Cannabis and schizophrenia

BACKGROUND Schizophrenia is a mental illness causing disordered beliefs, ideas and sensations. Many people with schizophrenia smoke cannabis, and it is unclear why a large proportion do so and if the effects are harmful or beneficial. It is also unclear what the best method is to allow people with schizophrenia to alter their cannabis intake. OBJECTIVES To assess the effects of specific psychological treatments for cannabis reduction in people with schizophrenia.To assess the effects of antipsychotics for cannabis reduction in people with schizophrenia.To assess the effects of cannabinoids (cannabis related chemical compounds derived from cannabis or manufactured) for symptom reduction in people with schizophrenia. SEARCH METHODS We searched the Cochrane Schizophrenia Group Trials Register, 12 August 2013, which is based on regular searches of BIOSIS, CINAHL, EMBASE, MEDLINE, PUBMED and PsycINFO.We searched all references of articles selected for inclusion for further relevant trials. We contacted the first author of included studies for unpublished trials or data. SELECTION CRITERIA We included all randomised controlled trials involving cannabinoids and schizophrenia/schizophrenia-like illnesses, which assessed:1) treatments to reduce cannabis use in people with schizophrenia;2) the effects of cannabinoids on people with schizophrenia. DATA COLLECTION AND ANALYSIS We independently inspected citations, selected papers and then re-inspected the studies if there were discrepancies, and extracted data. For dichotomous data we calculated risk ratios (RR) and for continuous data, we calculated mean differences (MD), both with 95% confidence intervals (CI) on an intention-to-treat basis, based on a fixed-effect model. We excluded data if loss to follow-up was greater than 50%. We assessed risk of bias for included studies and used GRADE to rate the quality of the evidence. MAIN RESULTS We identified eight randomised trials, involving 530 participants, which met our selection criteria.For the cannabis reduction studies no one treatment showed superiority for reduction in cannabis use. Overall, data were poorly reported for many outcomes of interest. Our main outcomes of interest were medium-term data for cannabis use, global state, mental state, global functioning, adverse events, leaving the study early and satisfaction with treatment. 1. Reduction in cannabis use: adjunct psychological therapies (specifically about cannabis and psychosis) versus treatment as usualResults from one small study showed people receiving adjunct psychological therapies specifically about cannabis and psychosis were no more likely to reduce their intake than those receiving treatment as usual (n = 54, 1 RCT, MD -0.10, 95% CI -2.44 to 2.24, moderate quality evidence). Results for other main outcomes at medium term were also equivocal. No difference in mental state measured on the PANSS positive were observed between groups (n = 62, 1 RCT, MD -0.30 95% CI -2.55 to 1.95, moderate quality evidence). Nor for the outcome of general functioning measured using the World Health Organization Quality of Life BREF (n = 49, 1 RCT, MD 0.90 95% CI -1.15 to 2.95, moderate quality evidence). No data were reported for the other main outcomes of interest 2. Reduction in cannabis use: adjunct psychological therapy (specifically about cannabis and psychosis) versus adjunct non-specific psychoeducation One study compared specific psychological therapy aimed at cannabis reduction with general psychological therapy. At three-month follow-up, the use of cannabis in the previous four weeks was similar between treatment groups (n = 47, 1 RCT, RR 1.04 95% CI 0.62 to 1.74, moderate quality evidence). Again, at a medium-term follow-up, the average mental state scores from the Brief Pscychiatric Rating Scale-Expanded were similar between groups (n = 47, 1 RCT, MD 3.60 95% CI - 5.61 to 12.81, moderate quality evidence). No data were reported for the other main outcomes of interest: global state, general functioning, adverse events, leaving the study early and satisfaction with treatment. 3. Reduction in cannabis use: antipsychotic versus antipsychotic In a small trial comparing effectiveness of olanzapine versus risperidone for cannabis reduction, there was no difference between groups at medium-term follow-up (n = 16, 1 RCT, RR 1.80 95% CI 0.52 to 6.22, moderate quality evidence). The number of participants leaving the study early at medium term was also similar (n = 28, 1 RCT, RR 0.50 95% CI 0.19 to 1.29, moderate quality evidence). Mental state data were reported, however they were reported within the short term and no difference was observed. No data were reported for global state, general functioning, and satisfaction with treatment.With regards to adverse effects data, no study reported medium-term data. Short-term data were presented but overall, no real differences between treatment groups were observed for adverse effects. 4. Cannabinoid as treatment: cannabidiol versus amisulprideAgain, no data were reported for any of the main outcomes of interest at medium term. There were short-term data reported for mental state using the BPRS and PANSS, no overall differences in mental state were observed between treatment groups. AUTHORS' CONCLUSIONS Results are limited and inconclusive due to the small number and size of randomised controlled trials available and quality of data reporting within these trials. More research is needed to a) explore the effects of adjunct psychological therapy that is specifically about cannabis and psychosis as currently there is no evidence for any novel intervention being better than standard treatment,for those that use cannabis and have schizophrenia b) decide the most effective drug treatment in treating those that use cannabis and have schizophrenia, and c) assess the effectiveness of cannabidiol in treating schizophrenia. Currently evidence is insufficient to show cannabidiol has an antipsychotic effect

Eliminating ambiguities for quantum corrections to strings moving in AdS4×CP3AdS_4\times \mathbb{CP}^3

We apply a physical principle, previously used to eliminate ambiguities in quantum corrections to the 2 dimensional kink, to the case of spinning strings moving in $AdS_4\times \mathbb{CP}^3$, thought of as another kind of two dimensional soliton. We find that this eliminates the ambiguities and selects the result compatible with AdS/CFT, providing a solid foundation for one of the previous calculations, which found agreement. The method can be applied to other classical string "solitons".Comment: 18 pages, latex; references added, comments added at end of section 4, a few words changed; footnote added on page 1

On the Fermionic Frequencies of Circular Strings

We revisit the semiclassical computation of the fluctuation spectrum around different circular string solutions in AdS_5xS^5 and AdS_4xCP^3, starting from the Green-Schwarz action. It has been known that the results for these frequencies obtained from the algebraic curve and from the worldsheet computations sometimes do not agree. In particular, different methods give different results for the half-integer shifts in the mode numbers of the frequencies. We find that these discrepancies can be removed if one carefully takes into account the transition matrices in the spin bundle over the target space.Comment: 13 pages, 1 figur

Kaluza-Klein gauge and minimal integrable extension of OSp(4|6)/(SO(1,3) x U(3)) sigma-model

Basing upon experience from performing double-dimensional reduction of the D=11 supermembrane on AdS_4 x S^7 background to Type IIA superstring on AdS_4 x CP^3 we introduce Kaluza-Klein (partial) kappa-symmetry gauge as a vanishing condition of the contribution to the D=11 supervielbein components tangent to D=10 space-time proportional to the differential of the coordinate parametrizing compact 11-th space-time dimension, that is identified with the supermembrane world-volume compact dimension. For AdS_4 x S^7 supermembrane Kaluza-Klein gauge removes half Grassmann coordinates associated with 8 space-time supersymmetries, broken by the AdS_4 x CP^3 superbackground, by imposing D=3 (anti-)Majorana condition on them. The consideration relies on the realization of osp(4|8) isometry superalgebra of the AdS_4 x S^7 superbackground as D=3 N=8 superconformal algebra. Requiring further vanishing of the D=10 dilaton leaves in the sector of broken supersymmetries just two Grassmann coordinates organized into D=3 (anti-)Majorana spinor that defines minimal SL(2,R)-covariant extension of the OSp(4|6)/(SO(1,3)x U(3)) sigma-model. Among 4 possibilities of such a minimal extension we consider in detail one, that corresponds to picking out D=3 Majorana coordinate related to broken Poincare supersymmetry, and show that the AdS_4 x CP^3 superstring equations of motion in this partial kappa-symmetry gauge are integrable. Also the relation between the OSp(4|6)/(SO(1,3) x U(3)) sigma-model and the AdS_4 x CP^3 superstring is revisited.Comment: LaTeX, 22 pages; v2: minor improvements in the text, typos corrected, references adde

Evolutionary quantitative genetics of juvenile body size in a population of feral horses reveals sexually antagonistic selection

This is the author accepted manuscript. The final version is available from Springer via the DOI in this record.Inter-individual variation in juvenile body size can have important consequences for individual fitness, population dynamics, and adaptive evolution. In wild vertebrate populations, larger juvenile size is usually expected to be selected for. However, understanding how such selection may translate into adaptive evolution requires an understanding of the genetic underpinnings of early development and the factors modulating selection. In this study, we characterised the genetic basis of and selection pressures acting upon juvenile body size in a large insular population of feral horses on Sable Island, Canada, to gain insights into the evolution of juvenile body size in wild vertebrate populations. We used pedigree-based quantitative genetic ‘animal models’ to quantify the sources of phenotypic variation in withers-knee length, and assessed the influence of maternal age, sex, and temporal (birth year) and spatial environmental heterogeneity in modulating overwinter survival selection. We found that withers-knee length is moderately heritable and that there was a significant positive genetic correlation between males and females. There was no indication of directional selection in a pooled-sex analysis, but we did find evidence for significant sexually antagonistic selection, with a tendency for smaller body size to be favoured in males and larger body size to be favoured in females. These results suggest that juvenile body size has the potential to evolve in this population, and that selection on juvenile size may play an important role in modulating sex-specific contributions to population dynamics. However, our results also suggest that there is unlikely to be evolutionary change in the mean body size of Sable Island foals.Natural Sciences and Engineering Research Council of CanadaCanada Foundation for InnovationRoyal SocietyUniversity of Exete

Functional and cognitive outcomes after COVID-19 delirium

Purpose: To ascertain delirium prevalence and outcomes in COVID-19. / Methods: We conducted a point-prevalence study in a cohort of COVID-19 inpatients at University College Hospital. Delirium was defined by DSM-IV criteria. The primary outcome was all-cause mortality at 4 weeks; secondary outcomes were physical and cognitive function. / Results: In 71 patients (mean age 61, 75% men), 31 (42%) had delirium, of which only 12 (39%) had been recognised by the clinical team. At 4 weeks, 20 (28%) had died, 26 (36%) were interviewed by telephone and 21 (30%) remained as inpatients. Physical function was substantially worse in people after delirium − 50 out of 166 points (95% CI − 83 to − 17, p = 0.01). Mean cognitive scores at follow-up were similar and delirium was not associated with mortality in this sample. / Conclusions: Our findings indicate that delirium is common, yet under-recognised. Delirium is associated with functional impairments in the medium term

Focusing on ICT in Rural and Regional Education in Australia

National priorities set by an Australian ministerial taskforce provide clear guidelines to develop pedagogy that integrates ICT. Although these guidelines do not specifically address rural and regional schools needs, the two priorities: promoting pedagogic leadership and creating new learning environments, are of particular interest. But how are these priorities reflected in the realities of rural and regional schools? Focus group interviews were conducted at a selection of rural and regional schools in each state and territory across Australia. These provided teachers, parents and students with the opportunity to identify key issues in relation to ICT in their schools. Issues identified by the focus groups were; the state of equipment in schools, comparability between home and school ICT experiences for students, pedagogical approaches, leadership, professional development and availability of ICT specialist teachers

A BIOMECHANICAL ANALYSIS OF FRONT VERSUS BACK SQUAT: INJURY IMPLICATIONS

The aim of this study was to examine the differences in trunk and lower limb kinematics between the front and back squat. 2D kinematic data was collected as participants (n = 12) completed three repetitions of both front and back squat exercises at 50 % of their back squat one repetition maximum. Stance width was standardised at 107(±10) % of biacromial breadth. The Wilcoxon signed ranks test was used to examine significant differences in dependent variables between both techniques. Results showed that the back squat exhibited a significantly greater trunk lean than the front squat throughout (p < 0.05) with no differences occurring in knee joint kinematics. The results of this study in conjunction with other squat related literature (Russell et al., 1989) suggest that the back squat gives rise to an increased risk of lower back injury

Light-cone gauge Hamiltonian for AdS_4 x CP^3 superstring

It is developed the phase-space formulation for the Type IIA superstring on the AdS_4 x CP^3 background in the kappa-symmetry light-cone gauge for which the light-like directions are taken from the D=3 Minkowski boundary of AdS_4. After fixing bosonic light-cone gauge the superstring Hamiltonian is expressed as a function of the transverse physical variables and in the quadratic approximation corresponds to the light-cone gauge-fixed IIA superstring in flat space.Comment: 12 pages, LaTeX; v2 minor improvements of the text, misprints corrected, reference added; v3: missing terms in Eqs.(8),(53) and (56) adde