Introduction: Illnesses which develop in a complex way are best described in stages, and those stages will describe not only a particular point in the course of the disease but also the appropriate treatment for that stage. This approach has, over the years, proved to be very appropriate for planning the treatment of various cancers. It is suggested that in the same way, it can be very important in planning the treatment of a complex illness such as schizophrenia. We aim to describe the staging model of schizophrenia, show the neuroimaging and clinical evidence for it, and discuss its implications for treatment.
Method: We propose that the development of schizophrenia can be described in at least three stages; the prodrome, the first episode, and the chronic phase. In order to describe these stages, we will use data derived wherever possible from literature published in Europe, and we will compare this with data produced from other continents of the world, notably Australia. This is done by reference to and examination of the original published literature, in order that this evidence may be tested against criteria for evidence of a staging model which we propose.
Results: There is much data, from clinical studies which show that schizophrenia develops over time and that its presentation can be described in at least three stages in the development of a schizophrenic illness; the prodrome, the first episode, and the long term chronic phase. It is also true that there is a pre-morbid phase before the prodrome, where it is possible to identify delays in such signs of early neurodevelopment as early paediatric milestones which may suggest an increased risk of schizophrenia in the future. This is mirrored in descriptions of the MRI findings, with loss of gray matter beginning in the prodrome, as well as in changes in cognition which develop as the illness develops over time.
Discussion: It follows from this model that treatment is different in all these three stages, and that the expected outcome of treatment will be different in each of the various stages of the illness. In all the phases of the illness, evidence based psychological interventions, including psycho-education, cognitive therapy, family interventions, and other interventions to prevent relapse work together with medication in order to optimise treatment.
Conclusion: Consequently, any attempt to optimise treatment in schizophrenia must take into account the different stages of the illness, and target outcomes must be appropriate for these stages. The treatments, both pharmacological and psychological must be appropriate to the stage of the disease. The application of treatment protocols which are inappropriate to the stage of the disease may lead to sub-optimal outcomes, and even to iatrogenic harm.
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JMIR Res Protoc
January 2025
Université de Sherbrooke, Sherbrooke, QC, Canada.
Background: The centralization of decision-making power in the public health care system has a negative impact on the practice of professionals and the quality of home care services (HCS) for seniors. To improve HCS, decentralized management could be a particularly promising approach. To be effective, strategies designed to incorporate this management approach require attention to 3 elements: autonomy of local stakeholders, individual and organizational capacities, and accountability for actions and decisions.
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January 2025
Research Center for Water Resources and Interface Science, School of Chemistry and Molecular Engineering, East China Normal University, Shanghai 200062, China.
The mechanism of the emulsion polymerization of styrene to polystyrene nanoparticles (PSNPs) remains a subject of debate. Herein, a series of reaction parameters with different surfactant concentrations, monomer contents, temperatures, and equilibration times were investigated to understand the formation mechanism of PSNPs, which demonstrate a correlation between the properties of PSNPs and the mesostructure of the premix. Cooling the model systems with self-emulsifying nanodroplets (SENDs) in the early reaction stages resulted in the hollow polystyrene spheres (H-PSSs), ruptured PSNPs, and dandelion-like PSNPs, further indicating that the oil nanodroplets are the key sites for the formation of PSNPs.
View Article and Find Full Text PDFPLoS One
January 2025
Rice Department, Bangkok, Thailand.
Bacterial Leaf Blight (BLB) usually attacks rice in the flowering stage and can cause yield losses of up to 50% in severely infected fields. The resulting yield losses severely impact farmers, necessitating compensation from the regulatory authorities. This study introduces a new pipeline specifically designed for detecting BLB in rice fields using unmanned aerial vehicle (UAV) imagery.
View Article and Find Full Text PDFPLoS One
January 2025
School of Optometry and Vision Science, UNSW Sydney, Sydney, New South Wales, Australia.
Purpose: In this study, we investigated the performance of deep learning (DL) models to differentiate between normal and glaucomatous visual fields (VFs) and classify glaucoma from early to the advanced stage to observe if the DL model can stage glaucoma as Mills criteria using only the pattern deviation (PD) plots. The DL model results were compared with a machine learning (ML) classifier trained on conventional VF parameters.
Methods: A total of 265 PD plots and 265 numerical datasets of Humphrey 24-2 VF images were collected from 119 normal and 146 glaucomatous eyes to train the DL models to classify the images into four groups: normal, early glaucoma, moderate glaucoma, and advanced glaucoma.
PLoS One
January 2025
Department of Management, Wroclaw University of Science and Technology, Wroclaw, Poland.
In the past few decades, any type of organization, from factories to government organizations, the banking sector, or educational institutions concentrates on increasing profit margins. To achieve this, one of the key factors is to achieve maximum output with minimum resources (input). Therefore, having an optimal plan to apply the resources has become extremely important for organizations.
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