Joint Crisis Plans and Crisis Cards in Inpatient Psychiatric Treatment

Rixe J, Neumann E, Möller J, et al. Joint Crisis Plans and Crisis Cards in Inpatient Psychiatric Treatment. Deutsches Ärzteblatt international . 2023;120(8):125-132.BACKGROUND: Joint Crisis Plans (JCP) and crisis cards (CC) are both instruments designed to improve the management of future psychiatric crisis situations, but they differ, for example, in terms of resource use, legal validity, and aims. International research findings for JCP are inconsistent.; METHODS: From January 2018 to December 2020, a single-blinded, two-armed multicenter RCT was carried out, with assessments at T0 (baseline) and T1 (18 months later). The patients included had schizophrenia or schizoaffective disorder and were aged between 18 and 62 years. The primary outcome was the cumulative duration of inpatient treatment (voluntary/involuntary), and coercive measures comprised the secondary outcome. Trial registration: DRKS00013985.; RESULTS: Of the 266 study participants, 157 completed the study. In the CC group 57.8% and in the JCP group 64.9% were admitted to psychiatric hospitals between the index treatment and T1 (p = 0.367); 8.4% of the CC group and 12.2% of the JPC group were admitted against their will (p = 0.441). The cumulative treatment duration was not significantly shorter (p = 0.631) in the JPC group (mean 42.43 days, SD = 48.60) than in the CC group (50.16 days, SD = 74.16). Thus, JPCs did not achieve the expected improvement with regard to the primary endpoint. There were also no relevant differences regarding the secondary endpoint. Major effects in favor of the JCP were observed, however, in patients' development of conficence in the treatment teams and in their active participation in the treatment procedure.; CONCLUSION: Although the study showed no superiority of JCP over CC with regard to the primary and secondary outcomes, JCP should be used more frequently in routine practice as an intervention to support a participative approach to treatment

Psychosocial functioning as a personal resource promoting a milder course of schizophrenia

Neumann E, Rixe J, Haussleiter IS, et al. Psychosocial functioning as a personal resource promoting a milder course of schizophrenia. Journal of Psychiatric Research . 2022;148:121-126.Schizophrenia has been shown repeatedly to be associated with a low level of psychosocial functioning. It is assumable that psychosocial functioning is related not only to current, but also to future symptom severity. To test this assumption, a follow-up study with two measurement time points with an interval of 18 months was conducted. In total, 154 inpatients from five psychiatric hospitals with a diagnosis of a schizophrenic disorder took part at both visits. Psychosocial functioning was measured with the Personal and Social Performance Scale (PSP scale) at baseline, and schizophrenic symptoms were assessed with the Positive and Negative Syndrome Scale (PANSS) at baseline and at follow-up. Two PSP subscales, i.e. socially useful activities and control over disturbing and aggressive behavior, turned out to be significant predictors of symptom severity 18 months later. The findings reveal that personal resources in the occupational domain and in adequate interpersonal behavior can have a positive impact on the long-term course of schizophrenia

Individual Assessment of Brain Tissue Changes in MS and the Effect of Focal Lesions on Short-Term Focal Atrophy Development in MS: A Voxel-Guided Morphometry Study

We performed voxel-guided morphometry (VGM) investigating the mechanisms of brain atrophy in multiple sclerosis (MS) related to focal lesions. VGM maps detect regional brain changes when comparing 2 time points on high resolution T1-weighted (T1w) magnetic resonace imaging (MRI). Two T1w MR datasets from 92 relapsing-remitting MS patients obtained 12 months apart were analysed with VGM. New lesions and volume changes of focal MS lesions as well as in the surrounding tissue were identified by visual inspection on colour coded VGM maps. Lesions were dichotomized in active and inactive lesions. Active lesions, defined by either new lesions (NL) (volume increase > 5% in VGM), chronic enlarging lesions (CEL) (pre-existent T1w lesions with volume increase > 5%), or chronic shrinking lesions (CSL) (pre-existent T1w lesions with volume reduction > 5%) in VGM, were accompanied by tissue shrinkage in surrounding and/or functionally related regions. Volume loss within the corpus callosum was highly correlated with the number of lesions in its close proximity. Volume loss in the lateral geniculate nucleus was correlated with lesions along the optic radiation. VGM analysis provides strong evidence that all active lesion types (NL, CEL, and CSL) contribute to brain volume reduction in the vicinity of lesions and/or in anatomically and functionally related areas of the brain

The synthesis, structure and ethene polymerisation catalysis of mono(salicylaldiminato) titanium and zirconium complexes

The silyl ethers 3- Bu-t - 2- ( OSiMe3) C6H3CH = NR ( 2a- e) have been prepared by deprotonation of the known iminophenols ( 1a - e) and treatment with SiClMe3 ( a, R = C6H5; b, R = 2,6- Pr-i 2C6H3; c, R = 2,4,6- Me3C6H2; d, R = 2- C6H5C6H4; e, R = C6F5). 2a - c react with TiCl4 in hydrocarbon solvents to give the binuclear complexes [ Ti {3- Bu-t - 2-( O) C6H3CH = N( R)} Cl( mu - Cl-3) TiCl3] ( 3a - c). The pentafluorophenyl species 2e reacts with TiCl4 to give the known complex Ti {3- Bu-t - 2- ( O) C6H3CH = N( R)} Cl-2(2). The mononuclear five- coordinate complex, Ti {3- Bu-t - 2- ( O) C6H3CH = N( 2,4,6- Me3C6H2)} Cl-3 ( 4c), was isolated after repeated recrystallisation of 3c. Performing the dehalosilylation reaction in the presence of tetrahydrofuran yields the octahedral, mononuclear complexes Ti {3- Bu-t - 2- ( O) C6H3CH = N( R)} Cl-3( THF) ( 5a - e). The reaction with ZrCl4( THF) (2) proceeds similarly to give complexes Zr {3- Bu-t - 2- ( O) C6H3CH = N( R)} Cl-3( THF) ( 6b - e). The crystal structures of 3b, 4c, 5a, 5c, 5e, 6b, 6d, 6e and the salicylaldehyde titanium complex Ti {3- Bu-t - 2- ( O) C6H3CH = O} Cl-3( THF) ( 7) have been determined. Activation of complexes 5a e and 6b e with MAO in an ethene saturated toluene solution gives polyethylene with at best high activity depending on the imine substituent

Present status and perspectives of cell-based therapies for liver diseases.

In recent years the interest in liver cell therapy has been increasing continuously, since the demand for whole liver transplantations in human beings far outweighs the supply. From the clinical point of view, transplantation of hepatocytes or hepatocyte-like cells may represent an alternative to orthotopic liver transplants in acute liver failure, for the correction of genetic disorders resulting in metabolically deficient states, and for late stage liver disease such as cirrhosis. Although the concept of cell therapy for various diseases of the liver is widely accepted, the practical approach in humans often remains difficult. An international expert panel critically discussed the recent published data on clinical and experimental hepatocyte transplantation and the possible role of stem cells in liver tissue repair. This paper aims to summarise the present status of cell based therapies for liver diseases and to identify areas of future preclinical and clinical research

Autoantibodies against SUMO1-DHX35 in long-COVID

Long COVID is a collection of symptoms as a late sequelae of SARS-CoV-2 infection. It often includes mental symptoms such as cognitive symptoms, persisting loss of smell and taste, in addition to exertional dyspnea. A role of various autoantibodies (autoAbs) has been postulated in long-COVID and is being further investigated. With the goal of identifying potentially unknown autoAbs, we screened plasma of patients with long COVID on in-house post-translationally modified protein macroarrays including citrullinated, SUMOylated and acetylated membranes. SUMO1ylated isoform DEAD/H (Asp-Glu-Ala-Asp/His) box helicase 35 (SUMO1-DHX35) was identified as only candidate antigen. In adult patients with long COVID, IgG autoAbs against SUMO1-DHX35 of IgG class were found in seven of 71 (9.8%) plasma samples, of IgM and IgG class in one of 69 (1.4%) samples, not in 200 healthy adult controls, not in 442 healthy children, and 146 children after SARS-CoV-2 infection. All autoAb-positive seven patients were female. AutoAb titers ranged between 200 to up to 400 By point mutagenesis and expression of FLAG-tagged mutants of DHX35 in HEK293 cells, and subsequent SUMOylation of purified constructs, lysine 53 was identified as a unique, never yet identified, SUMOylation site. The autoAbs had no reactivity against the non-SUMO1ylated mutant (K53R) of DHX35. To summarize, autoAbs against SUMO1-DHX35 were identified in adult female patients with long-COVID. Further studies are needed to verify the frequency of occurrence. The function of DHX35 has not yet been determined and there is no available information in relation to disease implication. The molecular mechanism causing the SUMOylation, the potential functional consequences of this post-translational modification on DHX35, and a potential pathogenicity of the autoAbs against SUMO1-DHX35 in COVID-19 and other possible contexts remain to be elucidated