Identification of primary care patients at risk of nonadherence to antidepressant treatment

Ann-Charlotte Åkerblad1, Finn Bengtsson2, Margareta Holgersson3, Lars von Knorring1, Lisa Ekselius11Department of Neuroscience, Psychiatry, Uppsala University Hospital, Uppsala University, Uppsala, Sweden; 2Division of Clinical Pharmacology, Medicine and Care, Faculty of Health Sciences, Linköping University, Linköping, Sweden; 3Quintiles AB, Uppsala, SwedenIntroduction: Poor adherence to antidepressant treatment is common, and results in increased disability and costs. Several factors are thought to influence patients’ ability and willingness to adhere. So far, however, consensus is lacking regarding patient characteristics that predict nonadherence. The purpose of this study was to identify predictors of nonadherence to antidepressant treatment that can be ascertained at treatment start.Method: The present study used data from a randomized controlled trial with the main objective of studying the effect of two different compliance-enhancing programs on treatment adherence and treatment response in 1031 primary care patients with major depression. In this study, logistic regression analyses were performed to examine patient- and illness-related characteristics potentially associated with nonadherence.Results: Nonadherence to antidepressant treatment was predicted by age under 35 or over 64 years, presence of personality disorder, sensation-seeking personality traits, substance abuse, and absence of concomitant medications.Conclusion: Certain patient- and illness-related characteristics may imply an increased risk of nonadherence to antidepressant treatment. Giving special attention to subjects with such characteristics may improve adherence.Keywords: unipolar depression, antidepressant, adherence, compliance, SSRI, predictor

Nitrogen substitutional defects in silicon. A quantum mechanical investigation of the structural, electronic and vibrational properties

RD and FSG acknowledges the CINECA award (HP10CTG8YY) under the ISCRA initiative, for the availability of high performance computing resources and support.The vibrational infrared (IR) and Raman spectra of seven substitutional defects in bulk silicon are computed, by using the quantum mechanical CRYSTAL code, the supercell scheme, an all electron Gaussian type basis set and the B3LYP functional. The relative stability of various spin states has been evaluated, the geometry optimized, the electronic structure analyzed. The IR and Raman intensities have been evaluated analitically. In all cases the IR spectrum is dominated by a single N peak (or by two or three peaks with very close wavenumbers), whose intensity is at least 20 times larger than the one of any other peak. These peaks fall in the 645–712 cm−1 interval, and a shift of few cm−1 is observed from case to case. The Raman spectrum of all defects is dominated by an extremely intense peak at about 530 cm−1, resulting from the (weak) perturbation of the peak of pristine silicon.ISCRA initiative CINECA award (HP10CTG8YY); Institute of Solid State Physics, University of Latvia as the Center of Excellence has received funding from the European Union’s Horizon 2020 Framework Programme H2020-WIDESPREAD-01-2016-2017-TeamingPhase2 under grant agreement No. 739508, project CAMART

Birth weight in relation to leisure time physical activity in adolescence and adulthood: meta-analysis of results from 13 nordic cohorts

Peer reviewe

Utilizing the flexibility of distributed thermal storage in solar power forecast error cost minimization

Highlights • Combines dynamic optimization and numerical weather prediction (NWP). • Annual solar PV forecast error cost for the 1 MWp plant is 830€. • Solar PV generation imbalances reduced by 10% with demand side management. • Average and marginal benefits per household decrease with increasing network size.Intermittent renewable energy generation, which is determined by weather conditions, is increasing in power markets. The efficient integration of these energy sources calls for flexible participants in smart power grids. It has been acknowledged that a large, underutilized, flexible resource lies on the consumer side of electricity generation. Despite the recently increasing interest in demand flexibility, there is a gap in the literature concerning the incentives for consumers to offer their flexible energy to power markets. In this paper, we examine a virtual power plant concept, which simultaneously optimizes the response of controllable electric hot water heaters to solar power forecast error imbalances. Uncertainty is included in the optimization in terms of solar power day-ahead forecast errors and balancing power market conditions. We show that including solar power imbalance minimization in the target function changes the optimal hot water heating profile such that more electricity is used during the daytime. The virtual power plant operation decreases solar power imbalances by 5–10% and benefits the participating households by 4.0–7.5 € in extra savings annually. The results of this study indicate that with the number of participating households, while total profits increase, marginal revenues decrease

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Effects of chronic citalopram treatment on central and peripheral spontaneous open-field behaviours in rats

The spontaneous open-field behavioural effects of 10 days of chronic treatment with two clinical doses (10 and 20 mg/kg daily) and one high/toxic dose (100 mg/kg daily) of the selective serotonin reuptake inhibitor citalopram (delivered subcutaneously by implanted osmotic pumps) were examined in rats. Central and peripheral arena locomotor and rearing activities were recorded simultaneously, and the data were assessed during the first hour as well as during the following 24 hr (the latter for effects on the diurnal rhythm). Rats treated with 100 mg/kg daily exhibited lower peripheral locomotor and rearing activities than the other groups during the first test hour. The ratio between central and peripheral activity increased in a dose-dependent non-proportional manner during the first test hour, indicating a general increase in the central arena activity exerted by the rats when treated with citalopram. No major differences were observed between any of the four groups in overall behavioural activities over the 24-hr period. This study indicated that the open-field locomotor and rearing behaviours in normal rats were affected by increasing doses of racemic citalopram, particularly during the first hour of adaptation

The influence of micro-level soil factors on mortality in southern Sweden, 1850-1914

We analyse the effects of soil type on mortality of children aged 2-15 living in five rural parishes in Sweden between 1850 and 1914. We use micro-level longitudinal demographic data combined with micro-level longitudinal geographic data. Here, the individuals in the parishes are linked to the property units they lived in. We find that, compared to those living in property units covered by 80-100% clayey till, living in areas covered by 50-80% clayey till increased the mortality risk by 44% for the period 1850-1879, and for the period 1880-1914, living in areas covered by 80-100% clay-till/lay increased the mortality risk by 150%. However, only children aged 7-15 were affected in the latter period. Hence, certain soil types affected the mortality of children between 1850 and 1879, but only older children between 1880 and 1914. The changes in the effect of the soil type groups between the two time periods indicate that, possibly, market and technological changes affected the suitability of certain soil types for agriculture. A possible explanation to the mortality differences among the soil types is that they affected the output produced at each farm which, in turn, affected the nutritional status of the children and hence their mortality