Older Chinese Americans are at high risk of dementia, yet they often do not access culturally relevant services/programs to reduce their risks due to issues such as language barriers and transportation. BrainHQ is a mobile-based, effective cognitive training program that can potentially address these barriers and delay cognitive decline in older Chinese Americans.

We aim to evaluate the feasibility and acceptability of a mobile-based cognitive training intervention co-designed by older Chinese Americans and their adult children.

We applied an experience-based co-design approach that leverages existing cognitive training features and older Chinese Americans' prior knowledge, lived experiences, and social norms around dementia to co-develop a cognitive training intervention. We conducted an experience-based co-design workshop with Older Chinese Americans (n=10), and their adult children (n=4) to optimize the cultural and linguistic relevance of the cognitive training intervention. Participants used a journey map to brainstorm challenges they may experience when participating in the intervention. Then, the participants created prototypes of intervention components to address these challenges. Finally, we incorporated these prototypes into the co-designed intervention protocol. A total of 30 participants will be recruited into the intervention study and will be randomly assigned to the intervention or waitlist control group (2:1 ratio). The intervention group will complete the mobile-based cognitive training for between 10 and 15 minutes daily for 12 weeks. The primary outcomes are feasibility and acceptability. Global cognition, mental health, physical functioning, and quality of life will be assessed at baseline, 8, and 12 weeks.

This pilot trial received institutional review board approval (Pro00109934l) in November 2024. We enrolled the first participant in December 2024 and aim to complete enrollment by May 2025. We expect to complete all data collection by September 2025. We will analyze the data and report study findings by February 2026.

This study leverages partnerships with academic, industry, and community stakeholders and provides the groundwork for a large-scale randomized controlled trial to test the efficacy of a mobile-based cognitive training intervention for older Chinese Americans. The co-design workshop served as a feasible, innovative approach to engage with the participants and improve the study design. These findings will enhance the culturally tailored delivery of cognitive training to older Chinese Americans and provide insights for broader implementation, improving their engagement in dementia research.

ClinicalTrials.gov NCT05355870; https://clinicaltrials.gov/study/NCT05355870.

PRR1-10.2196/69303.

The present study reports on the psychometric properties of the Dutch translation of the clinical impairment assessment (CIA) questionnaire in female patients with eating disorders. The aim of this study was to determine the factor structure of the CIA as there are conflicting studies supporting a three-factor, bifactor, and single-factor model with a general factor and three specific factors.

The CIA was translated and administered to 321 female patients with various eating disorders receiving treatment in a specialized eating disorder center. Its factor structure, internal consistency, convergent validity, and sensitivity to change were investigated.

Confirmatory factor analyses showed the best fit was a bifactor model with one strong general factor and three less strong specific factors for personal, social, and cognitive impairment. Furthermore, good internal consistency (Cronbach's α = 0.91), good convergent validity between CIA global score and eating disorder examination questionnaire global score (r = 0.58; p < 0.001) and good sensitivity to change (t (115) = 13.76, p < 0.001) were found.

The Dutch CIA is a reliable and valid instrument to measure impairment secondary to eating disorder symptoms, but interpretations made from subscales scores should be used with caution.

Level III, validation study.

To investigate the association between Mediterranean diet (MD) adherence, fruit and vegetable (FV) consumption, mental well-being (MWB) and quality of life (QoL) in Dutch adults.

Dutch adults (n = 696, aged 18-90) participated in a prospective study with assessments at baseline and two months follow-up. MD adherence and FV consumption were assessed using the Mediterranean Diet Adherence Screener (MEDAS). MWB was assessed using the WHO-5 and QoL using the Multicultural Quality of Life Index. Additionally, change between baseline and two months was calculated for the MEDAS, FV consumption, MWB and QoL. Multiple linear regression models were used to test the association between MD adherence/FV consumption and MWB and QoL, using both baseline data and change data.

Data were available for 617 participants at baseline and 459 at follow-up. At baseline significant positive association between FV consumption and QoL (Estimate = 0.005, p = <.001) and MWB was shown (Estimate = 0.07, p = <.001), with a slight non-linear trend for both (quadratic term estimate QoL - 0.000006; p = 0.01; MWB - 0.00007; p =.006). The associations between MD adherence, MWB and QoL were not significant (all p >.664). None of the change regression analyses showed a significant association.

FV consumption was cross-sectionally related to both QoL and MWB, but longitudinal change in FV consumption was not significantly related to QoL or MWB. MD adherence is not related to either MWB or QoL total score. Overall, FV consumption potentially should be promoted to enhance MWB and QoL.

The ability to calibrate learning according to new information is a fundamental component of an organism's ability to adapt to changing conditions. Yet, the exact neural mechanisms guiding dynamic learning rate adjustments remain unclear. Catecholamines appear to play a critical role in adjusting the degree to which we use new information over time, but individuals vary widely in the manner in which they adjust to changes. Here, we studied the effects of a low dose of methamphetamine (MA), and individual differences in these effects, on probabilistic reversal learning dynamics in a within-subject, double-blind, randomized design. Participants first completed a reversal learning task during a drug-free baseline session to provide a measure of baseline performance. Then they completed the task during two sessions, one with MA (20 mg oral) and one with placebo (PL). First, we showed that, relative to PL, MA modulates the ability to dynamically adjust learning from prediction errors. Second, this effect was more pronounced in participants who performed moderately low at baseline. These results present novel evidence for the involvement of catecholaminergic transmission on learning flexibility and highlights that baseline performance modulates the effect of the drug.

MRI-based whole-brain manual segmentation methods are considered the gold standard for brain volumetric analysis, but are time-consuming and prone to human error. Automated segmentation tools like FreeSurfer can identify differences in brain volumes between healthy and non-healthy individuals. Deep-learning-based segmentation tools, such as FastSurfer, offer faster processing times, but further validation is needed, particularly in pediatric cases. This study aims to compare FastSurfer with FreeSurfer in a pediatric cohort and compare the volume estimates with previously published reference values.

A multicenter cohort of 448 subjects aged 4-18 years from three centers was used to compare FastSurfer with FreeSurfer. Validation metrics, including the Dice Similarity Coefficient (DSC), relative volume differences (RVD), and intraclass correlation coefficient (ICC), were computed. Hemispheric asymmetries were assessed by calculating a hemispheric asymmetry index.

The segmentation methods demonstrated high agreement, with a mean DSC across subjects and regions of interest of 0.90 (95% CI: 0.79; 0.95), RVD of 0.3% (95% CI: -7.6%; 7.4%), and ICC of 0.87 (95% CI: 0.52; 0.94). After a visual inspection, which led to the exclusion of 12 subjects with segmentation errors, growth charts for relative volume estimates of 15 anatomical brain regions were generated, revealing varying growth patterns across ages. A potential clinical application is illustrated by plotting a patient's data on these growth charts, showing a specific atrophy pattern.

To our knowledge, this is the first study investigating the use of FastSurfer in volumetric analysis of a pediatric population. Our findings suggest that FastSurfer is a reliable segmentation tool for pediatric data and is particularly promising for clinical practice due to its high accuracy despite rapid processing times. The morphometric data, growth charts, and code are publicly accessible.

Existing dementia risk assessment tools, such as The Australian National University Alzheimer's Disease Risk Index (ANU-ADRI), LIfestyle for BRAin health (LIBRA) and Cognitive health and Dementia Risk Assessment (CogDrisk), show limited validation for middle-aged adults (age 40-64 years). The Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) tool, developed almost two decades ago, demonstrated moderate predictive accuracy. As key modifiable dementia risk factors emerge in midlife, there is a need for a new, more accurate midlife dementia risk assessment tool.

To develop CogDrisk-ML, a midlife dementia risk assessment tool that can complement the existing CogDrisk tool for late-life dementia risk assessment.

Data from the UK Biobank and the Atherosclerosis Risk in Communities (ARIC) study were used to develop and validate CogDrisk-ML, which was also externally validated using the Whitehall II cohort.

Participants without dementia at baseline were included, with CogDrisk predictors along with additional midlife risk factors based on recent evidence.

Cox regression models estimated the relationship between risk factors and dementia for each sex. A random-effects meta-analysis model aggregated cohort- and sex-specific regression coefficients to develop CogDrisk-ML. Harrell's C statistics measured predictability, with multiple imputation used for missing data.

CogDrisk-ML outperformed CAIDE in the UK Biobank and Whitehall II cohorts; however, it provided similar C statistics in the ARIC dataset. C statistics (95% confidence interval) for CogDrisk-ML were 0.71 (0.69, 0.74) for the ARIC, 0.75 (0.73, 0.77) for the UK Biobank and 0.70 (0.62, 0.79) for the Whitehall II study.

The novel CogDrisk-ML for assessing dementia risk in midlife offers improved predictive accuracy. Combined with the CogDrisk tool for late life, it provides a comprehensive framework for dementia prevention throughout the life course.

To investigate how rurality shapes individual care pathways and health outcomes for depression and to investigate the sociodemographic and economic relationships with urban-rural variations.

A retrospective cohort study using routinely collected data from adult patients diagnosed for depression and registered at a general practice in Lincolnshire in the UK. Access and time to access from the onset of depression symptoms to the following care pathway states were described (ie, access to a depression screening tool, confirmed diagnosis, access to treatment and outcomes). Multistate survival analyses were conducted to investigate the effect of the patient's living environment (rural/urban, index of multiple deprivation) on progression through their care pathway for depression.

Overall, 1,111 patients with depression were included. While access to depression services were lower for patients living in rural areas, they were more likely to experience positive depression outcomes, and more quickly, compared to their urban counterparts. Controlled depression and relapse rates were, respectively, 29% lower and 31% higher among urban residents. The level of deprivation was found to have a limited effect on care access, as well as on depression outcomes.

While accessing care services remains a challenge in rural areas, our study highlights the potential benefits of the rural context in improving depression outcomes and lowering relapse risk. Area-based deprivation had minimal impact on both care access and depression outcomes. Future mental health programs must tailor their strategies to the unique challenges of urban and rural environments to facilitate more effective interventions.

Small efficacy trials have demonstrated that multicomponent interventions can improve early child development. We evaluated the large-scale delivery of a multicomponent intervention delivered by government health workers throughout a rural subdistrict in northwestern Bangladesh.

We evaluated a group-based, multicomponent intervention with a curriculum covering responsive parenting, caregivers' mental health, lead exposure prevention strategies at the household level, water, sanitation, hygiene and nutrition. Group sessions were held throughout a rural subdistrict of Bangladesh (August 2019-March 2020). A longitudinal sample of caregivers (n=517) of children 6-24 months was assessed at baseline and endline (primary cohort), and 1179 additional caregivers were assessed only at endline (supplementary cross-sectional). Outcomes were the variety of child play activities and materials, number of books, caregiver depressive symptoms and nutrition and lead knowledge. For primary analyses, we used difference-in-difference.

Over half (n=276, 53%) of the cohort participants attended any of the 16 intervention sessions and of these, 83% (228) attended 2+. Caregivers attending 2+ sessions, compared with ≤1 session, had more play materials (adjusted mean difference: 0.58; 95% CI: 0.30, 0.85) and were more likely to have any children's books (adjusted prevalence difference (aPD): 0.26; 95% CI: 0.18, 0.34), to have heard of lead (aPD: 0.13; 95% CI: 0.07, 0.19) or to know how to avoid harm from lead (unadjusted PD: 0.13; 95% CI: 0.08, 0.17). These findings were similar to those from the supplementary cross-sectional analysis. There were no differences in caregiver depressive symptoms in either analysis. More child play activities and nutrition knowledge were associated with attendance in the cross-sectional sample.

A multicomponent child development intervention delivered by government health workers increased the presence of children's toys and books and caregiver knowledge of lead in families who attended two or more sessions. Further adaptation and alternative delivery methods are likely to improve the reach and the breadth of impacts.

NCT04111016.

There are few effective treatments for eating disorders (EDs), and new interventions are urgently needed. The MEDication and other drugs For Eating Disorders ("MED-FED") survey investigated the lived experience of adults with EDs regarding their prescription and non-prescription drugs use. Psychedelic drugs were highly rated in this survey for their impact on ED symptoms and general mental health. Here, we provide a more granular analysis of a subset of the data pertaining to psychedelic drug use from this survey.

The MED-FED survey recruited adults who self-reported either a clinically diagnosed ED or disordered eating that was currently undiagnosed but causing significant distress. The demographics of recent and lifetime psychedelic users relative to non-users were examined, as well as their use of other prescription and non-prescription drugs, and co-morbid conditions. Qualitative analysis was used to examine themes emerging from open-ended comments around use of psychedelic drugs.

Of the 5247 participants who completed the survey, 1699/5247 (32.4%) reported lifetime psychedelic use, with 1019/5247 (19.4%) having used in the last 12 months. Typical use involved infrequent consumption, once or twice per year, of psilocybin, LSD, 2-CB, or DMT. Those who reported recent psychedelic use were younger and less likely to currently use prescription drugs or to have been recently hospitalised for their ED. They were more likely to use other non-prescription drugs (e.g. cannabis, ketamine, stimulants) and to report co-morbid ADHD, PTSD, ASD, and substance misuse. Participants with a diagnosis of anorexia nervosa were less likely to report psychedelic use, while those with an undiagnosed ED were more likely. Qualitative analysis of responses (n = 200) revealed themes of profound transformation, increased connectedness, and new insights into illness following psychedelic experiences. A handful of respondents reported benefits from microdosing. A few respondents reported adverse outcomes in their open-ended comments, including "bad trips" (n = 15) and worsened ED symptoms (n = 8) after psychedelic use.

These findings provide a unique insight into psychedelic use among individuals with EDs. The results align with emerging evidence suggesting that psychedelics may be beneficial in this population, highlighting the need for further research, including clinical trials, to explore their efficacy and safety.

The impact of alcohol use disorder (AUD) on quality of life can be quantified by generic and specific measures. This study's aims are to compare different preference-based instruments to measure health-related quality of life (HRQoL) in patients with AUD and to examine their relationship with alcohol-specific measures used in the clinical setting.

A sample of 259 patients with AUD were recruited from a Spanish alcoholism unit. We administered EuroQoL-5Dimension -5levels (EQ-5D), ShortForm-6Dimension (SF-6D), AlcoholQuality-of-life-4Dimension (AlcQ-4D), Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and Alcohol Use Disorders Identification Test (AUDIT) instruments at the beginning of treatment and 12 months thereafter. Differences in HRQoL instruments scores were estimated and their capacity to discriminate among known clinical severity groups was analysed. Several mapping functions were tested to transform scores from the clinical setting (AUDIT or DSM-5) into HRQoL scores (EQ-5D, SF-6D or AlcQ-4D).

HRQoL scores are sensitive to the instrument used. Mean scores are always highest using EQ-5D, followed by SF-6D and AlcQ-4D. All HRQoL instruments discriminate among clinical severity groups defined using DSM-5 or AUDIT. Although several mapping functions were estimated, those using the total score of the clinical instruments were selected.

The results suggest that clinical measures used in the field of AUD could be adapted for use in economic evaluation. However, the incremental cost-utility ratio of AUD programs, and hence the policy decisions derived from it, may depend on the HRQoL instrument used.