Treatment response for acute depression is not associated with number of previous episodes: lack of evidence for a clinical staging model for major depressive disorder

Mental illness has been observed to follow a neuroprogressive course, commencing with prodrome, then onset, recurrence and finally chronic illness. In bipolar disorder and schizophrenia responsiveness to treatment mirrors these stages of illness progression, with greater response to treatment in the earlier stages of illness and greater treatment resistance in chronic late stage illness.

Using data from 5627 participants in 15 controlled trials of duloxetine, comparator arm (paroxetine, venlafaxine, escitalopram) or placebo for the treatment of an acute depressive episode, the relationship between treatment response and number of previous depressive episodes was determined. Data was dichotomised for comparisons between participants who had >3 previous episodes (n=1697) or ≤3 previous episodes (n=3930), and additionally for no previous episodes (n=1381) or at least one previous episode (n=4246). Analyses were conducted by study arm for each clinical trial, and results were then pooled.

There was no significant difference between treatment response and number of previous depressive episodes. This unexpected finding suggests that treatments to reduce symptoms of depression during acute illness do not lose efficacy for patients with a longer history of illness.

A comparison of Australian rural and metropolitan cardiovascular risk and mortality: the Greater Green Triangle and North West Adelaide population surveys

Objectives:
Cardiovascular (CVD) mortality disparities between rural/regional and urban-dwelling residents of Australia are persistent. Unavailability of biomedical CVD risk factor data has, until now, limited efforts to understand the causes of the disparity. This study aimed to further investigate such disparities.

Estimating nephron number in the developing kidney using the physical disector/fractionator combination

Over the last decade the development of new molecular biology tools, advanced microscopy, live imaging and systems biology approaches have revolutionized our conception of how embryonic development proceeds. One fundamental aspect of development biology is the concept of morphogenesis: understanding how a group of multipotent cells organize and differentiate into a complex organ. In Kidney Development: Methods and Protocols, expert researchers in the field detail different approaches to tackle kidney development. These approaches include culture and live imaging aspects of kidney development, analyzing the 3-dimensional aspects of branching morphogenesis as well as nephrogenesis, manipulation of the gene/protein expression during kidney development as well as in the adult kidney, and how to assess kidney malformation and disease. Written in the highly successful Methods in Molecular Biology series format, chapters include introductions to their respective topics, lists of the necessary materials and reagents, step-by-step, readily reproducible laboratory protocols, and key tips on troubleshooting and avoiding known pitfalls. Authoritative and practical, Kidney Development: Methods and Protocols seeks to aid scientists in the further study of the process of morphogenesis which is fundamental important not only for studying developmental biology but also for regenerative medicine.

Estimating the number of green and loggerhead turtles nesting annually in the Mediterranean

Most species of marine turtle breed every two or more years and it is the norm for females to lay more than one clutch of eggs within a nesting season. Knowing the interval between breeding seasons and the clutch frequency (number of clutches laid by an individual in a breeding season) of females allows us to assess the status of a nesting population. At Alagadi Beach, Northern Cyprus, over a period of 6 years (1995–2000), we attributed 96% of green Chelonia mydas and 80% of loggerhead Caretta caretta turtle clutches to known individual females. This intensive level of monitoring enabled us to estimate the clutch frequency for both species. Using four different methods we estimated clutch frequency to be 2.9–3.1 clutches per female for green turtles and 1.8–2.2 clutches per female for loggerhead turtles. The median interval between nesting seasons for green turtles was 3 years, and for loggerhead turtles it was 2 years. Utilizing these parameters and available data from other beaches that are monitored regularly, we estimate that there are 2,280–2,787 logger-head and 339–360 green turtles nesting annually at these sites in the Mediterranean. This highlights the Critically Endangered status of this population of green turtles. Furthermore, as conventional beach patrols underestimate clutch frequency, these population estimates are likely to be optimistic.

Mixing Matrix Estimation From Sparse Mixtures With Unknown Number of Sources

In blind source separation, many methods have been proposed to estimate the mixing matrix by exploiting sparsity. However, they often need to know the source number a priori, which is very inconvenient in practice. In this paper, a new method, namely nonlinear projection and column masking (NPCM), is proposed to estimate the mixing matrix. A major advantage of NPCM is that it does not need any knowledge of the source number. In NPCM, the objective function is based on a nonlinear projection and its maxima just correspond to the columns of the mixing matrix. Thus a column can be estimated first by locating a maximum and then deflated by a masking operation. This procedure is repeated until the evaluation of the objective function decreases to zero dramatically. Thus the mixing matrix and the number of sources are estimated simultaneously. Because the masking procedure may result in some small and useless local maxima, particle swarm optimization (PSO) is introduced to optimize the objective function. Feasibility and efficiency of PSO are also discussed. Comparative experimental results show the efficiency of NPCM, especially in the cases where the number of sources is unknown and the sources are relatively less sparse.

A design-based method for estimating glomerular number in the developing kidney

Low glomerular (nephron) endowment has been associated with an increased risk of cardiovascular and renal disease in adulthood. Nephron endowment in humans is determined by 36 wk of gestation, while in rats and mice nephrogenesis ends several days after birth. Specific genes and environmental perturbations have been shown to regulate nephron endowment. Until now, design-based method for estimating nephron number in developing kidneys was unavailable. This was due in part to the difficulty associated with unambiguously identifying developing glomeruli in histological sections. Here, we describe a method that uses lectin histochemistry to identify developing glomeruli and the physical disector/fractionator principle to provide unbiased estimates of total glomerular number (Nglom). We have characterized Nglom throughout development in kidneys from 76 rats and model this development with a 5-parameter logistic equation to predict Nglom from embryonic day 17.25 to adulthood (r2 = 0.98). This approach represents the first design-based method with which to estimate Nglom in the developing kidney.

Substantial reductions in the number of diabetic ketoacidosis and severe hypoglycaemia episodes requiring emergency treatment lead to reduced costs after structured education in adults with Type 1 diabetes

To determine the impact of structured education promoting flexible intensive insulin therapy on rates of diabetic ketoacidosis, and the costs associated with emergency treatment for severe hypoglycaemia and ketoacidosis in adults with Type 1 diabetes.

Glomerular hypertrophy in subjects with low nephron number: contributions of sex, body size and race

Background. We have shown that low nephron number (Nglom) is a strong determinant of individual glomerular volume (IGV) in male Americans. However, whether the same pattern is present in female Americans remains unclear. The contributions of body surface area (BSA) and race to IGV in the context of Nglom also require further evaluation. Methods. Kidneys without overt renal disease were collected at autopsy in Mississippi, USA. The extremes of female Nglom were used to define high and low N glom for both sexes. Nglom and IGV were estimated by design-based stereology. A total of 24 African and Caucasian American females (n = 12 per race; 6 per Nglom extreme) were included. These subjects were subsequently matched to 24 comparable males by age and Nglom and to 18 additional males by age, Nglom and BSA. Results. IGV average and variance were very similar in female African and Caucasian Americans with high and low Nglom. Males with low Nglom from both races showed greater IGV average and variance than comparable females matched by age and Nglom. These differences in IGV between sexes were not observed in Caucasian Americans with low Nglom that were matched by age, Nglom and BSA. In contrast, glomeruli from African Americans were larger than those from Caucasian Americans, especially in subjects with high Nglom. Conclusions. While female Americans with low Nglom did not show glomerular hypertrophy, comparable males with low Nglom showed marked glomerular hypertrophy that was closely associated with high BSA. Glomerular size in African Americans may be confounded by multiple additional factors. © The Author 2014. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.