Patients' previous experience with performance-based cognitive tests in clinical trials for cognitive impairment associated with schizophrenia can create practice-related improvements. ...Placebo-controlled trials for cognitive impairment associated with schizophrenia are at risk for these practice effects, which can be difficult to distinguish from placebo effects.
To conduct a systematic evaluation of the magnitude of practice effects on the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery (MCCB) in cognitive impairment associated with schizophrenia and to examine which demographic, clinical, and cognitive characteristics were associated with improvement in placebo conditions.
A blinded review was conducted of data from 813 patients with schizophrenia who were treated with placebo in 12 randomized placebo-controlled clinical trials conducted mostly in outpatient clinics in North America, Europe, Asia, and Latin America from February 22, 2007, to March 1, 2014. A total of 779 patients provided data for the primary outcome measure at baseline and at least 1 follow-up. Seven trials had prebaseline assessments wherein the patients knew that they were not receiving treatment, allowing a comparison of practice and placebo effects in the same patients.
Placebo compared with various experimental drug treatments.
Composite score on the MCCB.
Of the 813 patients in the study (260 women and 553 men; mean SD age, 41.2 11.5 years), the mean MCCB composite score at baseline was 22.8 points below the normative mean, and the mean (SEM) total change in the MCCB during receipt of placebo was 1.8 (0.2) T-score points (95% CI, 1.40-2.18), equivalent to a change of 0.18 SD. Practice effects in the 7 studies in which there was a prebaseline assessment were essentially identical to the postbaseline placebo changes. Baseline factors associated with greater improvements in the MCCB during receipt of placebo included more depression/anxiety (F1,438 = 5.41; P = .02), more motivation (F1,272 = 4.63; P = .03), and less improvement from screening to baseline (F1,421 = 59.32; P < .001).
Placebo effects were minimal and associated with the number of postbaseline assessments and several patient characteristics. Given that the patients performed 2.28 SDs below normative standards on average at baseline, a mean placebo-associated improvement of less than 0.2 SD provides evidence that ceiling effects do not occur in these trials. These minimal changes in the MCCB could not be responsible for effective active treatments failing to separate from placebo.
The COVID-19 pandemic has hugely affected the world and human lives, the economy, and lifestyles. The pandemic control measures, such as lockdowns, forced many people to migrate from their ...destination to their source in various states, leading to increased vulnerability of migrants. The present review aimed to explore the different health, economic, and social impacts on internal migrants of India during the pandemic. The publications on internal migration and COVID-19 from India were retrieved from PubMed and Google Scholar using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 159 articles were extracted, of which 28 were reviewed. The articles published after March 1, 2020, were included in the review, irrespective of the design. Out of 28 articles, only half were original studies; the rest were either perspective, opinion, and review studies or editorial and commentary papers. Depression, anxiety, and stress due to job loss and lockdown were the major health issues documented. There was livelihood disturbance due to loss of income, such as inability to pay rent, loans, borrowing from relatives, and fear of its consequences. The migrants also faced stigma and discrimination from the villagers. The review also highlighted that although the government implemented various schemes to help the migrants, the majority were left out due to the non-availability of identity proof and ration cards. The safeguarding measures for these unregistered migrants must be facilitated to access health, economic, and social protection. Although various publications have focused on the mental health of the migrants, the socio-ecological aspects have been least explored, which calls for further studies. The literature on the impact of COVID-19 on other vulnerable populations like women and children and access to healthcare services is also scant, which needs to be explored further.
Gentrification changes the neighborhood and family contexts in which children are socialized—for better and worse—yet little is known about its consequences for youth. This review, drawn from ...research in urban planning, sociology, and psychology, maps out mechanisms by which gentrification may impact children. We discuss indicators of gentrification and link neighborhood factors, including institutional resources and collective socialization, to family processes more proximally related to child development. Finally, we discuss implications for intervention and public policy recommendations that are intended to tip the scales toward better outcomes for low-income youth in gentrifying areas.
Background. Anti-citrullinated protein antibodies have been detected with high specificity in serum of patients with rheumatoid arthritis (RA), and citrullination of proteins may play a key role in ...the pathogenesis of RA. We therefore investigated the presence of citrullination in two extra-articular manifestations of RA, interstitial pneumonia (IP) and rheumatoid nodules.
Methods. Open-lung biopsy specimens from patients with RA-associated IP (n = 18), idiopathic IP (n = 20) and controls (n = 10), as well as specimens of rheumatoid nodules from 26 patients, were examined. All sections were incubated with an anti-modified citrulline antibody. Masked scoring of stained sections and analysis of results by stratification according to demographic and clinical characteristics was performed.
Results. Presence of citrulline could be detected in eight lung specimens of patients with RA-associated IP (44%) and nine patients with idiopathic IP (46%). Conversely, lung tissue from control patients showed weak extracellular citrullination in only two cases (20%). Citrullination did not show any significant associations with demographic or clinical characteristics such as age, gender, smoking habits, disease severity, histological subtype, degree of inflammation or steroid use.
Rheumatoid nodules were citrulline positive in a majority of cases (70%).
Conclusion. Citrullination is present in extra-articular manifestations of RA such as IP and nodules. In contrast to the high specificity of anti-citrulline antibodies in RA, citrullination is not only restricted to RA but can also be observed in idiopathic IP. Whether citrullination significantly contributes to the initiation or perpetuation of autoimmunity or merely reflects ongoing inflammation remains to be clarified.
SUMMARY
In the Earth’s upper mantle, seismic anisotropy mainly originates from the crystallographic preferred orientation (CPO) of olivine due to mantle deformation. Large-scale observation of ...anisotropy in surface wave tomography models provides unique constraints on present-day mantle flow. However, surface waves are not sensitive to the 21 coefficients of the elastic tensor, and therefore the complete anisotropic tensor cannot be resolved independently at every location. This large number of parameters may be reduced by imposing spatial smoothness and symmetry constraints to the elastic tensor. In this work, we propose to regularize the tomographic problem by using constraints from geodynamic modelling to reduce the number of model parameters. Instead of inverting for seismic velocities, we parametrize our inverse problem directly in terms of physical quantities governing mantle flow: a temperature field, and a temperature-dependent viscosity. The forward problem consists of three steps: (1) calculation of mantle flow induced by thermal anomalies, (2) calculation of the induced CPO and elastic properties using a micromechanical model, and (3) computation of azimuthally varying surface wave dispersion curves. We demonstrate how a fully nonlinear Bayesian inversion of surface wave dispersion curves can retrieve the temperature and viscosity fields, without having to explicitly parametrize the elastic tensor. Here, we consider simple flow models generated by spherical temperature anomalies. The results show that incorporating geodynamic constraints in surface wave inversion help to retrieve patterns of mantle deformation. The solution to our inversion problem is an ensemble of models (i.e. thermal structures) representing a posterior probability, therefore providing uncertainties for each model parameter.
Segregation of household waste at the source is an effective and sustainable strategy for management of municipal waste. However, household segregation levels remain insufficient as waste management ...approaches are mostly top down and lack local support. The realisation and recognition of effective, improved and adequate waste management may be one of the vital drivers for attaining environmental protection and improved health and well-being. The presence of a local level motivator may promote household waste segregation and ultimately pro-environmental behaviour. The present cluster randomized control trial aims to understand if volunteer based information on waste segregation (I-MISS) can effectively promote increased waste segregation practices at the household level when compared with existing routine waste segregation information in an urban Indian setting.
This paper describes the protocol of an 18 month two-group parallel,cluster randomised controlled trialin the urban setting of Ujjain, Madhya Pradesh, India. Randomization will be conducted at ward level, which is the last administrative unit of the municipality. The study will recruit 425 households in intervention and control groups. Assessments will be performed at baseline (0 months), midline (6 months), end line (12 months) and post intervention (18 months). The primary outcome will be the comparison of change in proportion of households practicing waste segregation and change in proportion of mis-sorted waste across the study period between the intervention and control groups as assessed by pick analysis. Intention to treat analysis will be conducted. Written informed consent will be obtained from all participants.
The present study is designed to study whether an external motivator, a volunteer selected from the participating community and empowered with adequate training, could disseminate waste segregation information to their community, thus promoting household waste segregation and ultimately pro-environmental behaviour. The study envisages that the volunteers could link waste management service providers and the community, give a local perspective to waste management, and help to change community habits through information, constant communication and feedback.
The study is registered prospectively with Indian Council of Medical Research- Clinical Trial Registry of India ( CTRI/2020/03/024278 ).
This paper reports the development of a new specific diagnostic technique to accurately quantify airborne inoculum of Sclerotinia sclerotiorum and discusses its potential use in disease-forecasting ...schemes, using examples of three contrasting epidemic seasons: 2007, when there was a severe epidemic of sclerotinia stem rot (SSR) in England and high numbers of airborne ascospores were trapped at Rothamsted, and, in contrast, 2003 and 2004, when the incidence of SSR in England was low and low numbers of airborne ascospores were trapped at Rothamsted. DNA was extracted from wax-coated plastic tapes, such as those used in Burkard (Hirst-type) spore traps and rotating-arm traps. A SYBR-green quantitative PCR (qPCR) method produced a linear relationship between ascospore numbers and S. sclerotiorum DNA (mean 0·35 pg DNA per spore) and was able to detect DNA representing as few as two ascospores. The technique was insensitive to DNA of the host plant, Brassica napus, and other plant pathogens, including Sclerotinia minor, S. trifoliorum and Botrytis cinerea, and common airborne fungal genera such as Cladosporium and Penicillium. There was no relationship between rainfall and numbers of airborne ascospores of S. sclerotiorum present at Rothamsted during the period of infection in the severe SSR season (2007).
Although the primary aim of pollicization is to augment function, aesthetic improvement is an important secondary aim. Satisfaction with hand appearance in children with index pollicization for thumb ...hypoplasia was evaluated in 18 patients at an average of 7.5 years after surgery. Patients and their parents rated the appearance of their operated hand using a 10-point visual analogue scale (VAS). Four independent surgeons and 16 non-surgeon observers also rated the hands after reviewing standardized photographs of each child. The median patient-reported and parent-reported scores were 9 for both groups (IQR: 7–10) with a trend for children 12 years and older, to report lower satisfaction with appearance. The non-surgeon group assessments varied more for a given hand than the surgeons’ assessments, though when scores were averaged within these groups for each hand, there was a high degree of correlation between the two groups. Surprisingly, the patient's own assessment showed a trend towards negative correlation when compared with the average rating of the non-surgeon assessors, suggesting that patients’ own assessment of their hand's appearance is more affected by subjective factors than the objective physical outcome.
Cognitive impairment is a common and pervasive feature of etiologically diverse disorders of the central nervous system, and a target indication for a growing number of symptomatic and disease ...modifying drugs. Remotely acquired digital endpoints have been recognized for their potential in providing frequent, real-time monitoring of cognition, but their ultimate value will be determined by the reliability and sensitivity of measurement in the populations of interest. To this end, we describe initial validation of remote self-administration of cognitive tests within a regulatorily compliant tablet-based platform. Participants were 61 older adults (age 55+), including 20 individuals with subjective cognitive decline (SCD). To allow comparison between remote (in-home) and site-based testing, participants completed 2 testing sessions 1 week apart. Results for three of four cognitive domains assessed demonstrated equivalence between remote and site-based tests, with high cross-modality ICCs (absolute agreement) for Symbol Coding (ICC = 0.75), Visuospatial Working Memory (ICC = 0.70) and Verbal Fluency (ICC > 0.73). Group differences in these domains were significant and reflected sensitivity to objective cognitive impairment in the SCD group for both remote and site-based testing (
< 0.05). In contrast, performance on tests of verbal episodic memory suggested inflated performance during unmonitored testing and indicate reliable use of remote cognitive assessments may depend on the construct, as well as the population being tested.
In this work, the thermal stability of the room temperature ionic liquid (RTIL) 1-ethyl-3-methylimidazolium ethylsulfate (EMIMEtSO4) is investigated using infrared (IR) spectroscopy. Quantitative IR ...absorption spectral data are measured for heated EMIMEtSO4. Spectra have been collected between 25 ℃ and 100 ℃ using a heated optical cell. Multiple samples and cell pathlengths are used to determine quantitative values for the molar absorptivity of EMIMEtSO4. These results are compared to previous computational models of the ion pair. These quantitative spectra are used to measure the rate of thermal decomposition of EMIMEtSO4 at elevated temperatures. The spectroscopic measurements of the rate of decomposition show that thermogravimetric methods overestimate the thermal stability of EMIMEtSO4.
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