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This is a secondary analysis of clinical trial data collected in 12 European countries. We examined changes in weight and weight-related quality of life among community patients with schizophrenia treated with aripiprazole (ARI) versus standard of care (SOC), consisting of other marketed atypical antipsychotics (olanzapine, quetiapine, and risperidone).
Five-hundred and fifty-five patients whose clinical symptoms were not optimally controlled and/or experienced tolerability problems with current medication were randomized to ARI (10–30 mg/day) or SOC. Weight and weight-related quality of life (using the IWQOL-Lite) were assessed at baseline, and weeks 8, 18 and 26. Random regression analysis across all time points using all available data was used to compare groups on changes in weight and IWQOL-Lite. Meaningful change from baseline was also assessed.
Participants were 59.7% male, with a mean age of 38.5 years (SD 10.9) and mean baseline body mass index of 27.2 (SD 5.1). ARI participants lost an average of 1.7% of baseline weight in comparison to a gain of 2.1% by SOC participants (p < 0.0001) at 26 weeks. ARI participants experienced significantly greater increases in physical function, self-esteem, sexual life, and IWQOL-Lite total score. At 26 weeks, 20.7% of ARI participants experienced meaningful improvements in IWQOL-Lite score, versus 13.5% of SOC participants. A clinically meaningful change in weight was also associated with a meaningful change in quality of life (p < 0.001). A potential limitation of this study was its funding by a pharmaceutical company.
Compared to standard of care, patients with schizophrenia treated with aripiprazole experienced decreased weight and improved weight-related quality of life over 26 weeks. These changes were both statistically and clinically significant.
A bidirectional association between type 2 diabetes and depression has been consistently reported. It is associated with worse biomedical outcomes and increased mortality. One possible question is whether the co-occurrence of type 2 diabetes and depression is due to genetic and/or environmental vulnerabilities in common to the two traits.
To examine the genetic relationship between type 2 diabetes and depression at a population level.
To quantify the genetic overlap between type 2 diabetes and depression using the Swedish Twin Registry.
The study included 43,565 twin pairs (12,363 monozygotic pairs and 31,202 dizygotic pairs). The primary outcomes were lifetime diagnosis of type 2 diabetes and depression from the Swedish National Hospital Discharge Registry. Standard bivariate twin models were fitted to the raw data to estimate the genetic and environmental (co)variance of the two traits.
Heritability estimates for lifetime diagnoses of type 2 diabetes and depression were similar to previous estimates, at 77% and 42% respectively. The phenotypic correlation between type 2 diabetes and depression was 0.14 (95%CI: 0.11-0.17), of which 58% was due to shared genetic influences. When covariates (age and gender) were included, the genetic contribution to the phenotypic correlation reduced to 51%.
This is the first study to demonstrate a small but significant genetic overlap between type 2 diabetes and depression at a population level, using hospital-registry records.
There is a high need for evidence-based psychosocial treatments for adult attention-deficit hyperactivity disorder (ADHD) to offer alongside treatment as usual (TAU). Mindfulness-based cognitive therapy (MBCT) is a promising psychosocial treatment. This trial investigated the efficacy of MBCT + TAU v. TAU in reducing core symptoms in adults with ADHD.
A multicentre, single-blind, randomised controlled trial (ClinicalTrials.gov: NCT02463396). Participants were randomly assigned to MBCT + TAU (n = 60), an 8-weekly group therapy including meditation exercises, psychoeducation and group discussions, or TAU only (n = 60), which reflected usual treatment in the Netherlands and included pharmacotherapy and/or psychoeducation. Primary outcome was ADHD symptoms rated by blinded clinicians. Secondary outcomes included self-reported ADHD symptoms, executive functioning, mindfulness skills, self-compassion, positive mental health and general functioning. Outcomes were assessed at baseline, post-treatment, 3- and 6-month follow-up. Post-treatment effects at group and individual level, and follow-up effects were examined.
In MBCT + TAU patients, a significant reduction of clinician-rated ADHD symptoms was found at post-treatment [M difference = −3.44 (−5.75, −1.11), p = 0.004, d = 0.41]. This effect was maintained until 6-month follow-up. More MBCT + TAU (27%) than TAU participants (4%) showed a ⩽30% reduction of ADHD symptoms (p = 0.001). MBCT + TAU patients compared with TAU patients also reported significant improvements in ADHD symptoms, mindfulness skills, self-compassion and positive mental health at post-treatment, which were maintained until 6-month follow-up. Although patients in MBCT + TAU compared with TAU reported no improvement in executive functioning at post-treatment, they did report improvement at 6-month follow-up.
MBCT might be a valuable treatment option alongside TAU for adult ADHD aimed at alleviating symptoms.
Declines in populations of the Critically Endangered Spoon-billed Sandpiper Calidris pygmaeus have been rapid, with the breeding population now perhaps numbering fewer than 120 pairs. The reasons for this decline remain unresolved. Whilst there is evidence that hunting in wintering areas is an important factor, loss of suitable habitat on passage and wintering areas is also of concern. While some key sites for the species are already documented, many of their wintering locations are described here for the first time. Their wintering range primarily stretches from Bangladesh to China. Comprehensive surveys of potential Spoon-billed Sandpiper wintering sites from 2005 to 2013 showed a wide distribution with three key concentrations in Myanmar and Bangladesh, but also regular sites in China, Vietnam and Thailand. The identification of all important non-breeding sites remains of high priority for the conservation of the species. Here, we present the results of field surveys of wintering Spoon-billed Sandpipers that took place in six countries between 2005 and 2013 and present species distribution models which map the potential wintering areas. These include known and currently unrecognised wintering locations. Our maximum entropy model did not identify any new extensive candidate areas within the winter distribution, suggesting that most key sites are already known, but it did identify small sites on the coast of eastern Bangladesh, western Myanmar, and the Guangxi and Guangdong regions of China that may merit further investigation. As no extensive areas of new potential habitat were identified, we suggest that the priorities for the conservation of this species are habitat protection in important wintering and passage areas and reducing hunting pressure on birds at these sites.
Recent efforts have demonstrated enhanced tailoring of material functionality with mixed anion materials, yet exploratory research with mixed anion chemistries is limited by the sensitivity of these materials to synthesis conditions. Synthesis of a particular metal oxynitride compound by traditional reactive annealing requires specific, limited ranges of both oxygen and nitrogen chemical potentials to establish equilibrium between the solid-state material and a reactive atmosphere. Using Ta–O–N as an example system, we describe a combination of reactive sputter deposition and rapid thermal processing (RTP) for synthesis of mixed anion inorganic materials. Heuristic optimization of reactive gas pressures to attain a desired anion stoichiometry is discussed, and the ability of RTP to enable amorphous to crystalline transitions without preferential anion loss is demonstrated through the controlled synthesis of nitride, oxide, and oxynitride phases.
The influence of genetic factors on major depressive disorder is lower than on other psychiatric disorders. Heritability estimates mainly derive from cross-sectional studies, and knowledge on the longitudinal aetiology of symptoms of anxiety and depression (SxAnxDep) across the lifespan is limited. We aimed to assess phenotypic, genetic and environmental stability in SxAnxDep between ages 3 and 63 years.
We used a cohort-sequential design combining data from 49 524 twins followed from birth to age ⩾20 years, and from adolescence into adulthood. SxAnxDep were assessed repeatedly with a maximum of eight assessments over a 25-year period. Data were ordered in 30 age groups and analysed with longitudinal genetic models.
Over age, there was a significant increase during adolescence in mean scores with sex differences (women>men) emerging. Heritability was high in childhood and decreased to 30–40% during adulthood. This decrease in heritability was due to an increase in environmental variance. Phenotypic stability was moderate in children (correlations across ages ~0.5) and high in adolescents (r = 0.6), young adults (r = 0.7), and adults (r = 0.8). Longitudinal stability was mostly attributable to genetic factors. During childhood and adolescence there was also significant genetic innovation, which was absent in adults. Environmental effects contributed to short-term stability.
The substantial stability in SxAnxDep is mainly due to genetic effects. The importance of environmental effects increases with age and explains the relatively low heritability of depression in adults. The environmental effects are transient, but the contribution to stability increases with age.
The High Throughput Experimentation (HTE) project of the Joint Center for Artificial Photosynthesis (JCAP, http://solarfuelshub.org/) performs accelerated discovery of new earth-abundant photoabsorbers and electrocatalysts. Through collaboration within the DOE solar fuels hub and with the broader research community, the new materials will be utilized in devices that efficiently convert solar energy, water and carbon dioxide into transportation fuels. JCAP-HTE builds high-throughput pipelines for the synthesis, screening and characterization of photoelectrochemical materials. In addition to a summary of these pipelines, we will describe several new screening instruments for high throughput (photo-)electrochemical measurements. These instruments are not only optimized for screening against solar fuels requirements, but also provide new tools for the broader combinatorial materials science community. We will also describe the high throughput discovery, follow-on verification, and device implementation of a new quaternary metal oxide catalyst. This rapid technology development from discovery to device implementation is a hallmark of the multi-faceted JCAP research effort.
Studies conducted in Europe and the USA have shown that co-morbidity between major depressive disorder (MDD) and anxiety disorders is associated with various MDD-related features, including clinical symptoms, degree of familial aggregation and socio-economic status. However, few studies have investigated whether these patterns of association vary across different co-morbid anxiety disorders. Here, using a large cohort of Chinese women with recurrent MDD, we examine the prevalence and associated clinical features of co-morbid anxiety disorders.
A total of 1970 female Chinese MDD patients with or without seven co-morbid anxiety disorders [including generalized anxiety disorder (GAD), panic disorder, and five phobia subtypes] were ascertained in the CONVERGE study. Generalized linear models were used to model association between co-morbid anxiety disorders and various MDD features.
The lifetime prevalence rate for any type of co-morbid anxiety disorder is 60.2%. Panic and social phobia significantly predict an increased family history of MDD. GAD and animal phobia predict an earlier onset of MDD and a higher number of MDD episodes, respectively. Panic and GAD predict a higher number of DSM-IV diagnostic criteria. GAD and blood-injury phobia are both significantly associated with suicidal attempt with opposite effects. All seven co-morbid anxiety disorders predict higher neuroticism.
Patterns of co-morbidity between MDD and anxiety are consistent with findings from the US and European studies; the seven co-morbid anxiety disorders are heterogeneous when tested for association with various MDD features.
This study aimed to investigate the relationship between hepatitis B virus (HBV) covalently closed circular DNA (cccDNA) in the ovary and vertical transmission of HBV. HBV DNA and HBV cccDNA were assayed in the ovaries of 33 pregnant women who were positive for HBV DNA. The HBVM (HBV markers, including HBsAg, HBsAb, HBeAg, HBeAb, HBcAb) level and the HBV DNA content in peripheral blood of infants were measured. The overall positive rate of HBV DNA and HBV cccDNA in samples was 51·52% (17/33). The intrauterine infection rate of the infants was 12·12% (4/33). When HBV DNA and HBV cccDNA were both positive, the intrauterine infection rate of infants was significantly higher than when they were both negative (P<0·05). Levels of HBV cccDNA and the rate of positive samples were significantly higher in mothers with infants with intrauterine infection than in those without (P<0·01 and P<0·05, respectively). HBV can infect the human ovary and may transmit to the filial generation via the ovum.
Although the phenomenon of ADHD (Attention-Deficit Hyperactivity Disorder) is well described in children, it is now thought that in up to 60% of cases the symptoms persist into adulthood. This volume reviews our growing knowledge of adult ADHD and presents a transatlantic perspective on the identification, assessment and treatment of the disorder. The introductory section covers the history of ADHD, as well as the epidemiology, consequences, gender differences and legal aspects. Detailed descriptions of the clinical features of ADHD in adults are then given to enhance the reader's clinical recognition and assessment. Subsequent sections cover treatment strategies, emphasising pharmacological, psychological and social interventions. Written and edited by experts internationally renowned for their work in ADHD, this is an essential resource for all mental health workers who encounter adults presenting with neurodevelopmental disorders.