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The increasing prevalence of mental health issues among adolescents and young adults, coupled with barriers to accessing traditional therapy, has led to growing interest in artificial intelligence (AI)-driven conversational agents (CAs) as a novel digital mental health intervention. Despite accumulating evidence suggesting the effectiveness of AI-driven CAs for mental health, there is still limited evidence on their effectiveness for different mental health conditions in adolescents and young adults. This study aims to examine the effectiveness of AI-driven CAs for mental health among young people, and explore the potential moderators of efficacy. A total of 5 main databases (PubMed, PsycINFO, Embase, Cochrane Library, and Web of Science) were searched systematically dated from the establishment of the database to August 6, 2024. Randomized controlled trials comparing AI-driven CAs with any other type of control condition in improving depressive symptoms, generalized anxiety symptoms, stress, mental well-being, and positive and negative affect were considered eligible when they were conducted in young people aged 12-25 years. The quality of these studies was assessed using the Cochrane Risk of Bias tool. Data were extracted by 2 independent reviewers and checked by a third reviewer. Pooled effect sizes (Hedges g) were calculated using random effect models and visually presented in forest plots. A total of 14 articles (including 15 trials) were included, involving 1974 participants. The results indicated that, after adjustment for publication bias, AI-driven CAs had a moderate-to-large (Hedges g=0.61, 95% CI 0.35-0.86) effect on depressive symptoms compared to control conditions. However, their effect sizes adjusting for publication bias for generalized anxiety symptoms (Hedges g=0.06, 95% CI -0.21 to 0.32), stress (Hedges g=0.002, 95% CI -0.19 to 0.20), positive affect (Hedges g=0.01, 95% CI -0.24 to 0.27), negative affect (Hedges g=0.07, 95% CI -0.13 to 0.27), and mental well-being (Hedges g=0.04, 95% CI -0.21 to 0.29) were all nonsignificant. Subgroup analyses revealed that AI-driven CAs were particularly effective in improving depressive symptoms among subclinical populations (Hedges g=0.74, 95% CI 0.50-0.98). The findings highlight the potential of AI-driven CAs for early intervention in depression among this population, and underscore the need for further improvements to enhance their efficacy across a broader range of mental health outcomes. Key limitations of the reviewed evidence include heterogeneity in therapeutic orientations of CAs and lack of follow-up measures. Future research should explore the long-term effects of AI-driven CAs on mental health outcomes.

Background Trait compliance involves people reacting favorably to demands made by others across different situations. This may lead to susceptibility to external pressures, exploitation, and manipulation. Moreover, trait compliance was found to correlate with various mental health outcomes, such as depression and anxiety. The Gudjonsson Compliance Scale (GCS) is an efficient tool for assessing trait compliance in Western contexts. To date, no study has validated the psychometric properties of the GCS in Chinese populations. Methods Two college student samples from China were recruited. The first sample ( N  = 4,276) was used to conduct exploratory factor analysis. The second ( N  = 4,356) was used to perform a confirmatory factor analysis. The reliability, measurement invariance, and correlational tests were conducted on the two combined samples. Results The Chinese GCS showed a 3-factor structure, with two items deleted. Reliability was supported by moderate-to-good internal consistency of the three-factor scales and good internal consistency on the full scale. Strong measurement invariance across sex, ethnicity, and group recruitment was supported. Scores of the total scale and factor scales were found to significantly associated with several mental health problems. Conclusions The Chinese version of the GCS appears to be a valid and reliable instrument for measuring trait compliance and could promote both the assessment and research on compliance in Chinese population.

Background The mental health issue of graduate students related to the strained relationships with their academic supervisors has triggered wide concern and heated discussion recently. The study aimed to explore the relationship between abusive supervision and the mental health of graduate students, and the mediating roles of autonomy need and professional identity. Method An online survey was conducted among 233 graduate students and the perceived abusive supervision, autonomy need, professional identity and the three indicators of mental health (anxiety, depressive symptoms and psychache) were measured. Results It was found that perceived abusive supervision positively correlated to the latent variable mental health, and it worked through the respective mediating effects of autonomy need ( β  = 0.060, p  = 0.004, 95% CI = [0.019, 0.100]), professional identity ( β  = 0.054, p  = 0.004, 95% CI = [0.017, 0.090]) and the chain mediating effect of them ( β  = 0.006, p  = 0.028, 95% CI = [0.001, 0.011]). The total indirect effect size was 0.119 ( p  < 0.001, 95% CI = [0.066, 0.173]), accounting for 24.44% of overall effect size. These findings deepen the understanding of the influence of abusive supervision on mental health among graduate students and provide practical insights into psychosocial intervention from the perspective of the Conservation of Resources theory and Self-Determination theory.

The incidence of non-suicidal self-injury (NSSI) has been on the rise in recent years. Studies have shown that people with NSSI have difficulties in emotion regulation and cognitive control. In addition, some studies have investigated the cognitive emotion regulation of people with NSSI which found that they have difficulties in cognitive emotion regulation, but there was a lack of research on cognitive emotion regulation strategies and related neural mechanisms. This study included 117 people with NSSI (age = 19.47 ± 5.13, male = 17) and 84 non-NSSI participants (age = 19.86 ± 4.14, male = 16). People with NSSI met the DSM-5 diagnostic criteria, and non-NSSI participants had no mental or physical disorders. The study collected all participants' data of Cognitive Emotion Regulation Questionnaire (CERQ) and functional magnetic resonance imaging (fMRI) to explore the differences in psychological performance and brain between two groups. Afterwards, Machine learning was used to select the found differential brain regions to obtain the highest correlation regions with NSSI. Then, Allen's Human Brain Atlas database was used to compare with the information on the abnormal brain regions of people with NSSI to find the genetic information related to NSSI. In addition, gene enrichment analysis was carried out to find the related pathways and specific cells that may have differences. The differences between NSSI participants and non-NSSI participants were as follows: positive refocusing (t = −4.74, p < 0.01); refocusing on plans (t = −4.11, p < 0.01); positive reappraisal (t = −9.22, p < 0.01); self-blame (t = 6.30, p < 0.01); rumination (t = 3.64, p < 0.01); catastrophizing (t = 9.10, p < 0.01), and blaming others (t = 2.52, p < 0.01), the precentral gyrus (t = 6.04, pFDR < 0.05) and the rolandic operculum (t = −4.57, pFDR < 0.05). Rolandic operculum activity was negatively correlated with blaming others (r = −0.20, p < 0.05). Epigenetic results showed that excitatory neurons (p < 0.01) and inhibitory neurons (p < 0.01) were significant differences in two pathways, “trans-synaptic signaling” (p < −log108) and “modulation of chemical synaptic transmission” (p < −log108) in both cells. People with NSSI are more inclined to adopt non-adaptive cognitive emotion regulation strategies. Rolandic operculum is also abnormally active. Abnormal changes in the rolandic operculum of them are associated with non-adaptive cognitive emotion regulation strategies. Changes in the excitatory and inhibitory neurons provide hints to explore the abnormalities of the neurological mechanisms at the cellular level of them. Trial registration number NCT04094623 •The use of non-adaptive cognitive emotion regulation strategies was associated with abnormal changes in the Rolandic operculum.•Changes in excitatory and inhibitory neurons and abnormal performance of related pathways may be related to changes in brain regions and the use of cognitive emotion regulation strategies.

Nonsuicidal self-injury (NSSI) is posited to arise from a complex interaction of biopsychosocial factors, with impulsivity playing a critical role. Given that current research on the neural mechanisms underlying this hypothesis remains inconsistent and limited in scope, we sought to explore how NSSI behaviours are associated with impulsivity resulting from structural brain alterations. We recruited patients with NSSI behaviours and healthy controls from 11 psychiatric hospitals. We assessed the differences in impulse control between the 2 groups using the Barratt Impulsiveness Scale version 11 and the Attention Network Test. We also conducted T1-weighted magnetic resonance imaging (MRI) and diffusion tensor imaging. Finally, we analyzed the associations among brain structure, psychological characteristics, and self-injurious behaviour among patients with NSSI. We included 293 patients with NSSI behaviours and 140 healthy controls. Among them, 182 patients with NSSI and 95 controls underwent the T1-weighted MRI and diffusion tensor imaging. Patients with NSSI showed increased impulsivity and alerting function, with the strongest correlation between NSSI frequency and motor impulsivity. Compared with controls, patients with NSSI exhibited decreased grey matter volume and increased white matter volume, with no significant difference in cortical thickness. Pathway analysis demonstrated that motor impulsivity significantly mediated the association between white matter volume and the NSSI frequency in the right superior frontal gyrus and right inferior parietal lobe. When examining the connecting fibre tracts in the right frontoparietal area, patients with NSSI showed decreased integrity of white matter microstructure in the right cingulum, right superior corona radiata, and the splenium of the corpus callosum. Accurately measuring executive control linked to NSSI is challenging in cognitive behavioural tasks, as impulsive tendencies during NSSI occurrence are not effectively captured. Our findings suggested that motor impulsivity, a prominent psychopathological characteristic of NSSI, is primarily modulated by the frontoparietal regions. These results provide empirical neuroimaging evidence for the impaired impulse control observed in NSSI.

Maribavir's anti‐cytomegalovirus (CMV) activity and favorable safety/tolerability profile is a welcomed addition to the CMV treatment armamentarium. To further characterize pharmacokinetic (PK) and exposure–response relationships of maribavir in transplant recipients with CMV, a population PK model was updated with data from the AURORA study, using non‐linear mixed‐effect modeling. Covariates were tested using a stepwise procedure. In exposure–response analyses, relationships between maribavir exposure metrics and the primary and key secondary response endpoints and safety data from AURORA were characterized. The final model was a two‐compartment disposition model with first‐order elimination, first‐order absorption and an absorption lag‐time. Exposure levels were similar irrespective of transplant type and in patients with refractory CMV infection versus those receiving first‐line maribavir. Concomitant administration of proton‐pump inhibitors resulted in reduced maribavir exposure that was not clinically significant. There was no apparent relationship between maribavir exposure and the primary or key secondary endpoints of the AURORA study. Steady‐state maribavir exposures were not significantly associated with any adverse events other than nausea and vomiting. In conclusion, maribavir's efficacy, safety, and favorable tolerability profile in transplant recipients with first CMV infection after transplant or refractory CMV infection is supported by PK exposure metrics. Higher maribavir steady‐state concentrations were not associated with greater efficacy or a higher frequency of adverse events other than nausea and vomiting.

Alzheimer’s disease (AD) is characterized by deposition of amyloid-β (Aβ) plaques and neurofibrillary tangles in the brain, accompanied by synaptic dysfunction and neurodegeneration. Antibody-based immunotherapy against Aβ to trigger its clearance or mitigate its neurotoxicity has so far been unsuccessful. Here we report the generation of aducanumab, a human monoclonal antibody that selectively targets aggregated Aβ. In a transgenic mouse model of AD, aducanumab is shown to enter the brain, bind parenchymal Aβ, and reduce soluble and insoluble Aβ in a dose-dependent manner. In patients with prodromal or mild AD, one year of monthly intravenous infusions of aducanumab reduces brain Aβ in a dose- and time-dependent manner. This is accompanied by a slowing of clinical decline measured by Clinical Dementia Rating—Sum of Boxes and Mini Mental State Examination scores. The main safety and tolerability findings are amyloid-related imaging abnormalities. These results justify further development of aducanumab for the treatment of AD. Should the slowing of clinical decline be confirmed in ongoing phase 3 clinical trials, it would provide compelling support for the amyloid hypothesis. Aducanumab, a human monoclonal antibody that selectively targets aggregated Aβ, reduces soluble and insoluble Aβ in the brain, an action accompanied by a dose-dependent slowing of clinical decline in treated patients. A prospect for amyloid-β-removal therapy Aducanumab is a recombinant human monoclonal antibody that selectively targets the amyloid-β (Aβ) peptide aggregates thought to play a part in the neurodegenerative process in Alzheimer's disease. Several Alzheimer's disease drugs have failed in development in recent years — including other anti-amyloid antibodies — so there is intense interest in any new developments. A new study reports interim results from a clinical trial of monthly infusions of aducanumab in subjects with prodromal or mild Alzheimer's disease. Treatment with aducanumab reduced brain Aβ plaques, an action accompanied by a dose-dependent slowing of clinical decline. The trial data support further development of aducanumab as an Aβ-removing therapy.

In this phase 2 randomized, placebo-controlled trial involving 112 participants with narcolepsy type 1, oveporexton significantly improved measures of wakefulness, sleepiness, and cataplexy over a period of 8 weeks.