The study evaluated the effectiveness and safety of single-stage versus multistage endovascular treatment in subarachnoid hemorrhage patients with Mirror Aneurysms.
Our research team performed a prospective study, focusing on the radiographic and clinical data of patients diagnosed with subarachnoid hemorrhage, specifically those who presented with Mirror Aneurysms upon admission to our institutions. According to the different endovascular treatment stages, these patients were grouped into the multistage cohort and the single-stage cohort.
A total of 216 aneurysms were identified among the 108 patients, with every patient having one ruptured aneurysm. The duration of follow-up was 2 years in both groups. In the single-stage cohort, all 114 aneurysms in 57 patients were managed during a single session. During the 2-year follow-up, it was observed that 49 patients achieved a modified Rankin Scale score ≤2. Five complications were encountered, including cerebral vasospasm in three patients, cerebral hemorrhage in one patient, and thromboembolism in one patient. In the multistage cohort, only the ruptured aneurysm (amounting to 51 in total) received treatment at the initial occurrence, while the remaining 51 aneurysms were addressed subsequently. Throughout the 2-year follow-up period, 46 subjects exhibited a modified Rankin scale score ≤2. Overall, four complications were documented, including cerebral vasospasm in two patients, a subarachnoid hemorrhage in one patient, and thromboembolism in one patient.
The safety and effectiveness of both endovascular treatment groups have been verified for patients with Mirror Aneurysms suffering from subarachnoid hemorrhage. If feasible, single-stage embolization should be considered a viable treatment option for these patients.
Suicide happens due to a complex interaction among multiple factors. Hence, prevention strategies should consider a wider range of personal and ecological aspects. It is an underprioritized public health problem in Bangladesh where risk factors for suicide have been poorly studied, and there is no national suicide prevention strategy. Therefore, exploring socioecological aspects of suicidal behavior would foster suicide prevention in the country.
We aim to discuss the ecological model for suicide and suicide prevention in Bangladesh.
We performed a narrative review and organized the risk factors and prevention strategies according to the socioecological model in the context of Bangladesh. We used ecological systems to analyze risk factors for suicide and suicide prevention strategies in the country.
Based on the available evidence, we categorized the risk factors for suicide into ontogenic system, microsystem, mesosystem, exosystem, macrosystem, and chronosystem. In addition, we contextualized the existing suicide prevention initiatives and potential suicide prevention strategies in ontogenic system, microsystem, mesosystem, exosystem, macrosystem, and chronosystem.
This article explored suicide and suicide prevention in Bangladesh through the lens of ecological systems theory that may foster the formulation of a national suicide prevention strategy in the country.
Previous studies have confirmed the significant role of cathepsins in the development of neurodegenerative diseases. We aimed to determine whether genetically predicted 10 cathepsins may have a causal effect on Alzheimer's disease (AD), Parkinson's disease (PD), and amyotrophic lateral sclerosis (ALS).
We conducted a two-sample bidirectional Mendelian randomization (MR) study using publicly available data from genome-wide association study (GWAS) to assess the causal associations between 10 cathepsins and three neurodegenerative diseases, including AD, PD, and ALS. We employed the following methods, including inverse variance weighting (IVW), MR-Egger, and weighted median (WM). The results were further validated using sensitivity analysis.
The forward MR analysis results indicate that elevated cathepsin H levels increase the risk of AD (p = 0.005, odds ratio [OR] = 1.040, 95% confidence interval [CI] = 1.011–1.069), elevated cathepsin B levels decrease the risk of PD (p < 0.001, OR = 0.890, 95% CI = 0.831–0.954), and no significant association was found between cathepsin levels and ALS. Reverse MR analysis suggests that there is no causal association between 10 cathepsins and three neurodegenerative diseases.
Our study provides new genetic insights into the role of cathepsin H in AD and cathepsin B in PD. However, our findings need to be further validated in a wider population, and future research should explore the potential mechanisms of cathepsins in these diseases in order to provide a basis for the development of new therapeutic strategies.
This extensive literature review investigates the relationship between post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD), focusing on the neurobiological changes associated with their co-occurrence. Given that these disorders frequently coexist, we analyze mechanisms through which alcohol serves as a coping strategy for PTSD symptoms, particularly highlighting the drinking-to-cope self-medication model, which suggests that alcohol use exacerbates PTSD symptoms and complicates recovery.
A systematic literature search was conducted across multiple databases, including PubMed and Google Scholar, to identify studies examining the intersection of the biopsychosocial model with PTSD, AUD, and associated neural alterations.
Findings demonstrate that chronic PTSD is associated with progressive dysfunction in the amygdala, hippocampus, prefrontal cortex, hypothalamic–pituitary–adrenal axis, and white matter pathways. Also, our findings underscore alterations within the reward system, prefrontal cortex, hippocampus, amygdala, basal ganglia, and hypothalamic–pituitary–adrenal axis that contribute to the pathophysiology of AUD. Our results support the notion that a biopsychosocial framework is essential for contemporary addiction treatment, particularly in the context of alcohol addiction and PTSD.
PTSD frequently leads individuals to use alcohol as a maladaptive coping strategy, ultimately resulting in neuroadaptive alterations across critical brain regions. These neurobiological changes contribute to the development and maintenance of AUD. The findings reiterate the necessity of employing a biopsychosocial model in treating individuals grappling with both PTSD and AUD. This model allows for a comprehensive understanding of the unique challenges faced by this population, integrating biological, psychological, and social factors that influence recovery.
Diabetic individuals are at an increased risk of mental illness and comorbidities. However, the precise association between depressive symptoms and comorbidity remains uncertain. Our study aimed to investigate this relationship among elderly Chinese diabetic patients.
Data from the China Health and Retirement Longitudinal Study (CHARLS) in 2020 were utilized for the cross-sectional analysis. Depressive status was defined as the dependent variable, while the presence, number, and type of comorbidities served as independent variables. Logistic regression analyses were performed, adjusting for potential demographic factors, and health status and functioning factors.
Our findings indicate that diabetic patients with complications are more likely to experience depression. With the exception for dyslipidemia (OR = 1.195, 95% CI: 0.969, 1.475), individuals with hypertension, heart disease, stroke, kidney disease, memory-related disease, or arthritis/rheumatism were prone to develop depressive status in the fully adjusted model. After adjusting for covariates, diabetic patients with memory-related diseases exhibited the most pronounced association with depressive symptoms (OR = 2.673, 95% CI: 1.882, 3.797). Furthermore, an increasing number of depression-related comorbidities strengthened the association (p < 0.05). Sensitivity analysis revealed that there were no significant differences stratified by gender or marital status (p < 0.05).
In the elderly diabetic population in China, the presence, number, and type of comorbidities were independently associated with depressive symptoms. Diabetic patients with memory-related diseases displayed the highest likelihood of experiencing depressive status. These findings underscore the importance of implementing effective strategies for multimorbidity management in diabetic patients.
A debilitating and poorly understood symptom of Parkinson's disease (PD) is freezing of gait (FoG), which increases the risk of falling. Clinical evaluations of FoG, relying on patients’ subjective reports and manual examinations by specialists, are unreliable, and most detection methods are influenced by subject-specific factors.
To address this, we developed a novel algorithm for detecting FoG events based on movement signals. To enhance efficiency, we propose a novel architecture integrating a bottleneck attention module into a standard bidirectional long short-term memory network (BiLSTM). This architecture, adaptable to a convolution bottleneck attention–BiLSTM (CBA-BiLSTM), classifies signals using data from ankle, leg, and trunk sensors.
Given three movement directions from three locations, we reduce computational complexity in two phases: selecting optimal channels through ensemble learning followed by feature reduction using attention mapping. In FoG event detection tests, performance improved significantly compared to control groups and existing methods, achieving 99.88% accuracy with only two channels.
The reduced computational complexity enables real-time monitoring. Our approach demonstrates substantial improvements in classification results compared to traditional deep learning methods.
Whether athletes possess superior executive functions still needs further examination. Therefore, the aim of this study is to explore the executive function advantages of athletes and the differences in these advantages between open- and closed-skill sports through systematic review and meta-analysis.
Computer searches of CNKI, Web of Science, PubMed, ScienceDirect, and SPORTDiscus databases were conducted. After document selection, data extraction, and quality assessment by two researchers, data processing, statistical analysis, and visual presentation were performed using SPSS 25.0, Stata 16.0, and GraphPad Prism 8 software.
A total of 41 articles were included, including 3845 athletes with a mean age of 9.6–42.8 years. Athletes showed more positive inhibitory control (Z = 5.18, standardized mean difference (SMD) = −0.631, 95% confidence intervals (CI) = −0.869 to −0.392, p = 0.000) and working memory (Z = 3.42, SMD = −0.382, 95%CI = −0.601 to −0.163, p = 0.001) compared to the general group with no sports experience. Elite and sub-elite, and sub-elite and amateur athletes all showed more positive performance on the cognitive flexibility task compared to the latter. In addition, open-skilled athletes performed more positively on working memory and cognitive flexibility tasks compared to closed-skilled athletes. Egger linear regression analysis revealed a possible publication bias for inhibitory control, whereas there was no publication bias for working memory and cognitive flexibility. Univariate meta-regression analysis revealed that date of publication (β = 0.145) and sample size (β = −0.002) were sources of heterogeneity between studies for the inclusion of cognitive flexibility (p < 0.05). The sensitivity analysis of the one-by-one elimination method and the cut-and-patch method found the results to be relatively robust and reliable.
Athletes have superior executive function performance that increases with sports experience. In addition, open-skilled athletes showed more positive executive function. The result has guiding significance for the selection and training of athletes in the future.
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