Protocol for Cancloz: multicentre randomised, placebo-controlled, double-blind, parallel-group adaptive trial of cannabidiol for clozapine-resistant schizophrenia.

Background: Although clozapine is the most effective antipsychotic for people with treatment-resistant schizophrenia (TRS), only 40% of people with TRS respond, and there is limited evidence for augmentation agents. Cannabidiol (CBD) reduces positive symptoms in individuals with schizophrenia, but no trials have specifically examined its efficacy in those with clozapine-resistant schizophrenia.

Aims: To examine the clinical efficacy of CBD augmentation in people with clozapine-resistant schizophrenia.

Sexual and Reproductive Health in Adolescents and Young Adults With Psychotic Disorders: A Scoping Review.

Background And Hypothesis: The sexual and reproductive health (SRH) of young people with psychosis has been largely overlooked. We hypothesised that there are key deficiencies in the existing literature on the SRH of adolescents and young adults with psychotic disorders.

Study Design: We conducted a systematic scoping review using Pubmed, Web of Science, Embase, PsycINFO, and CINAHL.

Risk factors for clozapine-induced myocarditis and cardiomyopathy: A systematic review and meta-analysis.

Objective: Clozapine is the most effective medication for treatment-refractory schizophrenia, but it is associated with severe cardiac adverse events including myocarditis and cardiomyopathy. To aid treatment decision-making for clinicians, patients and their carers, we conducted a systematic review and meta-analysis to identify potential risk factors for clozapine-induced myocarditis and cardiomyopathy.

Methods: A systematic search was conducted of PubMed, Embase, CINAHL, Web of Science, Cochrane and PsycInfo for studies reporting myocarditis and cardiomyopathy among people on clozapine and potential risk factors.

Cadence discovery: study protocol for a dose-finding and mechanism of action clinical trial of sodium benzoate in people with treatment-refractory schizophrenia.

Background: Schizophrenia is a persistent psychotic disorder often accompanied by severe disability and premature mortality. New pharmacological treatments are urgently needed. Sodium benzoate, a common food preservative holds potential to be an effective, accessible treatment for schizophrenia, though the optimal dosing and mechanism of action of the compound requires further investigation.

Electroconvulsive therapy, personal protective equipment and aerosol generating procedures: a review to guide practice during Coronavirus Disease 2019 (COVID-19) pandemic.

Objective: To review the literature on the definition of aerosol-generating procedures (AGPs), identify high-risk AGPs, guidelines to use personal protective equipment (PPE) and review evidence to see if electroconvulsive therapy (ECT) is a high-risk AGP requiring the use of PPE.

Methods: Existing guidelines and research data were reviewed to answer the questions.

Results: There is consensus about the type of anaesthesia used during ECT, what constitutes AGPs and what PPE should be used.

Physiological and genome-wide RNA-sequencing analyses identify candidate genes in a nitrogen-use efficient potato cv. Kufri Gaurav.

Nitrogen (N) is an important nutrient for plant growth. However, its excess application leads to environmental damage. Hence, improving nitrogen use efficiency (NUE) of plant is one of the plausible options to solve the problems.

Hepatocyte Nuclear Factor 4-Alpha Is Essential for the Active Epigenetic State at Enhancers in Mouse Liver.

Cell-fate determination is influenced by interactions between master transcription factors (TFs) and cis-regulatory elements. Hepatocyte nuclear factor 4 alpha (HNF4A), a liver-enriched TF, acts as a master controller in specification of hepatic progenitor cells by regulating a network of TFs to control onset of hepatocyte cell fate. Using analysis of genome-wide histone modifications, DNA methylation, and hydroxymethylation in mouse hepatocytes, we show that HNF4A occupies active enhancers in hepatocytes and is essential for active histone and DNA signatures, especially acetylation of lysine 27 of histone 3 (H3K27ac) and 5-hydroxymethylcytosine (5hmC).

Coprevalence of parasitic infections and diabetes in Sub-Himalayan region of Northern India.

Objectives: Parasitic infections such as toxoplasmosis, hydatidosis, and cysticercosis infect a large population worldwide. in the pancreas could damage the pancreatic cells. Hence, insulin secretion would be affected which leads to increased risk of diabetes.

CoMET: a protocol for a randomised controlled trial of co-commencement of METformin as an adjunctive treatment to attenuate weight gain and metabolic syndrome in patients with schizophrenia newly commenced on clozapine.

Introduction: Clozapine, while effective in treatment refractory schizophrenia, is associated with significant weight gain, heart disease and increased risk of type 2 diabetes mellitus (T2DM). Although there is evidence for weight loss with metformin for people with obesity who are already taking clozapine, there have been no published trials that have investigated the effect of metformin in attenuating weight gain at the time of clozapine initiation.

Methods And Analysis: A 24-week double-blind placebo-controlled trial of concomitant prescription of metformin at clozapine commencement.

Clozapine and concomitant medications: Assessing the completeness and accuracy of medication records for people prescribed clozapine under shared care arrangements.

Rationale, Aim, And Objective: The objective of the study is to assess the completeness and accuracy of medication records held by stakeholders (secondary care, general practice, and community pharmacy) for clozapine consumers managed in a shared care programme.

Methods: This was an exploratory, descriptive study examining secondary and primary care medication records in a large, urban, public mental health service setting in Queensland, Australia. Consumers (18-65 years old) prescribed clozapine under shared care management with capacity to consent were eligible (n = 55) to participate.

Psychiatrists' follow-up of identified metabolic risk: a mixed-method analysis of outcomes and influences on practice.

To describe and explain psychiatrists' responses to metabolic abnormalities identified during screening. We carried out an audit of clinical records to assess rates of monitoring and follow-up practice. Semi-structured interviews with 36 psychiatrists followed by descriptive and thematic analyses were conducted.

Critical Values of Facet Joint Angulation and Tropism in the Development of Lumbar Degenerative Spondylolisthesis: An International, Large-Scale Multicenter Study by the AOSpine Asia Pacific Research Collaboration Consortium.

Study Design: An international, multicenter cross-sectional image-based study performed in 33 institutions in the Asia Pacific region.

Objective: The study addressed the role of facet joint angulation and tropism in relation to L4-L5 degenerative spondylolisthesis (DS).

Methods: The study included 349 patients (63% females; mean age: 61.

Is lumbar facet joint tropism developmental or secondary to degeneration? An international, large-scale multicenter study by the AOSpine Asia Pacific Research Collaboration Consortium.

Background: Facet joint tropism is asymmetry in orientation of the bilateral facets. Some studies have shown that tropism may increase the risk of disc degeneration and herniations, as well as degenerative spondylolisthesis (DS). It remains controversial whether tropism is a pre-existing developmental phenomena or secondary to progressive remodeling of the joint structure due to degenerative changes.

An International Multicenter Study Assessing the Role of Ethnicity on Variation of Lumbar Facet Joint Orientation and the Occurrence of Degenerative Spondylolisthesis in Asia Pacific: A Study from the AOSpine Asia Pacific Research Collaboration Consortium.

Study Design A multinational, multiethnic, cross-sectional image-based study was performed in 33 institutions, representing 10 countries, which were part of the AOSpine Asia Pacific Research Collaboration Consortium. Objective Lumbar facet joint orientation has been reported to be associated with the development of degenerative spondylolisthesis (DS). The role of ethnicity regarding facet joint orientation remains uncertain.

Documentation of medication changes in inpatient clinical notes: an audit to support quality improvement.

Objective: To describe completeness and accuracy of recording medication changes in progress notes during psychiatric inpatient admissions.

Method: A retrospective audit of records of 54 randomly selected psychiatric admissions at a metropolitan tertiary hospital. Medication changes recorded on National Inpatient Medication Chart (NIMC) were compared to documentation in the clinical progress records and assessed for completeness against seven quality criteria.

Monitoring and management of metabolic abnormalities: mixed-method evaluation of a successful intervention.

Objective: To describe the process and impact of a service-level intervention on metabolic monitoring and follow-up of patients of a mental health service who were prescribed clozapine, and describe the metabolic health of these patients.

Methods: The intervention - Let's Get Physical - involved designating two months annually as 'physical health months', during which revised service protocol required metabolic monitoring for all eligible patients. Mixed methods were used to assess rates of monitoring at baseline, during the two physical health months, and follow-up and factors influencing practice.

A review of molecular mechanisms in the development of hepatocellular carcinoma by aflatoxin and hepatitis B and C viruses.

Aflatoxins are food-borne secondary fungal metabolites that are hepatotoxic, hepatocarcinogenic, and mutagenic. Urinary and serum biomarkers are more efficient in reflecting dietary exposure to aflatoxin B₁ (AFB₁) than other methods such as food sampling and dietary questionnaires. Chronic infection of the hepatitis B virus (HBV) and dietary exposure to AFB₁ are the major risk factors in a multifactorial etiology of hepatocellular carcinogenesis, raising the possibility of a synergistic interaction between 2 agents.

Effects of estrogen metabolite 2-methoxyestradiol on tumor suppressor protein p53 and proliferation of breast cancer cells.

An endogenous 17β-estradiol (E(2)) metabolite, 2-methoxyestradiol (2-ME(2)), has been reported to exhibit estrogen receptor (ER)-independent anti-angiogenic and anti-tumor effects. Several mechanisms have been proposed for 2-ME(2) actions, but there is a lack of evidence for a common pathway for all of the cell-types sensitive to this metabolite. We have examined potential alterations in p53 in response to 2-ME(2), E(2) and the microtubule disruptor taxol in T47D breast cancer cells.

A new clinical protocol for the pharmacological management of acute behavioural disturbance.

Objective: Psychiatry is awash with pharmacological acute behavioural disturbance protocols which list oral or intramuscular benzodiazepines and antipsychotics with numerous options. This results in frequent over-sedation and occasional profound sedation and death. This paper describes the development of a simplified sedation protocol for the pharmacological management of acute behavioural disturbance.

Effects of LY117018 (a SERM analog of raloxifene) on tumor suppressor proteins and proliferation of breast cancer cells.

We have previously shown that presence of estradiol (E2) in the growth medium causes (i) proliferation of T47D breast cancer cells, (ii) elevation of p53 levels, and (iii) hyperphos-phorylation of retinoblastoma protein (pRb). In the present study, we examined the expression of p53, phosphorylation state of pRb and proliferation of T47D cells in the presence of LY117018 (Courtesy of Lilly Research Laboratories), an analog of raloxifene, which is a known selective estrogen receptor modulator (SERM). The cells grown in charcoal-treated serum were treated with 1 nM E2 or different concentrations of LY117018 for 24 h.

Metabolic syndrome status changes with fitness level change: a retrospective analysis.

Background: Cardiorespiratory fitness level is inversely related to the incidence of Metabolic Syndrome (MetS). This study examined the effects of changes in cardiorespiratory fitness level on MetS status.

Methods: Male and female participants in a health enhancement program (n = 212) were clinically examined for changes in their MetS status and estimated aerobic capacity over a 3-year period.

Reversal of metabolic syndrome characteristics.

Background: Metabolic syndrome (MetS) is a constellation of three or more clinical health abnormalities from a list of five and, therefore, can vary significantly in its profile. Successful intervention strategies for preventing or resolving individuals' MetS may benefit from better understanding how specific risk factor profiles influence improvement in syndrome status.

Methods: A retrospective analysis of clinical records for members participating in a university-based health assessment/fitness center between 1978 and 2003 was undertaken in 2005.

Longitudinal modeling of the relationship between age and maximal heart rate.

Purpose: Maximal heart rate (HRmax)-prediction equations based on a person's age are frequently used in prescribing exercise intensity and other clinical applications. Results from various cross-sectional studies have shown a linear decrease in HRmax during exercise with increasing age. However, it is less well established that longitudinal tracking of the same individuals' HRmax as they age exhibits an identical linear relationship.