Empirically supported psychological treatments have been developed for a range of psychiatric disorders but there is evidence that patients are not receiving them in routine clinical care. ...Furthermore, even when patients do receive these treatments there is evidence that they are often not well delivered. The aim of this paper is to identify the barriers to the dissemination of evidence-based psychological treatments and then propose ways of overcoming them, hence potentially bridging the gap between research findings and clinical practice.
We made new estimates of the Galactic escape speed at various Galactocentric radii using the latest data release of the RAdial Velocity Experiment (RAVE DR4). Compared to previous studies we have a ...database that is larger by a factor of 10, as well as reliable distance estimates for almost all stars. Our analysis is based on statistical analysis of a rigorously selected sample of 90 high-velocity halo stars from RAVE and a previously published data set. We calibrated and extensively tested our method using a suite of cosmological simulations of the formation of Milky Way-sized galaxies. Our best estimate of the local Galactic escape speed, which we define as the minimum speed required to reach three virial radii R340, is 533+54-41 km s-1 (90% confidence), with an additional 4% systematic uncertainty, where R340 is the Galactocentric radius encompassing a mean overdensity of 340 times the critical density for closure in the Universe. From the escape speed we further derived estimates of the mass of the Galaxy using a simple mass model with two options for the mass profile of the dark matter halo: an unaltered and an adiabatically contracted Navarro, Frenk & White (NFW) sphere. If we fix the local circular velocity, the latter profile yields a significantly higher mass than the uncontracted halo, but if we instead use the statistics for halo concentration parameters in large cosmological simulations as a constraint, we find very similar masses for both models. Our best estimate for M340, the mass interiorto R340 (dark matter and baryons), is 1.3+0.4-0.3 × 1012 M⊙ (corresponds to M200 = 1.6+0.5-0.4 × 1012 M⊙). This estimate is in good agreement with recently published, independent mass estimates based on the kinematics of more distant halo stars and the satellite galaxy Leo I.
The RAdial Velocity Experiment survey, combined with proper motions and distance estimates, can be used to study in detail stellar kinematics in the extended solar neighbourhood (solar suburb). Using ...72 365 red-clump stars, we examine the mean velocity components in 3D between 6 < R < 10 kpc and −2 < Z < 2 kpc, concentrating on north-south differences. Simple parametric fits to the (R, Z) trends for V
φ and the velocity dispersions are presented. We confirm the recently discovered gradient in mean Galactocentric radial velocity, V
R, finding that the gradient is marked below the plane (δ〈V
R〉/δR = −8 km s−1 kpc−1 for Z < 0, vanishing to zero above the plane), with a Z gradient thus also present. The vertical velocity, V
Z
, also shows clear, large-amplitude (|V
Z
| = 17 km s−1) structure, with indications of a rarefaction-compression pattern, suggestive of wave-like behaviour. We perform a rigorous error analysis, tracing sources of both systematic and random errors. We confirm the north-south differences in V
R and V
Z
along the line of sight, with the V
R estimated independent of the proper motions. The complex three-dimensional structure of velocity space presents challenges for future modelling of the Galactic disc, with the Galactic bar, spiral arms and excitation of wave-like structures all probably playing a role.
We present the stellar atmospheric parameters (effective temperature, surface gravity, overall metallicity), radial velocities, individual abundances, and distances determined for 425,561 stars, ...which constitute the fourth public data release of the RAdial Velocity Experiment (RAVE). The stellar atmospheric parameters are computed using a new pipeline, based on the algorithms of MATISSE and DEGAS. The spectral degeneracies and the Two Micron All Sky Survey photometric information are now better taken into consideration, improving the parameter determination compared to the previous RAVE data releases. The individual abundances for six elements (magnesium, aluminum, silicon, titanium, iron, and nickel) are also given, based on a special-purpose pipeline that is also improved compared to that available for the RAVE DR3 and Chemical DR1 data releases. Together with photometric information and proper motions, these data can be retrieved from the RAVE collaboration Web site and the Vizier database.
The hypothalamic-pituitary-adrenal (HPA) axis has been implicated in the pathophysiology of a variety of mood and cognitive disorders. Neuroendocrine studies have demonstrated HPA axis overactivity ...in major depression, a relationship of HPA axis activity to cognitive performance and a potential role of HPA axis genetic variation in cognition. The present study investigated the simultaneous roles HPA axis activity, clinical symptomatology and HPA genetic variation play in cognitive performance. Patients with major depression with psychotic major depression (PMD) and with nonpsychotic major depression (NPMD) and healthy controls (HC) were studied. All participants underwent a diagnostic interview and psychiatric ratings, a comprehensive neuropsychological battery, overnight hourly blood sampling for cortisol and genetic assessment. Cognitive performance differed as a function of depression subtype. Across all subjects, cognitive performance was negatively correlated with higher cortisol, and PMD patients had higher cortisol than did NPMDs and HCs. Cortisol, clinical symptoms and variation in genes, NR3C1 (glucocorticoid receptor; GR) and NR3C2 (mineralocorticoid receptor; MR) that encode for GRs and MRs, predicted cognitive performance. Beyond the effects of cortisol, demographics and clinical symptoms, NR3C1 variation predicted attention and working memory, whereas NR3C2 polymorphisms predicted memory performance. These findings parallel the distribution of GR and MR in primate brain and their putative roles in specific cognitive tasks. HPA axis genetic variation and activity were important predictors of cognition across the entire sample of depressed subjects and HR. GR and MR genetic variation predicted unique cognitive functions, beyond the influence of cortisol and clinical symptoms. GR genetic variation was implicated in attention and working memory, whereas MR was implicated in verbal memory.
Abstract
We present a study of the low-frequency radio properties of star-forming (SF) galaxies and active galactic nuclei (AGNs) up to redshift z = 2.5. The new spectral window probed by the Low ...Frequency Array (LOFAR) allows us to reconstruct the radio continuum emission from 150 MHz to 1.4 GHz to an unprecedented depth for a radio-selected sample of 1542 galaxies in ∼ 7 deg2 of the LOFAR Boötes field. Using the extensive multiwavelength data set available in Boötes and detailed modelling of the far-infrared to ultraviolet spectral energy distribution (SED), we are able to separate the star formation (N = 758) and the AGN (N = 784) dominated populations. We study the shape of the radio SEDs and their evolution across cosmic time and find significant differences in the spectral curvature between the SF galaxy and AGN populations. While the radio spectra of SF galaxies exhibit a weak but statistically significant flattening, AGN SEDs show a clear trend to become steeper towards lower frequencies. No evolution of the spectral curvature as a function of redshift is found for SF galaxies or AGNs. We investigate the redshift evolution of the infrared–radio correlation for SF galaxies and find that the ratio of total infrared to 1.4-GHz radio luminosities decreases with increasing redshift: q
1.4 GHz = (2.45 ± 0.04) (1 + z)−0.15 ± 0.03. Similarly, q
150 MHz shows a redshift evolution following q
150 GHz = (1.72 ± 0.04) (1 + z)−0.22 ± 0.05. Calibration of the 150 MHz radio luminosity as a star formation rate tracer suggests that a single power-law extrapolation from q
1.4 GHz is not an accurate approximation at all redshifts.
We have carried out the largest randomised trial to date of newly diagnosed myeloma patients, in which lenalidomide has been used as an induction and maintenance treatment option and here report its ...impact on second primary malignancy (SPM) incidence and pathology. After review, 104 SPMs were confirmed in 96 of 2732 trial patients. The cumulative incidence of SPM was 0.7% (95% confidence interval (CI) 0.4-1.0%), 2.3% (95% CI 1.6-2.7%) and 3.8% (95% CI 2.9-4.6%) at 1, 2 and 3 years, respectively. Patients receiving maintenance lenalidomide had a significantly higher SPM incidence overall (P=0.011). Age is a risk factor with the highest SPM incidence observed in transplant non-eligible patients aged >74 years receiving lenalidomide maintenance. The 3-year cumulative incidence in this group was 17.3% (95% CI 8.2-26.4%), compared with 6.5% (95% CI 0.2-12.9%) in observation only patients (P=0.049). There was a low overall incidence of haematological SPM (0.5%). The higher SPM incidence in patients receiving lenalidomide maintenance therapy, especially in advanced age, warrants ongoing monitoring although the benefit on survival is likely to outweigh risk.
Allergic rhinoconjunctivitis (AR) is an allergic disorder of the nose and eyes affecting about a fifth of the general population. Symptoms of AR can be controlled with allergen avoidance measures and ...pharmacotherapy. However, many patients continue to have ongoing symptoms and an impaired quality of life; pharmacotherapy may also induce some side‐effects. Allergen immunotherapy (AIT) represents the only currently available treatment that targets the underlying pathophysiology, and it may have a disease‐modifying effect. Either the subcutaneous (SCIT) or sublingual (SLIT) routes may be used. This Guideline has been prepared by the European Academy of Allergy and Clinical Immunology's (EAACI) Taskforce on AIT for AR and is part of the EAACI presidential project “EAACI Guidelines on Allergen Immunotherapy.” It aims to provide evidence‐based clinical recommendations and has been informed by a formal systematic review and meta‐analysis. Its generation has followed the Appraisal of Guidelines for Research and Evaluation (AGREE II) approach. The process included involvement of the full range of stakeholders. In general, broad evidence for the clinical efficacy of AIT for AR exists but a product‐specific evaluation of evidence is recommended. In general, SCIT and SLIT are recommended for both seasonal and perennial AR for its short‐term benefit. The strongest evidence for long‐term benefit is documented for grass AIT (especially for the grass tablets) where long‐term benefit is seen. To achieve long‐term efficacy, it is recommended that a minimum of 3 years of therapy is used. Many gaps in the evidence base exist, particularly around long‐term benefit and use in children.
The masticatory muscles achieve a broad range of different activities such as chewing, sucking, swallowing, and speech. In order to accomplish these duties, masticatory muscles have a unique and ...heterogeneous structure and fiber composition, enabling them to produce their strength and contraction speed largely dependent on their motor units and myosin proteins that can change in response to genetic and environmental factors. Human masticatory muscles express unique myosin isoforms, including a combination of thick fibers, expressing myosin light chains (MyLC) and myosin class I and II heavy chains (MyHC) ‐IIA, ‐IIX, α‐cardiac, embryonic and neonatal and thin fibers, respectively. In this review, we discuss the current knowledge regarding the importance of fiber‐type diversity in masticatory muscles versus supra‐ and infrahyoid muscles, and versus limb and trunk muscles. We also highlight new information regarding the adaptive response and specific genetic variations of muscle fibers on the functional significance of the masticatory muscles, which influences craniofacial characteristics, malocclusions, or asymmetry. These findings may offer future possibilities for the prevention of craniofacial growth disturbances.
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