However, only two studies provided the data of responders, and the result failed to figure out a significant difference (Z = 0.75, P = 0.45, 95% CI (odds ratio) 1.47 (0.54-4.02); I2 = 61%). It is difficult to define whether tVNS improved QOL between treatment and control groups using the available data. The adverse effects seem to be very few, with the most common being headache. CONCLUSION tVNS is an effective procedure to control the frequency of seizures according to the available data, especially for those patients who do not want to tolerate a surgical procedure. © 2020 Royal Australasian College of Surgeons.BACKGROUND The concurrent presence of lupus anticoagulant, anti-cardiolipin and anti β2-glycoprotein I antibodies (triple positive profile) identifies patients at high-risk of thromboembolic events. These patients are also positive for anti phosphatidyl-serine/prothrombin antibodies (tetra positive profile). OBJECTIVE Understand which antibody among anti β2-glycoprotein I and anti phosphatidyl-serine/prothrombin is responsible for lupus anticoagulant activity is not defined. PATIENTS/METHODS Affinity purified anti β2-glycoprotein I antibodies from plasma of 14 tetra positive patients spiked into normal pooled plasma were tested. RESULTS AND CONCLUSIONS Anti β2-glycoprotein I antibodies did not prolong the diluted Russell Viper Venom Time and Silica Clotting Time (median ratio 0.98, IQR 0.9-1.06 and 1.0, IQR 0.91-1.03, respectively). Anticoagulant activity remained in the flow through that was deprived of anti β2 glycoprotein I antibodies (median ratio 1.88, IQR 1.58-2.77, and 1.75, IQR 1.17-2.9, respectively). This material was loaded on size-exclusion chromatography Sephacryl S-300 column and showed that anticoagulant activity and anti phosphatidyl-serine/prothrombin antibodies co-eluted in the same fractions. Besides, the flow through was poured into a prothrombin affinity column. Protein yield in three patients ranged from 54 to 91 μg/mL and showed strong positivity in phosphatidyl-serine/prothrombin ELISA. The affinity purified material prolonged the coagulation time of normal pooled plasma the diluted Russell Viper Venom ratio in the three patients was 2.09, 1.21, 1.35 and that of Silica Clotting Time was 2.05, 1.5, 2.13. In conclusion, under the assay conditions used, anticoagulant activity in tetra positive antiphospholipid syndrome patients may largely be attributable to anti phosphatidyl-serine/prothrombin antibodies. This article is protected by copyright. All rights reserved.Comprehensive social cognition training programs have been effective to improve social cognition in people with chronic schizophrenia, although there is insufficient quality evidence for recent-onset psychosis. The aim of this study was to assess the effects of Social Cognition and Interaction Training (SCIT) in a sample of recent-onset schizophrenia outpatients. Sixteen participants who had their first psychotic episode for less than 2 years were randomly allocated to the SCIT group during 20 weeks (weekly sessions) or to a psychoeducation group and completed baseline and post-training assessment for cognitive biases, social cognition, clinical symptoms and functioning. Permutation-based analysis revealed improvements in overall functioning (P = 0.036) and blame score (P = 0.070) in the SCIT group compared to the psychoeducation intervention, with large effect sizes (d = 1.438 and d = 1.204, respectively). There were also large effect sizes for hostility, emotion recognition, social perception, positive and total symptoms (d = 0.833-1.158). These results suggest that SCIT may be an effective tool to improve attributional biases and functional outcomes in recent-onset schizophrenia outpatients. Future controlled trials with larger sample size and follow-up assessments should be developed to further understand effective intervention outcomes for this population. © 2020 John Wiley & Sons Australia, Ltd.AIM Stigma is commonly experienced among individuals with schizophrenia spectrum disorders and has been shown to be a barrier to help-seeking and behavioural service utilization. Given the established relationships between stigma, barriers to treatment, and poorer psychiatric outcomes including depression and psychotic symptoms, we examined the relationships between symptoms of depression, positive and negative symptoms, and the emergence of stigma longitudinally among a sample of first-episode of psychosis (FEP) participants in the United States. METHODS Data were obtained from the Recovery After an Initial Schizophrenia Episode project of National Institute of Mental Health’s Early Treatment Program. Participants (n = 404) included adults between ages 15 and 40 with schizophrenia or other psychotic disorders based on the DSM-IV. Data were analysed using structural equation modelling (SEM). RESULTS Findings indicated that increased positive and negative symptoms independently related to greater symptoms of depression at baseline. Furthermore, increased positive symptoms and symptoms of depression at baseline independently related to the emergence of greater stigma being experienced over time. CONCLUSIONS Considering the role that symptoms of depression played as a factor explaining the relationships between positive and negative symptoms and emergence of stigma over time among individuals in FEP, and symptoms of depression is important predictor of stigma and may furthermore present as a viable and less stigmatizing initial treatment target in the early course of a psychotic disorder. © 2020 John Wiley & Sons Australia, Ltd.Preventing cancer metastasis is one of the remaining challenges in cancer therapy. As an efficient natural product, alpha-tocopheryl succinate (α-TOS), the most effective form of vitamin E, holds great anticancer potential. To improve its efficacy and bioavailability, lipid-coated calcium carbonate/phosphate (LCCP) nanoparticles (NPs) with folic acid and PEG modification are synthesized for efficient delivery of α-TOS to 4T1 cancer cells. The optimized LCCP-FA NPs (NP-TOS15) show an α-TOS loading efficiency of around 60%, and enhanced uptake by 4T1 metastatic cancer cells. Consequently, NP-TOS15 significantly enhance the anticancer effect in combination with interferon-gamma (IFN-γ) in terms of apoptosis facilitation and migration inhibition. Importantly, NP-TOS15 upregulate the anticancer immunity via downregulating program death ligand 1 (PD-L1) expression that is initially induced by IFN-γ, and remarkably prevent the lung metastasis, particularly in combination with IFN-γ. Further investigation reveals that this combination therapy also modulates the cytotoxic lymphocyte infiltration into the tumor microenvironment for tumor elimination. Taken together, the NP delivery of α-TOS in combination with IFN-γ provides an applicable strategy for cancer therapy. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.AIM Subthreshold syndromes (STS) frequently precede the onset of full-threshold syndromes (FTS) of the corresponding mental disorder (homotypic continuity). This study examines whether subthreshold conditions are comorbid and whether there is heterotypic continuity also between STS and FTS. METHODS Data were extracted from the Brisbane „19Up” cohort study of twins and siblings (N = 1838; 56% female) on individuals who (i) completed self-report ratings of depression-like (DLE), hypomanic-like (HMLE) and psychotic-like experiences (PLE) and (ii) were assessed for mood and psychotic FTS using the Composite International Diagnostic Interview (CIDI). Associations between STS and FTS were estimated using adjusted prevalence ratios (APR) and 95% confidence intervals (CI). RESULTS STS are prevalent, with 22% reporting DLE, 14% HMLE and 5% PLE; 7% reported >1 STS, with PLE most likely to demonstrate comorbidity. Individuals with DLE were likely to meet CIDI criteria for depression (APR 3.71, 95% CI 2.83, 4.89), hypo/mania (APR 3.62, 95% CI 2.21, 5.94) and psychotic disorders (APR 1.74, 95% CI 1.08, 2.83). Individuals with HMLE were likely to meet CIDI criteria for depression (APR 2.29, 95% CI 1.58, 3.31) and hypo/mania (APR 2.51, 95% CI 1.29, 4.91); those with PLE were likely to meet criteria for hypo/mania (APR 5.8, 95% CI 1.90, 17.70) and psychotic disorders (APR 17.27, 95% CI 7.54, 39.65). CONCLUSIONS The findings suggest that STS are common among young adults and show heterotypic as well as homotypic continuity with FTS and support the need for more trans-diagnostic research on the evolution of major mental disorders. © 2020 John Wiley & Sons Australia, Ltd.INTRODUCTION Treatment of fluid overload and anemia remains a challenge in patients undergoing hemodialysis. Hypervolemia can be evaluated using a carbon monoxide (CO) rebreathing method by which blood volume (BV), plasma volume (PV), and red blood cell volumes (RBCV) can be determined. We hypothesized that recurrent hypervolemia would cause hemoglobin (Hb) levels to be in the anemic range without a concurrent reduction in RBCV in patients undergoing hemodialysis. METHODS BV, PV, and RBCV were determined by a CO rebreathing test in 19 patients with type 2 diabetes undergoing chronic hemodialysis. The tests were performed 20 minutes before initiating dialysis, and the measured intravascular volumes were compared with predicted normal intravascular volumes according to Nadler’s equation. Before initiating dialysis, Hb and blood pressure were measured, and edema severity was graded. FINDINGS Measured BV was higher in 17 out of the 19 patients with a median of 71.1 (62.4-76.9) mL/kg and higher than the predicted BV of 58.3 (53.5-59.9) mL/kg (P  less then  0.001). The measured PV was found to be higher in all patients. RBCV was measured as 25.2 (23.4-28.2) mL/kg with a predicted volume of 25.9 (22.4-26.7) mL/kg (P = 0.56). Eighteen patients were anemic as determined by Hb concentrations (defined as Hb  less then  13 g/dL for men and less then 12 g/dL for women), and nine were anemic according to RBCV. DISCUSSION The CO rebreathing test is a new approach to measuring intravascular volumes in hemodialysis patients. Compared with predicted intravascular volumes, the predialysis BV was expanded in the majority with elevated PV as the main cause. No overall difference in RBCV was found between the measured and predicted volumes. According to predialysis Hb levels, all but one patient was anemic, but according to the measured RBCV, only nine were in the anemic range, indicating dilution of Hb. © 2020 International Society for Hemodialysis.Patients on peritoneal dialysis are at risk of developing peritoneal fibrosis and angiogenesis, which can lead to dysfunction of the peritoneal membrane. Recent evidence has identified cross-talk between transforming growth factor beta (TGFB) and the WNT/β-catenin pathway to induce fibrosis and angiogenesis. Limited evidence exists describing the role of non-canonical WNT signalling in peritoneal membrane injury. Non-canonical WNT5A is suggested to have different effects depending on the receptor environment. WNT5A has been implicated in antagonizing canonical WNT/β-catenin signalling in the presence of receptor tyrosine kinase-like orphan receptor (Ror2). We co-expressed TGFB and WNT5A using adenovirus and examined its role in the development of peritoneal fibrosis and angiogenesis. Treatment of mouse peritoneum with AdWNT5A decreased the submesothelial thickening and angiogenesis induced by AdTGFB. WNT5A appeared to block WNT/β-catenin signalling by inhibiting phosphorylation of glycogen synthase kinase 3 beta (GSK3B) and reducing levels of total β-catenin and target proteins.