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Synthetic Aperture Radar Interferometry (InSAR) is an active remote sensing method that uses repeated radar scans of the Earth's solid surface to measure relative deformation at centimeter precision over a wide swath. It has revolutionized our understanding of the earthquake cycle, volcanic eruptions, landslides, glacier flow, ice grounding lines, ground fluid injection/withdrawal, underground nuclear tests, and other applications requiring high spatial resolution measurements of ground deformation. This book examines the theory behind and the applications of InSAR for measuring surface deformation. The most recent generation of InSAR satellites have transformed the method from investigating 10's to 100's of SAR images to processing 1000's and 10,000's of images using a wide range of computer facilities. This book is intended for students and researchers in the physical sciences, particularly for those working in geophysics, natural hazards, space geodesy, and remote sensing. This title is also available as Open Access on Cambridge Core.
Spaceflight missions must limit biological contamination on both the outbound and return legs to comply with planetary protection requirements. Depending on the mission profile, contamination concerns may include the potential presence of bioactive molecules as defined by NASA’s Planetary Protection policies. Thus, the present study has examined the temperature and time requirements for sufficient inactivation/degradation of an infectious, heat-stable prion protein (Sup35NM), which serves as a model bioactive molecule. Bovine serum albumin was used to establish the method parameters and feasibility. Differential scanning calorimetry, Fourier transform infrared spectroscopy, analytical reversed-phase high-performance liquid chromatography, and mass spectrometry were utilized to analyze heat-treated samples, with non-treated samples serving as controls. Heat treatment at 400°C for 5 seconds was found to result in substantial decomposition of Sup35NM. In addition to the disruption of the protein backbone amide bonds, the side chain residues were also compromised. Fragments of molecular weight <4600 were observed by mass spectrometry but the impact of treatment on both the backbone and side chains of Sup35NM suggested that these fragments would not self-associate to create potentially pathogenic entities. The present methodology provided insight into the protein degradation process and can be applied to a variety of treatment strategies (e.g., any form of sterilization or inactivation) to ensure a lack of protein-based contamination of isolated extraterrestrial specimens.
The stars of the Milky Way carry the chemical history of our Galaxy in their atmospheres as they journey through its vast expanse. Like barcodes, we can extract the chemical fingerprints of stars from high-resolution spectroscopy. The fourth data release (DR4) of the Galactic Archaeology with HERMES (GALAH) Survey, based on a decade of observations, provides the chemical abundances of up to 32 elements for 917 588 stars that also have exquisite astrometric data from the Gaia satellite. For the first time, these elements include life-essential nitrogen to complement carbon, and oxygen as well as more measurements of rare-earth elements critical to modern-life electronics, offering unparalleled insights into the chemical composition of the Milky Way. For this release, we use neural networks to simultaneously fit stellar parameters and abundances across the whole wavelength range, leveraging synthetic grids computed with Spectroscopy Made Easy. These grids account for atomic line formation in non-local thermodynamic equilibrium for 14 elements. In a two-iteration process, we first fit stellar labels to all 1 085 520 spectra, then co-add repeated observations and refine these labels using astrometric data from Gaia and 2MASS photometry, improving the accuracy and precision of stellar parameters and abundances. Our validation thoroughly assesses the reliability of spectroscopic measurements and highlights key caveats. GALAH DR4 represents yet another milestone in Galactic archaeology, combining detailed chemical compositions from multiple nucleosynthetic channels with kinematic information and age estimates. The resulting dataset, covering nearly a million stars, opens new avenues for understanding not only the chemical and dynamical history of the Milky Way but also the broader questions of the origin of elements and the evolution of planets, stars, and galaxies.
The World Cancer Research Fund and the American Institute for Cancer Research recommend a plant-based diet to cancer survivors, which may reduce chronic inflammation and excess adiposity associated with worse survival. We investigated associations of plant-based dietary patterns with inflammation biomarkers and body composition in the Pathways Study, in which 3659 women with breast cancer provided validated food frequency questionnaires approximately 2 months after diagnosis. We derived three plant-based diet indices: overall plant-based diet index (PDI), healthful plant-based diet index (hPDI) and unhealthful plant-based diet index (uPDI). We assayed circulating inflammation biomarkers related to systemic inflammation (high-sensitivity C-reactive protein [hsCRP]), pro-inflammatory cytokines (IL-1β, IL-6, IL-8, TNF-α) and anti-inflammatory cytokines (IL-4, IL-10, IL-13). We estimated areas (cm2) of muscle and visceral and subcutaneous adipose tissue (VAT and SAT) from computed tomography scans. Using multivariable linear regression, we calculated the differences in inflammation biomarkers and body composition for each index. Per 10-point increase for each index: hsCRP was significantly lower by 6·9 % (95 % CI 1·6%, 11·8%) for PDI and 9·0 % (95 % CI 4·9%, 12·8%) for hPDI but significantly higher by 5·4 % (95 % CI 0·5%, 10·5%) for uPDI, and VAT was significantly lower by 7·8 cm2 (95 % CI 2·0 cm2, 13·6 cm2) for PDI and 8·6 cm2 (95 % CI 4·1 cm2, 13·2 cm2) for hPDI but significantly higher by 6·2 cm2 (95 % CI 1·3 cm2, 11·1 cm2) for uPDI. No significant associations were observed for other inflammation biomarkers, muscle, or SAT. A plant-based diet, especially a healthful plant-based diet, may be associated with reduced inflammation and visceral adiposity among breast cancer survivors.
Posttraumatic stress disorder (PTSD) has been associated with advanced epigenetic age cross-sectionally, but the association between these variables over time is unclear. This study conducted meta-analyses to test whether new-onset PTSD diagnosis and changes in PTSD symptom severity over time were associated with changes in two metrics of epigenetic aging over two time points.
Methods
We conducted meta-analyses of the association between change in PTSD diagnosis and symptom severity and change in epigenetic age acceleration/deceleration (age-adjusted DNA methylation age residuals as per the Horvath and GrimAge metrics) using data from 7 military and civilian cohorts participating in the Psychiatric Genomics Consortium PTSD Epigenetics Workgroup (total N = 1,367).
Results
Meta-analysis revealed that the interaction between Time 1 (T1) Horvath age residuals and new-onset PTSD over time was significantly associated with Horvath age residuals at T2 (meta β = 0.16, meta p = 0.02, p-adj = 0.03). The interaction between T1 Horvath age residuals and changes in PTSD symptom severity over time was significantly related to Horvath age residuals at T2 (meta β = 0.24, meta p = 0.05). No associations were observed for GrimAge residuals.
Conclusions
Results indicated that individuals who developed new-onset PTSD or showed increased PTSD symptom severity over time evidenced greater epigenetic age acceleration at follow-up than would be expected based on baseline age acceleration. This suggests that PTSD may accelerate biological aging over time and highlights the need for intervention studies to determine if PTSD treatment has a beneficial effect on the aging methylome.
Guideline-based tobacco treatment is infrequently offered. Electronic health record-enabled patient-generated health data (PGHD) has the potential to increase patient treatment engagement and satisfaction.
Methods:
We evaluated outcomes of a strategy to enable PGHD in a medical oncology clinic from July 1, 2021 to December 31, 2022. Among 12,777 patients, 82.1% received a tobacco screener about use and interest in treatment as part of eCheck-in via the patient portal.
Results:
We attained a broad reach (82.1%) and moderate response rate (30.9%) for this low-burden PGHD strategy. Patients reporting current smoking (n = 240) expressed interest in smoking cessation medication (47.9%) and counseling (35.8%). As a result of patient requests via PGHD, most tobacco treatment requests by patients were addressed by their providers (40.6–80.3%). Among patients with active smoking, those who received/answered the screener (n = 309 ) were more likely to receive tobacco treatment compared with usual care patients who did not have the patient portal (n = 323) (OR = 2.72, 95% CI = 1.93–3.82, P < 0.0001) using propensity scores to adjust for the effect of age, sex, race, insurance, and comorbidity. Patients who received yet ignored the screener (n = 1024) compared with usual care were also more likely to receive tobacco treatment, but to a lesser extent (OR = 2.20, 95% CI = 1.68–2.86, P < 0.0001). We mapped observed and potential benefits to the Translational Science Benefits Model (TSBM).
Discussion:
PGHD via patient portal appears to be a feasible, acceptable, scalable, and cost-effective approach to promote patient-centered care and tobacco treatment in cancer patients. Importantly, the PGHD approach serves as a real world example of cancer prevention leveraging the TSBM.
Patients discharged from emergency departments (ED) with antibiotics for common infections often receive unnecessarily prolonged durations, representing a target for transition of care (TOC) antimicrobial stewardship intervention.
Methods:
This study aimed to evaluate the effectiveness of TOC pharmacists’ review on decreasing the duration of discharge oral antibiotics in patients discharged from the ED at an academic medical center. Pharmacist interventions were guided by an antibiotic duration of therapy guidance focused on respiratory, urinary, and skin infections developed and implemented by the antimicrobial stewardship program. Pharmacist interventions from January 27, 2023, to December 29, 2023, were analyzed to quantify the total number of antibiotic days saved and the percentage of provider acceptance.
Results:
The ED TOC pharmacists reviewed a total of 157 oral antibiotic prescriptions. 86.6% percent of the reviews required pharmacist interventions. The most common indications for the discharge antibiotics were urinary tract infections (50.0%) and skin infections (23.4%). The total number of antibiotic days saved was 155 days with the provider acceptance rate of 76.5%. In 21% of cases, providers did not count the antibiotic doses administered in the ED, contributing to unnecessarily prolonged duration. 10.2% of patients re-presented to the ED while 6.4% of patients were hospitalized within 30 days of index ED discharge.
Conclusion:
The transitions of care pharmacist-led intervention was successful in optimizing the duration of discharge oral antibiotics in the ED utilizing prospective audit and feedback based on institutional guidance. The ED represents a high-yield setting for TOC-directed antimicrobial stewardship.
We present an approach for evaluating coherence in multivariate systems that considers all the variables simultaneously. We operationalize the multivariate system as a network and define coherence as the efficiency with which a signal is transmitted throughout the network. We illustrate this approach with time series data from 15 psychophysiological signals representing individuals’ moment-by-moment emotional reactions to emotional films. First, we summarize the time series through nonparametric Receiver Operating Characteristic (ROC) curves. Second, we use Spearman rank correlations to calculate relationships between each pair of variables. Third, based on the obtained associations, we construct a network using the variables as nodes. Finally, we examine signal transmission through all the nodes in the network. Our results indicate that the network consisting of the 15 psychophysiological signals has a small-world structure, with three clusters of variables and strong within-cluster connections. This structure supports an effective signal transmission across the entire network. When compared across experimental conditions, our results indicate that coherence is relatively stronger for intense emotional stimuli than for neutral stimuli. These findings are discussed in relation to multivariate methods and emotion theories.
Young stellar objects (YSOs) are protostars that exhibit bipolar outflows fed by accretion disks. Theories of the transition between disk and outflow often involve a complex magnetic field structure thought to be created by the disk coiling field lines at the jet base; however, due to limited resolution, these theories cannot be confirmed with observation and thus may benefit from laboratory astrophysics studies. We create a dynamically similar laboratory system by driving a $\sim$1 MA current pulse with a 200 ns rise through a $\approx$2 mm-tall Al cylindrical wire array mounted to a three-dimensional (3-D)-printed, stainless steel scaffolding. This system creates a plasma that converges on the centre axis and ejects cm-scale bipolar outflows. Depending on the chosen 3-D-printed load path, the system may be designed to push the ablated plasma flow radially inwards or off-axis to make rotation. In this paper, we present results from the simplest iteration of the load which generates radially converging streams that launch non-rotating jets. The temperature, velocity and density of the radial inflows and axial outflows are characterized using interferometry, gated optical and ultraviolet imaging, and Thomson scattering diagnostics. We show that experimental measurements of the Reynolds number and sonic Mach number in three different stages of the experiment scale favourably to the observed properties of YSO jets with $Re\sim 10^5\unicode{x2013}10^9$ and $M\sim 1\unicode{x2013}10$, while our magnetic Reynolds number of $Re_M\sim 1\unicode{x2013}15$ indicates that the magnetic field diffuses out of our plasma over multiple hydrodynamical time scales. We compare our results with 3-D numerical simulations in the PERSEUS extended magnetohydrodynamics code.
With the rapid expansion of the aviation industry, an increasing number of Close Spaced Parallel Runway (CSPR) airports are either planning or constructing End Around Taxiways (EAT) to alleviate field operation pressures and enhance safety. Taking Shanghai Hongqiao Airport’s typical CSPR EAT configuration as a case study, this research integrates the airport’s current operational status with the anticipated requirements for future structural renovations and increased flight volumes. Various operational scenarios are established, and simulation research on optimising EAT operations is conducted in advance. The simulation study proceeds as follows: first, an AirTOP simulation model is constructed based on Hongqiao Airport’s actual operational construction. Subsequently, leveraging existing operational scenarios, five simulation scenarios are devised by activating EATs at the departure and approach ends of the eastern zone. The merits and drawbacks of these scenarios are thoroughly analysed. The findings indicate that, with escalating flight volumes, the utilisation of EAT for larger aircraft can curtail their holding duration by nearly 8 min, consequently reducing overall arrival holding duration by 6 min. Departures from gates proximate to T1 experience a 3-min reduction in holding duration through the adoption of EAT at the approach end. Despite an increase in taxi distance due to a higher proportion of aircraft taxiing around, the overall taxi time is diminished. Activating EATs at the departure and approach ends of the eastern zone effectively mitigates the adverse effects of heightened flight volumes on field operational efficiency.
There is a relative lack of research, targeted models and tools to manage beaches in estuaries and bays (BEBs). Many estuaries and bays have been highly modified and urbanised, for example port developments and coastal revetments. This paper outlines the complications and opportunities for conserving and managing BEBs in modified estuaries. To do this, we focus on eight diverse case studies from North and South America, Asia, Europe, Africa and Australia combined with the broader global literature. Our key findings are as follows: (1) BEBs are diverse and exist under a great variety of tide and wave conditions that differentiate them from open-coast beaches; (2) BEBs often lack statutory protection and many have already been sacrificed to development; (3) BEBs lack specific management tools and are often managed using tools developed for open-coast beaches; and (4) BEBs have the potential to become important in “nature-based” management solutions. We set the future research agenda for BEBs, which should include broadening research to include greater diversity of BEBs than in the past, standardising monitoring techniques, including the development of global databases using citizen science and developing specific management tools for BEBs. We must recognise BEBs as unique coastal features and develop the required fundamental knowledge and tools to effectively manage them, so they can continue providing their unique ecosystem services.
Digital interventions have been found to be successful in preventing occupational mental health concerns, however, they seem to be affected by attrition bias through high attrition rates and differential attrition. Differential attrition arises when the rates of participant dropouts differ across different treatment conditions and is considered a significant challenge to internal validity.
Objectives
We aimed at systematically review and meta-analyse differential attrition of digital mental health interventions in the workplace setting.
Methods
On January 2, 2022, we performed a search in the following electronic databases: PubMed, Scopus, and Web of Science Core. We utilized a combination of terms from five distinct areas, namely mental health, intervention, workplace, implementation, and study design. The study encompassed adult employees who took part in a randomized control trial aimed at preventing mental health issues in the workplace through an online intervention. A team of six reviewers collaborated on the study selection process, while two independent researchers conducted the data extraction for the selected studies. We performed a meta-analysis of the log-transformed relative attrition rates of the included studies using a random-effects model with limited maximum-likelihood (REML) estimation to account for the degree of heterogeneity.
Results
A total of 19 studies were included in the meta-analysis. For baseline to post-intervention, the average total attrition was 26.27% (SD = 21.16%, range = 0 – 66.3%) and the random effects model revealed a higher attrition rate in the intervention group compared to the control group, with a pooled risk ratio of 1.05 (95% CI: 1.01 - 1.10, p = .014). For baseline to follow-up measurement the average total attrition was 27.71% (SD = 20.80%, range = 0 – 67.78%), however, in this case the random effects model did not indicate a higher attrition in the intervention group when compared to the control group (pooled risk ratio = 1.05, 95% CI: 0.98 – 1.12, p = .183).
Conclusions
There is an indication of higher attrition in the intervention group as compared to the control group in occupational e-mental health interventions from baseline to post-intervention, however this does not seem to be the case for baseline to follow-up attrition. These results should be taken into account in the design process of studies and statistical analyses should be adapted to counteract the bias that could result from differential attrition.
Background: Sex and gender are related but distinct determinants of disease, treatment response, and research reproducibility whose consideration is increasingly required for research funding. Nevertheless, the quality of sex and gender reporting in neurological randomized controlled trials (RCTs) remains unknown. Methods: This ongoing study of RCTs associated with Food and Drug Administration neurological drug approvals aims to determine the frequency of accurate reporting of RCT participants’ sex and gender. Secondary outcomes include changes in reporting over time and RCT design characteristics. Results: Preliminary analysis included 145 RCTs (153,410 participants) associated with 77 medications approved in 1985-2023, most commonly for epilepsy (19%), migraine (16%), and multiple sclerosis (16%). Sixty-six RCTs (45.5%) used sex-related terms appropriately. Nine RCTs (6.2%) reported gender accurately. Fifty-three RCTs (37%) used sex- or gender-related terms interchangeably. There are no statistically significant differences in the proportions of studies reporting sex and/or gender accurately when comparing those published until versus after 2017. No RCT reported sex or gender collection methods, definitions of sex or gender, or including sex or gender minority participants. Conclusions: Preliminary results suggest shortcomings in reporting sex and, especially, gender accurately and inclusively among neurological drug RCTs and no significant improvement thereof in recent years.
A significant proportion of people with clozapine-treated schizophrenia develop ‘checking’ compulsions, a phenomenon yet to be understood.
Aims
To use habit formation models developed in cognitive neuroscience to investigate the dynamic interplay between psychosis, clozapine dose and obsessive–compulsive symptoms (OCS).
Method
Using the anonymised electronic records of a cohort of clozapine-treated patients, including longitudinal assessments of OCS and psychosis, we performed longitudinal multi-level mediation and multi-level moderation analyses to explore associations of psychosis with obsessiveness and excessive checking. Classic bivariate correlation tests were used to assess clozapine load and checking compulsions. The influence of specific genetic variants was tested in a subsample.
Results
A total of 196 clozapine-treated individuals and 459 face-to-face assessments were included. We found significant OCS to be common (37.9%), with checking being the most prevalent symptom. In mediation models, psychosis severity mediated checking behaviour indirectly by inducing obsessions (r = 0.07, 95% CI 0.04–0.09; P < 0.001). No direct effect of psychosis on checking was identified (r = −0.28, 95% CI −0.09 to 0.03; P = 0.340). After psychosis remission (n = 65), checking compulsions correlated with both clozapine plasma levels (r = 0.35; P = 0.004) and dose (r = 0.38; P = 0.002). None of the glutamatergic and serotonergic genetic variants were found to moderate the effect of psychosis on obsession and compulsion (SLC6A4, SLC1A1 and HTR2C) survived the multiple comparisons correction.
Conclusions
We elucidated different phases of the complex interplay of psychosis and compulsions, which may inform clinicians’ therapeutic decisions.
The status of the genera Euparagonimus Chen, 1963 and Pagumogonimus Chen, 1963 relative to Paragonimus Braun, 1899 was investigated using DNA sequences from the mitochondrial cytochrome c oxidase subunit I (CO1) gene (partial) and the nuclear ribosomal DNA second internal transcribed spacer (ITS2). In the phylogenetic trees constructed, the genus Pagumogonimus is clearly not monophyletic and therefore not a natural taxon. Indeed, the type species of Pagumogonimus,P. skrjabini from China, is very closely related to Paragonimusmiyazakii from Japan. The status of Euparagonimus is less obvious. Euparagonimus cenocopiosus lies distant from other lungflukes included in the analysis. It can be placed as sister to Paragonimus in some analyses and falls within the genus in others. A recently published morphological study placed E. cenocopiosus within the genus Paragonimus and probably this is where it should remain.
Synthetic sodium bimessite, having a cation-exchange capacity (CEC) of 240 meq/100 g (cmol/kg) was transformed into Li, K, Mg, Ca, Sr, Ni, and Mn2+ cationic forms by ion exchange in an aqueous medium. Competitive adsorption studies of Ni and Ba vs. Mg showed a strong preference for Ni and Ba by bimessite. The product of Mg2+-exchange was buserite, which showed a basal spacing of 9.6 Å (22°C, relative humidity (RH) = 54%), which on drying at 105°C under vacuum collapsed to 7 Å. Of the cation- saturated bimessites with 7-Å basal spacing, only Li-, Na-, Mg-, and Ca-bimessites showed cation exchange.
Heating bimessite saturated with cations other than K produced a disordered phase between 200° and 400°C, which transformed to well-crystallized phases at 600°C. K-exchanged bimessite did not transform to a disordered phase; rather a topotactic transformation to cryptomelane was observed. Generally the larger cations, K, Ba, and Sr, gave rise to hollandite-type structures. Mn- and Ni-bimessite transformed to bixbyite-type products, and Mg-bimessite (buserite) transformed to a hausmannite-type product. Li-bimessite transformed to cryptomelane and at higher temperature converted to hausmannite. The hollandite-type products retained the morphology of the parent bimessite. The mineralogy of final products were controlled by the saturating cation. Products obtained by heating natural bimessite were similar to those obtained by heating bimessite saturated with transition elements.
Investigations were conducted to determine the hydrothermal transformations of synthetic birnessite exchanged with different metal ions. Autoclaving in a Teflon-lined stainless steel pressure vessel at 155°C for 24 hr of Mg-, Ca-, La-, and Co-saturated birnessite yielded manganese minerals having 10-Å X-ray powder diffraction (XRD) spacings. The autoclaved Mg-birnessite yielded a mineral identical to natural todorokite in its infrared (IR) spectrum and XRD patterns. High-resolution transmission electron microscopy (HRTEM) provided images having 10-, 12.5-, 15-, and 20-Å wide fringes indicating heterogeneous channel widths in the crystallographic a direction, and IR spectroscopy produced bands at 757, 635, 552, 515, 460, and 435 cm-1, confirming the product obtained by autoclaving Mg-birnessite to be todorokite. Prolonged autoclaving of Mg-birnessite yielded manganite (γ-MnOOH) as a by-product; manganite did not form when the autoclaving time was shortened to 8 hr. Also, when Ca-saturated samples were autoclaved, the product gave d-values of 10 Å, but the XRD lines were broad and heterogeneity of the channel sizes was evident from HRTEM observations. The Ca-derivative had an IR spectrum similar to that of natural todorokite. Images showing 10-Å lattice fringes were observed by HRTEM for the Ni-saturated sample, which also produced an XRD pattern similar to that of the Mg-saturated sample. Co- and Lasaturated samples did not form todorokite, although HRTEM of La-saturated samples indicated some 10-Å lattice fringes that were unstable in the electron beam. Birnessite saturated with Na, K, NH4, Cs, Ba, or Mn(II) gave products having 7-Å spacings upon autoclaving.
Na-saturated bimessite was synthesized by oxidizing an alkaline MnCl2 solution with gaseous O2. Transmission electron microscopy (TEM) showed no morphological change upon K-saturation of the bimessite, but selected-area diffraction (SAD) revealed structural disorder. Stepwise heating of the K-birnessite to 800°C yielded cryptomelane, as indicated by X-ray powder diffraction (XRD). Various degrees of transformation to the final cryptomelane product were observed by TEM and SAD, but not by XRD. Unaltered bimessite formed chiefly as thin, platy crystals of apparent hexagonal outline. The cryptomelane crystals that formed by heating the K-saturated bimessite were acicular. Bimessite crystals, partially transformed to cryptomelane and displaying non-integral diffraction spots, formed plates having linear striations and rods twinned at 60° to each other. These intermediate products commonly retained some of the original hexagonal appearance of the parent bimessite. Structural disorder was detected in the partially transformed crystals by SAD. TEM revealed 6.8- and 4.8-Å spacings of the (110) and (200) planes of cryptomelane, respectively. The basal planes of bimessite layers (001) appeared to correspond topotactically to the (110) plane of cryptomelane during these transformations.
Converging evidence has suggested that treatment augmentation with a second-generation atypical antipsychotic (SGA) may improve treatment outcomes in major depressive disorder (MDD) patients after an incomplete response to a first-line antidepressant. Cariprazine is a recently approved SGA for MDD augmentation. Herein, we evaluate both continuous (ie, change in depressive symptom severity scores over time) and categorical (ie, remission and response rates) outcomes. Following a full-text review, four randomized controlled trials (RCTs) were included in our meta-analysis, while five studies were included for a qualitative review. Risk ratios (RRs) were calculated for all included randomized controlled studies to determine the relative response and remission rates of cariprazine compared to placebo augmentation. The RR for all-cause dropout was also determined as a proxy for overall acceptability. Two studies found a statistically significant treatment response using cariprazine augmentation. One study observed depressive symptom remission for cariprazine compared to placebo. Our random-effects model revealed moderate antidepressant effects of cariprazine, with a standardized mean difference (SMD) in Montgomery–Åsberg Depression Rating Scale (MADRS) scores of −1.79 (95% CI): −2.89, −0.69). Our pooled response RR and remission RR were calculated as 1.21 (95% CI: 1.05, 1.39, P=0.008) and 0.99 (95% CI: 0.84, 1.17, P=0.91), respectively. The RR for response was statistically significant (P<0.05). However, the RR for remission was not statistically significant. The findings from our meta-analysis include a variable magnitude of effects. Evidence suggests cariprazine may be an effective treatment for MDD; however, further results are needed to clarify this relation.