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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.
To investigate the association of dietary patterns (DP) with prediabetes and type 2 diabetes (T2D) among Tibetan adults, first to identify DP associated with abdominal obesity and examine their relationships with prediabetes and T2D. Additionally, the study aims to investigate the mediating effects of body fat distribution and altitude on the associations between these DP and the prevalence of prediabetes and T2D.
Design:
An open cohort among Tibetans.
Setting:
Community-based.
Participants:
The survey recruited 1003 participants registered for health check-ups from November to December 2018 and 1611 participants from December 2021 to May 2022. During the baseline and follow-up data collection, 1818 individuals participated in at least one of the two surveys, with 515 of them participating in both.
Results:
Two DP were identified by reduced rank regression. DP1 had high consumption of beef and mutton, non-caloric drink and offal and low intake in tubers and roots, salty snacks, onion and spring onion, fresh fruits, desserts and nuts and seeds; DP2 had high intake of whole grains, Tibetan cheese, light-coloured vegetables and pork and low intake of sugar-sweetened beverages, whole-fat dairy products and poultry. Individuals in the highest tertile of DP1 showed higher risks of prediabetes (OR 95 % CI) 1·35 (1·05, 1·73) and T2D 1·36 (1·05, 1·76). The highest tertile of DP2 exhibited an elevated risk of T2D 1·63 (1·11, 2·40) in full adjustment.
Conclusion:
Abdominal adiposity-related DP are positively associated with T2D. Promoting healthy eating should be considered to prevent T2D among Tibetan adults.
We created a web-based design guide to transfer our previous research findings to better support design education in the digital health design area for improving patient experience. To seek insights to iteratively improve the design guide, we conducted a workshop with 19 MSc students who specialized in design for healthcare. The guide was perceived as having the potential to improve their understanding of digital PEx improvements, but the content clarity and information presentation need to be improved.
Do bilinguals have similar bilingual control mechanisms in speaking and writing? The present study investigated the patterns of switch costs (reflecting reactive language control) and mixing costs (reflecting proactive language control) between Chinese (L1) and English (L2) in spoken and written productions and whether these patterns could be modulated by response-stimulus intervals (RSIs). In two experiments, unbalanced Chinese–English bilinguals completed a cued language switching task in spoken naming (Experiment 1) and written naming (Experiment 2), respectively. The results revealed asymmetrical switch costs (i.e., the larger cost in L1 than in L2) in spoken and written productions in the short RSI condition. However, there were asymmetrical mixing costs in spoken production and symmetrical mixing costs in written production both in the short and long RSIs. These findings suggest that for spoken and written productions, reactive language control operates in similar mechanisms, while proactive language control operates in specific mechanisms.
Lubricants are an essential component in high-performance mechanical equipment, but traditional lubricants are becoming inadequate for meeting the increasing demands for anti-friction and anti-wear properties and they discharge harmful chemicals to the environment. The purpose of the present study was to explore the use of sepiolite as a novel oil additive to extend the performance of lubricants. Sepiolite nanofibers were first treated by acid followed by a dry air flow, aimed at increasing the pore volume and decreasing the particle size. Then the nanofibers were further modified by an organosilane coupling agent to reduce the surface free energy and to improve the dispersion stability in lubricant. A significant improvement in the performance of the lubricant was achieved by using the modified sepiolite nanofibers as an additive. When the amount of modified sepiolite nanofibers added was 1.5 wt.%, the best performance was demonstrated by the lubricant, showing a viscosity increase at 40°C and 100°C, and an increase in resistance to oxidation. Moreover, the acid value and pour point decreased, and the copper sheet corrosion level dropped to its lowest value.
The question of whether L2 learners can use discourse cues online during pronoun resolution remains debated in the field. We examine one factor that has been argued to impact pronoun resolution in native speakers, implicit causality (IC) bias, a property related to certain verbs in which one of verb’s arguments are considered to be the cause of an action. We investigate whether individual differences modulate sensitivity to IC bias in both native English speakers and Chinese-speaking learners of English, examining whether variability is similarly explained in the two populations. Results from a sentence completion task and a self-paced reading (SPR) task show similar sensitivity to IC bias in both groups; reading times on the SPR task were also modulated by working memory and vocabulary knowledge. The findings suggest that L2 learners are successful in using discourse-level cues during processing and that variability is qualitatively similar in both learners and natives.
The Huangshaping deposit is unique in southern Hunan Province, China, as it hosts economic reserves of both W–Mo and Pb–Zn mineralization, which are usually associated with granite and granodiorite porphyry in this area, respectively. This study reports results of in situ LA-MC-ICP-MS sulphur isotopic composition analyses conducted on sulphides from both W–Mo and Pb–Zn mineralization from the Huangshaping deposit with the aim of constraining ore genesis for this deposit. All samples from the proximal W–Mo mineralization have relatively uniform and high δ34S values (8.7 ‰ to 16.0 ‰), close to the range for carbonate sediments in this deposit (13.8 ‰ to 18.1 ‰). These patterns suggest that the granite porphyry in this deposit was the sulphur source for W–Mo mineralization, and that the assimilation of evaporite from the carbonate sediments led to the high δ34S values of the granite porphyry. Sulphides from the Pb–Zn mineralization have δ34S values (2.2 ‰ to 10.3 ‰) lower than those of the W–Mo mineralization, and generally increase in this paragenetic order, with the lowest δ34S values being similar to those of the basement (3.8 ‰ to 7.7 ‰). These patterns indicate that the original sulphur for the Pb–Zn mineralization was most likely derived from the basement, with input of sulphur from the carbonate sediments increasing during the evolution of ore-forming fluids. On the basis of the measured sulphur isotopic compositions, it is suggested that the ore-forming materials for the W–Mo mineralization were derived from the granite porphyry, whereas ore-forming materials extracted from the basement dominated the Pb–Zn mineralization.
This review intends to provide an overview of revealed preferences of decision-makers for recommendations of cancer drugs in health technology assessment (HTA) among the different agencies.
Methods
A systematic literature search was performed in MEDLINE and EMBASE databases from inception to July 2020. The studies were eligible for inclusion if they conducted a quantitative analysis of HTA’s previous decisions for cancer drugs. The factors with p-values below the significance level of .05 were considered as the statistically significant factors for HTA decisions.
Results
A total of nine studies for six agencies in Australia, Belgium, France, South Korea, the UK, and Canada were eligible to be included. From the univariable analysis, improvements in clinical outcomes and cost-effectiveness were found as significant factors for the agencies in Belgium, South Korea, and Canada. From the multivariable analysis, cost-effectiveness was found as a positive factor for the agencies in the UK, South Korea, and Canada. Few factors related to characteristics of disease and technology were found to be significant among the included agencies.
Conclusions
Despite the different drug reimbursement systems and the socioeconomic situations, cost-effectiveness and/or improvement on clinical outcomes seemed to be the most important factors for recommendations of cancer drugs among the agencies.
A pedagogical agent (PA) is a computerized humanlike onscreen image whose purpose is to guide the learner’s attention and facilitate learning. In this chapter, the main findings from research on pedagogical agents are reviewed and a meta-analysis is used to reveal the specific role of PAs on learning outcomes, yielding an effect size of g = .45 on transfer performance and g = .23 on retention performance. We also examine explanations for why PAs could have a positive effect on learning performance based on social agency theory, the embodiment principle, and the signaling principle. In addition, this chapter summarizes the main moderating variables for the effect of PAs, including characteristics of the learner such as the learner's prior knowledge, characteristics of the learning environment such as the subject matter, and characteristics of the PA such as voice and gesture.
The present study evaluated whether fat mass assessment using the triceps skinfold (TSF) thickness provides additional prognostic value to the Global Leadership Initiative on Malnutrition (GLIM) framework in patients with lung cancer (LC). We performed an observational cohort study including 2672 LC patients in China. Comprehensive demographic, disease and nutritional characteristics were collected. Malnutrition was retrospectively defined using the GLIM criteria, and optimal stratification was used to determine the best thresholds for the TSF. The associations of malnutrition and TSF categories with survival were estimated independently and jointly by calculating multivariable-adjusted hazard ratios (HR). Malnutrition was identified in 808 (30·2 %) patients, and the best TSF thresholds were 9·5 mm in men and 12 mm in women. Accordingly, 496 (18·6 %) patients were identified as having a low TSF. Patients with concurrent malnutrition and a low TSF had a 54 % (HR = 1·54, 95 % CI = 1·25, 1·88) greater death hazard compared with well-nourished individuals, which was also greater compared with malnourished patients with a normal TSF (HR = 1·23, 95 % CI = 1·06, 1·43) or malnourished patients without TSF assessment (HR = 1·31, 95 % CI = 1·14, 1·50). These associations were concentrated among those patients with adequate muscle mass (as indicated by the calf circumference). Additional fat mass assessment using the TSF enhances the prognostic value of the GLIM criteria. Using the population-derived thresholds for the TSF may provide significant prognostic value when used in combination with the GLIM criteria to guide strategies to optimise the long-term outcomes in patients with LC.
Childhood trauma is a vulnerability factor for the development of obsessive–compulsive disorder (OCD). Empirical findings suggest that trauma-related alterations in brain networks, especially in thalamus-related regions, have been observed in OCD patients. However, the relationship between childhood trauma and thalamic connectivity in patients with OCD remains unclear. The present study aimed to examine the impact of childhood trauma on thalamic functional connectivity in OCD patients.
Methods
Magnetic resonance imaging resting-state scans were acquired in 79 patients with OCD, including 22 patients with a high level of childhood trauma (OCD_HCT), 57 patients with a low level of childhood trauma (OCD_LCT) and 47 healthy controls. Seven thalamic subdivisions were chosen as regions of interest (ROIs) to examine the group difference in thalamic ROIs and whole-brain resting-state functional connectivity (rsFC).
Results
We found significantly decreased caudate-thalamic rsFC in OCD patients as a whole group and also in OCD_LCT patients, compared with healthy controls. However, OCD_HCT patients exhibited increased thalamic rsFC with the prefrontal cortex when compared with both OCD_LCT patients and healthy controls.
Conclusions
Taken together, OCD patients with high and low levels of childhood trauma exhibit different pathological alterations in thalamic rsFC, suggesting that childhood trauma may be a predisposing factor for some OCD patients.
A recently developed pneumonia caused by SARS-CoV-2 has quickly spread across the world. Unfortunately, a simplified risk score that could easily be used in primary care or general practice settings has not been developed. The objective of this study is to identify a simplified risk score that could easily be used to quickly triage severe COVID-19 patients. All severe and critical adult patients with laboratory-confirmed COVID-19 on the West campus of Union Hospital, Wuhan, China, from 28 January 2020 to 29 February 2020 were included in this study. Clinical data and laboratory results were obtained. CURB-65 pneumonia score was calculated. Univariate logistic regressions were applied to explore risk factors associated with in-hospital death. We used the receiver operating characteristic curve and multivariate COX-PH model to analyse risk factors for in-hospital death. A total of 74 patients (31 died, 43 survived) were finally included in the study. We observed that compared with survivors, non-survivors were older and illustrated higher respiratory rate, neutrophil-to-lymphocyte ratio, D-dimer and lactate dehydrogenase (LDH), but lower SpO2 as well as impaired liver function, especially synthesis function. CURB-65 showed good performance for predicting in-hospital death (area under curve 0.81, 95% confidence interval (CI) 0.71–0.91). CURB-65 ⩾ 2 may serve as a cut-off value for prediction of in-hospital death in severe patients with COVID-19 (sensitivity 68%, specificity 81%, F1 score 0.7). CURB-65 (hazard ratio (HR) 1.61; 95% CI 1.05–2.46), LDH (HR 1.003; 95% CI 1.001–1.004) and albumin (HR 0.9; 95% CI 0.81–1) were risk factors for in-hospital death in severe patients with COVID-19. Our study indicates CURB-65 may serve as a useful prognostic marker in COVID-19 patients, which could be used to quickly triage severe patients in primary care or general practice settings.
The aim of the present study was to investigate the effects of dietary Zn level on growth performance, Zn bioaccumulation, antioxidant capacity and innate immunity in juvenile mud crabs (Scylla paramamosain). Six semi-purified diets were formulated to contain dietary Zn levels of 44·5, 56·9, 68·5, 97·3, 155·6 or 254·7 mg/kg. Dietary Zn level significantly influenced percentage weight gain (PWG), with the highest observed in crabs fed the diet containing 97·3 mg/kg Zn. Tissue Zn concentrations significantly increased as dietary Zn levels increased from 44·5 to 254·7 mg/kg. Retention of Zn in hepatopancreas increased with dietary Zn levels up to 68·5 mg/kg and then significantly decreased. Moreover, inadequate dietary Zn (44·5 and 56·9 mg/kg) reduced antioxidation markers including total superoxide dismutase (SOD) and Cu/Zn SOD activities and total antioxidant level. Crabs fed the diet with 44·5 mg/kg Zn also showed significantly lower expression of genes involved in antioxidant status, such as Cu/Zn SOD, glutathione peroxidase, catalase and thioredoxin than those fed diets containing 68·5 and 97·3 mg/kg Zn. The highest activities of phenoloxidase and alkaline phosphatase were recorded in crabs fed the diets containing 68·5 and 97·3 mg/kg Zn. Expression levels of prophenoloxidase and toll-like receptor 2 were higher in crabs fed the 97·3 mg/kg Zn diet compared with crabs fed the other diets. Based on PWG alone, the optimal dietary Zn level was estimated to be 82·9 mg/kg, with 68·5 to 97·3 mg/kg recommended for maintaining optimal Zn bioaccumulation, oxidation resistance and innate immune response of juvenile mud crabs.
Most of original studies indicated maternal violence experiences is associated with adverse obstetric outcomes, to date, but it is not clear that the association of maternal violence experiences and the risk of postpartum depression (PPD). We aimed to assess the association between maternal violence experiences and risk of developing PPD by performing a meta-analysis of cohort studies.
Methods:
PubMed, Google Scholar, Cochrane Libraries and Chinese databases were searched through December 2017 to identify studies that assessed the association between violence and PPD. Meta-analysis was conducted by the RevMan software and Stata software. Potential heterogeneity source was explored by subgroup analysis and potential publication bias was assessed by Begg's funnel plots and Egger’s linear regression test.
Results:
Overall, women experiencing any violence events compared with the reference group were at a higher risk of developing PPD (odds ratio [OR] = 2.04; 95% confidence interval [CI]: 1.72–2.41). Additionally, different types of violence events such as sexual (OR = 1.56; 95%CI: 1.35–1.81), emotional (OR = 1.75; 95%CI: 1.61–1.89), and physical violence (OR = 1.90; 95%CI: 1.36–2.67), as well as domestic (OR = 2.05; 95%CI: 1.50–2.80) or childhood violence (OR = 1.59; 95%CI: 1.34–1.88) also increased the risk of developing PPD. Relevant heterogeneity moderators have been identified by subgroup analysis. Sensitivity analysis yielded consistent results.
Conclusions:
Maternal violence experiences are significantly associated with risk of developing PPD. These finding highlight the necessary to protect women from any types of violence and formulate preventive strategies to promote the maternal mental health.
Episodic memory starts to decline very early in the development of Alzheimer’s disease (AD). Subtle impairments in memory binding may be detected in mild cognitive impairment (MCI). This study aims to examine the psychometric properties of the Chinese version of the memory binding test (MBT).
Methods:
One hundred and sixty-four subjects (26 individuals with AD, 67 individuals with amnestic MCI (aMCI), 30 individuals with subjective cognitive impairment (SCI), and 41 cognitively normal elderly individuals (NC)) participated in the study. Twenty-two subjects repeated the assessment of the MBT within 6 weeks (± 2 weeks). Pearson correlation was used to calculate the convergent validity. The test––retest reliability was determined by the calculation of the intraclass correlation coefficient (ICC). Discriminative validity was calculated to evaluate the receiver–operating characteristic curves. The optimal index was chosen by comparing the area under the curve for specificity and sensitivity ≥ 0.80. The optimal cutoff score of the index was chosen to maximize the sum of sensitivity and specificity.
Results:
The absolute value of the convergent validity of the direct indexes of MBT ranged from 0.443 to 0.684. The ICC for each of direct indexes was 0.887–0.958. Total delayed paired recall (TDPR) was the optimal index for discriminating aMCI from NC. The cutoff score for TDPR was ≤25 to distinguish aMCI from NC (sensitivity = 0.896, specificity = 0.707).
Conclusion:
The Chinese version of MBT is a valid and reliable instrument to detect MCI.
The pathophysiology of obsessive-compulsive disorder (OCD) remains unclear despite extensive neuroimaging work on the disorder. Exposure to medication and comorbid mental disorders can confound the results of OCD studies. The goal of this study was to explore differences in brain functional connectivity (FC) within the cortico-striato-thalamo-cortical (CSTC) loop of drug-naïve and drug-free OCD patients and healthy controls (HCs).
Methods
A total of 29 drug-naïve OCD patients, 22 drug-free OCD patients, and 25 HCs matched on age, gender and education level underwent functional magnetic resonance imaging scanning at resting state. Seed-based connectivity analyses were conducted among the three groups. The Yale Brown Obsessive Compulsive Scale and clinical inventories were used to assess the clinical symptoms.
Results
Compared with HCs, the drug-naïve OCD patients had reduced FC within the limbic CSTC loop. In the drug-naïve OCD participants, we also found hyperconnectivity between the supplementary motor area and ventral and dorsal putamen (p < 0.05, corrected for multiple comparisons).
Conclusions
Exposure to antidepressants such as selective serotonin reuptake inhibitors may affect the function of some brain regions. Future longitudinal studies could help to reveal the pharmacotherapeutic mechanisms in these loops.
Endometrial injury is an important cause of intrauterine adhesion (IUA), amenorrhea and infertility in women, with limited effective therapies. Recently, stem cells have been used in animal experiments to repair and improve injured endometrium. To date, our understanding of adipose-derived stem cells (ADSCs) in endometrial injury repair and their further therapeutic mechanisms is incomplete. Here, we examined the benefit of ADSCs in restoration of injured endometrium by applying a rat endometrial injury model. The results revealed by immunofluorescence showed that green fluorescent protein (GFP)-labelled ADSCs can differentiate into endometrial epithelial cells in vivo. At 30 days after ADSCs transplantation, injured endometrium was significantly improved, with increased microvessel density, endometrial thickness and glands when compared with the model group. Furthermore, the fertility of rats with injured endometrium in ADSCs group was improved and had a higher conception rate (60% vs 20%, P = 0.014) compared with the control phosphate-buffered saline (PBS) group. However, there was no difference in the control group compared with the sham group. In addition, expression levels of the oestrogen receptor Eα/β (ERα, ERβ) and progesterone receptor (PR) detected by western blot and enzyme-linked immunosorbent assay (ELISA) were higher in the ADSCs group than in the PBS group. Taken together, these results suggested that ADSC transplantation could improve endometrial injury as a novel therapy for IUA.
Current available methods to detect cow milk adulteration or accidental contamination of goat milk are both laborious and time consuming. The aim of this technical research communication was to develop a simple, rapid, specific and sensitive method for quantitative detection of cow milk in goat milk. A competitive lateral flow immunoassay (LFIA) strip was developed using a specific monoclonal antibody (mAb) labeled with colloidal gold nanoparticles (GNPs) for specifically binding to cow milk casein. The detection limit of this rapid detection was 0.07% of cow milk in goat milk, providing equal specificity and higher sensitivity when compared with a commercial enzyme-linked immunosorbent assay (ELISA). These result suggest that the established rapid GNPs-LFIA strip could be used for monitoring cow milk adulteration/contamination of goat milk.
Pine wilt disease, which is caused by the pine wood nematode (PWN), Bursaphelenchus xylophilus, has caused huge damage to pine forests around the world. In this study, we analysed the PWN transcriptome to investigate the expression of genes related to the associated bacterial species Pseudomonas fluorescens and found that the gene adh-1 encoding alcohol dehydrogenase (ADH) was upregulated. The open reading frame of adh-1, which encoded a protein of 352 amino acid residues, was cloned from B. xylophilus. Recombinant ADH with a relative molecular weight of 39 kDa, was present mainly in inclusion bodies and was overexpressed in Escherichia coli BL21 (DE3) and purified after refolding. The biochemical assay revealed that recombinant ADH could catalyse the dehydrogen reaction of eight tested alcohols including ethanol in the presence of NAD+. Quantitative real-time RT-PCR analysis indicated that ethanol upregulated adh-1 expression in PWN. Results of RNA interference and inhibition of ADH treatment indicated that downregulating expression of adh-1 or inhibition of ADH could reduce ethanol tolerance and the vitality and reproduction ability of B. xylophilus, suggesting that adh-1 is involved in pathogenicity of PWN.
The role of the cerebellum in obsessive-compulsive disorder (OCD) has drawn increasing attention. However, the functional connectivity between the cerebellum and the cerebral cortex has not been investigated in OCD, nor has the relationship between such functional connectivity and clinical symptoms.
Methods
A total of 27 patients with OCD and 21 healthy controls (HCs) matched on age, sex and education underwent magnetic resonance imaging (MRI). Seed-based connectivity analyses were performed to examine differences in cerebellar-cerebral connectivity in patients with OCD compared with HCs. Associations between functional connectivity and clinical features in OCD were analyzed.
Results
Compared with HCs, OCD patients showed significantly decreased cerebellar-cerebral functional connectivity in executive control and emotion processing networks. Within the OCD group, decreased functional connectivity in an executive network spanning the right cerebellar Crus I and the inferior parietal lobule was positively correlated with symptom severity, and decreased connectivity in an emotion processing network spanning the left cerebellar lobule VI and the lingual gyrus was negatively correlated with illness duration.
Conclusions
Altered functional connectivity between the cerebellum and cerebral networks involved in cognitive-affective processing in patients with OCD provides further evidence for the involvement of the cerebellum in the pathophysiology of OCD, and is consistent with impairment in executive control and emotion regulation in this condition.