Case Report: REL-1017 Reduces Abnormal Clinician Administered Dissociative States Scale Scores in Patients with Major Depressive Disorder

BACKGROUND: Dissociative symptoms may be found in a subset of patients with major depressive disorders (MDD). The Clinician-Administered Dissociative States Scale (CADSS) is a 23-item scale for the measurement of present-state dissociative symptoms with good inter-rater reliability and construct validity that can discriminate patients with dissociative disorders. The total CADSS score is derived by adding the score for each of the 23 items. A score of 4 or more on the CADSS is considered abnormal and clinically meaningful. Uncompetitive N-methyl-d-aspartic acid receptor (NMDAR) channel blockers have been proposed as a treatment for post-traumatic stress disorder (PTSD). REL-1017 is a novel, low potency, NMDAR channel blocker currently in Phase 3 studies for MDD. METHODS: This retrospective case series describes a subset of patients from a double-blind, randomized, placebo-controlled, in-patient 7-day, phase 2 trial of oral, once daily, 25 mg (75 mg loading dose on day 1, first dose) and 50 mg REL-1017 (100 mg loading dose on day 1, first dose) as an adjunctive treatment for MDD. This subset of patients was selected based on abnormal CADSS score at baseline, pre-treatment with the study drug. As part of REL-1017 safety evaluation, the CADSS was administered at four timepoints to all study patients: (a) 30 to 60 minutes pre-treatment at baseline on day 1; (b) 2 hours post-treatment on day 1 (after the first dose of study drug); (c) 2 hours post-treatment on day 7 (after the last dose); and (d) prior to discharge on day 9 (2 days after the last dose). RESULTS: Among the 62 randomized patients, four patients had a CADSS score of at least 4 on day 1 before study drug administration (2 patients in the 25 mg arm [CADSS score 22 and 4]; 1 patient in the 50 mg arm [CADSS score 35]; 1 patient in the placebo arm [CADSS score 6]). Among these 4 patients, starting on day 1, 2 hours post-treatment, the 2 subjects in the 25 mg subgroup (75 mg loading dose) and 1 subject in the 50 mg subgroup (100 mg loading dose) showed a clinically meaningful decrease in their CADSS score, while the single patient in the placebo group showed no change. CADSS scores on Day 1 pre-treatment, day 1 post-treatment, day 7 post last treatment, and on day 9 prior to discharge were 22-2-6-0; 4-0-0-0; 35-14-9-0, and 6-6-n/a-n/a, for the two patients in the 25 mg REL-1017 subgroup, the single patient in the 50 mg REL-1017 subgroup, and the single patient in the placebo group, respectively. CONCLUSIONS: These retrospective case report data potentially signal that REL-1017 may determine rapid and sustained improvement in patients with MDD and concurrent clinically meaningful dissociative symptoms assessed by a CADSS score of 4 or above. Ongoing phase 3 trials with REL-1017 are expected to enroll a total of 1200 outpatients with MDD. These studies will potentially generate additional data that may support the initiation of controlled studies with REL-1017 for the treatment of PTSD. FUNDING: Relmada Therapeutics

Spin-polarized oxygen hole states in cation deficient La(1-x)CaxMnO(3+delta)

When holes are doped into a Mott-Hubbard type insulator, like lightly doped manganites of the La(1-x)CaxMnO3 family, the cooperative Jahn-Teller distortions and the appearance of orbital ordering require an arrangement of Mn(3+)/Mn(4+) for the establishment of the insulating canted antiferromagnetic (for x<=0.1), or of the insulating ferromagnetic (for 0.1<x<= 0.2) ground state. In the present work we provide NMR evidence about a novel and at the same time puzzling effect in La(1-x)CaxMnO(3+delta) systems with cation deficience. We show that in the low Ca-doping regime, these systems exhibit a very strong hyperfine field at certain La nuclear sites, which is not present in the stoichiometric compounds. Comparison of our NMR results with recent x-ray absorption data at the Mn K edge, suggests the formation of a spin-polarized hole arrangement on the 2p oxygen orbitals as the origin of this effect.Comment: 10 pages, 4 Figures, submitted to PR

Free electron lifetime achievements in Liquid Argon Imaging TPC

A key feature for the success of the liquid Argon imaging TPC (LAr-TPC) technology is the industrial purification against electro-negative impurities, especially Oxygen and Nitrogen remnants, which have to be continuously kept at an exceptionally low level by filtering and recirculating liquid Argon. Improved purification techniques have been applied to a 120 liters LAr-TPC test facility in the INFN-LNL laboratory. Through-going muon tracks have been used to determine the free electron lifetime in liquid Argon against electro-negative impurities. The short path length here observed (30 cm) is compensated by the high accuracy in the observation of the specific ionization of cosmic ray muons at sea level as a function of the drift distance. A free electron lifetime of (21.4+7.3-4.3) ms, namely > 15.8 ms at 90 % C.L. has been observed over several weeks under stable conditions, corresponding to a residual Oxygen equivalent of about 15 ppt (part per trillion). At 500 V/cm, the free electron speed is 1.5 m/ms. In a LAr-TPC a free electron lifetime in excess of 15 ms corresponds for instance to an attenuation of less than 15 % after a drift path of 5 m, opening the way to the operation of the LAr-TPC with exceptionally long drift distances.Comment: 15 pages, 10 figures; Accepted for publication in JINS

A model to explain angular distributions of J/ψJ/\psi and ψ(2S)\psi(2S) decays into ΛΛ‾\Lambda\overline{\Lambda} and Σ0Σ‾0\Sigma^0\overline{\Sigma}^0

BESIII data show a particular angular distribution for the decay of the $J/\psi$ and $\psi(2S)$ mesons into the hyperons $\Lambda\overline{\Lambda}$ and $\Sigma^0\overline{\Sigma}^0$. More in details the angular distribution of the decay $\psi(2S) \to \Sigma^0\overline{\Sigma}^0$ exhibits an opposite trend with respect to that of the other three channels: $J/\psi \to \Lambda\overline{\Lambda}$, $J/\psi \to \Sigma^0\overline{\Sigma}^0$ and $\psi(2S) \to \Lambda\overline{\Lambda}$. We define a model to explain the origin of this phenomenon.Comment: 6 pages, 7 figures, to be published in Chinese Physics

The Role of Psychological Well-Being in Weight Loss: New Insights from a Comprehensive Lifestyle Intervention

Background/Objective: Although the literature suggested that impaired psychological well-being (PWB) is associated with obesity, evidence on the role of PWB in weight outcomes is limited and inconclusive. This research aimed to investigate the joint role of PWB in achieving clinically significant weight loss (CWL; loss of 5% of the initial weight) through a comprehensive lifestyle intervention for obesity using a broad-based evaluation. Method: This study is a prospective cohort of 96 patients with obesity attending a comprehensive lifestyle intervention for weight loss. Data on weight, lifestyle, PWB, and distress, were collected before and after the intervention. Results: 30.5% of the participants achieved CWL at the end of treatment. A more pronounced increase in autonomy (odds ratio = 0.80 [95% CI: 0.68, 0.93], p ≤.01) and somatization (odds ratio = 0.83 [95% CI: 0.70, 0.98], p ≤.05) from pre- to post-treatment were independently associated with a lower probability of CWL. Conclusions: Unbalanced dimensions of PWB, in particular exceedingly high autonomy, may contribute to a poor weight loss outcome. This study paves the way for the addition of psychotherapeutic strategies geared to euthymia in comprehensive lifestyle intervention

A Phase 2a Double-Blind Randomized Trial of REL-1017 (Esmethadone) in Patients with MDD: Analysis of Subscales from the Symptoms of Depression Questionnaire

BACKGROUND: Major depressive disorder (MDD) is the second leading cause of disability and chronic disease burden in the United States. The importance of improving functional outcomes in MDD is increasingly recognized. The Symptoms of Depression Questionnaire (SDQ), a patient-reported measure, was developed to capture the heterogeneity of symptoms of MDD. REL-1017 (esmethadone HCl; d-methadone), is a novel N-methyl-d-aspartate receptor (NMDAR) channel blocker and potential rapid antidepressant currently in Phase 3 development. In a Phase 2a trial, REL-1017 showed robust, rapid, and sustained antidepressant efficacy as adjunctive treatment in patients with MDD. The objective of this study was to assess the effects of REL-1017 on SDQ subscales to better characterize the functional implications of its therapeutic effects. METHODS: A double-blind, placebo-controlled, inpatient, two-doses, 25 and 50&nbsp;mg, three-arm, 1:1:1, randomized, phase 2a trial of REL-1017 was conducted at 10 centers in the United States. Least square (LS) mean scores and Cohen's effect sizes of the total score of a 44-item of SDQ and its 5 subscales: lassitude, mood, cognitive/social functioning (SDQ-1); anxiety, agitation, anger, and irritability (SDQ-2); desire to be dead (SDQ-3); disruptions in sleep quality (SDQ-4); changes in appetite and weight (SDQ-5) were compared between REL-1017 and placebo. RESULTS: A total of 62 adult male and female patients (18-65&nbsp;years of age) diagnosed with MDD participated in the trial. On day 14, the last day of efficacy measurement, the difference from placebo of the LS mean (90% CI) for REL-1017 25&nbsp;mg and REL-1017 50&nbsp;mg groups, respectively, showed improvement for both tested doses on SDQ total score (-23.2; P&nbsp;=&nbsp;.0066 [effect size: 0.9]; -26.8 P&nbsp;=&nbsp;.0014 [effect size: 1.1]). Additionally, for SDQ subscales, REL-1017 25&nbsp;mg and REL-1017 50&nbsp;mg groups, respectively, showed significant improvement as compared with placebo: SDQ-1 (-13.9; P&nbsp;=&nbsp;.0025 [effect size: 1.0]; -15.0; P&nbsp;=&nbsp;.0009 [effect size: 1.1]), SDQ-2 (-4.6; P&nbsp;=&nbsp;.0398 [effect size: 0.7]; -7.2; P&nbsp;=&nbsp;.0012 [effect size: 1.1]) and SDQ-4 (-2.7; P&nbsp;=&nbsp;.0055 [effect size: 1.0]; -2.8; P&nbsp;=&nbsp;.0029 [effect size: 1.0]). No significant differences were observed between the treated groups and placebo in the SDQ-3 and SDQ-5 subscales. CONCLUSIONS: In patients with MDD, aside from improving the overall CFB compared to placebo in SDQ total score, REL-1017 resulted in clinically meaningful and statistically significant improvements in cognitive/motivational, anxiety/irritability, and sleep-specific domains. The robust, rapid, and sustained efficacy of REL-1017 for MDD is not limited to improving mood, but potentially extends to cognitive, motivational, sleep, and social functions, with potentially meaningful therapeutic and socioeconomic implications. These results may signal disease-modifying effects of esmethadone for MDD that may offer potential advantages over symptomatic treatment with standard antidepressants. FUNDING: Relmada Therapeutics, Inc

In vitro faecal fermentation of Tritordeum breads and its effect on the human gut health

Spontaneous fermentation of Tritordeum flour enhances the nutritional potential of this hybrid cereal. However, the effect of consumption of Tritordeum sourdough bread (SDB) on gut health remains to be elucidated. This study investigated the effect of in vitro digestion and faecal fermentation of SDB compared to that of traditional baker's yeast (BYB) Tritordeum bread. After 24-h anaerobic faecal fermentation, both SDB and BYB (1% w/v) induced an increase in the relative abundances of Bifidobacterium, Megasphaera, Mitsuokella, and Phascolarctobacterium genera compared to baseline, while concentrations of acetate and butyrate were significantly higher at 24 h for SDB compared to those for BYB. Integrity of intestinal epithelium, as assessed through in vitro trans-epithelial electrical resistance (TEER) assay, was slightly increased after incubation with SDB fermentation supernatants, but not after incubation with BYB fermentation supernatants. The SDB stimulated in vitro mucosal immune response by inducing early secretion of inflammatory cytokines, IL-6 and TNF-α, followed by downregulation of the inflammatory trigger through induction of anti-inflammatory IL-10 expression. Overall, our findings suggest that Tritordeum sourdough can modulate gut microbiota fermentation activity and positively impact the gut health