A meta-analysis of pharmacotherapy for social anxiety disorder: an examination of efficacy, moderators, and mediators

INTRODUCTION: Social anxiety disorder (SAD) is among the most prevalent mental disorders, associated with impaired functioning and poor quality of life. Pharmacotherapy is the most widely utilized treatment option. The current study provides an updated meta-analytic review of the efficacy of pharmacotherapy and examines moderators and mediators of treatment efficacy. Areas Covered: A comprehensive search of the current literature yielded 52 randomized, pill placebo-controlled trials of pharmacotherapy for adults diagnosed with SAD. Data on potential mediators of treatment outcome were collected, as well as data necessary to calculate pooled correlation matrices to compute indirect effects. Expert Opinion: The overall effect size of pharmacotherapy for SAD is small to medium (Hedges' g = 0.41). Effect sizes were not moderated by age, sex, length of treatment, initial severity, risk of study bias, or publication year. Furthermore, reductions in symptoms mediated pharmacotherapy's effect on quality of life. Support was found for reverse mediation. Future directions may include sustained efforts to examine treatment mechanisms of pharmacotherapy using rigorous longitudinal methodology to better establish temporal precedence

Producing a critique : writing about indigenous knowledge, intellectual property and cultural heritage

University of Technology, Sydney. Faculty of Arts and Social Sciences.Indigenous knowledge as a subject for discussion and analysis has become more prominent in academic literature and in public policy debates in the past decade or more. In my own published works, one of my main themes has been to review and critique Western legislative regimes’ attempts to define, protect, and regulate Indigenous knowledge, especially in terms of what is often called ‘indigenous intellectual property’. As a consequence of this interest in critique of legislation, I have also explored questions around the intersection between Indigenous knowledge and other kinds of knowledge, particularly that sometimes termed ‘Western science’. This latter interest has led me to consider the ways in which Indigenous knowledge and other forms of Indigenous heritage have been represented in ‘Western’ texts, language and discourses, including legislative and administrative developments and discussions, and in anthropological and historical writings. This Essay presents a critical review of my published works, discussed within the context of the particular circumstances (political, bureaucratic/administrative and legislative) in which they were written. I explore the ways in which the sum of my writings have contributed to, and at the same time have formed a critique of, prevailing State authorised discourses relating to Indigenous knowledge that are entrenched primarily in intellectual property rights law. In this Essay I suggest that, as a consistent body of critique, my writings taken as a whole are positioned outside, or between the borders of several discourses and bodies of knowledge. This ‘cross-border’ position of my writings has, I argue, created the possibility for a critique of Western discourses centred on intellectual property rights. I discuss these aspects within a theoretical framework of colonial discourse studies and postcolonial criticism

Does self-monitoring of blood glucose improve outcome in type 2 diabetes? The Fremantle Diabetes Study

AIMS/HYPOTHESIS: To assess whether self-monitoring of blood glucose (SMBG) is an independent predictor of improved outcome in a community-based cohort of type 2 diabetic patients. MATERIALS AND METHODS: We used longitudinal data from (1) 1,280 type 2 diabetic participants in the observational Fremantle Diabetes Study (FDS) who reported SMBG and diabetes treatment status at study entry (1993–1996), and (2) a subset of 531 participants who attended six or more annual assessments (referred to as the 5-year cohort). Diabetes-related morbidity, cardiac death and all-cause mortality were ascertained at each assessment, supplemented by linkage to the Western Australian Data Linkage System. RESULTS: At baseline, 70.2% (898 out of 1,280) of type 2 patients used SMBG. During 12,491 patient-years of follow-up (mean 9.8 ± 3.5 years), 486 (38.0%) type 2 participants died (196 [15.3%] from cardiac causes). SMBG was significantly less prevalent in those who died during follow-up than in those who were still alive at the end of June 2006 (65.4 vs 73.0%, p = 0.005). In Cox proportional hazards modelling, after adjustment for confounding and explanatory variables, SMBG was not independently associated with all-cause mortality, but was associated with a 79% increased risk of cardiovascular mortality in patients not treated with insulin. For the 5-year cohort, time-dependent SMBG was independently associated with a 48% reduced risk of retinopathy. CONCLUSIONS/INTERPRETATION: SMBG was not independently associated with improved survival. Inconsistent findings relating to the association of SMBG with cardiac death and retinopathy may be due to confounding, incomplete covariate adjustment or chance

Cosmic strings from pseudo-anomalous Fayet-Iliopoulos U(1) in D3/D7 brane inflation

We examine the consequences of recent developments on Fayet-Iliopoulos (FI) terms for D-term inflationary models. There is currently no known way to couple constant FI terms to supergravity consistently; only field-dependent FI terms are allowed. These are natural in string theory and we argue that the FI term in D3/D7 inflation turns out to be of this type, corresponding to a pseudo-anomalous U(1). T he anomaly is canceled by the Green-Schwarz mechanism in 4 dimensions. Inflation proceeds as usual, except that the scale is set by the GS parameter. Cosmic strings resulting from a pseudo-anomalous U(1) have potentially interesting characteristics. Originally expected to be global, they turn out to be local in the string theory context and can support currents. We outline the nature of these strings, discuss bounds on their formation, and summarize resulting cosmological consequences.Comment: 10 pages; minor changes to match published versio

Huntington's disease phenocopies are clinically and genetically heterogeneous

Huntington's disease (HD) classically presents with movement disorder, cognitive dysfunction and behavioral problems but is phenotypically variable. One percent of patients with HD-like symptoms lack the causative mutation and are considered HD phenocopies. Genetic diseases known to cause HD phenocopies include HD-like syndromes HDL1, HDL2, and HDL4 (SCA17). HD has phenotypic overlap with dentatorubral-pallidoluysian atrophy, the spinocerebellar ataxias and neuroferritinopathy. Identifying the genetic basis of HD phenocopies is important for diagnosis and may inform the search for HD genetic modifiers. We sought to identify neurogenetic diagnoses in the largest reported cohort of HD phenocopy patients. Two hundred eighty-five patients with syndromes consistent with HD, who were HD expansion-negative, were screened for mutations in PRNP, JPH3, TBP, DRPLA, SCA1, SCA2, SCA3, FTL and FRDA. Genetic diagnoses were made in 8 subjects: we identified 5 cases of HDL4, 1 of HDL1 and 1 of HDL2. One patient had Friedreich's ataxia. There were no cases of DRPLA, SCA1, SCA2, SCA3, or neuroferritinopathy. HD phenocopies are clinically and genetically diverse and a definitive genetic diagnosis is currently possible in only a minority of cases. When undertaken, it should be clinically directed and patients and clinicians should be prepared for the low probability of reaching a genetic diagnosis in this group of patients. (c) 2008 Movement Disorder Society

Steps towards online monitoring systems and interoperability

In the health area, there is, on a daily basis, an enormous amount of data being produced and disseminated. The fast-growing amount of collected data and the rich knowledge, possibly life-saving, that could be extracted from these data has demanded the search of new ways to ensure the reliability and availability of the information with an emphasis on the efficient use of information technology tools. Although the main focus of the information systems is the health professionals who contact directly with the patient, it is also imperative to have tools for the background of the health units (information services, managers of systems, etc.). The main purpose of this work is the development of an innovative and interactive web platform for the daily monitoring of the web services activities of a Portuguese hospital, Centro Hospitalar do Porto (CHP). This platform is a web application developed in React that aims to ensure the correct functioning of the web services, that are responsible for numerous tasks within the hospital environment, and which failure could result in disastrous consequences, both for the health institution and for the patients. The development of the web application followed the six stages of the Design Science Research (DSR) methodology and was submitted to the Strengths Weaknesses Opportunities and Threats (SWOT) analysis, which results were considered optimistic.This work has been supported by FCT – Fundação para a Ciência e Tecnologia within the Project Scope: UID/CEC/00319/201

B-L Cosmic Strings in Heterotic Standard Models

E_{8} X E_{8} heterotic string and M-theory, when compactified on smooth Calabi-Yau manifolds with SU(4) vector bundles, can give rise to softly broken N=1 supersymmetric theories with the exact matter spectrum of the MSSM, including three right-handed neutrinos and one Higgs-Higgs conjugate pair of supermultiplets. These vacua have the SU(3)_{C} X SU(2)_{L} X U(1)_{Y} gauge group of the standard model augmented by an additional gauged U(1)_{B-L}. Their minimal content requires that the B-L symmetry be spontaneously broken by a vacuum expectation value of at least one right-handed sneutrino. The soft supersymmetry breaking operators can induce radiative breaking of the B-L gauge symmetry with an acceptable B-L/electroweak hierarchy. In this paper, it is shown that U(1)_{B-L} cosmic strings occur in this context, potentially with both bosonic and fermionic superconductivity. We present a numerical analysis that demonstrates that boson condensates can, in principle, form for theories of this type. However, the weak Yukawa and gauge couplings of the right-handed sneutrino suggests that bosonic superconductivity will not occur in the simplest vacua in this context. The electroweak phase transition also disallows fermion superconductivity, although substantial bound state fermion currents can exist.Comment: 41 pages, 5 figure

Retrograde semaphorin-plexin signalling drives homeostatic synaptic plasticity.

Homeostatic signalling systems ensure stable but flexible neural activity and animal behaviour. Presynaptic homeostatic plasticity is a conserved form of neuronal homeostatic signalling that is observed in organisms ranging from Drosophila to human. Defining the underlying molecular mechanisms of neuronal homeostatic signalling will be essential in order to establish clear connections to the causes and progression of neurological disease. During neural development, semaphorin-plexin signalling instructs axon guidance and neuronal morphogenesis. However, semaphorins and plexins are also expressed in the adult brain. Here we show that semaphorin 2b (Sema2b) is a target-derived signal that acts upon presynaptic plexin B (PlexB) receptors to mediate the retrograde, homeostatic control of presynaptic neurotransmitter release at the neuromuscular junction in Drosophila. Further, we show that Sema2b-PlexB signalling regulates presynaptic homeostatic plasticity through the cytoplasmic protein Mical and the oxoreductase-dependent control of presynaptic actin. We propose that semaphorin-plexin signalling is an essential platform for the stabilization of synaptic transmission throughout the developing and mature nervous system. These findings may be relevant to the aetiology and treatment of diverse neurological and psychiatric diseases that are characterized by altered or inappropriate neural function and behaviour

The role of brand loyalty and social media in e-commerce interfaces: survey results and implications for user interfaces

This paper explores the role of brand loyalty and social media in e-commerce interfaces. A survey consisting of 118 respondents was contacted to address the questions relating to online shopping and brand loyalty. Link between the frequency of access and time spent on an e-commerce user interface, and brand loyalty, gender and age profile differences, and the role of social media to branding and on-line shopping was analyzed. It was found that online loyalty differs from offline loyalty and loyalty also differed across genders, showing men were more loyal than women when shopping online. Information shared about products on social media by friends and family played an important role in purchase decision making. Website interface and ease of navigation were also key aspects for online shopping. The research concluded with recommendations to create multimodal websites which are more interactive and targeted so customer experience is enhanced and loyalty is achieved through the use of interactivity and social media

Mining and analysis of audiology data to find significant factors associated with tinnitus masker

Objectives: The objective of this research is to find the factors associated with tinnitus masker from the literature, and by using the large amount of audiology data available from a large NHS (National Health Services, UK) hearing aid clinic. The factors evaluated were hearing impairment, age, gender, hearing aid type, mould and clinical comments. Design: The research includes literature survey for factors associated with tinnitus masker, and performs the analysis of audiology data using statistical and data mining techniques. Setting: This research uses a large audiology data but it also faced the problem of limited data for tinnitus. Participants: It uses 1,316 records for tinnitus and other diagnoses, and 10,437 records of clinical comments from a hearing aid clinic. Primary and secondary outcome measures: The research is looking for variables associated with tinnitus masker, and in future, these variables can be combined into a single model to develop a decision support system to predict about tinnitus masker for a patient. Results: The results demonstrated that tinnitus maskers are more likely to be fit to individuals with milder forms of hearing loss, and the factors age, gender, type of hearing aid and mould were all found significantly associated with tinnitus masker. In particular, those patients having Age<=55 years were more likely to wear a tinnitus masker, as well as those with milder forms of hearing loss. ITE (in the ear) hearing aids were also found associated with tinnitus masker. A feedback on the results of association of mould with tinnitus masker from a professional audiologist of a large NHS (National Health Services, UK) was also taken to better understand them. The results were obtained with different accuracy for different techniques. For example, the chi-squared test results were obtained with 95% accuracy, for Support and Confidence only those results were retained which had more than 1% Support and 80% Confidence. Conclusions: The variables audiograms, age, gender, hearing aid type and mould were found associated with the choice of tinnitus masker in the literature and by using statistical and data mining techniques. The further work in this research would lead to the development of a decision support system for tinnitus masker with an explanation that how that decision was obtained