Comparative effectiveness of dual-action versus single-action antidepressants for the treatment of depression in people living with HIV/AIDS

Background Depression is the most common psychiatric comorbidity among people living with HIV/AIDS (PLWHA). Little is known about the comparative effectiveness between different types of antidepressants used to treat depression in this population. We compared the effectiveness of dual-action and single-action antidepressants in PLWHA for achieving remission from depression. Methods We used data from the Centers for AIDS Research Network of Integrated Clinic Systems to identify 1175 new user dual-action or single-action antidepressant treatment episodes occurring from 2005 to 2014 for PLWHA diagnosed with depression. The primary outcome was remission from depression defined as a Patient Health Questionnaire-9 (PHQ-9) score <5. Mean difference in PHQ-9 depressive symptom severity was a secondary outcome. The main approach was an intent-to-treat (ITT) evaluation complemented with a per protocol (PP) sensitivity analysis. Generalized linear models were fitted to estimate treatment effects. Results In ITT analysis, 32% of the episodes ended in remission for both dual-action and single-action antidepressants. The odds ratio (OR) of remission was 1.02 (95%CI=0.63,1.67). In PP analysis, 40% of dual-action episodes ended in remission compared to 32% in single-action episodes. Dual-action episodes had 1.33 times the odds of remission (95%CI=0.55,3.21), however the result was not statistically significant. Non-significant differences were also observed for depressive symptom severity. Limitations Missing data was common but was addressed with inverse probability weights. Conclusions Results suggest that single-action and dual-action antidepressants are equally effective in PLWHA. Remission was uncommon highlighting the need to identify health service delivery strategies that aid HIV providers in achieving full remission of their patients’ depression

No Time for Dead Time: Timing analysis of bright black hole binaries with NuSTAR

Timing of high-count rate sources with the NuSTAR Small Explorer Mission requires specialized analysis techniques. NuSTAR was primarily designed for spectroscopic observations of sources with relatively low count-rates rather than for timing analysis of bright objects. The instrumental dead time per event is relatively long (~2.5 msec), and varies by a few percent event-to-event. The most obvious effect is a distortion of the white noise level in the power density spectrum (PDS) that cannot be modeled easily with the standard techniques due to the variable nature of the dead time. In this paper, we show that it is possible to exploit the presence of two completely independent focal planes and use the cross power density spectrum to obtain a good proxy of the white noise-subtracted PDS. Thereafter, one can use a Monte Carlo approach to estimate the remaining effects of dead time, namely a frequency-dependent modulation of the variance and a frequency-independent drop of the sensitivity to variability. In this way, most of the standard timing analysis can be performed, albeit with a sacrifice in signal to noise relative to what would be achieved using more standard techniques. We apply this technique to NuSTAR observations of the black hole binaries GX 339-4, Cyg X-1 and GRS 1915+105.Comment: 13 pages, 8 figures, submitted to Ap

Risk factors for Plasmodium falciparum infection in the Kenyan Highlands: a cohort study.

BACKGROUND: Malaria transmission in African highland areas can be prone to epidemics, with minor fluctuations in temperature or altitude resulting in highly heterogeneous transmission. In the Kenyan Highlands, where malaria prevalence has been increasing, characterising malaria incidence and identifying risk factors for infection is complicated by asymptomatic infection. METHODS: This all-age cohort study, one element of the Malaria Transmission Consortium, involved monthly follow-up of 3155 residents of the Kisii and Rachuonyo South districts during June 2009-June 2010. Participants were tested for malaria using rapid diagnostic testing at every visit, regardless of symptoms. RESULTS: The incidence of Plasmodium falciparum infection was 0.2 cases per person, although infections were clustered within individuals and over time, with the majority of infections detected in the last month of the cohort study. Overall, incidence was higher in the Rachuonyo district and infections were detected most frequently in 5-10-year-olds. The majority of infections were asymptomatic (58%). Travel away from the study area was a notable risk factor for infection. CONCLUSIONS: Identifying risk factors for malaria infection can help to guide targeting of interventions to populations most likely to be exposed to malaria

Low-cost 3D printed 1 nm resolution smartphone sensor-based spectrometer: instrument design and application in ultraviolet spectroscopy.

We report on the development of a low-cost spectrometer, based on off-the-shelf optical components, a 3D printed housing, and a modified Raspberry Pi camera module. With a bandwidth and spectral resolution of ≈60  nm and 1 nm, respectively, this device was designed for ultraviolet (UV) remote sensing of atmospheric sulphur dioxide (SO2), ≈310  nm. To the best of our knowledge, this is the first report of both a UV spectrometer and a nanometer resolution spectrometer based on smartphone sensor technology. The device performance was assessed and validated by measuring column amounts of SO2 within quartz cells with a differential optical absorption spectroscopy processing routine. This system could easily be reconfigured to cover other UV-visible-near-infrared spectral regions, as well as alternate spectral ranges and/or linewidths. Hence, our intention is also to highlight how this framework could be applied to build bespoke, low-cost, spectrometers for a range of scientific applications

South Korean Military Service Promotes Smoking: A Quasi-Experimental Design

∙ The authors have no financial conflicts of interest. © Copyright: Yonsei University College of Medicine 2012 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial Licens

The UK medical education database (UKMED) what is it?:Why and how might you use it?

The development of UKMED has not been directly funded by but has received support from the General Medical Council and Medical Schools Council as well as staff time from all participating organisations.Peer reviewedPublisher PD

Jography: Exploring meanings, experiences and spatialities of recreational road-running

Jogging is a relatively under-researched mobile practice with much existing literature focusing on ‘serious’ and competitive running. In this paper, we provide an account of some of the movements, meanings and experiences that together help produce the practice of jogging in the south-western English city of Plymouth. Drawing upon participant diaries and interviews, we uncover rich detail about how joggers ascribe not one but a number of meanings to their practice. Some of these are positive, some are negative; some complement each other and some compete with each other. We also consider how the experiences of joggers can be shaped by their ongoing need to develop tactics capable of enabling them to negotiate space with non-joggers. This is in some contrast to more competitive running that occurs in the separated space of an athletics track. Our sense is that better awareness of the meanings and experiences of jogging will be of value if the advertised health and sustainability benefits of the practice are to be more effectively encouraged and promoted

The Role of Hypoxia in 2-Butoxyethanol–Induced Hemangiosarcoma

To understand the molecular mechanisms underlying compound-induced hemangiosarcomas in mice, and therefore, their human relevance, a systems biology approach was undertaken using transcriptomics and Causal Network Modeling from mice treated with 2-butoxyethanol (2-BE). 2-BE is a hemolytic agent that induces hemangiosarcomas in mice. We hypothesized that the hemolysis induced by 2-BE would result in local tissue hypoxia, a well-documented trigger for endothelial cell proliferation leading to hemangiosarcoma. Gene expression data from bone marrow (BM), liver, and spleen of mice exposed to a single dose (4 h) or seven daily doses of 2-BE were used to develop a mechanistic model of hemangiosarcoma. The resulting mechanistic model confirms previous work proposing that 2-BE induces macrophage activation and inflammation in the liver. In addition, the model supports local tissue hypoxia in the liver and spleen, coupled with increased erythropoeitin signaling and erythropoiesis in the spleen and BM, and suppression of mechanisms that contribute to genomic stability, events that could be contributing factors to hemangiosarcoma formation. Finally, an immunohistochemistry method (Hypoxyprobe) demonstrated that tissue hypoxia was present in the spleen and BM. Together, the results of this study identify molecular mechanisms that initiate hemangiosarcoma, a key step in understanding safety concerns that can impact drug decision processes, and identified hypoxia as a possible contributing factor for 2-BE–induced hemangiosarcoma in mice

Daratumumab plus lenalidomide and dexamethasone in relapsed/ refractory multiple myeloma: extended follow-up of POLLUX, a randomized, open-label, phase 3 study

In POLLUX, daratumumab (D) plus lenalidomide/dexamethasone (Rd) reduced the risk of disease progression or death by 63% and increased the overall response rate (ORR) versus Rd in relapsed/refractory multiple myeloma (RRMM). Updated efficacy and safety after >3 years of follow-up are presented. Patients (N = 569) with ≥1 prior line received Rd (lenalidomide, 25 mg, on Days 1–21 of each 28-day cycle; dexamethasone, 40 mg, weekly) ± daratumumab at the approved dosing schedule. Minimal residual disease (MRD) was assessed by next-generation sequencing. After 44.3 months median follow-up, D-Rd prolonged progression-free survival (PFS) in the intent-to-treat population (median 44.5 vs 17.5 months; HR, 0.44; 95% CI, 0.35–0.55; P < 0.0001) and in patient subgroups. D-Rd demonstrated higher ORR (92.9 vs 76.4%; P < 0.0001) and deeper responses, including complete response or better (56.6 vs 23.2%; P < 0.0001) and MRD negativity (10–5; 30.4 vs 5.3%; P < 0.0001). Median time to next therapy was prolonged with D-Rd (50.6 vs 23.1 months; HR, 0.39; 95% CI, 0.31–0.50; P < 0.0001). Median PFS on subsequent line of therapy (PFS2) was not reached with D-Rd versus 31.7 months with Rd (HR, 0.53; 95% CI, 0.42–0.68; P < 0.0001). No new safety concerns were reported. These data support using D-Rd in patients with RRMM after first relapse