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Prior trials suggest that intravenous racemic ketamine is a highly effective for treatment-resistant depression (TRD), but phase 3 trials of racemic ketamine are needed.
To assess the acute efficacy and safety of a 4-week course of subcutaneous racemic ketamine in participants with TRD. Trial registration: ACTRN12616001096448 at www.anzctr.org.au.
This phase 3, double-blind, randomised, active-controlled multicentre trial was conducted at seven mood disorders centres in Australia and New Zealand. Participants received twice-weekly subcutaneous racemic ketamine or midazolam for 4 weeks. Initially, the trial tested fixed-dose ketamine 0.5 mg/kg versus midazolam 0.025 mg/kg (cohort 1). Dosing was revised, after a Data Safety Monitoring Board recommendation, to flexible-dose ketamine 0.5–0.9 mg/kg or midazolam 0.025–0.045 mg/kg, with response-guided dosing increments (cohort 2). The primary outcome was remission (Montgomery-Åsberg Rating Scale for Depression score ≤10) at the end of week 4.
The final analysis (those who received at least one treatment) comprised 68 in cohort 1 (fixed-dose), 106 in cohort 2 (flexible-dose). Ketamine was more efficacious than midazolam in cohort 2 (remission rate 19.6% v. 2.0%; OR = 12.1, 95% CI 2.1–69.2, P = 0.005), but not different in cohort 1 (remission rate 6.3% v. 8.8%; OR = 1.3, 95% CI 0.2–8.2, P = 0.76). Ketamine was well tolerated. Acute adverse effects (psychotomimetic, blood pressure increases) resolved within 2 h.
Adequately dosed subcutaneous racemic ketamine was efficacious and safe in treating TRD over a 4-week treatment period. The subcutaneous route is practical and feasible.
We describe an ultra-wide-bandwidth, low-frequency receiver recently installed on the Parkes radio telescope. The receiver system provides continuous frequency coverage from 704 to 4032 MHz. For much of the band (
), the system temperature is approximately 22 K and the receiver system remains in a linear regime even in the presence of strong mobile phone transmissions. We discuss the scientific and technical aspects of the new receiver, including its astronomical objectives, as well as the feed, receiver, digitiser, and signal processor design. We describe the pipeline routines that form the archive-ready data products and how those data files can be accessed from the archives. The system performance is quantified, including the system noise and linearity, beam shape, antenna efficiency, polarisation calibration, and timing stability.
This article examines the meaning of monuments in Italy and the United States (Chicago) dedicated to the Fascist gerarch Italo Balbo. A hugely popular personality in Fascist Italy, Balbo cemented his reputation in the early 1930s as the commander of mass-formation transatlantic flights to Brazil (1930-1931) and the United States (1933). Chicago’s monuments – a road (Balbo Drive) and a column (the ‘Balbo monument’) – are a legacy of Balbo’s triumphant arrival in the city in 1933. Italy’s monuments date from the postwar and contemporary periods. The article examines why Balbo Drive and the Balbo monument in Chicago have become more controversial over time, especially in recent decades, and why, despite calls for their removal, both remain. It contrasts the Chicago case with the situation in Italy where, since the 1990s, Balbo has been commemorated in numerous ways.
Recent studies on the ecology of two cereal aphid species, Sitobion avenae (F.) and Metopolophium dirhodum (Wlk.), are reviewed. The most important factors affecting their abundance were used to construct decision trees to assess the risk of outbreaks of these species in the summer in England. These factors for S. avenae were crop sowing date, the size of the autumn migration, the severity of the winter, the size of the spring migration and the incidence of natural enemies in spring and early summer. For M. dirhodum, only the last two factors were considered as it does not occur on cereals until the spring in England. These decision trees were successfully tested using field data from 1983, when no outbreaks of either species occurred due to the effects of natural enemies.
The effect on aphid population development of creating natural enemy refuges by spraying only alternate strips of winter wheat with the aphid-specific insecticide pirimicarb at 140 g a.i./ha was compared with those in an unsprayed and a completely sprayed block in south-eastern England. The numbers of Sitobion avenae (F.), Metopolophium dirhodum (Walker) and Rhopalosiphum padi (L.) increased rapidly in the unsprayed block and in the unsprayed strips to reach similar peak densities in early August. Natural enemy activity was similar in these two areas, indicating negligible movement of predators and parasitoids from the sprayed strips to the unsprayed strips. Instead, aphids re-colonized the sprayed strips more quickly than the sprayed block, and the peak density in the former was similar to those in the unsprayed areas.
Focused 30keV gallium ion beam, single-pixel drilling combined with backside particle detection is used to fabricate pores having exit diameters as small as ~11 nm in 200 nm-thick silicon nitride membranes. The backside channelplate detector response obtained about the onset of breakthrough is interpreted by plan-view transmission electron microscopy investigations of hole morphology. Immediately prior to breakthrough, there is a rise in detector signal as the local membrane thickness is reduced. This likely occurs as a result of ion transmission and, possibly, forward sputtering. At the dose required for breakthrough a maximum detector signal is obtained thus providing a potential method for end point detection. The focused ion drilling technique avoids broad area beam exposure methods that are often used to reduce hole diameter to nanometer dimension. In addition, the current approach overcomes difficulties in determining a required dose for breakthrough such as those that arise from an inhomogeneous membrane thickness, redeposition, or ion channeling.
This article examines the attitude and policy of Lord Malmesbury
in regard to the
growing Italian crisis of 1858–9. Making use of previously
unavailable archival material (in
particular the private papers of Malmesbury himself) it seeks to
present a much fuller picture of tory
Italian policy than has, until now, been possible. Although it is
recognized that Malmesbury's Italian
policy was based upon a sincere desire for peace, this does
not explain why Malmesbury chose to hold
Cavour personally responsible for the Italian crisis and directed
his peace efforts not at Paris but at
Turin and Vienna. This had much to do with Malmesbury's close
personal links with the French
emperor, Louis Napoleon. In addition, this article challenges the
traditional view of Sir James
Hudson as ‘more Italian than the Italians’. Hudson was
not prepared to support Cavour in a course
of action which promised only to deprive Piedmont of her constitutional
freedoms and deliver Italy into the hands of France.