Factors Influencing Pedestrian Smartphone Use and Effect of Combined Visual and Auditory Intervention on "Smombies": A Chinese Observational Study.

Objective: This was a large-scale multicenter study with two objectives. One was to study the factors influencing pedestrian smartphone use while crossing roads, and the other was to study the effect of combined visual and auditory intervention on smartphone zombies (smombies) at crossroads. Methods: This study was conducted in four different Chinese cities. By observing pedestrians crossing intersections, the weather, time, and characteristics of the pedestrians were recorded by four researchers. Then, its influencing factors and the effects of the intervention were studied in two consecutive periods. Results: A total of 25,860 pedestrians (13,086 without intervention and 12,774 with visual and auditory intervention) were observed in this study. Logistic regressions showed that gender, age of the pedestrians, weather, and time were the factors influencing smombies crossing roads. The number of smartphone users decreased from 4,289 to 3,579 (28.1%) (χ 2 = 69.120, p < 0.001) when the intervention was conducted. Conclusion: Based on large-sample, multicenter research, this study revealed the factors influencing pedestrian smartphone use while crossing roads, contributing to our understanding of the current situation of smombies in China. Furthermore, the effect of visual and auditory intervention was demonstrated, providing a new paradigm for global prevention of smombie behavior.

Effects of Electroacupuncture Combined With Psychological Intervention on Depressive Status and Contingent Negative Variation in Patients With Internet Addiction Disorder: A Randomized Controlled Trial.

Background: Depressive symptoms often accompany people with Internet addiction syndrome (IAD). Acupuncture has been found to have significant advantages in improving the severity and depressive symptoms of IAD. Contingent negative variation (CNV) is a common method to explore the mechanism of neurophysiology. Objective: The purpose of this study was to observe the efficacy of electroacupuncture (EA), psychological intervention (PI), and comprehensive intervention (CI) in the treatment of depression in Internet addiction disorder (IAD), and to observe the changes of contingent negative variation (CNV) in each group. Methods: One hundred and twenty subjects diagnosed with IAD were randomly assigned to the EA group, the PI group, or the CI group. They received EA, PI, or a combination of EA and PI for 40 days. The Internet Addiction Test (IAT), the Zung Self-rating Depression Scale (SDS), and the Hamilton Depression Scale (HAMD) were evaluated for all subjects at baseline, 20th, and 40th days of treatment, while CNV data were collected at baseline and 40th days of treatment. Results: Three treatments effectively reduced IAT, SDS, and HAMD scores, and the intergroup comparison showed that CI was superior to EA, while EA was superior to PI. CNV results indicated that the CNV amplitude increased in all three groups of IAD patients after treatment. The CNV latency of point A and A-S2' wave area of the EA group and the CI group did not change significantly after treatment. Only the A-S2' wave area of the PI group increased significantly compared with the baseline period. In addition, IAD's IAT score was positively correlated with SDS and HAMD score at baseline but negatively correlated with CNV latency. After treatment, only the change of HAMD score in the CI group was negatively correlated with amplitude. Conclusion: Our results demonstrate the efficacy of acupuncture and psychological intervention in the treatment of IAD from an electrophysiological perspective. Simultaneously, the increase in CNV amplitude might be the underlying neurophysiological mechanism by which CI improves depression and cognitive function in IAD patients. Clinical Trial Registration: ClinicalTrials.gov, identifier NCT02362698.

mRNA Levels of MAOA and 5-HT 2 A Receptor in Patients With Pathological Internet Use: Correlations With Comorbid Symptoms.

Objective: Uncontrolled internet use may lead to the emergence of pathological internet use (PIU). PIU has become a global public health concern that can cause a range of psychotic symptoms, including anxiety, depression, and impulse control disorder. To date, we know very little about the principal biological factors related to PIU. Monoamine oxidase type A (MAOA) and serotonin (5-HT) 5-HT2A receptor (5-HT2AR) play critical roles in the development of behavioural and drug addictions. Thus, the aim of this study was to measure the relative expression of mRNA of MAOA and 5-HT2AR in peripheral blood mononuclear cells (PBMCs) of patients with PIU and to determine the correlations between these biological indicators and the comorbid symptoms of patients with PIU. Methods: In this study, the mRNA of MAOA and 5-HT2AR was detected using real-time PCR in PBMCs of the patients with PIU (n = 24) and healthy controls (HCs, n = 25). The relationship between the mRNA levels of MAOA and 5-HT2AR and clinical symptoms in patients with PIU was further investigated. Results: MAOA mRNA in PBMCs was significantly upregulated in patients with PIU compared with that in HCs. mRNA levels of 5-HT2AR were not found to differ significantly between HCs and patients with PIU. Correlation analyses further revealed a significant positive correlation between the relative expression of MAOA mRNA in PBMCs of patients with PIU and the Young's Internet Addiction Test and Self-Rating Depression Scale scores. Conclusion: The present study revealed upregulated expression of MAOA mRNA in patients with PIU and an association between the expression of MAOA mRNA and clinical symptoms of PIU, suggesting that the neurobiological changes may be similar between PIU and substance addiction. Additionally, this study demonstrated a potential association between comorbid symptoms and mRNA levels of MAOA.

Acupuncture for Internet addiction: A protocol for systematic review.

BACKGROUND: Internet addiction (IA) has become a global problem characterized by excessive use of the internet, compulsive, and deleterious personal behaviors. Acupuncture has gained more and more attention in the treatment of IA. However, evidence of its effectiveness is lacking. The purpose of this systematic review is to evaluate the efficacy and safety of acupuncture in the treatment of IA. METHODS: The following databases will be searched from the inception to September 30, 2020: the Cochrane Library, PubMed, Embase, Web of Science, China National Knowledge Infrastructure, Wan-fang database, Chinese Biomedical Literature Database, and Chinese Scientific Journal Database. The research on acupuncture and IA meets the screening criteria, and two independent reviewers performed citation screening, data extraction, and risk assessment of bias. We used Cochrane Review Manager 5.3 software for statistical analysis. RESULTS: The findings will be published at scientific conferences or in a peer-reviewed journal. This study is based on the existing research, so there is no need for ethical approval. CONCLUSION: This systematic review provides evidence for the efficacy of acupuncture in treating IA disorder, and it is of great significance for effective clinical routine treatment of IA. TRIAL REGISTRATION NUMBER: INPLASY 2020120099.

A network meta-analysis protocol of conservative interventions for urinary incontinence in postpartum women.

BACKGROUND: Postpartum urinary incontinence (PPUI) is a common urological condition in women after childbirth. Due to the side effects of surgical and pharmacological therapies, the patients and physicians alike express a strong preference for conservative approaches on PPUI, such as pelvic floor muscle training, biofeedback, electrical stimulation, bladder training, vaginal cones and acupuncture. Application of these conservative approaches should be guided by high quality evidence, yet their comparative effectiveness has not been well documented. Therefore, the network meta-analysis aims to compare, rank and summarize all available studies to determine which conservative intervention is more effective for PPUI. METHODS: In this present study, qualified English and Chinese studies will be searched in PubMed, Scopus, EMBASE, The Cochrane Library, Web of Science, VIP Database, Wanfang Database, Chinese Biomedical Literature Database and China National Knowledge Infrastructure. All eligible randomized controlled trails (RCTs) of conservative interventions for PPUI will be included. R software 3.61 (R Foundation for Statistical Computing, Vienna, Austria) will be applied to synthesize data and conduct network meta-analysis. I statistic and Z test will be used to assess heterogeneity and inconsistency, respectively. RESULTS: Ethical approval is not required for this existed literature based meta-analysis. The findings of this research will be disseminated through a recognized journal. CONCLUSION: The findings of this study will provide ranking evidence for clinicians and patients to choose a more appropriate conservative therapy on PPUI. TRIAL REGISTRATION NUMBER: PROSPERO CRD42020168042.

Non-pharmacological interventions for postpartum depression: A protocol for systematic review and network meta-analysis.

BACKGROUND: Postpartum depression (PPD) is one of the most common mental disorders in women following childbirth with heightened prevalence across the globe. Both pharmacotherapy and non-pharmacological interventions are effective for PPD. However, due to the concerns about the side effect on the mother and child of pharmacological treatments, most of women with PPD choose non-pharmacological therapies as their first line option. Prescription of these non-drug approaches should be guided by high quality evidence. Therefore, this network meta-analysis aims to compare, rank and interpret existed non-pharmacological evidence for the effective treatment of women with PPD. METHODS: Electronic bibliographic databases including EMBASE, PubMed, Scopus, The Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI),VIP Database, Wanfang Database and Chinese Biomedical Literature Database will be searched for relevant randomized controlled trials (RCTs) of non-pharmacological interventions for PPD. Heterogeneity and inconsistencies will be analyzed by I statistic and Z test, respectively. We will assess the quality of evidence by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) and evaluate the risk of bias according to Cochrane risk of bias tool. R software 3.6.1 (R Foundation for Statistical Computing, Vienna, Austria) will be used to conduct a network meta-analysis. RESULTS: Formal ethical approval is not required, because the present study is a meta-analysis based on existed studies. The findings of this research will be reported in a recognized journal. CONCLUSION: The review results will ascertain the hierarchy of effectiveness of different non-pharmacological approaches for PPD, and systematically provide suggests for physicians and patients. TRIAL REGISTRATION NUMBER: PROSPERO CRD42020166801.