Clinical practice recommendations for depression

Objective:  To provide clinically relevant evidence-based recommendations for the management of depression in adults that are informative, easy to assimilate and facilitate clinical decision making.Method:  A comprehensive literature review of over 500 articles was undertaken using electronic database search engines (e.g. MEDLINE, PsychINFO and Cochrane reviews). In addition articles, book chapters and other literature known to the authors were reviewed. The findings were then formulated into a set of recommendations that were developed by a multidisciplinary team of clinicians who routinely deal with mood disorders. The recommendations then underwent consultative review by a broader advisory panel that included experts in the field, clinical staff and patient representatives.Results:  The clinical practice recommendations for depression (Depression CPR) summarize evidence-based treatments and provide a synopsis of recommendations relating to each phase of the illness. They are designed for clinical use and have therefore been presented succinctly in an innovative and engaging manner that is clear and informative.Conclusion:  These up-to-date recommendations provide an evidence-based framework that incorporates clinical wisdom and consideration of individual factors in the management of depression. Further, the novel style and practical approach should promote uptake and implementation.

Is lithium in a class of its own? A brief profile of its clinical use

Lithium is a unique and effective psychotropic agent with a long-standing history of clinical use yet it is increasingly overlooked in lieu of newer agents. The purpose of the present paper was to succinctly review the therapeutic profile of lithium particularly with respect to the treatment of mood disorders and consider its unique properties and clinical utility. A comprehensive literature review pertaining to lithium was undertaken using electronic database search engines to identify relevant clinical trials, meta-analyses and Cochrane reviews. In addition articles and book chapters known to the authors were carefully reviewed, and the authors appraised published guidelines. The evidence from these sources was rated using National Health and Medical Research Council evidence levels and synthesized according to phenotype and mood states. In addition, the authors have drawn upon published guidelines and their own clinical experience. Lithium has specificity for mood disorders with proven efficacy in the treatment of both unipolar depression and bipolar disorder. The recommendations are based predominantly on Level I evidence, but its clinical use has to be tempered against potential side-effects and the need for ongoing monitoring. In practice, lithium should be considered a first-line option in bipolar disorder, especially in prophylaxis and when onset of action is not an imperative. Lithium has been in use in modern medicine for 60 years and as such has been tried and tested across the full range of mood disorders. Arguably, lithium is the only true mood stabilizer and because of its unique properties is in a class of its own.

Clinical practice recommendations for bipolar disorder

Objective:  To provide clinically relevant evidence-based recommendations for the management of bipolar disorder in adults that are informative, easy to assimilate and facilitate clinical decision-making.Method:  A comprehensive literature review of over 500 articles was undertaken using electronic database search engines (e.g. MEDLINE, PsychINFO and Cochrane reviews). In addition articles, book chapters and other literature known to the authors were reviewed. The findings were then formulated into a set of recommendations that were developed by a multidisciplinary team of clinicians who routinely deal with mood disorders. These preliminary recommendations underwent extensive consultative review by a broader advisory panel that included experts in the field, clinical staff and patient representatives.Results:  The clinical practice recommendations for bipolar disorder (bipolar CPR) summarise evidence-based treatments and provide a synopsis of recommendations relating to each phase of the illness. They are designed for clinical use and have therefore been presented succinctly in an innovative and engaging manner that is clear and informative.Conclusion:  These up-to-date recommendations provide an evidence-based framework that incorporates clinical wisdom and consideration of individual factors in the management of bipolar disorder. Further, the novel style and practical approach should promote their uptake and implementation.

Our anonymous online research participants are not always anonymous: Is this a problem?

When educational research is conducted online, we sometimes promise our participants that they will be anonymous—but do we deliver on this promise? We have been warned since 1996 to be careful when using direct quotes in Internet research, as full-text web search engines make it easy to find chunks of text online. This paper details an empirical study into the prevalence of direct quotes from participants in a subset of the educational technology literature. Using basic web search techniques, the source of direct quotes could be found in 10 of 112 articles. Analysis of the articles revealed previously undiscussed threats from data triangulation and expert analysis/diagnosis. Issues of ethical obliviousness, obscurity and concern for future privacy-invasive technologies are also discussed. Recommendations for researchers, journals and institutional ethics review boards are made for how to better protect participants' anonymity against current and future threats.

Machinability assessment of titanium alloy Ti-6Al-4V for biomedical applications

Titanium alloy (Ti-6Al-4V) has a wide range of application in various fields of engineering. Titanium is mainly used to manufacture aerospace components like landing gear, fuselage, wings, engines etc. and biomedical components like hip joint, knee joint, dental implants etc. Titanium has outstanding material properties such as corrosion resistance, fatigue strength, tensile strength and a very good biocompatibility which makes this material very alluring for biomedical applications. Contrary, the machinability of the material is problematic because of the phase transformations and thus, titanium alloy is a challenge for machining operation. This research is a comparative analysis between the implants manufactured by traditional method of casting and machining. The femoral stem of the hip joint replacement is designed and the component is machined using a five-axis CNC machine.The machined component was subjected to surface roughness testing, tensile testing and bulk hardness testing. The values were compared with the values of titanium implants manufactured by casting. © (2014) Trans Tech Publications, Switzerland.

Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders

© 2015 The Royal Australian and New Zealand College of Psychiatrists. Objectives: To provide guidance for the management of mood disorders, based on scientific evidence supplemented by expert clinical consensus and formulate recommendations to maximise clinical salience and utility. Methods: Articles and information sourced from search engines including PubMed and EMBASE, MEDLINE, PsycINFO and Google Scholar were supplemented by literature known to the mood disorders committee (MDC) (e.g., books, book chapters and government reports) and from published depression and bipolar disorder guidelines. Information was reviewed and discussed by members of the MDC and findings were then formulated into consensus-based recommendations and clinical guidance. The guidelines were subjected to rigorous successive consultation and external review involving: expert and clinical advisors, the public, key stakeholders, professional bodies and specialist groups with interest in mood disorders. Results: The Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders (Mood Disorders CPG) provide up-to-date guidance and advice regarding the management of mood disorders that is informed by evidence and clinical experience. The Mood Disorders CPG is intended for clinical use by psychiatrists, psychologists, physicians and others with an interest in mental health care. Conclusions: The Mood Disorder CPG is the first Clinical Practice Guideline to address both depressive and bipolar disorders. It provides up-to-date recommendations and guidance within an evidence-based framework, supplemented by expert clinical consensus. Mood Disorders Committee: Professor Gin Malhi (Chair), Professor Darryl Bassett, Professor Philip Boyce, Professor Richard Bryant, Professor Paul Fitzgerald, Dr Kristina Fritz, Professor Malcolm Hopwood, Dr Bill Lyndon, Professor Roger Mulder, Professor Greg Murray, Professor Richard Porter and Associate Professor Ajeet Singh. International expert advisors: Professor Carlo Altamura, Dr Francesco Colom, Professor Mark George, Professor Guy Goodwin, Professor Roger McIntyre, Dr Roger Ng, Professor John O'Brien, Professor Harold Sackeim, Professor Jan Scott, Dr Nobuhiro Sugiyama, Professor Eduard Vieta, Professor Lakshmi Yatham. Australian and New Zealand expert advisors: Professor Marie-Paule Austin, Professor Michael Berk, Dr Yulisha Byrow, Professor Helen Christensen, Dr Nick De Felice, A/Professor Seetal Dodd, A/Professor Megan Galbally, Dr Josh Geffen, Professor Philip Hazell, A/Professor David Horgan, A/Professor Felice Jacka, Professor Gordon Johnson, Professor Anthony Jorm, Dr Jon-Paul Khoo, Professor Jayashri Kulkarni, Dr Cameron Lacey, Dr Noeline Latt, Professor Florence Levy, A/Professor Andrew Lewis, Professor Colleen Loo, Dr Thomas Mayze, Dr Linton Meagher, Professor Philip Mitchell, Professor Daniel O'Connor, Dr Nick O'Connor, Dr Tim Outhred, Dr Mark Rowe, Dr Narelle Shadbolt, Dr Martien Snellen, Professor John Tiller, Dr Bill Watkins, Dr Raymond Wu.

Fool me if you can: mimicking attacks and anti-attacks in cyberspace

Botnets have become major engines for malicious activities in cyberspace nowadays. To sustain their botnets and disguise their malicious actions, botnet owners are mimicking legitimate cyber behavior to fly under the radar. This poses a critical challenge in anomaly detection. In this paper, we use web browsing on popular web sites as an example to tackle this problem. First of all, we establish a semi-Markov model for browsing behavior. Based on this model, we find that it is impossible to detect mimicking attacks based on statistics if the number of active bots of the attacking botnet is sufficiently large (no less than the number of active legitimate users). However, we also find it is hard for botnet owners to satisfy the condition to carry out a mimicking attack most of the time. With this new finding, we conclude that mimicking attacks can be discriminated from genuine flash crowds using second order statistical metrics. We define a new fine correntropy metrics and show its effectiveness compared to others. Our real world data set experiments and simulations confirm our theoretical claims. Furthermore, the findings can be widely applied to similar situations in other research fields.