Randomized, double-blind, sham-controlled trial to evaluate the efficacy and tolerability of electroconvulsive therapy in patients with clozapine-resistant schizophrenia

There is no established treatment for patients with clozapine-resistant schizophrenia (CRS). Clozapine augmentation strategies with antipsychotics or others substances are effective in comparison with placebo while and Electroconvulsive therapy (ECT) showed to be effective in comparison with treatment as usual (TAU) but not with placebo (sham-ECT). In the present double- blind randomized controlled trial, we compared 40 outpatients who received 20 sessions of ECT (n = 21) or sham-ECT (n = 19) (age = 37.40 ± 9.62, males = 77.5 %, illness duration = 14.95 ± 8.32 years, mean total Positive and Negative Syndrome Scale (PANSS) = 101.10 ± 24.91) who fulfilled well-defined CRS criteria including baseline clozapine plasma levels ≥350 ng/mL. The primary outcome was the ≥50 % PANSS Total Score reduction; secondary outcomes were the scores of the PANSS subscales, PANSS five-factor dimensions, PANSS-6 and the Calgary Depression Rating Scale (CDRS). Treatment response was analyzed by percentage reduction, Linear Mixed Models and effect sizes. At baseline both groups showed no differences except for years of school education (included as a covariate). At endpoint, only 1/19 of the completers (5.26 %) in the ECT group and 0/17 in the sham-ECT group showed a ≥50 % total PANSS score reduction. Both groups showed no significant differences of the total PANSS score (F = 0.12; p = 0.73), Positive (F = 0.27, p = 0.61), Negative (F = 0.25, p = 0.62), and General Psychopathology scores (F = 0.01, p = 0.94) as well for all PANSS five factors, the PANSS-6 and CDRS. Thus, the present study found no evidence that ECT is better than Sham-ECT in patients with CRS. Future sham-ECT controlled studies with larger sample sizes are warranted to test the efficacy of ECT for patients with CRS.

Deafness in Australian Cattle Dogs associated to QTL on chromosome 20 in genome-wide association study analyses

Pigment-associated deafness is a common hereditary condition in a range of dog breeds. The aim of this study was to perform a genome-wide association analysis to investigate the genetic architecture of deafness in Australian Cattle Dogs. Genotypes for 104 757 polymorphisms in 216 dogs were available for analyses after quality control. A genomic relationship matrix was used in the mixed model analyses to account for polygenic effects, as we tested each polymorphism for its association with deafness, in a case/control experimental design. Three approaches were used to code the genotypes and test for additive, recessive and dominant SNP effects. The genome-wide association study analyses identified a clear association peak on CFA20, with the most significant SNPs on this chromosome (1.29 × 10^-4 ) in the vicinity of MITF. Variants in MITF have been associated with white pigmentation in dogs and with deafness in humans and other species, supporting the premise that canine deafness is associated with variants in or near this gene. A recessive inheritance for the peak in CFA20 is possible given the significant results in the recessive model; however, the estimated heritability was low (4.54 × 10^-5 ). Further validation, identification of variants and testing in other dog breeds are needed.

272 Proposing a combination of heritable fertility traits for bull selection

Traits such as sperm morphology and motility are routine in veterinarian evaluations of bull fertility. However, they rarely are included in livestock breeding programs, which typically use only scrotal circumference (SC) and some female traits for fertility selection. We studied 25 male fertility traits measured in two research populations of bulls (1,099 Brahman, and 1,719 Tropical Composite) and one commercial population (2,490 Santa Gertrude bulls). Measurements included standard semen evaluation (e.g. sperm motility and morphology) and SC. In the research data, we also measured sperm DNA fragmentation and sperm protamine deficiency for about 50% of the bulls. Using a mixture of genomic and pedigree analyses, we estimated heritabilities and genetic correlations for all traits, in each population. Our analyses suggest that bull fertility traits have a heritable component, which makes selective breeding possible. The phenotype variation in sperm DNA fragmentation and sperm protamine deficiency traits also have a heritable component (h2 ~ 0.05–0.22). These first estimates for heritability of sperm chromatin phenotypes require further studies, with larger datasets, to corroborate present results. In all three populations, we observed genetic correlations across traits that were favorable, but not high. For example, the percentage of normal sperm (PNS) from the sperm morphology evaluation was positively correlated with SC. In the research data, sperm DNA fragmentation was negatively correlated with PNS (r2 ~ 0.23–0.33), meaning that bulls with a higher PNS had less DNA fragmentation, being therefore more fertile according to both indicators. Given the favorable and yet not high genetic correlations between traits, it is possible to envision that sperm chromatin phenotypes might form a panel, together with PNS and SC, for a comprehensive bull fertility index. Selection indices that include fertility traits are being implemented in the dairy industry and could be recommended for beef cattle, too. An index that benefits from the favorable genetic correlations between traits that describe different aspects of bull fertility is a sensible approach to selective breeding. The clinical use of complementary indicators for male fertility is largely accepted, when deciding on bull fitness for the mating season. We propose extending this rationale to create a multi-trait index that captures genetic merit for bull fertility. In addition, we performed genome-wide association analyses in the research data and identified eight QTLs in the X chromosome. Correlations and shared SNP associations support the hypothesis that these phenotypes have the same underlying cause: abnormal spermatogenesis. In conclusion, it is possible to improve bull fertility through selective breeding, by measuring complementary fertility traits. Genomic selection for bull fertility might be more accurate if the X chromosome mutations that underlie the discovered QTL are included in the analyses. Polymorphisms associated with fertility in the bull accumulate in the X chromosome, as they do in humans and mice, thus suggesting specialization of this chromosome.

Validation of a shortened assessment of physical self in adults

The purpose was to adapt a brief tool, the Physical Self Inventory-Version b, for the assessment of physical self in adults. The inventory is a refined version of the previously validated version, which was derived from the Physical Self Inventory (25 items). This French validation of the Physical Self-Perception Profile of Fox and Corbin includes a global self-esteem scale. As in the earlier version the current one has 6 single items to assess dimensions of global self-esteem, physical selfworth, sport competence, physical condition, attractive body, and physical strength. Rating is performed on a visual analog scale. Items in the new inventory were stated in the first person and in more general terms to be acceptable to a wider range of subjects. An item of measurement error was added. Analysis of responses of 185 men and 148 women to the new version supported the hierarchical structure. Significant correlations between the scores and constructs like masculinity, neuroticism, and depression indicated external validity. The new inventory showed acceptable psychometric properties for use in idiographic studies.

Gender difference in coping strategies among patients enrolled in an inpatient rehabilitation program

BACKGROUND

Previous research has not addressed gender differences in coping strategies among patients with mild to moderate chronic obstructive pulmonary disease (COPD) who are enrolled in inpatient and multidisciplinary rehabilitation programs.

METHODS

The coping strategies of 182 consecutive patients (61 women aged 61.1 years; 121 men aged 62.7 years) with mild to moderate COPD were assessed on admission and then at discharge after 29 days of pulmonary rehabilitation, using the Coping Inventory for Stressful Situations. A one-way analysis of variance for repeated measures was used to test the differences in coping scores.

RESULTS

During the rehabilitation program, problem-focused strategies increased (+2.54 [95% confidence interval: 1.41-3.67] with F=23.77, P<.0001), emotion-focused strategies decreased (-2.75 [95% confidence interval: -4.06, -1.45], F=15.37, P<.001), and avoidance strategies were differently (t=2.97, P<.05) influenced in women (+2.43 [95% confidence interval: .66-4.19]) compared with men (-1.30 [95% confidence interval: -2.82-.22]). The prevalence of COPD in women is increasing, and rehabilitation professionals need a greater awareness of how women cope differently than men with this disease.

The Dynamics of Self-Esteem in Adults Over a 6-Month Period: An Exploratory Study

In this exploratory study, the authors examined the dynamics of self-esteem in 8 adults over a 6-month period. Each participant (M age = 29.4 years, SD = 7.9, SEM = 2.8) completed a single item from the Physical Self Inventory (G. Ninot, M. Fortes, & D. Delignières, 2001) using a 10-cm visual analog scale (horizontal line), twice a day between 7:00 and 9:00 a.m. and between 7:00 and 9:00 p.m. Time series analyses, including autocorrelation and autoregressive integrated moving average (ARIMA) procedures, showed that global self-esteem dynamics were neither stable, stationary, nor random. The ARIMA procedures indicated that this perceived dimension functioned as a moving average (0, 1, 1) without a significant constant, thus suggesting a short-term dynamic adjustment. This pattern is a typical signature of a complex system submitted to several constraints and not an indication of personality trait or state.

The fractal dynamics of self-esteem and physical self

The aim of this paper was to determine whether fractal processes underlie the dynamics of self-esteem and physical self. Twice a day for 512 consecutive days, four adults completed a brief inventory measuring six subjective dimensions: global self-esteem, physical self-worth, physical condition, sport competence, attractive body, and physical strength. The obtained series were submitted to spectral analysis, which allowed their classification as fractional Brownian motions. Three fractal analysis methods (Rescaled Range analysis, Dispersional analysis, and Scaled Windowed Variance analysis) were then applied on the series. These analyses yielded convergent results and evidenced long-range correlation in the series. The self-esteem and physical self series appeared as anti-persistent fractional Brownian motions, with a mean Hurst exponent of 0.21. These results reinforce the conception of self-perception as the emergent product of a dynamical system composed of multiple interacting elements.

Surgical considerations about the anterior syphon knee of the internal carotid artery. An anatomical study

An anatomical study about the anterior knee of the intracavernous carotid artery is presented. Twenty cavernous sinuses (CS) were dissected in cadavers using microsurgical techniques. A fibrous ring around the internal carotid artery (ICA) at the CS roof was found in all specimens. This fibrous attachment could be dissected from the surrounding dura and a loose connective tissue could be demonstrated around the ICA. This anatomical finding makes possible the microsurgical approach to vascular lesions of this portion of the ICA, without opening the cavernous sinus.