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The Hamilton Depression Rating Scale (HAMD) and the Beck Depression Inventory (BDI) are the most frequently used observer-rated and self-report scales of depression, respectively. It is important to know what a given total score or a change score from baseline on one scale means in relation to the other scale.
We obtained individual participant data from the randomised controlled trials of psychological and pharmacological treatments for major depressive disorders. We then identified corresponding scores of the HAMD and the BDI (369 patients from seven trials) or the BDI-II (683 patients from another seven trials) using the equipercentile linking method.
The HAMD total scores of 10, 20 and 30 corresponded approximately with the BDI scores of 10, 27 and 42 or with the BDI-II scores of 13, 32 and 50. The HAMD change scores of −20 and −10 with the BDI of −29 and −15 and with the BDI-II of −35 and −16.
The results can help clinicians interpret the HAMD or BDI scores of their patients in a more versatile manner and also help clinicians and researchers evaluate such scores reported in the literature or the database, when scores on only one of these scales are provided. We present a conversion table for future research.
The tachinid fly Drino inconspicuoides (Diptera: Tachinidae) is an ovolarviparous endoparasitoid whose larvae develop in the host haemocoel and avoids the host immune system. In this study, we investigated the immune evasion mechanisms of this species during infestation in the host Mythimna separata (Lepidoptera: Noctuidae). We discovered a unique ‘cloak’ that surrounded D. inconspicuoides larvae that penetrated into the host and determined through genomic polymerase chain reaction analysis that this structure originated from the host rather than the tachinid. The ‘cloak’ contained both haemocytes and fat body cells from the host, with the haemocytes assembling around the larvae first and the fat body cells then covering the haemocyte layer, following which the two mixed. Living D. inconspicuoides larvae that were wrapped in the ‘cloak’ were not melanized whereas encapsulated dead larvae were melanized, suggesting that this structure contributes to the avoidance of host immune reactions.
Either boron or nitrogen doped multilayered graphene was prepared by thermal chemical vapor deposition (CVD). Obtained heteroatom doped graphene was examined by Raman scattering, x-ray photo electron spectroscopy (XPS) and temperature dependence of sheet resistance. From the Raman scattering, obvious increase of ID/IG ratio could not be detected by boron doping, while it increased by ∼0.2 or more for nitrogen doped sample. From XPS, doping rates of boron and nitrogen were estimated to be in the range of 5∼12 at% and 1∼2 at%, respectively. XPS also showed that the boron and nitrogen atoms would locate at the doping sites of both graphitic and neighborhood of atomic defect. Magnitude of sheet resistance was decreased by either doping of boron or nitrogen.
Depression is increasingly recognized as a chronic and relapsing disorder. However, an important minority of patients who start treatment for their major depressive episode recover to euthymia. It is clinically important to be able to predict such individuals.
The study is a secondary analysis of a recently completed pragmatic megatrial examining first- and second-line treatments for hitherto untreated episodes of non-psychotic unipolar major depression (n = 2011). Using the first half of the cohort as the derivation set, we applied multiply-imputed stepwise logistic regression with backward selection to build a prediction model to predict remission, defined as scoring 4 or less on the Patient Health Quetionnaire-9 at week 9. We used three successively richer sets of predictors at baseline only, up to week 1, and up to week 3. We examined the external validity of the derived prediction models with the second half of the cohort.
In total, 37.0% (95% confidence interval 34.8–39.1%) were in remission at week 9. Only the models using data up to week 1 or 3 showed reasonable performance. Age, education, length of episode and depression severity remained in the multivariable prediction models. In the validation set, the discrimination of the prediction model was satisfactory with the area under the curve of 0.73 (0.70–0.77) and 0.82 (0.79–0.85), while the calibration was excellent with non-significant goodness-of-fit χ2 values (p = 0.41 and p = 0.29), respectively.
Patients and clinicians can use these prediction models to estimate their predicted probability of achieving remission after acute antidepressant therapy.
With the aim of understanding the excitation energy transfer mechanism in natural photosynthetic membranes, light-harvesting (LH)2 and LH1-reaction center, which are pigment-protein complexes separated from Rhodobacter sphaeroides, were aligned on a planar electrode surface in stripe patterns at 5 µm intervals. Observation of the absorption spectrum and fluorescence microphotographs revealed selective immobilization and conservation of the pigments. Photocurrent signals were obtained when the electrode was illuminated at either 880 or 800 nm. The fabricated structure was confirmed to function as a natural photosynthetic membrane with the highest photocurrent signal being obtained when using a co-immobilized substrate under excitation at 800 nm.
Cognitive-behaviour therapy (CBT) for panic disorder may consist of different combinations of several therapeutic components such as relaxation, breathing retraining, cognitive restructuring, interoceptive exposure and/or in vivo exposure. It is therefore important both theoretically and clinically to examine whether specific components of CBT or their combinations are superior to others in the treatment of panic disorder. Component network meta-analysis (NMA) is an extension of standard NMA that can be used to disentangle the treatment effects of different components included in composite interventions. We searched MEDLINE, EMBASE, PsycINFO and Cochrane Central, with supplementary searches of reference lists and clinical trial registries, for all randomized controlled trials comparing different CBT-based psychological therapies for panic disorder with each other or with control interventions. We applied component NMA to disentangle the treatment effects of different components included in these interventions. After reviewing 2526 references, we included 72 studies with 4064 participants. Interoceptive exposure and face-to-face setting were associated with better treatment efficacy and acceptability. Muscle relaxation and virtual-reality exposure were associated with significantly lower efficacy. Components such as breathing retraining and in vivo exposure appeared to improve treatment acceptability while having small effects on efficacy. The comparison of the most v. the least efficacious combination, both of which may be provided as ‘evidence-based CBT,’ yielded an odds ratio for the remission of 7.69 (95% credible interval: 1.75 to 33.33). Effective CBT packages for panic disorder would include face-to-face and interoceptive exposure components, while excluding muscle relaxation and virtual-reality exposure.
For treatment of patients diagnosed with schizophrenia, comparative
long-term effectiveness of antipsychotic drugs to reduce relapses when
minimising adverse effects is of clinical interest, hence prompting this
To evaluate the comparative long-term effectiveness of antipsychotic
We systematically searched electronic databases for reports of randomised
controlled trials (RCTs) of antipsychotic monotherapy aimed at reducing
relapse risks in schizophrenia. We conducted network meta-analysis of 18
antipsychotics and placebo.
Studies of 10 177 patients in 56 reports were included; treatment
duration averaged 48 weeks (range 4–156). Olanzapine was significantly
more effective than chlorpromazine (odds ratio (OR) 0.35, 95% CI
0.14–0.88) or haloperidol (OR=0.50, 95% CI 0.30–0.82); and fluphenazine
decanoate was more effective than chlorpromazine (OR=0.31, 95% CI
0.11–0.88) in relapse reduction. Fluphenazine decanoate, haloperidol,
haloperidol decanoate and trifluoperazine produced more extrapyramidal
adverse effects than olanzapine or quetiapine; and olanzapine was
associated with more weight gain than other agents.
Except for apparent superiority of olanzapine and fluphenazine decanoate
over chlorpromazine, most agents showed intermediate efficacy for relapse
prevention and differences among them were minor. Typical antipsychotics
yielded adverse neurological effects, and olanzapine was associated with
weight gain. The findings may contribute to evidence-based treatment
selection for patients with chronic psychotic disorders.
Radio-wave scattering is a convenient method to image the properties of large internal regions of ice sheets. We used a ground-based radar system with short pulses of 60 and 179MHz frequencies to scatter off internal strata within 100–700 m of the surface in the ice sheet of East Antarctica. Data were examined along an 1150 kmlong traverse line that was approximately along the ice flowline from inland of Dome Fuji station to the coast. The scattered waves are from strata, and the dominant cause of the scattering was changes in dielectric permittivity across the strata. Therefore, density fluctuations primarily cause the scattering, although variations in ice-crystal fabrics and acidity could also have effects. The power scattered from the same depths varied by > 15 dB from one location to another. These variations correlate with the accumulation rate, changes in the surface slope, and subglacial bedrock undulations. Variations of the scattered power suggest that density contrasts in the strata are highly variable depending on these interdependent local conditions. The distribution of strata along the route allowed estimates of the ice-flow trajectories to depths of about 250 m.
We studied the scattering of radio waves off strata within the ice sheet at Mizuho station, Antarctica, to determine the most plausible scattering mechanisms at this location. We measured the effects of birefringence and anisotropic scattering boundaries on the return signal using the following set of experimental conditions: (1) co-polarization and cross-polarization antenna arrangements, (2) all orientations of the antenna system, (3) 60 and 179 MHz frequencies, and (4) pulse lengths of 150–1000 ns. Analyses of the propagated radio waves suggested that the signal is dominated by anisotropic scatter-ingboundaries at 179 MHz, but effects from birefringence also occurred. At depths of 250– 750 m, the scattering was stronger when the polarization plane was along the flowline. In contrast, at depths of about 900–1500 m, scattering was stronger when the polarization plane was perpendicular to the flowline. We suggest that the scattering below about 250 m is related to a layered ice stratum of crystal-orientation fabrics with different types or different cluster strengths. Although our study was at a single site, similar remote measurements over wider regions should provide valuable information about the physical structure of this vast ice sheet.
To better understand how ice sheets respond to climate, we designed a new multi-frequency ice-penetrating radar system to investigate subsurface structures of ice sheets. The system is mounted on a single platform and handled by a single operator. Three radio frequencies, 30,60 and 179 MHz, were used. An underlying principle of these multi-frequency observations is that the lower frequencies are more sensitive to electrical conductivity changes, whereas the higher frequencies are more sensitive to dielectric permittivity fluctuations in the ice. The system is composed of three single-frequency pulse radars, a trigger-controller unit and a data-acquisition unit. The trigger controller is the key component of this system. It switches transmitters on at different timings to prevent mixing of signals among the three radars. The timing difference was set as 50 μs, which is equivalent to the two-way travel time for radio waves reflecting from 4250m below the surface. A field test was done along a 2000 km long traverse line in east Dronning Maud Land, Antarctica. The multi-frequency system successfully acquired data that are equivalent in quality to our earlier single-frequency measurements along the same traverse line. The details of the system and preliminary data are described.
To determine annual layers for reconstructing the past environment at annual resolution from ice cores, we employed snow-stake data back to 1972, tritium content, solid electrical conductivity measurements (ECM) and stratigraphic properties for the 73m ice core at the H72 site, east Dronning Maud Land, Antarctica. the average annual surface mass balance at H72 is 307 mma–1w.e. during the last 27 years from continuous accumulation data, 317 mma–1 w.e. according to the densification model and 311 mma–1 w.e. according to the average surface mass balance for 167 years based on annual-layer counting. the ECM age is closely coincident with tritium age, and corresponds with the snow-stake record back to AD 1972 from the surface to 15 m depth. the H72 ice core is dated as AD 1831by ECMat 73.16 mdepth.The time series of yearly surface mass balance at H72 shows an almost constant 311 mm a–1 w.e. for the last 167 years. the oxygen-isotope records indicate a significant trend to lower values, with negative gradient of 1.7% (100 years)–1.
Psychological and educational interventions are valuable adjuncts in the management of adult atopic dermatitis. We performed a systematic review and meta-analysis of randomised controlled trials (RCTs) of the efficacy of these interventions. Twelve articles published between 1986 and 2013 were identified through electronic searches. The methodological quality was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions, version 5.1.1 (Higgins & Green, 2015). A random-effects model was used to estimate the standardised mean difference (SMD). No significant difference was found in eczema severity determined in three RCTs (124 participants; SMD, -0.29; 95% CI [-0.64, 0.07]) and dropout rate in five RCTs (198 participants; relative risk, 0.66; 95% CI [0.20, 2.17]). Education via online video was significantly superior to handouts in ameliorating eczema severity in one RCT (80 participants). We conclude that, rather than a combination of these interventions with conventional therapy being of no value, the data did not have sufficient power to provide evidence-based conclusions.
The influence of baseline severity has been examined for antidepressant
medications but has not been studied properly for cognitive–behavioural
therapy (CBT) in comparison with pill placebo.
To synthesise evidence regarding the influence of initial severity on
efficacy of CBT from all randomised controlled trials (RCTs) in which
CBT, in face-to-face individual or group format, was compared with
pill-placebo control in adults with major depression.
A systematic review and an individual-participant data meta-analysis
using mixed models that included trial effects as random effects. We used
multiple imputation to handle missing data.
We identified five RCTs, and we were given access to individual-level
data (n = 509) for all five. The analyses revealed that
the difference in changes in Hamilton Rating Scale for Depression between
CBT and pill placebo was not influenced by baseline severity (interaction
P = 0.43). Removing the non-significant interaction
term from the model, the difference between CBT and pill placebo was a
standardised mean difference of –0.22 (95% CI –0.42 to –0.02,
P = 0.03, I2 = 0%).
Patients suffering from major depression can expect as much benefit from
CBT across the wide range of baseline severity. This finding can help
inform individualised treatment decisions by patients and their
Undulating topography on the East Antarctic ice sheet was clearly revealed by NOAA AVHRR. The following three patterns of undulating topography were detected by using high-pass filtered images from the visible to thermal infrared channels. In coastal regions (below 2000 m a.s.l.), undulation can be clearly detected by the fluctuation of reflectance in visible channel. It has wavy structure with spacing less than 10 km and alignment at a right angle to the ice-flow lines. In the katabatic zone (from 2000 m a.s.l. to 3000 m a.s.l) well defined fluctuations of albedo stpectrum can be seen with spacing from 10 km to 20 km, aligned at right angles to the ice-flow lines or prevailing katabatic wind direction. Ground-survey data show that the undulating topography is associated with large variations of net accumulation rate. On the inland plateau (above 3000 m a.s.l.), undulation can be clearly seen in the fluctuation of thermal infrared channel in winter. Ground-survey data show that the signal corresponds to the undulating topography. The alignment of the undulation is at a right angle to the ice-flow lines and the spacing is longer than 20 km. The characteristics of these undulations represent the ice-flow dynamics and accumulation anomaly.
We measured radiocarbon ages of 11 pieces of ancient Japanese documents by accelerator mass spectrometry (AMS). The purpose of this study is to compare the relationship between the calibrated 14C age and the historical age of Japanese paper samples. Calibrated ages of nine pieces agree with their historical ages, indicating that Japanese ancient documents can be used for 14C dating in the recent historic period. On the other hand, the 14C age of paper that was used for reinforcement of a sutra is ca. 300 yr older than the historical age of the sutra. This shows that the sutra was repaired with old paper.
Considering the ample evidence of involvement of the glutamate system in the pathophysiology of depression, pre-clinical and clinical studies have been conducted to assess the antidepressant efficacy of glutamate inhibition, and glutamate receptor modulators in particular. This review focuses on the use of glutamate receptor modulators in unipolar depression.