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Tetflupyrolimet (Dodhylex™ Active. FMC Corporation) is a novel herbicide inhibiting de novo pyrimidine biosynthesis that controls grassy weeds preemergence in rice (Oryza sativa L.) production. Field trials were conducted from 2021-2024 to evaluate turfgrass tolerance to tetflupyrolimet applications for annual bluegrass (Poa annua L.) and smooth crabgrass [Digitaria ischaemum (Schreb.) Schreb. ex Muhl.] control. Tolerance was evaluated on seven turfgrass species, including creeping bentgrass (Agrostis stolonifera L.), Kentucky bluegrass (Poa pratensis L.), tall fescue [Schedonorus arundinaceus (Schreb.) Dumort.; syn. Festuca arundinacea Schreb.], hybrid bermudagrass [C. dactylon (L.) Pers. x C. transvaalensis Burtt-Davy], and manilagrass [Zoysia matrella (L.) Merr.] at various mowing heights ranging from 3.8 to 12.5 mm. Separate experiments were conducted on each turfgrass species to evaluate tolerance in both fall and spring. Tetflupyrolimet was applied at rates of 0, 25, 50, 100, 200, 400, 800, 1600, 3200, or 6400 g ha-1. No injury was observed on any warm-season turfgrass species in either season, whereas cool-season grass tolerance varied among species each season; however, cool-season turfgrass tolerance for all species was greater in spring than fall. While efficacy of tetflupyrolimet (400 g ha-1) for preemergence D. ischaemum control varied among years, mixtures of tetflupyrolimet (400 g ha-1), pyroxasulfone (128 g ha-1), and rimsulfuron (35 g ha-1) applied preemergence or early postemergence effectively controlled multiple resistant P. annua in both seasons. Overall, these findings highlight that warm-season turfgrasses are highly tolerant of tetflupyrolimet applications for P. annua or D. ischaemum control.
Interpersonal psychotherapy (IPT) and antidepressant medications are both first-line interventions for adult depression, but their relative efficacy in the long term and on outcome measures other than depressive symptomatology is unknown. Individual participant data (IPD) meta-analyses can provide more precise effect estimates than conventional meta-analyses. This IPD meta-analysis compared the efficacy of IPT and antidepressants on various outcomes at post-treatment and follow-up (PROSPERO: CRD42020219891). A systematic literature search conducted May 1st, 2023 identified randomized trials comparing IPT and antidepressants in acute-phase treatment of adults with depression. Anonymized IPD were requested and analyzed using mixed-effects models. The prespecified primary outcome was post-treatment depression symptom severity. Secondary outcomes were all post-treatment and follow-up measures assessed in at least two studies. IPD were obtained from 9 of 15 studies identified (N = 1536/1948, 78.9%). No significant comparative treatment effects were found on post-treatment measures of depression (d = 0.088, p = 0.103, N = 1530) and social functioning (d = 0.026, p = 0.624, N = 1213). In smaller samples, antidepressants performed slightly better than IPT on post-treatment measures of general psychopathology (d = 0.276, p = 0.023, N = 307) and dysfunctional attitudes (d = 0.249, p = 0.029, N = 231), but not on any other secondary outcomes, nor at follow-up. This IPD meta-analysis is the first to examine the acute and longer-term efficacy of IPT v. antidepressants on a broad range of outcomes. Depression treatment trials should routinely include multiple outcome measures and follow-up assessments.
Many paediatric studies report that patients must be established on aspirin therapy for a minimum of 5 days to achieve adequate response. This is not always practical especially in critical settings. Prospective identification of patients that are unresponsive to aspirin sooner could potentially prevent thrombotic events.
Aims:
The aim of this study was to investigate prospectively if the first dose of aspirin is effective in decreasing platelet aggregation, and thromboxane formation and if this can be measured after 2 hours in paediatric cardiology patients. A secondary aim was to identify a cut-off for a novel marker of aspirin responsiveness the maximum amplitude with arachidonic acid, which could potentially dramatically reduce the blood volume required. Third, we aimed to prospectively identify potentially non-responsive patients by spiking a sample of their blood ex vivo with aspirin.
Results:
The majority (92.3%) of patients were responsive, when measured 2 hours post first dose of aspirin. Non-response or inadequate response (7.7%) can also be identified at 2 hours after taking the first dose of aspirin. Additionally, we have shown a novel way to reduce blood sample volume requirements by measurement of the maximum amplitude with arachidonic acid as a marker of response, particularly for monitoring.
Conclusions:
These findings of rapid efficacy in the majority of patients offer assurance in a sound, practical way to attending clinicians, patients, and families.
Despite strong evidence of efficacy of electroconvulsive therapy (ECT) in the treatment of depression, no sensitive and specific predictors of ECT response have been identified. Previous meta-analyses have suggested some pre-treatment associations with response at a population level.
Aims
Using 10 years (2009–2018) of routinely collected Scottish data of people with moderate to severe depression (n = 2074) receiving ECT we tested two hypotheses: (a) that there were significant group-level associations between post-ECT clinical outcomes and pre-ECT clinical variables and (b) that it was possible to develop a method for predicting illness remission for individual patients using machine learning.
Method
Data were analysed on a group level using descriptive statistics and association analyses as well as using individual patient prediction with machine learning methodologies, including cross-validation.
Results
ECT is highly effective for moderate to severe depression, with a response rate of 73% and remission rate of 51%. ECT response is associated with older age, psychotic symptoms, necessity for urgent intervention, severe distress, psychomotor retardation, previous good response, lack of medication resistance, and consent status. Remission has the same associations except for necessity for urgent intervention and, in addition, history of recurrent depression and low suicide risk. It is possible to predict remission with ECT with an accuracy of 61%.
Conclusions
Pre-ECT clinical variables are associated with both response and remission and can help predict individual response to ECT. This predictive tool could inform shared decision-making, prevent the unnecessary use of ECT when it is unlikely to be beneficial and ensure prompt use of ECT when it is likely to be effective.
Previous research showed that behavioural activation is as effective as cognitive–behavioural therapy for general depression. However, it remains unclear if it leads to greater improvement in depressive symptoms when compared with standard treatment for post-stroke depression.
Aims
To compare the effectiveness of behavioural activation against control conditions in reducing depression symptoms in individuals with post-stroke depression.
Method
This review searched five databases from inception until 13 July 2021 (updated 15 September 2023) for randomised controlled trials comparing behavioural activation and any control conditions for post-stroke depression. Risk of bias was assessed with the Cochrane Collaboration's Risk-of-Bias 2 tool. The primary outcome was improvement in depressive symptoms in individuals with post-stroke depression. We calculated a random-effects, inverse variance weighting meta-analysis.
Results
Of 922 initial studies, five randomised controlled trials with 425 participants met the inclusion criteria. Meta-analysis showed that behavioural activation was associated with reduced depressive symptoms in individuals with post-stroke depression at 6-month follow-up (Hedges’ g −0.39; 95% CI −0.64 to −0.14). The risk of bias was low for two (40%) of five trials, and the remaining three (60%) trials were rated as having a high risk of bias. Heterogeneity was low, with no indication of inconsistency.
Conclusions
Evidence from this review was too little to confirm the effectiveness of behavioural activation as a useful treatment for post-stroke depression when compared with control conditions. Further high-quality studies are needed to conclusively establish the efficacy of behavioural activation as a treatment option for post-stroke depression.
Edited by
Allan Young, Institute of Psychiatry, King's College London,Marsal Sanches, Baylor College of Medicine, Texas,Jair C. Soares, McGovern Medical School, The University of Texas,Mario Juruena, King's College London
This chapter describes evidence-based psychotherapeutic approaches for adults with depressive disorders. We focus on the most recognized, contemporary evidence-based psychotherapies for depression including: traditional and newer forms of cognitive behavioral therapy (defined broadly), interpersonal psychotherapy, brief dynamic psychotherapy and supportive psychotherapy. We summarize the findings on the extent to which these psychotherapies promote response, remission, relapse prevention, and recovery in adults and that permit these psychotherapies to be termed “evidence based.” Effect sizes are reported, allowing the reader to grasp quickly the efficacy of each psychotherapy used as a solitary treatment. We highlight current trends and future possibilities that may expand understanding of depressive disorders and increase access to effective psychotherapy for adults with depressive disorders.
We employed a Bayesian network meta-analysis for comparison of the efficacy and tolerability of US Food and Drug Administration (FDA)-approved atypical antipsychotics (AAPs) for the treatment of bipolar patients with depressive episodes. Sixteen randomized controlled trials with 7234 patients treated by one of the five AAPs (cariprazine, lumateperone, lurasidone, olanzapine, and quetiapine) were included. For the response rate (defined as an improvement of ≥50% from baseline on the Montgomery-Åsberg Depression Rating Scale [MADRS]), all AAPs were more efficacious than placebo. For the remission rate (defined as the endpoint of MADRS ≤12 or ≤ 10), cariprazine, lurasidone, olanzapine, and quetiapine had higher remission rates than placebo. In terms of tolerability, olanzapine was unexpectedly associated with lower odds of all-cause discontinuation in comparison with placebo, whereas quetiapine was associated with higher odds of discontinuation due to adverse events than placebo. Compared with placebo, lumateperone, olanzapine, and quetiapine showed higher odds of somnolence. Lumateperone had a lower rate of ≥ weight gain of 7% than placebo and other treatments. Olanzapine was associated with a significant increase from baseline in total cholesterol and triglycerides than placebo. These findings inform individualized prescriptions of AAPs for treating bipolar depression in clinical practice.
This observation purposed to investigate the effect of the Yangxin Huoxue Jiedu formula on children with viral myocarditis and its effect on inflammatory factors and oxidative response.
Materials and methods:
A total of 121 children with viral myocarditis were randomly divided into two groups, namely the control group (N = 60) and the traditional Chinese medicine group (N = 61). The control group was mainly treated with routine therapy, while the traditional Chinese medicine group was treated with Yangxin Huoxue Jiedu recipes based on the control group. The creatine kinase, creatine kinase myocardial isoenzyme, aspartate aminotransferase, lactic dehydrogenase, hydroxybutyrate dehydrogenase, cardiac troponin I, brain natriuretic peptide, interleukin-6, interleukin-8, and tumour necrosis factor-alpha, superoxide dismutase and malondialdehyde in viral myocarditis patients were tested to estimate the myocardial function, inflammation, and oxidative situation.
Results:
After Yangxin Huoxue Jiedu treatment, 15 cases were recovered, 20 were excellent, and 21 were effective, which had a significant difference from the control group. The concentration of creatine kinase, creatine kinase myocardial isoenzyme, aspartate aminotransferase, lactic dehydrogenase, hydroxybutyrate dehydrogenase, cardiac troponin I and brain natriuretic peptide was decreased in the traditional Chinese medicine group. The levels of interleukin-6, interleukin-8, and tumour necrosis factor-alpha in the traditional Chinese medicine group were significantly lower than those in the control group. Superoxide dismutase was higher and malondialdehyde was lower than those in the control group.
Conclusion:
The use of Yangxin Huoxue Jiedu in the treatment of viral myocarditis has a definite clinical effect, which could improve myocardial function, reduce body inflammation, and promote oxidative recovery.
The influence of baseline severity on the efficacy of Silexan, a proprietary essential oil from Lavandula angustifolia, in anxiety disorders has not been investigated in a pooled dataset. We report on an individual patient data analysis of all five double-blind, randomized, placebo-controlled trials with Silexan in anxiety disorders. Eligible participants received Silexan 80 mg/d or placebo for 10 weeks. Analyses were based on the Hamilton Anxiety Rating Scale (HAMA), its psychic and somatic anxiety subscores, and the Clinical Global Impressions (CGI) scale. To correlate baseline severity with outcome, patients were segregated into mild, moderate, and severe cases. Altogether 1,172 patients (Silexan, n = 587; placebo, n = 585) were analyzed. For the HAMA total score, we found a significant association between the score at baseline and the treatment effect of Silexan versus placebo at week 10 (p < 0.001). HAMA items from the somatic domain scored lower at baseline and showed less improvement than items from the psychic domain, particularly in patients with mild or moderate baseline symptoms. For CGI item 2 (global improvement), significant efficacy favoring Silexan were observed in mild, moderate, and severe baseline symptom severity. Although significant improvements were found for all subsets, the more severe the initial symptoms, the greater the treatment effects documented by the HAMA. Overall this analysis confirms that Silexan is an effective treatment option in early or mild stages of anxiety disorder. Given its favorable safety profile, Silexan can thus fill a therapeutic gap in the treatment of (subsyndromal) anxiety disorders.
Positively experienced relationships with family, partners and friends are the most important source of meaning in life for older persons. At the same time, Western countries are confronted with a growing number of socially isolated older adults who lack those relationships. This study aims to explore whether and how older adults who live in social isolation experience meaning in life. Data were collected via in-depth, semi-structured interviews with 24 socially isolated older adults, ranging in age from 62 to 94, all living in Rotterdam, The Netherlands. The criterion-based sampling of participants took place in close consultation with social workers of a mentoring project for socially isolated older adults. Follow-up interviews with 22 participants improved the credibility of findings and contributed to the breadth and depth of the researched casuistry. Data were analysed using an analytical framework based on seven needs of meaning identified by Baumeister (purpose, values, efficacy, self-worth) and Derkx (coherence, excitement, connectedness). The study demonstrates that isolated older adults may find anchors for meaning in life, although not all needs for meaning are satisfied, and there can also be tension between different needs. The needs-based model provides concrete distinctions for enabling care-givers to recognise elements of meaning.
This chapter shared Black youth’s perspectives on how civic organizations helped develop their agency and sustain their changemaking over time. Civic organizations supported youth in developing agency through: (1) seeing impact from their civic actions; (2) taking ownership of their civic work; (3) gaining critical knowledge; (4) feeling encouraged by adults; and (5) being in community with other Black people. Any civic organization that works with youth has the potential to create these opportunities for Black youth, but Black-centered organizations play an especially valuable role in offering safe spaces for Black youth to use their voices, opportunities for gaining critical knowledge about Black history, and opportunities for building community with other Black people. Service organizations offered opportunities to see immediate tangible impacts through helping others and taking ownership within organizational structures, and in contrast, advocacy organizations offered opportunities to see impact over a longer term and amplified youth voice to community audiences. Despite these distinctions, youth experienced opportunities to build agency across both service and advocacy organizations.
Theme #9 is about exploiting dynamics already present in a situation to advance one’s interests. Many Sun Tzu ideas find a place here, reflecting Sun Tzu’s keen appreciation of war’s larger context (Passage #1.1) conjoined with the inherently dynamic quality of Sun Tzu’s core concept of shi.
Repetitive transcranial magnetic stimulation (rTMS) has been increasingly used for treating obsessive-compulsive disorder (OCD). Although several meta-analyses have explored its effectiveness and safety, there is no umbrella review specifically focused on rTMS for OCD. This umbrella review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and analyzed relevant meta-analyses on rTMS for OCD.
Methods
Twenty-three articles were identified from PubMed, and after screening, 12 meta-analyses were included in the review. The studies analyzed in the meta-analyses ranged from 10 to 27, with total participants ranging from 282 to 791. The most commonly studied regions were the dorsolateral prefrontal cortex (DLPFC), supplementary motor area (SMA), and orbito-frontal cortex (OFC).
Result
The majority of the meta-analyses consistently supported the effectiveness of rTMS in reducing OCD symptoms when applied to the DLPFC and SMA. Encouraging results were also observed when targeting the medial prefrontal cortex (mPFC) and anterior cingulate cortex (ACC) through deep transcranial magnetic stimulation (dTMS). However, there was a high level of heterogeneity in the findings of nine out of 12 meta-analyses.
Conclusion
In conclusion, existing evidence suggests that rTMS targeting the DLPFC and SMA consistently reduces OCD symptoms, but targeting the mPFC and ACC through dTMS shows variable results. However, the high heterogeneity in the study findings indicates a need for further research and standardization in the field.
Six field experiments were established in southwestern Ontario in 2021 and 2022 to evaluate whether the addition of a grass herbicide (acetochlor, dimethenamid-p, flufenacet, pendimethalin, pyroxasulfone, or S-metolachlor) to tolpyralate + atrazine improves late-season weed control in corn. Tolpyralate + atrazine caused 12% and 5% corn injury at 1 and 4 wk after herbicide application (WAA); corn injury was not increased with the addition of a grass herbicide. Weed interference reduced corn yield 60%. The addition of a grass herbicide to tolpyralate + atrazine did not enhance velvetleaf control. The addition of acetochlor or dimethenamid-p to tolpyralate + atrazine enhanced pigweed species control 4% 4 WAA; the addition of other grass herbicides tested did not increase pigweed species control. The addition of acetochlor enhanced common ragweed control 5% at 4 WAA, and the addition of acetochlor or dimethenamid-p enhanced common ragweed control 8% at 8 WAA; the addition of other grass herbicides did not improve common ragweed control. The addition of acetochlor to tolpyralate + atrazine enhanced common lambsquarters control up to 4%; there was no enhancement in common lambsquarters control with the addition of the other grass herbicides. Tolpyralate + atrazine controlled barnyardgrass 90% and 78% at 4 and 8 WAA, respectively; the addition of a grass herbicide enhanced barnyardgrass control 9% to 10% and 21% at 4 and 8 WAA, respectively. Tolpyralate + atrazine controlled green or giant foxtail 80% and 69% at 4 and 8 WAA, respectively; the addition of a grass herbicide enhanced foxtail species control 15% to 19% and 24% to 29% at 4 and 8 WAA, respectively. This research shows that adding a grass herbicide to tolpyralate + atrazine mixture can improve weed control efficacy, especially increased annual grass control in corn production.
Conventional treatment methods have limited effectiveness in addressing late-life depression (LLD) that does not respond well. While a new approach called priming repetitive transcranial magnetic stimulation (rTMS) has shown promise in treating depression in adults, its effectiveness in LLD has not been explored. This study aimed to investigate the impact of priming rTMS on LLD.
Methods
This study investigated the effectiveness of priming rTMS in 31 patients with LLD who did not improve after an adequate trial of antidepressants. Patients were randomly assigned to receive either active priming rTMS or sham priming rTMS. Active priming rTMS was delivered over the right dorsolateral prefrontal cortex for 10 sessions, lasting 31 minutes each, over a period of 2 weeks.
Results
The group receiving active priming rTMS demonstrated greater improvements in scores on the Hamilton Rating Scale for Depression (p < 0.037; partial η2 0.141) and the Geriatric Depression Rating Scale (p < 0.045; partial η2 0.131) compared to the sham priming group, with a mild effect size. At the end of the second and fourth weeks, the priming rTMS group achieved a response rate of 50%, while the sham priming group had response rates of 26.7% and 6.7%, respectively. No adverse effects requiring intervention were observed.
Conclusion
Priming rTMS is well-tolerated for the treatment of LLD and not only reduces the severity of depression but also maintains the achieved response over time.
A significant percentage of people with bipolar disorder (BD) exhibit suboptimal functional adjustment, even when appropriately treated and after symptomatic recovery is achieved. Given that cognitive impairment is one of the strongest correlates of socio-occupational outcomes and quality of life in BD, cognitive remediation (CR) is currently acknowledged as a promising treatment that could help bridge the gap between symptomatic and full functional recovery. The aim of this review was to explore the efficacy of CR approaches in improving cognitive and functional outcomes in BD patients. PubMed, PsycINFO, and CENTRAL were searched from inception to November 2022. Randomized controlled trials exploring the effects of CR on cognition and/or functional adjustment in adult BD patients were eligible. Ten studies based on seven independent trials (n = 586) were included. Change-score effect sizes (Hedges' g) were obtained for efficacy outcome measures and combined by means of meta-analytic procedures. Small but significant overall effects were observed for working memory (g = 0.32, 95% CI 0.11–0.52), planning (g = 0.30, 95% CI 0.03–0.56), and verbal learning (g = 0.40, 95% CI 0.15–0.66). However, CR was not found to exert any significant effects on functional outcomes at treatment completion or at follow-up assessment. Although CR may modestly enhance the cognitive performance of BD patients, this effect does not translate into an improvement at the functional level. The current data do not support the inclusion of CR as a treatment recommendation in clinical practice guidelines for the management of BD.
Interim analyses in clinical trials can take on a multitude of forms. They are often used to guide Data and Safety Monitoring Board (DSMB) recommendations to study teams regarding recruitment targets for large, later-phase clinical trials. As collaborative biostatisticians working and teaching in multiple fields of research and across a broad array of trial phases, we note the large heterogeneity and confusion surrounding interim analyses in clinical trials. Thus, in this paper, we aim to provide a general overview and guidance on interim analyses for a nonstatistical audience. We explain each of the following types of interim analyses: efficacy, futility, safety, and sample size re-estimation, and we provide the reader with reasoning, examples, and implications for each. We emphasize that while the types of interim analyses employed may differ depending on the nature of the study, we would always recommend prespecification of the interim analytic plan to the extent possible with risk mitigation and trial integrity remaining a priority. Finally, we posit that interim analyses should be used as tools to help the DSMB make informed decisions in the context of the overarching study. They should generally not be deemed binding, and they should not be reviewed in isolation.
The number of grassroots members of populist radical right (PRR) parties is on the rise, in contrast to the trend of membership decline in mainstream parties. While scholars have explained this by studying PRR parties' organizational strategies, I focus on party members and ask: Why do people join PRR parties? To answer this, I look not only at motivations, which is the dominant framework in party membership studies, but also at triggers – factors activating those motivations. Drawing on collective action scholarship, I argue that grievances and efficacy can work as triggers for joining PRR parties. Using interviews with 82 members of the Bharatiya Janata Party, the League in Italy and the Sweden Democrats, I uncover three elements in the path to PRR party membership: disaffection, affiliation and action. As well as questioning established narratives on why citizens join parties, my findings provide a novel theoretical framework to investigate this form of political participation.
Every year, over 1,000 public schools are permanently closed across the United States. And yet, little is known about their impacts on American democracy. Closed for Democracy is the first book to systematically study the political causes and democratic consequences of mass public school closures in the United States. The book investigates the declining presence of public schools in large cities and their impacts on the Americans most directly affected – poor Black citizens. It documents how these mass school closure policies target minority communities, making them feel excluded from the public goods afforded to equal citizens. In response, targeted communities become superlative participators to make their voices heard. Nevertheless, the high costs and low responsiveness associated with the policy process undermines their faith in the power of political participation. Ultimately, the book reveals that when schools shut down, so too does Black citizens' access to, and belief in, American democracy.