Engagement challenges in digital mental health programs: hybrid approaches and user retention of an online self-knowledge journey in Brazil.

Digital mental health interventions (DMHIs) have surged in popularity over the last few years. However, adherence to self-guided interventions remains a major hurdle to overcome. The current study utilized a phased implementation design, incorporating diverse samples and contexts to delve into the engagement challenges faced by a recently launched online mental health platform in Brazil with self-evaluation forms. Employing an iterative mixed-methods approach, including focus groups, online surveys, and think-aloud protocols, the research aims to evaluate user satisfaction, identify barriers to adherence, and explore potential hybrid solutions. Engagement in the platform was evaluated by descriptive statistics of the number of instruments completed, and qualitative interviews that were interpreted thematically. In the fully self-guided mode, 2,145 individuals registered, but a substantial majority (88.9%) engaged with the platform for only 1 day, and merely 3.3% completed all activities. In another sample of 50 participants were given a choice between online-only or a hybrid experience with face-to-face meetings. 40% of individuals from the hybrid group completed all activities, compared to 8% in the online-only format. Time constraints emerged as a significant barrier to engagement, with suggested improvements including app development, periodic reminders, and meetings with healthcare professionals. While the study identified weaknesses in the number and length of instruments, personalized results stood out as a major strength. Overall, the findings indicate high satisfaction with the mental health platform but underscore the need for improvements, emphasizing the promise of personalized mental health information and acknowledging persistent barriers in a digital-only setting.

Survey of Moral Distress and Self-Awareness among Health Care Professionals.

Health care professionals experience moral distress due to challenging ethical decision-making during patient care. Self-awareness can be associated with moral distress. This study determined the levels of and relationship between moral distress and self-awareness of health care professionals. A convenience sample of physicians and nurses was recruited. Data were collected using the Moral Distress and Self-Awareness Scales. In total, 168 physicians and 201 nurses participated with a mean age of 30.54 ± 7.87 and clinical experience of 6.40 ± 6.22 years. Moderate levels of moral distress (127.07 ± 71.90) and high levels of self-awareness (70.20 ± 11.37) were found. A weak positive correlation was found between self-awareness and moral distress (r = 0.21, p < 0.001) and weak negative correlation between moral distress (r = - 0.115, p = 0.03) and age. Nurses were more self-aware, but no differences were observed in moral distress based on sex and clinical settings. A weak correlation between self-awareness and moral distress may suggest that self-awareness can increase intrapersonal tensions, contributing to distress. Further research is needed to support any conclusive relationship between moral distress and self-awareness.

The association between self-knowledge from Islamic perspective and mental health among Iranian female students.

This study aimed to relate self-knowledge to mental health (from Islamic perspective), and compare it among the female students. Using the Morgan table, we selected 379 students from four universities, namely alzahra University, a single-sex university, the University of Tehran, Shahid Beheshti University, and Kharazmi University. The samples were selected randomly by applying a stratified sampling method. We utilized two instruments: Islamic self-knowledge and general mental health questionnaires. The collected data were analyzed using Pearson Correlation Coefficient, independent samples t-test, and linear regression analysis using SPSS version 25. The results showed that there were significant association between self-knowledge and mental health. However, there were no significant differences between the female students of humanities and sciences, whether from the point of self-knowledge or mental health. The results also showed no significant differences between the students of alzahra University and the female students of the other three universities in self-knowledge and mental health. In each case, the results are compared to Islamic viewpoints (Quran, Hadith, and Quotations from various Islamic thinkers) as well as the psychological viewpoints of Maslow and Rogers. Our findings underline the importance of enhancing self-knowledge among female university students as a protective factor against mental health outcomes (substance abuse, depression, and anxiety) Moreover, Faith based strategies are known to be effective, more accessible than mental health professional services and will carry less stigma in the target community.

A multi-modal assessment of self-knowledge in adolescents with non-suicidal self-injury: a research domains criteria (RDoC) study.

BACKGROUND: Adolescence is a critical period for brain development, consolidation of self-understanding, and onset of non-suicidal self-injury (NSSI). This study evaluated the RDoC (Research Domain Criteria) sub-construct of Self-Knowledge in relation to adolescent NSSI using multiple units of analysis. METHODS: One hundred and sixty-four adolescents assigned female at birth (AFAB), ages 12-16 years with and without a history of NSSI entered a study involving clinical assessment and magnetic resonance imaging (MRI), including structural, resting-state functional MRI (fMRI), and fMRI during a self-evaluation task. For imaging analyses, we used an a priori defined Self Network (anterior cingulate, orbitofrontal, and posterior cingulate cortices; precuneus). We first examined interrelationships among multi-level Self variables. We then evaluated the individual relationships between NSSI severity and multi-level Self variables (self-report, behavior, multi-modal brain Self Network measures), then conducted model testing and multiple regression to test how Self variables (together) predicted NSSI severity. RESULTS: Cross-correlations revealed key links between self-reported global self-worth and self-evaluation task behavior. Individually, greater NSSI severity correlated with lower global self-worth, more frequent and faster negative self-evaluations, lower anterior Self Network activation during self-evaluation, and lower anterior and posterior Self Network resting-state connectivity. Multiple regression analysis revealed the model including multi-level Self variables explained NSSI better than a covariate-only model; the strongest predictive variables included self-worth, self-evaluation task behavior, and resting-state connectivity. CONCLUSIONS: Disruptions in Self-Knowledge across multiple levels of analysis relate to NSSI in adolescents. Findings suggest potential neurobiological treatment targets, potentially enhancing neuroplasticity in Self systems to facilitate greater flexibility (more frequently positive) of self-views in AFAB adolescents.

Metacognitive knowledge about self-control.

Good self-control is highly valuable, but the processes that promote it are not fully understood. This review emphasizes that self-control is "inherently metacognitive" (p. 204, Duckworth et al., 2014) and describes the potential benefits of metacognitive knowledge for self-control. In line with research on metacognition in academic goal pursuit, we elaborate how three distinct types of metacognitive knowledge may aid self-control: strategy knowledge (for example, a repertoire of self-regulatory strategies), task knowledge (for example, understanding self-control demands), and person knowledge (for example, awareness of one's self-control strengths and weaknesses). Additionally, we identify research gaps and suggest that future studies should investigate the development and updating of metacognitive knowledge about self-control and how metacognitive knowledge can prevent individuals from justifying indulgence.

The mediating role of mentalization and integrative self-knowledge in the relationship between childhood trauma and fear of intimacy.

Introduction: Since intimacy is a fundamental human need within social relationships, and recognizing that a fear of intimacy correlates with various negative consequences, it becomes crucial to examine the origins and factors that contribute to addressing this issue. This research aimed to investigate the mediating roles of mentalization and integrative self-knowledge in the link between childhood trauma and the fear of intimacy. Methods: Conducted as correlational descriptive research, our study incorporates a total sample of 303 adult women and men participants aged 20 to 50 in Tehran using the convenience sampling method. They completed the Fear of Intimacy Scale (FIS), the Childhood Trauma Questionnaire (CTQ), the Mentalization Scale (MentS), and the Integrative Self-Knowledge Scale (ISK). To analyze the research data at the descriptive level, frequency, percentage, standard deviation, and Pearson's correlation coefficient were used, while path analysis tested our hypotheses in SPSS version 26 and AMOS version 24. Fit indices were used to check the model's fit, and the mediation test was performed using the bootstrapping method. The fit indices revealed an excellent fit of the model with the data (χ2 = 1.51, χ2/df = 1.51, p = 0.219; RMSEA = 0.05; SRMR = 0.02; CFI = 0.99; NFI = 0.99; TLI = 0.99). Results: Results indicate mentalization fully mediates the childhood trauma-fear of intimacy relationship (ß = 0.14, p < 0.01). However, the indirect relationship between childhood trauma and fear of intimacy through integrative self-knowledge was insignificant. The results also showed that the path coefficient from mentalization to fear of intimacy was negative and significant (ß = -0.41, p < 0.001), while the path coefficient from integrative self-knowledge to fear of intimacy was not significant (ß = -0.02, p > 0.05). Discussion: Based on the current findings indicating the complete mediation of mentalization and the insignificance of the mediation of integrative self-knowledge, we can deduce that enhancing the capacity for mentalization holds promise in effectively addressing intimacy-related issues. Overall, the study suggests mentalization effectively predicts the relationship between childhood trauma and fear of intimacy. This, in turn, may mitigate the detrimental effects of challenging childhood experiences on an individual's ability to engage in intimacy and cultivate emotional closeness.

Enhancing Relapse Prevention: Examining the Impact of Experiential Avoidance, Integrative Self-Knowledge, and Basic Psychological Needs in Substance Use Treatment.

Background: The harmful effects of drug relapse have always been one of the major challenges in addiction treatment. The present study aimed to predict drug relapse in addicted men under treatment based on experiential avoidance, integrative self-knowledge, and basic psychological needs. Methods: The present study was a correlational one. The statistical population included all addicted men in Choubindar prison in Qazvin in 2021, among whom 200 individuals were selected randomly. Then, the participants filled out the Relapse Prediction Scale (RPS), Multidimensional Experiential Avoidance Questionnaire (MEAQ), Integrative Self-Knowledge Scale (ISK), and Basic Psychological Needs Scale (BPNS). Data were analyzed using stepwise regression via SPSS software (version 25). Findings: The results of the study demonstrated that some of the components of experiential avoidance including distraction, distress endurance, behavioral avoidance, and distress aversion could account for 14.0% of the variance of the relapse in the addicts (P<0.05). Moreover, the obtained results considering the reflective self-knowledge component and the overall score of integrative self-knowledge could explain 15.0% of the variance in relapse in the addicts. Among the basic psychological needs, communication could predict 3.8% of the variance in relapse. Conclusion: Based on the results of the present study, it is suggested that through addiction treatment and prevention of relapse programs, psychologists reduce drug relapse in addicts by decreasing distractions and behavioral avoidance, increasing distress endurance, enhancing self-knowledge, and improving efficient relationships.

Emotional self-knowledge profiles and relationships with mental health indicators support value in 'knowing thyself'.

"Know thyself" may be indicated by a balanced high pairing of two emotional self-knowledge indicators: attention to emotions and emotional clarity. Closely associated but often evaluated separately, emotional clarity is consistently, inversely associated with psychopathology, while evidence regarding attention to emotions is less consistent. Variables of high/low emotional clarity and attention to emotions yielded four emotional self-knowledge profiles which were analyzed for associations with mental health indicators (depression and anxiety symptoms, self-esteem, self-schema, resiliency, transcendence) in n = 264 adolescents. Here we report regression models which show that compared with neither, both high (attention + clarity) show higher positive self-schema (B = 2.83, p = 0.004), more resiliency (B = 2.76, p = 0.015) and higher transcendence (B = 82.4, p < 0.001), while high attention only is associated with lower self-esteem (B = - 3.38, p < 0.001) and more symptoms (B = 5.82, p < 0.001 for depression; B = 9.37, p < 0.001 for anxiety). High attention only is associated with most severe impairment all indicators excepting transcendence. Profiles including high clarity suggest protective effects, and 'implicit' versus 'explicit' emotional awareness are discussed. Balanced vs. imbalanced emotional self-awareness profiles dissimilarly affect mental health, which have implications for treatment and policy.

A dança no processo terapêutico: trânsitos do universo de si para o autoconhecimento e libertação dos nódulos emocionais / Dance in the therapeutic process: transitis from the self-universe to self-knowledge and release from emotional nodules / La danza en el proceso terapéutico: transitos del universo del yo al autoconocimiento y liberación de nódulos emocionales

O ser humano é um ser que se constrói, apresenta e reverbera, no mínimo, em dois universos, que não são opostos; são complementares, e se pronunciam em relações multidirecionais, plurais e imbricadas em rizomas físicos, mentais, emocionais e espirituais. Somos seres individuais e coletivos, onde tecemos uma complexa trama relacional tanto no campo da razão quanto das emoções. No entanto, essas últimas são territórios muito, e quase sempre, negligenciados por nós. Nesse artigo, propomos trazer reflexões sobre nossos estados de desajustes emocionais e levando o olhar para a dança como potencialidades de se conhecer de forma mais verdadeira e honesta no intuito de repensarmos nosso conceito de saúde (AU)

The human being is a being that is constructed, presented, and reverberates, at least, in two universes which are not opposites, are com-plementary and are pronounced in multidirectional, plural relationships and imbricated in physical, mental, emotional, and spiritual rhizomes. We are individual and collective beings where we weave a complex rela-tional web both in the Field of reason and emotions. However, the latter are territories that are very anl almost ways neglected by us. In this ar-ticle we propose to bring reflections on our states of emotional mal ad-justment and taking the look at dance as a potential to know each other more truthfully and honestly to rethink our concept of health (AU).

El ser humano es un ser que se construye, se presenta y re-percute, por lo menos, em dos universos que no son opuestos, son com-plementarios y se manifiestan em relaciones multidireccionales, plurales e imbricados en rizomas físicos, mentales, emocionales y espirituales. Somos seres individuales y colectivos donde tenemos una compleja red relacional tanto en El campo de la razón como em El de las emociones. Sin embargo, estos últimos son territorios muy y casi siempre descui-dados por nosotros. Em este artículo nos proponemos traer reflexiones sobre nuestros estados de desajuste emocional y la mirada a la danza como potencial para conocérnoslas veraz y honestamente para repen-sar nuestro concepto de salud (AU).

A dança no processo terapêutico: trânsitos do universo de si para o autoconhecimento e libertação dos nódulos emocionais / Dance in the therapeutic process: transitis from the self-universe to self-knowledge and release from emotional nodules / La danza en el proceso terapéutico: transitos del universo del yo al autoconocimiento y liberación de nódulos emocionales

O ser humano é um ser que se constrói, apresenta e reverbera, no mínimo, em dois universos, que não são opostos; são complementa-res, e se pronunciam em relações multidirecionais, plurais e imbricadas em rizomas físicos, mentais, emocionais e espirituais. Somos seres indi-viduais e coletivos, onde tecemos uma complexa trama relacional tanto no campo da razão quanto das emoções. No entanto, essas últimas são territórios muito, e quase sempre, negligenciados por nós. Nesse artigo, propomos trazer reflexões sobre nossos estados de desajustes emocionais e levando o olhar para a dança como potencialidades de se conhe-cer de forma mais verdadeira e honesta no intuito de repensarmos nos-so conceito de saúde.

The human being is a being that is constructed, presented, and reverberates, at least, in two universes which are not opposites, are com-plementary and are pronounced in multidirectional, plural relationships and imbricated in physical, mental, emotional, and spiritual rhizomes. We are individual and collective beings where we weave a complex rela-tional web both in the Field of reason and emotions. However, the latter are territories that are very anl almost ways neglected by us. In this ar-ticle we propose to bring reflections on our states of emotional mal ad-justment and taking the look at dance as a potential to know each other more truthfully and honestly to rethink our concept of health.

El ser humano es un ser que se construye, se presenta y re-percute, por lo menos, em dos universos que no son opuestos, son com-plementarios y se manifiestan em relaciones multidireccionales, plurales e imbricados en rizomas físicos, mentales, emocionales y espirituales. Somos seres individuales y colectivos donde tenemos una compleja red relacional tanto en El campo de la razón como em El de las emociones. Sin embargo, estos últimos son territorios muy y casi siempre descui-dados por nosotros. Em este artículo nos proponemos traer reflexiones sobre nuestros estados de desajuste emocional y la mirada a la danza como potencial para conocérnoslas veraz y honestamente para repen-sar nuestro concepto de salud.

Aging, Dying, and the Analytic Process.

The panel discussion presented at the New York Psychoanalytic Society and Institute's 1066th Scientific Meeting held on June 8, 2023, takes up aging and dying of an analyst and their impact on patients and on the nature of analytic process. Participants reflect on conflicts and challenges arising with more analysts and patients living to an advanced age, on the unregulated nature of analysts' retirement, and on multilayered meanings of analysts' ethical commitment to their work.

Track Thyself? The Value and Ethics of Self-knowledge Through Technology.

Novel technological devices, applications, and algorithms can provide us with a vast amount of personal information about ourselves. Given that we have ethical and practical reasons to pursue self-knowledge, should we use technology to increase our self-knowledge? And which ethical issues arise from the pursuit of technologically sourced self-knowledge? In this paper, I explore these questions in relation to bioinformation technologies (health and activity trackers, DTC genetic testing, and DTC neurotechnologies) and algorithmic profiling used for recommender systems, targeted advertising, and technologically supported decision-making. First, I distinguish between impersonal, critical, and relational self-knowledge. Relational self-knowledge is a so far neglected dimension of self-knowledge which is introduced in this paper. Next, I investigate the contribution of these technologies to the three types of self-knowledge and uncover the connected ethical concerns. Technology can provide a lot of impersonal self-knowledge, but we should focus on the quality of the information which tends to be particularly insufficient for marginalized groups. In terms of critical self-knowledge, the nature of technologically sourced personal information typically impedes critical engagement. The value of relational self-knowledge speaks in favour of transparency of information technology, notably for algorithms that are involved in decision-making about individuals. Moreover, bioinformation technologies and digital profiling shape the concepts and norms that define us. We should ensure they not only serve commercial interests but our identity and self-knowledge interests.

The future of metacognition research: Balancing construct breadth with measurement rigor.

Foundational work in the psychology of metacognition identified a distinction between metacognitive knowledge (stable beliefs about one's capacities) and metacognitive experiences (local evaluations of performance). More recently, the field has focused on developing tasks and metrics that seek to identify metacognitive capacities from momentary estimates of confidence in performance, and providing precise computational accounts of metacognitive failure. However, this notable progress in formalising models of metacognitive judgments may come at a cost of ignoring broader elements of the psychology of metacognition - such as how stable meta-knowledge is formed, how social cognition and metacognition interact, and how we evaluate affective states that do not have an obvious ground truth. We propose that construct breadth in metacognition research can be restored while maintaining rigour in measurement, and highlight promising avenues for expanding the scope of metacognition research. Such a research programme is well placed to recapture qualitative features of metacognitive knowledge and experience while maintaining the psychophysical rigor that characterises modern research on confidence and performance monitoring.

When fixing problems kills personal development: fMRI reveals conflict between Real and Ideal selves.

Many coaching approaches aim to change behavior by increasing self-knowledge. However, self-knowledge can be difficult to achieve. One hypothesis (e.g., Jung, Rogers) is that self-knowledge is challenging because there is inherent conflict between different aspects of the self. This hypothesis is foundational to Boyatzis' intentional change theory (ICT). ICT holds that effective coaching requires deliberate sequencing of the client's exploration of different aspects of their self. Coaches initially encourage clients to focus exclusively on their Ideal self. The ICT approach differs from that advocated by most coaching organizations that suggest collaborative goal setting at the start of the coaching engagement, encouraging clients to focus on fixing performance deficits and problematic behaviors-aspects of the Real self. If there is conflict between thinking about Ideal and Real selves, then this strategy will be suboptimal. The hypothesis of attentional conflict therefore has significant implications for coaching practice. Previous findings establish a link between attention to Ideal vs. Real selves and global vs. local visual processing, respectively. This association alone does not imply conflict because, in naturalistic settings, global and local perceptual processes usually work in concert. However, certain stimuli such as Navon figures (letters made from many smaller letters, e.g., a large E made of small R's) create conflict due to incongruence between the global and local features. Does thinking about the self inherently generate conflict, like a Navon figure, or is it more akin to everyday perception? To answer this question the current study uses functional magnetic resonance imaging to examine the overlap in brain activity in young adults between two pairs of otherwise very dissimilar tasks: coaching interactions focused on Ideal vs. Real self; and attention to global vs. local features of Navon figures. Despite the ostensible absence of overlap in the psychological processes involved in these pairs of tasks, we find a remarkable degree of overlap in brain activity. This overlap was pronounced in higher (parietal and temporal) areas known to be involved in resolving attentional conflict. These findings provide compelling biological evidence for inherent conflict between thinking about Ideal and Real selves.

The Self Course: Lessons Learned from Students' Weekly Questions.

In this paper, I tentatively answer 50 questions sampled from a pool of over 10,000 weekly questions formulated by students in a course entitled "The Self". The questions pertain to various key topics related to self-processes, such as self-awareness, self-knowledge, self-regulation, self-talk, self-esteem, and self-regulation. The students' weekly questions and their answers highlight what is currently known about the self. Answers to the student questions also allow for the identification of some recurrent lessons about the self. Some of these lessons include: all self-processes are interconnected (e.g., prospection depends on autobiography), self-terms must be properly defined (e.g., self-rumination and worry are not the same), inner speech plays an important role in self-processes, controversies are numerous (are animals self-aware?), measurement issues abound (e.g., self-recognition as an operationalization of self-awareness), deficits in some self-processes can have devastating effects (e.g., self-regulatory deficits may lead to financial problems), and there are lots of unknowns about the self (e.g., gender differences in Theory-of-Mind).

Who am I really? The ephemerality of the self-schema following vmPFC damage.

We studied the role of the ventromedial prefrontal cortex (vmPFC) in supporting the self-schema, by asking vmPFC patients, along with healthy and brain-damaged controls, to judge the degree to which they (or another person) were likely to engage in a series of activities, and how confident they were in their responses. Critically, participants provided their judgments on two separate occasions, a week apart. Our underlying assumption was that a strong self-schema would lead to confident and stable self-related judgments. We observed that control groups exhibited higher across-session consistency for self-related compared to other-related judgments, while this self-advantage was absent in vmPFC patients. In addition, regression analyses showed that in control groups the level of confidence associated with a specific (self- or other-related) judgment predicted the stability of that judgment across sessions. In contrast, vmPFC patients' confidence and rating consistency were aligned only for other-related judgments. By contrast, self-related judgments changed across sessions regardless of the confidence level with which they were initially endorsed. These findings indicate that the vmPFC is crucial to maintaining the self-schema and supporting the reliable retrieval of self-related information.

Personality, self-knowledge, and meat reduction intentions.

OBJECTIVE: Meat consumption has a host of serious negative consequences for nonhuman animals, underprivileged humans, and the natural environment. Several interventions have been developed to encourage meat reduction but to relatively limited effect. There is also a range of established predictors of meat consumption, but much less is known about the factors that predict intentions to reduce meat consumption. The goal of this study was to determine the roles of personality and self-knowledge in meat reduction intentions. METHOD: In this set of three preregistered studies, we tested brief interventions to encourage meat reduction intentions and examined personality predictors of intentions to reduce meat consumption. RESULTS: We found no evidence that brief interventions with or without a self-knowledge component had a meaningful effect on changing meat reduction intentions. However, we found robust evidence for relatively small associations between intending to eat less meat and high Openness to Experience, high Emotionality, and perceiving meat reduction as moral behaviors. CONCLUSION: Individual differences may be a more influential predictor of meat reduction intentions than brief interventions. Implications for promoting meat reduction are discussed.

The self and self-knowledge after frontal lobe neurosurgical lesions.

BACKGROUND: Evidence suggests that damage to the frontal lobes can be associated with changes in cognitive and behavioral functioning and reduced awareness that such changes have occurred. In the current study, the Cognitive Awareness Model was used as a theoretical framework to explore knowledge of the self in people with acquired frontal lesions. METHODS: Fifteen individuals with focal frontal lobe lesions (FFL) and their nominated informants were compared with fifteen healthy matched control-informant dyads on questionnaire measures designed to assess awareness of difficulties. Questionnaires were adapted to ensure all enabled pre- and post-injury perspectives to be gained from both patient and informant, and to allow novel exploration of awareness of deficits from a third person perspective. RESULTS: Individuals with frontal lobe lesions showed adequate awareness of their post-surgery changes, which was substantiated by their informant report. Compared to the control group, the patient group was found to acknowledge more difficulties in current functioning. Perspective-taking ability was limited with both patients and controls being comparatively unreliable in assessing how they were perceived by others. CONCLUSION: These results demonstrate that FLL patients are engaging in more atypical behaviors compared to healthy controls, but suggest that they are aware of and acknowledge these difficulties. The importance of obtaining multiple viewpoints when examining an individual's level of awareness and the clinical implications of this are discussed.

Prior knowledge-based precise diagnosis of blend sign from head computed tomography.

Introduction: Automated diagnosis of intracranial hemorrhage on head computed tomography (CT) plays a decisive role in clinical management. This paper presents a prior knowledge-based precise diagnosis of blend sign network from head CT scans. Method: We employ the object detection task as an auxiliary task in addition to the classification task, which could incorporate the hemorrhage location as prior knowledge into the detection framework. The auxiliary task could help the model pay more attention to the regions with hemorrhage, which is beneficial for distinguishing the blend sign. Furthermore, we propose a self-knowledge distillation strategy to deal with inaccuracy annotations. Results: In the experiment, we retrospectively collected 1749 anonymous non-contrast head CT scans from the First Affiliated Hospital of China Medical University. The dataset contains three categories: no intracranial hemorrhage (non-ICH), normal intracranial hemorrhage (normal ICH), and blend sign. The experimental results demonstrate that our method performs better than other methods. Discussion: Our method has the potential to assist less-experienced head CT interpreters, reduce radiologists' workload, and improve efficiency in natural clinical settings.