Placebo Response of Non-Pharmacological and Pharmacological Trials in Major Depression: A Systematic Review and Meta-Analysis

Background: Although meta-analyses have shown that placebo responses are large in Major Depressive Disorder (MDD) trials; the placebo response of devices such as repetitive transcranial magnetic stimulation (rTMS) has not been systematically assessed. We proposed to assess placebo responses in two categories of MDD trials: pharmacological (antidepressant drugs) and non-pharmacological (device-rTMS) trials. Methodology/Principal Findings: We performed a systematic review and meta-analysis of the literature from April 2002 to April 2008, searching MEDLINE, Cochrane, Scielo and CRISP electronic databases and reference lists from retrieved studies and conference abstracts. We used the keywords placebo and depression and escitalopram for pharmacological studies; and transcranial magnetic stimulation and depression and sham for non-pharmacological studies. All randomized, double-blinded, placebo-controlled, parallel articles on major depressive disorder were included. Forty-one studies met our inclusion criteria-29 in the rTMS arm and 12 in the escitalopram arm. We extracted the mean and standard values of depression scores in the placebo group of each study. Then, we calculated the pooled effect size for escitalopram and rTMS arm separately, using Cohen's d as the measure of effect size. We found that placebo response are large for both escitalopram (Cohen's d-random-effects model-1.48; 95% C.I. 1.26 to 1.6) and rTMS studies (0.82; 95% C.I. 0.63 to 1). Exploratory analyses show that sham response is associated with refractoriness and with the use of rTMS as an add-on therapy, but not with age, gender and sham method utilized. Conclusions/Significance: We confirmed that placebo response in MDD is large regardless of the intervention and is associated with depression refractoriness and treatment combination (add-on rTMS studies). The magnitude of the placebo response seems to be related with study population and study design rather than the intervention itself.

Harmonic Distortion of Unstrained and Strained FinFETs Operating in Saturation

The harmonic distortion (HD) exhibited by un-strained and biaxially strained fin-shaped field-effect transistors operating in saturation as single-transistor amplifiers has been investigated for devices with different channel lengths L and fin widths W(fin). The study has been performed through device characterization, 3-D device simulations, and modeling. Nonlinearity has been evaluated in terms of second- and third-order HDs (HD2 and HD3, respectively), and a discussion on its physical sources has been carried out. Also, the influence of the open-loop voltage gain AV in HD has been observed.

Junctionless Multiple-Gate Transistors for Analog Applications

This paper presents the evaluation of the analog properties of nMOS junctionless (JL) multigate transistors, comparing their performance with those exhibited by inversion-mode (IM) trigate devices of similar dimensions. The study has been performed for devices operating in saturation as single-transistor amplifiers, and we have considered the dependence of the analog properties on fin width W(fin) and temperature T. Furthermore, this paper aims at providing a physical insight into the analog parameters of JL transistors. For that, in addition to device characterization, 3-D device simulations were performed. It is shown that, depending on gate voltage, JL devices can present both larger Early voltage V(EA) and larger intrinsic voltage gain A(V) than IM devices of similar dimensions. In addition, V(EA) and A(V) are always improved in JL devices when the temperature is increased, whereas they present a maximum value around room temperature for IM transistors.

Phylogeography of Chelonus insularis (Hymenoptera: Braconidae) and Campoletis sonorensis (Hymenoptera: Ichneumonidae), Two Primary Neotropical Parasitoids of the Fall Armyworm (Lepidoptera: Noctuidae)

In a previous study, we observed no spatial genetic structure in Mexican populations of the parasitoids Chelonus insularis Cresson (Hymenoptera: Braconidae) and Campoletis sonorensis Cameron (Hymenoptera: Ichneumonidae) by using microsatellite markers In the current study, we Investigated whether for these important parasitoids of the fall armyworm (Lepidoptera: Noctuidae) there is any genetic structure at a larger scale Insects of both species were collected across the American continent and their phylogeography was Investigated using both nuclear and mitochondria] markers Our results suggest an ancient north-south migration of C insularis, whereas no clear pattern] could be determined for C sonorensis. Nonetheless, the resulting topology indicated the existence of a cryptic taxon within this later species. a few Canadian specimens determined as C. sonorensis branch outside a clack composed of the Argentinean Chelonus grioti Blanchard, the Brazilian Chelonus flavicincta Ashmead, and the rest of the C sonorensis individuals The individuals revealing the cryptic taxon were collected from Thichoplusia in (Hubner) (Lepidoptera. Noctuidae) on tomato (Lycopersicon spp) and may represent a biotype that has adapted to the early season phenology of its host. Overall, the loosely defined spatial genetic structure previously shown at a local fine scale also was found at the larger scale, for both species Dispersal of these insects may be partly driven by wind as suggested by genetic similarities between Individuals coming from very distant locations.

Oviposition by a moth suppresses constitutive and herbivore-induced plant volatiles in maize

Plant volatiles function as important signals for herbivores, parasitoids, predators, and neighboring plants. Herbivore attack can dramatically increase plant volatile emissions in many species. However, plants do not only react to herbivore-inflicted damage, but also already start adjusting their metabolism upon egg deposition by insects. Several studies have found evidence that egg deposition itself can induce the release of volatiles, but little is known about the effects of oviposition on the volatiles released in response to subsequent herbivory. To study this we measured the effect of oviposition by Spodoptera frugiperda (J.E. Smith) (Lepidoptera: Noctuidae) moths on constitutive and herbivore-induced volatiles in maize (Zea mays L.). Results demonstrate that egg deposition reduces the constitutive emission of volatiles and suppresses the typical burst of inducible volatiles following mechanical damage and application of caterpillar regurgitant, a treatment that mimics herbivory. We discuss the possible mechanisms responsible for reducing the plant`s signaling capacity triggered by S. frugiperda oviposition and how suppression of volatile organic compounds can influence the interaction between the plant, the herbivore, and other organisms in its environment. Future studies should consider oviposition as a potential modulator of plant responses to insect herbivores.

Claude Jones addressing a Communist Party of Australia meeting in Brisbane, Australia

Claude Jones addressing a Communist Party of Australia meeting in Brisbane, Australia. Ted Bacon can be seen at the table.

Adopting turtle excluder devices in Australia and the United States: What are the differences in technology transfer, promotion, and acceptance?

Turtle excluder devices (TEDs) are being trialed on a voluntary basis in many Australian prawn (shrimp) trawl fisheries to reduce sea turtle captures. Analysis of TED introductions into shrimp trawl fisheries of the United States provided major insights into why conflicts occurred between shrimpers, conservationists, and government agencies. A conflict over the introduction and subsequent regulation of TEDs occurred because the problem and the solution were perceived differently by the various stakeholders. Attempts to negotiate and mediate the conflict broke down, resulting in litigation against the U.S. government by conservationists and shrimpers. Litigation was not an efficient resolution to the sea turtle-TED-trawl conflict but it appears that litigation was the only remaining path of resolution once the issue became polarized. We review two major Australian trawl fisheries to identify any significant differences in circumstances that may affect TED acceptance. Australian trawl fisheries are structured differently and good communication occurs between industry and researchers. TEDs are being introduced as mature technology. Furthermore, bycatch issues are of increasing concern to all stakeholders. These factors, combined with insights derived from previous conflicts concerning TEDs in the United Stares, increase the possibilities that TEDs will be introduced to Australian fishers with better acceptance.

Challenges and Recommendations for Placebo Controls in Randomized Trials in Physical and Rehabilitation Medicine A Report of the International Placebo Symposium Working Group

Compared with other specialties, the field of physical and rehabilitation medicine has not received the deserved recognition from clinicians and researchers in the scientific community. One of the reasons is the lack of sound evidence to support the traditional physical and rehabilitation medicine treatments. The best way to change this disadvantage is through a well conducted clinical research, such as standard placebo- or sham-controlled randomized clinical trials. Therefore, having placebo groups in clinical trials is essential to improve the level of evidence-based practice in physical and rehabilitation medicine that ultimately translates to better clinical care. To address the challenges for the use of placebo in physical and rehabilitation medicine and randomized clinical trials and to create useful recommendations, we convened a working group during the inaugural International Symposium in Placebo (February 2009, in Sao Paulo, Brazil) in which the following topics were discussed: (1) current status of randomized clinical trials in physical and rehabilitation medicine, (2) challenges for the use of placebo in physical and rehabilitation medicine, (3) bioethics, (4) use of placebo in acupuncture trials and for the treatment of low-back pain, (5) mechanisms of placebo, and (6) insights from other specialties. The current article represents the consensus report from the working group.

Comparative study of Botox (R) injection treatment for upper eyelid retraction with 6-month follow-up in patients with thyroid eye disease in the congestive or fibrotic stage

Aim To compare morphometric data of the eyelid fissure and the levator muscle function (LF) before and up to 6 months after transcutaneous injection with five units of Botox (R) in patients with upper lid retraction (ULR) from congestive or fibrotic thyroid eye disease (TED). Methods Twenty-four patients with ULR from TED were submitted to transcutaneous injection of 5 units (0.1 ml) of Botox in one eye only. Patients were divided into two groups: 12 with congestive-stage TED (CG), and 12 with fibrotic-stage TED (FG). Bilateral lid fissure measurements using digital imaging and computer-aided analysis were taken at baseline and at regular intervals 2 weeks, 1 month, 3 months and 6 months after unilateral Botox injection. Mean values taken at different follow-up points were compared for the two groups. Results Most patients experienced marked improvement in ULR, with a mean reduction of 3.81 mm in FG and 3.05 mm in CG. The upper eyelid margin reflex distance, fissure height and total area of exposed interpalpebral fissure were significantly smaller during 1 month in CG and during 3 months in FG. Reduction in LF and in the difference between lateral and medial lid fissure measurements was observed in both groups. The treatment lasted significantly longer in FG than in CG. Conclusions A single 5-unit Botox injection improved ULR, reduced LF and produced an adequate lid contour in patients with congestive or fibrotic TED. The effect lasts longer in patients with fibrotic orbitopathy than in patients with congestive orbitopathy.

Translation of the leisure satisfaction scale into French: A validity study

Presents a study which described the process of translating an English standardized assessment into another language. Details of the study design; Translation of the Leisure Satisfaction Scale (LSS) into French using the translation/validation methodologies; Correlations between both language versions of LSS.

Functional assessment tools for paediatric clients with Juvenile Chronic Arthritis: An update and review for occupational therapists

Juvenile chronic arthritis (JCA) is one cause of chronic illness and disability in childhood. Traditional clinical assessment of clients with JCA include objective measures of joint deformity, joint swelling, range of motion, duration of morning stiffness, pain, walking speed, running speed and muscle strength. In many instances, these traditional measures have little or no significance or relevance to paediatric clients and their parents whereas functional skills used in everyday living are more likely to be meaningful. Measures of physical, social, and psychological functioning ensure a comprehensive health assessment. Responsible occupational therapy assessment and management of paediatric clients diagnosed with JCA requires the use of reliable, valid and sensitive measures of function. Several instruments are now available which measure a child's or adolescent's functional abilities. In this paper, JCA and the impact of JCA on functional development are reviewed. As well, seven functional assessment tools designed for use with paediatric clients with JCA which occupational therapists can use in their clinical practice will be appraised. The various characteristics of these tools are discussed in order to assist practitioners and researchers in selecting the functional instrument which best meets their needs.

Research utilization among pediatric health professionals

The present study investigated research use and attitudes toward research among pediatric health professionals. All nurses and allied health professionals in a pediatric teaching hospital were surveyed using previously tested and published measures. Over half of the participants had some formal education in research but, for some participants, that education was many years ago. Most participants reported poor or very poor understanding of research design. Two variables were independently associated with a positive attitude towards research: (i) better understanding of how to conduct a literature search; and (ii) higher level of education. Five variables were independently associated with research use: better understanding of research design; having presented at a conference in the past two years; sense of calling to the profession; better understanding of how to conduct a literature search; and attending rounds. A small proportion of variance in both research use and a positive attitude towards research was explained by the independent predicator variables. Further research is required to identify characteristics of the workplace environment that support research use.

An international perspective on sunken state vessels as underwater cultural heritage

On 2 November 2001, the General Assembly of the United Nations Scientific, Economic and Cultural Organisation (UNESCO) adopted the convention on the Protection of the Underwater Cultural Heritage. Among the many complex issues addressed in the convention is the legal status of sunken state-owned vessels, including warships. Prior to the adoption of this convention, no conventional or customary international law existed with regards to the question of abandonment of state-owned vessels or the application of the principle of sovereign immunity to sunken state vessels. While difficulties between coastal states and maritime and former colonial powers resulted in a regime that does not comprehensively address the issues, the convention does provide some guidance in this regard and may provide a basis for further development.

Possibilidades e limitações da amamentação entre mulheres trabalhadoras formais

INTRODUÇÃO: Pesquisas sobre a amamentação e a questão do trabalho da mulher são de difícil comparabilidade. A prática de amamentar entre mulheres com um emprego formal no Brasil tem sido pouco estudada, em que pesem as mudanças havidas como a extensão da licença maternidade para 120 dias. Decidiu-se realizar estudo com o objetivo de descrever o padrão de amamentação de mulheres empregadas em empresas, as limitações que elas enfrentam e que fatores contribuem para que elas possam conciliar trabalho e amamentação. MATERIAL E MÉTODO: Estudo exploratório realizado em 13 indústrias de São Paulo em 1994, onde todas as mulheres no terceiro trimestre da gestação (76) foram entrevistadas e reentrevistadas (69) na volta ao trabalho (em torno de 5,4 meses pós-parto). RESULTADOS: Iniciaram a amamentação 97% das mulheres, apresentando uma duração mediana de 150 dias; quanto ao Aleitamento Materno Exclusivo, a duração mediana foi de 10 dias, e à Amamentação Predominante, a mediana foi de 70 dias. As mulheres de melhor nível socioeconômico e as que tinham creche no local de trabalho ou sala de coleta e estocagem de leite materno, foram as que amamentaram por mais tempo. A possibilidade de flexibilizar seu horário e não trabalhar na linha de produção também mostraram ser fatores significantes que levam as mulheres dessas indústrias a amamentar mais. CONCLUSÕES: A licença-maternidade tem sido útil e usada pela maioria das trabalhadoras para amamentar, mas há outros fatores que são fundamentais para que a manutenção da lactação seja facilitada, tais como aqueles que permitem a proximidade mãe-criança e/ou a retirada periódica de leite materno durante a jornada de trabalho.