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1.
Nat Commun ; 15(1): 5996, 2024 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-39013848

RESUMO

Machine learning can be used to define subtypes of psychiatric conditions based on shared biological foundations of mental disorders. Here we analyzed cross-sectional brain images from 4,222 individuals with schizophrenia and 7038 healthy subjects pooled across 41 international cohorts from the ENIGMA, non-ENIGMA cohorts and public datasets. Using the Subtype and Stage Inference (SuStaIn) algorithm, we identify two distinct neurostructural subgroups by mapping the spatial and temporal 'trajectory' of gray matter change in schizophrenia. Subgroup 1 was characterized by an early cortical-predominant loss with enlarged striatum, whereas subgroup 2 displayed an early subcortical-predominant loss in the hippocampus, striatum and other subcortical regions. We confirmed the reproducibility of the two neurostructural subtypes across various sample sites, including Europe, North America and East Asia. This imaging-based taxonomy holds the potential to identify individuals with shared neurobiological attributes, thereby suggesting the viability of redefining existing disorder constructs based on biological factors.


Assuntos
Algoritmos , Substância Cinzenta , Imageamento por Ressonância Magnética , Esquizofrenia , Humanos , Esquizofrenia/diagnóstico por imagem , Esquizofrenia/patologia , Masculino , Feminino , Adulto , Substância Cinzenta/diagnóstico por imagem , Substância Cinzenta/patologia , Aprendizado de Máquina , Pessoa de Meia-Idade , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Estudos Transversais , Europa (Continente) , Neuroimagem , Reprodutibilidade dos Testes , América do Norte , Hipocampo/diagnóstico por imagem , Hipocampo/patologia
2.
Sci Adv ; 10(24): eadk6063, 2024 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-38865456

RESUMO

Schizophrenia lacks a clear definition at the neuroanatomical level, capturing the sites of origin and progress of this disorder. Using a network-theory approach called epicenter mapping on cross-sectional magnetic resonance imaging from 1124 individuals with schizophrenia, we identified the most likely "source of origin" of the structural pathology. Our results suggest that the Broca's area and adjacent frontoinsular cortex may be the epicenters of neuroanatomical pathophysiology in schizophrenia. These epicenters can predict an individual's response to treatment for psychosis. In addition, cross-diagnostic similarities based on epicenter mapping over of 4000 individuals diagnosed with neurological, neurodevelopmental, or psychiatric disorders appear to be limited. When present, these similarities are restricted to bipolar disorder, major depressive disorder, and obsessive-compulsive disorder. We provide a comprehensive framework linking schizophrenia-specific epicenters to multiple levels of neurobiology, including cognitive processes, neurotransmitter receptors and transporters, and human brain gene expression. Epicenter mapping may be a reliable tool for identifying the potential onset sites of neural pathophysiology in schizophrenia.


Assuntos
Imageamento por Ressonância Magnética , Neuroimagem , Esquizofrenia , Esquizofrenia/patologia , Esquizofrenia/diagnóstico por imagem , Humanos , Neuroimagem/métodos , Imageamento por Ressonância Magnética/métodos , Masculino , Feminino , Adulto , Mapeamento Encefálico/métodos , Encéfalo/patologia , Encéfalo/diagnóstico por imagem , Pessoa de Meia-Idade
3.
JAMA Netw Open ; 7(6): e2415110, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38842809

RESUMO

Importance: Available antipsychotic medications are predominantly used to treat positive symptoms, such as hallucinations and delusions, in patients with first-episode psychosis (FEP). However, treating negative and cognitive symptoms, which are closely related to functional outcomes, remains a challenge. Objective: To explore the cognitive characteristics of patients with negative symptom-dominant (NSD) psychosis. Design, Setting, and Participants: This large-scale cross-sectional study of patients with FEP was led by the Shanghai Mental Health Center in China from 2016 to 2021, with participants recruited from 10 psychiatric tertiary hospitals. A comprehensive cognitive assessment was performed among 788 patients with FEP who were drug-naive. Symptom profiles were determined using the Positive and Negative Symptoms Scale (PANSS), and NSD was defined as a PANSS score for negative symptoms higher than that for positive and general symptoms. Positive symptom-dominant (PSD) and general symptom-dominant (GSD) psychosis were defined similarly. Data were analyzed in 2023. Exposure: Psychotic symptoms were categorized into 3 groups: NSD, PSD, and GSD. Main Outcomes and Measures: Neurocognitive performance, assessed using the Chinese version of the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery. Results: This study included 788 individuals with FEP (median age, 22 [IQR, 17-28] years; 399 men [50.6%]). Patients with NSD exhibited more-pronounced cognitive impairment than did those with PSD or GSD. Specifically, cognitive differences between the NSD and PSD group, as well as between the NSD and GSD group, were most notable in the processing speed and attention domains (Trail Making [F = 4.410; P = .01], Symbol Coding [F = 4.957; P = .007], Verbal Learning [F = 3.198; P = .04], and Continuous Performance [F = 3.057; P = .05]). Patients with PSD and GSD showed no significant cognitive differences. Cognitive impairment was positively associated with the severity of negative symptoms. Most of the cognitive function tests used were able to differentiate patients with NSD from those with PSD and GSD, with significant differences observed across a range of tests, from Brief Visuospatial Memory Test-Revised (χ2 = 3.968; P = .05) to Brief Assessment of Cognition in Schizophrenia symbol coding (χ2 = 9.765; P = .002). Conclusions and Relevance: The findings of this cross-sectional study of patients with FEP suggest the presence of a clinical subtype characterized by a predominance of negative symptoms and cognitive impairment.


Assuntos
Disfunção Cognitiva , Transtornos Psicóticos , Humanos , Masculino , Feminino , Estudos Transversais , Disfunção Cognitiva/etiologia , Transtornos Psicóticos/tratamento farmacológico , Transtornos Psicóticos/complicações , Transtornos Psicóticos/psicologia , Adulto , China/epidemiologia , Adulto Jovem , Escalas de Graduação Psiquiátrica , Esquizofrenia/complicações , Esquizofrenia/tratamento farmacológico , Adolescente , Testes Neuropsicológicos/estatística & dados numéricos
4.
Syst Rev ; 13(1): 165, 2024 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-38915121

RESUMO

BACKGROUND: Non-invasive brain stimulation (NIBS) is a promising intervention for treatment-resistant schizophrenia. However, there are multiple available techniques and a comprehensive synthesis of evidence is lacking. Thus, we will conduct a systematic review and network meta-analysis to investigate the comparative efficacy and safety of NIBS techniques as an add-on to antipsychotics for treatment-resistant schizophrenia. METHODS: We will include single- and double-blind randomized-controlled trials (RCT) comparing any NIBS technique with each other or with a control intervention as an add-on to antipsychotics in adult patients with treatment-resistant schizophrenia. We will exclude studies focusing on predominant negative symptoms, maintenance treatment, and single sessions. The primary outcome will be a change in overall symptoms, and secondary outcomes will be a change in symptom domains, cognitive performance, quality of life, functioning, response, dropouts, and side effects. We will search for eligible studies in previous reviews, multiple electronic databases and clinical trial registries from inception onwards. At least two independent reviewers will perform the study selection, data extraction, and risk of bias assessment. We will measure the treatment differences using standardized mean difference (SMD) and odds ratio (OR) for continuous and dichotomous outcomes, respectively. We will conduct pairwise and network meta-analysis within a frequentist framework using a random-effects model, except for rare event outcomes where we will use a fixed-effects Mantel-Haenszel method. We will investigate potential sources of heterogeneity in subgroup analyses. Reporting bias will be assessed with funnel plots and the Risk of Bias due to Missing Evidence in Network meta-analysis (ROB-MEN) tool. The certainty in the evidence will be evaluated using the Confidence in Network Meta-analysis (CINeMA) approach. DISCUSSION: Our network meta-analysis would provide an up-to-date synthesis of the evidence from all available RCTs on the comparative efficacy and safety of NIBS for treatment-resistant schizophrenia. This information could guide evidence-based clinical practice and improve the outcomes of patients. SYSTEMATIC REVIEW REGISTRATION: PROSPERO-ID CRD42023410645.


Assuntos
Metanálise em Rede , Esquizofrenia Resistente ao Tratamento , Revisões Sistemáticas como Assunto , Estimulação Transcraniana por Corrente Contínua , Humanos , Esquizofrenia Resistente ao Tratamento/terapia , Estimulação Transcraniana por Corrente Contínua/métodos , Antipsicóticos/uso terapêutico , Estimulação Magnética Transcraniana/métodos , Metanálise como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Esquizofrenia/terapia
5.
Artigo em Inglês | MEDLINE | ID: mdl-38909898

RESUMO

BACKGROUND: Restricted scan path mode is hypothesized to explain abnormal scanning patterns in patients with schizophrenia. Here, we calculated entropy scores (drawing upon gaze data to measure the statistical randomness of eye movements) to quantify how strategical and random participants were to process image stimuli. METHODS: Eighty-six patients with first-episode schizophrenia (FES), 124 individuals at clinical high risk (CHR) for psychosis, and 115 healthy controls (HCs) completed an eye-tracking examination for freely viewing 35 static images (each presented 10s) and cognitive assessments. We compared the group differences in overall entropy score, as well as entropy scores under various conditions. Furthermore, we also investigated the correlation between entropy scores and symptoms along with cognitive function. RESULTS: Increased overall entropy scores were noted in FES and CHR groups relative to HCs, and these differences were already apparent within 0∼2.5s. In addition, the CHR group exhibited higher entropy when viewing low-meaning images compared to HCs. Moreover, the entropy within 0∼2.5s showed significant correlations with negative symptoms in the FES group, Attention/Vigilance scores in the CHR group, as well as Speed of processing and Attention/Vigilance scores across all three groups. CONCLUSIONS: The results indicate that FES and CHR individuals scan pictures more randomly and less strategically than HCs. These patterns also correlate with clinical symptoms and neurocognition. The present study highlights the potential of the eye movement entropy measure as a neurophysiological marker for early psychosis.

6.
Child Adolesc Psychiatry Ment Health ; 18(1): 53, 2024 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-38704567

RESUMO

BACKGROUND: The effects of antipsychotic (AP) medications on cognitive functions in individuals at clinical high-risk (CHR) of psychosis are poorly understood. This study compared the effects of AP treatment on cognitive improvement in CHR adolescents and adults. METHODS: A total of 327 CHR participants, with an age range of 13 to 45 years, who underwent baseline neuropsychological assessments and a 1-year clinical follow-up were included. Participants with CHR were categorized into four groups based on their age: adolescents (aged < 18) and adults (aged ≥ 18), as well as their antipsychotic medication status (AP+ or AP-). Therefore, the four groups were defined as Adolescent-AP-, Adolescent-AP+, Adult-AP-, and Adult-AP+. RESULTS: During the follow-up, 231 CHR patients received AP treatment, 94 converted to psychosis, and 161 completed the 1-year follow-up. The Adolescent-AP+ group had more positive symptoms, lower general functions, and cognitive impairments than the Adolescent-AP- group at baseline, but no significant differences were observed among adults. The Adolescent-AP+ group showed a significant increase in the risk of conversion to psychosis (p < 0.001) compared to the Adolescent-AP- group. The Adult-AP+ group showed a decreasing trend in the risk of conversion (p = 0.088) compared to the Adult-AP- group. The Adolescent-AP- group had greater improvement in general functions (p < 0.001), neuropsychological assessment battery mazes (p = 0.025), and brief visuospatial memory test-revised (p = 0.020), as well as a greater decrease in positive symptoms (p < 0.001) at follow-up compared to the Adolescent-AP+ group. No significant differences were observed among adults. CONCLUSIONS: Early use of AP was not associated with a positive effect on cognitive function in CHR adolescents. Instead, the absence of AP treatment was associated with better cognitive recovery, suggesting that AP exposure might not be the preferred choice for cognitive recovery in CHR adolescents, but may be more reasonable for use in adults.

7.
J Alzheimers Dis ; 99(4): 1385-1396, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38788072

RESUMO

Background: Long noncoding RNAs (lncRNAs) regulate the pathogenesis of Alzheimer's disease (AD). Objective: To identify lncRNAs in the peripheral blood as potential diagnostic biomarkers for amnestic mild cognitive impairment. Methods: In the discovery group, a microarray was used to screen for significant differences in lncRNA expression between patients with mild cognitive impairment (MCI) caused by AD and normal controls (NCs) (n = 10; MCI, 5; NC, 5). Furthermore, two analytic groups were assessed (analytic group 1: n = 10; amnestic MCI (aMCI), 5; NC, 5; analytic group 2: n = 30; AD, 10; aMCI, 10; NC, 10) and finalized in the validation group (n = 150; AD, 50; aMCI, 50; NC, 50). In the analytic and validation groups, real-time quantitative reverse-transcription polymerase chain reaction was used to identify differentially expressed lncRNAs between the aMCI and NC groups. Results: We identified 67 upregulated and 220 downregulated lncRNAs among the expression profiles. The panel with lncRNAs T324988, NR_024049, ENST00000567919, and ENST00000549762 displayed the highest discrimination ability between patients with aMCI and NCs. The area under the receiver operating characteristic curve of this combined model was 0.941, with a sensitivity of 92.00% and specificity of 84.00%. Conclusions: This study reports on a panel of four lncRNAs as promising biomarkers to diagnose aMCIs.


Assuntos
Doença de Alzheimer , Biomarcadores , Disfunção Cognitiva , RNA Longo não Codificante , Humanos , RNA Longo não Codificante/sangue , RNA Longo não Codificante/genética , Disfunção Cognitiva/sangue , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/genética , Masculino , Idoso , Feminino , Biomarcadores/sangue , Doença de Alzheimer/sangue , Doença de Alzheimer/genética , Doença de Alzheimer/diagnóstico , Amnésia/sangue , Amnésia/diagnóstico , Amnésia/genética , Curva ROC , Idoso de 80 Anos ou mais , Pessoa de Meia-Idade
8.
Schizophr Bull ; 2024 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-38741342

RESUMO

BACKGROUND AND HYPOTHESIS: This review examines the evolution and future prospects of prevention based on evaluation (PBE) for individuals at clinical high risk (CHR) of psychosis, drawing insights from the SHARP (Shanghai At Risk for Psychosis) study. It aims to assess the effectiveness of non-pharmacological interventions in preventing psychosis onset among CHR individuals. STUDY DESIGN: The review provides an overview of the developmental history of the SHARP study and its contributions to understanding the needs of CHR individuals. It explores the limitations of traditional antipsychotic approaches and introduces PBE as a promising framework for intervention. STUDY RESULTS: Three key interventions implemented by the SHARP team are discussed: nutritional supplementation based on niacin skin response blunting, precision transcranial magnetic stimulation targeting cognitive and brain functional abnormalities, and cognitive behavioral therapy for psychotic symptoms addressing symptomatology and impaired insight characteristics. Each intervention is evaluated within the context of PBE, emphasizing the potential for tailored approaches to CHR individuals. CONCLUSIONS: The review highlights the strengths and clinical applications of the discussed interventions, underscoring their potential to revolutionize preventive care for CHR individuals. It also provides insights into future directions for PBE in CHR populations, including efforts to expand evaluation techniques and enhance precision in interventions.

9.
Lancet Reg Health West Pac ; 45: 100580, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38699294

RESUMO

Exposure to disasters and public health emergencies negatively affects mental health. Research documenting the psychosocial responses to these calamities in China increased dramatically after the 2008 Wenchuan earthquake. However, there is no comprehensive assessment of the available literature on China's mental health and psychosocial support (MHPSS) responses to these events. This scoping review systematically maps existing published research and grey literature sources regarding MHPSS to disasters and emergencies in China. We examined relevant literature in English and Chinese from six databases and official websites from Jan 1, 2000, to Aug 13, 2021, and included 77 full-text records in this review. The main types of interventions reported included a) stepped care intervention models, b) individual structured psychotherapy and pharmacotherapy, c) mental health education, d) psychological counselling, and e) government-based policy interventions. Most interventions were evaluated using quantitative methods that assessed the treatment of common mental disorders. The review found that rapid national mobilization, emphasis on resilience-strengthening interventions, and the widespread use of step-care models were essential components of reducing the adverse psychosocial effects of disasters. The review also identified remaining gaps, including a) a lack of integration of disaster-related services with the pre-existing health care system, b) inadequate supervision of MHPSS providers, and c) limited monitoring and evaluation of the services provided. These results show where additional research is needed in China to improve mental health services. It also provides a framework that other countries can adapt when developing and evaluating MHPSS policies and plans in response to disasters.

10.
Psychiatry Clin Neurosci ; 78(7): 385-392, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38591426

RESUMO

AIM: Although many studies have explored the link between inflammatory markers and psychosis, there is a paucity of research investigating the temporal progression in individuals at clinical high-risk (CHR) who eventually develop full psychosis. To address this gap, we investigated the correlation between serum cytokine levels and Timeframe for Conversion to Psychosis (TCP) in individuals with CHR. METHODS: We enrolled 53 individuals with CHR who completed a 5-year follow-up with a confirmed conversion to psychosis. Granulocyte macrophage-colony stimulating factor (GM-CSF), interleukin (IL)-1ß, 2, 6, 8, 10, tumor necrosis factor-α (TNF-α), and vascular endothelial growth factor (VEGF) levels were measured at baseline and 1-year. Correlation and quantile regression analyses were performed. RESULTS: The median TCP duration was 14 months. A significantly shorter TCP was associated with higher levels of TNF-α (P = 0.022) and VEGF (P = 0.016). A negative correlation was observed between TCP and TNF-α level (P = 0.006) and VEGF level (P = 0.04). Quantile regression indicated negative associations between TCP and GM-CSF levels below the 0.5 quantile, IL-10 levels below the 0.3 quantile, IL-2 levels below the 0.25 quantile, IL-6 levels between the 0.65 and 0.75 quantiles, TNF-α levels below the 0.8 quantile, and VEGF levels below the 0.7 quantile. A mixed linear effects model identified significant time effects for IL-10 and IL-2, and significant group effects for changes in IL-2 and TNF-α. CONCLUSIONS: Our findings underscore that a more pronounced baseline inflammatory state is associated with faster progression of psychosis in individuals with CHR. This highlights the importance of considering individual inflammatory profiles during early intervention and of tailoring preventive measures for risk profiles.


Assuntos
Citocinas , Progressão da Doença , Transtornos Psicóticos , Humanos , Transtornos Psicóticos/sangue , Masculino , Feminino , Citocinas/sangue , Adulto , Adulto Jovem , Fator A de Crescimento do Endotélio Vascular/sangue , Adolescente , Fator Estimulador de Colônias de Granulócitos e Macrófagos/sangue , Seguimentos , Fator de Necrose Tumoral alfa/sangue , Risco , Fatores de Tempo , Sintomas Prodrômicos
11.
Artigo em Inglês | MEDLINE | ID: mdl-38657896

RESUMO

OBJECTIVE: Negative symptoms and neurocognitive impairments in psychosis correlate with their severity. Currently, there is no satisfactory treatment. We aimed to evaluate and compare the effects of repetitive transcranial magnetic stimulation(rTMS) on negative symptoms and neurocognitive impairments in patients in first-episode of psychosis(FEP) in a randomized controlled trial(RCT). METHOD: This is a single-site RCT of 85 patients with FEP. Patients were randomized to receive a 4-week course of active(n = 45) or sham rTMS(n = 40). Factor analysis was applied to a cross-sectional dataset of 744 FEP patients who completed negative symptom evaluation and neurocognitive battery tests. Two independent dimensions were generated and used for the K-means cluster analysis to produce sub-clusters. rTMS of 1-Hz was delivered to the right orbitofrontal(OFC) cortex. RESULTS: Two distinct dimensional factors of neurocognitive functions(factor-1) and negative symptoms(factor-2), and three clusters with distinctive features were generated. Significant improvements in factor-1 and factor-2 were observed after 4-weeks of rTMS treatment in both the active and sham rTMS groups. The repeated-measures analysis of variance revealed a significant effect of time×group(F = 5.594, p = 0.021, η2 = 0.073) on factor-2, but no effect of time×group on factor-1. Only improvements in negative symptoms were significantly different between the active and sham rTMS groups(p = 0.028). Patients in cluster-3 characterized by extensive negative symptoms, showed greater improvement in the active rTMS group than in the sham rTMS group. CONCLUSIONS: The 1-Hz right OFC cortex rTMS is more effective in reducing negative symptoms than neurocognitive impairments. It is especially effective in patients with dominantly negative symptoms in FEP.


Assuntos
Transtornos Psicóticos , Estimulação Magnética Transcraniana , Humanos , Estimulação Magnética Transcraniana/métodos , Masculino , Feminino , Transtornos Psicóticos/terapia , Transtornos Psicóticos/complicações , Adulto , Adulto Jovem , Disfunção Cognitiva/terapia , Disfunção Cognitiva/etiologia , Testes Neuropsicológicos/estatística & dados numéricos , Resultado do Tratamento , Estudos Transversais , Córtex Pré-Frontal , Adolescente , Escalas de Graduação Psiquiátrica
12.
Micromachines (Basel) ; 15(3)2024 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-38542621

RESUMO

The process of forming metal components through selective laser melting (SLM) results in inherent spherical effects, powder adhesion, and step effects, which collectively lead to surface roughness in stainless steel, limiting its potential for high-end applications. This study utilizes a laser-electrochemical hybrid process to polish SLM-formed 316L stainless steel (SS) and examines the influence of process parameters such as laser power and scanning speed on surface roughness and micro-morphology. A comparative analysis of the surface roughness, microstructure, and wear resistance of SLM-formed 316L SS polished using laser, electrochemical, and laser-electrochemical hybrid processes is presented. The findings demonstrate that, compared to laser and electrochemical polishing alone, the laser-electrochemical hybrid polishing exhibits the most significant improvement in surface roughness and the highest material wear resistance. Additionally, the hybrid process results in a surface free of cracks and only a small number of tiny corrosion holes, making it more suitable for polishing the surface of 316L SS parts manufactured via SLM.

13.
Artigo em Inglês | MEDLINE | ID: mdl-38470538

RESUMO

OBJECTIVE: Indicators of heart rate variability (HRV) have been used to assess the autonomic activity. However, the influence of obesity on HRV in these patients remains to be determined. This study aimed to examine how obesity (measured with the body mass index [BMI]) affects HRV and determine whether the effect varies among different psychiatric disorders. We recruited 3159 consecutive patients, including 1744 with schizophrenia, 966 with mood disorders, and 449 with anxiety disorders. Patients were divided into four groups based on BMI: underweight (< 18.5), normal weight (18.5-23.9), overweight (24-27.9), and obese (≥ 28). The cardiovascular status was assessed using several time- and frequency-based HRV indicators, measured via electrocardiogram signals recorded for 5 min. The mean BMI of the participants was 23.6 ± 4.0. The patients in the overweight and obese groups were 29.4% and 13.6% of the total, respectively. The HRV indicators were higher in underweight and normal-weight patients than in the overweight and obese ones. After stratification based on the psychiatric diagnosis, the patients with mood disorders showed lower HRV than those with schizophrenia or anxiety disorder in the normal-weight group. In contrast, in the overweight and obese groups the patients with mood disorders showed higher HRV than those with the other disorders. The HRV variables were significantly associated with BMI, and higher BMI was associated with higher heart rates and lower HRV. These results indicate that weight gain in psychiatric disorders is associated with an imbalance in autonomic nerve activity. However, the relationship between autonomic activity, weight gain, and psychiatric disorders warrants further investigation.

14.
Front Immunol ; 15: 1386072, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38464538

RESUMO

[This corrects the article DOI: 10.3389/fimmu.2022.897366.].

15.
Psychol Med ; : 1-12, 2024 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-38433595

RESUMO

BACKGROUND: Mild cognitive deficits (MCD) emerge before the first episode of psychosis (FEP) and persist in the clinical high-risk (CHR) stage. This study aims to refine risk prediction by developing MCD models optimized for specific early psychosis stages and target populations. METHODS: A comprehensive neuropsychological battery assessed 1059 individuals with FEP, 794 CHR, and 774 matched healthy controls (HCs). CHR subjects, followed up for 2 years, were categorized into converters (CHR-C) and non-converters (CHR-NC). The MATRICS Consensus Cognitive Battery standardized neurocognitive tests were employed. RESULTS: Both the CHR and FEP groups exhibited significantly poorer performance compared to the HC group across all neurocognitive tests (all p < 0.001). The CHR-C group demonstrated poorer performance compared to the CHR-NC group on three sub-tests: visuospatial memory (p < 0.001), mazes (p = 0.005), and symbol coding (p = 0.023) tests. Upon adjusting for sex and age, the performance of the MCD model was excellent in differentiating FEP from HC, as evidenced by an Area Under the Receiver Operating Characteristic Curve (AUC) of 0.895 (p < 0.001). However, when applied in the CHR group for predicting CHR-C (AUC = 0.581, p = 0.008), the performance was not satisfactory. To optimize the efficiency of psychotic risk assessment, three distinct MCD models were developed to distinguish FEP from HC, predict CHR-C from CHR-NC, and identify CHR from HC, achieving accuracies of 89.3%, 65.6%, and 80.2%, respectively. CONCLUSIONS: The MCD exhibits variations in domains, patterns, and weights across different stages of early psychosis and diverse target populations. Emphasizing precise risk assessment, our findings highlight the importance of tailored MCD models for different stages and risk levels.

16.
Opt Express ; 32(5): 8364-8378, 2024 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-38439493

RESUMO

In this paper, we demonstrate a simplified one-to-many scheme for efficient mid-infrared (MIR) parametric conversion. Such a scheme is based on a continuous wave (CW) single longitudinal mode master oscillator power-amplifier (MOPA) fiber system as the signal source and a picosecond pulsed MOPA fiber system, exhibiting multiple longitudinal modes, as the pump source. The signal and pump beams are combined and co-coupled into a piece of 50-mm long 5% MgO-doped PPLN crystal for the parametric conversion. As high as ∼3.82 W average power at a central idler wavelength of ∼3.4 µm is achieved when the launched pump and signal powers are ∼41.73 and ∼11.45 W, respectively. Above some threshold value, the delivered idler power shows a roll-over effect against the signal power and saturation-like effect against the pump power. Consequently, the highest conversion efficiency is observed at such a threshold pump power. To the best of our knowledge, our result represents the highest average power produced from any single-pass parametric conversion source with >3 µm idler wavelength feeding with a CW signal. Moreover, our proposed scheme can simplify the design of parametric conversion system significantly and meanwhile make the system more robust in applications. This is attributed to two main aspects. Firstly, the scheme's one-to-many feature can reduce wavelength sensitivity remarkably in the realization of quasi-phase-matching. Secondly, for moderate power requirement it does not always require a high peak power synchronized pulsed signal source; a CW one can be an alternative, thereby making the system free from complex time synchronization and the related time jitter.

17.
Nutrients ; 16(5)2024 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-38474868

RESUMO

BACKGROUND: Healthy diets and physical exercise, two modifiable lifestyle factors, are protective against depression in older adults. This study aimed to investigate whether physical exercise may influence the associations of dietary habits with depression in Chinese community-dwelling older adults. METHODS: In the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey, 12,708 community-dwelling older adults aged ≥65 years were included for analyses. Older adults' dietary habits (including daily intake of food components such as fruits, vegetables, animal oil, and so on) and physical exercise were assessed. Depression was evaluated via the 10 item Center for Epidemiologic Studies Depression (CES-D-10) scale. The influences of physical exercise on the associations of dietary habits with depression were estimated using logistic regression models adjusted for confounders. RESULTS: Older adults who took physical exercise had a significantly decreased probability of depression (adjusted OR = 0.73, p < 0.001). As for dietary habits, the intake of fruits, vegetables, eggs, nut products, mushrooms or algae, and vitamins were inversely associated with the prevalence of depression (adjusted ORs = 0.61-0.81; p-values: from <0.001 to 0.025), while animal oil was positively associated with it (adjusted OR = 1.52, p < 0.001). When stratified by physical exercise, older adults who ate fruits or vegetables had consistent decreased risk of depression, no matter whether they took physical exercise or not (adjusted ORs = 0.52-0.70), while the intake of eggs, nut products, and vitamins were inversely associated, and animal oil was consistently positively associated with depression only in older adults who did not take physical exercise (adjusted ORs = 0.79, 0.68, 0.63, and 1.67, respectively). CONCLUSIONS: Physical exercise may conceal the potential protective effects of some healthy dietary habits in terms of depression and counteract the detrimental effects of the unhealthy habits. Some dietary habits may be considered as alternative protective measures for depression in community-dwelling older adults when physical exercise cannot be performed.


Assuntos
Depressão , Vida Independente , Animais , Estudos Transversais , Depressão/epidemiologia , Dieta , Exercício Físico , Verduras , Vitaminas , Comportamento Alimentar , China
18.
Cereb Cortex ; 34(2)2024 01 31.
Artigo em Inglês | MEDLINE | ID: mdl-38383721

RESUMO

Given the increasing presence of robots in everyday environments and the significant challenge posed by social interactions with robots, it is crucial to gain a deeper understanding into the social evaluations of robots. One potentially effective approach to comprehend the fundamental processes underlying controlled and automatic evaluations of robots is to probe brain response to different perception levels of robot-related stimuli. Here, we investigate controlled and automatic evaluations of robots based on brain responses during viewing of suprathreshold (duration: 200 ms) and subthreshold (duration: 17 ms) humanoid robot stimuli. Our behavioral analysis revealed that despite participants' self-reported positive attitudes, they held negative implicit attitudes toward humanoid robots. Neuroimaging analysis indicated that subthreshold presentation of humanoid robot stimuli elicited significant activation in the left amygdala, which was associated with negative implicit attitudes. Conversely, no significant left amygdala activation was observed during suprathreshold presentation. Following successful attenuation of negative attitudes, the left amygdala response to subthreshold presentation of humanoid robot stimuli decreased, and this decrease correlated positively with the reduction in negative attitudes. These findings provide evidence for separable patterns of amygdala activation between controlled and automatic processing of robots, suggesting that controlled evaluations may influence automatic evaluations of robots.


Assuntos
Robótica , Humanos , Robótica/métodos , Encéfalo/fisiologia , Neuroimagem , Tonsila do Cerebelo/diagnóstico por imagem , Autorrelato
19.
Brain Sci ; 14(2)2024 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-38391744

RESUMO

Recent research suggests a possible association between midlife obesity and an increased risk of dementia in later life. However, the underlying mechanisms remain unclear. Little is known about the relationship between body mass index (BMI) and hippocampal subfield atrophy. In this study, we aimed to explore the associations between BMI and hippocampal subfield volumes and cognitive function in non-demented Chinese older adults. Hippocampal volumes were assessed using structural magnetic resonance imaging. Cognitive function was evaluated using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). A total of 66 participants were included in the final analysis, with 35 females and 31 males. We observed a significant correlation between BMI and the hippocampal fissure volume in older females. In addition, there was a negative association between BMI and the RBANS total scale score, the coding score, and the story recall score, whereas no significant correlations were observed in older males. In conclusion, our findings revealed sex-specific associations between BMI and hippocampal subfield volumes and cognitive performance, providing valuable insights into the development of effective interventions for the early prevention of cognitive decline.

20.
Ann Med Surg (Lond) ; 86(2): 805-810, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38333288

RESUMO

Objective: Due to the information-rich nature of positron emission tomography/computed tomography (PET/CT) images, the authors hope to explore radiomics features that could distinguish metastatic lymph nodes (LNs) from hypermetabolic benign LNs, in addition to conventional indicators. Methods: PET/CT images of 106 patients with early-stage cervical cancer from 2019 to 2021 were retrospectively analyzed. The tumor lesions and LN regions of PET/CT images were outlined with SeeIt, and then radiomics features were extracted. The least absolute shrinkage and selection operator (LASSO) was used to select features. The final selected radiomics features of LNs were used as predictors to construct a machine learning model to predict LN metastasis. Results: The authors determined two morphological coefficient characteristics of cervical lesions (shape - major axis length and shape - mesh volume), one first order characteristics of LNs (first order - 10 percentile) and two gray-level co-occurrence matrix (GLCM) characteristics of LNs (GLCM - id and GLCM - inverse variance) were closely related to LN metastasis. Finally, a neural network was constructed based on the radiomic features of the LNs. The area under the curve of receiver operating characteristic (AUC-ROC) of the model was 0.983 in the training set and 0.860 in the test set. Conclusion: The authors constructed and demonstrated a neural network based on radiomics features of PET/CT to evaluate the risk of single LN metastasis in early-stage cervical cancer.

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