Factors Associated With Depressive Episode Recurrences in Primary Care: A Retrospective, Descriptive Study

Introduction and Objective: The early identification of depressive patients having a poor evolution, with frequent relapses and/or recurrences, is one of the priority challenges in this study of high prevalence mental disorders, and specifically in depression. So, this study aims to analyze the factors that may be associated with an increased risk of recurrence of major depression episodes in patients treated in primary care. Methods: A retrospective, descriptive study of cases-controls was proposed. The cases consisted of patients who had been diagnosed with major depression and who had presented recurrences (n = 101), in comparison with patients who had experienced a single major depression episode with no recurrence (n = 99). The variables of the study are age at first episode; number of episodes; perception of severity of the depression episode suffered prior to recurrence; number of residual symptoms; physical and psychiatric comorbidity; history of anxiety disorders; family psychiatric history; high incidence of stressful life events (SLEs); and experiences of physical, psychological, or sexual abuse in childhood. The differences of the variables were compared between the case subjects and the control subjects, using the Mann–Whitney, chi-square, and Fisher’s U statistics. A multivariate analysis (ordinary logistic regression) was performed. Results: The average age of those suffering more than one depressive episode is significantly older (5 years), and a higher percentage of subjects who have experienced more than one depressive episode have a history of anxiety disorders. In the multivariate analysis, the variables that obtained a significant value in the logistic regression analysis were age (OR: 1.03; value: 0.007) and having suffered sexual abuse during childhood (OR: 1.64; value: 0.072). Conclusion: These indicators should be considered by primary care physicians when attending patients suffering from major depression

Analysis of depressive episodes, their recurrence and pharmacologic treatment in primary care patients: A retrospective descriptive study

Background: Depression is one of the most prevalent health problems, frequently being a medium- and long-term condition, with a high comorbidity rate and with frequent relapses and recurrences. Although numerous studies have compared the effectiveness of specific antidepressant therapy drugs and have assessed relapses, scientific evidence on the relationship between pharmacologic treatments and recurrence is scarce. The objective of this study is to describe depressive episodes in a primary care patient cohort, the percentage of depression recurrences and the administered pharmacologic treatment, from a naturalistic perspective. Methods: Retrospective descriptive study. 957 subjects were included. The dependent variable was a depression diagnosis and independent variables were: gender, age at time of data collection; age of onset, first-episode treatment, number of recurrences, age at recurrences, treatment prescribed for recurrences using therapeutic groups categorization. Results: Recurrences are frequent, affecting more than 40% of the population. In the first episode, 13.69% of the patients were not prescribed pharmacological treatment, but this percentage decreased over the following depression episodes. 80.9% of the patients who did not receive drug treatment in the first depression episode did not experience subsequent episodes. Monotherapy, and specifically, SSRIs were the most frequently prescribed treatment option for all depressive episodes. Regards the combined pharmacologic treatment, the most frequent drug combinations were SSRIs and benzodiazepines. Limitations In order to increase the power of results, the statistical analysis was performed using therapeutic groups categorization, not individually analyzing each drug and dose. Conclusions: Depressive episode recurrence is frequent in primary care patients. Further studies having a prospective design are needed in order to expand on this issue

NICER X-ray Observations of Eta Carinae During its Most Recent Periastron Passage

We report high-precision X-ray monitoring observations in the 0.4-10 keV band of the luminous, long-period colliding-wind binary Eta Carinae up to and through its most recent X-ray minimum/periastron passage in February 2020. Eta Carinae reached its observed maximum X-ray flux on 7 January 2020, at a flux level of $3.30 \times 10^{-10}$ ergs s$^{-1}$ cm$^{-2}$, followed by a rapid plunge to its observed minimum flux, $0.03 \times 10^{-10}$ ergs s$^{-1}$ cm$^{-2}$ near 17 February 2020. The NICER observations show an X-ray recovery from minimum of only $\sim$16 days, the shortest X-ray minimum observed so far. We provide new constraints of the "deep" and "shallow" minimum intervals. Variations in the characteristic X-ray temperature of the hottest observed X-ray emission indicate that the apex of the wind-wind "bow shock" enters the companion's wind acceleration zone about 81 days before the start of the X-ray minimum. There is a step-like increase in column density just before the X-ray minimum, probably associated with the presence of dense clumps near the shock apex. During recovery and after, the column density shows a smooth decline, which agrees with previous $N_{H}$ measurements made by SWIFT at the same orbital phase, indicating that changes in mass-loss rate are only a few percent over the two cycles. Finally, we use the variations in the X-ray flux of the outer ejecta seen by NICER to derive a kinetic X-ray luminosity of the ejecta of $\sim 10^{41}$ ergs s$^{-1}$ near the time of the "Great Eruption'

Eta Carinae: an evolving view of the central binary, its interacting winds and its foreground ejecta

FUV spectra of Eta Car, recorded across two decades with HST/STIS, document multiple changes in resonant lines caused by dissipating extinction in our line of sight. The FUV flux has increased nearly ten-fold which has led to increased ionization of the multiple shells within the Homunculus and photo-destruction of molecular hydrogen. Comparison of observed resonant line profiles with CMFGEN model profiles allows separation of wind-wind collision and shell absorptions from the primary wind, P Cygni profiles.The dissipating occulter preferentially obscured the central binary and interacting winds relative to the very extended primary wind. We are now able to monitor changes in the colliding winds with orbital phase. High velocity transient absorptions occurred across the most recent periastron passage, indicating acceleration of the primary wind by the secondary wind which leads to a downstream, high velocity bowshock that is newly generated every orbital period. There is no evidence of changes in the properties of the binary winds.Comment: 36 pages, 22 figures, accepted Astrophysical Journa

Aurora kinase A drives the evolution of resistance to third-generation EGFR inhibitors in lung cancer.

Although targeted therapies often elicit profound initial patient responses, these effects are transient due to residual disease leading to acquired resistance. How tumors transition between drug responsiveness, tolerance and resistance, especially in the absence of preexisting subclones, remains unclear. In epidermal growth factor receptor (EGFR)-mutant lung adenocarcinoma cells, we demonstrate that residual disease and acquired resistance in response to EGFR inhibitors requires Aurora kinase A (AURKA) activity. Nongenetic resistance through the activation of AURKA by its coactivator TPX2 emerges in response to chronic EGFR inhibition where it mitigates drug-induced apoptosis. Aurora kinase inhibitors suppress this adaptive survival program, increasing the magnitude and duration of EGFR inhibitor response in preclinical models. Treatment-induced activation of AURKA is associated with resistance to EGFR inhibitors in vitro, in vivo and in most individuals with EGFR-mutant lung adenocarcinoma. These findings delineate a molecular path whereby drug resistance emerges from drug-tolerant cells and unveils a synthetic lethal strategy for enhancing responses to EGFR inhibitors by suppressing AURKA-driven residual disease and acquired resistance

The apparent eta Carinae's long-term evolution and the critical role played by the strengthening of P Cygni absorption lines

Over the entire 20th century, Eta Carinae (\ec) has displayed a unique spectrum, which recently has been evolving towards that of a typical LBV. The two competing scenarios to explain such evolution are: (1) a dissipating occulter in front of a stable star or (2) a decreasing mass loss rate of the star. The first mechanism simultaneously explains why the central star appears to be secularly increasing its apparent brightness while its luminosity does not change; why the Homunculus' apparent brightness remains almost constant; and why the spectrum seen in direct light is becoming more similar to that reflected from the Homunculus (and which resembles a typical LBV). The second scenario does not account for these facts and predicts an increase in the terminal speed of the wind, contrary to observations. In this work, we present new data showing that the P Cygni absorption lines are secularly strengthening, which is not the expected behaviour for a decreasing wind-density scenario. CMFGEN modelling of the primary's wind with a small occulter in front agrees with observations. One could argue that invoking a dissipating coronagraphic occulter makes this object even more peculiar than it already appears to be. However, on the contrary, it solves the apparent contradictions between many observations. Moreover, by assigning the long-term behaviour to circumstellar causes and the periodic variations due to binarity, a star more stable after the 1900s than previously thought is revealed, contrary to the earlier paradigm of an unpredictable object.Comment: 17 pages, 12 figures, submitted to MNRA

Selenium Toxicity to Honey Bee (Apis mellifera L.) Pollinators: Effects on Behaviors and Survival

We know very little about how soil-borne pollutants such as selenium (Se) can impact pollinators, even though Se has contaminated soils and plants in areas where insect pollination can be critical to the functioning of both agricultural and natural ecosystems. Se can be biotransferred throughout the food web, but few studies have examined its effects on the insects that feed on Se-accumulating plants, particularly pollinators. In laboratory bioassays, we used proboscis extension reflex (PER) and taste perception to determine if the presence of Se affected the gustatory response of honey bee (Apis mellifera L., Hymenoptera: Apidae) foragers. Antennae and proboscises were stimulated with both organic (selenomethionine) and inorganic (selenate) forms of Se that commonly occur in Se-accumulating plants. Methionine was also tested. Each compound was dissolved in 1 M sucrose at 5 concentrations, with sucrose alone as a control. Antennal stimulation with selenomethionine and methionine reduced PER at higher concentrations. Selenate did not reduce gustatory behaviors. Two hours after being fed the treatments, bees were tested for sucrose response threshold. Bees fed selenate responded less to sucrose stimulation. Mortality was higher in bees chronically dosed with selenate compared with a single dose. Selenomethionine did not increase mortality except at the highest concentration. Methionine did not significantly impact survival. Our study has shown that bees fed selenate were less responsive to sucrose, which may lead to a reduction in incoming floral resources needed to support coworkers and larvae in the field. If honey bees forage on nectar containing Se (particularly selenate), reductions in population numbers may occur due to direct toxicity. Given that honey bees are willing to consume food resources containing Se and may not avoid Se compounds in the plant tissues on which they are foraging, they may suffer similar adverse effects as seen in other insect guilds

A systematic review of clinical trials of pharmacological interventions for acute ischaemic stroke (1955-2008) that were completed, but not published in full

<p>Abstract</p> <p>Background</p> <p>We assessed the prevalence, and potential impact of, trials of pharmacological agents for acute stroke that were completed but not published in full. Failure to publish trial data is to be deprecated as it sets aside the altruism of participants' consent to be exposed to the risks of experimental interventions, potentially biases the assessment of the effects of therapies, and may lead to premature discontinuation of research into promising treatments.</p> <p>Methods</p> <p>We searched the Cochrane Stroke Group's Specialised Register of Trials in June 2008 for completed trials of pharmacological interventions for acute ischaemic stroke, and searched MEDLINE and EMBASE (January 2007 - March 2009) for references to recent full publications. We assessed trial completion status from trial reports, online trials registers and correspondence with experts.</p> <p>Results</p> <p>We identified 940 trials. Of these, 125 (19.6%, 95% confidence interval 16.5-22.6) were completed but not published in full by the point prevalence date. They included 16,058 participants (16 trials had over 300 participants each) and tested 89 different interventions. Twenty-two trials with a total of 4,251 participants reported the number of deaths. In these trials, 636/4251 (15.0%) died.</p> <p>Conclusions</p> <p>Our data suggest that, at the point prevalence date, a substantial body of evidence that was of relevance both to clinical practice in acute stroke and future research in the field was not published in full. Over 16,000 patients had given informed consent and were exposed to the risks of therapy. Responsibility for non-publication lies with investigators, but pharmaceutical companies, research ethics committees, journals and governments can all encourage the timely publication of trial data.</p

Corrigendum: Factors Associated With Depressive Episode Recurrences in Primary Care: A Retrospective, Descriptive Study (Frontiers in Psychology, (2020), 11, (1230), 10.3389/fpsyg.2020.01230)

In the original article, we neglected to include the funder Feder Funds “Another way to make Europe”. The corrected funding statement appears below. The authors apologize for this error and state that this does not change the scientific conclusions of the article in any way. The original article has been updated. FUNDING This work was supported by Carlos III Health Institute (ISCIII) grant number PI18/01336. The authors declare that this study received funding from Carlos III Health Institute (ISCIII)— Feder Funds “Another way to make Europe”. The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of this article or the decision to submit it for publication