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Background The human brain is a dynamic neural system with time-varying functional connectivity (FC) strengths between brain regions. Evidence indicates that adolescents with major depressive disorder (MDD) exhibit decreased average FC strength in cognitive tasks. Nevertheless, research focused on dynamic FC analysis in this population remains limited. This study aims to identify cognitive task-related dynamic FC features as valuable biomarkers to characterize clinical symptoms in adolescents with MDD. Methods A total of 83 adolescents with MDD and 78 age/sex-matched healthy controls (HCs) were recruited. We utilized functional near-infrared spectroscopy (fNIRS) to record brain functional data from participants while they performed the verbal fluency task (VFT). An analytical framework for fNIRS data was proposed, in which the average FC strength values over the entire VFT duration and the principal components (PCs) of dynamic (time-varying) FC strength values were extracted as static and dynamic FC features, respectively. A random forest model was built to distinguish adolescents with MDD from HCs. Statistical analyses of the FC features were conducted to identify between-group differences, as well as their relationships with clinical symptoms in adolescents with MDD. Results The random forest model achieved an accuracy of 86.32% (95% confidence interval: 83.75%-89.38%) for distinguishing adolescents with MDD from HCs. Significant between-group differences emerged in several FC features (false discovery rate-corrected q  < 0.05). For adolescents with MDD, the average FC strength value in the right dorsolateral prefrontal cortex (DLPFC) ~ right medial prefrontal cortex (mPFC) pathway was a significant predictor of depressive and anxious symptoms; the 3rd PC of dynamic FC strength values in the left DLPFC ~ left temporal lobe (TL) pathway and the 5th PC of dynamic FC strength values in the right mPFC ~ right TL pathway were significant predictors of anhedonic symptoms. Conclusions VFT-related static and dynamic FC features in specific brain pathways are potential biomarkers for characterizing clinical symptoms in adolescents with MDD. The developed random forest model holds promise as a diagnostic tool for MDD in adolescents. Clinical trial number Not applicable.

Epilepsy is a common neurological disorder characterized by recurrent epileptic seizures. The cause of most cases of epilepsy is unknown. Although changes of calcium events in a single brain region during seizures have been reported before, there have been few studies on relations between calcium events of two different brain regions and epileptic behaviors in freely moving mice. To analyze calcium events simultaneously recorded in hippocampal CA1 (CA1) and primary motor cortex M1 (M1), and to explore their relations to various epileptic behaviors in freely moving epileptic models. Epileptic models were induced by Kainic acid (KA), a direct agonist of glutamatergic receptor, on adult male C57/BL6J mice. Calcium events of neurons and glia in CA1 and M1 labeled by a calcium indicator dye were recorded simultaneously with a multi-channel fiber photometry system. Three typical types of calcium events associated with KA-induced seizures were observed, including calcium baseline-rising, cortical spreading depression (CSD) and calcium flashing with a steady rate. Our results showed that the calcium baseline-rising occurred in CA1 was synchronized with that in M1, but the CSD waves were not. However, synchronization of calcium flashing in the two areas was uncertain, because it was only detected in CA1. We also observed that different calcium events happened with different epileptic behaviors. Baseline-rising events were accompanied by clonus of forelimbs or trembling, CSD waves were closely related to head movements (15 out of 18, 6 mice). Calcium flashing occurred definitely with drastic convulsive motor seizures (CMS, 6 mice). The results prove that the synchronization of calcium event exists in CA1 and M1, and different calcium events are related with different seizure behaviors. Our results suggest that calcium events involve in the synchronization of neural network and behaviors in epilepsy.

Isoflurane contributes to cognitive deficits when used as a general anesthetic, and so does sleep deprivation (SD). Patients usually suffer from insomnia before an operation due to anxiety, fear, and other factors. It remains unclear whether preoperative SD exacerbates cognitive impairment induced by isoflurane. In this study, we observed the effects of pretreated 24-h SD in adult isoflurane-exposed mice on the cognitive behaviors, the Ca 2+ signals of dorsal hippocampal CA1 (dCA1) neurons in vivo with fiber photometry, and the density of dendritic spines in hippocampal neurons. Our results showed that in cognitive behavior tasks, short-term memory damages were more severe with SD followed by isoflurane exposure than that with SD or isoflurane exposure separately, and interestingly, severe long-term memory deficits were induced only by SD followed by isoflurane exposure. Only the treatment of SD followed by isoflurane exposure could reversibly decrease the amplitude of Ca 2+ signals when mice were freely moving and increase the duration of Ca 2+ signals during the long-term memory behavior test. The density of dendritic spines with both SD and isoflurane exposure was lower than that with SD alone. This study suggests that SD should be avoided preoperatively in patients undergoing elective surgery under isoflurane anesthesia.

Obstructive sleep apnea hypopnea syndrome (OSAHS) and parasomnia overlap disorder (POD) are types of sleep disorders. When the symptoms of both conditions coexist, the POD symptoms are most likely caused by OSAHS. In these cases, the symptoms of POD will be relieved when OSAHS is effectively treated. We refer to these cases as symptomatic POD (related to OSAHS), which differs in pathophysiology, complications, and treatment from idiopathic POD. It is important to note that the treatment for idiopathic POD may aggravate the symptoms of OSAHS. In this case, we used video polysomnography (v-PSG) on a POD patient with suspected OSAHS to distinguish idiopathic POD from symptomatic POD, to inform the appropriate treatment course. The video results and clinical features lead us to diagnose symptomatic POD, and we treated the patient with auto-set continuous positive airway pressure to address their OSAHS. This course of treatment resolved all POD-related symptoms. Here, we discuss this case and review the relevant literature. This report highlights the importance of the use of v-PSG in the clinical diagnosis, differential diagnosis, and subsequent treatment of POD.

Background This study aimed to investigate sex differences in risk factors for suicide attempts in first‐episode and drug naive (FEDN) major depressive disorder (MDD) with comorbid subclinical hypothyroidism (SCH). Methods A total of 1034 FEDN MDD patients with comorbid SCH were enrolled. The Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and Positive and Negative Syndrome Scale (PANSS) positive subscale were used to assess patients’ symptoms. Thyroid hormone levels and metabolic parameters were measured. Results MDD patients with SCH had a significantly higher risk of suicide attempts than those without SCH (25.4% vs. 12.2%). Logistic regression showed that HAMA score, thyroid stimulating hormone (TSH) levels, and thyroid peroxidase antibody (TPOAb) levels were significantly associated with an increased risk for suicide attempts in both male and female MDD patients comorbid SCH, while low‐density lipoprotein cholesterol (LDL‐C) was significantly associated with an increased risk for suicide attempts only in male patients, HAMD score and systolic blood pressure were significantly associated with an increased risk for suicide attempts only in female patients. Conclusion SCH comorbidities may increase suicide attempts in MDD patients. Our results showed significant sex differences in clinical and metabolic factors associated with suicide attempts among FEDN MDD patients with comorbid SCH, highlighting appropriate sex‐based preventive interventions are needed. SCH comorbidities may increase suicide attempts in MDD patients. Our results showed significant sex differences in clinical and metabolic factors associated with suicide attempts among FEDN MDD patients with comorbid SCH.

Major depressive disorder (MDD) is associated with worse cognitive functioning. We aim to examine the association between baseline cognitive functioning and the reduction rate in HDRS-17 total scores and to highlight the predictors of the reduction rate in HDRS-17 total scores in MDD with first-episode, drug-naïve (FED) patients. Ninety FED patients were recruited consecutively and evaluated using the 17-item Hamilton Depression Rating Scale (HDRS-17), the 14-item Hamilton Anxiety Scale (HAMA-14), the Functioning Assessment Short Test (FAST) and the MATRICS Consensus Cognitive Battery (MCCB) at baseline and again at week 8. Eighty-four FED patients completed the study. Comparison showed that response group had significantly higher T scores in TMT-A, BACS-SC, WMS-III, BVMT-R, MSCEI and CPT-IP, but showed significantly lower scores in FAST total scores including autonomy, occupational functioning, cognitive functioning, interpersonal relationship than non- response group (all < 0.05). Partial correlation analysis also found that the reduction rate in HDRS-17 total scores could be negatively associated with autonomy, cognitive functioning and interpersonal relationship domains as well as total FAST scores, also was further positively associated with T-scores of BACS-SC, CPT-IP and MSCEI in MCCB, even when accounting for potential confounders. Furthermore, the levels of cognitive function domain, autonomy domain in FAST, and BACS-SC, CPT-IP in MCCB may predict the reduction rate in HDRS-17 total scores in FED patients (all < 0.05). Our findings underscore significant correlations between baseline functioning and the reduction rate in HDRS-17 total scores in FED patients. Moreover, better baseline cognitive function, autonomy, speed of processing and attention/vigilance are more likely to predict patients' response to antidepressant treatment, indicating pre-treatment better cognitive functioning may be predictors to treatment response in FED.

Anodal-transcranial pulsed current stimulation (a-tPCS) has been used in human studies to modulate cortical excitability or improve behavioral performance in recent years. Multiple studies show crucial roles of astrocytes in cortical plasticity. The calcium activity in astrocytes could regulate synaptic transmission and synaptic plasticity. Whether the astrocytic activity is involved in a-tPCS-induced cortical plasticity is presently unknown. The purpose of this study is to investigate the calcium responses in neurons and astrocytes evoked by a-tPCS with different current intensities, and thereby provides some indication of the mechanisms underlying a-tPCS-induced cortical plasticity. Two-photon calcium imaging was used to record the calcium responses of neurons and astrocytes in mouse somatosensory cortex. Local field potential (LFP) evoked by sensory stimulation was used to assess the effects of a-tPCS on plasticity. We found that long-duration a-tPCS with high-intensity current could evoke large-amplitude calcium responses in both neurons and astrocytes, whereas long-duration a-tPCS with low-intensity current evoked large-amplitude calcium responses only in astrocytes. The astrocytic Ca2+ elevations are driven by noradrenergic-dependent activation of the alpha-1 adrenergic receptors (A1ARs), while the intense Ca2+ responses of neurons are driven by action potentials. LFP recordings demonstrated that low-intensity a-tPCS led to enhancement of cortical excitability while high-intensity a-tPCS resulted in diminution of cortical excitability. The results provide some evidence that the enhancement of a-tPCS-induced cortical excitability might be partly associated with calcium elevation in astrocytes, whereas the diminution of a-tPCS-induced cortical excitability might be caused by excessive calcium activity in neurons. These findings indicate that the appropriate current intensity should be used in the application of a-tPCS.

The development of water drive gas reservoirs (WDGRs) with fractures or strong heterogeneity is severely influenced by water invasion. Accurately simulating the rules of water invasion and drainage gas recovery countermeasures in fractured WDGRs, thereby revealing the mechanism of water invasion and an appropriate development strategy, is important for formulating water management measures and enhancing the recovery of gas reservoirs. In this work, physical simulation methods were proposed to gain a better understanding of water invasion and to optimize the water control of fractured WDGRs. Five groups of experiments were designed and conducted to probe the impacts of the distance between the fractures and the gas well, the drainage position, the drainage timing and the aquifer size on the water invasion and production performance of a gas reservoir. The gas and water production and the internal pressure drop were monitored in real time during the experiments. Based on the above experimental works, a theoretical analysis was conducted to quantitatively evaluate the performance of the gas reservoir recovery via the gas well production performance, water invasion, dynamic pressure drop and residual gas and water distribution analysis. The results show that when the fracture scale was appropriate, a gas well drilled close to a fracture (Experiment 1-3) or a high-permeability formation could also produce gas and achieve drainage efficiently. The recovery factor of Experiment 1-3 reached 62.5%, which was 24.6% and 21.1% higher than those of Experiments 1-1 and 1-2, respectively, which had wells drilled in low-permeability areas. Draining water near an aquifer can effectively inhibit water invasion during the early stage of gas recovery. The setup in Experiment 2-1 effectively inhibited water invasion and avoided the formation of water-sealed volumes of gas to recover 30% more gas than recovered with that of Experiment 1-1 without drainage wells. A shorter distance between the drainage well and the aquifer increased the drainage capacity and decreased the gas production capacity, respectively (Well 2 at Point A vs Point B). A larger aquifer had a lower gas recovery, which reduced the economic benefit. For example, due to an infinitely large aquifer, the reserves in Experiment 4-1 were developed by a single well, the gas recovery was only 33.4%. These research results are expected to be beneficial for the preparation of development plans and the optimization of water control measures for WDGRs.

To evaluate the impact of opioid-free anesthesia (OFA) combined with regional blocks on the quality of recovery (QoR) in patients who underwent mastectomy. This randomized controlled trial involved 132 mastectomy patients who were randomized to receive either OFA combined with PECS block or opioid-based anesthesia (OBA) combined with PECS block. The QoR was assessed using the QoR-15 global score at 24 h post-surgery. Secondary outcomes included postoperative sufentanil consumption, incidence of postoperative nausea and vomiting (PONV), Numerical Rating Scale (NRS) scores at 1, 4, and 24 h, incidence of postoperative adverse events, extubation, incidence of severe bradycardia and intraoperative mean artrial pressure (MAP) and heart rate (HR) at after entering the operating room (T0, baseline value), after intubation (T1), after skin incision (T2), and after extubation (T3). The QoR-15 global score at 24 h was not significantly different between groups (MD = -0.4, 95% CI [-3.8 to 4.7], P = 0.67). Postoperative sufentanil consumptions (P = 0.075), the incidence of PONV (P = 0.12), NRS scores at 1 h (P = 0.36), 4 h (P = 0.53), and 24 h (P = 0.02) were not significantly different. Incidence of adverse events (OR = 0, 95% CI [0 to 0.44], P = 0.0063) were lower in Group OFA than that in Group OBA. Extubation time was significantly longer in Group OFA than in Group OBA (MD = 15, 95%CI [10-18], P <  0.001). MAPs at T1 and T2 were significantly higher in Group OFA than in Group OBA (P <  0.0125), while MAP and HR at T3 were significantly lower in Group OFA than in Group OBA(P <  0.0125). Incidence of severe bradycardia were not significantly different (P = 0.67). In conclusion, while OFA contributes to a reduction in adverse events, its integration with PECS blocks does not improve QoR or postoperative analgesia at 24 h post-mastectomy. Moreover, OFA was associated with a prolonged extubation time. chictr.org; registration number: ChiCTR2100043575.

Traditional porous media imbibition models deviate from the actual imbibition process in oil and gas reservoirs. Experimental studies on gas–water imbibition in reservoirs were carried out to describe the dynamic profile variation process of wet phase saturation in reservoirs and to further reveal the variation of the imbibition front and the imbibition amount. Optimization and correction methods were established, and experimental verifications were performed. Studies have shown the following: (1) Unlike homogeneous porous media, the water phase imbibition process in oil and gas reservoirs is more complicated, and it is impossible for the maximum saturation of imbibition to reach 100%. (2) Contrary to the theoretical hypothesis, the imbibition of water is not piston-like, and there is a clear transition zone at the imbibition front. This transition zone is the main cause of water saturation variations in the imbibition zone; with the expansion of the imbibition zone, the influence of the transition zone on water saturation weakens. (3) Traditional theoretical models predict a positive correlation between the imbibition amount and the measurements; however, there is a large deviation in the numerical values, which must be corrected. (4) The L-W model was optimized and the parameter group fluid factor F and the reservoir factor R were proposed to characterize the properties of the fluid and the reservoir, respectively. These two parameters have a clear physical significance and are easy to accurately test. After experimental correction, the optimized model is favourably suitable for oil and gas reservoirs.