We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Bipolar depression remains difficult to treat, and people often experience ongoing residual symptoms, decreased functioning and impaired quality of life. Adjunctive therapies targeting novel pathways can provide wider treatment options and improve clinical outcomes. Garcinia mangostana Linn. (mangosteen) pericarp has serotonogenic, antioxidant anti-inflammatory and neurogenic properties of relevance to the mechanisms of bipolar depression.
Aims
The current 28-week randomised, multisite, double-blind, placebo-controlled trial investigated mangosteen pericarp extract as an adjunct to treatment-as-usual for treatment of bipolar depression.
Method
This trial was prospectively registered on the Australia New Zealand Clinical Trials Registry (no. ACTRN12616000028404). Participants aged 18 years and older with a diagnosis of bipolar I or II and with at least moderate depressive symptoms were eligible for the study. A total of 1016 participants were initially approached or volunteered for the study, of whom 712 did not progress to screening, with an additional 152 screened out. Seventy participants were randomly allocated to mangosteen and 82 to a placebo control. Fifty participants in the mangosteen and 64 participants in the placebo condition completed the treatment period and were analysed.
Results
Results indicated limited support for the primary hypothesis of superior depression symptom reduction following 24 weeks of treatment. Although overall changes in depressive symptoms did not substantially differ between conditions over the course of the trial, we observed significantly greater improvements for the mangosteen condition at 24 weeks, compared with baseline, for mood symptoms, clinical impressions of bipolar severity and social functioning compared with controls. These differences were attenuated at week 28 post-discontinuation assessment.
Conclusions
Adjunctive mangosteen pericarp treatment appeared to have limited efficacy in mood and functional symptoms associated with bipolar disorder, but not with manic symptoms or quality of life, suggesting a novel therapeutic approach that should be verified by replication.
Recent changes to US research funding are having far-reaching consequences that imperil the integrity of science and the provision of care to vulnerable populations. Resisting these changes, the BJPsych Portfolio reaffirms its commitment to publishing mental science and advancing psychiatric knowledge that improves the mental health of one and all.
Antimicrobial resistance (AMR) is a major global health threat with a projected 10 million deaths globally by 2050. Antimicrobial stewardship (AMS) programs are coordinated efforts involving doctors, nurses, pharmacists, and other healthcare providers. Understanding knowledge, attitudes, and practices of health providers is pivotal for implementing strategies to curb the spread of AMR. The aim of this study was to evaluate knowledge, attitudes, and practices surrounding AMR and AMS among healthcare workers in Kenya.
Design:
A qualitative study using in-depth semi-structured interviews
Setting:
12 private outpatient clinics in Kenya.
Participants:
Healthcare workers including administrators and clinicians.
Methods:
A thematic analysis approach was used; the Capability, Opportunity, and Motivation for Behavior model was used to understand the knowledge, attitudes, and practices surrounding AMR and AMS.
Results:
Twenty-four participants were interviewed. They had some knowledge regarding AMR but lacked knowledge about AMS and its components. Although participants did not perceive AMR as a problem in their clinics, they reported it was a major problem in the country and globally. There was lack of prioritization of AMS in the clinics.
Conclusions:
The lack of knowledge on AMS and its components coupled with failure to recognize AMR as a problem in the facilities led to a lack of prioritization of AMS. There is therefore an urgent need to educate healthcare administrators and clinicians on AMR and AMS to foster a sense of ownership of the problem of AMR and to be pro-active in implementing measures to curb it.
Objectives/Goals: Transmission-blocking vaccines hold promise for malaria elimination by reducing community transmission. But a major challenge that limits the development of efficacious vaccines is the vast parasite’s genetic diversity. This work aims to assess the genetic diversity of the Pfs25 vaccine candidate in complex infections across African countries. Methods/Study Population: We employed next-generation amplicon deep sequencing to identify nonsynonymous single nucleotide polymorphisms (SNPs) in 194 Plasmodium falciparum samples from four endemic African countries: Senegal, Tanzania, Ghana, and Burkina Faso. The individuals aged between 1 and 74 years, but most of them ranged from 1 to 19 years, and all presented symptomatic P. falciparum infection. The genome amplicon sequencing was analyzed using Geneious software and P. falciparum 3D7 as a reference. The SPNs were called with a minimum coverage of 500bp, and for this work, we used a very sensitive threshold of 1% variant frequency to determine the frequency of SNPs. The identified SNPs were threaded to the crystal structure of the Pfs25 protein, which allowed us to predict the impact of the novel SNP in the protein or antibody binding. Results/Anticipated Results: We identified 26 SNPs including 24 novel variants, and assessed their population prevalence and variant frequency in complex infections. Notably, five variants were detected in multiple samples (L63V, V143I, S39G, L63P, and E59G), while the remaining 21 were rare variants found in individual samples. Analysis of country-specific prevalence showed varying proportions of mutant alleles, with Ghana exhibiting the highest prevalence (44.6%), followed by Tanzania (12%), Senegal (11.8%), and Burkina Faso (2.7%). Moreover, we categorized SNPs based on their frequency, identifying dominant variants (>25%), and rare variants (Discussion/Significance of Impact: We identified additional SNPs in the Pfs25 gene beyond those previously reported. However, the majority of these newly discovered display low variant frequency and population prevalence. Further research exploring the functional implications of these variations will be important to elucidate their role in malaria transmission.
With wide-field phased array feed technology, the Australian Square Kilometre Array Pathfinder (ASKAP) is ideally suited to search for seemingly rare radio transient sources that are difficult to discover previous-generation narrow-field telescopes. The Commensal Real-time ASKAP Fast Transient (CRAFT) Survey Science Project has developed instrumentation to continuously search for fast radio transients (duration $\lesssim$ 1 s) with ASKAP, with a particular focus on finding and localising fast radio bursts (FRBs). Since 2018, the CRAFT survey has been searching for FRBs and other fast transients by incoherently adding the intensities received by individual ASKAP antennas, and then correcting for the impact of frequency dispersion on these short-duration signals in the resultant incoherent sum (ICS) in real time. This low-latency detection enables the triggering of voltage buffers, which facilitates the localisation of the transient source and the study of spectro-polarimetric properties at high time resolution. Here we report the sample of 43 FRBs discovered in this CRAFT/ICS survey to date. This includes 22 FRBs that had not previously been reported: 16 FRBs localised by ASKAP to $\lesssim 1$ arcsec and 6 FRBs localised to $\sim 10$ arcmin. Of the new arcsecond-localised FRBs, we have identified and characterised host galaxies (and measured redshifts) for 11. The median of all 30 measured host redshifts from the survey to date is $z=0.23$. We summarise results from the searches, in particular those contributing to our understanding of the burst progenitors and emission mechanisms, and on the use of bursts as probes of intervening media. We conclude by foreshadowing future FRB surveys with ASKAP using a coherent detection system that is currently being commissioned. This will increase the burst detection rate by a factor of approximately ten and also the distance to which ASKAP can localise FRBs.
The simplest of the continuity theorems considered states that a Baire-measurable function between metric spaces has only a meagre set of discontinuity points. Results on Baire continuity (again, this theme goes back to Banach’s book) are given, for instance the Baire homomorphism theorem states that a Baire homomorphism between normed groups X, Y with X topologically complete is continuous. Another generalization is presented as Banach’s continuous-homomorphism theorem. The coincidence theorems we present derive from Sandro Levi’s 1983 result on the comparison of topologies, to the effect that if one refines the other, they must coincide on a subspace.
This starred (omittable) chapter is devoted to non-separable versions of results already proved in the more tractable separable context. As the star indicates, the results here are aimed more at the specialist topologist than at the general mathematical reader, our usual intended audience.
As well as BGT, the other main influence on this book is Oxtoby’s Measure and Category: A Survey of the Analogies between Topological and Measures Spaces (Springer, 1971). For Oxtoby, (Lebesgue) measure is primary, (Baire) category is secondary. Our view, as our title shows, reverses this. The book may thus be regarded as an extended demonstration of the power and wide applicability of the Baire category theorem. Chapter 2 – where we use ‘meagre’ and ‘non-meagre’ for ‘of first (Baire) category’ and ‘of second category’ – proves and discusses several versions of Baire’s (category) theorem: on the line, the intersection of any sequence of dense open sets is dense. We also discuss Baire measurability, and the Baire property. We likewise give a full treatment of the Banach category theorem – a union of any family of meagre open sets is meagre – also used extensively in the book. We discuss countability conditions, and games of Banach–Mazur type. The chapter ends with a discussion of p-spaces (plumed spaces).
This chapter may be viewed as a brief treatment of such parts of descriptive set theory as are needed in the main body of the text. The Borel hierarchy and analytic sets (Chapter 1) are developed further. The theorems of Souslin (analytic plus co-analytic imply Borel), Nikodym (preservation of the Baire property under the Souslin operation) and Marczewski (preservation of measurability under the Souslin operation) are stated (proved in more generality in Chapter 12). The Cantor Intersection Theorem is extended from closed (or compact) sets to analytic sets (Analytic Cantor Theorem). The Borel hierarchy is extended to the projective hierarchy: starting with the analytic sets $\sum^1_1$, their complements $\prod^1_1$ and the intersection of these, $\Delta^1_1$ (the Borel sets), one proceeds inductively: $\sum^1_{n+1}$ contains projections of $\prod^1_n$; their complements give $\prod^1_{n+1}$; intersections of these give $\Delta^1_{n+1}$, etc. The special importance of $\Delta^1_2$ is discussed.
The importance of infinite combinatorics is indicated by the book’s subtitle. Category (and indeed measure) methods are particularly useful for establishing generic behaviour: showing that a particular property predominates, without needing to (or indeed, being able to) show any specific example. Results of this type proved here include the Generic Dichotomy Principle, Generic Completeness Principle, Kestelman–Borwein–Ditor Shift-Compactness Theorem (used many times and abbreviated to KBD) and Kemperman’s Displacement Theorem.
The KBD theorem is about embedding subsequences of shifts of a suitably regular set into some target set. Developing work of Kingman (1963, 1964), we extend this here to embedding into all members of a family of sets. Useful here is the idea of shift-compactness. We also begin to pass effortlessly between the category and measure cases by working bitopologically, using the Euclidean topology for the category case and the density topology (Chapter 7) for the measure case.
Group-norms are vector-space norms but with the scalars restricted to units (invertibles), ±1. The Birkhoff–Kakutani theorem (a first-countable Hausdorff topological group has a right-invariant metric) we view as a normability theorem rather than a metrization theorem, a relative of Kolmogorov’s normability theorem for topological vector spaces (the condition for whose normability is that the origin have a convex bounded neighbourhood). The groups here need not be abelian, so one has left-sided and right-sided versions. Proved here is the Analytic Baire Theorem: if a normed group contains an (either-sided) non-meagre analytic set, it is Baire, separable and (modulo a meagre set) itself analytic. Other results here include the ‘Analytic Shift Theorem’ and the ‘Squared Pettis Theorem’, category relatives of the Steinhaus Difference Theorem.
The infinite combinatorics developed in the previous chapters may be harnessed to give a treatment of regular variation in quite general contexts. Particularly useful tools here are the Category Embedding Theorem and the Effros Theorem. The main theorems of regular variation (see, e.g., BGT) include the Uniform Convergence Theorem (UCT) and the Characterization Theorem. The UCT is extended to the $L_1$-algebra of a locally compact metric group, using Reiter-like conditions from amenability. The Characterization Theorem can be formulated for normed groups X and H, with T a connected non-meagre Baire subgroup of the group of homeomorphisms from X to H. If for h : X → H is Baire and $h(tx)h(x)^{-1} \rightarrow k(t)$ for x → ∞ in X, then k is a continuous homomorphism from T to H. A calculus of regular variation is developed, involving the ‘differential modulus’. The theory is extended to the case of non-commutative H.
The Category Embedding Theorem (CET) is a result in infinite combinatorics related to the Kestelman–Borwein–Ditor Theorem KBD, and also to the concept of shift-compactness. The relationships between KBD, CET and various forms of No Trumps NT are given.
The text proper of the book begins with Littlewood’s three principles. The first – ‘any measurable set is nearly a finite union of intervals’ – is essentially regularity of Lebesgue measure. The second – ‘any measurable function is nearly continuous’ – is Lusin’s Theorem. The third – ‘any convergent sequence of measurable functions is nearly uniformly continuous’ – is Egorov’s Theorem. Then what will be needed from general topology is summarised, with references, going as far as para-compactness. Modes of convergence – in measure (in probability), almost everywhere (almost sure), etc. – are discussed. The Borel hierarchy – the result of applying, to (say) the open sets, the sigma and delta operations (union and intersection) alternately – is developed, as far as the Souslin operation. Analytic sets – much used in the book – are briefly treated here.