Understanding psychosis: treatment and rehabilitation (updates for clinicians)

Psychosis is a group of psychotic disorders. Its manifestation depends on the specific type of functional violation. However, this is characterized by a gradual increase in clinical signs and a change in behavior. Symptoms of psychosis can be recognized by the following manifestations: hallucinations, delusional ideas, movement disorders, mood disorders including manic and depressive disorders and changes in emotional sphere. Psychosis occurs due to problems in the functioning of neurons. Due to the violation of bonds in the molecules, they do not receive nutrition and they are deficient in oxygen. This leads to the fact that neurons cannot transmit nerve impulses; multiple dysfunctions occur in the central nervous system. The type of psychosis depends on a part of the brain suffered from the hunger strike. The causes of this disorder are of 3 types: endogenous, associated with internal processes, exogenous or external and organic, when the causes of psychosis are changes in the brain such as tumors, trauma or hemorrhage. Psychosis is usually treated in a hospital setting. Such patients require urgent admission as they cannot control their actions, they can harm themselves and others. Psychosis is a relapse-prone disease. With timely and comprehensive treatment, the prognosis will be favorable. This review article is a good educational material for medical and psychological practitioners whose goal is to improve knowledge of treatment and rehabilitation processes of psychosis and its related disorders.

Measles-Associated Severe Pneumonia in a Patient with HBeAg-Negative Chronic Hepatitis B: A Case Report

Background: Every year, approximately 800,000 people die from liver diseases associated with hepatitis B virus (HBV) infection. Complications outside the liver are common, such as fungal lung infections and viral infections. These complications may be associated with poor immune function, thus making clinical treatment difficult and increasing the risk of death. Therefore, HBV-infection-related liver diseases are worthy of clinical attention and further research. Case summary: We report a case of HBeAg-negative chronic hepatitis B in which the patient received entecavir as an anti-HBV treatment after liver dysfunction. During the treatment, the patient was diagnosed with measles and severe viral pneumonia. After comprehensive treatment, including active antiviral medications and mechanical ventilation, the patient recovered and was discharged. Conclusion: HBV infection causes liver damage, affects immune function, and is likely to be associated with viral infections such as measles. Consequently, infections may lead to complications, such as severe viral pneumonia, that endanger patients’ lives. To decrease complications and mortality, better understanding of the disease is necessary to enable early diagnosis.

The Alliance AMBUSH Trial: Rationale and Design

Unlike medulloblastoma (MB) in children, robust prospective trials have not taken place for older patients due to the low incidence of MB in adults and adolescent and young adults (AYA). Current MB treatment paradigms for older patients have been extrapolated from the pediatric experience even though questions exist about the applicability of these approaches. Clinical and molecular classification of MB now provides better prognostication and is being incorporated in pediatric therapeutic trials. It has been established that genomic alterations leading to activation of the sonic hedgehog (SHH) pathway occur in approximately 60% of MB in patients over the age of 16 years. Within this cohort, protein patched homolog (PTCH) and smoothened (SMO) mutations are commonly found. Among patients whose tumors harbor the SHH molecular signature, it is estimated that over 80% of patients could respond to SHH pathway inhibitors. Given the advances in the understanding of molecular subgroups and the lack of robust clinical data for adult/AYA MB, the Alliance for Clinical Trial in Oncology group developed the AMBUSH trial: Comprehensive Management of AYA and Adult Patients with Medulloblastoma or Pineal Embryonal Tumors with a Randomized Placebo Controlled Phase II Focusing on Sonic Hedgehog Pathway Inhibition in SHH Subgroup Patients (Adult & Adolescent MedulloBlastoma Using Sonic Hedgehog Trial). This trial will enroll patients 18 years of age or older with MB (any molecular subgroup and risk stratification) or pineal embryonal tumor. Patients will be assigned to one of three cohorts: (1) average risk non-SHH-MB, (2) average risk SHH-MB, and (3) high risk MB or pineal embryonal tumors. All patients will receive protocol-directed comprehensive treatment with radiation therapy and chemotherapy. Patients with SHH-MB in cohort 1 will be randomized to a smoothened inhibitor or placebo as maintenance therapy for one year.

Structural and System Reliability

Based on material taught at the University of California, Berkeley, this textbook offers a modern, rigorous and comprehensive treatment of the methods of structural and system reliability analysis. It covers the first- and second-order reliability methods for components and systems, simulation methods, time- and space-variant reliability, and Bayesian parameter estimation and reliability updating. It also presents more advanced, state-of-the-art topics such as finite-element reliability methods, stochastic structural dynamics, reliability-based optimal design, and Bayesian networks. A wealth of well-designed examples connect theory with practice, with simple examples demonstrating mathematical concepts and larger examples demonstrating their applications. End-of-chapter homework problems are included throughout. Including all necessary background material from probability theory, and accompanied online by a solutions manual and PowerPoint slides for instructors, this is the ideal text for senior undergraduate and graduate students taking courses on structural and system reliability in departments of civil, environmental and mechanical engineering.

Evaluating the Implementation of the Diabetes Self-Management Program in a Rural Population

The evidence-based Diabetes Self-Management Program (DSMP) has been shown to improve a variety of health-related outcomes, but the program has been challenging to implement in rural areas, and rural dissemination has been low. The purpose of this project was to evaluate the effect of implementing the DSMP on self-reported outcomes in a rural region. Through a collaboration with multiple partners, the Living Well program delivered 28 DSMP workshops from 2017 to 2019. Data were collected to determine whether there were post-intervention changes in patient-reported outcomes on measures of diabetes distress, self-management, and patient activation. In addition, secondary analysis of A1C was abstracted from the medical records of participants with type 2 diabetes who completed at least four sessions of a DSMP workshop between 2017 and 2019 and whose medical records had a A1C value in the year before the program and at least one A1C value >3 months after the program. Statistically significant improvements were seen for the Diabetes Distress Scale (P = 0.0017), the Diabetes Self-Management Questionnaire (P <0.0001) and the 10-item Patient Activation Measure (P <0.0001). There was no evidence of change in A1C over time in analyses of all participants (P = 0.5875), but a consistent though nonsignificant (P = 0.1087) decline in A1C was seen for a subset of participants with a baseline A1C ≥8%. This evaluation provides preliminary support for implementing the DSMP as part of a comprehensive treatment and self-management plan for people living with diabetes in rural areas.

Colocolic intussusception in children: A case series and literature review

Background Colocolic intussusceptions is a rare subtype of intussusception mostly caused by juvenile polyps. The treatment of colocolic intussusception caused by other pathologic lead points remains poorly understood. Methods A systematic literature review between January 2000 and June 2021 was performed to characterize the comprehensive treatment of colocolic intussusception in children. This report also included 10 patients admitted to our center between 2010 and 2020 not previously reported in the literature. Results We identified 27 patients in 20 studies in addition to 10 patients from our center for a total of 37 patients (median age, 4.0 years; 54.1% male). The lead point was identified in 33 patients (33/37, 89.2%). The most common lead point was juvenile polyps (16/33, 48.5%). A therapeutic enema was performed in 12 patients with colocolic intussusception caused by juvenile polyps and was successful in 8 patients (8/12, 66.7%). Colonoscopic polypectomy was subsequently performed in 7 patients and was successful in 6 patients (6/7, 85.7%). The other patient had undergone laparoscopic exploration, and no abnormality was found. Subsequently, the patient underwent open surgery. The patients with colocolic intussusception caused by other pathologic lead points almost underwent surgical treatment (14/17, 82.4%), including 12 open surgeries and 2 laparoscopic surgeries. Conclusion A therapeutic enema followed by colonoscopic polypectomy is feasible to treat colocolic intussusception caused by juvenile polyps unless the patient has bowel perforation; however, open surgery is sometimes needed. For patients with colocolic intussusception caused by other pathologic lead points, open surgery may be preferable to laparoscopic surgery.

Solidification performances of contaminants by red mud-based cementitious paste filling material and leaching behavior of contaminants in different pH and redox potential environments

Considering the urgent need for disposal of red mud and the comprehensive treatment of coal mined-out areas, this paper presented red mud-based cementitious paste filling material (RMFM) to achieve the purpose of green filling treatment. However, the solidification performance of alkaline RMFM for contaminants can be affected when in contact with acid goaf water in practice, which may in turn causes secondary pollution to the surroundings. The leaching tests of RMFM under different pH and redox potential (Eh) conditions were designed to investigate the effects of environmental elements on the solidification performance of RMFM, and primarily investigated the treatment effectiveness of RMFM on goaf water. The test results manifest that the acidic and oxidizing environments could damage the hydration products generated by alkali and sulfate activation, thus affecting the solidification performance, while the alkaline and reducing environments could effectively prevent the release of the contaminants by enhancing the degree of alkali activation and inhibiting oxidation acid forming process. In the possible exposure environment, RMFM could effectively stabilize its own pollutants without secondary pollution. In addition, the powder RMFM samples had significant removal effects on heavy metals, the values of Cu, Pb, and As removal efficiency all reached more than 96.15%.

Analysis of the Role of Comprehensive Treatment Model in the Treatment of Prostate Cancer

The incidence of prostate cancer is gradually increasing. There are many methods for clinical treatment of prostate cancer, such as surgical treatment and endocrine treatment. In the case of advanced prostate cancer, we must not only extend patients’ survival times but also enhance their quality of life. Endocrine medications are the most effective therapy for advanced prostate cancer. This research will investigate the therapeutic impact of a complete treatment model in prostate cancer in order to discover a trustworthy clinical treatment model. This research discovered that, as compared to endocrine treatment, radical resection of prostate cancer may diminish and reach lower serum PSA levels in a short amount of time, as well as sustain low PSA levels and delay progression to castration resistance. Moreover, the comprehensive treatment mode can effectively reduce the possibility of complications. The research results show that the comprehensive treatment model can play an important role in the treatment of prostate cancer.

A Necroptosis-Related Gene Signature for Predicting Prognosis, Immune Landscape, and Therapy Sensitivity in Hepatocellular Carcinoma

Background: Hepatocellular carcinoma (HCC) remains a growing threat to global health. Necroptosis is a newly discovered regulated cell necrosis that plays a vital role in cancer development. Thus, we conducted this study to develop a predictive signature based on necroptosis-related genes.Methods: The tumor samples in The Cancer Genome Atlas (TCGA) Liver Hepatocellular Carcinoma (LIHC) cohort were subtyped using the consensus clustering algorithm. Univariate Cox regression and LASSO-Cox analysis were performed to construct a gene signature model from differentially expressed genes between tumor clusters. Then we integrated TNM stage and the prognostic model to build a nomogram. The gene signature and the nomogram were externally validated in the GSE14520 cohort from the gene expression omnibus (GEO) and LIRP-JP cohort from the International Cancer Genome Consortium (ICGC). Predictive performance evaluation was conducted using Kaplan-Meier plot, time-dependent receiver operating characteristic curve, principal components analysis, concordance index, and decision curve analysis. The tumor microenvironment was estimated using seven published methods. Finally, we also predicted the drug responses to immunotherapy, conventional chemotherapy and molecular-targeted therapy using two algorithms and two datasets. Results: We identified two necroptosis-related clusters and a ten-gene signature (MTMR2, CDCA8, S100A9, ANXA10, G6PD, SLC1A5, SLC2A1, SPP1, PLOD2, and MMP1). The gene signature and the nomogram had good predictive ability in TCGA, ICGC, and GEO cohorts. The risk score was positively associated with the degree of necroptosis and immune infiltration (especially immunosuppressive cells). The high-risk group could benefit more from immunotherapy. Chemotherapy and molecular-targeted therapy should be adapted to the molecular profiles of each patient.Conclusion: The necroptosis-related gene signature provides reliable evidence for prognosis prediction, comprehensive treatment, and new therapeutic targets for HCC patients. The nomogram can further improve predictive accuracy.