Antidepressant medication use in Inflammatory Bowel Disease: a nationally representative population-based study.

BACKGROUND: Despite high rates of depression and anxiety, little is known about the use of antidepressants amongst individuals diagnosed with inflammatory bowel disease (IBD). AIMS: To evaluate temporal trends in the use of antidepressants; rates of antidepressant initiation and adherence of antidepressant use to international guidelines amongst individuals with IBD. METHODS: This is a study of 14,525 incident IBD cases from 2004 to 2016 compared with 58,027 controls matched 1:4 for age and sex from the Clinical Practice Research Datalink. After excluding tricyclic antidepressants, we performed a Cox regression analysis to determine the risk associated with antidepressant use and logistic regression analysis to determine risk associated with antidepressant undertreatment. RESULTS: Antidepressant use amongst individuals with IBD increased by 51% during the 12-year study period, who were 34% more likely to initiate antidepressants in the year after IBD diagnosis compared with controls (aHR:1.34, 95% CI 1.21-1.49). In those with IBD starting antidepressants, 67% received treatment lasting less than the duration recommended in international guidelines, of which 34% were treated for 1 month or less. 18-24 year olds were twice as likely to discontinue treatment within 1 month compared with those aged 40-60 years (aHR:2.03, 95% CI 1.40-2.95). Socioeconomic deprivation was also associated with early treatment discontinuation (aHR:1.40, 95% CI 1.07-1.83). CONCLUSIONS: In the year following IBD diagnosis individuals are significantly more likely to start antidepressants compared with controls, but treatment duration fell short of recommendations in the majority. Better integration of services may benefit individuals with IBD and psychiatric comorbidity

Quantum Hall Effect in a Holographic Model

We consider a holographic description of a system of strongly coupled fermions in 2+1 dimensions based on a D7-brane probe in the background of D3-branes, and construct stable embeddings by turning on worldvolume fluxes. We study the system at finite temperature and charge density, and in the presence of a background magnetic field. We show that Minkowski-like embeddings that terminate above the horizon describe a family of quantum Hall states with filling fractions that are parameterized by a single discrete parameter. The quantization of the Hall conductivity is a direct consequence of the topological quantization of the fluxes. When the magnetic field is varied relative to the charge density away from these discrete filling fractions, the embeddings deform continuously into black-hole-like embeddings that enter the horizon and that describe metallic states. We also study the thermodynamics of this system and show that there is a first order phase transition at a critical temperature from the quantum Hall state to the metallic state.Comment: v2: 27 pages, 12 figures. There is a major revision in the quantitative analysis. The qualitative results and conclusions are unchanged, with one exception: we show that the quantum Hall state embeddings, which exist for discrete values of the filling fraction, deform continuously into metallic state embeddings away from these filling fraction

Prompt Decays of General Neutralino NLSPs at the Tevatron

Recent theoretical developments have shown that gauge mediation has a much larger parameter space of possible spectra and mixings than previously considered. Motivated by this, we explore the collider phenomenology of gauge mediation models where a general neutralino is the lightest MSSM superpartner (the NLSP), focusing on the potential reach from existing and future Tevatron searches. Promptly decaying general neutralino NLSPs can give rise to final states involving missing energy plus photons, Zs, Ws and/or Higgses. We survey the final states and determine those where the Tevatron should have the most sensitivity. We then estimate the reach of existing Tevatron searches in these final states and discuss new searches (or optimizations of existing ones) that should improve the reach. Finally we comment on the potential for discovery at the LHC.Comment: 41 pages, minor changes, added refs and discussion of previous literatur

Emerging applications of fluorescence spectroscopy in medical microbiology field

There are many diagnostic techniques and methods available for diagnosis of medically important microorganisms like bacteria, viruses, fungi and parasites. But, almost all these techniques and methods have some limitations or inconvenience. Most of these techniques are laborious, time consuming and with chances of false positive or false negative results. It warrants the need of a diagnostic technique which can overcome these limitations and problems. At present, there is emerging trend to use Fluorescence spectroscopy as a diagnostic as well as research tool in many fields of medical sciences. Here, we will critically discuss research studies which propose that Fluorescence spectroscopy may be an excellent diagnostic as well as excellent research tool in medical microbiology field with high sensitivity and specificity

Clearing the Backlog: Trichiasis Surgeon Retention and Productivity in Northern Ethiopia

Blindness from trachoma is caused by the abrasive effect of trichiasis (in-turned eyelashes). Surgery is performed to correct this anatomical abnormality, and prevent blindness. Despite the progress made in many regions in controlling the active/infectious stages of this disease, the global prevalence of trichiasis remains about the same. Current surgical activity is barely keeping abreast of incident trichiasis; this is undermining all the other efforts to control trachoma. We examine staff retention and productivity in Amhara Region, Ethiopia, where many hundreds of health care workers have been trained to perform the surgery. We found that the majority of people trained to do the surgery are now not in a position to do so. Amongst the sub-set that is still active within the programme, surgical productivity is low, with most surgery performed during “outreach campaigns” Insufficient surgical instruments and consumables were frequent problems. Strengthened health-systems management can overcome many of the problems that are holding back the delivery of an effective trichiasis surgical service

Normal growth and development in mice over-expressing the CCN family member WISP3

Loss-of-function mutations in the gene WISP3 cause the autosomal recessive human skeletal disease Progressive Pseudorheumatoid Dysplasia, whereas mice with knockout mutations of Wisp3 have no phenotype. The lack of a phenotype in the Wisp3 knockout mice has constrained studies of the protein’s in vivo function. Over-expression experiments in zebrafish indicated that WISP3 may function as a BMP and Wnt signaling modulator. To determine whether these biologic activities are retained in mice, we created two strains of transgenic mice that over-express WISP3 in a broad array of tissues. Despite strong and persistent protein over-expression, the transgenic mice remained phenotypically indistinguishable from their non-transgenic littermates. Surprisingly, WISP3 contained in conditioned medium recovered from transgenic mouse primary kidney cell cultures was able to bind BMP and to inhibit BMP signaling in vitro. Factors that account for the difference between the in vitro and in vivo activities of WISP3 remain unknown. At present, the mouse remains a challenging model organism in which to explore the biologic function of WISP3

Social Structure Predicts Genital Morphology in African Mole-Rats

BACKGROUND:African mole-rats (Bathyergidae, Rodentia) exhibit a wide range of social structures, from solitary to eusocial. We previously found a lack of sex differences in the external genitalia and morphology of the perineal muscles associated with the phallus in the eusocial naked mole-rat. This was quite surprising, as the external genitalia and perineal muscles are sexually dimorphic in all other mammals examined. We hypothesized that the lack of sex differences in naked mole-rats might be related to their unusual social structure. METHODOLOGY/PRINCIPAL FINDINGS:We compared the genitalia and perineal muscles in three African mole-rat species: the naked mole-rat, the solitary silvery mole-rat, and the Damaraland mole-rat, a species considered to be eusocial, but with less reproductive skew than naked mole-rats. Our findings support a relationship between social structure, mating system, and sexual differentiation. Naked mole-rats lack sex differences in genitalia and perineal morphology, silvery mole-rats exhibit sex differences, and Damaraland mole-rats are intermediate. CONCLUSIONS/SIGNIFICANCE:The lack of sex differences in naked mole-rats is not an attribute of all African mole-rats, but appears to have evolved in relation to their unusual social structure and reproductive biology

Clinical decision support tools: analysis of online drug information databases

BACKGROUND: Online drug information databases are used to assist in enhancing clinical decision support. However, the choice of which online database to consult, purchase or subscribe to is likely made based on subjective elements such as history of use, familiarity, or availability during professional training. The purpose of this study was to evaluate clinical decision support tools for drug information by systematically comparing the most commonly used online drug information databases. METHODS: Five commercially available and two freely available online drug information databases were evaluated according to scope (presence or absence of answer), completeness (the comprehensiveness of the answers), and ease of use. Additionally, a composite score integrating all three criteria was utilized. Fifteen weighted categories comprised of 158 questions were used to conduct the analysis. Descriptive statistics and Chi-square were used to summarize the evaluation components and make comparisons between databases. Scheffe's multiple comparison procedure was used to determine statistically different scope and completeness scores. The composite score was subjected to sensitivity analysis to investigate the effect of the choice of percentages for scope and completeness. RESULTS: The rankings for the databases from highest to lowest, based on composite scores were Clinical Pharmacology, Micromedex, Lexi-Comp Online, Facts & Comparisons 4.0, Epocrates Online Premium, RxList.com, and Epocrates Online Free. Differences in scope produced three statistical groupings with Group 1 (best) performers being: Clinical Pharmacology, Micromedex, Facts & Comparisons 4.0, Lexi-Comp Online, Group 2: Epocrates Premium and RxList.com and Group 3: Epocrates Free (p < 0.05). Completeness scores were similarly stratified. Collapsing the databases into two groups by access (subscription or free), showed the subscription databases performed better than the free databases in the measured criteria (p < 0.001). CONCLUSION: Online drug information databases, which belong to clinical decision support, vary in their ability to answer questions across a range of categories