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In recent years much focus has been put on the role of immune/inflammatory alterations in affecting Major Depression (MDD) development and antidepressant efficacy. Neutrophil-to-lymphocyte ratio (NLR) is an inexpensive inflammatory marker shown to be elevated in depressed patients, with large population studies reporting this effect only in women. However, its relation to treatment response is much less clear. Reduced hippocampal volumes (HV) are among the few consistent brain structural predictors of poor treatment response, and they have been shown to be influenced by inflammatory status.
Objectives
To investigate the effect of NLR on treatment response in MDD patients, testing a possible moderating role of sex. To investigate the effect of NLR on HV and test a possible mediating role of the latter in the relation between NLR and treatment response.
Methods
Our study was performed on a sample of 120 MDD inpatients suffering from a non psychotic depressive episode (F=78; M=42). Depression severity was assessed via the Hamilton Depression Rating Scale (HDRS), both at admission and discharge; as a measure of treatment response, delta HDRS was calculated subtracting the two scores. NLR was calculated for each subject. Patients underwent 3T MRI acquisition and bilateral HV were estimated.
Results
We found a significant moderating effect of sex on the relationship between NLR and Delta HDRS (p < 0.001): a negative relation was found in women (p < 0.001) and a positive one in men (p = 0.042). NLR was found to negatively affect left HV in the whole sample (p = 0.027) and in women (p = 0.038). A positive effect on Delta HDRS was found for both left (p = 0.038) and right (p = 0.027) HV. Finally, we found a significant indirect effect of NLR values on Delta HDRS through left HV in women (95% BCa CI [- 0.948, -0.017]); the direct effect of NLR on Delta HDRS also remained significant (p = 0.002).
Conclusions
Sex was found to moderate the relation between NLR and treatment response. The detrimental effect in women is in line with previous reports linking inflammation to hampered antidepressant effect; the positive one in men is more surprising: however, the only studies to date on the effect of NLR on antidepressant efficacy report a positive effect in patients with psychotic depression. In women we found NLR to affect treatment response partially through its effect on left HV, providing a possible, albeit incomplete, mechanistic explanation of the effect of inflammatory status on antidepressant efficacy.
Across South Africa, Lesotho, and Eswatini, long-term citizen science atlas data have suggested concerning declines in the population of Black Stork Ciconia nigra. Unlike the Asian and European populations, the southern African Black Stork population is described as resident and is listed as “Vulnerable” in South Africa, Lesotho, and Eswatini. Here we report on surveys of historical nesting locations across northern South Africa, finding evidence for nest site abandonment and limited evidence of recent breeding. We undertook detailed species distribution modelling within a maximum entropy framework, using occurrence records from the BirdLasser mobile app. We cross-validated the models against information in the Southern African Bird Atlas Project (SABAP2) database, highlighting Lesotho as an important potential breeding area. Additionally, we used SABAP2 to assess population trends by investigating interannual patterns in reporting rate. Comparing current reporting rates with those from SABAP1 (1987–1992), we found that there has been a dramatic decrease. We noted that a large proportion of the population occurs outside the breeding range during the breeding season, suggesting a considerable non-breeding population, especially in the extensive wildlife refuge of the Kruger National Park. The slow declines observed might be indicative of a population which is not losing many adults but is failing to recruit significant numbers of juveniles due to limited breeding. Using densities derived from transect surveys, we used predictive models to derive estimates of breeding range carrying capacity and a population estimate, which suggested declines to numbers around 600 for this subregion. Minimising disturbance at breeding sites of this cliff-nesting species and improving water quality at key population strongholds are pathways to improving the status of the species in the subregion.
Bronchoscopic procedures are commonly performed for diagnosis of respiratory disorders and therapeutic airway treatment and management. A thorough understanding of procedural and technical fundamentals is critical for improving yield and safety, but they are not featured in procedural reviews for advanced endoscopists. In this book those critical cornerstones of performing bronchoscopy are discussed and explained in detail. Following the successful structure of the first edition, the fully updated content provides detailed reviews of procedural fundamentals including endobronchial ultrasound. Equipment components are described and maintenance is discussed. All chapters include advice on procedural quality improvement. Regulatory requirements, bronchoscopy procedure unit design and management principles are also addressed. This text will be beneficial to a wide range of practitioners including trainees and specialists in pulmonary and all critical care fields, surgeons, anaesthesiologists and respiratory therapists.
In unipolar depressed patients participating in trials on antidepressants, we investigated if illness characteristics at baseline could predict conversion to bipolar disorder.
Method
A long-term register-based follow-up study of 290 unipolar depressed patients with a mean age of 50.8 years (SD = 11.9) participating in three randomized trials on antidepressants conducted in the period 1985–1994. The independent effects of explanatory variables were examined by applying Cox regression analyses.
Results
The overall risk of conversion was 20.7%, with a mean follow-up time of 15.2 years per patient. The risk of conversion was associated with an increasing number of previous depressive episodes at baseline, [HR 1.18, 95% CI (1.10–1.26)]. No association with gender, age, age at first depressive episode, duration of baseline episode, subtype of depression or any of the investigated HAM-D subscales included was found.
Limitations
The patients were followed-up through the Danish Psychiatric Central Research Register, which resulted in inherent limitations such as possible misclassification of outcome.
Conclusion
In a sample of middle-aged hospitalized unipolar depressed patients participating in trials on antidepressants, the risk of conversion was associated with the number of previous depressive episodes. Therefore, this study emphasizes that unipolar depressed patients experiencing a relatively high number of recurrences should be followed more closely, or at least be informed about the possible increased risk of conversion.
As physical activity may modify the effect of the apolipoprotein E (APOE) ε4 allele on the risk of dementia and Alzheimer's disease (AD) dementia, we tested for such a gene–environment interaction in a sample of general practice patients aged ⩾75 years.
Method
Data were derived from follow-up waves I–IV of the longitudinal German study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe). The Kaplan–Meier survival method was used to estimate dementia- and AD-free survival times. Multivariable Cox regression was used to assess individual associations of APOE ε4 and physical activity with risk for dementia and AD, controlling for covariates. We tested for gene–environment interaction by calculating three indices of additive interaction.
Results
Among the randomly selected sample of 6619 patients, 3327 (50.3%) individuals participated in the study at baseline and 2810 (42.5%) at follow-up I. Of the 2492 patients without dementia included at follow-up I, 278 developed dementia (184 AD) over the subsequent follow-up interval of 4.5 years. The presence of the APOE ε4 allele significantly increased and higher physical activity significantly decreased risk for dementia and AD. The co-presence of APOE ε4 with low physical activity was associated with higher risk for dementia and AD and shorter dementia- and AD-free survival time than the presence of APOE ε4 or low physical activity alone. Indices of interaction indicated no significant interaction between low physical activity and the APOE ε4 allele for general dementia risk, but a possible additive interaction for AD risk.
Conclusions
Physical activity even in late life may be effective in reducing conversion to dementia and AD or in delaying the onset of clinical manifestations. APOE ε4 carriers may particularly benefit from increasing physical activity with regard to their risk for AD.
The WGARG was created in 2001 to oversee the rapid growth of the quantitative determination and understanding of the abundance patterns seen in red-giant stars. As the field progresses we are regularly reminded of how broad and multi-disciplinary is this area of research.
Christian Friedrich Baron Stockmar (1787–1863) was physician and advisor to Prince Leopold, son-in-law of George IV and later King of the Belgians. He was influential in promoting the marriage of Leopold's nephew Prince Albert to Queen Victoria, and became a trusted advisor to them both. His involvement in English politics was often seen as German interference in English matters, while in Germany he was regarded as a spy. These two volumes of his papers, selected by his son Ernst, were published in both German and English in 1872, and displeased Queen Victoria by its revelations about clashes between Lord Palmerston and the Prince Consort. Volume 2 focuses on the period 1838–1863, beginning with the Queen's engagement and marriage to Prince Albert, and describing the difficulties of the Prince Consort's role. It also covers English politics and foreign affairs, including the European revolutions of 1848 and the Crimean War.
Christian Friedrich Baron Stockmar (1787–1863) was physician and advisor to Prince Leopold, son-in-law of George IV and later King of the Belgians. He was influential in promoting the marriage of Leopold's nephew Prince Albert to Queen Victoria, and became a trusted advisor to them both. His involvement in English politics was often seen as German interference in English matters, while in Germany he was regarded as an English spy. These two volumes of his papers, selected by his son Ernst, were published in both German and English in 1872, and displeased Queen Victoria by its revelations about clashes between Lord Palmerston and the Prince Consort. Volume 1 covers the period 1814–1838, including significant events in European politics such as treaties, dynastic marriages, the accession of Leopold to the Belgian throne, the preparations for Victoria's accession to the throne and the plans for her marriage to Prince Albert.
Gas-accepting ion sources for radiocarbon accelerator mass spectrometry (AMS) have permitted the direct analysis of CO2 gas, eliminating the need to graphitize samples. As a result, a variety of analytical instruments can be interfaced to an AMS system, processing time is decreased, and smaller samples can be analyzed (albeit with lower precision). We have coupled a gas chromatograph to a compact 14C AMS system fitted with a microwave ion source for real-time compound-specific 14C analysis. As an initial test of the system, we have analyzed a sample of fatty acid methyl esters and biodiesel. Peak shape and memory was better then existing systems fitted with a hybrid ion source while precision was comparable. 14C/12C ratios of individual components at natural abundance levels were consistent with those determined by conventional methods. Continuing refinements to the ion source are expected to improve the performance and scope of the instrument.
The classical time series decomposition method was used to compare the temporal pattern of rabies in Chile before and after the implementation of the control programme. In the years 1950–60, a period without control measures, rabies showed an increasing trend, a seasonal excess of cases in November and December and a cyclic behaviour with outbreaks occurring every 5 years. During 1961–1970 and 1971–86, a 26-year period that includes two different phases of the rabies programme which started in 1961, there was a general decline in the incidence of rabies. The seasonality disappeared when the disease reached a low frequency level and the cyclical component was not evident.
In the context of a general survey on the thermoelectric potential of cationic clathrates, formation, crystal chemistry and physical properties were investigated for novel inverse clathrates deriving from Sn19.3Cu4.7P22I8. Substitution of Cu by Zn and Sn by Ni was attempted to bring down electrical resistivity and lower thermal conductivity. Materials were synthesized by mechanical alloying using a ball mill and hot pressing. Structural investigations for all specimens confirm isotypism with the cubic primitive clathrate type I structure (lattice parameters a = ˜1.1 nm and space group type Pm-3n). Studies of transport properties evidence holes as the majority charge carriers. Thermal expansion data, measured in a capacitance dilatometer from 4 to 300 K on Sn19.3Cu1.7Zn3P19.92.1I8, compare well with literature data available for Sn24P19.62.4Br8 and for an anionic type I clathrate Ba8Zn8Ge38. From the rather complex crystal structure including split atom sites and lattice defects thermal conductivity in inverse clathrates is generally low. Following Zintl rules rather closely inverse clathrates tend to be semiconductors with attractive Seebeck coefficients. Thus for thermoelectric applications the main activity will have to focus on achieving low electrical resistivity in a compromise with still sufficiently high Seebeck coefficients.
The main activity of the WG on Abundances in Red Giants has been to propose a JD for the IAU GA in 2009. The increasing evidence for distinct populations within globular clusters is leading to the view that there is a continuum between globular clusters and the smallest of the galaxies. Our JD was designed to investigate this link. However, our JD was incorporated into IAU Symposium No. 266 Star Clusters: Basic Building Blocks throughout Time and Space for the IAU XXVII in Rio de Janeiro, 2009. We will be responsible for organising one session in the Symposium to cover the agenda put forward in our JD proposal.
Chronic elevations of endogenous cortisol levels have been shown to alter medial temporal cortical structures and to be accompanied by declarative memory impairments and depressive symptoms in human adults. These effects of elevated endogenous levels of cortisol have not been directly studied in adolescents. Because adolescents with Cushing syndrome show endogenous elevations in cortisol, they represent a unique natural model to study the effects of prolonged hypercortisolemia on brain function, and memory and affective processes during this developmental stage. Using functional magnetic resonance imaging (fMRI), we compared 12 adolescents with Cushing syndrome with 22 healthy control adolescents on amygdala and anterior hippocampus activation during an emotional faces encoding task. None of these adolescents manifested depressive symptoms. Encoding success was assessed using a memory recognition test performed after the scan. The fMRI analyses followed an event-related design and were conducted using the SPM99 platform. Compared to healthy adolescents, patients with Cushing syndrome showed greater left amygdala and right anterior hippocampus activation during successful face encoding. Memory performance for faces recognition did not differ between groups. This first study of cerebral function in adolescents with chronic endogeneous hypercortisolemia due to Cushing syndrome demonstrates the presence of functional alterations in amygdala and hippocampus, which are not associated with affective or memory impairments. Such findings need to be followed by work examining the role of age and related brain maturational stage on these effects, as well as the identification of possible protective factors conferring resilience to affective and cognitive consequences in this disease and/or during this stage of cerebral development.