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Patients with posttraumatic stress disorder (PTSD) exhibit smaller regional brain volumes in commonly reported regions including the amygdala and hippocampus, regions associated with fear and memory processing. In the current study, we have conducted a voxel-based morphometry (VBM) meta-analysis using whole-brain statistical maps with neuroimaging data from the ENIGMA-PGC PTSD working group.
Methods
T1-weighted structural neuroimaging scans from 36 cohorts (PTSD n = 1309; controls n = 2198) were processed using a standardized VBM pipeline (ENIGMA-VBM tool). We meta-analyzed the resulting statistical maps for voxel-wise differences in gray matter (GM) and white matter (WM) volumes between PTSD patients and controls, performed subgroup analyses considering the trauma exposure of the controls, and examined associations between regional brain volumes and clinical variables including PTSD (CAPS-4/5, PCL-5) and depression severity (BDI-II, PHQ-9).
Results
PTSD patients exhibited smaller GM volumes across the frontal and temporal lobes, and cerebellum, with the most significant effect in the left cerebellum (Hedges’ g = 0.22, pcorrected = .001), and smaller cerebellar WM volume (peak Hedges’ g = 0.14, pcorrected = .008). We observed similar regional differences when comparing patients to trauma-exposed controls, suggesting these structural abnormalities may be specific to PTSD. Regression analyses revealed PTSD severity was negatively associated with GM volumes within the cerebellum (pcorrected = .003), while depression severity was negatively associated with GM volumes within the cerebellum and superior frontal gyrus in patients (pcorrected = .001).
Conclusions
PTSD patients exhibited widespread, regional differences in brain volumes where greater regional deficits appeared to reflect more severe symptoms. Our findings add to the growing literature implicating the cerebellum in PTSD psychopathology.
Background: The complement component C5 inhibitor, ravulizumab, is approved in Canada for the treatment of adults with AQP4-Ab+ NMOSD. Updated efficacy and safety results from the ongoing CHAMPION-NMOSD (NCT04201262) trial are reported. Methods: Participants received IV-administered, weight-based dosing of ravulizumab, with loading on day 1 and maintenance doses on day 15 and every 8 weeks thereafter. Following a primary treatment period (PTP; up to 2.5 years), patients could enter a long-term extension (LTE). Outcome measures included safety, time to first adjudicated on-trial relapse (OTR), risk reduction, and disability scores. Results: 56/41 patients entered/completed the LTE as of June 14, 2024. Median follow-up was 170.3 weeks (186.6 patient-years). No patients experienced an OTR. 94.8% (55/58 patients) had stable or improved Hauser Ambulation Index scores. 89.7% (52/58 patients) had no clinically important worsening in Expanded Disability Status Scale scores. Treatment-emergent adverse events (98.4%) were predominantly mild and unrelated to ravulizumab. Serious adverse events occurred in 25.9% of patients. Two cases of meningococcal infection occurred during the PTP, and none in the LTE. One unrelated death (cardiovascular) occurred during the LTE. Conclusions: Ravulizumab demonstrated long-term clinical benefit in AQP4-Ab+ NMOSD relapse prevention while maintaining or improving disability measures, with no new safety concerns.
Flumioxazin and S-metolachlor are widely used in conventional sweetpotato production in North Carolina and other states; however, some growers have recently expressed concerns about potential effects of these herbicides on sweetpotato yield and quality. Previous research indicates that activated charcoal has the potential to reduce herbicide injury. Field studies were conducted in 2021 and 2022 to determine whether flumioxazin applied preplant and S-metolachlor applied before and after transplanting negatively affect sweetpotato yield and quality when activated charcoal is applied with transplant water. The studies evaluated five herbicide treatments and two activated charcoal treatments. Herbicide treatments included two flumioxazin rates, one S-metolachlor rate applied immediately before and immediately after transplanting, and no herbicide. Charcoal treatments consisted of activated charcoal applied at 9 kg ha−1, and no charcoal. No visual injury from herbicides or charcoal was observed. Likewise, no effect of herbicide or charcoal treatment on no. 1, marketable (sum of no. 1 and jumbo grades), or total yield (sum of canner, no. 1, and jumbo grades) was observed. Additionally, shape analysis conducted on calculated length-to-width ratio (LWR) for no. 1 sweetpotato roots found no effect from flumioxazin at either rate on sweetpotato root shape. However, both S-metolachlor treatments resulted in lower LWR of no. 1 sweetpotato roots in 2021. Results are consistent with prior research and indicate that flumioxazin and S-metolachlor are safe for continued use on sweetpotato at registered rates.
Background: CHAMPION-NMOSD (NCT04201262) is an ongoing global, open-label, phase 3 study evaluating ravulizumab in AQP4+ NMOSD. Methods: Adult patients received an intravenous, weight-based loading dose of ravulizumab on day 1 and a maintenance dose on day 15 and every 8 weeks thereafter. Following a primary treatment period (PTP; up to 2.5 years), patients could enter a long-term extension (LTE). Results: 58 patients completed the PTP; 56/2 entered/completed the LTE. As of June 16, 2023, median (range) follow-up was 138.4 (11.0-183.1) weeks for ravulizumab (n=58), with 153.9 patient-years. Across the PTP and LTE, no patients had an adjudicated on-trial relapse during ravulizumab treatment. 91.4% (53/58 patients) had stable or improved Hauser Ambulation Index score. 91.4% (53/58 patients) had no clinically important worsening in Expanded Disability Status Scale score. The incidence of treatment-emergent adverse events (TEAEs) and serious adverse events was 94.8% and 25.9%, respectively. Most TEAEs were mild to moderate in severity and unrelated to ravulizumab. TEAEs leading to withdrawal from ravulizumab occurred in 1 patient. Conclusions: Ravulizumab demonstrated long-term clinical benefit in the prevention of relapses in AQP4+ NMOSD with a safety profile consistent with prior analyses.
The effect of anions on clay dispersion and the hydraulic conductivity (HC) of clay-sand mixtures has received little attention. This study investigates the effect that adding small amounts of anions has on the dispersivity and HC of reference clays. Mixtures of 3 and 6 g 100 g−1 kaolinite, smectite, and illite with quartz sand were packed in columns. The columns were saturated with Ca and then leached with 1 molc m−3 of one of the following organic and inorganic Na salts: chloride, hydroxide, EDTA, silicate, citrate, formate, oxalate, hexametaphosphate, orthophosphate, tartrate, or humate. Changes in HC and clay concentration in the effluent were measured and clay dispersion was evaluated as a function of the various anions added. In the kaolinite clay-sand mixtures, a significant amount of clay was observed in the effluent for all anions tested, and the HC increased above its original value. The HC of smectite clay-sand mixtures decreased following the addition of the various anions. Dispersed clay appeared in the effluent only upon addition of citrate or hexametaphosphate. In the latter two cases, the HC started to increase once maximum clay concentration appeared in the effluent. Clay concentration in the effluent of smectite was one order of magnitude lower than that of kaolinite. Illite clay-sand mixtures showed dispersion behavior intermediate between smectite and kaolinite but behaved in the same way as kaolinite with respect to HC changes.
Ménière's disease is a debilitating chronic peripheral vestibular disorder associated with psychiatric co-morbidities, notably depression.
Methods
Database searches were performed to identify studies that assessed depression in Ménière's disease. Metrics used to diagnose depression were extracted, along with the prevalence of depression in each study.
Results
Fifteen studies from 8 different countries reported on 6587 patients. The weighted average age was 55.3 years (range, 21–88 years). Depression was measured by eight different scales, with Zung's Self-Rating Depression Scale used most often. A weighted proportion of 45.9 per cent of patients (confidence interval = 28.9–63.3) were depressed. Weighted averages (± standard deviations) of Beck's Depression Inventory and the Illness Behavior Questionnaire – Dysphoria were 8.5 ± 7.9 and 2.4 ± 1.7, respectively.
Conclusion
The prevalence of depression in patients with Ménière's disease is nearly 50 per cent. Treating otolaryngologists should have a low threshold to screen and refer appropriately. Identifying and treating depression should allow for improvement of overall quality of life in patients with Ménière's disease.
Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. We assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9.
Methods
We conducted an individual patient data meta-analysis. We fit bivariate random-effects models to assess diagnostic accuracy.
Results
16 742 participants (2097 major depression cases) from 54 studies were included. The correlation between PHQ-8 and PHQ-9 scores was 0.996 (95% confidence interval 0.996 to 0.996). The standard cutoff score of 10 for the PHQ-9 maximized sensitivity + specificity for the PHQ-8 among studies that used a semi-structured diagnostic interview reference standard (N = 27). At cutoff 10, the PHQ-8 was less sensitive by 0.02 (−0.06 to 0.00) and more specific by 0.01 (0.00 to 0.01) among those studies (N = 27), with similar results for studies that used other types of interviews (N = 27). For all 54 primary studies combined, across all cutoffs, the PHQ-8 was less sensitive than the PHQ-9 by 0.00 to 0.05 (0.03 at cutoff 10), and specificity was within 0.01 for all cutoffs (0.00 to 0.01).
Conclusions
PHQ-8 and PHQ-9 total scores were similar. Sensitivity may be minimally reduced with the PHQ-8, but specificity is similar.
Different diagnostic interviews are used as reference standards for major depression classification in research. Semi-structured interviews involve clinical judgement, whereas fully structured interviews are completely scripted. The Mini International Neuropsychiatric Interview (MINI), a brief fully structured interview, is also sometimes used. It is not known whether interview method is associated with probability of major depression classification.
Aims
To evaluate the association between interview method and odds of major depression classification, controlling for depressive symptom scores and participant characteristics.
Method
Data collected for an individual participant data meta-analysis of Patient Health Questionnaire-9 (PHQ-9) diagnostic accuracy were analysed and binomial generalised linear mixed models were fit.
Results
A total of 17 158 participants (2287 with major depression) from 57 primary studies were analysed. Among fully structured interviews, odds of major depression were higher for the MINI compared with the Composite International Diagnostic Interview (CIDI) (odds ratio (OR) = 2.10; 95% CI = 1.15–3.87). Compared with semi-structured interviews, fully structured interviews (MINI excluded) were non-significantly more likely to classify participants with low-level depressive symptoms (PHQ-9 scores ≤6) as having major depression (OR = 3.13; 95% CI = 0.98–10.00), similarly likely for moderate-level symptoms (PHQ-9 scores 7–15) (OR = 0.96; 95% CI = 0.56–1.66) and significantly less likely for high-level symptoms (PHQ-9 scores ≥16) (OR = 0.50; 95% CI = 0.26–0.97).
Conclusions
The MINI may identify more people as depressed than the CIDI, and semi-structured and fully structured interviews may not be interchangeable methods, but these results should be replicated.
Declaration of interest
Drs Jetté and Patten declare that they received a grant, outside the submitted work, from the Hotchkiss Brain Institute, which was jointly funded by the Institute and Pfizer. Pfizer was the original sponsor of the development of the PHQ-9, which is now in the public domain. Dr Chan is a steering committee member or consultant of Astra Zeneca, Bayer, Lilly, MSD and Pfizer. She has received sponsorships and honorarium for giving lectures and providing consultancy and her affiliated institution has received research grants from these companies. Dr Hegerl declares that within the past 3 years, he was an advisory board member for Lundbeck, Servier and Otsuka Pharma; a consultant for Bayer Pharma; and a speaker for Medice Arzneimittel, Novartis, and Roche Pharma, all outside the submitted work. Dr Inagaki declares that he has received grants from Novartis Pharma, lecture fees from Pfizer, Mochida, Shionogi, Sumitomo Dainippon Pharma, Daiichi-Sankyo, Meiji Seika and Takeda, and royalties from Nippon Hyoron Sha, Nanzando, Seiwa Shoten, Igaku-shoin and Technomics, all outside of the submitted work. Dr Yamada reports personal fees from Meiji Seika Pharma Co., Ltd., MSD K.K., Asahi Kasei Pharma Corporation, Seishin Shobo, Seiwa Shoten Co., Ltd., Igaku-shoin Ltd., Chugai Igakusha and Sentan Igakusha, all outside the submitted work. All other authors declare no competing interests. No funder had any role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.
Mulching the soil with polyethylene sheets before sowing during the hot season, increased the soil temperatures, which resulted in the control of soil-borne pathogens and weeds. This method was tested in a field heavily infested with Egyptian broomrape (Orobanche aegyptiaca L.). Soil was irrigated and mulched for 36 days during August–September 1977, prior to sowing carrot (Daucus carota L. ‘Nantes Tip Top’) seeds. Mulching increased soil temperatures by 8 to 12 C, up to 56 C in the top 5 cm. In the non-mulched plots the carrot plants became stunted due to heavy parasitization with broomrape and they were completely destroyed by the end of the season. In contrast, broomrape and other weeds were controlled in the mulched plots and the carrot plants grew normally. This effect was less pronounced in the border rows of the mulched plots. Mulching also greatly reduced the infestation of other weeds. Egyptian broomrape was also controlled in two other field experiments with carrots and eggplants (Solanum melongena L. ‘Black oval’). As compared with fumigation, this new method of control is economical, simple, nonhazardous, and does not employ toxic materials.
This study investigated factors that influence occurrence and persistence of plant DNA in the soil environment in three crop rotations. In each rotation, soil was sampled in May before planting, in July and August while crops were growing, and in October after harvest. Total DNA was recovered from soil samples taken at two different depths in the soil profile and quantified. Three target plant genes (corn CP4 epsps, corn 10-kD Zein, and soybean CP4 epsps) also were quantified in these DNA extracts using species-specific quantitative real-time PCR assays. In general, total plant DNA content in the soil environment was greatest when the crop was growing in the field and decreased rapidly after harvest. Nevertheless, low levels of target plant DNA were often still detectable the following spring. Age of rotation did not influence target DNA quantities found in the soil environment. Data were collected for a combination of 10 location-years, which allowed for estimation of the variance components for six factors including time of sampling, year, location, crop, sampling depth, and herbicide to total and target DNA content in the soil samples. Mean target recombinant DNA content in soil was influenced most strongly by time of sampling and year (85 and 6%, respectively), whereas total soil DNA content was less dynamic and was most strongly influenced by location and year (49 and 25%, respectively). Over the duration of this study, no accumulation of transgenic plant DNA in the soil environment was observed.
Data were pooled from three Australian sentinel general practice influenza surveillance networks to estimate Australia-wide influenza vaccine coverage and effectiveness against community presentations for laboratory-confirmed influenza for the 2012, 2013 and 2014 seasons. Patients presenting with influenza-like illness at participating GP practices were swabbed and tested for influenza. The vaccination odds of patients testing positive were compared with patients testing negative to estimate influenza vaccine effectiveness (VE) by logistic regression, adjusting for age group, week of presentation and network. Pooling of data across Australia increased the sample size for estimation from a minimum of 684 to 3,683 in 2012, from 314 to 2,042 in 2013 and from 497 to 3,074 in 2014. Overall VE was 38% [95% confidence interval (CI) 24–49] in 2012, 60% (95% CI 45–70) in 2013 and 44% (95% CI 31–55) in 2014. For A(H1N1)pdm09 VE was 54% (95% CI–28 to 83) in 2012, 59% (95% CI 33–74) in 2013 and 55% (95% CI 39–67) in 2014. For A(H3N2), VE was 30% (95% CI 14–44) in 2012, 67% (95% CI 39–82) in 2013 and 26% (95% CI 1–45) in 2014. For influenza B, VE was stable across years at 56% (95% CI 37–70) in 2012, 57% (95% CI 30–73) in 2013 and 54% (95% CI 21–73) in 2014. Overall VE against influenza was low in 2012 and 2014 when A(H3N2) was the dominant strain and the vaccine was poorly matched. In contrast, overall VE was higher in 2013 when A(H1N1)pdm09 dominated and the vaccine was a better match. Pooling data can increase the sample available and enable more precise subtype- and age group-specific estimates, but limitations remain.
Femtosecond near IR laser irradiation is explored as a general methodology to produce metal nanoparticles from metal precursor solutions. Initial studies of the formation and transformations of gold nanoparticles in aqueous solution are used as model processes to evaluate the effects of laser parameters, reaction medium and surfactants in controlling metal nanoparticle formation. The addition of polymer surfactants such as poly(ethylene glycol) (PEG) was found to significantly accelerate Au(III) reduction as compared to surfactant-free systems. Photo-reduction for aqueous solutions of Au(III) in the presence of PEG results in relatively small narrowly dispersed spherical gold nanoparticles compared to relatively large well-formed crystalline nanoparticles that are observed in the absence of surfactants. Varying the concentration of PEG is an effective approach to tune the diameter and size distribution from 3.9±0.7 nm to 11±2.4 nm for Au nanoparticles produced by laser processing.
Join David J. Eicher in this fast-paced and entertaining journey through the history, present, and future of these important yet mysterious cosmic bodies. From ancient times, humans have been fascinated by 'broom stars' and 'blazing scimitars' lighting up the sky and moving against the fixed background of stars. The Great Comets of our time still receive in-depth attention - ISON, Hale-Bopp, Hyakutake, West, and others - while recent spacecraft encounters offer amazing insight into the earliest days of the solar system. In this guide you will discover the cutting-edge science of what comets are, how they behave, where they reside, how groups of comets are related, and much more. The author carefully explores the ideas relating comets and life on Earth - and the danger posed by impacts. He finishes with practical, how-to techniques, tips, and tricks on how to successfully observe comets and even to capture your own images of them.