Introduction Major depressive disorder (MDD) is a leading cause of disability among adolescents, yet available treatments remain limited. Bright light therapy (BLT) is a non-pharmacological intervention with demonstrated efficacy in adults. However, its clinical utility and underlying neural mechanisms in adolescents remain unclear. This trial aims to evaluate the clinical efficacy, time to onset, safety and applicability of home-based BLT in outpatient adolescents with MDD, and to explore its underlying neural mechanisms using functional near-infrared spectroscopy (fNIRS).Methods and analysis This is a randomised, placebo-controlled, three-arm multicentre clinical trial. A total of 126 outpatient adolescents aged 13–17 years with MDD will be randomly assigned to receive high-intensity BLT, medium-intensity BLT or placebo dim red light using a portable light box in a home-based setting for 40 min each morning over 4 weeks, followed by a 2-week follow-up. 42 age-matched and gender-matched healthy controls will also be enrolled for baseline assessments only, serving as normative references for comparison. The primary outcome will be the change in total scores on the 17-item Hamilton Rating Scale for Depression from baseline to week 4. All analyses will follow an intention-to-treat framework to ensure methodological rigour. The primary outcome will be analysed using analysis of covariance and linear mixed-effects models. Secondary outcomes will include response and remission rates, time to onset, maintenance of efficacy, self-reported depressive symptoms, sleep quality, cognitive function, anxiety, irritability, suicidal ideation, non-suicidal self-injury, self-efficacy and the overall safety profile of BLT. Prefrontal cortical activity will be measured using fNIRS at baseline and week 4 to explore potential neural mechanisms. Approximately 15% of participants will additionally take part in a qualitative substudy exploring experiences and acceptability of BLT.Ethics and dissemination The study protocol has been approved by the Ethics Committee of Peking University Sixth Hospital (approval number: 2025–24). Written informed consent will be obtained from all participants and their legal guardians prior to enrolment. Study findings will be disseminated through peer-reviewed journals and conference presentations.Trial registration number NCT06913309.

Objective Existing artificial vision devices can be divided into two types:implanted devices and extracorporeal devices,both of which have some disadvantages.The former requires surgical implantation,which may lead to irreversible trauma,while the latter has some defects such as relatively simple instructions,limited application scenarios and relying too much on the judgment of artificial intelligence(AI)to provide enough security.Here we propose a system that has voice interaction and can convert surrounding environment information into tactile commands on head and neck.Compared with existing extracorporeal devices,our device can provide a larger capacity of information and has advantages such as lower cost,lower risk,suitable for a variety of life and work scenarios.Methods With the latest remote wireless communication and chip technologies,microelectronic devices,cameras and sensors worn by the user,as well as the huge database and computing power in the cloud,the backend staff can get a full insight into the scenario,environmental parameters and status of the user remotely(for example,across the city)in real time.In the meanwhile,by comparing the cloud database and in-memory database and with the help of AI-assisted recognition and manual analysis,they can quickly develop the most reasonable action plan and send instructions to the user.In addition,the backend staff can provide humanistic care and emotional sustenance through voice dialogs.Results This study originally proposes the concept of"remote virtual companion"and demonstrates the related hardware and software as well as test results.The system can not only achieve basic guide functions,for example,helping a person with visual impairment to shop in supermarkets,find seats at cafes,walk on the streets,construct complex puzzles,and play cards,but also can meet the demand for fast-paced daily tasks such as cycling.Conclusion Experimental results show that this"remote virtual companion"is applicable for various scenarios and demands.It can help blind people with their travels,shopping and entertainment,or accompany the elderlies with their trips,wilderness explorations,and travels.

Objective For people with impaired central vision,novel artificial optical devices can provide access to simplified images by projecting them onto retina regions out of the macula,thus allowing them to utilize peripheral vision to perceive information.We investigate perceptual characteristics of peripheral visual field and provide clues for the design of implantable optical artificial vision devices.Methods We propose an experimental environment for investigating perceptual characteristics of peripheral vision,in which pattern stimuli of symbols,numerals,and Chinese characters are applied to the subjects,with variables including the size,the color combination,the eccentricity,and the motion controlled.The relation between perceptual capability and the variables are analyzed using graphical methods.Results The perceptual capability declines as the eccentricity increases,forming two appreciable trends,and it is significantly influenced by color combination and size.Conclusion Variable combinations with considerable perception rate are provided.The results may promisingly act as a reference for the implantation of artificial optical devices in eyes,the development of color symbol codes for special communication,etc.

无抽搐电休克治疗(Modified Electroconvulsive Therapy,MECT)是精神障碍疾病临床治疗的方法之一,有效的脑电信号量化参数有助于认识MECT的治疗效果和进行临床规划.该文针对MECT期间精神障碍患者单通道脑电信号进行分析,利用离散小波变换将脑电信号分解到不同频段,采用样本熵分析MECT过程中诱导的人工癫痫充分发作后和非充分发作后各频段脑电信号的复杂度.实验和分析结果表明,接受MECT的精神障碍患者经诱导人工癫痫充分发作后的额叶皮层脑电信号小波系数A4、D4和D3的样本熵值显著小于非充分发作后对应样本熵值,表明癫痫充分发作可以有效增加脑电信号的规律性,降低脑电信号的复杂程度.利用t检验对结果进行分析,证明了该方法的可行性和准确性,其将为MECT治疗的疗效评估和临床规划提供有效的量化指标.

The blue light hazard (BLH) and luminous efficacy of a source (ηV) are associated with the photobiological safety and energy saving of light-emitting diodes (LEDs), respectively. In this study, we used genetic algorithm (GA) to optimize the BLH, ηV, and color rendering parameters of five-chip hybrid white LEDs. Based on the optimal results, we used five-chip LEDs to obtain the hybrid white light. Their peak wavelengths were 461.5 (blue), 523.9 (green), 588.2 (orange), 643.3 (red), and 694.2 nm (far-red), respectively. In practice, the blue light hazard efficiency of radiation (BLHER) of the hybrid white light was less than 0.10, which was lower than half of the most common light sources. The ηV ranged from 51.6 to 115.6 lm/W at correlated color temperature (CCT) from 2700 to 6500 K. On average, the CIE general color rendering index (Ra), CIE special color rendering index for the ninth deep red test sample (R9), ANSI/IES TM-30 color fidelity index (Rf), and color gamut index (Rg) of hybrid white light were 91.3, 87.8, 83.3, and 96.7, respectively. The melanopic efficacy of luminous radiation (Kmel,V) was tunable in the range of 0.60 to 1.35 mW/lm. These results demonstrated that we used far-red LEDs to fabricate white light with low BLH and relatively high efficiency.

目的 研究夜班环境中,睡眠剥夺对成年人认知表现的影响.方法 纳入48例试验对象,通过模拟夜班工作建立睡眠剥夺环境,试验期间采用持续注意力表现测试、数字广度实验以及卡罗林斯卡嗜睡量表评价试验对象的认知表现.使用单因素重复测量方差法分析数据.结果 夜班期间的睡眠剥夺会对试验对象的持续注意力表现、警觉性产生不良影响(P<0.05);与夜班开始时比较,夜班结束后,试验对象的正确数量减少,错误数量、错失数量及反应时间增加,卡罗林斯卡嗜睡量表评分降低.睡眠剥夺对工作记忆表现未产生显著影响.结论 夜班环境下的睡眠剥夺会使试验对象的持续注意力表现下降、警觉性降低,但是尚未发现对工作记忆表现的影响.

Anxiety is a common disorder among college students, especially those with obesity. Obesity contributes to metabolic disorders and disturbs the neural functions, further leading to anxiety. In this cross-sectional study, we aimed to determine the association between obesity and anxiety among college students and identified the potential factors for obesity-associated anxiety. We evaluated the intervention effects of calorie restriction on anxiety. Self-reported questionnaires were distributed to 1381 college students from January to March in 2021. Anxiety was measured by the State-Trait Anxiety Inventory (STAI). Participants were classified into anxiety and non-anxiety groups according to their STAI scores. Chi-squared test and logistic regression were used to analyze the potential factors. We found that 383 college students exhibited anxiety, accounting for 30.1% among all included college students, which was higher than the global average. The association between anxiety and obesity was observed among college students (p = 0.009), especially in males (p = 0.007). We identified that pre-obesity (p = 0.012), unhealthy calorie intake (p = 0.001), dieting (p = 0.003) and high academic year (p = 0.006) as the risk factors for anxiety and found that the long sleep duration was a protective factor for anxiety (p < 0.001). We found that more obese students showed an improvement of anxiety than the underweight students after calorie restriction (p < 0.001). Collectively, our findings suggest that obesity-associated anxiety is prevalent among the college students and could be alleviated by moderate calorie restriction. It is necessary for students to receive anxiety management in their college life. Additionally, the proper calorie restriction should be promoted to help students protect against obesity and obesity-associated anxiety.

Introduction Processed betel quid product chewing is a public health problem in areca non-plant areas in China. However, there is no valid instrument to screen for betel quid use disorder (BQUD) in mainland China. We developed a self-administered screening test for betel quid use disorders (SST-BQUD) and tested its reliability and validity in a sample of betel quid chewers (BQCers) in Hunan, China. Methods Items of SST-BQUD were selected from the test results of an item pool, which includes 52 questions related to the psycho-social and behavioral presentations of BQUD. All participants, in a self-administered manner, completed the item pool. A subsample completed the re-test one week later. Two psychiatrists interviewed all participants to ascertain the presence of BQUD. The receiver Operating Characteristic curve was used to determine the best cut-off value to discriminate BQUD. Results One hundred and twelve BQCers were recruited. Based on the statistical analysis of receiver operating characteristic (ROC) curves, 14 yes/no questions were selected for SST-BQUD. As indicated by Cronbach’s α coefficient, the internal consistency was 0.876. The area under the curve of SST-BQUD was 0.881, representing a satisfactory diagnostic value. The one-week re-test reliability test was 0.771 (P<0.001), suggesting good stability over time. The optimal cut-off score for BQUD screening was six, with a sensitivity of 0.921 and a specificity of 0.716, implying the satisfactory accuracy of SST-BQUD to screen for BQUD. Conclusion The standard version of SST-BQUD consists of 14 items. The total score of SST-BQUD was the sum of affirmative answers, with higher scores denoting a more severe BQUD symptom. If one answered six or more times “yes” to these 14 questions, they can be classified with BQUD. The SST-BQUD is a valid screening method for BQUD among BQCers in betel quid processed area.

The circadian effect and photobiological safety of the display should be concerned, as well as the color gamut. By adding another primary color to the traditional blue-green-red (RGB) direct emission display, a four-primary-color display was proposed. The display presents wide color gamut and high stability with variation of pri-mary colors. The optimal color gamut coverage (CGC) in Rec. 2020 standard reaches 98.2 %, and it also maintains above 96.5 % with 20 nm variation of peak wavelengths and full widths at half maximum (FWHMs). At D65 white point, the melanopic efficacy of luminous radiation (MELR) of four-primary-color display decreases to 0.60, which is 29.4 % and 43.9 % less than liquid crystal display (LCD) and organic light-emitting diode (OLED) display, respectively. Presenting ten reference colors, the MELRs of four-primary-color display are also less than other displays in most cases. In addition, the blue light hazard efficiency of radiation (BLHER) of four-primary-color display is slightly less than other displays. At last, the further improvement for the four-primary-color display was discussed.

Light is effective to suppress the melatonin and affects the non-visual responses. The relationship between light conditions and melatonin suppression is significant when designing light environments. Based on the α-opic illuminances of five fundus photoreceptors, various previous models are built to fit and predict the experimental melatonin suppression. In this study, we present models based on α-opic fluxes, which are products of α-opic illuminances and pupil areas, to improve the fitting results of the experimental melatonin suppression. For 30- and 90-min light exposures, the α-opic flux models present higher adjusted R-squared and lower root mean square of error (RMSE) when fitting the experimental melatonin suppression, regardless of pupil dilation or not. The α-opic flux models also explain the spectral opponency on melatonin suppression. According to the residuals between predicable and experimental melatonin suppression, the effects of pupil dilation, type of light source, and subject's age are further discussed. The subject's age has little effect on the melatonin suppression. The α-opic flux models decrease the fitting residuals under different conditions, improving the applicability of the fitting models on melatonin suppression.

The spectral transmittance of ocular media on the short-wavelength light is higher for young observers than elders. It is essential to concentrate on the photobiological safety of children and circadian effect of elders when designing the light sources. In this study, we optimized the peak wavelengths and ratios of four-channel light emitting-diodes (LEDs), to fabricate the dynamic white light which performed well on photobiological safety, circadian effect, and color rendition for observers of different ages. Based on the optimal results, we selected the four monochromatic LEDs of 461.0, 525.0, 589.0, and 660.0 nm, and then fabricated the practical white light. The correlated color temperature (CCT) of the dynamic white light is tunable from 2700 to 6500 K. For 1-year-old observers, the blue light hazard efficiency of radiation (BLHER) is less than 0.237. For 70-year-old observers, the melanopic efficacy of luminous radiation (MELR) reaches 0.987 mW/lm and its tunability is optimized to be 2.10. The general color rendering index (Ra), special color rendering index (R9), color fidelity index (Rf), and color gamut index (Rg) are more than 89.3, 79.1,81.7, and 93.6, respectively. At last, we also discussed the impacts of the peak wavelength variation on the performances of hybrid white light.

Objective: This study aimed to investigate the Chinese norms for the Symptom Checklist 90 (SCL-90) scale and its application. Methods: In total, 7,489 adults from Tianjin and Qingdao in China were included. Their data were compared with the norm data of 1,388 people published by Jin et al., the combined norms published by Tang et al., the data of 2,808 adults published by Chen and Li, and the data of 1,890 adults from Tong in China. Results: In five different periods, notable changes were observed in each factor of the SCL-90 that significantly differed from the previous norms. The scores of each factor showed an increasing annual trend. Compulsion consistently obtained the highest scores, and phobia consistently obtained the lowest scores. The scores tended to decrease from compulsion to anxiety, and psychosis scored lower than paranoia. There was a significant difference in the detection rate between the critical screening value of two points and the standard score. Using the standard score as the critical value, the detection rate ranged between 13 and 16% and was relatively concentrated. Using two points as the critical value, the detection rate ranged between 38 and 50%. Conclusion: The usual model in China is not consistent with social development. Using two points as the critical value is no longer suitable for the SCL-90. New Chinese norms and measurement standards should be developed. The mean value plus one standard deviation could be used as the new measurement standard.

Shift workers are mostly suffered from the disruption of circadian rhythm and health problems. In this study, we designed proper light environment to maintain stable circadian rhythm, cognitive performance, and mood status of shift workers. We used five-channel light-emitting diodes to build up the dynamic daylight-like light environment. The illuminance, correlated color temperature, and circadian action factor of light were tunable in the ranges of 226 to 678 lx, 2680 to 7314 K, and 0.32 to 0.96 throughout the day (5:30 to 19:40). During the nighttime, these parameters maintained about 200 lx, 2700 K, and 0.32, respectively. In this light environment, three subjects had engaged in shift work for 38 consecutive days. We measured plasma melatonin, activity counts, continuous performance tests, and visual analogue scale on mood to assess the rhythm, cognitive performance, and mood of subjects. After 38-day shift work, the subjects' peak melatonin concentration increased significantly. Their physiological and behavioral rhythms maintained stable. Their cognitive performance improved significantly after night work, compared with that before night work. Their mood status had no significant change during the 38-day shift work. These results indicated that the light environment was beneficial to maintain circadian rhythm, cognitive performance and mood status during long-term shift work in closed environment.

Background: Shift work is associated with reduced performance and efficiency, the current study aimed at investigating whether blue-enriched white light could improve workers’ performance. Methods: The study, which adopted a randomized controlled trial, was conducted among 48 simulated shift workers. The participants performed sustained attention task, working memory task, and sleepiness task during night shift work. The data was analyzed using two-way repeated measure ANOVA. Results: The results indicated that, compared to conventional light, participants’ correct responses of the sustained attention significantly increased when they were exposed to blue-enriched white light, correspondingly, the commission errors and omission errors declined. Furthermore, the blue-enriched white light had a significant effect on the decrease of sleepiness. However, the working memory was not significantly affected. Conclusion: Exposing to blue-enriched white light can improve sustained attention and reduce sleepiness.

OBJECTIVES:Chromogranin A (CgA) is regarded as an indicator of sympathetic tone and adrenomedullary system activity. Catestatin is one of CgA-derived fragments through proteolytic processing. Many studies have confirmed the correlation between anxiety/depression and the salivary CgA level. The study was to investigate the associations between anxiety/depression and plasma CgA/catestatin levels in healthy workers without cardiovascular disease. METHODS:The study included 263 healthy workers (175 men and 88 women). The symptoms of anxiety and depression were measured with the Hospital Anxiety and Depression Scale (HADS). Plasma CgA and catestatin levels were measured by ELISA kits. RESULTS:In bivariate correlation analysis, anxiety and depression were positively associated with plasma CgA level, respectively (r = 0.298, P < .001; r = 0.304, P < .001), but not significantly associated with plasma catestatin level. The anxiety group had significantly higher plasma CgA level than that in the no-anxiety group (median 158.60 vs 70.90, P < .001). The similar results were found for depression scales. The depression group had significantly higher plasma CgA level (median 145.60 vs 82.40, P < .001). In the multiple linear regression model, after adjusting for age, gender, and BMI, anxiety was positively correlated with plasma CgA level (β = 0.359, P < .001), while anxiety was negatively correlated with plasma catestatin level (β = -0.128, P = .044), depression was also positively correlated with plasma CgA level (β = 0.343, P < .001). CONCLUSIONS:Plasma CgA was associated with anxiety and depression in healthy workers. It can be considered as the blood indicator for the evaluation of anxiety and depression.

目的 针对体检人群心理健康测评场景,修订症状自评量表(SCL-90)中文版常模.方法 抽取2019年青岛市区体检中心成人体检样本1826例,并使用1986年金华等的常模资料、1999年唐秋萍等的合并常模资料、陈树林等杭州2808人数据资料以及2006年童辉杰全国范围内1890人的数据资料与之进行比较分析.结果 2019年样本的SCL-90各因子分均高于金华等、唐秋萍等、陈树林等以及童辉杰的数据资料(P<0.001).样本各个因子上的得分呈逐年上升的趋势.所有的数据集都是强迫因子得分最高,恐怖因子得分最低.使用传统的2分的因子粗分作为体检人群心理健康筛查的临界值与参照本研究提出的常模的检出率比较,除恐怖因子外,其余各因子检出率差异均存在统计学意义(P<0.001).结论 以2分作为临界值不适应体检人群SCL-90的筛查需要,本研究提出的根据现实人群修订的常模数据作为衡量标准更适用.

Objective:To explore ways and methods for public mental health intervention during the COVID-19 epidemic.Methods:A comprehensive literature review was conducted. Mental healthcare publicity materials posted by over 100 Chinese hospitals in multiple media (till February 24, 2020) were also systematically collected and analyzed.Results:Firstly, anxiety and fear were the most common mental health problems among people during the epidemic. Secondly, to achieve better outcomes, mental health intervention should be provided according to the type of service clients. Thirdly, new media can facilitate the transmission of mental healthcare knowledge, but the limitation is that it can not approach older adults who have limited access to new media. It is therefore essential to strengthen the mental health knowledge transmission to older adults.Conclusions:Mental health intervention is effective when it is provided according to the type of service clients during the COVID-19 epidemic.

Schizophrenia is a type of serious mental illness. In clinical practice, it is still a challenging problem to identify schizophrenia-related brain patterns due to the lack of objective physiological data support and a unified data analysis method, physicians can only use the subjective experience to distinguish schizophrenia patients and healthy people, which may easily lead to misdiagnosis. In this study, we designed an optimized data-preprocessing method accompanied with techniques of general linear model feature extraction, independent sample t-test feature selection and support vector machine to identify a set of robust fNIRS pattern features as a biomarker to discriminate schizophrenia patients and healthy people. Experimental results demonstrated that the proposed combination way of data preprocessing, feature extraction, feature selection and support vector machine classification can effectively identify schizophrenia patients and the healthy people with a leave-one-out-cross-validation classification accuracy of 89.5%.

Humans can undergo circadian disruption and misalignment when living in closed environments without sufficient daylight. Therefore, it is of great significance to investigate the effects of artificial light on the circadian rhythm. In this work, the red, green, blue, warm white, and cool white (RGBWW) five-channel light-emitting diodes (LEDs) were fabricated as the only light sources in the closed environment. The LED mixed lighting showed a high color rendering index (CRI) all the time. During the day, the light simulated the daylight and increased the tunability of the circadian action factor (CAF) and correlated color temperature (CCT). At night, it maintained low CAF and CCT. Three subjects did irregular shift work in the closed environment for 38 days. Their plasma melatonin and daily activity were measured to assess the circadian rhythm. After 38 days, the subjects' peak melatonin times did not shift significantly (p = 0.676), while their peak melatonin concentrations increased apparently (p = 0.005). The start times of the least active 5-h period (L5) in one day fluctuated in a small range. The standard deviation (SD) was <15.11 min in most times. These results demonstrated that the subjects' rhythms maintained stable and were enhanced. The periods of circular cross-correlation between activity and CAF oscillated around 24 h (SD = 15.4 min), indicating the entrainment of light on the stable 24-h rhythm. It was concluded that the daylight-like LED lighting effectively entrained and enhanced the circadian rhythm in the closed environment.