Multiple-therapy-resistant-major depressive disorder: a clinically important concept

Many novel therapeutic options for depression exist which are either not mentioned in clinical guidelines or recommended only for use in highly specialist services. The challenge faced by clinicians is when it might be appropriate to consider such ‘non-standard’ interventions. This analysis proposes a framework to aid this decision

Diverse staghorn corals (Acropora) in high-latitude Eocene assemblages: implications for the evolution of modern diversity patterns of reef corals

Acropora is the most diverse genus of reef-building corals in the world today. It occurs in all three major oceans; it is restricted to latitudes 31° N–31° S, where most coral reefs occur, and reaches greatest diversity in the central Indo-Pacific. As an exemplar genus, the long-term history of Acropora has implications for the evolution and origins of present day biodiversity patterns of reef corals and for predicting their response to future climate change. Diversification of Acropora was thought to have occurred in the central Indo-Pacific within the previous two million years. We examined Eocene fossils from southern England and northern France and found evidence that precursors of up to nine of 20 currently recognized Acropora species groups existed 49–34 Myr, at palaeolatitudes far higher than current limits, to 51° N. We propose that pre-existing diversity contributed to later rapid speciation in this important functional group of corals