Negative Treatment Effects Research Articles

Positive and negative effects of perampanel treatment on psychiatric and behavioral symptoms in adult patients with epilepsy

PurposesThe purpose of the study was to investigate the positive and negative effects of perampanel (PER) treatment on the psychiatric and behavioral symptoms in patients with epilepsy and to evaluate factors associated with the psychiatric and behavioral changes caused by PER. MethodsWe retrospectively examined medical records of patients with epilepsy treated with PER in the Department of Psychiatry, Epilepsy Center, Nishiniigata Chuo National Hospital. Multiple regression analyses were performed with the psychiatric and behavioral prognoses as dependent variables and clinical characteristics of the patients as independent variables. ResultsThirty-two of 135 patients (23.7%) had psychiatric and behavioral deterioration after the initiation of PER, whereas 22 patients (16.3%) showed improvement in psychiatric and behavioral symptoms after PER administration. Etiology of structural abnormalities, concomitant use of nitrazepam, and comorbidities of irritability and depression were significantly associated with increasing incidence of psychiatric and behavioral deterioration. Concomitant use of carbamazepine was significantly associated with decreasing incidence of psychiatric and behavioral deterioration. Suppression of awareness-impaired seizures by PER, concomitant use of carbamazepine, and comorbidities of insomnia, anxiety, and amnesia were significantly associated with an increasing incidence of psychiatric and behavioral improvement. Improvements in psychiatric symptoms by PER were associated with a reduction in the use of psychotropic drugs. In particular, about 1/4 of benzodiazepines had been discontinued. ConclusionsPerampanel therapy may aggravate or even ameliorate psychiatric and behavioral symptoms in patients with epilepsy. The psychiatric and behavioral prognoses after administration of PER vary depending on the type of psychiatric and behavioral comorbidities in patients with epilepsy. Psychiatric and behavioral symptoms may improve in patients with successful suppression of seizures by PER. Additionally, combination therapy consisting of PER and carbamazepine may be associated with good outcomes of psychiatric and behavioral symptoms in patients with epilepsy.

Abstract GS2-10: Targeting depressive symptoms in younger breast cancer survivors: A randomized controlled trial of mindfulness meditation and survivorship education

Abstract Purpose Breast cancer before age 50 comprises 25% of incident breast cancer cases in women. Younger breast cancer survivors (YBCS) are at increased risk for the negative effects of cancer diagnosis and treatment, including elevated levels of depression and related symptoms (i.e., anxiety, stress, fatigue, sleep disturbance, vasomotor symptoms), leading to significantly diminished quality of life. Patients and Methods This Phase III, randomized, multi-institution trial was designed to examine the efficacy of two brief interventions- mindfulness meditation and survivorship education - for YBCS (ClinicalTrials.gov NCT03025139). We recruited women diagnosed at age 50 or younger with early-stage breast cancer who had completed cancer treatment between 6 months and 5 years earlier and endorsed at least mild depressive symptoms. Participants were randomly assigned to Mindful Awareness Practices (MAPs), Survivorship Education (SE), or wait-list control (WL). Both intervention programs were tailored for YBCS and included 6 weeks of structured content delivered in a group format. Assessments were conducted at baseline, post-intervention, and at 3- and 6- month post-intervention follow-ups. The primary outcome was depressive symptoms (Center for Epidemiologic Studies Depression scale; CESD) at post-intervention; secondary outcomes included anxiety (Generalized Anxiety Disorder-7), fatigue severity (Fatigue Symptom Inventory), sleep disturbance (Insomnia Severity Index), and hot flashes (BCPT symptom checklist). Results We enrolled and randomized 247 women (85 MAPS, 81 SE, 81 WL). On average, participants were 45.4 years old at study entry and had been diagnosed 2.6 years earlier. Linear mixed models were conducted to compare each intervention group to WL on primary and secondary outcomes, controlling for baseline differences across groups in study site, race, and marital status. MAPs led to significant reductions in depressive symptoms at post-intervention and at 3- and 6-month follow-up relative to WL (Ps < .01); see Table 1. SE also led to significant reductions in the CESD at post-intervention and 3-month follow-up (Ps < .01). Both MAPs and SE produced reductions in anxiety at post-intervention relative to WL (Ps < .05), though effects did not persist over follow-up. MAPs also had beneficial effects on other secondary outcomes, yielding significant decreases in fatigue severity, sleep disturbance, and hot flashes that persisted over the 6-month follow-up (Ps < .05). In contrast, there was minimal evidence that SE impacted these outcomes. Conclusion Two brief behavioral intervention programs specially designed for YBCS were effective in reducing depressive symptoms and, in the case of mindfulness, improving related symptoms (fatigue, sleep disturbance) that pose serious threats to younger women’s health and well-being after cancer. These interventions are standardized, manualized, and have the potential for wide dissemination over virtual platforms. Table 1 Adjusted means and standard error (SE) for CESD depressive symptoms by group and time, controlling for study site, race, marital status. A CESD score of 16 or greater indicates moderately severe depressive symptoms. P-values are for differences between intervention and waitlist control groups in change over time between Baseline and Post-Intervention (1-2), Baseline to 3-month Follow-up (1-3), and Baseline to 6-month Follow-up (P 1-4). BaselinePost-intvP (1-2)3 mo FUP (1-3)6 mo FUP (1-4)GroupCESDCESDCESDPCESDMindful Awareness Practices (MAPs)18.4 (1.0)13.6 (1.1).00113.4 (1.1)<.00112.9 (1.1).013Survivorship Education (SE)17.4 (1.1)13.3 (1.1).00713.6 (1.2).00312.7 (1.2).063Waitlist (WL)16.5 (1.1)16.3 (1.1)17.3 (1.2)14.6 (1.1) Citation Format: Patty Ganz, Julienne E Bower, Ann H Partridge, Antonio C Wolff, Elissa D Thorner, Hadine Joffe, Michael R Irwin, Laura Petersen, Laura Petersen, Catherine M Crespi. Targeting depressive symptoms in younger breast cancer survivors: A randomized controlled trial of mindfulness meditation and survivorship education [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr GS2-10.

Effects of late miticide treatments on foraging and colony productivity of European honey bees (Apis mellifera)

Chemical miticides are used routinely in honey bee colonies worldwide as treatment for the parasitic mite Varroa destructor, but there have been very few long-term colony-level field studies of the impacts of miticides on the bees themselves. Lab-based studies with individual bees or bees in small groups have highlighted many negative effects of miticides on bee behaviour and physiology; hence, there is an urgent need to better understand the consequences of miticides on honey bee colonies in an apicultural setting. Here we compared effects of commercial treatments of the miticides tau-fluvalinate and thymol, and controls, on honey bee colonies and bee foraging behaviour over five months, from autumn through winter in Sydney, Australia. Since V. destructor does not occur in Sydney, in this study, we could isolate the direct effects of the miticides from indirect effects resulting from reduced mite load. We found the autumn treatment of either miticide caused no significant change in bee adult or brood population or size of food stores. The average temperature in the thymol group differed from the temperature in the control group and was lower during winter. Neither miticide reduced bee longevity. Tau-fluvalinate caused bees to start foraging earlier in life and perform shorter trips, but no other effects on foraging behaviour were documented. To conclude, in Sydney, Australia, limited negative effects of autumn thymol or tau-fluvalinate treatments were observed on bees or bee colony performance.

Иммуномодулирующие свойства пробиотического препарата «ВедаБиотик» при старении

The homeostatic immunological dialogue between the host and its microbiota is critical to maintaining health. The weakening of the organism occurring with age, its greater dependence on the external life conditions, make old age the period of the greatest morbidity. In the context of a progressive increase in life expectancy, more and more attention is being paid to the possibility of influencing human health through personalized nutritional and therapeutic strategies aimed at modifying the intestinal microbiota, which include the use of pro- and prebiotics. The aim of this work is to study the effect of the VedaBiotic preparation, which is an original complex of probiotics (freeze-dried biomass of live active bifidobacteria, lactobacilli, Streptococcus thermophilus), prebiotics (microcrystalline cellulose, lactulose) and vitamin C, on the cellular immune response and functional activity of immunocytes in age-dependent mammals (male mice at the age of 10 months). It was found that in age-dependent mammals, a course administration of the drug leads to the stimulation of the proliferative activity of immunocytes and the cellular immune response, also including the case of the induced immunosuppression (when the delayed-type hypersensitivity reaction increased to the level observed in intact animals of similar age). The VedaBiotic also has a modulating effect on the cytokines production, causing a decrease in the pro-inflammatory cytokines IL-1β and IFN-γ, and an increase in the anti-inflammatory cytokine IL-10. Thus, the VedaBiotic preparation has a favorable immunomodulatory effect and can be used as a nutritional supplement — as a source of probiotic microorganisms — to reduce the negative side effects of cytostatic treatment, as well as by elderly persons to improve the quality of life and to prevent the development of age-associated pathology.

Medication of Postpartum Depression and Maternal Outcomes: Evidence from Geographic Variation in Dutch Prescribing

Using data on over 420,000 first time Dutch mothers, we examine the effects of postpartum antidepressant use on a wide range of maternal outcomes including further treatment for severe mental illness, labor market outcomes, and family formation. We exploit rules which state that Dutch general practitioners (GPs) must be available to make house calls to their patients. In practice many therefore use postal code boundaries to limit their practices. We instrument a postpartum woman’s receipt of antidepressants with the propensity to prescribe antidepressants to women aged 46 to 65 among GPs in her postal code. Ordinary Least Squares estimates suggest highly negative effects of postpartum treatment with antidepressants, but this is mainly due to selection into treatment. Instrumental variable estimates suggest that the marginal patient treated with postpartum antidepressants is much more likely to continue taking antidepressants long-term, with little evidence of effects on other outcomes.

Youth and parent perceptions on participating in specialized multidisciplinary pain rehabilitation options: A qualitative timeline effect analysis

ABSTRACT Background: Little is known about how the specialized treatment journey is perceived by youth with pain-related disability and their parents. Aims: Describe and compare the treatment effects and outcomes as perceived by youth and their parents enrolled in intensive interdisciplinary pain treatment (IIPT) or multimodal treatment (MMT). Methods: Eleven IIPT youth and five parents and three MMT youth and five parents were recruited. All were asked to complete a treatment journey timeline, followed by separately conducted semistructured interviews. Transcribed interviews were analyzed using reflective thematic analysis. Results: The main themes spanned the treatment trajectory. All participants described similar initial struggles (Theme 1). Positive and negative treatment effects associated with acquisitions and disruptions (Theme 2), and outcomes post-discharge related to supports and realities (Theme 3) emerged. Knowledge, skills, and support acquisition during treatment and feeling empowered and confident to self-manage postdischarge were identified as IIPT benefits. However, the change effort and life disruptions required and the difficulty transitioning to real life postprogram were acknowledged as detrimental IIPT impacts. Continuing with life as usual and maintaining supports in daily contexts (e.g., school personnel, friends) were reported MMT benefits. However, the challenges of managing pain, treatment adherence within the competing demands of daily realities, and the lack of support to integrate strategies were emphasized as detrimental MMT impacts. Conclusions: Detailed impacts of two specialized multidisciplinary pain rehabilitation interventions on the lives of youth with pain-related disability and their parents are described. The treatments benefits and previously unexplored detrimental effects are unveiled.

The Effectiveness of Technology-Aided Monitoring for Early Childhood Vaccination Coverage: Evidence from a Natural Experiment

Achieving population-wide vaccination coverage against vaccine-preventable diseases (VPDs) remains a challenge across the globe. A promising solution involves technology-aided monitoring and accountability, which has promised to improve vaccination rates. The current study estimates the impact of a similar intervention on early childhood vaccination rates in the province of Punjab, Pakistan. During late 2014, E-VACCS (an Electronic Vaccine Registration System) was implemented across the province of Punjab, one of the four provinces in Pakistan. We use yearly data (2010-2019) from Pakistan Social and Living Standards Measurement Survey (PSLM) in a difference-in-differences framework to exploit the natural across-province over-time variation offered to us by Punjab’s adoption of E-VACCS. We analyze the impact of E-VACCS on complete vaccination coverage as well as antigen-specific vaccination rates. Our analysis suggests that E-VACCS did improve vaccination coverage but these increases are largely driven by specific sub-populations. The intervention led to a 2.2% increase in the instance of a child having received at least 1 dose of vaccination. Across urban households, we find a 6.2% increase in vaccination coverage on the intensive margin. However these treatment effects within urban areas are limited to mid-high income households. Our estimates for antigen-specific rates of vaccination coverage confirm similar trends. Among urban mid-high income households, improvements occurred in the antigen-specific coverage rates for vaccines administered towards the end of the childhood vaccination cycle (.e.g D-Tap-3 or Hep-B-3). However for rural low-income households, we find negative treatment effects for antigen-specific vaccine coverage rates, particularly for the three hepatitis doses. The results suggest that the increase in vaccination coverage across urban mid-high income households came at the expense of a significant decrease in coverage across low-income rural households, signaling redirection of critical resources. Our estimates remain robust to several variations in the specifications. Further robustness checks are provided through event study plots and synthetic control methods.

Cellular benefits of single-use negative pressure wound therapy demonstrated in a novel ex vivo human skin wound model.

Negative pressure wound therapy is a widely used treatment for chronic, nonhealing wounds. Surprisingly, few studies have systematically evaluated the cellular and molecular effects of negative pressure treatment on human skin. In addition, no study to date has directly compared recently available single‐use negative pressure modalities to traditional negative pressure devices in a controlled setting. Here we developed a novel large‐scale ex vivo human skin culture system to effectively evaluate the efficacy of two different negative pressure wound therapy modalities. Single‐use and traditional negative pressure devices were applied to human ex vivo wounded skin sheets cultured over a period of 48 hours. Cellular tissue response to therapy was evaluated via a combination of histological analysis and transcriptional profiling, in samples collected from the wound edge, skin adjacent to the wound, and an extended skin region. Single‐use negative pressure wound therapy caused less damage to wound edge tissue than traditional application, demonstrated by improved skin barrier, reduced dermal‐epidermal junction disruption and a dampened damage response. Transcriptional profiling confirmed significantly less activation of multiple pro‐inflammatory markers in wound edge skin treated with single‐use vs traditional negative pressure therapy. These findings may help to explain the greater efficacy of sNPWT in the clinic, while offering a noninvasive system to develop improved NPWT‐based therapies.

Do Body-Worn Cameras Change Law Enforcement Arrest Behavior? A National Study of Local Police Departments

Controlling police officers’ discretionary behavior during public encounters has been an important issue in U.S. policing, especially following several high-profile police-involved deaths of racial minorities. In response, body-worn cameras (BWCs) were introduced to enhance police accountability by providing police managers an opportunity to monitor police–public encounters. Although many U.S. local police departments have now implemented BWC programs, evidence of program effects on daily police behavior has been limited. This study therefore focuses on whether officers’ arrest behavior changes when they perceive that BWCs are recording their interactions with the public. By conducting a difference-in-differences analysis using 142 police departments, I found that BWCs have negative and small treatment effects on arrest rates and null effects on the racial disparity between numbers of Black and White arrests. These findings imply that officers may become slightly more cautious in the use of arrests after wearing BWCs, but BWCs do not change their overall disparate treatment of Black versus White suspects. The results further indicate that the effects of BWCs on arrests are prominent in municipalities with high crime rates or a high proportion of non-White residents, which suggests that BWC programs demonstrate different effects according to the characteristics of communities served.

Sleep Well, Endoscopist: January 2021 Annals of Emergency Medicine Journal Club

Sleep Well, Endoscopist: January 2021 Annals of Emergency Medicine Journal Club

Effect of continuous positive airway pressure on maximal exercise capacity in patients with obstructive sleep apnea: a systematic review and meta-analysis.

Exercise capacity is impaired in obstructive sleep apnea (OSA). There are conflicting reports on the effect of continuous positive airway pressure (CPAP) on maximal exercise capacity. The objective of this review was to determine if there is a change in exercise capacity and anaerobic threshold following CPAP treatment in OSA patients. We conducted a systematic review and meta-analyses to summarize the changes in peak rate of oxygen uptake (V̇O₂ peak) or maximum rate of oxygen uptake (V̇O2 max) and anaerobic threshold (AT) during cardiopulmonary exercise testing following CPAP intervention in patients with OSA. A systematic literature review was conducted to identify published literature on markers of V̇O₂ peak, V̇O₂ max, and AT pre- vs post-CPAP using a web-based literature search of PubMed/MEDLINE, Embase, CINAHL, and Cochrane review (CENTRAL) databases. Two independent reviewers screened the articles for data extraction and analysis. The total search of all the databases returned 470 relevant citations. Following application of eligibility criteria, 6 studies were included in the final meta-analysis for V̇O₂ peak, 2 studies for V̇O₂ max, and five studies for AT. The meta-analysis showed a mean net difference in V̇O₂ peak between pre- and post-CPAP of 2.69 mL·kg-1·min-1, P = .02, favoring treatment with CPAP. There was no difference in V̇O₂ max or AT with CPAP treatment (mean net difference 0.66 mL·kg-1·min-1 [P = .78] and -144.98 mL·min-1 [P = .20] respectively). There is a paucity of high-quality studies investigating the effect of CPAP on exercise capacity. Our meta-analysis shows that V̇O₂ peak increases following CPAP treatment in patients with OSA, but we did not observe any change in V̇O₂ max or AT. Our findings should be considered preliminary and we recommend further randomized controlled trials to confirm our findings and to clarify the peak and maximum rates of oxygen uptake adaptations with CPAP therapy.

Association between multidisciplinary team care and the completion of treatment for oral squamous cell carcinoma: A cohort population-based study.

This study investigates the relationship between multidisciplinary team care (MDTC) and patient completion of their treatment regimen for oral squamous cell carcinoma (OSCC). We conducted a retrospective cohort study in patients diagnosed with OSCC in Taiwan from 1 January 2016 to 30 June 2018 using a linked cancer registry database. Of the 969 OSCC MDTC patients in the study cohort, 6.3% reported incomplete treatment, with 1.3% interrupting ongoing treatment and 5.0% terminating definitive treatment. Patients who had advanced-stage disease, experienced primary cancer recurrence or a secondary cancer, or were treated with surgery combined with chemotherapy, radiotherapy or chemoradiotherapy were more likely to terminate treatment before completion. The major reasons for interruption of ongoing treatment included 'patient or their family considered the patient to be in poor physical condition' and 'difficulty enduring physical discomfort caused by treatment'. The major reason for termination of definitive treatment was 'patient or their families or friends experienced negative treatment effects and worried about the side-effects of treatment'. Advanced-stage cancer, recurrence or secondary cancer, and surgery combined with chemotherapy, radiotherapy or chemoradiotherapy negatively affected treatment completion. MDTC allows for shared decision-making to determine the optimal treatment.

Countervailing Effects of Targeted Incentives on Test Scores: Experimental Evidence from India

We present results from a large-scale, randomized cluster experiment involving over 14,000 undergraduate students, in which college cohorts were randomly assigned to one of four groups: i) rank-based incentives for low-income students, ii) rank-based incentives for students belonging to historically discriminated social groups, iii) rank-based incentives for all students and iv) control group to, test the direct and indirect impact of targeted incentives in future high-stakes, anonymized university exams in India. We find a negative impact of income-targeted incentives but no impact of socially targeted or untargeted incentives on student test scores. The negative income-targeted treatment effect is driven by non-poor peers excluded from the rewards. We show that income-based incentives targeted a subset of high-achieving students from low income but socially advantaged backgrounds, inducing competition, and reducing cooperation from high-achieving peers. Our findings are relevant to settings where peer learning is salient and suggest that an approach to preferential targeting should take into account complementarities in peer effort.

The Economic Cost of the Islamic Revolution and War for Iran: Synthetic Counterfactual Evidence

ABSTRACT This study estimates the joint effect of a new political regime and war against Iraq, on Iran’s per capita Gross Domestic Product (‘GDP,’ constant 2010 US$) for the period 1978–1988, during the revolution/war. I use a synthetic control approach, whereby a synthetic Iran is constructed as a weighted average of other Middle East and North Africa (‘MENA’)/Organization of the Petroleum Exporting (‘OPEC’) countries to match the average level of some key per capita GDP correlates over the period 1970–1977 as well as the evolution of the actual Iranian per capita GDP during that period. I find a sizable negative effect of the joint treatment. The average Iranian lost an accumulated sum of approximately US$ 34,660 during 1978–1988 (i.e. the average annual real per capita income loss of US$ 3,150). This loss equals 40% of the real income per capita, which an Iranian could earn in the absence of revolution and war. The confidence sets based on constant, linear, and uniform assumptions of treatment effect show that estimated income loss for Iran is sizeable and statistically significant. The results remain robust to a set of placebo tests.

Evaluation of outpatient cancer rehabilitation for upper extremity functioning for individuals with breast cancer.

287 Background: Specialized cancer rehabilitation is recommended for individuals with breast cancer from diagnosis throughout survivorship to mitigate the negative acute, late and lasting effects of cancer and cancer treatment on upper extremity functioning. However, evidence supporting the impact of community-based outpatient rehabilitation services is lacking, especially for older adults. Methods: Individuals with breast cancer attended cancer-specialized outpatient physical or occupational therapy provided by a single institution with multiple locations across the US in 2019, and completed the Quick DASH (Disabilities of the Arm, Shoulder and Hand). From de-identified rehabilitation records, we abstracted patient and therapy characteristics, Quick DASH scores and therapy satisfaction scores (0-10 point scale) for individuals with a history of breast cancer (identified by ICD code). We used descriptive statistics to summarize characteristics, paired samples t-tests to evaluate Quick DASH scores from initial evaluation (pre) and discharge (post) therapy, and independent samples t-test to compare mean pre-post difference for individuals younger than 65 ( < 65) versus 65 and older (≥ 65). Results: Patients ( N= 556) were 60.56 ± 12.24 (range = 31.52-89.95) years old and predominantly female ( n= 551, 99.1%). They attended cancer rehabilitation (Physical: n= 477, 85.8%, Occupational: n = 79 (14.2%)) for a median of 8 ( IQR= 5.0 – 13.0) sessions over 8.97 ± 7.57 (range = 0.71-47.7) weeks. Average pre-post change in Quick DASH score (-13.51) was significant (p < .01) and exceeded the validated minimal clinically important difference (-11.20). There was no significant difference between average pre-post change for Quick Dash scores between < 65 (n = 334, 60.1%) and ≥ 65 (n = 222, 39.9%) groups (-15.84 vs. -10.01, p = .07). Therapy satisfaction was rated high (median = 10.0, IQR = 10.0-10.0). Conclusions: Specialized rehabilitation for individuals with breast cancer was associated with statistically and clinically significant improvement in upper extremity function and high rates of satisfaction. Older adults demonstrated benefits similar to younger adults. These findings add to the growing evidence for specialized outpatient cancer rehabilitation.

Iodine-rich thermal water in cure and rehabilitation from the perspective of the thyroid gland

Bei einzelnen Schilddrüsenerkrankungen (Immunthyreopathie Morbus Basedow, Immunthyreopathie Hashimoto, Struma mit Autonomie) sollte eine übermäßige Jodzufuhr vermieden werden. Betreffend alimentärer Jodzufuhr gibt es dazu reichliches Informationsmaterial. Kuranwendungen werden zu einem breiten Indikationsspektrum eingesetzt und tragen einen wichtigen Teil zur Therapie gerade chronisch degenerativen Erkrankungen, zur Rehabilitation nach Traumen oder Tumorerkrankungen bei. Eine Jodzufuhr ist auch bei Kuranwendungen mit jodhaltigem Thermalwasser möglich, das Ausmaß der Jodzufuhr ist dabei abhängig von der Applikationsform und der Expositionsdauer. Informationsmaterial dazu ist nur spärlich in der Literatur zu finden. Der Artikel betrachtet jodhaltige Kuranwendungen aus thyreologischer Sicht im Spannungsfeld von positiven und möglichen negativen Auswirkungen einer jodhaltigen Kuranwendung. Neben einem Einblick in die Physiologie und Pathophysiologie des Jodstoffwechsels und Auswirkungen auf einzelne Schilddrüsenerkrankungen wird die Intensität einer Jodaufnahme bei unterschiedlichen Kuranwendungen dargestellt. Eine Übersicht von Kurorten/Thermen mit jodhaltigem Wasser in Österreich und seinen Nachbarstaaten ergänzt von einem Algorithmus zur Selektion von Patienten für eine Kur in Kurorten mit jodhaltigem Wasser wird präsentiert, um mögliche negative jodinduzierte Schilddrüsenfehlfunktionen schon vor Kurantritt zu vermeiden. Dem klinisch tätigen Arzt wird damit eine Unterstützung in der Entscheidungsfindung bei der Auswahl bzw. Ablehnung einer jodhaltigen Kuranwendung für seine Patienten zur Verfügung gestellt.Zusatzmaterial onlineZusätzliche Informationen sind in der Online-Version dieses Artikels (10.1007/s10354-020-00782-x) enthalten.

Believing is achieving - On the role of treatment expectation in neurofeedback applications

In neurofeedback applications, neural activity is recorded, processed in real-time and fed back to the user in order to facilitate self-regulation of the putative neural mechanisms that underlie cognition and behavior. Numerous studies suggest that neurofeedback interventions are an efficacious treatment particularly for patients with attention-deficit/hyperactivity disorder (ADHD). In recent years, however, findings of several well-controlled studies raised doubts concerning the proposed mechanism of action behind the behavioral effect of neurofeedback. This study investigated the impact of expectation on the efficacy of a sensorimotor rhythm (SMR) training. In a within-subjects design 30 blinded volunteers with ADHD symptoms received a standard SMR training session after inducing no (no-expectancy condition), positive (placebo condition), and negative (nocebo condition) expectations regarding the effectiveness of neurofeedback (by telling them that they would train a specific frequency band that was previously shown to be either unrelated to attention, should improve attention, or interfere with attentional processes). After each training, participants were presented with a cognitive test and subsequently requested to rate their performance on it. We could show that participants were able to successfully modify their EEG signal during training. Further, we found an effect over trainings on objective attentional performance. Most importantly, we found that the expectancy of positive or negative treatment effects considerably changed participants' perception of neurofeedback's efficacy even in the absence of any objective evidence. This study presents strong first evidence for a substantial effect of self-confirming response expectancies as one factor underlying the efficacy of neurofeedback. Future research has to carefully consider the impact of such psychosocial mechanisms when evaluating the (specific) efficacy of neuromodulatory treatments.

Impact of bio-inoculation with Bradyrhizobium spp. on yield and Seed quality of forage cowpea (Vigna unguiculata L.) under soil salinity conditions

A study was carried out to assess the effect of single and/or combined inoculation with Bradyrhizobium spp. isolates on seed yield and quality of forage cowpea (Vigna unguiculata cv. Baladi) under salinity-affected soil conditions. The experiment was conducted in a split plot design for two growing seasons, 2018 and 2019, with two main plot treatments of irrigation water (normal and saline) and four sub-plot inoculation treatments. Results revealed that sub-main plot treatments differed significantly for number of branches, number of pods, pod length, number of seeds pod-1, pod weight plot-1 (Kg) and seed yield (Kg fed-1) of forage cowpea plants as affected by the type of irrigation water in the two growing seasons. Also, combination treatment (Bradyrhizobium SARS-Rh3 and Bradyrhizobium SARS-Rh5) significantly minimized the negative effects of saline irrigation water treatment for seed content of elements (N, P, K, Zn, Mn, Fe and Cu). In the same context, inoculation treatments followed the descending order of SARS-Rh3 + SARS-Rh5 > SARS-Rh5 > SARS-Rh3 > control for total carbohydrate and protein % of cowpea seeds during 2018 and 2019 seasons. For assessment of seed quality viz., seed germination (%), seedling length (cm), seedling weight (g), vigour index I and vigour index II were higher in 2019 than 2018 season. Similar finding was observed in economic evaluation for SARS-Rh3+SARS-Rh5 treatment which enhanced profitability of cowpea during the two growing seasons.

Anticholinergic burden and cognitive functions in schizophrenia: a systematic literature review

Abstract Background Cognitive dysfunction in schizophrenia forms the key cause of the disease's disability, leading in serious functional implications at the individual level and socioeconomic effects at global level. Dopaminergic-cholinergic balance is considered essential to cognitive function in schizophrenia while patients are often treated with many drugs with anticholinergic activity. This study aims to examine the association between high anticholinergic burden medication and cognitive function in schizophrenia patients. Methods A systematic review was performed on English language research studies published on PubMed from inception to December 2019 focusing on the effect of anticholinergic loads on cognitive domains in schizophrenia. No restrictions on study designs, age or geographical distribution were applied. Two researchers performed independently the screening and shortlisting of the eligible articles. A narrative synthesis of the main characteristics and the findings of included studies was reported. Results In total, fourteen articles of varying methodological design met the inclusion criteria. Three of them found significant improvement in cognition after anticholinergic discontinuation without adverse effects. Eleven studies found a significant association between high anticholinergic burden and cognitive impairment (e.g. verbal memory, information processing speed and working memory). However, the magnitude of the association in the largest study is statistically significant but of dubious clinical significance. Conclusions Medication with increased anticholinergic load has been found in most of the studies to affect the cognitive functions of people with schizophrenia. However, the lack of clinical and methodological homogeneity of selected studies, limit our interpretation and conclusions. Key messages There is some evidence indicating a negative effect of anticholinergic drug treatment on cognitive function of schizophrenia patients. Well-designed large prospective studies and randomized clinical trials are required to examine the effect of anticholinergic drug treatment in the cognition of schizophrenia patients.

From genetics to epigenetics to unravel the etiology of adolescent idiopathic scoliosis.

Scoliosis is defined as the three-dimensional (3D) structural deformity of the spine with a radiological lateral Cobb angle (a measure of spinal curvature) of ≥10° that can be caused by congenital, developmental or degenerative problems. However, those cases whose etiology is still unknown, and affect healthy children and adolescents during growth, are the commonest form of spinal deformity, known as adolescent idiopathic scoliosis (AIS). In AIS management, early diagnosis and the accurate prediction of curve progression are most important because they can decrease negative long-term effects of AIS treatment, such as unnecessary bracing, frequent exposure to radiation, as well as saving the high costs of AIS treatment. Despite efforts made to identify a method or technique capable of predicting AIS progression, this challenge still remains unresolved. Genetics and epigenetics, and the application of machine learning and artificial intelligence technologies, open up new avenues to not only clarify AIS etiology, but to also identify potential biomarkers that can substantially improve the clinical management of these patients. This review presents the most relevant biomarkers to help explain the etiopathogenesis of AIS and provide new potential biomarkers to be validated in large clinical trials so they can be finally implemented into clinical settings.