Depression screening in patients with aneurysmal subarachnoid haemorrhage and their caregivers: A systematic review.

BACKGROUND: Depression commonly occurs after aneurysmal subarachnoid haemorrhage (aSAH) which can negatively impact patients and their caregivers. Identification and validation of depression screening instruments specifically for patients with aSAH and their caregivers has not been performed. OBJECTIVES: The objectives of this study were to identify the common depression screening tools in patients with aSAH and their caregivers and to determine if they are validated for use in these populations. METHODS: Medical Subject Headings and keyword search terms were used in five electronic databases to identify randomised controlled, quasi-experimental and observational studies published between 1 January 2010 and 26 June 2022. Screening, data extraction and study quality assessments were conducted by two independent reviewers. RESULTS: Of the 3440 identified studies, 61 met inclusion, with 2 of 61 (3%) RCTs, 2 of 61 (3%) quasi-experimental, and 57 of 61 (93%) observational studies included. The majority of studies (58/61 [95%]) reported patient-only depression screening, 1 of 61 (2%) reported both patients' and caregivers' depression screening, and 2 of 61 (3%) reported caregiver-only depression screening. Nine depression screening instruments were identified. The Beck Depression Inventory-II (BDI-II) was the most commonly used (13/59; 22%), followed by the Hospital Anxiety and Depression Scale (HADS) (12/59; 20%). In the ischaemic stroke population, the BDI-II was reported to have excellent sensitivity (0.85) and specificity (0.75); the HADS was also found to have good sensitivity (0.62) and specificity (0.83) in the ischaemic stroke population. Only two depression screening instruments for caregivers were identified: HADS and Goldberg Depression Scale. Both were found to have good sensitivity (>0.80) and specificity (>0.80) in the general population. CONCLUSION: The BDI-II and HADS were the most commonly used depression screening instruments in patients with aSAH. Neither of these instruments has been specifically validated in an aSAH population. None of the nine depression instruments were validated for patients with aSAH. Due to an insufficient number of studies in caregivers' population, validity was unable to be determined.

Determining the coordination environment and electronic structure of polymer-encapsulated cobalt phthalocyanine under electrocatalytic CO2 reduction conditions using in situ X-Ray absorption spectroscopy.

Encapsulating cobalt phthalocyanine (CoPc) within the coordinating polymer poly-4-vinylpyridine (P4VP) results in a catalyst-polymer composite (CoPc-P4VP) that selectively reduces CO2 to CO at fast rates at low overpotential. In previous studies, we postulated that the enhanced selectively for CO over H2 production within CoPc-P4VP compared to the parent CoPc complex is due to a combination of primary, secondary, and outer-coordination sphere effects imbued by the encapsulating polymer. In this work, we perform in situ electrochemical X-ray absorption spectroscopy measurements to study the oxidation state and coordination environment of Co as a function of applied potential for CoPc, CoPc-P4VP, and CoPc with an axially-coordinated py, CoPc(py). Using in situ X-ray absorption near edge structure (XANES) we provide experimental support for our previous hypothesis that Co changes from a 4-coordinate square-planar geometry in CoPc to a mostly 5-coordinate species in CoPc(py) and CoPc-P4VP. The coordination environment of CoPc-P4VP is potential-independent but pH-dependent, suggesting that the axial coordination of pyridyl groups in P4VP to CoPc is modulated by the protonation of the polymer. Finally, we show that at low potential the oxidation state of Co in the 4-coordinate CoPc is different from that in the 5-coordinate CoPc(py), suggesting that the primary coordination sphere modulates the site of reduction (metal-centered vs. ligand centered) under catalytically-relevant conditions.