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The treatment response for the negative symptoms of schizophrenia is not ideal, and the efficacy of antidepressant treatment remains a matter of considerable controversy. This systematic review and meta-analysis aimed to assess the efficacy of adjunctive antidepressant treatment for negative symptoms of schizophrenia under strict inclusion criteria.
Methods
A systematic literature search (PubMed/Web of Science) was conducted to identify randomized, double-blind, effect-focused trials comparing adjuvant antidepressants with placebo for the treatment of negative symptoms of schizophrenia from database establishment to April 16, 2025. Negative symptoms were examined as the primary outcome. Data were extracted from published research reports, and the overall effect size was calculated using standardized mean differences (SMD).
Results
A total of 15 articles, involving 655 patients, were included in this review. Mirtazapine (N = 2, n = 48, SMD −1.73, CI −2.60, −0.87) and duloxetine (N = 1, n = 64, SMD −1.19, CI −2.17, −0.21) showed significantly better efficacy for negative symptoms compared to placebo. In direct comparisons between antidepressants, mirtazapine showed significant differences compared to reboxetine, escitalopram, and bupropion, but there were no significant differences between other antidepressants or between antidepressants and placebo. No publication bias for the prevalence of this condition was observed.
Conclusions
These findings suggest that adjunctive use of mirtazapine and duloxetine can effectively improve the negative symptoms of schizophrenia in patients who are stably receiving antipsychotic treatment. Therefore, incorporating antidepressants into future treatment plans for negative symptoms of schizophrenia is a promising strategy that warrants further exploration.
This focused textbook demonstrates cutting-edge concepts at the intersection of machine learning (ML) and wireless communications, providing students with a deep and insightful understanding of this emerging field. It introduces students to a broad array of ML tools for effective wireless system design, and supports them in exploring ways in which future wireless networks can be designed to enable more effective deployment of federated and distributed learning techniques to enable AI systems. Requiring no previous knowledge of ML, this accessible introduction includes over 20 worked examples demonstrating the use of theoretical principles to address real-world challenges, and over 100 end-of-chapter exercises to cement student understanding, including hands-on computational exercises using Python. Accompanied by code supplements and solutions for instructors, this is the ideal textbook for a single-semester senior undergraduate or graduate course for students in electrical engineering, and an invaluable reference for academic researchers and professional engineers in wireless communications.
This chapter mainly investigates the role of Artificial Intelligence (AI) in augmenting search interactions to enhance users’ understanding across various domains. The chapter begins by examining the current limitations of traditional search interfaces in meeting diverse user needs and cognitive capacities. It then discusses how AI-driven enhancements can revolutionize search experiences by providing tailored, contextually relevant information and facilitating intuitive interactions. Through case studies and empirical analysis, the effectiveness of AI-supported search interaction in improving users’ understanding is evaluated in different scenarios. This chapter contributes to the literature on AI and human–computer interaction by highlighting the transformative potential of AI in optimizing search experiences for users, leading to enhanced comprehension and decision-making. It concludes with implications for research and practice, emphasizing the importance of human-centered design principles in developing AI-driven search systems.
Le Liang, Southeast University, Nanjing,Shi Jin, Southeast University, Nanjing,Hao Ye, University of California, Santa Cruz,Geoffrey Ye Li, Imperial College of Science, Technology and Medicine, London
Le Liang, Southeast University, Nanjing,Shi Jin, Southeast University, Nanjing,Hao Ye, University of California, Santa Cruz,Geoffrey Ye Li, Imperial College of Science, Technology and Medicine, London
Le Liang, Southeast University, Nanjing,Shi Jin, Southeast University, Nanjing,Hao Ye, University of California, Santa Cruz,Geoffrey Ye Li, Imperial College of Science, Technology and Medicine, London
Le Liang, Southeast University, Nanjing,Shi Jin, Southeast University, Nanjing,Hao Ye, University of California, Santa Cruz,Geoffrey Ye Li, Imperial College of Science, Technology and Medicine, London
Le Liang, Southeast University, Nanjing,Shi Jin, Southeast University, Nanjing,Hao Ye, University of California, Santa Cruz,Geoffrey Ye Li, Imperial College of Science, Technology and Medicine, London
Le Liang, Southeast University, Nanjing,Shi Jin, Southeast University, Nanjing,Hao Ye, University of California, Santa Cruz,Geoffrey Ye Li, Imperial College of Science, Technology and Medicine, London
Le Liang, Southeast University, Nanjing,Shi Jin, Southeast University, Nanjing,Hao Ye, University of California, Santa Cruz,Geoffrey Ye Li, Imperial College of Science, Technology and Medicine, London
Le Liang, Southeast University, Nanjing,Shi Jin, Southeast University, Nanjing,Hao Ye, University of California, Santa Cruz,Geoffrey Ye Li, Imperial College of Science, Technology and Medicine, London
Le Liang, Southeast University, Nanjing,Shi Jin, Southeast University, Nanjing,Hao Ye, University of California, Santa Cruz,Geoffrey Ye Li, Imperial College of Science, Technology and Medicine, London
Le Liang, Southeast University, Nanjing,Shi Jin, Southeast University, Nanjing,Hao Ye, University of California, Santa Cruz,Geoffrey Ye Li, Imperial College of Science, Technology and Medicine, London
Le Liang, Southeast University, Nanjing,Shi Jin, Southeast University, Nanjing,Hao Ye, University of California, Santa Cruz,Geoffrey Ye Li, Imperial College of Science, Technology and Medicine, London
Le Liang, Southeast University, Nanjing,Shi Jin, Southeast University, Nanjing,Hao Ye, University of California, Santa Cruz,Geoffrey Ye Li, Imperial College of Science, Technology and Medicine, London
Broad-spectrum antibiotic use in febrile neutropenia is often driven by concerns for severe and drug-resistant infections. In select patients who do not have an active infection and improve, their prolonged and unnecessary use contributes to antimicrobial resistance, drug toxicity, and increased healthcare costs. We describe the implementation of an antibiotic de-escalation protocol to reduce inappropriate antibiotic use in febrile neutropenia among hematology patients.
Methods:
We conducted baseline analysis (January–June 2024) of antibiotic use in febrile neutropenia cases admitted under hematology. Interventions included the (i) development of an antibiotic de-escalation protocol to guide clinical management, (ii) a roadshow to educate and improve uptake of this protocol, and (iii) regular feedback via “report cards” for hematology teams. The primary outcome was the proportion of febrile neutropenia cases with inappropriate antibiotic use, with secondary measures including adverse outcomes (in-hospital mortality, Clostridioides difficile infection, need for intensive care).
Results:
Baseline data indicated inappropriate antibiotic use rates of 45.5–66.7% per month from January to June 2024, with 13–28 days of inappropriate therapy. The protocol was developed in July 2024, with a subsequent roadshow to promote its uptake. Regular feedback was provided in the form of “report cards” every 2-monthly thereafter. Post-intervention, inappropriate antibiotic use decreased to a median of 23.35% from July to December 2024, with no observed increase in adverse outcomes.
Conclusions:
The implementation of a structured de-escalation protocol, combined with frequent education and feedback, effectively reduced inappropriate antibiotic use in febrile neutropenia without compromising patient safety.
Oncomelania hupensis (O. hupensis), the sole intermediate host of Schistosoma japonicum, greatly influence the prevalence and distribution of schistosomiasis japonica. The distribution area of O. hupensis has remained extensive for numerous years. This study aimed to establish a valid agent-based model of snail density and further explore the environmental conditions suitable for snail breeding. A marshland with O. hupensis was selected as a study site in Dongting Lake Region, and snail surveys were monthly conducted from 2007 to 2016. Combined with the data from historical literature, an agent-based model of snail density was constructed in NetLogo 6.2.0 and validated with the collected survey data. BehaviorSpace was used to identify the optimal ranges of soil temperature, pH, soil water content, and vegetation coverage for snail growth, development and reproduction. An agent-based model of snail density was constructed and showed a strong agreement with the monthly average snail density from the field surveys. As soil temperature increased, the snail density initially rose before declining, reaching its peak at around 21°C. There were similar variation patterns for other environmental factors. The findings from the model suggested that the optimum ranges of soil temperature, pH, soil water content and vegetation coverage were 19°C to 23 °C, 6.4 to 7.6, 42% to 75%, and 70% to 93%, respectively. A valid agent-based model of snail density was constructed, providing more objective information about the optimum ranges of environmental factors for snail growth, development and reproduction.
Iodine (I) is a trace element with health and environmental significance. Iodate (IO3-), iodide (I-) and organic iodine (org-I) are the major species of iodine that exist in the environment. Dissimilatory IO3--reducing bacteria reduce IO3- to I- directly under anoxic conditions via their IO3- reductases that include periplasmic iodate reductase IdrABP1P2, extracellular DMSO reductase DmsEFAB and metal reductase MtrCAB. IdrAB and DmsEFAB reduce IO3- to hypoiodous acid (HIO) and H2O2. The reaction intermediate HIO is proposed to be disproportionated abiotically into I- and IO3- at a ratio of 2:1. The H2O2 is reduced to H2O by IdrP1P2 and MtrCAB as a detoxification mechanism. Additionally, dissimilatory Fe(III)- and sulfate-reducing bacteria reduce IO3- to I- directly via their IO3- reductases and indirectly via the reduction products Fe(II) and sulfide in the presence of Fe(III) and sulfate, respectively. I--oxidizing bacteria oxidize I- to molecular iodine (I2) directly under oxic conditions via their extracellular multicopper iodide oxidases IoxAC. In addition to I2, a variety of org-I compounds are also produced by the I--oxidizing bacteria during I- oxidation. Furthermore, ammonia-oxidizing bacteria oxidize I- to IO3- directly under oxic conditions, probably via their intracellular ammonia-oxidizing enzymes. Many bacteria produce extracellular reactive oxygen species that can oxidize I- to triiodide (I3-). Bacteria also accumulate I- during which I- is oxidized to HIO by their extracellular vanadium iodoperoxidases. The HIO is then transported into the bacterial cells. Finally, bacteria methylate I- to org-I CH3I, probably via their methyltransferases. Thus, bacteria play crucial and versatile roles in the global biogeochemical cycling of iodine via IO3- reduction, I- oxidation and accumulation and org-I formation.
Purple nutsedge (Cyperus rotundus L.) is one of the world’s resilient upland weeds, primarily spreading through its tubers. Its emergence in rice (Oryza sativa L.) fields has been increasing, likely due to changing paddy-farming practices. This study aimed to investigate how C. rotundus, an upland weed, can withstand soil flooding and become a problematic weed in rice fields. The first comparative analysis focused on the survival and recovery characteristics of growing and mature tubers of C. rotundus exposed to soil-flooding conditions. Notably, mature tubers exhibited significant survival and recovery abilities in these environments. Based on this observation, further investigation was carried out to explore the morphological structure, nonstructural carbohydrates, and respiratory mechanisms of mature tubers in response to prolonged soil flooding. Over time, the mature tubers did not form aerenchyma but instead gradually accumulated lignified sclerenchymal fibers, with lignin content also increasing. After 90 d, the lignified sclerenchymal fibers and lignin contents were 4.0 and 1.1 times higher than those in the no soil-flooding treatment. Concurrently, soluble sugar content decreased while starch content increased, providing energy storage, and alcohol dehydrogenase activity rose to support anaerobic respiration via alcohol fermentation. These results indicated that mature tubers survived in soil-flooding conditions by adopting a low-oxygen quiescence strategy, which involves morphological adaptations through the development of lignified sclerenchymal fibers, increased starch reserves for energy storage, and enhanced anaerobic respiration. This mechanism likely underpins the flooding tolerance of mature C. rotundus tubers, allowing them to endure unfavorable conditions and subsequently germinate and grow once flooding subsides. This study provides a preliminary explanation of the mechanism by which mature tubers of C. rotundus from the upland areas confer flooding tolerance, shedding light on the reasons behind this weed’s increasing presence in rice fields.
In 2018, an Ionplus 200 kV MIni-CArbon DAting System (MICADAS) accelerator mass spectrometer (AMS) was installed at the Laboratory of AMS Dating and the Environment, Nanjing University (NJU-AMS Laboratory), China. The NJU-AMS Laboratory is largely devoted to research on radiocarbon dating and 14C analysis in fields of earth, environmental and archaeological sciences. The laboratory has successfully employed various pretreatment methods, including routine pretreatment of tree rings, buried wood and subfossil wood, seeds, charcoal, pollen concentrates, organic matter, and shells. In this study, operational status of the NJU-AMS is presented, and results of radiocarbon measurements made on different sample types are reported. Measurements on international standards, references of known age, and blank samples demonstrate that the NJU-AMS runs stably and has good reproducibility on measurement of single samples. The facility is capable of measuring 14C in samples with the precision and accuracy that meet the requirements for investigating annual 14C changes, history-prehistory age dating, and Late Quaternary stratigraphic chronology research.