullying), ES = 0.025. (2) PA negatively predicts IRD, which has an indirect effect on being bullied (PA → IRD → Being bullied), ES = -0.044. EM and IRD serve as chain mediators between PA and being bullied (PA → EM → IRD → Being bullied), ES = -0.071.ConclusionPA can positively predict bullying, but it can be mitigated through EM to reduce IRD, thereby decreasing the occurrence of campus bullying and being bullied.

Deep brain stimulation and pallidotomy in primary Meige syndrome: a prospective cohort study.

Primary Meige syndrome (PMS) is a rare form of dystonia, and comparative analysis of globus pallidus internal deep brain stimulation (GPi-DBS), subthalamic nucleus deep brain stimulation (STN-DBS), and pallidotomy has been lacking. This study aims to compare the efficacy, safety, and psychiatric features of GPi-DBS, STN-DBS, and pallidotomy in patients with PMS. This prospective cohort study was divided into three groups: GPi-DBS, STN-DBS, and pallidotomy. Clinical assessments, including motor and non-motor domains, were evaluated at baseline and at 1year and 3years after neurostimulation/surgery. Ninety-eight patients were recruited: 46 patients received GPi-DBS, 34 received STN-DBS, and 18 underwent pallidotomy. In the GPi-DBS group, the movement score of the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) improved from a mean (SE) of 13.8 (1.0) before surgery to 5.0 (0.7) (95% CI, -10.5 to -7.1; P < 0.001) at 3years. Similarly, in the STN-DBS group, the mean (SE) score improved from 13.2 (0.8) to 3.5 (0.5) (95% CI, -10.3 to -8.1; P < 0.001) at 3years, and in the pallidotomy group, it improved from 14.9 (1.3) to 6.0 (1.1) (95% CI, -11.3 to -6.5; P < 0.001) at 3years. They were comparable therapeutic approaches for PMS that can improve motor function and quality of life without non-motor side effects. DBS and pallidotomy are safe and effective treatments for PMS, and an in-depth exploration of non-motor symptoms may be a new entry point for gaining a comprehensive understanding of the pathophysiology.

A - 69 The Use of Neuropsychological Assessments in the Diagnosis of ADHD among Racial and Ethnic Minorities in the US

Abstract Objectives Neuropsychological evaluations provide information that can potentially minimize the risk of poor outcomes and enhance the quality of life for children with attention deficit hyperactivity disorder (ADHD). Black and Brown students have higher incidences of misdiagnosis of Oppositional Defiant Disorder (ODD) and being funneled into Emotional and behavioral disorders (EBD) classrooms. There is support for the incremental efficacy of neuropsychological evaluation compared to routine care in the diagnosis and management of ADHD. This study analyzes neuropsychological assessment practices and diagnosis trends by race, ethnicity, and gender, incorporating teacher and parent perceptions through behavioral rating scales. Data Selection The following selection criteria were utilized: -published in peer-reviewed journals focusing on neuropsychological evaluations for ADHD among black and brown clients -employed a variety of assessment tools and methodologies - reporting on cultural considerations, validity, and reliability of neuropsychological assessments in black and brown populations. Data Synthesis Gender and racial differences in the timing and rate of diagnosis have delayed the onset of treatment. Additionally, there has been a difference in how parents and teachers endorse symptoms of ADHD by race on rating scales included in comprehensive neuropsychological evaluations. Conclusions Early intervention is associated with improved outcomes for individuals diagnosed with ADHD. However, there is a significant imbalance between the growing numbers of ethnic/racial and linguistic minority children in the United States who need neuropsychological services and the limited number of neuropsychologists trained to handle the cultural complexities. Accurate, culturally informed neuropsychological assessments are needed to ensure equitable behavioral health services are provided.

A - 128 Informant Characteristics Impact Clinical Dementia Rating Scale Sum of Boxes in Mild Cognitive Impairment

Abstract Objective The Clinical Dementia Rating (CDR) Scale is an informant-based instrument widely used in clinical and research settings to stage dementia severity. Informant-based reports of functioning have been shown to be influenced by informant characteristics, indicating a potential source of bias. The current study adds to this growing area of research by exploring the differential impact of informant characteristics on CDR Sum of Boxes (CDR-SB) among non-Hispanic White (NHW), non-Hispanic Black (NHB) and Hispanic older adults with mild cognitive impairment (MCI). Method Participants included 2775 older adults diagnosed with MCI from the National Alzheimer’s Coordinating Center Uniform Data Set. Multiple linear regression models with forward selection evaluated the extent to which various informant characteristics predicted CDR-SB scores in the whole sample and NHW (n = 2170), NHB (n = 495), and Hispanic (n = 110) groups, covarying for participant demographics and cognition (MoCA). Results Informant sex, education, age, relationship type, and cohabitation status significantly predicted CDR-SB scores in this sample (R2 = 0.096, p &amp;lt; 0.001). Models stratified by race and ethnicity accounted for 20.2%, 10.3%, and 6.9% of the variance in CDR-SB scores in Hispanic, NHB, and NHW groups, respectively (ps &amp;lt; 0.001). Variability in model predictors was observed across groups, with informant characteristics accounting for more model variance than participant demographics in Hispanic and NHB groups. Results remained significant after adjusting for multiple comparisons. Conclusions Informant characteristics and relational factors may influence perceptions of participant functioning on the CDR-SB and may particularly affect scores among Hispanic older adults with MCI, though further validation in community-based cohorts with adequate racial and ethnic representation is warranted.

A - 132 Perceptions of Functional Competency in Persons with Subjective Memory Complaints, Mild Cognitive Impairment, and Early Dementia of the Alzheimer’s Type

Abstract Objective This study evaluated whether persons with Subject Memory Complaints (SMC) perceive their overall functional abilities differently than persons with known memory impairments. We predicted SMC persons would describe themselves as less functionally competent compared to persons with objective memory impairments while relatives would perceive them as more functionally competent than what they report. Method As a part of an ongoing study evaluating cognitive and motor correlates of SMC, Mild Cognitive Impairment (MCI), and early Alzheimer’s disease (ad), 10 persons with SMC, 14 with MCI, and 11 with early ad completed the Patient Competency Rating Scale (PCRS). A family member or significant other completed the Patient Competency Rating Scale-Relative Form. Subjects were matched on age, education, and sex. Results Self-reported competency varied across groups (p &amp;lt; 0.05), with the SMC group reporting less competency than the MCI group but at a level of competency similar to the ad group. Relatives’ ratings were also significantly different across groups (p &amp;lt; 0.05). SMC persons were considered by relatives as more functionally competent than the MCI and ad groups. Discrepancy scores between the PCRS and PCRS-R differed across groups (p &amp;lt; 0.05). SMC persons underestimated their functional abilities while persons with MCI and ad overestimated their abilities. Conclusion The findings support the predictions and are compatible with reports in the literature. The PCRS and PCRS-R provide clinically relevant information regarding both a person’s functional abilities in everyday life (according to a relative) while also detecting potential disturbances in self-awareness. SMC patients appear to overstate their functional limitations in many domains in addition to memory.