Potential drivers of the recent large Antarctic ozone holes.

The past three years (2020-2022) have witnessed the re-emergence of large, long-lived ozone holes over Antarctica. Understanding ozone variability remains of high importance due to the major role Antarctic stratospheric ozone plays in climate variability across the Southern Hemisphere. Climate change has already incited new sources of ozone depletion, and the atmospheric abundance of several chlorofluorocarbons has recently been on the rise. In this work, we take a comprehensive look at the monthly and daily ozone changes at different altitudes and latitudes within the Antarctic ozone hole. Following indications of early-spring recovery, the October middle stratosphere is dominated by continued, significant ozone reduction since 2004, amounting to 26% loss in the core of the ozone hole. We link the declines in mid-spring Antarctic ozone to dynamical changes in mesospheric descent within the polar vortex, highlighting the importance of continued monitoring of the state of the ozone layer.

Ozone impact from solar energetic particles cools the polar stratosphere.

Understanding atmospheric impacts of solar energetic particle precipitation (EPP) remains challenging, from quantification of the response in ozone, to implications on temperature. Both are necessary to understand links between EPP and regional climate variability. Here we use a chemistry-climate model to assess the importance of EPP on late winter/spring polar stratosphere. In transient simulations, the impact on NOy, ozone, and temperature is underestimated when using EPP forcing from the current recommendation of the Coupled Model Intercomparison Project (CMIP6). The resulting temperature response is largely masked by overall dynamical variability. An idealised experiment with EPP forcing that reproduces observed levels of NOy results in a significant reduction of ozone (up to 25%), cooling the stratosphere (up to 3 K) during late winter/spring. Our results unravel the inconsistency regarding the temperature response to EPP-driven springtime ozone decrease, and highlight the need for an improved EPP forcing in climate simulations.

Predictors of response to pharmacological treatments in treatment-resistant schizophrenia - A systematic review and meta-analysis.

BACKGROUND: As the burden of treatment-resistant schizophrenia (TRS) on patients and society is high it is important to identify predictors of response to medications in TRS. The aim was to analyse whether baseline patient and study characteristics predict treatment response in TRS in drug trials. METHODS: A comprehensive search strategy completed in PubMed, Cochrane and Web of Science helped identify relevant studies. The studies had to meet the following criteria: English language clinical trial of pharmacological treatment of TRS, clear definition of TRS and response, percentage of response reported, at least one baseline characteristic presented, and total sample size of at least 15. Meta-regression techniques served to explore whether baseline characteristics predict response to medication in TRS. RESULTS: 77 articles were included in the systematic review. The overall sample included 7546 patients, of which 41% achieved response. Higher positive symptom score at baseline predicted higher response percentage. None of the other baseline patient or study characteristics achieved statistical significance at predicting response. When analysed in groups divided by antipsychotic drugs, studies of clozapine and other atypical antipsychotics produced the highest response rate. CONCLUSIONS: This meta-analytic review identified surprisingly few baseline characteristics that predicted treatment response. However, higher positive symptoms and the use of atypical antipsychotics - particularly clozapine -was associated with the greatest likelihood of response. The difficulty involved in the prediction of medication response in TRS necessitates careful monitoring and personalised medication management. There is a need for more investigations of the predictors of treatment response in TRS.

Mobile therapeutic attention for treatment-resistant schizophrenia (m-RESIST): a prospective multicentre feasibility study protocol in patients and their caregivers.

INTRODUCTION: Treatment-resistant schizophrenia (TRS) is a severe form of schizophrenia. In the European Union, approximately 40% of people with schizophrenia have TRS. Factors such as the persistence of positive symptoms or higher risk of comorbidities leave clinicians with a complex scenario when treating these patients. Intervention strategies based on mHealth have demonstrated their ability to support and promote self-management-based strategies. Mobile therapeutic attention for treatment-resistant schizophrenia (m-RESIST), an innovative mHealth solution based on novel technology and offering high modular and flexible functioning, has been developed specifically for patients with TRS and their caregivers. As intervention in TRS is a challenge, it is necessary to perform a feasibility study before the cost-effectiveness testing stage. METHODS AND ANALYSIS: This manuscript describes the protocol for a prospective multicentre feasibility study in 45 patients with TRS and their caregivers who will be attended in the public health system of three localities: Hospital Santa Creu Sant Pau (Spain), Semmelweis University (Hungary) and Gertner Institute & Sheba Medical Center (Israel). The primary aim is to investigate the feasibility and acceptability of the m-RESIST solution, configured by three mHealth tools: an app, wearable and a web-based platform. The solution collects data about acceptability, usability and satisfaction, together with preliminary data on perceived quality of life, symptoms and economic variables. The secondary aim is to collect preliminary data on perceived quality of life, symptoms and economic variables. ETHICS AND DISSEMINATION: This study protocol, funded by the Horizon 2020 Programme of the European Union, has the approval of the ethics committees of the participating institutions. Participants will be fully informed of the purpose and procedures of the study, and signed inform consents will be obtained. The results will be published in peer-reviewed journals and presented in scientific conferences to ensure widespread dissemination. TRIAL REGISTRATION NUMBER: NCT03064776; Pre-results.