Chir pine and banj oak responses to pre-monsoon drought across slope aspects and positions in Central Himalaya.

The difference in maintaining a safety margin with regard to hydraulic conductance between pine and oak species influences their distribution in a region. Chir pine (Pinus roxburghii) and banj oak (Quercus leucotrichophora) are the principal species of Central Himalayan forests between 1000 and 2000 m elevations. Nearly 80% of annual precipitation of ~ 1400 mm in the region occurs during monsoon, from mid-June to September, whereafter droughts of varying length and intensity are common. The main objective of the study is to find out the responses of these two evergreen tree species to pre-monsoon (March to mid-June) water stress and topographical heterogeneity that occur in Central Himalaya. We measured soil and tree water potential and osmotic adjustment across five seasons on three slope positions, namely, hill base, mid-slope, and hill top, on north and south slope aspects. Chir pine showed an early response to pre-monsoon drought by restraining daily change in Ψ to 0.89 MPa, while predawn Ψ (ΨPD) was still moderate (isohydric tendency). In contrast, the daily reduction in Ψ of banj oak kept on increasing up to 1.49 MPa, despite severely low ΨPD (anisohydric tendency). In both tree species, Ψ was invariably lower on south aspect than north aspect and declined from hill base to hill top. Such responses to slope aspect and position, however, were relatively less apparent in chir pine, which tended to maintain a wide safety margin when under stress. As for soil Ψ, banj oak site retained monsoon rainwater more effectively than chir pine.

Chir pine forest and pre-monsoon drought determine spatial, and temporal patterns of forest fires in Uttarakhand Himalaya.

Associated with farming practices (between 300 and 2000 m elevations), human-ignited small, and patchy surface forest fires occur almost every year in Uttarakhand (between 28°43`- 31°27` N and 77°34`- 81°02`E; area 51,125 km2), a Himalayan state of India. Using fire incidence data of 19 years (2002-2020) generated by MODIS, we analysed the factors which drive temporal and spatial patterns of fire in the region. The fire incidence data were organized by 24 forest divisions, the unit of state forest management and administration. The standardized regression model showed that pre-monsoon temperature (March to May or mid-June), proportional area of the forest division under chir pine (Pinus roxburghii) forest (positive effect), and pre-monsoon and winter precipitation (negative effect) accounted for 56% of the variance in fire incidence density (FID). The pre-monsoon temperature (warmer) and precipitation (lower) were significantly different in 2009, 2012, 2016 and 2019, the years with high FID (average 54.9 fire/100 km2) than the rest of years with low FID (average 20.9 fire/100 km2). During the two decades of warming, high FID (> 30 incidence per year /100 km2) occurred after every three to four years, and fire peaks tended to increase with time. The study suggests that effective fire management can be attained by improving pre-monsoon precipitation forecasting and targeting forest compartments with a higher occurrence of chir pine and fire-vulnerable oaks. Furthermore, since fires are human-ignited, periodical analysis of changes in population distribution and communities' dependence on forests would need to be conducted. Supplementary Information: The online version contains supplementary material available at 10.1007/s42965-023-00306-9.

Role of GhHDA5 in H3K9 deacetylation and fiber initiation in Gossypium hirsutum.

Cotton fibers are single-celled trichomes that initiate from the epidermal cells of the ovules at or before anthesis. Here, we identified that the histone deacetylase (HDAC) activity is essential for proper cotton fiber initiation. We further identified 15 HDACs homoeologs in each of the A- and D-subgenomes of Gossypium hirsutum. Few of these HDAC homoeologs expressed preferentially during the early stages of fiber development [-1, 0 and 6 days post-anthesis (DPA)]. Among them, GhHDA5 expressed significantly at the time of fiber initiation (-1 and 0 DPA). The in vitro assay for HDAC activity indicated that GhHDA5 primarily deacetylates H3K9 acetylation marks. Moreover, the reduced expression of GhHDA5 also suppresses fiber initiation and lint yield in the RNA interference (RNAi) lines. The 0 DPA ovules of GhHDA5RNAi lines also showed alterations in reactive oxygen species homeostasis and elevated autophagic cell death in the developing fibers. The differentially expressed genes (DEGs) identified through RNA-seq of RNAi line (DEP12) and their pathway analysis showed that GhHDA5 modulates expression of many stress and development-related genes involved in fiber development. The reduced expression of GhHDA5 in the RNAi lines also resulted in H3K9 hyper-acetylation on the promoter region of few DEGs assessed by chromatin immunoprecipitation assay. The positively co-expressed genes with GhHDA5 showed cumulative higher expression during fiber initiation, and gene ontology annotation suggests their involvement in fiber development. Furthermore, the predicted protein interaction network in the positively co-expressed genes indicates HDA5 modulates fiber initiation-specific gene expression through a complex involving reported repressors.

Sterol glycosyltransferases required for adaptation of Withania somnifera at high temperature.

Heat is a major environmental stress factor that confines growth, productivity, and metabolism of plants. Plants respond to such unfavorable conditions through changes in their physiological, biochemical and developmental processes. Withania somnifera, an important medicinal plant, grows in hot and dry conditions, however, molecular mechanisms related to such adaptive properties are not known. Here, we elucidated that members of the sterol glycosyltransferases (SGT) gene family play important roles in the survival of W. somnifera under adverse conditions through maintaining the integrity of the membrane. SGTs are enzymes involved in sterol modifications and participate in metabolic flexibility during stress. Silencing of WsSGT members, for instance WsSGTL1, WsSGTL2 and WsSGTL4, was inimical for important physiological parameters, such as electron transport rate, photochemical quantum yield, acceptor side limitation, non-photochemical quenching (NPQ), Fv/Fm and net photosynthetic rate, whereas stomatal conductance, transpiration rate and dark respiration rates (Rds) were increased. Decreased NPQ and increased Rds helped to generate significant amount of ROS in the Wsamisgt lines. After heat stress, H2 O2 , lipid peroxidation and nitric oxide production increased in the Wsamisgt lines due to high ROS generation. The expression of HSPs in Wsamisgt lines might be involved in regulation of physiological processes during stress. We have also observed increased proline accumulation which might be involved in restricting water loss in the Wsamisgt lines. Taken together, our observations revealed that SGTL enzyme activity is required to maintain the internal damages of the cell against high temperature by maintaining the sterol vs sterol glycosides ratio in the membranes of W. somnifera.

Bioprocessing of bagasse hydrolysate for ethanol and xylitol production using thermotolerant yeast.

Fermentation of xylose-rich and glucose-rich bagasse hydrolysates, obtained from the two-stage acid hydrolysis was studied using the thermotolerant yeast Kluyveromyces sp. IIPE453. The yeast could grow on xylose-rich hydrolysate at 50 °C with the dry cell weight, cell mass yield and maximum specific growth rate of 5.35 g l(-1), 0.58 g g(-1) and 0.13 h(-1), respectively. The yeast was found to be very promising for ethanol as well as xylitol production from the sugars obtained from the lignocellulosic biomass. Batch fermentations of xylose-rich and glucose-rich hydrolysates yielded 0.61 g g(-1) xylitol and 0.43 g g(-1) ethanol in the broth, respectively based on the sugars present in the hydrolysate. Overall ethanol yield of 165 g (210 ml) and 183 g xylitol per kg of bagasse was obtained, when bagasse hydrolysate was used as a substrate. Utilization of both the glucose and xylose sugars makes the process most economical by producing both ethanol and xylitol based on biorefinery concept. On validating the experimental data of ethanol fermentation, the modified Luong kinetic model for product inhibition as well as inhibition due to inhibitory compounds present in hydrolysate, the model was found to be the best fit for ethanol formation from bagasse hydrolysate using Kluyveromyces sp. IIPE453.

Causal association of entrepreneurship ecosystem and financial inclusion.

Economic development fosters a favorable ecosystem for entrepreneurs. Economic development and entrepreneurship ecosystem have positive causality with each other. Subsequently, economic development is also a useful determinant of the entrepreneurship ecosystem and vice-versa. The entrepreneurship ecosystem cannot be nurtured without financial development. However, limited studies have observed the causal association between an entrepreneurship ecosystem and financial inclusion. As financial development has a vital contribution to increasing the entrepreneurship ecosystem, this study examines the cause-and-effect relationship between entrepreneurship ecosystem and financial inclusion across countries. The regression coefficients of selected independent variables are estimated through robust empirical models. For said investigation, the global financial inclusion index and global entrepreneurship ecosystem index score were used as proxy variables for financial inclusion and entrepreneurship ecosystem, respectively in regression analysis. The empirical findings revealed that financial inclusion can be improved with an increase in entrepreneurship ecosystem, economic development, ease of doing business, employers, foreign direct investment net inflow, use of internet facilities, and wage and salaried workers. In the same way, entrepreneurship ecosystem can also be nurtured with financial inclusion, economic development, trade openness, ease of doing business, total employers, use of internet facilities and wage and salaried workers increase. The empirical results also inferred that entrepreneurship ecosystem, gross domestic per capita, foreign direct investment net inflow, ease of doing business, employer's start-up procedures to register a business and wages and salaries are important indicators to expand financial inclusion. Further, the results claimed that entrepreneurship ecosystem and financial inclusion are complementary to each other.

Efficacy of agomelatine in major depressive disorder: meta-analysis and appraisal.

Agomelatine is the first approved antidepressant that mediates its activity through the melatoninergic pathway rather than the monoaminergic system. This meta-analysis aims to summarize an up-to-date report on the efficacy of agomelatine in major depressive disorder. Archives of published results in PubMed, CINAHL, Cochrane Library, EMBASE and PsycINFO databases were searched for randomized double-blind trials comparing agomelatine against placebo or antidepressant in major depressive disorder. Change in severity of depression as a result of intervention was the main outcome measure. Data necessary to compute the standardized mean difference (SMD) of this outcome and additional sample parameters that were likely to influence the main outcome were extracted for each selected studies. Summary effect sizes of various groups and subgroups were computed from SMDs between agomelatine and control (placebo or antidepressants) arms. There were nine trials involving 3943 severe cases of depression on agomelatine (n=2390) and either placebo (n=689) or antidepressants (n=864). Agomelatine (n=1274) stood superior to placebo (n=689) by a small margin (SMD -0.26, p=3.48×10-11) and the superiority of agomelatine (n=834, dose ≥ 25 mg/d) over antidepressants (paroxetine, fluoxetine, sertraline, venlafaxine; n=864) was even smaller (SMD -0.11, p=0.02). Although there is evidence of the superiority of agomelatine over placebo and selected antidepressants, it is questionable whether the magnitude of effect size is clinically significant and sample characteristics are relevant to the general patient population with major depressive disorder.

Malignant Transformation in Chronic Stage IV Sacral Pressure Ulcer: A Case of Marjolin Ulcer.

A Marjolin ulcer (MU) is a rare type of skin cancer that most commonly occurs in burns and other traumatic scars, and it also may arise in chronic, poorly healing wounds. Typically, MU presents as a squamous cell carcinoma and has a high rate of metastasis resulting in poor prognosis. The mechanism of the aggressive and metastatic potential of MU has not been clearly defined. This malignancy is more common in patients who are elderly or immunocompromised and has also been characterized as a disease of economically developing nations in which health care resources are less abundant and treatment is delayed. Marjolin ulcer is a challenging, although rare, disease. This article presents a case of MU that arose in a chronic sacral pressure ulcer. This was a rare, multifactorial case; the patient's many comorbidities required coordinated efforts by wound care, oncology, and infectious disease specialists. As seen in this case, MU can be insidious and may not become apparent until considerable progression has occurred. This article discusses the multidisciplinary treatment measures undertaken for this patient, the strategies for prophylaxis and early detection of MU, and ultimately, the poor prognosis of MU in such a scenario where diagnosis is delayed.

Review and meta-analysis of usage of ginkgo as an adjunct therapy in chronic schizophrenia.

This study aimed to review the roles of antioxidants in the pathophysiology of schizophrenia, whether the properties of ginkgo can ameliorate symptoms of this illness, and evaluate available literature to test this assumption. This review is based upon published works on antioxidants and ginkgo. A primary electronic search for meta-analysis on the usage of ginkgo or its derived products in schizophrenia was conducted using Pubmed, Cochrane Library, EMBASE, CINAHL, PsycINFO and AMED. Inclusion criteria were: criteria-based diagnosis of schizophrenia, randomized case assignment, use of ginkgo as an add-on therapy, and assessment using standardized rating scales to measure the state of psychopathology for negative and total symptoms of schizophrenia. Additionally, a detailed review was undertaken to investigate if antioxidants are involved in development of psychotic symptoms in schizophrenia. The six studies that fulfilled the selection criteria were constituted of 466 cases on ginkgo and 362 cases on placebo. They all used the Scale for the Assessment of Negative Symptoms (SANS) to measure negative symptoms, and the Scale for the Assessment of Positive Symptoms (SAPS) or the Brief Psychiatric Rating Scale (BPRS) to measure total symptoms. Difference between ginkgo and control groups from their pre- and post-trial scores and its pooled standard deviation were used to compute standardized mean difference (SMD). Ginkgo as an add-on therapy to antipsychotic medication produced statistically significant moderate improvement (SMD=-0.50) in total and negative symptoms of chronic schizophrenia. Ginkgo as add-on therapy ameliorates the symptoms of chronic schizophrenia. The role of antioxidants in pathogenesis of schizophrenia has also been explored.

Efficacy of antidepressants in treating the negative symptoms of chronic schizophrenia: meta-analysis.

BACKGROUND: Treatment of negative symptoms in chronic schizophrenia continues to be a major clinical issue. AIMS: To analyse the efficacy of add-on antidepressants for the treatment of negative symptoms of chronic schizophrenia. METHOD: Systematic review and meta-analysis of randomised controlled trials comparing the effect of antidepressants and placebo on the negative symptoms of chronic schizophrenia, measured through standardised rating scales. Outcome was measured as standardised mean difference between end-of-trial and baseline scores of negative symptoms. RESULTS: There were 23 trials from 22 publications (n = 819). The antidepressants involved were selective serotonin reuptake inhibitors, mirtazapine, reboxetine, mianserin, trazodone and ritanserin; trials on other antidepressants were not available. The overall standardised mean difference was moderate (-0.48) in favour of antidepressants and subgroup analysis revealed significant responses for fluoxetine, trazodone and ritanserin. CONCLUSIONS: Antidepressants along with antipsychotics are more effective in treating the negative symptoms of schizophrenia than antipsychotics alone.

Polyacrylamide stabilized alkenyl succinic anhydride emulsion as sizing agent for various cellulosic pulps and fillers.

Cellulosic fiber is hydrophilic in nature and making it hydrophobic represents a process called sizing in papermaking. Alkenyl succinic anhydride (ASA) sizing is dominating over other sizing processes due to its high reactivity and economy. The shelf life of conventionally used cationic starch (CS) stabilized ASA emulsion is 20-25 min. In our previous study, the ASA emulsion was found to be stable up to 4 h using anionic polyacrylamide (APAM) as stabilizer. Present communication was aimed to utilize, the APAM stabilized ASA emulsion with most commonly utilized cellulosic pulps (mixed hardwood, bagasse and recycled) and fillers to assist its commercial utilization in papermaking. APAM stabilized ASA emulsion facilitated back water utilization with improved sizing degree unlike CS based ASA emulsion. Lower amount of ASA sizing was required in bagasse pulp compared to other pulps which might be attributed to low crystallinity ratios and hydrogen bond energy.

Ethanol and xylitol production from glucose and xylose at high temperature by Kluyveromyces sp. IIPE453.

A yeast strain Kluyveromyces sp. IIPE453 (MTCC 5314), isolated from soil samples collected from dumping sites of crushed sugarcane bagasse in Sugar Mill, showed growth and fermentation efficiency at high temperatures ranging from 45 degrees C to 50 degrees C. The yeast strain was able to use a wide range of substrates, such as glucose, xylose, mannose, galactose, arabinose, sucrose, and cellobiose, either for growth or fermentation to ethanol. The strain also showed xylitol production from xylose. In batch fermentation, the strain showed maximum ethanol concentration of 82 +/- 0.5 g l(-1) (10.4% v/v) on initial glucose concentration of 200 g l(-1), and ethanol concentration of 1.75 +/- 0.05 g l(-1) as well as xylitol concentration of 11.5 +/- 0.4 g l(-1) on initial xylose concentration of 20 g l(-1) at 50 degrees C. The strain was capable of simultaneously using glucose and xylose in a mixture of glucose concentration of 75 g l(-1) and xylose concentration of 25 g l(-1), achieving maximum ethanol concentration of 38 +/- 0.5 g l(-1) and xylitol concentration of 14.5 +/- 0.2 g l(-1) in batch fermentation. High stability of the strain was observed in a continuous fermentation by feeding the mixture of glucose concentration of 75 g l(-1) and xylose concentration of 25 g l(-1) by recycling the cells, achieving maximum ethanol concentration of 30.8 +/- 6.2 g l(-1) and xylitol concentration of 7.35 +/- 3.3 g l(-1) with ethanol productivity of 3.1 +/- 0.6 g l(-1) h(-1) and xylitol productivity of 0.75 +/- 0.35 g l(-1) h(-1), respectively.

An efficient synthesis of enamides from ketones.

A new synthesis of enamides from ketones is disclosed that involves a phosphine-mediated reductive acylation of oximes. The resulting enamides are isolated in good yields (up to 89%) and excellent purity, permitting a subsequent hydrogenation to access enantiopure acetamides at catalyst loadings practical for large-scale applications.

Timberline structure and woody taxa regeneration towards treeline along latitudinal gradients in Khangchendzonga National Park, Eastern Himalaya.

With main purpose of developing a coherent baseline information of timberline forests of Sikkim, Eastern Himalaya, we investigated, (i) forest structure and composition, (ii) regeneration status of dominant timberline tree species between timberline and treeline, (iii) influence of environmental variables in species composition, and (iv) relationship between environmental variables and ecological attributes. The study was conducted along the timberline stretch of Dzongri landscape nested within the Khangchendzonga National Park (UNESCO's World Heritage Site, 2016), a core zone of Khangchendzonga Biosphere Reserve (in UNESCO WNBRs, 2018), Sikkim, India. We employed quadrat method to sample 9 contiguous sites to capture all possible variations in timberline composition. Transect method was used to study the regeneration of woody taxa between timberline to treeline. In total, 20 woody species belonging to 10 genera and 6 families were recorded. Among these, Abies densa, Rhododendron lanatum and Sorbus microphylla exhibited higher dominance, comprising of 50% of the total importance value index (IVI) weightage. Betula utilis the common treeline species in much of the western and central parts of Himalaya was absent here. Tree density in studied timberline was significantly higher than its western Himalayan counterparts of Indian Himalayan region. Environmental variables viz., elevation, slope, and humus were observed determinants of species composition across the study area. The species dominance correlated negatively (p<0.01; n = 9) with species diversity and richness. We observed an irregular spatial pattern of timberline across the 9 study sites, and the extent of timberline elements (seedling; sapling; live tree or dead tree) ranged between 5.3m to 187.7m higher than the current timberline at different sites. The present trends suggest that upslope advancement is unlikely to occur in near future, while treeline densification is anticipated. Further investigations are suggested to develop a holistic understating of these timberline patterns across the Indian Himalayan region.

Insights on the persistence of pines (Pinus species) in the Late Cretaceous and their increasing dominance in the Anthropocene.

Although gymnosperms were nearly swept away by the rise of the angiosperms in the Late Cretaceous, conifers, and pines (Pinus species) in particular, survived and regained their dominance in some habitats. Diversification of pines into fire-avoiding (subgenus Haploxylon) and fire-adapted (subgenus Diploxylon) species occurred in response to abiotic and biotic factors in the Late Cretaceous such as competition with emerging angiosperms and changing fire regimes. Adaptations/traits that evolved in response to angiosperm-fuelled fire regimes and stressful environments in the Late Cretaceous were key to pine success and are also contributing to a new "pine rise" in some areas in the Anthropocene. Human-mediated activities exert both positive and negative impacts of range size and expansion and invasions of pines. Large-scale afforestation with pines, human-mediated changes to fire regimes, and other ecosystem processes are other contributing factors. We discuss traits that evolved in response to angiosperm-mediated fires and stressful environments in the Cretaceous and that continue to contribute to pine persistence and dominance and the numerous ways in which human activities favor pines.

Accuracy of telepsychiatric assessment of new routine outpatient referrals.

BACKGROUND: Studies on the feasibility of telepsychiatry tend to concentrate only on a subset of clinical parameters. In contrast, this study utilises data from a comprehensive assessment. The main objective of this study is to compare the accuracy of findings from telepsychiatry with those from face to face interviews. METHOD: This is a primary, cross-sectional, single-cluster, balanced crossover, blind study involving new routine psychiatric referrals. Thirty-seven out of forty cases fulfilling the selection criteria went through a complete set of independent face to face and video assessments by the researchers who were blind to each other's findings. RESULTS: The accuracy ratio of the pooled results for DSM-IV diagnoses, risk assessment, non-drug and drug interventions were all above 0.76, and the combined overall accuracy ratio was 0.81. There were substantial intermethod agreements for Cohen's kappa on all the major components of evaluation except on the Risk Assessment Scale where there was only weak agreement. CONCLUSION: Telepsychiatric assessment is a dependable method of assessment with a high degree of accuracy and substantial overall intermethod agreement when compared with standard face to face interview for new routine outpatient psychiatric referrals.

Tree seed traits' response to monsoon climate and altitude in Indian subcontinent with particular reference to the Himalayas.

Seed traits are related to several ecological attributes of a plant species, including its distribution. While the storage physiology of desiccation-sensitive seeds has drawn considerable attention, their ecology has remained sidelined, particularly how the strong seasonality of precipitation in monsoonal climate affects their temporal and spatial distribution. We compiled data on seed mass, seed desiccation behavior, seed shedding, and germination periodicity in relation to monsoon and altitude for 198 native tree species of Indian Himalayas and adjoining plains to find out (1) the adaptive significance of seed mass and seed desiccation behavior in relation to monsoon and (2) the pattern of change in seed mass in relation to altitude, habitat moisture, and succession. The tree species fall into three categories with respect to seed shedding and germination periodicities: (1) species in which both seed shedding and germination are synchronized with monsoon, referred to as monsoon-synchronized (MS, 46 species); (2) species in which seed germination is synchronized with monsoon, but seeds are shed several months before monsoon, referred to as partially monsoon-synchronized (PMS, 112 species); and (3) species in which both shedding and germination occur outside of monsoon months, referred to as monsoon-desynchronized (MD, 39 species). The seed mass of MS species (1,718 mg/seed) was greater than that of PMS (627 mg/seed) and MD (1,144 mg/seed). Of the 40 species with desiccation-sensitive seeds, 45% belong to the MS category, almost similar (approx. 47%) to woody plants with desiccation-sensitive seeds in evergreen rain forests. Seed mass differed significantly as per seed desiccation behavior and successional stage. No relationship of seed mass was found with altitude alone and on the basis of seed desiccation behavior. However, seed mass trend along the altitude differed among monsoon synchronization strategies. Based on our findings, we conclude that in the predicted climate change (warming and uncertain precipitation pattern) scenario, a delay or prolonged break-spell of monsoon may adversely affect the regeneration ecology of desiccation-sensitive seed-bearing species dominant over large forest areas of monsoonal climate.

Prevalence of child abuse in school environment in Kerala, India: An ICAST-CI based survey.

Very few studies focus on childhood abuse in developing countries and only a small fraction of such studies explicitly deal with abuse in a school environment. The purpose of this study was to estimate the prevalence of sexual, physical, and emotional abuse in a school environment in a developing country. Abuse history was collected using the International Society for the Prevention of Child Abuse and Neglect (ISPCAN) Child Abuse Screening Tool - Children's Institutional Version (ICAST-CI). Demographic variables were also collected. Student supportive measures were provided both during and after the survey. 6682 school attending adolescents in Thrissur, Kerala participated in this cross sectional self report study. One year and lifetime prevalence of physical (75.5%, 78.5%), emotional (84.5%, 85.7%) and sexual (21.0%, 23.8%) abuse was high. Abuse was considered to be present even if an individual item from these three categories was reported. Most abuse was reported as occurring 'sometimes' rather than 'many times'. More males than females reported being victims of abuse; figures for one-year prevalence were: physical abuse (83.4% vs. 61.7%), emotional abuse (89.5% vs. 75.7%), and sexual abuse (29.5% vs. 6.2%). Various factors significantly increase the likelihood of abuse-male gender, low socioeconomic status, regular use of alcohol and drugs by family member at home, and having other difficulties at school. Children tended to report abuse less frequently if they liked attending school and if they always felt safe at school. The results highlight the urgent need to address the issue of abuse in the school environment and minimize its impact.

Fixed dose-combination products in psychiatry: Systematic review and meta-analysis.

Despite highly prevalent use of drug combinations in psychiatry, combination products are not commonly available. We aimed to systematically review the evidence for the use and efficacy of combination products in the practice of psychiatry. Systematic search of major data bases yielded nine double-blind randomized controlled trials, which generated 15 comparisons of combination products against a single therapeutic agent, that included a placebo. All these studies included 2827 participants: 976 in their combination products arms and 1851 patients in the comparator arms. The number of combination products were identified, but all except two studies tested only one combination drug (e.g. olanzapine and fluoxetine (OFC)). All combined formulations were significantly superior to a single agent, with standardized mean distance (SMD) of - 0.29 (confidence interval (CI) = - 0.43, - 0 .14; p < 0.001) in improving depression. In the subgroup analysis, the OFC combination was significantly superior to a single therapeutic agent for bipolar depression (SMD = - 0.32; CI = - 0.45, - 0.19; p < 0.001) and for treatment-resistant depression (SMD = - 0.29; CI = - 0.49, - 0.08; p < 0.005), but not for borderline personality nor major depressive disorder (MDD). The evidence in general medicine suggests that combination products can offer significant advantage in improving efficacy and treatment adherence; but in psychiatry, research and development in fixed-dose combinations has been limited.

Dynamics of Nutrients and Leaf Mass in Central Himalayan Forest Trees and Shrubs.

Leaf dynamics, nutrient (N, P, K, Ca, and Na) changes, and retranslocation from the leaves of 13 species were investigated in four representative forest communities of the Central Himalaya, India. In evergreens of the temperate regions, with leaf longevities of several years, there is negligible movement of substances from leaves during the first year. For evergreens of the Central Himalaya, by contrast, loss of leaf mass beings in autumn and often continues until summer, when new leaves are formed. The decrease in leaf dry mass during this period was 12.3-34.1% of the maximum leaf mass. The concentration of N, P, and K decreased from the initial peak, stabilized as leaves matured, and declined markedly during senescence, while Ca and Na concentrations increased throughout the life-span of leaves. Leaf mass loss was positively related to most of the nutrient retranslocation percentages. There were significant correlations between retranslocation levels of many nutrients. The dominant canopy species (chir pine), which is adapted to infertile sites, showed conspicuously greater levels of nutrient retranslocation than species adapted to fertile sites (oaks). However, species of different growth forms occupying the same sites differed markedly in the extent of nutrient retranslocation.