Algorithm-based modular psychotherapy vs. cognitive-behavioral therapy for patients with depression,psychiatric comorbidities and early trauma: a proof-of-concept randomized controlled trial

Effect sizes of psychotherapies currently stagnate at a low-to-moderate level. Personalizing psychotherapy by algorithm-based modular procedures promises improved outcomes, greater flexibility, and a better fit between research and practice. However, evidence for the feasibility and efficacy of modular-based psychotherapy, using a personalized treatment algorithm, is lacking. This proof-of-concept randomized controlled trial was conducted in 70 adult outpatients with a primary DSM-5 diagnosis of major depressive disorder, a score higher than 18 on the 24-item Hamilton Rating Scale for Depression (HRSD-24), at least one comorbid psychiatric diagnosis according to the Structured Clinical Interview for DSM-5 (SCID-5), a history of at least “moderate to severe” childhood maltreatment on at least one domain of the Childhood Trauma Questionnaire (CTQ), and exceeding the cut-off value on at least one of three measures of early trauma-related transdiagnostic mechanisms: the Rejection Sensitivity Questionnaire (RSQ), the Interpersonal Reactivity Index (IRI), and the Difficulties in Emotion Regulation Scale-16 (DERS-16). Patients were randomized to 20 sessions of either standard cognitive-behavioral therapy alone (CBT) or CBT plus transdiagnostic modules according to a mechanism-based treatment algorithm (MoBa), over 16 weeks. We aimed to assess the feasibility of MoBa, and to compare MoBa vs. CBT with respect to participants’ and therapists’ overall satisfaction and ratings of therapeutic alliance (using the Working Alliance Inventory - Short Revised, WAI-SR), efficacy, impact on early trauma-related transdiagnostic mechanisms, and safety. The primary outcome for efficacy was the HRSD-24 score at post-treatment. Secondary outcomes included, among others, the rate of response (defined as a reduction of the HRSD-24 score by at least 50% from baseline and a score <16 at post-treatment), the rate of remission (defined as a HRSD-24 score ≤8 at post-treatment), and improvements in early trauma-related mechanisms of social threat response, hyperarousal, and social processes/empathy. We found no difficulties in the selection of the transdiagnostic modules in the individual patients, applying the above-mentioned cut-offs, and in the implementation of MoBa. Both participants and therapists reported higher overall satisfaction and had higher WAI-SR ratings with MoBa than CBT. Both approaches led to major reductions of depressive symptoms at post-treatment, with a non-significant superiority of MoBa over CBT. Patients randomized to MoBa were nearly three times as likely to experience remission at the end of therapy (29.4% vs. 11.4%; odds ratio, OR = 3.2, 95% CI: 0.9-11.6). Among mechanism-based outcomes, MoBa patients showed a significantly higher post-treatment effect on social processes/empathy (p<0.05) compared to CBT patients, who presented an exacerbation on this domain at post-treatment. Substantially less adverse events were reported for MoBa compared to CBT. These results suggest the feasibility and acceptability of an algorithm-based modular psychotherapy complementing CBT in depressed patients with psychiatric comorbidities and early trauma. While initial evidence of efficacy was observed, potential clinical advantages and interindividual heterogeneity in treatment outcomes will have to be investigated in fully powered confirmation trials.     

FAHP ranking and selection of pretreatment module for membrane separation processes in textile cluster

Recent development in membrane manufacturing and extensive application of membranes in effluent treatment has opened up a new water resource. The effluent pretreatment module plays a critical role in membrane performance. Appropriate selection of conventional and advanced pretreatment modules in membrane separation processes (MSP) is significant to the success of zero effluent discharge (ZED). This study addresses performance assessment of eight conventional and advanced pretreatment modules implemented for wastewater management in a textile cluster in South India. The comparative pollutant reduction, capital, operation and maintenance (OM) cost of pretreatment modules are discussed. The ranking and interdependence of the pretreatment modules were analyzed through fuzzy analytical hierarchy process (FAHP) with MATLAB software.The pretreatment module IV ranked third with a composite weight of 15.46%. The integrated study of performance assessment and FAHP resulted in an optimum pretreatment module IV comprising the sequence of chemical precipitation, bio-oxidation processes (activated sludge processes) followed by chemical precipitation, to achieve the ZED. This study provides a techno-economically feasible solution for selection of an effective pretreatment module for MSP in the textile cluster.     

Functional relationships for determining similarities and differences in comparative cognition

Pigeons, capuchin monkeys and rhesus monkeys were trained in nearly identical same/different tasks with an expanding 8-item training set and showed qualitatively similar functional relationships: increasing novel-stimulus transfer (i.e., concept learning) as a function of the training-set size and the level of transfer eventually becoming equivalent to baseline training performance. There were also some quantitative functional differences: pigeon transfer increases were more gradual and baseline-equivalent transfer occurred at a larger set size (256 items) than for monkeys (128 items). Other pigeon groups trained at 32 and 64-item initial set sizes showed improved transfer (relative to expanding the 8-item training set), equivalent to the monkey species’ transfer at these same training set sizes. This finding of equivalent concept learning over a portion of the functional range (8, 32, and 64 items or 64-4096 training pairs) is discussed in terms of species differences: carryover effects from smaller-set training, evolved neural systems, cognitive and cortical modules, and general distributed learning systems for “higher-order” cognitive abilities.     

Economic and Social Impact Assessment of China's Multi‐Crystalline Silicon Photovoltaic Modules Production

It is important to have insights into the potential sustainability impacts as early as possible in the development of technology. Solar photovoltaic (PV) technologies provide significant environmental, economic, and social benefits in comparison to the conventional energy sources. Because most previous studies of multi‐crystalline silicon (Multi‐Si) PV modules discuss the environmental impacts, this study quantitatively assesses the economic and social impacts of China's multi‐crystalline silicon (mc‐Si) PV modules production stages. The economic analysis is uses life cycle cost analysis, and the social impact analysis is carried out by applying the social index evaluation method. The economic analysis results demonstrate that the main cost of mc‐Si PV modules production in China lies in raw materials and labor and the production of Multi‐Si PV cells have the highest cost among the five manufacturing processes involved in Multi‐Si PV. The result of the social impact analysis reveal that the employment contribution index, S₁₁, is 0.72, indicating that Multi‐Si PV modules production in China has a prominent contribution to employment in comparison with other industries; the labor civilization degree, S₁₂ (i.e., the proportion of mental labor involved in a given job), and labor income contribution index, S₁₃, are both approximately 0.6, indicating that Multi‐Si PV modules production has a less‐significant labor level and income contribution in comparison with other industries; the production capacity contribution index, S₁₄, is merely 0.183, indicating that production of Multi‐Si PV modules does not contribute significantly to the gross domestic product (GDP). Based on the results of these evaluations, some recommendations to improve the economic and social impact of Multi‐Si PV modules production in China are presented, including support for research on polycrystalline silicon production for the purpose of reducing the raw material cost, as well as upgrading manufacturing facilities and implementing the corresponding production training in order to promote the labor civilization degree.     

Microbial and viral chitinases: Attractive biopesticides for integrated pest management

The negative impact of the massive use of synthetic pesticides on the environment and on human health has stimulated the search for environment-friendly practices for controlling plant diseases and pests. Among them, biocontrol, which relies on using beneficial organisms or their products (bioactive molecules and/or hydrolytic enzymes), holds the greatest promise and is considered a pillar of integrated pest management. Chitinases are particularly attractive to this purpose since they have fungicidal, insecticidal, and nematicidal activities. Here, current knowledge on the biopesticidal action of microbial and viral chitinases is reviewed, together with a critical analysis of their future development as biopesticides.     

A galaxy of folds

Many protein classification systems capture homologous relationships by grouping domains into families and superfamilies on the basis of sequence similarity. Superfamilies with similar 3D structures are further grouped into folds. In the absence of discernable sequence similarity, these structural similarities were long thought to have originated independently, by convergent evolution. However, the growth of databases and advances in sequence comparison methods have led to the discovery of many distant evolutionary relationships that transcend the boundaries of superfamilies and folds. To investigate the contributions of convergent versus divergent evolution in the origin of protein folds, we clustered representative domains of known structure by their sequence similarity, treating them as point masses in a virtual 2D space which attract or repel each other depending on their pairwise sequence similarities. As expected, families in the same superfamily form tight clusters. But often, superfamilies of the same fold are linked with each other, suggesting that the entire fold evolved from an ancient prototype. Strikingly, some links connect superfamilies with different folds. They arise from modular peptide fragments of between 20 and 40 residues that co‐occur in the connected folds in disparate structural contexts. These may be descendants of an ancestral pool of peptide modules that evolved as cofactors in the RNA world and from which the first folded proteins arose by amplification and recombination. Our galaxy of folds summarizes, in a single image, most known and many yet undescribed homologous relationships between protein superfamilies, providing new insights into the evolution of protein domains.