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There has been debate about the frequency and severity of antidepressant withdrawal effects.
Methods
We set out to appraise and reanalyze an influential systematic review by Henssler and colleagues that concluded that withdrawal effects are not particularly common and rarely severe. We repeated the meta-analysis, including only studies where data were derived from systematic measures of withdrawal symptoms.
Results
Most data in the Henssler review are derived from pharmaceutical industry–sponsored efficacy studies in which withdrawal was a minor consideration. Shortcomings of the review include the use of spontaneously reported adverse events to estimate withdrawal symptoms, potential misclassification of withdrawal symptoms as relapse, inclusion of data from retrospective case-note studies, short duration of prior antidepressant use, short observation periods, the overlooking of differences between placebo and drug withdrawal effects, and the use of questionable proxies for severe withdrawal. There were also discrepancies and uncertainties in some figures used. In our reanalysis, we included only the five studies that used a systematic and relevant method to assess the incidence of any withdrawal symptom. Prior treatment was short-term (12 weeks or less) in all but one of these. The pooled percentage was 55% (95% confidence interval, CI, 31% to 81%; N = 601) without subtracting nocebo effects, with high heterogeneity.
Conclusions
Henssler’s review is based on unreliable data and does not provide an adequate basis for the evaluation of antidepressant withdrawal effects. Further good-quality research on antidepressant withdrawal is required.
We present the Evolutionary Map of the Universe (EMU) survey conducted with the Australian Square Kilometre Array Pathfinder (ASKAP). EMU aims to deliver the touchstone radio atlas of the southern hemisphere. We introduce EMU and review its science drivers and key science goals, updated and tailored to the current ASKAP five-year survey plan. The development of the survey strategy and planned sky coverage is presented, along with the operational aspects of the survey and associated data analysis, together with a selection of diagnostics demonstrating the imaging quality and data characteristics. We give a general description of the value-added data pipeline and data products before concluding with a discussion of links to other surveys and projects and an outline of EMU’s legacy value.
The Lyman alpha (Ly$\alpha$) forest in the spectra of $z\gt5$ quasars provides a powerful probe of the late stages of the epoch of reionisation (EoR). With the recent advent of exquisite datasets such as XQR-30, many models have struggled to reproduce the observed large-scale fluctuations in the Ly$\alpha$ opacity. Here we introduce a Bayesian analysis framework that forward-models large-scale lightcones of intergalactic medium (IGM) properties and accounts for unresolved sub-structure in the Ly$\alpha$ opacity by calibrating to higher-resolution hydrodynamic simulations. Our models directly connect physically intuitive galaxy properties with the corresponding IGM evolution, without having to tune ‘effective’ parameters or calibrate out the mean transmission. The forest data, in combination with UV luminosity functions and the CMB optical depth, are able to constrain global IGM properties at percent level precision in our fiducial model. Unlike many other works, we recover the forest observations without invoking a rapid drop in the ionising emissivity from $z\sim7$ to 5.5, which we attribute to our sub-grid model for recombinations. In this fiducial model, reionisation ends at $z=5.44\pm0.02$ and the EoR mid-point is at $z=7.7\pm0.1$. The ionising escape fraction increases towards faint galaxies, showing a mild redshift evolution at fixed UV magnitude, $M_\textrm{UV}$. Half of the ionising photons are provided by galaxies fainter than $M_\textrm{UV} \sim -12$, well below direct detection limits of optical/NIR instruments including $\textit{ JWST}$. We also show results from an alternative galaxy model that does not allow for a redshift evolution in the ionising escape fraction. Despite being decisively disfavoured by the Bayesian evidence, the posterior of this model is in qualitative agreement with that from our fiducial model. We caution, however, that our conclusions regarding the early stages of the EoR and which sources reionised the Universe are more model-dependent.
Preschool anxiety is highly prevalent and well known to predict risk for future psychopathology. The present study explores whether a diagnosis of an anxiety disorder in preschool interacts with (a) social skills and (b) cognitive ability to longitudinally predict psychopathology, two well-known protective factors, among a sample of 207 children measured at preschool (Mage = 4.34 years) and early childhood (Mage = 6.61 years). To assess social skills and cognitive ability, we utilized the Social Skills Rating Scale and the Differential Abilities Scale, respectively. To assess psychopathology, we utilized the parent report of the Preschool Age Psychiatric Assessment. Hierarchical linear regression models revealed significant interactions between both social skills and cognitive ability with preschool anxiety. We observed that social skills protected against emergent psychopathology for both children with and without anxiety, although this association was stronger for children with preschool anxiety. Contrastingly, cognitive ability served as a protective factor against future psychopathology primarily among children without preschool anxiety. Results from this study identify targets for future intervention and inform our understanding of how preschool anxiety, a common disorder among young children, shapes future psychopathology risk in childhood.
From early on, infants show a preference for infant-directed speech (IDS) over adult-directed speech (ADS), and exposure to IDS has been correlated with language outcome measures such as vocabulary. The present multi-laboratory study explores this issue by investigating whether there is a link between early preference for IDS and later vocabulary size. Infants’ preference for IDS was tested as part of the ManyBabies 1 project, and follow-up CDI data were collected from a subsample of this dataset at 18 and 24 months. A total of 341 (18 months) and 327 (24 months) infants were tested across 21 laboratories. In neither preregistered analyses with North American and UK English, nor exploratory analyses with a larger sample did we find evidence for a relation between IDS preference and later vocabulary. We discuss implications of this finding in light of recent work suggesting that IDS preference measured in the laboratory has low test-retest reliability.
Trauma plays an important role in the development of psychosis, but no studies have investigated whether a trauma-focused therapy could prevent psychosis.
Aims
This study aimed to establish whether it would be feasible to conduct a multicentre randomised controlled trial (RCT) to prevent psychosis in people with an at-risk mental state (ARMS), using eye-movement desensitisation and reprocessing therapy (EMDR).
Method
This started as a mixed-method randomised study comparing EMDR to treatment as usual but, as a result of low participant recruitment, was changed to a single-arm feasibility study. The proposed primary outcome for an RCT was transition to psychosis at 12-month follow-up. Data on secondary outcomes were also collected. Qualitative interviews were conducted with patients and therapists.
Results
Fourteen participants were recruited from the Early Intervention teams. Most people who expressed an interest in taking part attended an assessment to determine eligibility. All those eligible consented to take part. A total of 64% (7 of 11) of participants who were offered EMDR were followed up at 12 months. Of the 11 participants offered EMDR, one (11%, 95% CI: 0.2%, 48%) transitioned to psychosis. Nine patients and three therapists were interviewed. Participants who completed therapy (n = 4; mean 10.5 sessions) found EMDR helpful, but those who discontinued (n = 6; mean 5.2 sessions) said it had not benefitted them overall. Therapists said EMDR could be effective, although not for all patients.
Conclusions
Future studies recruiting people with an ARMS to an RCT may need to extend recruitment beyond Early Intervention teams. Although some individuals found EMDR helpful, reasons for discontinuing need to be addressed in future studies.
The rapid growth of cultural evolutionary science, its expansion into numerous fields, its use of diverse methods, and several conceptual problems have outpaced corollary developments in theory and philosophy of science. This has led to concern, exemplified in results from a recent survey conducted with members of the Cultural Evolution Society, that the field lacks ‘knowledge synthesis’, is poorly supported by ‘theory’, has an ambiguous relation to biological evolution and uses key terms (e.g. ‘culture’, ‘social learning’, ‘cumulative culture’) in ways that hamper operationalization in models, experiments and field studies. Although numerous review papers in the field represent and categorize its empirical findings, the field's theoretical challenges receive less critical attention even though challenges of a theoretical or conceptual nature underlie most of the problems identified by Cultural Evolution Society members. Guided by the heterogeneous ‘grand challenges’ emergent in this survey, this paper restates those challenges and adopts an organizational style requisite to discussion of them. The paper's goal is to contribute to increasing conceptual clarity and theoretical discernment around the most pressing challenges facing the field of cultural evolutionary science. It will be of most interest to cultural evolutionary scientists, theoreticians, philosophers of science and interdisciplinary researchers.
Hippocampal hyperperfusion has been observed in people at Clinical High Risk for Psychosis (CHR), is associated with adverse longitudinal outcomes and represents a potential treatment target for novel pharmacotherapies. Whether cannabidiol (CBD) has ameliorative effects on hippocampal blood flow (rCBF) in CHR patients remains unknown.
Methods
Using a double-blind, parallel-group design, 33 CHR patients were randomized to a single oral 600 mg dose of CBD or placebo; 19 healthy controls did not receive any drug. Hippocampal rCBF was measured using Arterial Spin Labeling. We examined differences relating to CHR status (controls v. placebo), effects of CBD in CHR (placebo v. CBD) and linear between-group relationships, such that placebo > CBD > controls or controls > CBD > placebo, using a combination of hypothesis-driven and exploratory wholebrain analyses.
Results
Placebo-treated patients had significantly higher hippocampal rCBF bilaterally (all pFWE<0.01) compared to healthy controls. There were no suprathreshold effects in the CBD v. placebo contrast. However, we found a significant linear relationship in the right hippocampus (pFWE = 0.035) such that rCBF was highest in the placebo group, lowest in controls and intermediate in the CBD group. Exploratory wholebrain results replicated previous findings of hyperperfusion in the hippocampus, striatum and midbrain in CHR patients, and provided novel evidence of increased rCBF in inferior-temporal and lateral-occipital regions in patients under CBD compared to placebo.
Conclusions
These findings suggest that hippocampal blood flow is elevated in the CHR state and may be partially normalized by a single dose of CBD. CBD therefore merits further investigation as a potential novel treatment for this population.
India has an extensive bird trade that provides income and livelihoods for many people but involves considerable unregulated and illegal activity, threatening both native and exotic species and posing potential health risks to people and wildlife. Action to curb illegal trade is vital, but there is currently a lack of information on trade routes and the species involved to inform the development of strategies to address such trade. We therefore examined media reports of bird trade seizures published during 2010–2020 as a cost-effective approach to gaining insights into the composition and structure of the bird trade in India. We collected 182 media reports referring to 109 seizure events by searching for keywords on popular search engines and Indian newspaper websites. We found that 25,850 birds were seized, most frequently members of the family Psittacidae. Of the 58 species identified, 18 were native and 40 non-native to India. The greatest numbers of birds were seized in Uttar Pradesh. Analyses of trade networks indicate that Uttar Pradesh is an important trade hotspot particularly for native species and has strong transnational connections with neighbouring Nepal. We identified West Bengal as an important trade hotspot, particularly for non-native species, probably because of its extensive land borders with neighbouring countries, including Bangladesh. Our study highlights priority areas for interventions as well as key knowledge gaps that need to be addressed to facilitate the development of strategies to manage illegal, unsustainable and otherwise harmful trading of birds.
For an increasing proportion of Australian households, the Australian dream of home ownership is no longer an option. Neoliberal housing policy and the financialisation of housing has resulted in a housing affordability crisis. Historically, Australian housing policy has afforded only a limited role to local government. This article analyses the results of a nation-wide survey of Australian local governments’ perceptions of housing affordability in their local government area, the possibilities for their meaningful intervention, the challenges they face, the role of councillors and councils’ perceptions of what levels of government should take responsibility for housing. Almost all of the respondents from Sydney and Melbourne councils were clear that there is a housing affordability crisis in their local government area. We apply a framework analysing housing policy in the context of neoliberalism and the related financialisation of housing in order to analyse the housing affordability crisis in Sydney and Melbourne. We conclude that in order to begin resolving the housing crisis in Australia’s two largest cities there has to be an increasing role for local government, a substantial increase in the building of social and affordable housing and a rollback of policies that encourage residential property speculation.
We detected no correlation between standardized antimicrobial administration ratios (SAARs) and healthcare facility-onset Clostridioides difficile infection (HO-CDI) rates in 102 acute-care Veterans Affairs medical centers over 16 months. SAARs may be useful for investigating trends in local antimicrobial use, but no ratio threshold demarcated HO-CDI risk.
Genes associated with educational attainment may be related to or interact with adolescent alcohol, tobacco and cannabis use. Potential gene–environment interplay between educational attainment polygenic scores (EA-PGS) and adolescent alcohol, tobacco, and cannabis use was evaluated with a series of regression models fitted to data from a sample of 1871 adult Australian twins. All models controlled for age, age2, cohort, sex and genetic ancestry as fixed effects, and a genetic relatedness matrix was included as a random effect. Although there was no evidence that adolescent alcohol, tobacco or cannabis use interacted with EA-PGS to influence educational attainment, there was a significant, positive gene–environment correlation with adolescent alcohol use at all PGS thresholds (ps <.02). Higher EA-PGS were associated with an increased likelihood of using alcohol as an adolescent (ΔR2 ranged from 0.5% to 1.1%). The positive gene–environment correlation suggests a complex relationship between educational attainment and alcohol use that is due to common genetic factors.
Several Miscanthus species are cultivated in the U.S. Midwest and Northeast, and feral populations can displace the native plant community and potentially negatively affect ecosystem processes. The monetary cost of eradicating feral Miscanthus populations is unknown, but quantifying eradication costs will inform decisions on whether eradication is a feasible goal and should be considered when totaling the economic damage of invasive species. We managed experimental populations of eulaliagrass (Miscanthus sinensis Andersson) and the giant Miscanthus hybrid (Miscanthus × giganteus J.M. Greef & Deuter ex Hodkinson & Renvoize) in three floodplain forest and three old field sites in central Illinois with the goal of eradication. We recorded the time invested in eradication efforts and tracked survival of Miscanthus plants over a 5-yr period, then estimated the costs associated with eradicating these Miscanthus populations. Finally, we used these estimates to predict the total monetary costs of eradicating existing M. sinensis populations reported on EDDMapS. Miscanthus populations in the old field sites were harder to eradicate, resulting in an average of 290% greater estimated eradication costs compared with the floodplain forest sites. However, the cost and time needed to eradicate Miscanthus populations were similar between Miscanthus species. On-site eradication costs ranged from $390 to $3,316 per site (or $1.3 to $11 m−2) in the old field sites, compared with only $85 to $547 (or $0.92 to $1.82 m−2) to eradicate populations within the floodplain forests, with labor comprising the largest share of these costs. Using our M. sinensis eradication cost estimates in Illinois, we predict that the potential costs to eradicate populations reported on EDDMapS would range from $10 to $37 million, with a median predicted cost of $22 million. The monetary costs of eradicating feral Miscanthus populations should be weighed against the benefits of cultivating these species to provide a comprehensive picture of the relative costs and benefits of adding these species to our landscapes.
The expansion of wildlife trade on social media presents many challenges but also opportunities to gain insights into areas of trade where there is little recent data. West Africa has historically been a major source of wild birds in international trade but in 2007, the requirement for CITES (Convention on International Trade in Endangered Species of Wild Fauna and Flora) Parties to monitor a host of West-African species ended and there is little data regarding current trade. To address this gap, we surveyed trade-related posts created by known traders from 2016 to 2020 on a popular social-media platform to identify species composition, trade routes and potential conservation and biosecurity risks. We identified 427 social-media posts featuring a broad taxonomic diversity of birds, including 83 species from 26 avian families, including nine CITES-listed species, four listed in IUCN Threatened categories and 19 associated with alien introductions linked to bird trade. Disease risks were identified, with multiple species housed together in densely-stocked facilities and nine species recorded as posing a potential disease risk. Using novel analyses of post-engagement, we observed social-media posts facilitating connections with users across the globe. Trade-related engagement particularly came from countries in the Middle East and South Asia, notably India which has strong domestic restrictions on the importation of wild birds. Further research is needed to monitor the impact of trade from this region, as data regarding the population status and volume of trade in many observed species is largely absent.
This paper is about the contemporary debate concerning folk psychology – the debate between the proponents of the theory theory of folk psychology and the friends of the simulation alternative. At the outset, we need to ask: What should we mean by this term ‘folk psychology’?
We assessed the effectiveness of lyophilised banked human milk (HM) as a fortifier to feed very-low-birth-weight infants (VLBWI). This study aimed to evaluate the safety and tolerability of HM with HM lyophilisate as an additive compared with the standard additive (cows’ milk protein). In this phase I double-blind randomised controlled clinical trial, set in the intensive and intermediate care units of a tertiary hospital, forty VLBWI were enrolled and allocated into two groups: HM plus HM lyophilisate (LioNeo) or HM plus commercial additive (HMCA). The inclusion criteria were preterm infants, birth weight 750–1500 g, small or adequate for gestational age, exclusively receiving donor HM, volume ≥ 100 ml/kg per d and haemodynamically stable. Participants were followed up for 21 consecutive days. The primary outcome measures were necrotising enterocolitis (NEC), late-onset sepsis (LOS), death, gastrointestinal (GI) bleeding or perforation, diarrhoea, regurgitation, vomiting and abdominal distension. The LioNeo and HMCA groups had similar weights at baseline. The regression models showed no differences between the groups in terms of the primary outcomes. Diarrhoea, GI perforation, NEC and LOS were absent in the LioNeo group (one LOS and one NEC in the HMCA group). Multiple regression analysis with the total volume of milk as a covariate did not show significant differences. The lyophilisation of donor HM was considered safe and tolerable for use in stable haemodynamically VLBWI.