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Profiling patients on a proposed ‘immunometabolic depression’ (IMD) dimension, described as a cluster of atypical depressive symptoms related to energy regulation and immunometabolic dysregulations, may optimise personalised treatment.
Aims
To test the hypothesis that baseline IMD features predict poorer treatment outcomes with antidepressants.
Method
Data on 2551 individuals with depression across the iSPOT-D (n = 967), CO-MED (n = 665), GENDEP (n = 773) and EMBARC (n = 146) clinical trials were used. Predictors included baseline severity of atypical energy-related symptoms (AES), body mass index (BMI) and C-reactive protein levels (CRP, three trials only) separately and aggregated into an IMD index. Mixed models on the primary outcome (change in depressive symptom severity) and logistic regressions on secondary outcomes (response and remission) were conducted for the individual trial data-sets and pooled using random-effects meta-analyses.
Results
Although AES severity and BMI did not predict changes in depressive symptom severity, higher baseline CRP predicted smaller reductions in depressive symptoms (n = 376, βpooled = 0.06, P = 0.049, 95% CI 0.0001–0.12, I2 = 3.61%); this was also found for an IMD index combining these features (n = 372, βpooled = 0.12, s.e. = 0.12, P = 0.031, 95% CI 0.01–0.22, I2= 23.91%), with a higher – but still small – effect size compared with CRP. Confining analyses to selective serotonin reuptake inhibitor users indicated larger effects of CRP (βpooled = 0.16) and the IMD index (βpooled = 0.20). Baseline IMD features, both separately and combined, did not predict response or remission.
Conclusions
Depressive symptoms of people with more IMD features improved less when treated with antidepressants. However, clinical relevance is limited owing to small effect sizes in inconsistent associations. Whether these patients would benefit more from treatments targeting immunometabolic pathways remains to be investigated.
How do failed coups influence power personalization in dictatorships? While scholars have studied the mechanisms of personalism in dictatorships in detail, little attention has been paid to the timing and determinants of surges in personalism levels. In this article, we propose that personalism can evolve non-linearly, and show that large, quite rapid increases in personalization by dictators occur after a failed coup attempt. The logic is that failed coups are information-revealing events that provide the dictator with strong motives and ample opportunities to accumulate power. The leader uses this window of opportunity to rapidly consolidate his power at the expense of the ruling coalition. We test the theory using time-series, cross-sectional data on dictatorships in 114 countries in the period between 1946 and 2010. Two placebo tests indicate that disruptive events by regime outsiders – failed assassination attempts and civil war onsets – do not promote the rush to personalize.
Most major nonviolent civil resistance campaigns target autocratic regimes. Yet, most dictators are toppled by their close supporters, not civilian protesters. Building on theories of strategic interactions between leaders, security agents, and protesters, we make three core claims: first, protesters are relatively less likely to mount a major nonviolent uprising against dictatorships with personalized security forces; secondly, personalized security forces are more likely to repress realized protest; and, thirdly, security force personalization shapes the prospects for success of mass uprisings in promoting democratic transitions. We leverage new data on security force personalization—a proxy for loyal security agents—and major nonviolent protest campaigns to test these expectations. Our theory explains why many dictatorships rarely face mass protest mobilization and why uprisings that are met with violent force often fail in bringing about new democracies.
This study details the results of an experimental intervention designed to address the issue of price anchoring in the choice experiment framework. The intervention, which informs respondents of the tendency to anchor choices on potentially arbitrary pieces of information, is applied to a choice experiment used to examine consumers’ willingness to pay for local and/or organic tomatoes in Northern New England and develops three primary contributions. First, evidence from this study shows that anchoring effects are present. Second, providing information to consumers plays a mitigating role on these effects; price anchoring changes willing to pay estimates between 44% and 51% and exposure to anchoring-specific cheap talk is associated with a reduction in these anchoring effects between 60% and 80%. These results are explained through decreases in price sensitivity induced by increasing the mean price vector and subsequent increases in price sensitivity due to the information intervention. Finally, this study reveals that consumers are willing to pay a substantial price premium for locally grown tomatoes, from $0.96 to $1.12 per pound, offering some guidance for policy regarding growing practice and farm land use as regional coalitions support local agriculture expansion in the Northeast.
Patients with single-ventricle CHD undergo a series of palliative surgeries that culminate in the Fontan procedure. While the Fontan procedure allows most patients to survive to adulthood, the Fontan circulation can eventually lead to multiple cardiac complications and multi-organ dysfunction. Care for adolescents and adults with a Fontan circulation has begun to transition from a primarily cardiac-focused model to care models, which are designed to monitor multiple organ systems, and using clues from this screening, identify patients who are at risk for adverse outcomes. The complexity of care required for these patients led our centre to develop a multidisciplinary Fontan Management Programme with the primary goals of earlier detection and treatment of complications through the development of a cohesive network of diverse medical subspecialists with Fontan expertise.
This paper summarizes a multi-state, multi-year study assessing the potential for local agriculture in northern New England. While largely rural, this region's agricultural sector differs greatly from the rest of the United States, and demand for locally produced food has been increasing. To assess this unique economic landscape, researchers and Cooperative Extension at the Universities of Maine, New Hampshire, and Vermont investigated four key areas: (1) local food capacities, (2) constraints to agricultural expansion, (3) consumer preferences for local and organic produce, and (4) the role of intermediaries as alternative local food outlets. The project included input from local farmers, Extension members, restaurants, and the general public. We present the four research areas in a sequential, overlapping fashion. The timing of our research was such that each step in the process informed the next and can be used as a template for assessing a region's potential for local agricultural production.
Propensity score matching is used to estimate treatment effects when data are observational. Results presented in this study demonstrate the use of propensity score matching to evaluate the average treatment effect of unit-based pricing of household trash for reducing municipal solid waste disposal. Average treatment effect of the treated for 34 New Hampshire communities range from an annual reduction of 631 pounds per household to 823 pounds per household. This represents an annual reduction of 42 percent to 54 percent from an average of 1530 pounds per household if a town did not adopt municipal solid waste user fees.
We have developed a novel, facile, and reproducible synthesis of highly crystalline oleylamine-capped colloidal platinum nanocubes by microwave (MW) heating. Use of MW heating decreases reaction times, eliminates the need for dangerous reagents [e.g., Fe(CO)5], and gives efficient production of monodispersed 8 nm Pt nanocubes [MW-nanoparticles (NPs)]. We also present a study of the optical properties of these NPs, which to our knowledge has not been previously reported. Absorbance spectra of the MW-NPs show a distinct localized surface plasmon resonance band at 213 nm. This observation could be significant for developments in plasmonic photocatalysis and advanced catalytic materials.
Policy makers often face the problem of evaluating how water quality affects a region's economic well-being. Using water clarity as a measure of the degree of eutrophication levels (as a lake becomes inundated with nutrients, water clarity decreases markedly), analysis is performed on sales data collected over a six-year period. Our results indicate that water clarity has a significant effect on prices paid for residential properties. Effects of a one-meter change in clarity on property value are also estimated for an average lake in four real estate market areas in New Hampshire, with effects differing substantially by area. Our findings provide state and local policy makers a measure of the cost of water quality degradation as measured by changes in water clarity, and demonstrate that protecting water quality may have a positive effect on property tax revenues.
Fontan survivors have depressed cardiac index that worsens over time. Serum biomarker measurement is minimally invasive, rapid, widely available, and may be useful for serial monitoring. The purpose of this study was to identify biomarkers that correlate with lower cardiac index in Fontan patients.
Methods and results
This study was a multi-centre case series assessing the correlations between biomarkers and cardiac magnetic resonance-derived cardiac index in Fontan patients ⩾6 years of age with biochemical and haematopoietic biomarkers obtained ±12 months from cardiac magnetic resonance. Medical history and biomarker values were obtained by chart review. Spearman’s Rank correlation assessed associations between biomarker z-scores and cardiac index. Biomarkers with significant correlations had receiver operating characteristic curves and area under the curve estimated. In total, 97 cardiac magnetic resonances in 87 patients met inclusion criteria: median age at cardiac magnetic resonance was 15 (6–33) years. Significant correlations were found between cardiac index and total alkaline phosphatase (−0.26, p=0.04), estimated creatinine clearance (0.26, p=0.02), and mean corpuscular volume (−0.32, p<0.01). Area under the curve for the three individual biomarkers was 0.63–0.69. Area under the curve for the three-biomarker panel was 0.75. Comparison of cardiac index above and below the receiver operating characteristic curve-identified cut-off points revealed significant differences for each biomarker (p<0.01) and for the composite panel [median cardiac index for higher-risk group=2.17 L/minute/m2 versus lower-risk group=2.96 L/minute/m2, (p<0.01)].
Conclusions
Higher total alkaline phosphatase and mean corpuscular volume as well as lower estimated creatinine clearance identify Fontan patients with lower cardiac index. Using biomarkers to monitor haemodynamics and organ-specific effects warrants prospective investigation.
The aim of the present study was to report the survival outcomes and late toxicity of high-dose-rate brachytherapy (HDRBT) boost for dose escalation in patients with intermediate-to-high-risk prostate cancer.
Materials and methods
Retrospective data were collected from 137 patients who had undergone definitive radiotherapy for prostate cancer between 2006 and 2010. All patients had external-beam radiotherapy (median dose 46Gy) and HDRBT. Brachytherapy dose was 19Gy in two fractions (6 hours apart) with one implant using Ir-192.
Results
There were 94 high-risk and 43 intermediate-risk patients (NCCN classification). The median follow-up period was 60 months. The 5-year biochemical progression-free survival was 92 and 76% for intermediate- and high-risk groups, respectively. Prostate cancer-specific survival for the intermediate-risk group was 100% and for the high-risk group it was 92% at 5 years. For the entire cohort, the 5-year rate of urethral stricture formation was 13%, and the 5-year rate of late grade 2 and grade 3 gastrointestinal toxicity was 4·7 and 4·6%, respectively. There was no grade 3 or greater genitourinary toxicity.
Findings
Our data add to the growing body of literature supporting the use of HDRBT in prostate cancer. Late toxicity rates were marginally higher than that expected.
We attempt to value health risks by combining traditional demand impact analysis with direct elicitation of individuals' risk perceptions of food safety. We examine the impact of multiple risks of related goods on consumption of a risky good. We argue that the consumption of a risky good depends on both its absolute risk level and its relative risks to other risky goods. Seafood consumption in eastern North Carolina was studied. We elicited, in a survey, individual perceived risks as reference points to derive the economic value of reducing health risk in seafood consumption. Revealed and stated data were combined to trace out demand changes in response to absolute and relative risk reductions. Our results show that seafood consumption is affected by the perceived absolute risk and by the relative risk to poultry and that individuals react to the multiple risks in a nonlinear way, as was suggested by our analytical model.
Factors affecting quality of life (QOL) ratings for people with dementia (PWD) have been well studied, but few studies have examined the effect of residence on PWD- and caregiver-rated QOL for PWDs. We designed this study to determine the factors related to PWD- and caregiver-rated QOL in dementia as well as factors related to the discrepancy in these ratings.
Methods:
For this cross-sectional study, we analyzed data from a convenience sample of 106 PWD-family caregiver dyads (58 community-dwelling dyads and 48 nursing-home dyads). PWDs’ data included socio-demographic variables, QOL (assessed by the Quality of Life-Alzheimer's Disease [QOL-AD] scale), cognition, dementia severity, depression, comorbidities, and quality of the dyadic relationship. Caregivers’ data included socio-demographic variables, depressive symptoms, and mutuality of the dyadic relationship.
Results:
QOL-AD scores were lower when rated by caregivers than by PWDs. The key factors positively related to both PWD- and caregiver-rated QOL for PWDs were fewer PWD depressive symptoms and higher quality of the PWD-caregiver relationship. The key factors related to the discrepancy in PWD- and caregiver-rated QOL in dementia were PWD residence in a nursing home and lower dementia severity, as well as higher caregiver depression, being an adult child caregiver, and lower caregiver-PWD mutuality.
Conclusion:
Caregiver-rated QOL for PWDs and the discrepancy in rated QOL were significantly associated with PWD residence. If caregiver-rated QOL is needed, the effect of residence of PWD should be taken into consideration. Caregivers’ depressive status and mutuality with PWD must be also carefully assessed.
Pony Lake, at Cape Royds, Antarctica, is a shallow, eutrophic, coastal lake that freezes solid in the winter. Changes in Pony Lake's physicochemical parameters and microbial community were studied during the transition from ice to open water. Due to rising water temperatures, the progressive melt of the ice column and the gradual mixing of basal brines into the remaining water column, Pony Lake evolved physically and chemically over the course of the summer, thereby affecting the microbial community composition. Temperature, pH, conductivity, nutrients and major ion concentrations reached their maximum in January. Pony Lake was colonized by bacteria, viruses, phytoflagellates, ciliates, and a small number of rotifers. Primary and bacterial production were highest in mid-December (2.66 mg C l-1 d-1 and 30.5 μg C l-1 d-1, respectively). A 16S rRNA gene analysis of the bacterioplankton revealed 34 unique sequences dominated by members of the β- and γ-proteobacteria lineages. Cluster analyses on denaturing gradient gel electrophoresis (DGGE) banding patterns and community structure indicated a shift in the dominant members of the microbial community during the transition from winter ice, to early, and late summer lakewater. Our data demonstrate that temporal changes in physicochemical parameters during the summer months determine community dynamics and mediate changes in microbial species composition.
An enormous effort is underway worldwide to attempt to detect gravitational waves. If successful, this will open a new frontier in astronomy. An essential portion of this effort is being carried out in Australia by the Australian Consortium for Interferometric Gravitational Astronomy (ACIGA), with research teams working at the Australia National University, University of Western Australia, and University of Adelaide involving scientists and students representing many more institutions and nations. ACIGA is developing ultrastable high-power continuous-wave lasers for the next generation interferometric gravity wave detectors; researching the problems associated with high optical power in resonant cavities; opening frontiers in advanced interferometry configurations, quantum optics, and signal extraction; and is the world's leader in high-performance vibration isolation and suspension design. ACIGA has also been active in theoretical research and modelling of potential astronomical gravitational wave sources, and in developing data analysis detection algorithms. ACIGA has opened a research facility north of Perth, Western Australia, which will be the culmination of these efforts. This paper briefly reviews ACIGA's research activities and the prospects for gravitational wave astronomy in the southern hemisphere.
3D integration enabled by through-silicon-via (TSV) allows continued performance enhancement and power reduction for semiconductor devices, even without further scaling. For TSV wafers with all Applied Materials unit processes, we evaluate the integrity of oxide liner and copper barrier by capacitance-voltage (C-V) and current-voltage (I-V) measurements, from which oxide capacitance, minimum TSV capacitance, and leakage current are extracted. The capacitance values match well with model predictions. The leakage data also demonstrate good wafer-scale uniformity. The liner and barrier quality are further verified with microanalysis techniques.