Cochrane Systematic Review and Meta-analysis of the Impact of Psychological Treatments for People with Epilepsy on Health-related Quality of Life

Objective: Given the significant impact epilepsy can have on the Health Related Quality of Life (HRQoL) of individuals with this condition and their families, there is great clinical interest in evidence-based psychological treatments aimed at enhancing well-being in people with epilepsy (PWE). An evaluation of the current evidence is needed to assess the effects of psychological treatments for PWE on HRQoL outcomes in order to inform future therapeutic recommendations and research designs.Methods: The operational definition of 'psychological treatments' included a broad range of interventions that use psychological or behavioral techniques designed to improve HRQoL, psychiatric comorbidities, and seizure frequency and severity for adults and children with epilepsy. A systematic literature search was conducted in line with Cochrane criteria for randomized controlled trials (RCTs) and quasi-RCTs investigating psychological treatments using HRQoL outcome measures as primary or secondary outcome measures. Standard methodological procedures required by the Cochrane Collaboration were used for data collection and analysis. Results: Twenty-four completed RCTs were included in this review (2,439 participants). Based on satisfactory methodological homogeneity, data from nine studies (468 participants) providing Quality of Life in Epilepsy-31 (QOLIE-31) outcomes were pooled for meta-analyses showing significant mean changes for QOLIE-31 Total Score and six subscales. The significant mean changes of QOLIE-31 Total Score [mean improvement of 5.68 points (95% CI 3.11 to 8.24, p < 0.0001)] and three subscales (Emotional Well-being, Energy/Fatigue, Overall QoL) exceeded the threshold of Minimally Important Change (MIC), indicating a clinically meaningful post-intervention improvement of QoL. Overall, the meta-analysis quality of evidence was characterized as “moderate” due to risk of bias present in eight of the nine included studies 1, 2. A narrative synthesis was conducted for all trials and outcomes that were not entered in the meta-analysis.Significance: These results provide moderate quality evidence that psychological treatments for adults with epilepsy may enhance HRQoL in people with epilepsy

Trajectory versus probability density entropy

We study the problem of entropy increase of the Bernoulli-shift map without recourse to the concept of trajectory and we discuss whether, and under which conditions if it does, the distribution density entropy coincides with the Kolmogorov-Sinai entropy, namely, with the trajectory entropy.Comment: 24 page

Targeting the undruggable in pancreatic cancer using nano-based gene silencing drugs

Pancreatic cancer is predicted to be the second leading cause of cancer-related death by 2025. The best chemotherapy only extends survival by an average of 18 weeks. The extensive fibrotic stroma surrounding the tumor curbs therapeutic options as chemotherapy drugs cannot freely penetrate the tumor. RNA interference (RNAi) has emerged as a promising approach to revolutionize cancer treatment. Small interfering RNA (siRNA) can be designed to inhibit the expression of any gene which is important given the high degree of genetic heterogeneity present in pancreatic tumors. Despite the potential of siRNA therapies, there are hurdles limiting their clinical application such as poor transport across biological barriers, limited cellular uptake, degradation, and rapid clearance. Nanotechnology can address these challenges. In fact, the past few decades have seen the conceptualization, design, pre-clinical testing and recent clinical approval of a RNAi nanodrug to treat disease. In this review, we comment on the current state of play of clinical trials evaluating siRNA nanodrugs and review pre-clinical studies investigating the efficacy of siRNA therapeutics in pancreatic cancer. We assess the physiological barriers unique to pancreatic cancer that need to be considered when designing and testing new nanomedicines for this disease

Overexpression of the Trichoderma brevicompactum tri5 Gene: Effect on the Expression of the Trichodermin Biosynthetic Genes and on Tomato Seedlings

Trichoderma brevicompactum IBT 40841 produces trichodermin, a trichothecene-type toxin that shares most of the steps of its biosynthesis with harzianum A, another trichothecene produced by several Trichoderma species. The first specific step in the trichothecene biosynthesis is carried out by a terpene cylcase, trichodiene synthase, that catalyzes the conversion of farnesyl pyrophosphate to trichodiene and that is encoded by the tri5 gene. Overexpression of tri5 resulted in increased levels of trichodermin production, but also in an increase in tyrosol and hydroxytyrosol production, two antioxidant compounds that may play a regulatory role in trichothecene biosynthesis, and also in a higher expression of three trichothecene genes, tri4, tri6 and tri10, and of the erg1 gene, which participates in the synthesis of triterpenes. The effect of tri5 overexpression on tomato seedling disease response was also studied

Hydrodynamic theory for granular gases

A granular gas subjected to a permanent injection of energy is described by means of hydrodynamic equations derived from a moment expansion method. The method uses as reference function not a Maxwellian distribution $f_{\sf M}$ but a distribution $f_0 = \Phi f_{\sf M}$, such that $\Phi$ adds a fourth cumulant $\kappa$ to the velocity distribution. The formalism is applied to a stationary conductive case showing that the theory fits extraordinarily well the results coming from our molecular dynamic simulations once we determine $\kappa$ as a function of the inelasticity of the particle-particle collisions. The shape of $\kappa$ is independent of the size $N$ of the system.Comment: 10 pages, 9 figures, more about our research in http://www.cec.uchile.cl/cinetica

Nomenclature for renal replacement therapy and blood purification techniques in critically ill patients: practical applications

This article reports the conclusions of the second part of a consensus expert conference on the nomenclature of renal replacement therapy (RRT) techniques currently utilized to manage acute kidney injury and other organ dysfunction syndromes in critically ill patients. A multidisciplinary approach was taken to achieve harmonization of definitions, components, techniques, and operations of the extracorporeal therapies. The article describes the RRT techniques in detail with the relevant technology, procedures, and phases of treatment and key aspects of volume management/fluid balance in critically ill patients. In addition, the article describes recent developments in other extracorporeal therapies, including therapeutic plasma exchange, multiple organ support therapy, liver support, lung support, and blood purification in sepsis. This is a consensus report on nomenclature harmonization in extracorporeal blood purification therapies, such as hemofiltration, plasma exchange, multiple organ support therapies, and blood purification in sepsis