A systematic review of online interventions for mental health in low and middle income countries : a neglected field

Background. Low and middle income countries (LMICs) are facing an increase of the impact of mental health problems while confronted with limited resources and limited access to mental health care, known as the ‘mental health gap’. One strategy to reduce the mental health gap would be to utilize the internet to provide more widely-distributed and low cost mental health care. We undertook this systematic review to investigate the effectiveness and efficacy of online interventions in LMICs. Methods. We systematically searched the data-bases PubMed, PsycINFO, JMIR, and additional sources. MeSH terms, Thesaurus, and free text keywords were used. We included all randomized controlled trials (RCTs) of online interventions in LMICs. Results. We found only three articles reported results of RCTs on online interventions for mental health conditions in LMICs, but none of these interventions was compared with an active control condition. Also, the mental health conditions were diverse across the three studies. Conclusions. There is a dearth of studies examining the effect of online interventions in LMICs, so we cannot draw a firm conclusion on its effectiveness. However, given the effectiveness of online interventions in high income countries and sharp increase of internet access in LMICs, online interventions may offer a potential to help reduce the ‘mental health gap’. More studies are urgently needed in LMICs

Interaction between the MTHFR C677T polymorphism and traumatic childhood events predicts depression

Childhood trauma is associated with the onset and recurrence of major depressive disorder (MDD). The thermolabile T variant of the methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism (rs1801133) is associated with a limited (oxidative) stress defense. Therefore, C677T MTHFR could be a potential predictor for depressive symptomatology and MDD recurrence in the context of traumatic stress during early life. We investigated the interaction between the C677T MTHFR variant and exposure to traumatic childhood events (TCEs) on MDD recurrence during a 5.5-year follow-up in a discovery sample of 124 patients with recurrent MDD and, in an independent replication sample, on depressive syniptomatology in 665 healthy individuals from the general population. In the discovery sample, Cox regression analysis revealed a significant interaction between MTHFR genotype and TCEs on MOD recurrence (P = 0.017). Over the 5.5-year follow-up period, median time to recurrence was 191 days for T-allele carrying patients who experienced TCEs (T + and TCE +); 461 days for T - and TCE + patients; 773 days for T + and TCE - patients and 866 days for T - and TCE - patients. In the replication sample, a significant interaction was present between the MTHFR genotype and TCEs on depressive symptomatology (P = 0.002). Our results show that the effects of TCEs on the prospectively assessed recurrence of MOD and self-reported depressive symptoms in the general population depend on the MTHFR genotype. In conclusion, T-allele carriers may be at an increased risk for depressive symptoms or MOD recurrence after exposure to childhood trauma

Floor transfer test for assessing people with chronic stroke

published_or_final_versio

Spatially Resolved Magnetic Field Structure in the Disk of a T Tauri Star

Magnetic fields in accretion disks play a dominant role during the star formation process but have hitherto been observationally poorly constrained. Field strengths have been inferred on T Tauri stars themselves and possibly in the innermost part of the accretion disk, but the strength and morphology of the field in the bulk of the disk have not been observed. Unresolved measurements of polarized emission (arising from elongated dust grains aligned perpendicular to the field) imply average fields aligned with the disks. Theoretically, the fields are expected to be largely toroidal, poloidal, or a mixture of the two, which imply different mechanisms for transporting angular momentum in the disks of actively accreting young stars such as HL Tau. Here we report resolved measurements of the polarized 1.25 mm continuum emission from HL Tau's disk. The magnetic field on a scale of 80 AU is coincident with the major axis (~210 AU diameter) of the disk. From this we conclude that the magnetic field inside the disk at this scale cannot be dominated by a vertical component, though a purely toroidal field does not fit the data well either. The unexpected morphology suggests that the magnetic field's role for the accretion of a T Tauri star is more complex than the current theoretical understanding.Comment: Accepted for publication in Natur

Age-dependent reduction in voltage-gated inward sodium current and<em> Scn8a</em> gene expression in murine stellate ganglia

\ua9 2025 The Author(s). Annals of the New York Academy of Sciences published by Wiley Periodicals LLC on behalf of The New York Academy of Sciences.Stellate ganglia (SG) provide sympathetic innervation to the heart and may predispose the myocardial conducting system to arrhythmias. However, little is known about age-related changes in the electrophysiology of murine SG. We investigated alterations in the electrophysiological properties of SG with aging. The loose patch clamp technique was adapted to SG tissue to investigate the voltage-gated ionic currents in its neuronal cells. We compared SG and ventricular cells from young (4 months) and aged (13 months) C57BL/6J mice to explore age-related alterations in their voltage-gated ionic currents (n &gt; 30 patches, eight mice in each group). We observed that the voltage-gated inward sodium current (peak INa(Max)) was significantly decreased with aging in the SG, but not in the ventricle. Additionally, Scn8a gene expression, which encodes the Nav 1.6 channel, was decreased with aging in the SG. Application of loose patch clamp electrophysiology thus suggests that ionic current alterations with age in murine SG could contribute to cardiac autonomic dysregulation in geriatric conditions

What are the effects of preventative interventions on major depressive disorder (MDD) in young adults? A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Depression is a prevalent disorder with a peak rate of onset in young adulthood from 18 to 25 years. To date, no review has systematically assessed the effectiveness of programs that aim to reduce depressive symptoms or diagnosis of depression in young adults. METHOD: A systematic search was performed in Cochrane, PubMed, PsycINFO and EMBASE. We performed a random-effects meta-analysis of the randomized controlled studies that compared an intervention for young adults (aged 18-25) without a diagnosis or history of depression and a control condition. Comparisons between intervention and control group outcomes were carried out at the post-intervention time point. We also compared intervention and control group outcomes at later follow-up time points where data were available. RESULTS: Twenty-six randomized controlled trials among 2865 young adults were included in the analysis. The pooled effect size of the interventions versus control at post-intervention was g?=?0.37 (95% CI: 0.28-0.47, NNT?=?9) and heterogeneity was moderate I2?=?36 (95% CI: 11-64). There were no significant effects in terms of the type of delivery, focus of study, type of control, or type of support within the interventions. LIMITATIONS: The authors were unable to assess the effects of interventions on the onset of depression as none of the included studies measured incidence. The risk of bias was high in most studies (81%). Only one study included a follow-up of more than a year. Demographic factors were inconsistently reported in the included articles. CONCLUSION: While it was not possible to investigate the effects of interventions on depression incidence, some evidence was found for the effectiveness of preventative interventions in reducing depressive symptoms in young adults. Future research should address limitations of the current evidence base to allow stronger conclusions to be drawn

Gene Expression, Morphology, and Electrophysiology During the Dynamic Development of Human-Induced Pluripotent Stem Cell-Derived Atrial- and Ventricular-Like Cardiomyocytes [Response to Letter]

Yafei Zhou,1,2 Christopher LH Huang,3 Yanmin Zhang1,2,4 1Key Laboratory of Precision Medicine to Pediatric Diseases of Shaanxi Province, Affiliated Children&rsquo;s Hospital of Xi&rsquo;an Jiaotong University, Xi&rsquo;an, Shaanxi, People&rsquo;s Republic of China; 2Shaanxi Institute for Pediatric Diseases, Affiliated Children&rsquo;s Hospital of Xi&rsquo;an Jiaotong University, Xi&rsquo;an, Shaanxi, People&rsquo;s Republic of China; 3Physiological Laboratory, University of Cambridge, Cambridge, UK; 4Department of Cardiology, Xi&rsquo;an Children&rsquo;s Hospital, Affiliated Children&rsquo;s Hospital of Xi&rsquo;an Jiaotong University, Xi&rsquo;an, Shaanxi, People&rsquo;s Republic of ChinaCorrespondence: Yanmin Zhang, Key Laboratory of Precision Medicine to Pediatric Diseases of Shaanxi Province, Affiliated Children&rsquo;s Hospital of Xi&rsquo;an Jiaotong University, No. 69 Xi Ju Yuan Xiang, Xi&rsquo;an, Shaanxi, 710000, People&rsquo;s Republic of China, Tel +86 029-87692527, Fax +86 029-87692000, Email [email protected]

High temperature dielectric ceramics: a review of temperature-stable high-permittivity perovskites

Recent developments are reviewed in the search for dielectric ceramics which can operate at temperatures >200 °C, well above the limit of existing high volumetric efficiency capacitor materials. Compositional systems based on lead-free relaxor dielectrics with mixed cation site occupancy on the perovskite lattice are summarised, and properties compared. As a consequence of increased dielectric peak broadening and shifts to peak temperatures, properties can be engineered such that a plateau in relative permittivity–temperature response (εr–T) is obtained, giving a ±15 %, or better, consistency in εr over a wide temperature range. Materials with extended upper temperature limits of 300, 400 and indeed 500 °C are grouped in this article according to the parent component of the solid solution, for example BaTiO3 and Na0.5Bi0.5TiO3. Challenges are highlighted in achieving a lower working temperature of −55 °C, whilst also extending the upper temperature limit of stable εr to ≥300 °C, and achieving high-permittivity and low values of dielectric loss tangent, tan δ. Summary tables and diagrams are used to help compare values of εr, tan δ, and temperature ranges of stability for different material

Inhibitory effect of Panax Notoginseng (PNG) extracts on the TNF-α-induced MMP-9 activity in cardiomyoblasts

Poster Presentation 10Cardiac remodeling is a compensatory physiologic response to myocardial infarction. The progression of cardiac remodeling may lead to congestive heart failure which has high mortality rate. In this progression, matrix metalloproteinases (MMPs) plays an important role in the degradation of extracellular matrix (ECM) and subsequent ventricular dilation. Therefore, new treatments targeting MMPs are suggested to ...published_or_final_versio

Disrupting the rhythm of depression using Mobile Cognitive Therapy for recurrent depression: randomized controlled trial design and protocol

Background: Major depressive disorder (MDD) is projected to rank second on a list of 15 major diseases in terms of burden in 2030. The major contribution of MDD to disability and health care costs is largely due to its highly recurrent nature. Accordingly, efforts to reduce the disabling effects of this chronic condition should shift to preventing recurrence, especially in patients at high risk of recurrence. Given its high prevalence and the fact that interventions are necessary during the remitted phase, new approaches are needed to prevent relapse in depression. Methods/design: The best established effective and available psychological intervention is cognitive therapy. However, it is costly and not available for most patients. Therefore, we will compare the effectiveness and cost-effectiveness of self-management supported by online CT accompanied by SMS based tele-monitoring of depressive symptomatology, i.e. Mobile Cognitive Therapy (M-CT) versus treatment as us usual (TAU). Remitted patients (n = 268) with at least two previous depressive episodes will be recruited and randomized over (1) M-CT in addition to TAU versus (2) TAU alone, with follow-ups at 3, 12, and 24 months. Randomization will be stratified for number of previous episodes and type of treatment as usual. Primary outcome is time until relapse/recurrence over 24 months using DSM-IV-TR criteria as assessed by the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID). For the economic evaluation the balance between costs and health outcomes will be compared across strategies using a societal perspective. Discussion: Internet-based interventions might be helpful in empowering patients to become their own disease managers in this lifelong recurrent disorder. This is, as far as we are aware of, the first study that examines the (cost) effectiveness of an E-mental health program using SMS monitoring of symptoms with therapist support to prevent relapse in remitted recurrently depressed patient