A Systematic Review of the Soteria Paradigm for the Treatment of People Diagnosed With Schizophrenia

Background: The “Soteria paradigm” attempts to support people diagnosed with schizophrenia spectrum disorders using a minimal medication approach. Interest in this approach is growing in the United Kingdom, several European countries, North America, and Australasia. Aims: To summarize the findings from all controlled trials that have assessed the efficacy of the Soteria paradigm for the treatment of people diagnosed with schizophrenia spectrum disorders. Methods: A systematic search strategy was used to identify controlled studies (randomized, pseudorandomized, and nonrandomized) employing the Soteria paradigm to treat adults and adolescents meeting the criteria for schizophrenia spectrum disorders according to International Classification of Diseases and Diagnostic and Statistical Manual for Mental Disorders criteria. Results: We identified 3 controlled trials involving a total of 223 participants diagnosed with first- or second-episode schizophrenia spectrum disorders. There were few major significant differences between the experimental and control groups in any of the trials across a range of outcome measures at 2-year follow-up, though there were some benefits in specific areas. Conclusions: The studies included in this review suggest that the Soteria paradigm yields equal, and in certain specific areas, better results in the treatment of people diagnosed with first- or second-episode schizophrenia spectrum disorders (achieving this with considerably lower use of medication) when compared with conventional, medication-based approaches. Further research is urgently required to evaluate this approach more rigorously because it may offer an alternative treatment for people diagnosed with schizophrenia spectrum disorders

X-ray diffraction to probe the kinetics of ice recrystallization inhibition

Understanding the nucleation and growth of ice is crucial in fields ranging from infrastructure maintenance, to the environment, and to preserving biologics in the cold chain. Ice binding and antifreeze proteins are potent ice recrystallization inhibitors (IRI), and synthetic materials that mimic this function have emerged, which may find use in biotechnology. To evaluate IRI activity, optical microscopy tools are typically used to monitor ice grain size either by end-point measurements or as a function of time. However, these methods provide 2-dimensional information and image analysis is required to extract the data. Here we explore using wide angle X-ray scattering (WAXS/X-ray powder diffraction (XRD)) to interrogate 100's of ice crystals in 3-dimensions as a function of time. Due to the random organization of the ice crystals in the frozen sample, the number of orientations measured by XRD is proportional to the number of ice crystals, which can be measured as a function of time. This method was used to evaluate the activity for a panel of known IRI active compounds, and shows strong agreement with results obtained from cryo-microscopy, as well as being advantageous in that time-dependent ice growth is easily extracted. Diffraction analysis also confirmed, by comparing the obtained diffraction patterns of both ice binding and non-binding additives, that the observed hexagonal ice diffraction patterns obtained cannot be used to determine which crystal faces are being bound. This method may help in the discovery of new IRI active materials as well as enabling kinetic analysis of ice growth

Reverse Engineering of Aircraft Wing Data Using a Partial Differential Equation Surface Model

Reverse engineering is a multi-step process used in industry to determine a production representation of an existing physical object. This representation is in the form of mathematical equations that are compatible with computer-aided design and computer-aided manufacturing (CAD/CAM) equipment. The four basic steps to the reverse engineering process are data acquisition, data separation, surface or curve fitting, and CAD/CAM production. The surface fitting step determines the design representation of the object, and thus is critical to the success or failure of the reverse engineering process. Although surface fitting methods described in the literature are used to model a variety of surfaces, they are not suitable for reversing aircraft wings. In this dissertation, we develop and demonstrate a new strategy for reversing a mathematical representation of an aircraft wing. The basis of our strategy is to take an aircraft design model and determine if an inverse model can be derived. A candidate design model for this research is the partial differential equation (PDE) surface model, proposed by Bloor and Wilson and used in the Rapid Airplane Parameter Input Design (RAPID) tool at the NASA-LaRC Geolab. There are several basic mathematical problems involved in reversing the PDE surface model: (i) deriving a computational approximation of the surface function; (ii) determining a radial parametrization of the wing; (iii) choosing mathematical models or classes of functions for representation of the boundary functions; (iv) fitting the boundary data points by the chosen boundary functions; and (v) simultaneously solving for the axial parameterization and the derivative boundary functions. The study of the techniques to solve the above mathematical problems has culminated in a reverse PDE surface model and two reverse PDE surface algorithms. One reverse PDE surface algorithm recovers engineering design parameters for the RAPID tool from aircraft wing data and the other generates a PDE surface model with spline boundary functions from an arbitrary set of grid points. Our numerical tests show that the reverse PDE surface model and the reverse PDE surface algorithms can be used for the reverse engineering of aircraft wing data

A Power Scheduling Software Package for Planetary Habitats

Mankind has established a permanent presence in space with the International Space Station. The next step is building habitats on the Moon or Mars. However, these habitats will have to be nearly self-sustaining because replenishment from Earth will be costly. Power for life support and other electrical devices will be limited and must be monitored and allocated. This thesis develops the framework for power scheduling software to perform these tasks. The software includes a graphical user interface (GUI) to allow the user to interact with the power schedule, a database and server, and a simulation for the effects of device heat production on the habitat air temperature. The software was designed using objectoriented techniques to maximize code reuse and improve maintainability. Design patterns were used to solve common programming problems. In particular, the modelview- controller pattern was used to decouple the data from the GUI views. The algorithm for partitioning the power data is developed using set notation, and the physical equation1 modeling the air temperature change due to device heat dissipation are derived and implemented in the software. Two power-scheduling scenarios arc presented to test the software. The first is uncomplicated to allow comparison of the power partitioning with hand calculations. The second demonstrates scheduling for two devices over a twenty-four hour period. This is a more rigorous test of the GUI and the simulation. The results are compared to the results from a general simulation package

Study of application of practical performance criteria for the implementation of efficient error-reduction coding Final report

Criteria for implementation of efficient error reduction codin

An Improvement Study of the Decomposition-based Algorithm Global WASF-GA for Evolutionary Multiobjective Optimization

The convergence and the diversity of the decompositionbased evolutionary algorithm Global WASF-GA (GWASF-GA) relies on a set of weight vectors that determine the search directions for new non-dominated solutions in the objective space. Although using weight vectors whose search directions are widely distributed may lead to a well-diversified approximation of the Pareto front (PF), this may not be enough to obtain a good approximation for complicated PFs (discontinuous, non-convex, etc.). Thus, we propose to dynamically adjust the weight vectors once GWASF-GA has been run for a certain number of generations. This adjustment is aimed at re-calculating some of the weight vectors, so that search directions pointing to overcrowded regions of the PF are redirected toward parts with a lack of solutions that may be hard to be approximated. We test different parameters settings of the dynamic adjustment in optimization problems with three, five, and six objectives, concluding that GWASF-GA performs better when adjusting the weight vectors dynamically than without applying the adjustment.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Determination of MIC and Disk Diffusion Quality Control Guidelines for Meropenem–Vaborbactam, a Novel Carbapenem/Boronic Acid β-Lactamase Inhibitor Combination

Meropenem–vaborbactam is a carbapenem/cyclic boronic acid β-lactamase inhibitor combination primarily active against Gram-negative bacilli, including those harboring class A serine carbapenemases such as Klebsiella pneumoniae carbapenemase (KPC). A Clinical and Laboratory Standards Institute M23-A4 (Tier 2) quality control study established broth microdilution and disk diffusion ranges for reference strains. Two KPC-producing K. pneumoniae ATCC strains are recommended for quality control testing

A Phenomenological Study of Farmer or Rancher Quality of Life Perceptions Who Have Conditions of Aging, Chronic Health Issues, or Aging

Health care providers with little knowledge or experience in agriculture often provide farmers and ranchers with recommendations anticipated to improve health status, but may negatively affect quality of life (QoL) and participation in valued life activities. Scant data is available to identify QoL as experienced by farmers and ranchers.The study purpose is to identify quality of life factors of farmers and ranchers with conditions of aging, chronic health conditions, and disability.Interviews from five agricultural producers were conducted and transcribed verbatim.Tentative inferences of results are that existing and preferred QoL assessment tools do not accurately represent the distinct qualities and characteristics of farmer and rancher QoL, resulting in biased, inaccurate, or irrelevant data.

Clozapine dose for schizophrenia

Background: Schizophrenia and related disorders such as schizophreniform and schizoaffective disorder are serious mental illnesses characterised by profound disruptions in thinking and speech, emotional processes, behaviour and sense of self. Clozapine is useful in the treatment of schizophrenia and related disorders, particularly when other antipsychotic medications have failed. It improves positive symptoms (such as delusions and hallucinations) and negative symptoms (such as withdrawal and poverty of speech). However, it is unclear what dose of clozapine is most effective with the least side effects. Objectives: To compare the efficacy and tolerability of clozapine at different doses and to identify the optimal dose of clozapine in the treatment of schizophrenia, schizophreniform and schizoaffective disorders. Search methods: We searched the Cochrane Schizophrenia Group’s Study-Based Register of Trials (August 2011 and 8 December 2016). Selection criteria: All relevant randomised controlled trials (RCTs), irrespective of blinding status or language, that compared the effects of clozapine at different doses in people with schizophrenia and related disorders, diagnosed by any criteria. Data collection and analysis: We independently inspected citations from the searches, identified relevant abstracts, obtained full articles of relevant abstracts, and classified trials as included or excluded. We included trials that met our inclusion criteria and reported useable data. For dichotomous data, we calculated the relative risk (RR) and the 95% confidence interval (CI) on an intention-to-treat basis based on a random-effects model. For continuous data, we calculated mean differences (MD) again based on a random-effects model. We assessed risk of bias for included studies and created ’Summary of findings’ tables using GRADE. Main results: We identified five studies that could be included. Each compared the effects of clozapine at very low dose (up to 149 mg/day), low dose (150 mg/day to 300 mg/day) and standard dose (301 mg/day to 600 mg/day). Four of the five included studies were based on a small number of participants. We rated all the evidence reported for the main outcomes of interest as low or very low quality. No data were available for the main outcomes of global state, service use or quality of life. Very low dose compared to low dose: We found no evidence of effect on mental state between low and very low doses of clozapine in terms of average Brief Psychiatric Rating Scale-Anchored (BPRS-A) endpoint score (1 RCT, n = 31, MD 3.55, 95% CI −4.50 to 11.60, very low quality evidence). One study found no difference between groups in body mass index (BMI) in the short term (1 RCT, n = 59, MD −0.10, 95% CI −0.95 to 0.75, low-quality evidence). Very low dose compared to standard dose: We found no evidence of effect on mental state between very low doses and standard doses of clozapine in terms of average BPRS-A endpoint score (1 RCT, n = 31,MD 6.67, 95%CI −2.09 to 15.43, very low quality evidence). One study found no difference between groups in BMI in the short term (1 RCT, n = 58, MD 0.10, 95% CI −0.76 to 0.96, low-quality evidence) Low dose compared to standard dose: We found no evidence of effect on mental state between low doses and standard doses of clozapine in terms of both clinician-assessed clinical improvement (2 RCTs, n = 141, RR 0.76, 95%CI 0.36 to 1.61, medium-quality evidence) and clinically important response as more than 30% change in BPRS score (1 RCT, n = 176, RR 0.93, 95% CI 0.78 to 1.10, medium-quality evidence). One study found no difference between groups in BMI in the short term (1 RCT, n = 57, MD 0.20, 95% CI −0.84 to 1.24, low-quality evidence). We found some evidence of effect for other adverse effect outcomes; however, the data were again limited. Very low dose compared to low dose: There was limited evidence that serum triglycerides were lower at low-dose clozapine compared to very low dose in the short term (1 RCT, n = 59, MD 1.00, 95% CI 0.51 to 1.49). Low dose compared to standard dose: Weight gain was lower at very low dose compared to standard dose (1 RCT, n = 27, MD −2.70, 95% CI −5.38 to −0.02). Glucose level one hour after meal was also lower at very lose dose (1 RCT, n = 58, MD −1.60, 95% CI −2.90 to −0.30). Total cholesterol levels were higher at very low compared to standard dose (1 RCT, n = 58, n = 58, MD 1.00, 95% CI 0.20 to 1.80). Low dose compared to standard dose: There was evidence of fewer adverse effects, measured as lower TESS scores, in the low-dose group in the short term (2 RCTs, n = 266, MD −3.99, 95% CI −5.75 to −2.24); and in one study there was evidence that the incidence of lethargy (RR 0.77, 95% CI 0.60 to 0.97), hypersalivation (RR 0.70, 95% CI 0.57 to 0.84), dizziness (RR 0.56, 95% CI 0.39 to 0.81) and tachycardia (RR 0.57, 95% CI 0.45 to 0.71) was less at low dose compared to standard dose. Authors’ conclusions: We found no evidence of effect on mental state between standard, low and very low dose regimes, but we did not identify any trials on high or very high doses of clozapine. BMI measurements were similar between groups in the short term, although weight gain was less at very low dose compared to standard dose in one study. There was limited evidence that the incidence of some adverse effects was greater at standard dose compared to lower dose regimes. We found very little useful data and the evidence available is generally of low or very low quality. More studies are needed to validate our findings and report on outcomes such as relapse, remission, social functioning, service utilisation, cost-effectiveness, satisfaction with care, and quality of life. There is a particular lack of medium- or long-term outcome data, and on dose regimes above the standard rate