Which placebo to cure depression? A thought-provoking network meta-analysis

BACKGROUND: Antidepressants are often considered to be mere placebos despite the fact that meta-analyses are able to rank them. It follows that it should also be possible to rank different placebos, which are all made of sucrose. To explore this issue, which is rather more epistemological than clinical, we designed an unusual meta-analysis to investigate whether the effects of placebo in one situation are different from the effects of placebo in another situation. METHODS: Published and unpublished studies were searched for by three reviewers on Medline, the Cochrane Library, Embase, clinicaltrials.gov, Current Controlled Trial, in bibliographies, and by mailing key organizations. The following studies in first-line treatment for major depressive disorder were considered to construct an “evidence network”: 1) randomized controlled trials (RCTs) versus placebo on fluoxetine, venlafaxine and 2) fluoxetine versus venlafaxine head-to-head RCTs. Two network meta-analyses were run to indirectly compare response and remission rates among three different placebos: 1) fluoxetine placebo, 2) venlafaxine placebo, and 3) venlafaxine/fluoxetine placebo (that is, placebo compared to both venlafaxine and fluoxetine). Publication biases were assessed using funnel plots and statistically tested. RESULTS: The three placebos were not significantly different in terms of response or remission. The antidepressant agents were significantly more efficacious than the placebos, and venlafaxine was more efficacious than fluoxetine. The funnel plots, however, showed a major publication bias. CONCLUSION: The presence of significant levels of publication bias indicates that we cannot even be certain of the conclusion that sucrose equals sucrose in trials of major depressive disorder. This result should remind clinicians to step back to take a more objective view when interpreting a scientific result. It is of crucial importance for their practice, far more so than ranking antidepressant efficacy

Sex and Exercise Intensity Do Not Influence Oxygen Uptake Kinetics in Submaximal Swimming.

The aim of this study was to compare the oxygen uptake ([Formula: see text]) kinetics in front crawl between male and female swimmers at moderate and heavy intensity. We hypothesized that the time constant for the primary phase [Formula: see text] kinetics was faster in men than in women, for both intensities. Nineteen well trained swimmers (8 females mean ± SD; age 17.9 ± 3.5 years; mass 55.2 ± 3.6 kg; height 1.66 ± 0.05 m and 11 male 21.9 ± 2.8 years; 78.2 ± 11.1 kg; 1.81 ± 0.08 m) performed a discontinuous maximal incremental test and two 600-m square wave transitions for both moderate and heavy intensities to determine the [Formula: see text] kinetics parameters using mono- and bi-exponential models, respectively. All the tests involved breath-by-breath analysis of front crawl swimming using a swimming snorkel. The maximal oxygen uptake [Formula: see text] was higher in men than in women [4,492 ± 585 ml·min(-1) and 57.7 ± 4.4 ml·kg(-1)·min(-1) vs. 2,752.4 ± 187.9 ml·min(-1) (p ≤ 0.001) and 50.0 ± 5.7 ml·kg(-1)·min(-1)(p = 0.007), respectively]. Similarly, the absolute amplitude of the primary component was higher in men for both intensities (moderate: 1,736 ± 164 vs. 1,121 ± 149 ml·min(-1); heavy: 2,948 ± 227 vs. 1,927 ± 243 ml·min(-1), p ≤ 0.001, for males and females, respectively). However, the time constant of the primary component (τp) was not influenced by sex (p = 0.527) or swimming intensity (p = 0.804) (moderate: 15.1 ± 5.6 vs. 14.4 ± 5.1 s; heavy: 13.5 ± 3.3 vs. 16.0 ± 4.5 s, for females and males, respectively). The slow component in the heavy domain was not significantly different between female and male swimmers (3.2 ± 2.4 vs. 3.8 ± 1.0 ml·kg(-1)·min(-1), p = 0.476). Overall, only the absolute amplitude of the primary component was higher in men, while the other [Formula: see text] kinetics parameters were similar between female and male swimmers at both moderate and heavy intensities. The mechanisms underlying these similarities remain unclear

A Software Toolbox to Carry-out Virtual Experiments on Human Motion

We present a simulation toolbox to carry-out virtual experiments on human motion. 3D visualization, automatic code generation and generic control design patterns bring dynamic simulation tools into the hands of biomechanicians and doctors

Use of very-high-dose olanzapine in treatment-resistant schizophrenia

International audienc

Passive mucosal immunisation with novel simplified IgA antibodies produced in seeds prevents enterotoxigenic Escherichia coli (ETEC) infection in weaned piglets

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Subthalamic Nucleus Stimulation Affects Theory of Mind Network: A PET Study in Parkinson's Disease

Background: There appears to be an overlap between the limbic system, which is modulated by subthalamic nucleus (STN) deep brain stimulation (DBS) in Parkinson’s disease (PD), and the brain network that mediates theory of mind (ToM). Accordingly, the aim of the present study was to investigate the effects of STN DBS on ToM of PD patients and to correlate ToM modifications with changes in glucose metabolism. Methodology/Principal Findings: To this end, we conducted 18 FDG-PET scans in 13 PD patients in pre- and post-STN DBS conditions and correlated changes in their glucose metabolism with modified performances on the Eyes test, a visual ToM task requiring them to describe thoughts or feelings conveyed by photographs of the eye region. Postoperative PD performances on this emotion recognition task were significantly worse than either preoperative PD performances or those of healthy controls (HC), whereas there was no significant difference between preoperative PD and HC. Conversely, PD patients in the postoperative condition performed within the normal range on the gender attribution task included in the Eyes test. As far as the metabolic results are concerned, there were correlations between decreased cerebral glucos

Digital phenotype of mood disorders: A conceptual and critical review

BackgroundMood disorders are commonly diagnosed and staged using clinical features that rely merely on subjective data. The concept of digital phenotyping is based on the idea that collecting real-time markers of human behavior allows us to determine the digital signature of a pathology. This strategy assumes that behaviors are quantifiable from data extracted and analyzed through digital sensors, wearable devices, or smartphones. That concept could bring a shift in the diagnosis of mood disorders, introducing for the first time additional examinations on psychiatric routine care.ObjectiveThe main objective of this review was to propose a conceptual and critical review of the literature regarding the theoretical and technical principles of the digital phenotypes applied to mood disorders.MethodsWe conducted a review of the literature by updating a previous article and querying the PubMed database between February 2017 and November 2021 on titles with relevant keywords regarding digital phenotyping, mood disorders and artificial intelligence.ResultsOut of 884 articles included for evaluation, 45 articles were taken into account and classified by data source (multimodal, actigraphy, ECG, smartphone use, voice analysis, or body temperature). For depressive episodes, the main finding is a decrease in terms of functional and biological parameters [decrease in activities and walking, decrease in the number of calls and SMS messages, decrease in temperature and heart rate variability (HRV)], while the manic phase produces the reverse phenomenon (increase in activities, number of calls and HRV).ConclusionThe various studies presented support the potential interest in digital phenotyping to computerize the clinical characteristics of mood disorders

Quinine-Resistant Malaria in Traveler Returning from Senegal, 2007

We describe clinical and parasitologic features of in vivo and in vitro Plasmodium falciparum resistance to quinine in a nonimmune traveler who returned to France from Senegal in 2007 with severe imported malaria. Clinical quinine failure was associated with a 50% inhibitory concentration of 829 nmol/L. Increased vigilance is required during treatment follow-up

Control Architecture Concepts and Properties of an Ontology Devoted to Exchanges in Mobile Robotics

National audienceA specific ontology is proposed in the scope of the development of a platform devoted to exchanges between academics and industrials of the robotic domain. This paper presents the tools used for knowledge elicitation, the concepts and properties linked with control architecture, the use of the resulting ontology for description of some scenarios and the tracks for the development of a domain specific language grounded on the ontology. Knowledge elicitation is performed in web ontology language thanks to Protégé ontology editor. The ontology is structured as a set of modules organized around a kernel. Modules addressing systems, information, robot and mission include concepts and properties for control architecture description. The expressivity of the ontology is demonstrated describing architectures for a set of scenarios; urban robotic scenario, air-ground scenario, landmark search scenario and military unmanned aerial vehicles scenario. Finally some tracks for the use of the ontology for developing a domain specific language are given