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The objective of this work was to describe treatment-emergent sexual dysfunction (TESD) and tolerability following a switch from selective serotonin reuptake inhibitor (SSRI: citalopram, paroxetine, or sertraline) monotherapy to vortioxetine or escitalopram monotherapy in adults with well-treated major depressive disorder (MDD) and SSRI-induced sexual dysfunction.
Data were analyzed from the primary study, an 8-week, randomized, double-blind, head-to-head study in which participants with well-treated depressive symptoms but experiencing TESD with SSRIs were directly switched to flexible doses (10/20 mg) of vortioxetine or escitalopram. Sexual functioning was assessed by the Changes in Sexual Functioning Questionnaire-14 (CSFQ-14), efficacy by the Montgomery–Åsberg Depression Rating Scale scores (MADRS) and Clinicians Global Impression of Severity/Improvement (CGI-S/CGI-I), and tolerability by adverse events. Efficacy and tolerability were assessed by pre-switch SSRI therapy where possible, and by participant characteristics.
Greater improvements in TESD were seen in the vortioxetine compared with escitalopram groups based on: participant demographics (≤45 years, women; P = 0.045), prior SSRI treatment (P = 0.044), number of prior major depressive episodes (MDEs) (1–3; P = 0.001), and duration of prior SSRI therapy (>1 year; P = 0.001). Prior SSRI treatment did not appear to influence the incidence or severity of TEAEs, except for nausea. Regardless of prior SSRI, both treatments maintained antidepressant efficacy after 8 weeks.
Results suggest that vortioxetine is a safe and effective switch therapy for treating SSRI-induced sexual dysfunction in adults with well-treated MDD. Also, improvement in sexual dysfunction with vortioxetine or escitalopram may be influenced by prior SSRI usage, sex, age, and history of MDEs.
Clay minerals are one of the most difficult classes of materials to analyze by x-ray powder diffraction, yet powder diffraction is the only technique which can yield the important crystallographic information necessary to identify and classify the minerals. The importance of clay minerals in industry and in the studies of rocks, due to their chemical properties and sensitivity to geological changes, often requires the analyses of large numbers of samples in short periods of time. Such sample throughput requires computerized analysis* Because definitive, meaningful d-I data are difficult to obtain from the broad diffraction peaks obtained from most clay samples, this problem has been approached by using the whole diffraction, trace as the basis of a computerized analytical scheme.
Accurate and reproducible patient positioning is a critical step in radiotherapy for breast cancer. This has seen the use of permanent skin markings becoming standard practice in many centres. Permanent skin markings may have a negative impact on long-term cosmetic outcome, which may in turn, have psychological implications in terms of body image. The aim of this study was to investigate the feasibility of using a semi-permanent tattooing device for the administration of skin marks for breast radiotherapy set-up.
Materials and methods
This was designed as a phase II double-blinded randomised-controlled study comparing our standard permanent tattoos with the Precision Plus Micropigmentation (PPMS) device method. Patients referred for radical breast radiotherapy were eligible for the study. Each study participant had three marks applied using a randomised combination of the standard permanent and PPMS methods and was blinded to the type of each mark. Follow up was at routine appointments until 24 months post radiotherapy. Participants and a blind assessor were invited to score the visibility of each tattoo at each follow-up using a Visual Analogue Scale. Tattoo scores at each time point and change in tattoo scores at 24 months were analysed by a general linear model using the patient as a fixed effect and the type of tattoo (standard or research) as covariate. A simple questionnaire was used to assess radiographer feedback on using the PPMS.
In total, 60 patients were recruited to the study, of which 55 were available for follow-up at 24 months. Semi-permanent tattoos were more visible at 24 months than the permanent tattoos. Semi-permanent tattoos demonstrated a greater degree of fade than the permanent tattoos at 24 months (final time point) post completion of radiotherapy. This was not statistically significant, although it was more apparent for the patient scores (p=0·071) than the blind assessor scores (p=0·27). No semi-permanent tattoos required re-marking before the end of radiotherapy and no adverse skin reactions were observed.
The PPMS presents a safe and feasible alternative to our permanent tattooing method. An extended period of follow-up is required to fully assess the extent of semi-permanent tattoo fade.
New IUE observations confirm the differences between the Galactic and LMC ultraviolet extinction curves and show some evidence for variations within the LMC. Visual and infrared photometry and polarimetry show that the anomalous properties of the LMC dust do not extend to longer wavelengths. Despite the much different dust to gas ratios in the Galaxy and the Magellanic clouds, the dust formation efficiency is similar when the abundances are included.
Our intention was to describe and compare the perspectives of national hospice thought leaders, hospice nurses, and former family caregivers on factors that promote or threaten family caregiver perceptions of support.
Nationally recognized hospice thought leaders (n = 11), hospice nurses (n = 13), and former family caregivers (n = 14) participated. Interviews and focus groups were audiotaped and transcribed. Data were coded inductively, and codes were hierarchically grouped by topic. Emergent categories were summarized descriptively and compared across groups.
Four categories linked responses from the three participant groups (95%, 366/384 codes): (1) essentials of skilled communication (30.6%), (2) importance of building authentic relationships (28%), (3) value of expert teaching (22.4%), and (4) critical role of teamwork (18.3%). The thought leaders emphasized communication (44.6%), caregivers stressed expert teaching (51%), and nurses highlighted teamwork (35.8%). Nurses discussed teamwork significantly more than caregivers (z = 2.2786), thought leaders discussed communication more than caregivers (z = 2.8551), and caregivers discussed expert teaching more than thought leaders (z = 2.1693) and nurses (z = 2.4718; all values of p < 0.05).
Significance of Results:
Our findings suggest differences in priorities for caregiver support across family caregivers, hospice nurses, and thought leaders. Hospice teams may benefit from further education and training to help cross the schism of family-centered hospice care as a clinical ideal to one where hospice team members can fully support and empower family caregivers as a hospice team member.
The objects of this investigation were to discover the amount of current inbreeding, the extent of any genetic divergence between the beef and dairy types, and whether the breed was dominated by an élite group of herds as for example, in the British Friesian (Robertson, 1953). An extensive investigation by Sewall Wright (1923a), (1923b) and McPhee and Wright (1925), (1926) established that there was at that time little current inbreeding and that genetic divergence between Dairy and Beef Shorthorns was negligible. This work adds to and corroborates their findings and throws some light on breed structure.
The sampling technique in this investigation is based upon Wright (1925). If consisted of noting the number, parents, grandparents and great-grandparents of a randomly selected sample of 128 females registered in Coates’ Herd Book, Vol. 94, 1948. Simple random lines were traced back from each great-grandparent as far as 1900, a toss of a coin deciding whether to record a sire or a dam. The information contained in Coates’ Herd Book made it a simple matter to record in addition the mate of the randomly selected ancestor, thus providing 16 random lines behind the eight great-grandparents.
An inline metal organic chemical vapor deposition system was used to deposit tin sulfide at temperatures >500 °C. Tetramethyltin was used as the tin source and diethyldisulfide as the sulfur source. An overhead injector configuration was used delivering both precursors directly over the substrate. The tin and sulfur precursors were premixed before injection to improve chemical reaction in the gas phase. Growth temperatures 500 – 540 °C were employed producing films with approximate 1:1 stoichiometry of Sn and S detected by energy dispersive x-ray spectroscopy. X-ray diffraction showed there to be mixed phases with Sn2S3 present with SnS.
Using a combination of pollen, non-pollen palynomorphs (NPPs) and charcoal particle stratigraphies from sediment cores from two sites, along with historical records, we reconstructed paleoenvironmental change in mid-coastal California. The San Antonio Creek section contains a discontinuous, Holocene-length record, while Mod Pond includes a continuous late Holocene record. Together the records allow for interpretation of most of the present interglacial. The longer record documents coastal sage scrub and chaparral dominated by woodland elements early in the Holocene to about 9000 yr ago, a potential decline in woodland communities with drying conditions during the middle Holocene to about 4800 yr ago, and an expansion of coastal sage scrub with grassland during the late Holocene. Evidence for climatic fluctuations during the last 1000 yr at Mod Pond is equivocal, suggesting that the Medieval Climate Anomaly–Little Ice Age had modest impact on the Mod Pond environment. However, evidence of significant environmental change associated with cultural transitions in the 18th–19th centuries is stark. Introduction of non-native plants, establishment of cattle and sheep grazing, missionization of the native population, changes in burning practices during the Spanish period and enhanced cropping activities during North American settlement worked together to substantially modify the mid-California coastal landscape in about a century's time.
Hyparrhenia cymbaria (boat thatching grass, ipopo grass) and Hyparrhenia variabilis (no common name), robust African savanna grasses with complex taxonomies, have not yet been reported for the Americas. Large populations were found in central Jalisco, northeastern Michoacán, and Morelos, Mexico. The species grow in maize and sorghum fields as well as on roadsides and in old fields, but always in association with present or past sorghum cultivation; this suggests introduction through contaminated seed material from Africa. Because of the size and density of the populations, and their native ecology, they are both agricultural pests as well as a potentially dangerous invaders for the American (sub)tropical grasslands and native scrublands, including the southern United States. The invasion underlines the importance of effective phytosanitary controls of the seed supply.
The quantification of probabilistic uncertainties in the outputs of physical, biological, and social systems governed by partial differential equations with random inputs require, in practice, the discretization of those equations. Stochastic finite element methods refer to an extensive class of algorithms for the approximate solution of partial differential equations having random input data, for which spatial discretization is effected by a finite element method. Fully discrete approximations require further discretization with respect to solution dependences on the random variables. For this purpose several approaches have been developed, including intrusive approaches such as stochastic Galerkin methods, for which the physical and probabilistic degrees of freedom are coupled, and non-intrusive approaches such as stochastic sampling and interpolatory-type stochastic collocation methods, for which the physical and probabilistic degrees of freedom are uncoupled. All these method classes are surveyed in this article, including some novel recent developments. Details about the construction of the various algorithms and about theoretical error estimates and complexity analyses of the algorithms are provided. Throughout, numerical examples are used to illustrate the theoretical results and to provide further insights into the methodologies.
The two goals of our study were to (1) identify which of five types of social support (Informational, Esteem, Emotional, Tangible, Belonging) are most cited by hospice nurses and family caregivers and (2) determine the match in perception of support needs.
As part of a larger multiphase project, focus groups were conducted with former family caregivers and hospice nurses to discuss their experiences of home hospice care and to gather their opinions on the important issues involved in that care. Transcripts of focus group discussions were coded for support type (Informational, Esteem, Emotional, Tangible, Belonging) based on definitions from the literature. Nurse and caregiver data were compared to assess for potential match.
Analysis of coded data suggested that nurses see different types of support to be needed in equal measure across their caseloads, while caregivers expressed priorities for some types of support. Illustrative examples of each type of support are provided and discussed.
Significance of Results:
Because matching support provided with the type of support desired has been linked to improved physical and psychological outcomes, it is important to focus on this match in healthcare populations particularly vulnerable to psychological stress, including family caregivers of home hospice patients. This research has implications for interventions to match support provision to caregiver needs, or for education for home hospice providers to ensure that they are not only sensitive to the possibility of a broad range of needs but also to the necessity to tailor care to those needs.
Thin film deposition process and integrated scribing technologies are key to forming large area Cadmium Telluride (CdTe) modules. In this paper, baseline Cd1-xZnxS/CdTe solar cells were deposited by atmospheric-pressure metal organic chemical vapor deposition (AP-MOCVD) onto commercially available ITO coated boro-aluminosilicate glass substrates. Thermally evaporated gold contacts were compared with a screen printed stack of carbon/silver back contacts in order to move towards large area modules. P2 laser scribing parameters have been reported along with a comparison of mechanical and laser scribing process for the scribe lines, using a UV Nd:YAG laser at 355 nm and 532 nm fiber laser.
The relationship between DIBs and dust is still unknown. The correlation between reddening and DIB strength means that the DIBs are mixed in with the dust and gas in interstellar clouds. The DIBs are relatively stronger in the diffuse interstellar medium than in dense clouds. There is only a weak correlation between the DIBs and the UV extinction parameters including the 2175 Å bump strength and the far-UV rise. In addition, the bump dust grains are sometimes polarized, while the DIBs are not. However, observations of DIBs in the SMC show that when the 2175 Å bump is weak or missing so are the DIBs. Two of the four sightlines that deviate strongly from the CCM UV extinction in the Galaxy show weak DIBs.
This paper provides a comprehensive account of the distribution of miospore species which are considered to be stratigraphically significant in the Dinantian (Calciferous Sandstone Measures and Lower Limestone Group) of the Midland Valley of Scotland. Five miospore concurrent range zones are recognised in these beds:
Tripartites vetustus—Rotaspora fracta (VF) Zone
Raistrickia nigra—Triquitrites marginatus (NM) Zone
Perotrilites tessellatus—Schulzospora campyloptera (TC) Zone
Lycospora pusilla (Pu) Zone
Schopfites claviger—Auroraspora macra (CM) Zone
The distribution of these zones in the sections studied provides a method of correlation in a series of rocks, which are largely of non-marine origin and notable for their lack of stratigraphically useful macrofossils and for marked variations in facies and thickness. The zones have also been proved in sections of Lower Carboniferous rocks in the Northumbrian trough, thereby providing a potential method of correlation between the two areas.
Two new genera, Colatisporites and Biannulatisphaerites, are described and one Tricidarisporites emended. Fifteen new species and one new type are described, three species recombined and three emended. Representative assemblages of the miospore zones are illustrated.
Plant miospore assemblages obtained from eight beds of the Foulden sequence, ranging from Bed 1 to Bed 17, are basically similar to each other in stratigraphical significance. The presence of Convolutispora circumvallata, Crassispora trychera and Schopfltes claviger and the absence of Lycospora pusilla suggest assignment to the Schopfites claviger-Auroraspora macra (CM) Biozone. This indicates the Courceyan Stage of the British Dinantian and the late Tournaisian (Tn3) of the Belgian Series. Comparable miospore assemblages have been described from Cementstone Group localities elsewhere in Berwickshire, East Lothian, Ayrshire and northern England. Preservation, and lack of marine palynomorphs and scolecodonts, suggest non-marine deposition. The presence of vitrinite fragments and megaspores as well as miospore tetrads suggests little transport before deposition.
Boron ions were implanted into completed planar and edge Nb/Nb oxide/PbAuIn Josephson tunnel junctions to directly trim the Josephson pair currents, Io. The implantation caused an increase in Io and in the junction subgap conductance and a decrease in the junction energy gap. For a fixed junction fabrication procedure, the variations were observed to be monotonic with 11B implant dose. Optimum trimming was found when the 11B ions were implanted such that the peak in the depth distribution occurred at the tunnel barrier. The implantation caused an increase in Io and in the junction subgap conductance and a decrease in the junction energy gap. The implanted junctions are stable at 80°C and under storage.