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Treatment options for secondary progressive multiple sclerosis (SPMS) are limitedly investigated. We aimed to compare the efficacy of rituximab (RTX) and glatiramer acetate (GA) in SPMS patients.

This open, randomized clinical trial was conducted on 84 SPMS patients, assigned to receive RTX or GA for 12months. In RTX group, patients received 1g intravenous RTX primarily and then every 6-months. In GA group, patients received 40mg of GA 3-times/week subcutaneously. We measured EDSS as the primary outcome and neuroimaging findings, relapse rate (RR), and side effects as the secondary outcomes.

Seventy-three patients completed the study (37 and 36 in RTX and GA groups, respectively). The mean EDSS increased from 3.05±1.01 to 4.14±0.91 in RTX group (p<0.001) and from 3.22±1.20 to 4.60±0.67 in GA group (p<0.001). No statistically significant difference was observed in EDSS between two groups (F(1, 67)=3.377; p=0.071). The number of active lesions in brain and cervical spine decreased with no difference between groups (p>0.05). Also, RR decreased in both groups without significant difference between them (F(1, 67)=0.390; p=0.534). Non-serious complications were observed in both groups.

Neither RTX nor GA affects EDSS in SPMS patients. They are equally effective in the relapse control of these patients.

Neither RTX nor GA affects EDSS in SPMS patients. They are equally effective in the relapse control of these patients.This study compared the effects of contralateral eccentric-only (ECC) and concentric-/eccentric-coupled resistance training (CON-ECC) of the elbow flexors on immobilized arm. Thirty healthy participants (18-34 y) were randomly allocated to immobilization only (CTRL; n = 10), immobilization and ECC (n = 10), or immobilization and CON-ECC group (n = 10). The non-dominant arms of all participants were immobilized (8 h·day-1 ) for 4 weeks, during which ECC and CON-ECC were performed by the dominant (non-immobilized) arm 3 times a week (3-6 sets of 10 repetitions per session) with an 80%-120% and 60%-90% of one concentric repetition maximum (1-RM) load, respectively, matching the total training volume. Arm circumference, 1-RM and maximal voluntary isometric contraction (MVIC) strength, biceps brachii surface electromyogram amplitude (sEMGRMS ), rate of force development (RFD), and joint position sense (JPS) were measured for both arms before and after immobilization. CTRL showed decreases (P less then .05) in MVIC (-21.7%), sEMGRMS (-35.2%), RFD (-26.0%), 1-RM (-14.4%), JPS (-87.4%), and arm circumference (-5.1%) of the immobilized arm. These deficits were attenuated or eliminated by ECC and CON-ECC, with greater effect sizes for ECC than CON-ECC in MVIC (0.29 +12.1%, vs -0.18 -0.1%) and sEMGRMS (0.3117.5% vs -0.15 -5.9%). For the trained arm, ECC showed greater effect size for MVIC than CON-ECC (0.47 vs 0.29), and increased arm circumference (+2.9%), sEMGRMS (+77.9%), and RDF (+31.8%) greater (P less then .05) than CON-ECC (+0.6%, +15.1%, and + 15.8%, respectively). The eccentric-only resistance training of the contralateral arm was more effective to counteract the negative immobilization effects than the concentric-eccentric training.

Catheter ablation (CA) for atrial fibrillation (AF) is used as a treatment to restore and maintain sinus rhythm in patients with AF. However, limited data exist regarding the temporal trends of AF ablation in Asia. This study aimed to describe the temporal trends of CA for AF in Korean over 11 years.

The nationwide claims database in Korea was utilized. Patients underwent CA for AF were identified using combinations of diagnostic codes, claims history, and procedure codes. Comorbidities and complications were also identified, and their temporal trends were evaluated.

The numbers of patients underwent CA for AF were observed to gradually increased over 11 years (452 patients in 2007 vs. 3035 patients in 2017). Mean age of the study population increased (55.4 in 2007-2010 vs. 58.9 in 2015-2017); and mean CHA

DS

-VASc score also increased (1.9 in 2007-2010 vs. 2.2 in 2015-2017). Risks of complications decreased during the study period but risks of all-cause deaths did not changed significantly. Older age, women, hypertension, cerebrovascular accident, chronic obstructive pulmonary disease, chronic kidney disease, general anesthesia, and small procedure volume were independent predictors of complications but, only diabetes and occurrence of any complication were associated with mortality after CA.

CA for AF has become an increasingly important treatment option. Although the proportion of high-risk patients increased, risks of complications decreased over time. Performing procedure without complications and prompt managements are essential to improve the outcome of the patients with AF underwent CA.

CA for AF has become an increasingly important treatment option. Although the proportion of high-risk patients increased, risks of complications decreased over time. Performing procedure without complications and prompt managements are essential to improve the outcome of the patients with AF underwent CA.This paper explores the issue of cultural trauma, which is an area of concern in psychology generally and has emerged as one within the International Association for Analytical Psychology's Router training programme. A summary of responses to the issues of cultural trauma and complexes (alongside cultural differences) within analytical psychology are presented, followed by an overview of findings from the IAAP's evaluation of the Router training programme. These findings are then aligned with contemporary sociological research. The significant issues involved in healing cultural trauma seem to be 'working through', as well as the place of imagination, dreamwork, symbolism and metaphor. Research in Poland has specifically highlighted the importance of good governance, economic vitality, personal and social capital (as in education and social participation), a meaning system, certain external contingencies, channels of mobility and ritualism.While psychotherapy is related to both science and art, it is primarily a craft activity requiring the development of skilful practice, epitomized by the discipline of the analytic attitude. In terms of the forms of knowledge outlined by Aristotle, this places psychotherapy in the realm of 'technê' (arts and craft) rather than epistêmê (science). In particular, the technê of psychotherapy is concerned with the development of phronesis (practical wisdom) in both patient and analyst and its ultimate aim is concerned with the promotion of eudaimonia, a state of well-being considered by Aristotle to be definitive of 'the good life'. It is therefore fundamentally an ethical endeavour. The nature of psychotherapeutic skill is illustrated by analogy with three other forms of technê - music, meditation and pottery. Clinical examples illustrate the crafting of interpretations and the art of patient holding.This paper details Von Lüttichau's relationship with Carl Jung and Bill Wilson, co-founder of Alcoholics Anonymous (AA), and her role as intermediary in the relationship between the two men. Her contribution within this mediator role has not been previously recognized but is an important factor in explaining how Jung became introduced to the AA 12-step format and validated the effectiveness of group work. After the Second World War, Von Lüttichau travelled between America and Switzerland and introduced the writings and ideas of Wilson and Jung to each other and acted as an intermediary between both titans. Jung gave Von Lüttichau extraordinarily detailed instructions on how the 12-step programme of AA could be applied to 'general neurotics'. see more Von Lüttichau's private papers provide a bridge between Jung and Wilson's correspondence and help to piece together gaps in both Jungian and AA history.This personal account charts the changing relationship to a Jungian identity arising from the interrelated processes of understanding the roots of the colonial and racial ideologies that underpin Jung's thinking, and a developing awareness of what it means to be a white person in a system of racism that maintains white supremacy. This is illustrated with reference to the image of a black man appearing in the dream of the white author and with use of post-Jungian thinking to critique the notion of an objective, non-racial psyche.Using Ignacio Matte Blanco's approach to the unconscious, this paper attempts to explain why the experience of the Self or the unconscious, for example in dreams, is difficult for the ego to understand. Matte Blanco believes that the logic of the unconscious is radically different from the logic of consciousness. The unconscious uses processes that Matte Blanco refers to as symmetry and generalization. Symmetry means that the converse of any relationship is identical to it, so that asymmetrical relationships are treated as if they were symmetrical. Generalization means that the unconscious treats any object as belonging to a larger class of objects that is a subset of an even larger class which is in turn a subset of a wider class ad infinitum. Hence Matte Blanco's idea of the unconscious as infinite sets. These unconscious mechanisms, combined with the possibility that the unconscious has more dimensions than consciousness, contribute to the difficulty of understanding dreams, and help to explain why the Self is experienced as other to the ego.Coronavirus disease 2019 (COVID-19) reinfections could be a major aggravating factor in this current pandemic, as this would further complicate potential vaccine development and help to maintain worldwide virus pockets. To investigate this critical question, we conducted a clinical meta-analysis including all available currently reported cases of potential COVID-19 reinfections. We searched for all peer-reviewed articles in the search engine of the National Center for Biotechnology Information. While there are over 30,000 publications on COVID-19, only about 15 specifically target the subject of COVID-19 reinfections. Available patient data in these reports was analyzed for age, gender, time of reported relapse after initial infection and persistent COVID-19 positive polymerase chain reaction (PCR) results. Following the first episode of infection, cases of clinical relapse are reported at 34 (mean) ± 10.5 days after full recovery. Patients with clinical relapse have persisting positive COVID-19 PCR testing results until 39 ± 9 days following initial positive testing. For patients without clinical relapse, positive testing was reported up to 54 ± 24 days. There were no reports of any clinical reinfections after a 70-day period following initial infection.

People living in 'humanitarian settings' in low- and middle-income countries (LMICs) are exposed to a constellation of physical and psychological stressors that make them vulnerable to developing mental disorders. A range of psychological and social interventions have been implemented with the aim to prevent the onset of mental disorders and/or lower psychological distress in populations at risk, and it is not known whether interventions are effective.

To compare the efficacy and acceptability of psychological and social interventions versus control conditions (wait list, treatment as usual, attention placebo, psychological placebo, or no treatment) aimed at preventing the onset of non-psychotic mental disorders in people living in LMICs affected by humanitarian crises.

We searched the Cochrane Common Mental Disorders Controlled Trials Register (CCMD-CTR), the Cochrane Drugs and Alcohol Review Group (CDAG) Specialized Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (OVID), Embase (OVID), PsycINFO (OVID), and ProQuest PILOTS database with results incorporated from searches to February 2020.