Electroconvulsive therapy for agitation in schizophrenia: Meta-analysis of randomized controlled trials

Background: Agitation poses a significant challenge in the treatment of schizophrenia. Electroconvulsive therapy (ECT) is a fast, effective and safe treatment for a variety of psychiatric disorders, but no meta-analysis of ECT treatment for agitation in schizophrenia has yet been reported. Aims: To systematically evaluate the efficacy and safety of ECT alone or ECT-antipsychotics (APs) combination for agitation in schizophrenia. Methods: Systematic literature search of randomized controlled trials (RCTs) was performed. Two independent evaluators selected studies, extracted data about outcomes and safety with available data, conducted quality assessment and data synthesis. The Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) was used to judge the level of the overall evidence of main outcomes. Results: Seven RCTs from China, including ECT alone (4 RCTs with 5 treatment arms, n=240) and ECT-APs combination (3 RCTs, n=240), were identified. Participants in the studies were on average 34.3(4.5) years of age and lasted an average of 4.3(3.1) weeks of treatment duration. All 7 RCTs were non-blinded, and were rated as low quality based on Jadad scale. Meta-analysis of the pooled sample found no significant difference in the improvement of the agitation sub-score of the Positive and Negative Syndrome Scale (PANSS) when ECT alone (weighted mean difference=-0.90, (95% confidence interval (CI): -2.91, 1.11), p=0.38) or ECT-APs combination (WMD=-1.34, (95%CI: -4.07, 1.39), p=0.33) compared with APs monotherapy. However, ECT alone was superior to APs monotherapy regarding PANSS total score (WMD=-7.13, I2=0%, p=0.004) and its excitement sub-score (WMD=-1.97, pI2=0%, p=0.004) and its excitement sub-score at 7 and 14 days (WMD=-1.97 to -1.92, p=0.002 to 0.0001) after ECT. The ECT-APs combination was superior to APs monotherapy with respect to the PANSS total score at treatment endpoint (WMD=-10.40, p=0.03) and 7 days (WMD=-5.01, p=0.02). Headache ( number-needed-to-harm (NNH)=3, 95%CI=2-4) was more frequent in the ECT alone group compared to AP monotherapy. According to the GRADE approach, the evidence levels of main outcomes were rated as ‘‘very low’’ (37.5%) and “low” (50%). Conclusion: Pooling of the data based on 7 RCTs from China found no advantage of ECT alone or ECT-APs combination in the treatment of agitation related outcomes in schizophrenia patients. However, ECT alone or ECT-APs combination were associated with significant reduction in the PANSS total score. High-quality RCTs are needed to confirm the current interpretations. Review registration number: CRD4201400668

Enhanced sensing performance by the plasmonic analogue of electromagnetically induced transparency in active metamaterials

The gain-assisted plasmonic analogue of electromagnetically induced transparency (EIT) in a metallic metamaterial is investigated for the purpose to enhance the sensing performance of the EIT-like plasmonic structure. The structure is composed of three bars in one unit, two of which are parallel to each other (dark quadrupolar element) but perpendicular to the third bar (bright dipolar element), The results show that, in addition to the high sensitivity to the refractive-index fluctuation of the surrounding medium, the figure of merit for such active EIT-like metamaterials can be greatly enhanced, which is attributed to the amplified narrow transparency peak

Decreased Peripheral BDNF Levels and Cognitive Impairment in Late-Life Schizophrenia

Objectives: There are relatively few studies on mechanisms of cognitive deficits in late-life schizophrenia (LLS). Brain-derived neurotrophic factor (BDNF), as an important neuroplastic molecule, has been reported to be involved in neurocognitive impairment in schizophrenia. This study aimed to examine whether peripheral BDNF levels were associated with cognitive deficits in LLS, which has not been explored yet.Methods: Forty-eight LLS patients and 45 age-matched elderly controls were recruited. We measured all participants on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) for cognition and serum BDNF levels. Psychopathological symptoms in patients were assessed by the Positive and Negative Syndrome Scale (PANSS).Results: The levels of BDNF in LLS patients were significantly lower than those in healthy controls (8.80 ± 2.30 vs. 12.63 ± 5.08 ng/ml, p < 0.001). The cognitive performance of LLS patients was worse than that of the controls on RBANS total score and scores of immediate memory, attention, language, and delayed memory (all p ≤ 0.005). BDNF was positively associated with attention in LLS patients (r = 0.338, p = 0.019).Conclusion: Our findings suggest that older patients with schizophrenia exhibit lower BDNF levels and more cognitive deficits than older controls, supporting the accelerated aging hypothesis of schizophrenia. Moreover, decreased BDNF is related to attention deficits, indicating that BDNF might be a candidate biomarker of cognitive impairments in LLS patients

Invasive reperfusion after 12 hours of the symptom onset remains beneficial in patients with ST-segment elevation myocardial infarction: Evidence from a meta-analysis of published data

Background: Early myocardial reperfusion therapy (< 12 h) in patients with acute myocardial infarc­tion (AMI) can significantly improve their prognosis. However, the effect of late reperfusion (> 12 h) remains controversial. In this study, the effects of late reperfusion versus standard drug therapy on the outcomes of patients with AMI were evaluated by systematic review and meta-analysis. Methods: PubMed, Embase, Medline, Cochrane, Wanfang, and CNKI databases were searched for eligible studies for the present study. Meta-analysis was performed using RevMan 5.3.3 software. Rela­tive risk (RR) and the 95% confidence interval (CI) were used to compare the outcomes between the two groups. The main outcome measures were major adverse cardiac events (MACEs), all-cause mortality, recurrent myocardial infarction (MI), and heart failure. Results: Eighteen studies were identified including 14,677 patients, of whom 5157 received late reperfusion with percutaneous coronary intervention (PCI) and 9520 received medication therapy (MT). Compared to MT, late PCI was associated with decreased all-cause mortality (RR 0.60, 95% CI 0.44–0.83; p = 0.002), MACEs (RR 0.67; 95% CI 0.50–0.89; p < 0.001), and heart failure (RR 0.76; 95% CI 0.60–0.97; p = 0.03), while there was also a trend toward decreased recurrent MI (RR 0.70; 95% CI 0.47–1.05; p = 0.08). However, subgroup analysis according to time to PCI showed that the clinical benefit was only from PCI after 12 h but not from 2 to 60 days of the onset of symptoms. Conclusions: The present meta-analysis suggested that PCI performed > 12 h but not 2–60 days after AMI is associated with significant improvement in clinical outcomes. However, these results need further rigorously designed large sample size clinical trials to be validated

Ancient mitochondrial genomes reveal extensive genetic influence of the steppe pastoralists in Western Xinjiang

The population prehistory of Xinjiang has been a hot topic among geneticists, linguists, and archaeologists. Current ancient DNA studies in Xinjiang exclusively suggest an admixture model for the populations in Xinjiang since the early Bronze Age. However, almost all of these studies focused on the northern and eastern parts of Xinjiang; the prehistoric demographic processes that occurred in western Xinjiang have been seldomly reported. By analyzing complete mitochondrial sequences from the Xiabandi (XBD) cemetery (3,500–3,300 BP), the up-to-date earliest cemetery excavated in western Xinjiang, we show that all the XBD mitochondrial sequences fall within two different West Eurasian mitochondrial DNA (mtDNA) pools, indicating that the migrants into western Xinjiang from west Eurasians were a consequence of the early expansion of the middle and late Bronze Age steppe pastoralists (Steppe_MLBA), admixed with the indigenous populations from Central Asia. Our study provides genetic links for an early existence of the Indo-Iranian language in southwestern Xinjiang and suggests that the existence of Andronovo culture in western Xinjiang involved not only the dispersal of ideas but also population movement.Introduction Materials and methods - Archaeological Background, Sampling, and Sequencing - Sequence Mapping and Mitochondrial DNA Haplogroup Determination - Analysis of Xiabandi Mitochondrial DNA Genomes Results - Mitochondrial DNA Authentication and Contamination Assessment - Major Bronze Age Steppe Pastoralist Origin of the Xiabandi Mitochondrial Haplogroups - Expansion of the Bronze Age Steppe Pastoralists as a Dynamic Process to Form the Genetic Landscape of Xiabandi Individuals Discussion Conclusion

Adjunctive melatonin for tardive dyskinesia in patients with schizophrenia: A meta-analysis

Background: Tardive dyskinesia (TD) is characterized by abnormal and involuntary movements. Importantly, TD could cause considerable personal suffering and social and physical disabilities. Aims: This meta-analysis based on randomized controlled trials (RCTs) systematically assessed the therapeutic effect and tolerability of melatonin for TD in schizophrenia. Methods: A computerized and systematical search of both Chinese (Wanfang Data, Chinese National Knowledge Infrastructure (CNKI), SINOMED) and English (PubMed, PsycINFO, Embase, Cochrane Library databases) databases, from their inception until June 8, 2017, was conducted by two independent authors. The severity of TD symptoms were the primary outcome measure and analyzed using a random effects model by the Review Manager (RevMan) Version 5.3. Quality evaluation of included RCTs was conducted using the Cochrane risk of bias and Jadad scale. The GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) system recommendation grading method was used to assess the overall quality level of meta-analytic outcomes. Results: Four RCTs (n=130) were identified and analyzed. Three RCTs used double blind and 1 RCT used masked assessors using the Cochrane risk of bias, and 3 RCTs were rated as high quality based on Jadad scale. Compared with the control group, adjunctive melatonin was superior in reducing the severity of TD as measured by the Abnormal Involuntary Movement Scale (AIMS) (4 RCTs, n=130, weighted mean difference (WMD): -1.52 (95% confidence intervals (CI): -3.24, 0.20), p=0.08; I2=0%) although the improvement did not reach a significant level. The overall evidence quality of the improvement of TD symptoms, according to GRADE approach, was rated as “Low”. The data on the ADRs and cognitive effect were limited. Conclusions: This meta-analysis shows that melatonin has potential for improving TD symptoms in schizophrenia. Future higher quality and larger RCTs are warranted to confirm the findings

The ClpP protease homologue is required for the transmission traits and cell division of the pathogen Legionella pneumophila

<p>Abstract</p> <p>Background</p> <p><it>Legionella pneumophila</it>, the intracellular bacterial pathogen that causes Legionnaires' disease, exhibit characteristic transmission traits such as elevated stress tolerance, shortened length and virulence during the transition from the replication phase to the transmission phase. ClpP, the catalytic core of the Clp proteolytic complex, is widely involved in many cellular processes via the regulation of intracellular protein quality.</p> <p>Results</p> <p>In this study, we showed that ClpP was required for optimal growth of <it>L. pneumophila </it>at high temperatures and under several other stress conditions. We also observed that cells devoid of <it>clpP </it>exhibited cell elongation, incomplete cell division and compromised colony formation. Furthermore, we found that the <it>clpP</it>-deleted mutant was more resistant to sodium stress and failed to proliferate in the amoebae host <it>Acanthamoeba castellanii</it>.</p> <p>Conclusions</p> <p>The data present in this study illustrate that the ClpP protease homologue plays an important role in the expression of transmission traits and cell division of <it>L. pneumophila</it>, and further suggest a putative role of ClpP in virulence regulation.</p

Proizvodnja β-fruktofuranozidaze s pomoću bakterije Arthrobacter sp. i primjena tog enzima u pretvorbi steviozida i rebaudiozida A

Arthrobacter sp. 10137 has been used to produce β-fructofuranosidase (FFase). Sucrose and corn steep powder in an optimized ratio of 10:1 were the best carbon and nitrogen sources for enzyme production in a shake flask. The maximum FFase activity was 26.69 U/mL after 22.5 h in batch culture, and the crude FFase, obtained by ultrafiltration and (NH4)2SO4 fractionation, was purified about 7-fold as measured by specific activity from the crude culture filtrate. The FFase was specific for introduction of a fructose molecule at the C19 position on both the stevioside and rebaudioside A, with high transfructosylating activity of 65 % after 15 h of incubation.U proizvodnji enzima β-fruktofuranozidaze upotrijebljen je soj bakterije Arthrobacter sp. 10137. Kao najbolji izvori ugljika i dušika za proizvodnju enzima u pokusu na tresilici upotrijebljeni su saharoza i kukuruzni ekstrakt u omjeru 10:1. Maksimalna aktivnost β-fruktofuranozidaze od 26,69 U/mL postignuta je šaržnim uzgojem nakon 22,5 h. Sirovi enzim β-fruktofuranozidaza, dobiven ultrafiltracijom i frakcioniranjem s (NH4)2SO4, pročišćen je 7 puta, što je potvrđeno usporedbom specifične aktivnosti pročišćenog enzima s filtratom sirovoga enzima. Utvrđeno je da je dobiveni enzim specifičan za uvođenje molekule fruktoze na poziciju C19 steviozida i rebaudiozida A, te da je aktivnost transfruktozilaze nakon 15 sati inkubacije iznosila 65 %

Non-left-handed transmission and bianisotropic effect in a [pi]-shaped metallic metamaterials

A [pi]-shaped metallic metamaterial (geometrically, a combination medium of C-shaped resonators and continuous wires) is proposed to numerically investigate its transmission band near the resonant frequency, where otherwise it should be a negative-permeability (or negative-permittivity) stop band if either the C-shaped or continuous-wire constituent is separately considered. However, in contrast to the left-handed materials (LHMs)composed of split-ring resonators and wires as well as other metallic LHMs, this resonant transmission is a non-left-handed one as a result of the intrinsic bianisotropic effect attributed to the electrically asymmetric configuration of this [pi]-shaped metamaterial.Comment: 19 pages, 6 figure