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It remains unclear which individuals with subthreshold depression benefit most from psychological intervention, and what long-term effects this has on symptom deterioration, response and remission.
Aims
To synthesise psychological intervention benefits in adults with subthreshold depression up to 2 years, and explore participant-level effect-modifiers.
Method
Randomised trials comparing psychological intervention with inactive control were identified via systematic search. Authors were contacted to obtain individual participant data (IPD), analysed using Bayesian one-stage meta-analysis. Treatment–covariate interactions were added to examine moderators. Hierarchical-additive models were used to explore treatment benefits conditional on baseline Patient Health Questionnaire 9 (PHQ-9) values.
Results
IPD of 10 671 individuals (50 studies) could be included. We found significant effects on depressive symptom severity up to 12 months (standardised mean-difference [s.m.d.] = −0.48 to −0.27). Effects could not be ascertained up to 24 months (s.m.d. = −0.18). Similar findings emerged for 50% symptom reduction (relative risk = 1.27–2.79), reliable improvement (relative risk = 1.38–3.17), deterioration (relative risk = 0.67–0.54) and close-to-symptom-free status (relative risk = 1.41–2.80). Among participant-level moderators, only initial depression and anxiety severity were highly credible (P > 0.99). Predicted treatment benefits decreased with lower symptom severity but remained minimally important even for very mild symptoms (s.m.d. = −0.33 for PHQ-9 = 5).
Conclusions
Psychological intervention reduces the symptom burden in individuals with subthreshold depression up to 1 year, and protects against symptom deterioration. Benefits up to 2 years are less certain. We find strong support for intervention in subthreshold depression, particularly with PHQ-9 scores ≥ 10. For very mild symptoms, scalable treatments could be an attractive option.
Sleep is essential for the health of midlife women, yet the barriers and facilitators to achieving adequate sleep, particularly among Latin American working-class women, are not well understood. This study aims to provide a nuanced understanding of the factors influencing sleep among working-class midlife women in Mexico City. A mixed-methods approach was employed among women enrolled in a Mexico City cohort. We utilized epidemiologic data to describe sleep and its correlates in a sample of 120 women, incorporating both self-reported (questionnaires and sleep diaries) and behavioral (actigraphy) measures of sleep.
A subset of 30 women participated in ethnographic interviews to explore barriers and facilitators to sleep, including coping strategies. Many women experienced poor sleep, with 43% reporting insomnia-related difficulties and 53% experiencing short sleep duration. Barriers included family-related stress, lack of sleep due to caregiving responsibilities, mental health challenges, and food insecurity. Women turned to coping mechanisms such as caffeine use and napping, along with natural remedies. This study highlights the critical role social factors play in shaping sleep outcomes among midlife women. Sleep is inherently a social behavior influenced by family dynamics, caregiving responsibilities, and other social pressures. These findings underscore the importance of considering psychosocial and cultural contexts in promoting healthy sleep among Mexican midlife women.
In the last 50 years, the field of paleobiology has undergone a computational revolution that opened multiple new avenues for recording, storing, and analyzing vital data on the history of life on Earth. With these advances, the amount of data available for research has grown, but so too has our responsibility to ensure that our data tools and infrastructures continue to innovate in order to best serve our diverse community. This review focuses on data equity in paleobiology, an aspirational goal, wherein data in all forms are collected, stored, shared and analyzed in a responsible, equitable, and sustainable manner. While there have been many advancements across the last five decades, inequities persist. Our most significant challenges relate to several interconnected factors, including ethical data collection, sustainable infrastructure, socioeconomic biases, and global inequalities. We highlight the ways in which data equity is critical for paleobiology and stress the need for collaborative efforts across the paleobiological community to urgently address these data equity challenges. We also provide recommendations for actions from individuals, teams, academic publishers, and academic societies in order to continue enhancing data equity and ensuring an equitable and sustainable future for our field.
Two new tests for a model for the response times on pure speed tests by Rasch (1960) are proposed. The model is based on the assumption that the test response times are approximately gamma distributed, with known index parameters and unknown rate parameters. The rate parameters are decomposed in a subject ability parameter and a test difficulty parameter. By treating the ability as a gamma distributed random variable, maximum marginal likelihood (MML) estimators for the test difficulty parameters and the parameters of the ability distribution are easily derived. Also the model tests proposed here pertain to the framework of MML. Two tests or modification indices are proposed. The first one is focused on the assumption of local stochastic independence, the second one on the assumption of the test characteristic functions. The tests are based on Lagrange multiplier statistics, and can therefore be computed using the parameter estimates under the null model. Therefore, model violations for all items and pairs of items can be assessed as a by-product of one single estimation run. Power studies and applications to real data are included as numerical examples.
In Cue-Exposure-Therapy (CET), clients are exposed to triggers through objects, people and environments that arouse craving (Sinha et al. Neuropsychopharmacol. 2009;34 1198–1208). Virtual Reality Exposure therapy (VRET) is used to experience these triggers in a realistic, safe, and personalized way. VR has been used successfully in the treatment of psychiatric disorders. It has not yet been developed and sufficiently tested as an adjuvant in the clinical post-detoxification phase of treatment of alcohol use disorders (AUD) (e.g. Bordnick et al. Addict.Behav 2008;33 743-756; Hone-Blanchet et al. Front.Hum.Neurosci. 2014; 8(844) 1-15). Additionally, these treatment methods have been tested for effect, but not for effectiveness around different VR technologies (Ghita & Gutierrez-Maldonado. Addict.Behav 2018; 81 1-11; ). This study focuses on VRET-Recovry to examine to what extent VR worlds could be personalized in an effective manner to help treat AUD as well as clarifying on the ways in which the VR worlds could be optimized to achieve its goal.
Objectives
The primary objectives of this study are to assess the necessity of personalization in VR environments for AUD treatment, identify the critical elements for personalization, and examine their impact on craving in AUD patients.
Methods
The study included 10 AUD patients diagnosed according to DSM-V criteria, aged between 18 and 65, who were in the final week of clinical detoxification at a large addiction clinic in The Netherlands. A controlled experiment was conducted using the Recovry 1.0 VR system on Samsung Gear VR and Samsung Galaxy S9. The experiment involved exposure to various VR scenes (CG and 360o), including a neutral setting, a bar scene, and a home situation, with the duration and sequence controlled by a therapist. Data collection consisted of pre- and post-exposure questionnaires, heart rate and blood pressure measurements, and interviews.
Results
Craving was remarkably low in the VR bar scene, primarily due to its unsociable context, limited alcohol visibility, and absence of peer pressure. Technical limitations, such as suboptimal resolution, also affected the feeling of presence. Positive results were shown that craving was predominantly stimulated in the apartment scene, driven by the presence of alcohol-related visual cues and social elements, resembling relaxed drinking with others.
Conclusions
This study underscores that some degree of personalization is needed on all craving dimensions with clear preference was given to CG or 360°. The environments were dependent on the personal history and associations they represent to different levels of alcohol visibility (messy or clean), and types of drink (based on past drinking behavior), and different emotional contexts are needed (positive and negative).
Bioethnography, the combination of ethnographic observation and biochemical sampling, is a synthetic method for understanding environmental and bodily interactions. DOHaD researchers can use bioethnographically derived data to examine the complex processes that shape health and disease. Using examples from a longitudinal birth cohort study in Mexico City, the authors describe how bioethnography, which begins with an open-ended observational stage, can counteract some of the limitations of DOHaD research, which can be reductionist and universalising. DOHaD researchers often focus on the behaviour of individuals, especially mothers, instead of on the political-economic processes and environments that contribute to poor health and inequality. In addition, DOHaD researchers, who often reside in high-resource environments, tend to universalise their own experience rather than identify relevant research questions for people living in different circumstances. To combat reductionist and universalising tendencies, bioethnography allows researchers to develop inductively derived hypotheses and then test these in specific contexts. Validating and testing theories derived from bioethnographic methods in the same population where they were observed can fill critical gaps in DOHaD research that seeks to understand the complex relationship between environments and disease over the lifecourse.
Cognitive control (CC) involves a top–down mechanism to flexibly respond to complex stimuli and is impaired in schizophrenia.
Methods
This study investigated the impact of increasing complexity of CC processing in 140 subjects with psychosis and 39 healthy adults, with assessments of behavioral performance, neural regions of interest and symptom severity.
Results
The lowest level of CC (Stroop task) was impaired in all patients; the intermediate level of CC (Faces task) with explicit emotional information was most impaired in patients with first episode psychosis. Patients showed activation of distinct neural CC and reward networks, but iterative learning based on the higher-order of CC during the trust game, was most impaired in chronic schizophrenia. Subjects with first episode psychosis, and patients with lower symptom load, demonstrate flexibility of the CC network to facilitate learning, which appeared compromised in the more chronic stages of schizophrenia.
Conclusion
These data suggest optimal windows for opportunities to introduce therapeutic interventions to improve CC.
Audit and feedback is an antimicrobial stewardship (AMS) strategy, with the potential to also optimize antimicrobial use in non-audited patients. This study aimed to determine whether audit and feedback reduce antimicrobial use in both audited and non-audited patients.
Design:
Before-after trial with a 1-year intervention period and 2.5-year historical cohort.
Setting:
750-bed community hospital in the Netherlands.
Patients:
All patients admitted to the urology wards during the 3.5-year study period were observed. Patients were classified as using antimicrobials if any antimicrobial was used for therapeutic reasons. Patients using antimicrobials prophylactically were excluded from measurements.
Intervention:
The AMS team provided audit and feedback on antimicrobial use for patients using antimicrobials for 2 days. Retrospectively, antimicrobial use and length of stay (LOS) were compared with the historical cohort.
Results:
Audits modified antimicrobial treatment in 52.8% of the cases. De-escalating, stopping, and switching from intravenous to oral treatment accounted for 72% of these modifications. Compared to patients from the cohort, who also used antimicrobials for 2 days, antimicrobial use decreased from 14.21 DDD/patient (95% CI, 13.08–15.34) to 11.45 DDD/patient (95% CI, 8.26–14.64; P = .047) for audited patients. Furthermore, mean LOS decreased from 7.42 days (95% CI, 6.79–8.06) to 6.13 days (95% CI, 5.38–6.89; P = .031). However, looking at all patients admitted to the urology wards, the percentage of patients using antimicrobials and total antimicrobial use remained unchanged.
Conclusions:
Audit and feedback reduce antimicrobial use and LOS, but only for audited patients. Positive effects are not automatically transferred to patients for whom no audits have been performed.
In the chemical system Na2O-Al2O3-SiO2-H2O, the stability field of Na-beidellite is presented as a function of pressure, temperature, and Na- and Si-activity. Na0.7-beidellite was hydrothermally synthesized using a stoichiometric gel composition in the temperature range from 275° to 475°C and at pressures from 0.2 to 5 kbar. Below 275°C kaolinite was the only crystalline phase, and above about 500°C paragonite and quartz developed instead of beidellite. An optimum yield of 95% of the Na0.7- beidellite was obtained at 400°C and 1 kbar after 20 days. Gels with a Na-content equivalent to a layer charge lower than 0.3 per O20(OH)4 did not produce beidellite. They yielded kaolinite below 325°C and pyrophyllite above 325°C. With gels of a Na-content equivalent to a layer charge of 1.5, the Na-beidellite field shifted to a minimum between temperatures of 275° and 200°C. This procedure offers the potential to synthesize beidellite at low temperatures. Beidellite synthesized from Na1.0-gel approach a Na1.35 composition and those from Na1.5- and Na2.0-gels a Na1.8 composition.
The effects of reaction time (2 to 72 h) and NH4+/A13+ molar ratio (1.6, 2.4 and 3.2) on the hydrothermal synthesis of ammonium-saponites are investigated. The gels are obtained by mixing powders, resulting in a stoichiometric composition, Mg3Si34Al0.6O10(OH)2, with aqueous ammonium solutions, with and without F, to result in initial NH4+/Al3+ molar ratios of 1.6, 2.4 and 3.2. The solid bulk products are characterized by X-raydiffraction (XRD), X-ray fluorescence (XRF) and scanning electron microscopy (SEM) combined with energy-dispersive X-ray (EDX) analysis. The cation exchange capacity (CEC) is determined with an ammonia selective electrode and the pH of the water from the first washing is measured. Ammonium-saponite is formed rapidly within 16 h. A higher NH4+/A13+ molar ratio and the presence of F facilitate the crystallization of saponite. Small metastable amounts of bayerite, Al(OH)3, are present at low NH4+/A13+ molar ratios; after short reaction times, they disappear. During the first 4 h, the pH decreases rapidly, then drops slowly to a constant level of approximately 4.6 after 60 h. With increasing reaction time, saponite crystallites grow in the ab directions of the individual sheets with almost no stacking to thicker flakes. The NH4+ CEC of the solid products increases strongly within the first 24 h. A maximum of 53.3 meq/100 g is observed. The saponite yield increases from approximately 25% after 2 h to almost 100% after 72 h.
Data compilations expand the scope of research; however, data citation practice lags behind advances in data use. It remains uncommon for data users to credit data producers in professionally meaningful ways. In paleontology, databases like the Paleobiology Database (PBDB) enable assessment of patterns and processes spanning millions of years, up to global scale. The status quo for data citation creates an imbalance wherein publications drawing data from the PBDB receive significantly more citations (median: 4.3 ± 3.5 citations/year) than the publications producing the data (1.4 ± 1.3 citations/year). By accounting for data reuse where citations were neglected, the projected citation rate for data-provisioning publications approached parity (4.2 ± 2.2 citations/year) and the impact factor of paleontological journals (n = 55) increased by an average of 13.4% (maximum increase = 57.8%) in 2019. Without rebalancing the distribution of scientific credit, emerging “big data” research in paleontology—and science in general—is at risk of undercutting itself through a systematic devaluation of the work that is foundational to the discipline.
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.
High cognitive activity possibly reduces the risk of cognitive decline and dementia.
Aims
To investigate associations between an individual's need to engage in cognitively stimulating activities (need for cognition, NFC) and structural brain damage and cognitive functioning in the Dutch general population with and without existing cognitive impairment.
Method
Cross-sectional data were used from the population-based cohort of the Maastricht Study. NFC was measured using the Need For Cognition Scale. Cognitive functioning was tested in three domains: verbal memory, information processing speed, and executive functioning and attention. Values 1.5 s.d. below the mean were defined as cognitive impairment. Standardised volumes of white matter hyperintensities (WMH), cerebrospinal fluid (CSF) and presence of cerebral small vessel disease (CSVD) were derived from 3T magnetic resonance imaging. Multiple linear and binary logistic regression analyses were used adjusted for demographic, somatic and lifestyle factors.
Results
Participants (n = 4209; mean age 59.06 years, s.d. = 8.58; 50.1% women) with higher NFC scores had higher overall cognition scores (B = 0.21, 95% CI 0.17–0.26, P < 0.001) and lower odds for CSVD (OR = 0.74, 95% CI 0.60–0.91, P = 0.005) and cognitive impairment (OR = 0.60, 95% CI 0.48–0.76, P < 0.001) after adjustment for demographic, somatic and lifestyle factors. The association between NFC score and cognitive functioning was similar for individuals with and without prevalent cognitive impairment. We found no significant association between NFC and WMH or CSF volumes.
Conclusions
A high need to engage in cognitively stimulating activities is associated with better cognitive functioning and less presence of CSVD and cognitive impairment. This suggests that, in middle-aged individuals, motivation to engage in cognitively stimulating activities may be an opportunity to improve brain health.
Maternal diet during pregnancy has been associated with obesity among offspring. The extent to which trimester-specific dietary patterns are associated with markers of adiposity during adolescence remains unclear. We examined associations between prenatal diet patterns with adolescent offspring measures of adiposity and adipokines in 384 mother–adolescent dyads from the Mexico City ELEMENT cohort. Trimester-specific diet patterns were derived from principal component analysis of food frequency questionnaire data. Adolescent anthropometry and serum leptin and adiponectin were measured at 10–17 years. Three maternal diet patterns were identified: Prudent Diet (PD), high in fish and vegetables, the High Meat and Fat Diet (HMFD), high in pork and processed meats, and the Transitioning Mexican Diet (TMD), high in corn tortillas and sugar-sweetened beverages. Multiple linear regression was used to estimate sex-stratified associations among quartiles of diet patterns with adiposity and adipokines, adjusting for maternal marital status, education, and parity. First trimester TMD was associated with greater anthropometric measures and higher leptin in females, while third trimester HMFD was associated higher body fat percentage, triceps thickness, waist circumference, and leptin, but lower adiponectin among males. Contrary to expectation, there were positive associations between the trimester 1 PD pattern and anthropometric measurements in females, and for trimester 2 HMFD and TMD patterns with adipokines among males. Findings suggest maternal diet patterns may influence offspring adiposity markers during adolescence in a sex-specific manner.
In decision making, people may rely on their own information as well as oninformation from external sources, such as family members, peers, or experts.The current study investigated how these types of information are used bycomparing four decision strategies: 1) an internal strategy that relies solelyon own information; 2) an external strategy that relies solely on theinformation from an external source; 3) a sequential strategy that relies oninformation from an external source only after own information is deemedinadequate; 4) an integrative strategy that relies on an integration of bothtypes of information. Of specific interest were individual and developmentaldifferences in strategy use. Strategy use was examined via Bayesian hierarchicalmixture model analysis. A visual decision task was administered to children andyoung adolescents (N=305, ages 9–14). Individual differences but noage-related changes were observed in either decision accuracy or strategy use.The internal strategy was dominant across ages, followed by the integrative andsequential strategy, respectively, while the external strategy was extremelyrare. This suggests a reluctance to rely entirely on information provided byexternal sources. We conclude that there are individual differences but notdevelopmental changes in strategy use pertaining to perceptual decision-makingin 9- through 14-year-olds. Generalizability of these findings is discussed withregard to different forms of social influence and varying perceptions of theexternal source. This study provides stepping stones in better understanding andmodeling decision making processes in the presence of both internal and externalinformation.
Antarctic and Southern Ocean environments are facing increasing pressure from multiple threats. The Antarctic Treaty System regularly looks to the Scientific Committee on Antarctic Research (SCAR) for the provision of independent and objective advice based on the best available science to support decision-making, policy development and effective environmental management. The recently approved SCAR Scientific Research Programme Ant-ICON - ‘Integrated Science to Inform Antarctic and Southern Ocean Conservation‘ - facilitates and coordinates high-quality transdisciplinary research to inform the conservation and management of Antarctica, the Southern Ocean and the sub-Antarctic in the context of current and future impacts. The work of Ant-ICON focuses on three research themes examining 1) the current state and future projections of Antarctic systems, species and functions, 2) human impacts and sustainability and 3) socio-ecological approaches to Antarctic and Southern Ocean conservation, and one synthesis theme that seeks to facilitate the provision of timely scientific advice to support effective Antarctic conservation. Research outputs will address the most pressing environmental challenges facing Antarctica and offer high-quality science to policy and advisory bodies including the Antarctic Treaty Consultative Meeting, the Committee for Environmental Protection and the Scientific Committee of the Commission for the Conservation of Antarctic Marine Living Resources.
In this special issue, we have collected 13 articles that offer new vantage points for research on dynamic capabilities. We offer a selection of thought-provoking papers that advance current thinking on dynamic capabilities and provide directions for new inquiries using the dynamic capability framework. The microfoundations of dynamic capabilities have increasingly received interest. This special issue offers a range of conceptual methodological approaches to deepen our understanding of the issues surrounding the microfoundations of dynamic capabilities.
We solve a flexible model that captures transactions costs and infrequencies of trading opportunities for illiquid assets to better understand the shadow costs of illiquidity for different origins of asset illiquidity and heterogeneous investor types. We show that illiquidity that results in suboptimal asset allocation carries low shadow costs, whereas these costs are high when illiquidity restricts consumption. As a result, the shadow costs are high for short-term investors, investors who face substantial liquidity shocks, and investors who desire to allocate a large fraction of their wealth to illiquid assets.
This chapter will highlight one way by which to improve the mental healthcare for people with psychosis: providing enhanced, specialized professional training at the graduate and postdoctoral level. Specialized training is needed for clinical providers of all professions and disciplines, and this chapter will review the recent Substance Abuse and Mental Health Services Administration (SAMHSA) funded Recovery to Practice Initiative, aimed at enhancing knowledge, ability, and practice among interprofessional clinicians working with individuals with serious mental illnesses. The chapter will also provide an overview of cutting-edge efforts to revolutionize psychology training, with a description of the “Serious Mental Illness Psychology” postdoctoral specialty which was recently recognized by the American Psychological Association, as well as current efforts to create a psychology board certification in serious mental illness.