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Objective, and systematic evidence-based practice for monitoring symptom severity and treatment efficacy to assist clinicians in developing individualized treatment strategies for patients with major depressive disorder (MDD). This study aimed to identify the barriers and facilitators of enhanced MBC (eMBC) in the outpatient setting to clarify the eMBC utilization dilemma. Methods: Between September 2022 and June 2023, we collected the opinions of healthcare providers, adult and adolescent patients, and family members of adolescent patients via online surveys. Specifically, we surveyed their acceptance and perspectives on MBC and eMBC primarily through custom-designed Likert scales developed for this study. Results: We received responses from 270 adult patients, 144 adolescent patients, 109 family members, and 355 healthcare providers. The results showed that 85.3% of patients and family members were willing to use the eMBC intervention. However, adolescent patients responded significantly differently from the other two groups, with lower acceptance and confidence. Among healthcare providers, while only 69.9% used MBC in practice, 94% believed standardized scales would be effective in treatment, and 91.8% were willing to try eMBC. Additionally, we received 277 remarks regarding eMBC from patients and families. Conclusion: In general, both clinicians and patients looked forward to using eMBC and recognized the potential benefits. However, they still had many concerns about privacy, professionalism, and time consumption. Responses from adolescent patients appeared more conservative and lacked confidence in eMBC. Further implementations are required to explore how eMBC can be operationalized in the outpatient setting to help different patients. [ABSTRACT FROM AUTHOR]

Purpose: To validate the efficacy of enhanced measurement-based care against standard measurement-based care in patients with major depressive disorder. Patients and Methods: In this pilot study of an ongoing multicenter cluster randomized controlled trails, 160 patients diagnosed with major depressive disorder were enrolled from 2 mental health centers, with a plan to include 12 centers in total. One hundred patients engaged in a six-month evaluation using a technology-enhanced measurement-based care tool, including assessments of clinical symptoms, side effects, and functionality at baseline, two months, four months and six months. Simultaneously, the remaining 60 patients underwent standard paper-based measurement-based care, utilizing the same set of scales over the same six-month period, with assessments at the same time points. Results: Patients utilizing the enhanced measurement-based care tool demonstrated a significantly higher reduction rate in PHQ-9 scores compared to those using standard paper-based measurement-based care during the two-month follow-up. Additionally, a notable positive correlation was observed between the frequency of enhanced measurement-based care tool usage and the quality of life during the two-month follow-up. Conclusion: Enhanced measurement-based care has the effect of reducing depressive symptoms. Our study emphasized that using enhanced measurement-based care via smartphones is a feasible tool for patients with major depressive disorder. Our future study, including results from additional research centers, may further validate the effectiveness of enhanced measurement-based care. [ABSTRACT FROM AUTHOR]

The flame behavior of engine fires, such as those caused by leaked fuel coming into contact with an ignition source, is significant in practical applications, where flame detection is used to minimize the damage of the attendant ship fire safety problem. In this work, the flame behavior of hot-surface ignition (HSI) under crossflow was studied, with a particular focus on the difference in lateral airflow velocities for HSI-driven flame deviations at the windward and leeward sides of a ship engine room; a problem such as this has not previously been quantified. Full-scale experiments were conducted in a ship engine room using marine diesel and hydraulic oil as the fuel, and by adopting lateral airflow with the velocities of 0 m/s, 1.0 m/s, 3.0 m/s, and 5.0 m/s, together with an HSI mechanism consisting of marine diesel and hydraulic oil coming into contact with elevated hot-surface temperatures. The results show that the effects of disturbing the combustible gaseous mixture for marine fuel HSI, at both the windward and leeward sides, strengthened as the airflow velocity increased. The HSI position of the leaked marine fuel in the engine room was strongly dependent on ventilation, while that under the airflow condition decreased with the increase in the hot-surface temperature. A model was proposed to characterize this difference on the basis of the HSI height, which was defined as the ratio of the height during the initial HSI to the stationary period. The results indicate that the scale of the flame gradually increased in the horizontal direction, which was significantly different from the result in the scenario without mechanical ventilation. The results also revealed that the fluctuation of hydraulic oil through the temperature field was significant and lasted for a long time under a low HSI temperature. [ABSTRACT FROM AUTHOR]