Effects of Oral Alpha-Lipoic Acid Treatment on Diabetic Polyneuropathy: A Meta-Analysis and Systematic Review.

Alpha-lipoic acid (ALA) was found to improve the symptoms in patients with diabetic sensorimotor peripheral neuropathy (DSPN) by reducing oxidative stress and ameliorating microcirculation. Our meta-analysis is aimed at evaluating the effects of oral-administered ALA versus a placebo in patients with DSPN and determining the optimal dosage for this treatment. We systematically reviewed randomized controlled trials (RCTs) in the PubMed, Embase, and Cochrane databases to determine the efficacy of oral ALA for patients with DSPN. The primary outcome was total symptoms' score (TSS), and secondary outcomes were the neurological disability score (NDS), neuropathy impaired score (NIS), NIS-lower limb (NIS-LL), vibration perception threshold (VPT), nerve conduction study (NCS) results, and global satisfaction. A subgroup analysis of the ALA dosage (600, 1200, and 1800 mg/day) was also conducted. Ten RCTs (1242 patients) were included. ALA treatment produced favorable results for TSS (a dose-related trend was observed), NDS, and the global satisfaction score. For VAS, VPT, NIS-LL, and NCS results, ALA did not produce favorable results. ALA treatment had favorable effects on DSPN by reducing sensory symptoms, and it resulted in a dose-dependent response relative to the placebo for TSS and the global satisfaction score. The use of ALA to prevent neurological symptoms should be further researched.

Effect of Vortioxetine on Cognitive Impairment in Patients With Major Depressive Disorder: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

BACKGROUND: Dementia and depression are increasingly common worldwide, and their effective control could ease the burden on economies, public health systems, and support networks. Vortioxetine is a new antidepressant with multipharmacologic actions that elevate the concentration of serotonin and modulate multiple neurotransmitter receptors in the brain. We conducted a meta-analysis to explore whether the cognitive function of patients with major depressive disorder (MDD) treated with vortioxetine would improve. METHODS: We systematically reviewed randomized controlled trials (RCTs) in the PubMed, Embase, and Cochrane databases to assess the treatment effects of vortioxetine on the cognitive function of patients with MDD. The outcome measures included the Digit Symbol Substitution Test (DSST), Perceived Deficits Questionnaire (PDQ), and Montgomery-Åsberg Depression Rating Scale (MADRS) scores. Pooled results were calculated using a fixed-effects or random-effects model according to the heterogeneity of the included trials. RESULTS: Six RCTs with a total of 1782 patients were included in the meta-analysis, which demonstrated that vortioxetine improved DSST, PDQ, and MADRS scores in patients with MDD. The results were consistent at the 10- and 20-mg doses. In the 20-mg group, the decrease in MADRS scores was more significant than that in the placebo group. CONCLUSIONS: Both the 10- and 20-mg doses of vortioxetine can significantly increase DSST scores and decrease PDQ and MADRS scores in patients with MDD and cognitive dysfunction, but further studies with longer follow-up periods to assess mental function are required.

Chronic Immune Sensory Polyradiculoneuropathy-Plus With Diffuse Enlarged Dorsal Root Ganglion and Positive Serum Human Leukocyte Antigen (HLA)-B27.

The peripheral nerve is usually spared in chronic immune sensory polyradiculoneuropathy (CISP) according to a literature review; however, an extended-spectrum of CISP, CISP-plus, was introduced recently. Here we report a 29-year-old Taiwanese man who presented with numbness and hypoesthesia in all distal extremities, tightness sensation in the left posterior thigh, and sensory ataxia for three months. The clinical and neurophysiological examinations revealed proximal sensory abnormalities along with sural nerve involvement. The elevated protein level of cerebrospinal fluid (CSF) was noted and enlarged dorsal root ganglia were seen on the magnetic resonance imaging (MRI) of the whole spine. Autoimmune workup showed only positive human leukocyte antigen (HLA)-B27. Biopsy of the sural nerve revealed inflammatory demyelinating neuropathy. Only mild improvement was noted after methylprednisolone pulse therapy (1,000mg/day) for three days, and he was then treated with intravenous immunoglobulin with the dosage of 2g/kg-BW followed by azathioprine, and objective improvements were reported. Different from the previous case reports, CISP may also associate with peripheral nerve involvements. A sural nerve biopsy could assist the diagnosis. Further investigation is needed for the possible immune association between CISP-plus and HLA-B27.

High-Dimensional Phase Space Reconstruction with a Convolutional Neural Network for Structural Health Monitoring.

In order to accurately diagnose the health of high-order statically indeterminate structures, most existing structural health monitoring (SHM) methods require multiple sensors to collect enough information. However, comprehensive data collection from multiple sensors for high degree-of-freedom structures is not typically available in practice. We propose a method that reconciles the two seemingly conflicting difficulties. Takens' embedding theorem is used to augment the dimensions of data collected from a single sensor. Taking advantage of the success of machine learning in image classification, high-dimensional reconstructed attractors were converted into images and fed into a convolutional neural network (CNN). Attractor classification was performed for 10 damage cases of a 3-story shear frame structure. Numerical results show that the inherently high dimension of the CNN model allows the handling of higher dimensional data. Information on both the level and the location of damage was successfully embedded. The same methodology will allow the extraction of data with unsupervised CNN classification to be consistent with real use cases.

Parental experience of family resources in single-parent families having a child with cancer.

AIM: The purpose of this study was to explore the essence of family experiences in terms of family resources and how these assist a single-parent caring for a child with cancer. BACKGROUND: When families face stresses caused by cancer, they need to readjust their roles, interactive patterns and relationships, both inside and outside the family. During the adaptation process, family resources may assist recovery from stress and a return to equilibrium. Most research has emphasised the support resources available to two-parent families during the treatment process. There is a lack of information on the experiences of single-parent families and their available resources together with the functions and roles played by family resources during the adjustment process. DESIGN: Qualitative. RESULTS: Five major themes were identified: (i) facing the disease with courage; (ii) hope kindled by professionals; (iii) constructing parental role ability; (iv) assisting the children to live with the illness; and (v) family flexibility. CONCLUSION: The results of the current study demonstrate that single-parent families with a child suffering from cancer employ family resources to assist family adjustment and to maintain family function/equilibrium. These results explain the dynamic interactions between the multiple levels of resources available to the family. RELEVANCE TO CLINICAL PRACTICE: The study results provide evidence-based information that identifies the nature of family resources in single-parent families and describes how these resources can be applied to assist the families.