Scale Total Score Research Articles

Olanzapine vs. magnesium valproate vs. lamotrigine in anti-N-methyl-D-aspartic acid receptor encephalitis: a retrospective study

BackgroundThis study aimed to compare the impact of olanzapine, magnesium valproate, and lamotrigine as adjunctive treatments for anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. And it is expected to add supporting points related to the rebalance of neurotransmitters in the brain through adjuvant therapy in the clinical management of anti-NMDAR encephalitis.MethodsThis retrospective study included patients diagnosed with anti-NMDAR encephalitis who received standardized immunotherapy at Hunan Brain Hospital between January 2018 and December 2020.ResultsCompared to the olanzapine group, both the magnesium valproate and lamotrigine groups showed lower scores on the positive and negative symptom scale (PANSS) total score after 3 weeks of treatment (all P < 0.05). The Montreal Cognitive Assessment Scale (MoCA) scores in the magnesium valproate and lamotrigine groups were significantly higher than in the olanzapine group after 3 weeks and 3 months of treatment (all P < 0.05). After 3 months of treatment, the proportions of patients with a modified Rankin scale score (mRS) of 0–1 in the magnesium valproate and lamotrigine groups were significantly higher than in the olanzapine group (all P < 0.05). The electroencephalogram (EEG) abnormality ranks at 3 months were significantly lower in the magnesium valproate and lamotrigine groups compared with the olanzapine group (all P < 0.05). Furthermore, the Glx/Cr ratio significantly decreased after 3 months of treatment (all P < 0.05) in the magnesium valproate and lamotrigine groups, while the Glx/Cr ratio in the olanzapine group showed no significant change (P > 0.05).ConclusionCompared with olanzapine, the addition of magnesium valproate or lamotrigine to immunotherapy might be associated with a lower PANSS score, higher MoCA score, and lower mRS score. The improvement of neurological functions and cognitive function may be related to the decreased Glx/Cr ratio.

Long-term outcomes in children with riboflavin transporter deficiency and surveillance recommendations.

The aim of this longitudinal case series was to describe long-term functional outcome in a group of individuals with riboflavin transporter deficiency (RTD) treated with high-dose oral riboflavin. Data were collected between 2012 to 2022. Eleven individuals with RTD were assessed at 12-month intervals for monitoring of disease progression. Patients had commenced high-dose oral riboflavin from the time of genetic diagnosis. Individuals for whom riboflavin supplementation was initiated early after disease onset had better outcomes compared to those in whom diagnosis was delayed. Despite ongoing riboflavin supplementation, the Charcot-Marie-Tooth disease Pediatric Scale (CMTPedS) total score and the subitems of balance and the 6-Minute Walk Test distance as well as respiratory function worsened, while grip strength improved. There was evidence of improvement in hearing loss and optic atrophy limited to the first 12 months of treatment. While treatment with riboflavin slowed disease progression, patients were left with residual disability. To track disease progression and response to riboflavin supplementation over time, we recommend using the RTD Pediatric Scale and provide a list of clinical measures for regular surveillance of children with RTD.

Hearing preservation and quality of life in small to medium sized vestibular schwannomas after a wait and scan approach or stereotactic radiosurgery: a systematic review and meta-analysis.

The management of vestibular schwannomas (VS) encompasses a choice between conservative "wait-and-scan" (WAS) approach, stereotactic radiosurgery (SRS) or open microsurgical resection. Currently, there is no consensus on the optimal management approach for small to mediumsized VS. This study aims to compared outcomes related to hearing in patients with small and mediumsized VS who underwent initial treatment with WAS versus SRS. A systematic review of the available literature was conducted using PubMed/MEDLINE, Embase, and Cochrane up December 08, 2023. Meta-analysis was performed using a random-effect model to calculate mean difference (MD) and relative risk (RR). A leave-one-out analysis was conducted. The risk of bias was assessed via the Risk of Bias in Non-randomized Studies-Interventions (ROBINS-I) and Cochrane Risk of Bias assessment tool (RoB-2). Ultimately, the certainty of evidence was evaluated using the GRADE assessment. The primary outcomes were serviceable hearing, and pure-tone average (PTA). The secondary outcome was the Penn Acoustic Neuroma Quality of Life Scale (PANQOL) total score. Nine studies were eligible for inclusion, comprising a total of 1,275 patients. Among these, 674 (52.86%) underwent WAS, while 601 patients (47.14%) received SRS. Follow-up duration ranged from two to eight years. The meta-analysis indicated that WAS had a better outcome for serviceable hearing (0.47; 95% CI: 0.32 - 0.68; p < 0.001), as well as for postoperative functional measures including PTA score (MD 13.48; 95% CI 3.83 - 23.13; p < 0.01), and PANQOL total score (MD 3.83; 95% CI 0.42 - 7.25; p = 0.03). The overall certainty of evidence ranged from "very low" to "moderate". Treating small to mediumsized VS with WAS increases the likelihood of preserving serviceable hearing and optimized PANQOL overall postoperative score compared to SRS. Nevertheless, the limited availability of literature and the methodological weakness observed in existing studies outline the need for higher-quality studies.

Evaluation of Microbiota Awareness Among the Healthcare Professionals in Kars Harakani State Hospital

Purpose: This study aimed to evaluate microbiota awareness among the healthcare professionals in Kars Harakani State Hospital by their gender, educational status, marital status, and occupational groups. Methods: This descriptive and cross-sectional study was conducted between 1-31 December 2023 with the participation of the healthcare professionals (n=329) working at Kars Harakani State Hospital. In the study, a questionnaire form inquiring about sociodemographic characteristics and Microbiota Awareness Scale (MAS) were used. MAS consists of the subfactors of “general information”, “product information”, “chronic disease”, and “probiotic and prebiotic”. Results: Product information, chronic disease, and probiotic and prebiotic subscale scores and MAS total scale scores of females were found to be higher than males. The general information mean score of those with graduate education levels was higher than those with associate degree levels. The product information score of the married participants was determined to be higher than the single participants. The general information mean score of physicians was higher compared to the mean scores of nurses and technicians, while the product information mean score of technicians was lower than the mean scores of physicians, nurses, and midwives. The chronic disease mean score of nurses was higher than that of physicians, and their probiotic and prebiotic mean score and MAS total scale mean score were higher compared to the mean scores of technicians. Conclusion: Microbiota awareness levels among healthcare professionals vary according to their occupational groups.

Efficacy and safety of a Chinese medicine formula Diankuang Mengxing Decoction combined with antipsychotics in the treatment of schizophrenia: A meta-analysis of randomized controlled trials.

In patients with schizophrenia, Diankuang Mengxing Decoction with antipsychotics is one of the treatments for it. However, little information is available regarding the difference between the therapeutic effect of Diankuang Mengxing Decoction with antipsychotics and other treatments. Systematic evaluation is conducted to assess the efficacy and safety of Diankuang Mengxing Decoction and other antipsychotics, which are used to treat schizophrenia. We performed a systematic review (PROSPERO ID: CRD42023414603). This entailed a computerized search of several research databases from their respective dates of establishment until April 11, 2023, which collected clinical randomized controlled trials of Diankuang Mengxing Decoction combined with antipsychotics. The databases that contributed to this study were PubMed, Web of Science, Embase, EBSCOhost, Cochrane, Scopus, and Google Scholar. Each publication was screened according to defined inclusion and exclusion criteria, and appropriate literature was extracted and evaluated for quality, for which meta-analysis was performed using RevMan 5.4. A literature review of 456 publications resulted in the inclusion of 18 randomized controlled trials with data collected from a total of 1636 patients. Meta-analytical results showed combination with risperidone, olanzapine, chlorpromazine, clozapine, ziprasidone, or aripiprazole increased the overall effectiveness of Diankuang Mengxing Decoction when treating schizophrenia (P < . 00001), among whom olanzapine demonstrated the greatest enhancement (Z = 3.65, odds ratio = 4.26, 95% CI: 1.96-9.28, P = .0003). The 4-week/30-day treatment (P = .0003) and a dosage of 400 mL/d of Diankuang Mengxing Decoction (P = .0004) were more effective. Also, there were widespread reductions to the Positive And Negative Syndrome Scale (PANSS) total scores, PANSS-positive symptom scores, PANSS-negative symptom scores, general psychopathology scores (P < .05 for all), as well as the incidence of adverse effects (Z = 2.79, odds ratio = 0.34, 95% CI: 0.16-0.73, P = .005) in patients with schizophrenia. The combination of Diankuang Mengxing Decoction with different antipsychotics can improve the overall prognosis of patients with schizophrenia; Diankuang Mengxing Decoction combined olanzapine, a dosage of 400 mL/d and a duration of 4 weeks/30 days being the best in this regard, by alleviating the symptoms and diminishing the disorder's adverse effects. To build on this work, more large-sample, multi-center, and high-quality clinical studies in the future would help to further validate our findings.

Determination of the relationship between obesity prejudice status and eating behaviors of faculty of health sciences students

BackgroundPeople living with obesity receive treatment services from health professionals for their weight or other health needs. In order for the students of the Faculty of Health Sciences, who will be a member of the health team in the future, to raise awareness of the society, it is necessary to first determine their obesity prejudices and eating habits.MethodsThe study is a cross-sectional and descriptive research. The study data were collected from 406 students studying at the Faculty of Health Sciences by online questionnaire method using a personal characteristics identification form, GAMS 27-Obesity Bias Scale and University Students Eating Behavior Scale (USEBS). The data were analyzed with SPSS 26 statistical software.ResultsIn this study, all students were found to be prone to prejudice according to the mean total score of the Obesity Bias Scale and Obesity Bias Scale was higher in female students studying in perfusion department. In the sub-dimensions of the University Students Eating Behavior Scale, the enjoyment of food score was found to have the highest mean score.ConclusionAccording to the results of the study, there is a need to develop educational planning that will both increase the awareness of university students about the relationship between eating behaviors and obesity and eliminate obesity prejudice tendencies due to the fact that they are educated to provide services in the field of health.

Upadacitinib to improve anxiety in patients with adalimumab-treated psoriatic arthritis: study protocol for a randomized controlled trial

BackgroundPatients with psoriatic arthritis (PsA) often suffer from anxiety disorders. While upadacitinib has shown effectiveness in reducing various disease activity indicators in active PsA, its impact on anxiety disorders in PsA patients needs further investigation.MethodsIn this 12-week randomized, open-label, controlled trial, PsA patients with coexisting anxiety were randomly assigned to either the upadacitinib group or the adalimumab group in a 1:1 ratio. The upadacitinib group received a daily dose of 15 mg, while the adalimumab group received 40 mg every 2 weeks. The primary outcome measured the change in Hospital Anxiety Self-Assessment Scale (HADS-A) total scores after the 12-week intervention. Secondary outcomes included changes in the Health Assessment Questionnaire-Disability Index (HAQ-DI), the percentage of participants meeting the ACR20 criteria compared to baseline after 12 weeks, and the percentage of participants achieving a grade 0 or 1 in the psoriasis static Investigator’s overall assessment (sPGA) at week 12 with an improvement of at least 2 points from baseline (sPGA 0/1). One-way analysis of variance (ANOVA) was used to compare the means of normally distributed variables between the upadacitinib and adalimumab groups.DiscussionThe impact of upadacitinib on anxiety in PsA patients remains uncertain. This 12-week open randomized controlled trial aims to provide insights into disease progression and underscore the importance of addressing PsA-related anxiety during treatment.Trial registrationChiCTR2400079755. Registered on January 11, 2024, with ChiCTR. https://www.chictr.org.cn/showproj.html?proj=216538

Investigation of the effect of nurses’ professional values on their perceptions of good death: a cross-sectional study in Türkiye

BackgroundThe care of patient individuals in the good death process should be planned based on nursing values. The aim of the study is to determine nurses’ perceptions of a good death and its relationship with nursing values.MethodsThe study is descriptive and cross-sectional and was completed with 210 nurses. Data were collected using the Nurse Information Form, Good Death Scale, and Revised Nursing Professional Values Scale. In the study, an attempt was made to reach nurses across Türkiye over a three-month period using the snowball sampling method without calculating the sample size beforehand. Descriptive statistics, Kruskal Wallis and Mann Whitney U test, LSD test, Spearman correlation and linear regression analyzes were used in the study.ResultsThe nurses’ Good Death Scale total mean score was 53.52 ± 7.11, and The Revised Nursing Professional Values Scale mean score was 97.77 ± 15.71. There was a moderate, positive, statistically significant relationship between the nurses’ Good Death Scale total mean scores and the Revised Nursing Professional Values Scale total mean scores (r = 0.522; p < 0.001).ConclusionsValue-based educational activities may be effective in helping nurses have positive perceptions about a good death.

Is climate change awareness a predictor of anxiety among nursing students?: A cross-sectional study

BackgroundDetermining the climate change anxiety and awareness of student nurses, who will provide health services in various parts of the world after the borders are removed, is important in combating climate change. ObjectivesThe study aims to assess whether nursing students' climate change awareness is a predictor of climate change anxiety. DesignThis research adopts a descriptive cross-sectional study design. ParticipantsThe population of the study consisted of a total of 562 students studying in the nursing department of a state university. 419 students were included in study. MethodsData were gathered from 419 students enrolled in the nursing department of a university during the fall semester of 2022–2023, employing online questionnaires via Google Forms from January to March 2023. The research instrument comprised three parts: a Descriptive Information Form developed in line with the literature, the Global Climate Change Awareness Scale, and the Climate Change Anxiety Scale. SPSS 20.0 software was used for data analysis. The study obtained ethical committee approval, institutional permissions, and participant consent. ResultsFindings indicated that nursing students' mean Global Climate Change Awareness Scale total score was 59.06 ± 15.78, Climate Change Anxiety Scale total score was determined to be 21.27 ± 8.75. A moderate positive relationship was identified between global climate change awareness and climate change anxiety levels among nursing students (r = 0.304, p < 0.05). Furthermore, the study revealed that the participants' awareness of global climate change served as a predictor for their anxiety levels. ConclusionThe climate change awareness of nursing students significantly influences their levels of anxiety related to climate change. Integrating climate change awareness into nursing education is quite important and necessary. This can empower future nurses to be more prepared and effective in a changing world.

The Best Start Trial: A randomised controlled trial of ultra-early parent-administered physiotherapy for infants at high risk of cerebral palsy or motor delay

BackgroundIt is unknown whether ultra-early physiotherapy commenced during neonatal intensive care unit admission is of value for optimising developmental outcomes in preterm/term infants at high-risk of cerebral palsy or motor-delay. AimsTo determine whether ultra-early parent-administered physiotherapy to preterm/term high- risk infants commenced at earliest from 34-weeks post menstrual age, improves motor outcomes at 16-weeks corrected age (CA) compared to usual care. MethodsSingle-blind randomised controlled pilot study with 30 infant participants. The primary outcome was the Alberta Infant Motor Scale (AIMS) total score at 16-weeks CA. Secondary outcomes included (i) parent Depression Anxiety and Stress Score and Parent Perceptions Survey at 16-weeks CA; and (ii) Bayley Scales of Infant Development at 12-months CA. ResultsThere were no clinically worthwhile effects at 16-weeks CA on the AIMS (mean between-group difference, 95% CI: -0.2, -2.4 to 2.0) or most secondary outcomes. However, the parents' “perception of treatment effectiveness” and “perception of change” favoured the experimental group. ConclusionsIn this pilot trial, there was no clinically worthwhile effect of ultra-early parent-administered physiotherapy over usual care on the AIMS. However, the intervention was feasible for infants, acceptable to parents and parents perceived a benefit of treatment. Whilst this trial did not demonstrate treatment effectiveness using the AIMS, these findings should be interpreted cautiously because of the small sample size, the low responsivity of the AIMS to change in motor performance and the heterogeneity of the participants. Therefore, the intervention should not be abandoned on the basis of this trial, but rather further evaluated in a larger trial that addresses some of the learnings from this one.

Social determinants of health on attitudes toward childbearing among women with multiple sclerosis: A cross-sectional study.

Pregnancy and motherhood are very valuable but challenging for women with multiple sclerosis (MS). Given that there are limited studies in this field, this study aimed to determine the social determinants of health on attitudes toward childbearing among women with MS. We conducted a cross-sectional study on 206 women with MS in Alborz province, Iran, from February to June 2023 using convenience sampling. The data were collected using the questionnaire, and a linear regression analysis was applied. The mean age of the participants was 36.80±6.50 years. Participants' Attitudes toward Fertility and Childbearing (PAFC) had a positive significant association with social support (B=.10, SE=.04, p=.023) and a significant negative association with the total score of depression, anxiety, and stress scale (B=-.13, SE=.06, p=.047) and depression (B=-.40, SE=.18, p=.023). However, the association between anxiety (B=-.25, SE=.20, p=.211), stress (B=-.36, SE=.18, p=.050), MS severity (B=.04, SE=.30, p=.890), and socioeconomic status scale (SES) (B=-.08, SE=.32, p=.806) was nonsignificant with PAFC. Our results showed that factors, including social support and mental health especially depression, can affect PAFC in women with MS. Therefore, it is necessary to determine specific strategies for policymakers to help MS patients manage pregnancy and motherhood.

Evaluation of adolescents' cardiovascular health behaviors and health literacy levels in Turkey

PurposeThe study aimed to examine the relationship between cardiovascular health behaviors and health literacy levels of adolescents. Design and methodsCross-sectional design was used in this study. The sample consisted of 1228 students from two secondary schools in Turkey. The study data were collected in 2020. The data were collected via the Cardiovascular Health Behavior Scale and the The Health Literacy Scale. ResultsCardiovascular Health Behavior Scale for Children mean score was 56.07 ± 10.80. The Health Literacy Scale total mean score of the students was 30.93 ± 5.31. The mean scores of the Cardiovascular Health Behavior Scale for those who were 14 years old, female, studying in the 8th grade, whose parents were primary school graduates, and presence of a person who has had a heart attack in the family were found to be statistically significantly higher. The average health literacy score of students who were female, high income, and who had parents with a baccalaureate or graduate degree was found to be statistically significantly higher. The Cardiovascular Health Behavior Scale and The Health Literacy Scale showed a weak negative correlation. ConclusionsThe cardiovascular health behaviors and health literacy of adolescents were found to be moderate. In order to improve adolescents' health literacy and help them develop good cardiovascular health habits from an early age, interventions should be planned and overseen in collaboration. Practice implicationsAdolescent health promotion requires that nurses assess adolescents' cardiovascular health behaviors and health literacy levels. To achieve the objectives of enhanced cardiovascular health behaviors and better health literacy, parent cooperation is also required.

The effect of reflexology and pelvic floor muscle (Kegel) exercises on urinary incontinence in people with multiple sclerosis

Purpose: This study was conducted to determine the effects of reflexology and Kegel exercise on urinary incontinence in patients with multiple sclerosis (MS). Materials and methods: A single-blind, controlled pretest-posttest study was conducted. The study included 15 patients with MS who presented to the neurology outpatient clinic between March 2020 and February 2022. Patients were assigned to the reflexology, Kegel exercise, or control group using block randomization. Data were collected from all patients using a sociodemographic information form, and quality of life was assessed using the International Consultation on Incontinence Questionnaire–Short Form, Incontinence Quality of Life Scale, and Incontinence Severity Index. The Wilcoxon paired-samples test and Kruskal-Wallis test were used to analyze the data. Results: The mean age of the patients was 39.86 ± 9.99 years, and the mean MS duration was 104.46 ± 84.12 months. International Consultation on Incontinence Questionnaire–Short Form scores did not differ significantly between the groups before or after the intervention (P = 0.788). Incontinence Quality of Life Scale total and subscale scores also did not differ between the groups, but significant improvement was noted in the reflexology group between the pretest and posttest assessments (P = 0.970). Incontinence Severity Index scores did not differ between or within the groups (P = 0.193). Conclusion: Reflexology and Kegel exercise did not exert different effects on urinary incontinence, whereas reflexology improved incontinence-related quality of life.

Efficacy of Clonidine Adhesive Patch for Patients With Tourette Syndrome: A Randomized, Double-blind, Placebo-Controlled, Multicenter Clinical Trial.

This study aimed to explore the efficacy of the clonidine adhesive patch for participants with Tourette syndrome (TS). This randomized, double-blind, placebo-controlled, multicenter phase IV clinical trial included participants with TS at 20 centers between May 2012 and March 2015. Treatment efficacy at week 8 was the primary outcome. The Clinical Global Impression-Severity scale and Improvement scale were the secondary endpoints. This trial included 488 participants, with 121 participants in the 2.0-mg/wk group, 119 participants in the 1.5-mg/wk group, 126 participants in the 1.0-mg/wk group, and 122 participants in the placebo group. For Yale Global Tic Severity Scale score reduction rate, compared with the placebo group (39.60 ± 25.56), those of the 2.0-mg/wk group (63.21 ± 32.60) and the 1.5-mg/wk group (68.16 ± 25.88) were statistically significantly different (all P < 0.001). For total Yale Global Tic Severity Scale score, compared with the placebo group (17.0 ± 8.03), the score for the 2.0-mg/wk group was 9.9 ± 8.36 ( P < 0.001); 1.5-mg/wk group, 9.6 ± 8.03 ( P < 0.001); and 1.0-mg/wk group, 10.5 ± 9.28 ( P < 0.001). The Clinical Global Impression-Severity scale and Improvement scale scores were statistically significantly different in the 3 clonidine (or experimental) groups compared with the placebo group (all P < 0.001). Larger doses of the clonidine adhesive patch such as 1.5 and 2.0 mg/wk are effective in improving the symptoms and overall function of participants with TS.

Determination of Skin Cancer and Sun Knowledge Status of Nursing Students

Aim: The purpose of this study was to assess nursing students' awareness of sun knowledge and skin cancer. Method: The research is cross-sectional and descriptive. Through the use of an online questionnaire, 272 nursing students provided the study's data. Data were gathered using the Skin Cancer and Sun Knowledge Scale and a form asking participants to describe their personal information. The statistical application IBM SPSS 26.0 was utilized to analyze the data. Results: The Skin Cancer and Sun Knowledge Scale total score (14.51±3.24) was determined to be higher than the middle level. The total score of the scale did not significantly correlate with the students' age, grade level, prior knowledge of skin cancer, or the existence of a family history of the disease (p&amp;gt;0.05). However, there was a significant correlation (p&amp;lt;0.05) between gender and the scale's total score. The students' ages and the scale's overall score did not significantly correlate (p&amp;gt;0.05). Conclusion: According to the study's findings, most respondents have knowledge that is above the intermediate level. Even though the study's conclusions paint a generally positive picture, they also demonstrate the need for further development. At this point, more effective community awareness of skin cancer may result from evaluating and updating the methods and content of nursing education programs. Future work could focus on the development of more specific strategies to increase knowledge in this area.

The Effect of Home Education Provided to Caregivers of Children with Cancer on Caregiving Burden, Depression and Life Satisfaction

Aim: In this study; It was aimed to reduce the care burden, decrease depression levels and increase life satisfaction by providing training to the caregivers of children with cancer. Method: The research was designed as pre-test post-test, single group and semi-experimental. The target population of the study consisted of family members who give care for children with cancer patients. The study was conducted with 30 family members between May 2017 and September 2018, without using the sampling method, who met the criteria for participation in the study. "Information Forms Describing Patients and Caregivers, Caregiving Burden Scale, Beck Depression Scale and Life Satisfaction Scale" were used in data collection. In analysis the data; percent distribution and t test in independent groups was used. Results: In the study, the caregivers' total mean score on the Caregiving Burden Scale was found to be 53.63±11.67 before the training and 44.76±6.99 after the training. Beck Depression Scale total score average before 13.23±5.01 and after training It was found to be 9.03±3.66. The mean total score of the Life Satisfaction Scale was found to be 20.16±7.01 before the training and 25.23±5.22 after the training. These differences between the average scores were determined to be statistically significant (p&amp;lt;0.01). Conclusion: It has been found that education given to caregivers of children with cancer is effective in reducing the burden on caregivers, decreasing their depression levels, and increasing their life satisfaction.

Efficacy and safety of intravenous ketamine treatment in Japanese patients with treatment-resistant depression: A double-blind, randomized, placebo-controlled trial.

Although the antidepressant effect of ketamine on treatment-resistant depression (TRD) has been frequently reported in North American and European countries, evidence is scarce among the Asian population. We aimed to evaluate the efficacy and safety of intravenous ketamine in Japanese patients with TRD. In this double-blind randomized placebo-controlled trial, 34 Japanese patients with TRD were randomized to receive either intravenous ketamine (0.5 mg/kg) or placebo, administered over 40 min, twice a week, for 2 weeks. The primary outcome was the change in the Montgomery Åsberg Depression Rating Scale (MADRS) total score from baseline to post-treatment. Secondary outcomes included changes in other depressive symptomatology scores and remission, response, and partial response rates. We also examined the association between baseline clinical demographic characteristics and changes in the MADRS total score. Intention-to-treat analysis indicated no significant difference in the decrease in MADRS total score between the groups (-8.1 ± 10.0 vs -2.5 ± 5.2, t[32] = 2.02, P = 0.052), whereas per-protocol analysis showed a significant reduction in the ketamine group compared to the placebo group (-9.1 ± 10.2 vs -2.7 ± 5.3, t[29] = 2.22, P = 0.034). No significant group differences were observed in other outcomes. Adverse events were more frequent in the ketamine group than in the placebo group, and no serious adverse events were reported. A higher baseline MADRS total score and body mass index were associated with a greater reduction in the MADRS total score. Intravenous ketamine outperformed placebo in Japanese patients with TRD who completed the study, suggesting that ketamine could alleviate depressive symptoms of TRD across diverse ethnic populations.

The added value of the cognition, dining, gastrointestinal problems, sleep and tiredness bolt-on dimensions to the EQ-5D-5L in patients with coeliac disease.

Multiple studies suggest that the EQ-5D may overestimate health-related quality of life (HRQoL) in patients with coeliac disease (CD). We aimed to develop and psychometrically test potentially relevant bolt-on dimensions to improve the measurement performance of the EQ-5D-5L in CD patients. The development and selection of bolt-ons were informed by a literature review on HRQoL in CD, expert and patient input. A cross-sectional online survey was conducted amongst 312 adult CD patients. Respondents completed the EQ-5D-5L, two condition-specific bolt-ons newly-developed for the present study [dining (DI) and gastrointestinal problems (GI)] and three existing bolt-ons [cognition (CO), sleep (SL) and tiredness (TI)]. The following psychometric properties were tested: ceiling, informativity, convergent and known-group validity, and dimensionality (confirmatory factor analysis). Adding the TI, SL, GI, DI and CO individual bolt-ons reduced the ceiling of the EQ-5D-5L (39%) to 17%, 23%, 24%, 26% and 37%, respectively. GI excelled with strong convergent validity with the Gastrointestinal Symptom Rating Scale total score (rs=0.71) and improved the discriminatory power for all known-groups. GI was the only bolt-on loading on a different factor from the five core dimensions, whereas the other four bolt-ons loaded onto the same 'psychosocial health' factor as the EQ-5D-5L anxiety/depression dimension. The DI, GI, SL and TI bolt-ons, especially the GI, enhance the validity of EQ-5D-5L in patients with CD, suggesting their value in capturing important HRQoL aspects potentially missed by the five core dimensions. These bolt-ons can be used in sensitivity analyses supporting health technology assessments and subsequent resource allocation decisions.

Within-subject comparison of near-death and psychedelic experiences: acute and enduring effects.

Mystical-like states of consciousness may arise through means such as psychedelic substances, but may also occur unexpectedly during near-death experiences (NDEs). So far, research studies comparing experiences induced by serotonergic psychedelics and NDEs, along with their enduring effects, have employed between-subject designs, limiting direct comparisons. We present results from an online survey exploring the phenomenology, attribution of reality, psychological insights, and enduring effects of NDEs and psychedelic experiences (PEs) in individuals who have experienced both at some point during their lifetime. We used frequentist and Bayesian analyses to determine significant differences and overlaps (evidence for null hypotheses) between the two. Thirty-one adults reported having experienced both an NDE (i.e. NDE-C scale total score ≥27/80) and a PE (intake of lysergic acid diethylamide, psilocybin/mushrooms, ayahuasca, N,N-dimethyltryptamine, or mescaline). Results revealed areas of overlap between both experiences for phenomenology, attribution of reality, psychological insights, and enduring effects. A finer-grained analysis of the phenomenology revealed a significant overlap in mystical-like effects, while low-level phenomena (sensory effects) were significantly different, with NDEs displaying higher scores of disembodiment and PEs higher scores of visual imagery. This suggests psychedelics as a useful model for studying mystical-like effects induced by NDEs, while highlighting distinctions in sensory experiences.

A sense of urgency: Trait impulsivity in co-occurring bipolar and alcohol use disorder.

Bipolar disorder (BD) and alcohol use disorder (AUD) often co-occur, with BD + AUD characterized by higher levels of impulsivity relative to either disorder alone. Emotional facets of impulsivity (e.g., "urgency," measured by the UPPS-P), however, remain underexplored in this population and could have distinct associations with clinical correlates. This cross-sectional study used a two-by-two (BDxAD) factorial design, including groups with BD + AD (n = 28), BD (n = 29), AD (n = 28), and healthy controls (HC) (n = 27), to identify between-group differences among the five subscales of the UPPS-P. Associations of UPPS-P subscales with Barratt Impulsiveness Scale (BIS) total scores and clinical variables of interest were also examined. BD + AD had the highest scores for every UPPS-P subscale but Sensation Seeking, with the Positive and Negative Urgency subscales having the largest main effects for both BD and AD. BIS-11 total scores were most correlated with the urgency subscales of the UPPS-P. Negative Urgency was found to be uniquely relevant to clinical measures in the BD + AD group. Rapid cycling was associated with both urgency subscales and BIS-11 scores, and the Alcohol Dependence Scale was most correlated with the Premeditation subscale. Cross sectional design and predominantly white sample. Unlike the BIS-11, UPPS-P is able to distinguish emotional from nonemotional facets of impulsivity, something especially relevant to people with co-occurring BD + AD, where fluid emotionality is a key part of symptom presentation. For this reason, the UPPS-P should be utilized in future studies and clinical settings measuring trait impulsivity in this population.