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How Effective are Psychotherapeutic Interventions at Repairing Positive and Negative Affect in Depression and Anxiety? An Updated Systematic Review and Meta-analysis & A Case Series Evaluation of Augmented Depression Therapy (ADepT) for the Treatment of Depression following Non-Remittance to NHS Talking Therapies High-Intensity Interventions
No full textBackground: The core symptoms of depression are low mood (heightened negative
affect; NA) and reduced interest or pleasure (diminished positive affect; PA). Existing
research examining psychotherapeutic repair of PA and NA in depression is limited
and conflicting. This review systematically updated a 2016 meta-analysis examining
the effect of psychotherapy on PA and NA in depression. Methodological adjustments
aimed to: ensure all included trials reflected genuine, adequately dosed, clinician guided psychotherapies; include novel research developments using mixed samples
or active controls; and utilise between-group, within-group, and z-transformed within group meta-analyses to evaluate affective repair.
Method: Comprehensive searches of the MetaPsy Depression and Transdiagnostic
databases, and recent reviews identified: RCTs comparing clinician-guided (≥2 acute
treatment therapist contacts) psychotherapy lasting ≥2 sessions, with a passive or
active control, in adults (18+) with depression and/or mixed depression/anxiety
(permitting a majority of the sample are depressed), measuring pre-post treatment
change on a PA and NA measure.
Results: 15 RCTs with 1,953 participants were included from 1,619 studies. At pre treatment, NA was more impaired (z = 1.75 [1.55; 1.94]) than PA (z = -1.39 [-1.56; -
1.21]). Within-arm analysis of active arms observed a significant large pre-post effect
size (ES) for NA (g = -1.07, [-1.31; -0.83]) and a significant medium ES for PA (g =
0.78, [0.59; 0.96]). Between-group analysis of experimental arms over passive
comparators observed significant medium ES advantages for NA (g = -0.60, 95% CI
[-1.08; -0.13]) and a significant small ES for PA (g = 0.31, 95% CI [0.00; 0.63]).
Versus active comparators, non-significant small and negligible ES advantages of
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experimental arms were observed for NA (g = -0.31, 95% CI [-0.65; 0.03]) and PA (g
= 0.23, 95% CI [-0.05; 0.51]) respectively. Pooled post-treatment z-scores indicated
no clear significant difference between PA (z = -0.55, 95% CI [-0.73; -0.36]) and NA
(z = 0.49, 95% CI [0.27; 0.71]). Subgroup analysis showed indications that novel
therapies designed to target PA outperformed conventional psychotherapies at
repairing PA and NA, however, the study was underpowered to reach definitive
conclusions.
Limitations: The small number of highly heterogeneous studies included, with
possible publication bias, necessitates cautious interpretation of findings.
Additionally, reliance on modulus inspection of 95% confidence intervals to ascertain
PA-NA significant difference increased the Type II error risk.
Conclusions: A trend towards greater NA relative to PA repair was observed during
active treatment. Relative to the greater NA impairment at pre-treatment, PA was
equally, if not slightly more impaired than NA at post-treatment. However, significant
difference between PA and NA was only observed during certain sensitivity analyses.
Further reviews, with greater number of trials and statistical methods of significance
are warranted. ackground: Non-remittance following psychological treatments for depression
remains a widespread clinical challenge. In the UK, a critical gap exists in service
provisions for depressed individuals who have not remitted to high-intensity NHS
Talking Therapies (NHS-TT) interventions, with the majority not qualifying for further line treatment in secondary care. Augmented Depression Therapy (ADepT), a novel
talking therapy concurrently targeting wellbeing enhancements and symptom
reduction, may be a suitable further treatment option given it aligns with the
recovery-oriented priorities of those with lived experience of more persistent
depression.
Method: Using a randomised multiple baseline case series design, this study
provided an interim evaluation of the feasibility, safety and preliminary efficacy of
ADepT for individuals with depression following non-remittance to NHS-TT high intensity interventions, with outcomes evaluated relative to pre-specified continuation
targets.
Results: At the time of interim analysis, 11 participants had been successfully
recruited from NHS-TT, with eight having completed acute ADepT treatment. Seven
of eight participants (88%) received a minimum adequate treatment dose (>8
sessions); none showed reliable deterioration on co-primary outcomes of
depression, wellbeing or anxiety (meeting <30% target); and no trial-related serious
adverse incidents occurred. Five of the seven participants completing treatment
(71%) showed clinical improvement on at least one co-primary measure during
visual analysis of level change in time series analysis (surpassing the >60% efficacy
target), and by meeting reliable improvement criteria from pre- to post-treatment.
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ADEPT FOR NHS-TT NON-REMITTANCE
Pre- to post-treatment ESs were large for depression (g = 1.71), wellbeing (g = 1.11),
and anxiety (g = 0.977), but the wide 95% confidence intervals of each necessitates
cautious interpretation. Prespecified continuation targets regarding acceptability,
safety and clinical outcomes were largely met.
Conclusions: This interim analysis suggests ADepT may be a safe, feasible, and
effective further-line treatment option for NHS-TT non-remittance. However,
replication of these results within a larger sample size, with qualitative evaluations of
treatment acceptability is needed before progression to a randomised-controlled
evaluation of ADepT for NHS-TT non-remittance is warranted.</p
Flexibility-Induced Robustness in Molecular Catalysts for Electrocatalytic CO2 Reduction
No full textCO2 electroreduction to produce fuels and chemicals is of great significance. Molecular catalysts offer valuable advantages in light of their well-defined active sites and tunable structural and electronic properties. However, their stability is often compromised by rigid conjugated structures. Herein, we proposed a hydrogen-bond regulation strategy that enables reversible structural deformation of metal phthalocyanines (MPcs) by incorporating methoxy groups into the phthalocyanine framework, thereby improving the flexibility and stability of MPcs. Calculations suggested that intermediate absorption induced structural deformation in MPcs. Moreover, hydrogen-bond interactions and conformational changes enriched with substituted methoxy groups in MPcs enhance structural flexibility. Operando Raman studies revealed that these hydrogen bonds correlated with the reversible structural deformation of NiPc. The optimized catalysts, facilitated by hydrogen bonds, achieved stable operation for over 500 h at 100 mA cm–2 with >98% Faradaic efficiency in CO2-to-CO electrocatalytic reduction, significantly outperforming molecular catalysts lacking appropriate hydrogen-bond interactions.</p
What is the post-industrial rural for? Intangible cultural heritage, rural world-making and core-periphery imaginaries
No full textIn common with many other areas of Europe connected with national minority cultures, each of the case study regions is considered to be geographically both peripheral and rural. Within these settings, the insider-outsider relationship inhabits a geopolitical context that is ever-changing; yet within which ‘periphery’ and ‘rurality’ nevertheless continue to carry particular implications for the construction of place (and those people within it), potentially leading to entrenched perceptions and discourses. The minority culture may add voice to these narratives but may just as often be silenced, or misaligned with narratives constructed by a potentially dissonant gaze. This peripherality therefore carries particular sets of stereotypes and assumptions regarding the kinds of value that is ascribed to the region, and the affective markers that shape knowledges about it (see Eriksson 2008; Willett 2016). In this chapter Willett engages with these stereotypes, asking how they are entangled and resisted within the cultural practices in each of the case study regions. She uses the New Materialist device of the affective assemblage (Coole and Frost 2010) to explore the affective meanings that ICH generates, how they are shared, the symbolic repertoire utilised, and how this feeds back into centre-periphery perceptions of place.</p
The HOSTS Survey: Suspected variable dust emission and constraints on companions around θ Boo
No full textContext. During the Hunt for Observable Signatures of Terrestrial Systems (HOSTS) survey by the Large Binocular Telescope Interferometer (LBTI), an excess emission from the main sequence star θ Boo (F7V spectral type, 14.5 pc distance) was observed. This excess indicates the presence of exozodiacal dust near the habitable zone (HZ) of the star. Previous observations from Spitzer and
Herschel showed no sign of outer cold dust within their respective detection limits. Since exozodiacal dust is generally thought to originate from material located further out in the system, the source of exozodiacal dust around θ Boo remains unclear.
Aims. Additional nulling and high-contrast adaptive optics (AO) observations were taken to spatially constrain the dust distribution, search for variability, and directly image potential companions in the system. This study presents the results of these observations and provides an interpretation of the inner system’s architecture.
Methods. The star was observed using the LBTI’s N’-band nulling mode during three epochs in 2017, 2018, and 2023. The dust distribution is modeled and constrained for each epoch using the standard LBTI nulling pipeline, assuming a vertically thin disk with a face-on inclination. In addition, high-contrast AO observations are performed in the L’-band and H-band to constrain the presence
of substellar companions around the star.
Results. Several solutions are found for the dust distribution, and for each epoch. However, the LBTI nulling observations are not able to discriminate between them. Using the upper limits from previous observations, we constrain the representative size of the dust grains around 3-5 µm. A tentative increase in dust brightness is also measured at the Earth-equivalent insolation distance between2017 and 2023. This increase corresponds to the injection of 4 × 10−8 − 4 × 10−7 M⊕ new material in the disk. Several options are considered to explain the origin of the observed dust and its variability, but no clear sources could be identified from the current observations. Partly because our high-contrast AO observations could only constrain the presence of companions down to 11 MJup at 1.3′′separation.</p
Undiagnosed G6PD deficiency in Black and Asian individuals is prevalent and contributes to health inequalities in type 2 diabetes diagnosis and complications
No full textOBJECTIVEGlucose-6-phosphate dehydrogenase (G6PD) deficiency presents silently and is not routinely screened. It is associated with markedly lower HbA1c for the prevailing glucose levels. Since HbA1c is internationally recommended to diagnose and manage type 2 diabetes (T2D), we investigated the population-level impact of undiagnosed G6PD deficiency on T2D diagnosis and complications in the U.K.RESEARCH DESIGN AND METHODSWe used whole-exome sequencing and electronic health record data from UK Biobank (n = 467,368) and Genes & Health (n = 43,011) cohorts.RESULTSIn the U.K., we estimated that ∼1 in 7 Black and 1 in 63 Asian males carry G6PD deficiency alleles, compared with fewer than 1 in 10,000 White males. Despite this, less than 1 in 50 G6PD‐deficient men are clinically recognized. Male G6PD carriers have considerably lower average HbA1c (0.9% [International Federation of Clinical Chemistry and Laboratory Medicine: 10.0 mmol/mol]) compared with noncarriers, while differences in average glucose were negligible. G6PD‐deficient men had 1.37 (95% CI: 1.01, 1.86) higher odds of developing diabetes‐related microvascular complications than noncarriers. Although risk factors were similar prior to diagnosis, male G6PD carriers diagnosed with T2D since 2011 were, on average, 4.1 years (95% CI: 0.6, 7.7) older at diagnosis compared with noncarriers. In addition, lower mean HbA1c values in G6PD carriers falsely underestimated their 10‐year T2D risk.CONCLUSIONSUndiagnosed G6PD deficiency has significant impact on T2D diagnosis with HbA1c and associates with increased risk of diabetes complications. This has major implications for global populations using HbA1c for diagnosis and monitoring, and could contribute significantly to inequalities in diabetes outcomes.</p
The association between park visits, outdoor play and child social-emotional competency in a multi-ethnic, urban cohort
No full textIncreased access to greenspaces and frequent outdoor play has been shown to be associated with improved social-emotional competency (SEC) in children, but this finding may not be generalisable to all communities and contexts. This study undertook a cross-sectional analysis of 2568 children (7.1–12.6 years old; mean 9.8) assessing the association between child-reported outdoor play and park visits, and two aspects of SEC in a sample from Born in Bradford (BiB), a multi-ethnic urban cohort in the UK. SEC was measured by the Strengths and Difficulties Questionnaire (SDQ) Total Difficulties Score (TDS), and the SDQ prosocial subscale. Increased outdoor play was linearly associated with improved scores in both aspects of SEC; park visits were predominately null or inconsistently associated with SEC. Stratification by ethnicity and area deprivation displayed that associations were generally stronger in the White origin compared to Asian origin populations. However, stratification also showed that different ethnic groups may gain benefits from outdoor play at different times of the week, reflecting different uses of leisure time and cultural practices. There was some evidence that associations were stronger in the least deprived populations compared to the most deprived populations. Outdoor play may be an important contributor to SEC in children; however, effects vary by ethnic origin and area deprivation, showing the association is influenced by factors such as demographics and place. Ensuring children’s environments offer safe, culturally appropriate, local spaces for children to play, and increasing opportunities for children to play outdoors has the potential to improve children’s SEC.</p
Structural dynamics of botulinum neurotoxins
No full textBotulinum neurotoxins are the most potent neurotoxins known to humans, produced by the bacterium Clostridium botulinum, resulting in the disease botulism. The focus of this study was on botulinum neurotoxin type A (BoNT A), with its mechanism of action and structural dynamics largely not understood. BoNT A binds to synaptic vesicle glycoprotein (SV2C) and ganglioside (GT1b) to enter the motor neurons; however, the processes of binding and translocation of the molecule still requires further investigation. Additionally, the allosteric or conformational changes that occur when BoNT A binds to SV2C and GT1b have not been investigated and compared to the apo state of BoNT A. Thus, this work focused on developing Hydrogen/deuterium exchange mass spectrometry methods to investigate BoNT type A with and without its binding partners.
Initially, we aimed to optimise the mapping of BoNT A, to generate high numbers of peptides, sequence coverage and redundancy, that are transferrable to future HDX-MS experiments. We aimed to interrogate the structural dynamics of BoNT A in its apo state. Specifically, in comparison to the crystal structure and to investigate the possible regions of flexibility and stability. A titration of SV2C against BoNT A was used to determine the ideal concentration of SV2C to be used in future HDX-MS experiments. The goal was then to characterise the binding partners of SV2C and GT1b, with the allosteric or conformational impact of BoNT A assessed, then attempting to rationalise these with BoNT A’s mechanism of action. Further, applying cryo-electron microscopy (cryo-EM) to support the HDX-MS data, showing the overall allosteric or conformational changes due to the interaction of the binding partners with BoNT A. Here we present analysis of the structural dynamics of BoNT A, primarily using HDX-MS, in its solution phase state and how the molecule changes when exposed to binding partners, SV2C and GT1b
Tropical Pacific Trends and Their Impact on Global Climate
No full textUnderstanding the influence of tropical Pacific trends on global atmospheric circulation is crucial for improving climate simulations and assessing future climate risk. This thesis explores the role of tropical Pacific trends in driving long-term changes in atmospheric circulation, precipitation patterns, and climate variability.
The analysis reveals that strengthening subtropical highs in the boreal winter during 1979-2021 led to a poleward shift in the Eady Growth Rate, intensifying both the Hadley and Ferrel cells. The tropical Pacific has played a key role in modulating the subtropical highs’ intensity. These results highlight the interannual variability and trend are driven by the same mechanism.
An analysis of coupled models reveals a systematic underestimation of observed tropical Pacific trade wind trends from 1979 to 2014. This discrepancy has led to inaccurate rainfall simulations over the Americas, with southwestern North America experiencing less drying and northern South America experiencing weak wetting. By applying a linear multidecadal adjustment based on the principle that the interannual ENSO-driven variability operates by the same mechanism as this long term trend, the observed rainfall patterns can be effectively reproduced.
The study also highlights the remote influence of tropical Pacific trends on the Southern Annular Mode (SAM). A strong positive SAM trend from 1979 to 2014 is found to be driven not only by greenhouse gas increases and stratospheric ozone depletion but also by a La Niña-like trend in the tropical Pacific. As stratospheric ozone recovers, its effect counteracts greenhouse gas-driven changes, making future SAM trends highly dependent on the evolution of tropical Pacific conditions. If the current La Niña trend continues, the SAM is expected to remain in a positive phase.
These findings underscore the critical role of tropical Pacific trends in shaping global climate. Improving climate model representations of these processes is essential for more accurate future climate projections
Pathways to differentiated horticultural futures: a study of the South West of England’s fruit and vegetable growers, farmers and intermediaries, past and present
No full textConcerns about the environmental impact of agriculture, projections for changing global climates and poor diets amongst the domestic population suggests that future patterns of UK horticultural production and supply will undergo significant transformation. Long forgotten horticultural production areas, such as the South West of England (SWE), may in-time recontribute to a rising domestic fruit and vegetable supply by deploying unconventional production patterns and routes to market. However, understanding of, and policy support for UK horticulture falls far behind the rest of the agricultural sector.
Taking predominantly van der Ploeg’s (2018) The New Peasantries as a conceptual framing, this thesis explores the interplay between structural barriers, enabling relationships and grower agency manifesting in types of horticultural production practice in SWE. Through a multi-temporal, mixed methodology including archival research, quantitative survey and semi structured interviews of farmers, intermediaries and industry witnesses, a number of key findings emerge. Firstly, archival research uncovers the extent to which UK horticultural production struggled during the post-war agricultural revolution, neglected while wider farming benefitted from a supportive policy environment, adding nuance to the traditional story of modern agricultural change. Secondly, knowledge of domestic horticultural production is clouded by official data collection methods which have been eroded over time, eclipsing the complexity of existing horticultural practice. Thirdly, prevailing moralistic narratives of food system actors underplay critical dynamics, such as de-commoditisation and enabling intermediary-grower relationships, which can support diverse and resilient horticultural production and marketing systems. Finally, food system actors may express alignment with competing industry visions for the future, however narrative pathways to these futures remain unclear. In particular, this research challenges the reified perception of the new generation of UK agroecological growers as autonomous neo-peasants, instead exposing the web of interrelationships and the structuration of the factors of production moulding the precarious entrepreneurship of the sector
Digital Technology For The Circular Economy In Manufacturing Industry
No full textThis thesis investigates how digital technologies (DT) can support the circular economy (CE) within the manufacturing context. In existing literate, there is a weakness in systematic frameworks for understanding the functions of DTs that can support CE in the manufacturing context, and a lack of empirical evidence to underpin theoretical assumptions. The thesis seeks to address these gaps by employing systematic literature review and semi-structured interview research methods to investigate three aspects: (1) the functions of DTs and how to use them for CE, as described in the literature, (2) the extent to which empirical evidence supports the digital functions (DFs) identified in the literature, and investigates their applications in practice, and (3) how manufacturing firms collaborate with technology providers to implement DT for CE.
The thesis is organized into three corresponding research chapters:
1. This research aims to identify what are the main functions of DTs for the CE in literature? And how can these DFs be used to implement CE strategies in literature? This study reviews 174 papers and identifies thirteen DFs relevant to CE strategies and seven mechanisms for their implementation.
2. This research seeks answer two questions: What are the main functions of DTs for the CE in practice? How can these DFs be used to implement CE strategies in practice? Based on interviews with 61 experts, the research validates the relevance of the thirteen DFs identified in the literature and introduces a new function, "Visualize." On the basis of the empirical evidence, the research also identifies five general application patterns and eleven implementation mechanisms for manufacturers and their stakeholders.
3. This research aims to find out how technology providers can support manufacturing firms’ sustainable value creation in Circular Economy practices. This study uses semi-structured interviews to determine how firms manage collaboration with technology providers to implement DTs for CE. The findings suggest four degrees of DT integration, three levels of CE value co-creation networks, and four patterns for technology providers’ sustainable value co-creation