Neuroimaging markers of aberrant brain activity and treatment response in schizophrenia patients based on brain complexity.

The complexity of brain activity reflects its ability to process information, adapt to environmental changes, and transition between states. However, it remains unclear how schizophrenia (SZ) affects brain activity complexity, particularly its dynamic changes. This study aimed to investigate the abnormal patterns of brain activity complexity in SZ, their relationship with cognitive deficits, and the impact of antipsychotic medication. Forty-four drug-naive first-episode (DNFE) SZ patients and thirty demographically matched healthy controls (HC) were included. Functional MRI-based sliding window analysis was utilized for the first time to calculate weighted permutation entropy to characterize complex patterns of brain activity in SZ patients before and after 12 weeks of risperidone treatment. Results revealed reduced complexity in the caudate, putamen, and pallidum at baseline in SZ patients compared to HC, with reduced complexity in the left caudate positively correlated with Continuous Performance Test (CPT) and Category Fluency Test scores. After treatment, the complexity of the left caudate increased. Regions with abnormal complexity showed decreased functional connectivity, with complexity positively correlated with connectivity strength. We observed that the dynamic complexity of the brain exhibited the characteristic of spontaneous, recurring "complexity drop", potentially reflecting transient state transitions in the resting brain. Compared to HC, patients exhibited reduced scope, intensity, and duration of complexity drop, all of which improved after treatment. Reduced duration was negatively correlated with CPT scores and positively with clinical symptoms. The results suggest that abnormalities in brain activity complexity and its dynamic changes may underlie cognitive deficits and clinical symptoms in SZ patients. Antipsychotic treatment partially restores these abnormalities, highlighting their potential as indicators of treatment efficacy and biomarkers for personalized therapy.

A matrix management of prevention and control for carbapenem-resistant Enterobacteriaceae in an urban compact medical union.

PURPOSE: To understand the epidemiological characteristics of nosocomial infection of carbapenem-resistant Enterobacteriaceae (CRE) in an urban medical union includes 10 medical hospitals with different number of beds in China. METHODS: Epidemiological data on age, department, and infection of CRE cases detected from January 2014 to December 2021 were collected via a real-time hospital-infection monitoring system or manually for subsequent characterization. A multi-departmental and multi-disciplinary matrix (MMM) management of CRE was established and implemented within a medical union. RESULTS: A total of 1327 cases of CRE infection were detected during the 8 years, of which 352 were due to nosocomial infection, with an infection morbidity of 0.046% and a resistance rate of 10.79%. The morbidity of CRE infection showed a trend of year-to-year fluctuation. The morbidity of CRE infection was significantly higher in winter and spring than that in summer and autumn, significantly higher in men than in women (χ2 â€‹= â€‹55.891, p â€‹< â€‹0.001), and 3 times higher in elderly patients ≥65 years old than in patients <65 years old (χ2 â€‹= â€‹117.517, p â€‹< â€‹0.001). The morbidity of CRE infection after intervention with MMM management decreased significantly from 0.071% to 0.042% (χ2 â€‹= â€‹15.628, p â€‹< â€‹0.001). CONCLUSIONS: CRE prevention and control practice should be adapted to seasonal variations, gender and age differences. The effective prevention and control of CRE nosocomial infections can be achieved by implementing MMM management within a medical association.

Multidisciplinary collaboration in diagnosis and treatment of neuroleptic malignant syndrome complicated with pneumonia: report of three cases.

BACKGROUND: Neuroleptic malignant syndrome (NMS) is a relatively rare and a potentially fatal syndrome. It is a serious complication associated with antipsychotic therapy. NMS is easily prone to pneumonia, rhabdomyolysis and other problems. However, the clinical features of NMS complicated with pneumonia remains largely unclear. CASE PRESENTATION: Here, we described three female adult patients of NMS complicated with pneumonia in our own hospital. The symptoms of the patients were controlled with antipsychotic drugs at admission. Symptoms such as high fever, high muscle tone, difficulty in eating, phlegm in the throat, anhelation, rhabdomyolysis and autonomic nervous dysfunction occurred 2 days after the treatment, which mainly concentrated within 1 week. In addition, they are all healed. CONCLUSIONS: NMS is a rare and serious complication in psychiatric department, which is easy to be complicated with pneumonia and respiratory failure. Timely identification and early intervention could help achieve a good prognosis.

High Concentration and Frequent Application of Disinfection Increase the Detection of Methicillin-Resistant Staphylococcus aureus Infections in Psychiatric Hospitals During the COVID-19 Pandemic.

The tolerance of certain multi-drug resistant bacteria to disinfectants may be promoted while the requirements of environmental disinfection have been raised in the high-risk areas of medical institutions during the COVID-19 pandemic. The current research addressed the mechanisms underlying a sharp increase in the detection of methicillin-resistant Staphylococcus aureus (MRSA) observed in a closed-management unit of elderly patients with mental disorders in 2020 as compared with the previous 4 years. We first conducted microbial detection in staff-hand and environment and a molecular epidemiology analysis, rejecting the hypothesis that the MRSA increase was due to an outbreak. Afterward, we turned to disinfectant concentration and frequency of use and analyzed the varied MRSA detection rates with different concentrations and frequencies of disinfection in 2020 and the previous 4 years. The MRSA detection rate increased with elevated concentration and frequency of disinfection, with 1,000 or 500 mg/L two times per day since January in 2020 vs. 500 mg/L 2-3 times per week in 2016-2019. When the disinfectant concentration was reduced from 1,000 to 500 mg/L, the MRSA detection decreased which indicated a modulatory role of disinfectant concentration. With a sustained frequency of disinfection in 2020, the MRSA detection rate was still higher, even after May, than that in the previous years. This suggested that the frequency of disinfection also contributed to the MRSA increase. Overall, the MRSA detection was augmented with the increase in disinfection concentration and frequency during the COVID-19 epidemic, suggesting that highly-concentrated and highly-frequent preventive long-term disinfection is not recommended without risk assessments in psychiatric hospitals.