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In major depressive disorder (MDD), only ~35% achieve remission after first-line antidepressant therapy. Using UK Biobank data, we identify sociodemographic, clinical, and genetic predictors of antidepressant response through self-reported outcomes, aiming to inform personalized treatment strategies.
Methods
In UK Biobank Mental Health Questionnaire 2, participants with MDD reported whether specific antidepressants helped them. We tested whether retrospective lifetime response to four selective serotonin reuptake inhibitors (SSRIs) (N = 19,516) – citalopram (N = 8335), fluoxetine (N = 8476), paroxetine (N = 2297) and sertraline (N = 5883) – was associated with sociodemographic (e.g. age, gender) and clinical factors (e.g. episode duration). Genetic analyses evaluated the association between CYP2C19 variation and self-reported response, while polygenic score (PGS) analysis assessed whether genetic predisposition to psychiatric disorders and antidepressant response predicted self-reported SSRI outcomes.
Results
71%–77% of participants reported positive responses to SSRIs. Non-response was significantly associated with alcohol and illicit drug use (OR = 1.59, p = 2.23 × 10−20), male gender (OR = 1.25, p = 8.29 × 10−08), and lower-income (OR = 1.35, p = 4.22 × 10−07). The worst episode lasting over 2 years (OR = 1.93, p = 3.87 × 10−16) and no mood improvement from positive events (OR = 1.35, p = 2.37 × 10−07) were also associated with non-response. CYP2C19 poor metabolizers had nominally higher non-response rates (OR = 1.31, p = 1.77 × 10−02). Higher PGS for depression (OR = 1.08, p = 3.37 × 10−05) predicted negative SSRI outcomes after multiple testing corrections.
Conclusions
Self-reported antidepressant response in the UK Biobank is influenced by sociodemographic, clinical, and genetic factors, mirroring clinical response measures. While positive outcomes are more frequent than remission reported in clinical trials, these self-reports replicate known treatment associations, suggesting they capture meaningful aspects of antidepressant effectiveness from the patient’s perspective.
Minimally invasive procedures (MIPs) shorten procedural, hospital, and patient recovery time, providing patient benefits and reducing healthcare resource use (HCRU). This study explored the economic impact of two MIPs as discussed in published literature: transcatheter aortic valve replacement (TAVI), a step-change in cardiac clinical practice (“revolutionary”); and water vapor thermal therapy (WVTT), a progressive innovation in benign prostatic hyperplasia (BPH) (“evolutionary”).
Methods
Two pragmatic literature reviews were conducted to identify studies reporting comparative HCRU for TAVI versus surgical aortic valve replacement (SAVR) in aortic stenosis (AS), and WVTT versus other procedures in BPH. Searches were conducted on 20 October 2023 in the MEDLINE and MEDLINE plus Embase databases for the AS and BPH reviews, respectively. Studies from Asia-Pacific (AS review) and all geographies (BPH review) were included. HCRU data reported in the literature were identified and extracted.
Results
Forty eligible studies were included (14 AS, 26 BPH). Commonly reported outcomes were hospital length of stay (LOS) (AS, BPH studies), intensive care unit (ICU) LOS (AS studies), and procedure duration (BPH studies). In AS studies, hospital LOS was shorter for TAVI (8.00 to 19.96 days) than SAVR (13.09 to 29.50 days). ICU LOS was shorter with TAVI (0.00 to 6.40 days) than SAVR (1.00 to 8.13 days). In BPH, WVTT had shorter hospital LOS (0.00 to 1.10 days) than other procedures (1.00 to 3.00 days). Of five studies reporting procedure duration, four showed shorter procedure time with WVTT (4.00 to 30.00 mins) than other procedures (5.20 to 148.00 mins).
Conclusions
MIPs, whether “revolutionary” or “evolutionary,” could offer notable time-savings (both in terms of procedure duration and length of stay) at the hospital level, which may also lead to cost savings. This highlights the importance of establishing mechanisms in payer-level economic evaluations or health technology assessments that can account for the time-saving advantages of MIPs at the hospital level.
In 1975 Bollobás, Erdős, and Szemerédi asked the following question: given positive integers $n, t, r$ with $2\le t\le r-1$, what is the largest minimum degree $\delta (G)$ among all $r$-partite graphs $G$ with parts of size $n$ and which do not contain a copy of $K_{t+1}$? The $r=t+1$ case has attracted a lot of attention and was fully resolved by Haxell and Szabó, and Szabó and Tardos in 2006. In this article, we investigate the $r\gt t+1$ case of the problem, which has remained dormant for over 40 years. We resolve the problem exactly in the case when $r \equiv -1 \pmod{t}$, and up to an additive constant for many other cases, including when $r \geq (3t-1)(t-1)$. Our approach utilizes a connection to the related problem of determining the maximum of the minimum degrees among the family of balanced $r$-partite $rn$-vertex graphs of chromatic number at most $t$.
Alzheimer’s disease (AD) is one of the biggest challenges to modern medicine. However, before February 2021, the last AD drug approval occurred in 2003, implying a 100% failure rate of AD therapeutic programs over the 17 years to that point; the lowest probability of success among all diseases. One of the key challenges is funding, which we explore in more depth in this chapter by first reviewing the current funding landscape for AD, and then considering the strengths and weaknesses of various commercialization strategies. Despite the discouraging track record of the biopharma industry in addressing AD, there is reason to be hopeful due to substantial scientific progress in developing a deeper understanding of the biology of the disease as well as increased federal funding for AD research. However, we also we need the private sector to translate these scientific breakthroughs into new medicines, which takes additional funding and new business models so as to reduce risk and improve returns for investors. If we can change the narrative of AD therapeutics to give investors new hope, the private sector can serve as a powerful partner to the biomedical community.
The interaction between product market competition, R&D investment, and the financing choices of R&D-intensive firms on the development of innovative products is only partially understood. We hypothesize that as competition increases, R&D-intensive firms will: i) increase R&D investment relative to existing assets in place; ii) carry more cash; and iii) maintain less net debt. Using the Hatch–Waxman Act as an exogenous shock to competition, we provide causal evidence supporting these hypotheses through a differences-in-differences analysis that exploits differences between the biopharma industry and other industries, and heterogeneity within the biopharma industry. We also explore how these changes affect innovative output.
This volume contains eight survey articles based on the invited lectures given at the 27th British Combinatorial Conference, held at the University of Birmingham in July 2019. This biennial conference is a well-established international event, with speakers from around the world. The volume provides an up-to-date overview of current research in several areas of combinatorics, including graph theory, cryptography, matroids, incidence geometries and graph limits. Each article is clearly written and assumes little prior knowledge on the part of the reader. The authors are some of the world's foremost researchers in their fields, and here they summarise existing results and give a unique preview of cutting-edge developments. The book provides a valuable survey of the present state of knowledge in combinatorics, and will be useful to researchers and advanced graduate students, primarily in mathematics but also in computer science and statistics.
Given hypergraphs F and H, an F-factor in H is a set of vertex-disjoint copies of F which cover all the vertices in H. Let K−4 denote the 3-uniform hypergraph with four vertices and three edges. We show that for sufficiently large n ∈ 4ℕ, every 3-uniform hypergraph H on n vertices with minimum codegree at least n/2−1 contains a K−4-factor. Our bound on the minimum codegree here is best possible. It resolves a conjecture of Lo and Markström [15] for large hypergraphs, who earlier proved an asymptotically exact version of this result. Our proof makes use of the absorbing method as well as a result of Keevash and Mycroft [11] concerning almost perfect matchings in hypergraphs.
Abstract Historical accounts of financial crises suggest that fear and greed are the common denominators of these disruptive events: periods of unchecked greed eventually lead to excessive leverage and unsustainable asset-price levels, and the inevitable collapse results in unbridled fear, which must subside before any recovery is possible. The cognitive neurosciences may provide some new insights into this boom/bust pattern through a deeper understanding of the dynamics of emotion and human behavior. In this chapter, I describe some recent research from the neurosciences literature on fear and reward learning, mirror neurons, theory of mind, and the link between emotion and rational behavior. By exploring the neuroscientific basis of cognition and behavior, we may be able to identify more fundamental drivers of financial crises, and improve our models and methods for dealing with them.
Introduction
In March 1933, unemployment in the United States was at an all-time high. Over 4,000 banks had failed during the previous two months. Bread lines stretched around entire blocks in the largest cities. The country was in the grip of the Great Depression. This was the context in which Franklin Delano Roosevelt delivered his first inaugural address to the American people as the 32nd president of the United States. He began his address not by discussing economic conditions, nor by laying out his proposal for the “New Deal”, but with a powerful observation that still resonates today: “So, first of all, let me assert my firm belief that the only thing we have to fear is fear itself – nameless, unreasoning, unjustified terror which paralyzes needed efforts to convert retreat into advance”.
We describe observations with the Mopra radiotelescope designed to assess the feasibility of the H2O Maser Southern Galactic Plane Survey. We mapped two one-square-degree regions along the Galactic plane using the new 12-mm receiver and the UNSW Mopra spectrometer. We covered the entire spectrum between 19.5 and 27.5 GHz using this setup with the main aim of finding out which spectral lines can be detected with a quick mapping survey. We report on detected emission from H2O masers, NH3 inversion transitions (1,1), (2,2) and (3,3), HC3N (3–2), as well as several radio recombination lines.
A survey of the Milky Way disk and the Magellanic System at the wavelengths of the 21-cm atomic hydrogen (H i) line and three 18-cm lines of the OH molecule will be carried out with the Australian Square Kilometre Array Pathfinder telescope. The survey will study the distribution of H i emission and absorption with unprecedented angular and velocity resolution, as well as molecular line thermal emission, absorption, and maser lines. The area to be covered includes the Galactic plane (|b| < 10°) at all declinations south of δ = +40°, spanning longitudes 167° through 360°to 79° at b = 0°, plus the entire area of the Magellanic Stream and Clouds, a total of 13 020 deg2. The brightness temperature sensitivity will be very good, typically σT≃ 1 K at resolution 30 arcsec and 1 km s−1. The survey has a wide spectrum of scientific goals, from studies of galaxy evolution to star formation, with particular contributions to understanding stellar wind kinematics, the thermal phases of the interstellar medium, the interaction between gas in the disk and halo, and the dynamical and thermal states of gas at various positions along the Magellanic Stream.
This paper considers the parametric estimation problem for continuous-time stochastic processes described by first-order nonlinear stochastic differential equations of the generalized Itô type (containing both jump and diffusion components). We derive a particular functional partial differential equation which characterizes the exact likelihood function of a discretely sampled Itô process. In addition, we show by a simple counterexample that the common approach of estimating parameters of an Itô process by applying maximum likelihood to a discretization of the stochastic differential equation does not yield consistent estimators.
Objectives: We aimed to conduct a retrospective analysis of patients treated with radiotherapy for laryngeal carcinoma at a single institution.
Methods: We analysed data from 202 consecutive patients treated with primary or post-operative radiotherapy for laryngeal carcinoma over a 10-year period.
Results: Sixty-nine patients had a T1, 65 a T2, 39 a T3 and 29 a T4 lesion. Forty-one patients were node-positive. The clinical stage was I in 67 patients, II in 53, III in 36 and IV in 46. Primary radiotherapy was given to 152 patients. The median follow up was 60 months. The five-year overall local control rate was 86 per cent, the ultimate local control rate was 93 per cent, the five-year regional control rate was 96 per cent, the five-year relapse-free survival rate was 82 per cent and the five-year overall survival rate was 69 per cent.
Conclusions: Patients with laryngeal carcinoma treated with primary or post-operative radiotherapy had a five-year overall survival rate of 69 per cent.