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Depress Anxiety ; 37(9): 926-934, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32579280


BACKGROUND: Psychiatrists frequently struggle with how to sequence treatment for depressed adolescents who do not respond to an adequate trial of a selective serotonin reuptake inhibitor (SSRI). This study leveraged recent statistical and computational advances to create Bayesian hierarchal models (BHMs) of response in the treatment of SSRI-resistant depression in adolescents study to inform treatment planning. METHODS: BHMs of individual treatment trajectories were developed and estimated using Hamiltonian Monte Carlo no u-turn sampling. From the Monte Carlo pseudorandom sample, 95% credible intervals, means, posterior tail probabilities, and so forth, were determined. Then, for the random effects model, posterior tail probabilities were used to create Bayesian two-tailed p values to evaluate the null hypotheses: no difference in efficacy between SSRIs and venlafaxine. The robustness of the results was examined using the fixed effects model of treatment comparisons. RESULTS: In patients not receiving cognitive behavioral therapy (CBT; n = 168), SSRIs produced greater and faster improvement in depressive symptoms compared to venlafaxine (p = .015). No differences in response or trajectory of response for symptoms of anxiety were detected between SSRIs and venlafaxine (p = .168). For patients receiving CBT (n = 162), SSRIs and venlafaxine produced similar improvements in symptoms of anxiety and depression. CONCLUSIONS: Findings from this novel computational approach suggest that a second trial of an SSRI is warranted for depressed adolescents who fail to respond to initial SSRI treatment.

Lab Chip ; 18(19): 3011-3017, 2018 09 26.
Artigo em Inglês | MEDLINE | ID: mdl-30131982


Micromilling is an underutilized technique for fabricating microfluidic platforms that is well-suited for the diverse needs of the biologic community. This technique, however, produces culture surfaces that are considerably rougher than in commercially available culture platforms and the hydrophilicity of these surfaces can vary considerably depending on the choice of material. In this study, we evaluated the impact of surface topography and hydrophilicity in milled microfluidic devices on the cellular phenotype and function of primary human macrophages. We found that the rough culture surface within micromilled systems affected the phenotype of macrophages cultured in these devices. However, the presence, type, and magnitude of this effect was dependent on the surface hydrophilicity as well as exposure to chemical polarization signals. These findings confirm that while milled microfluidic systems are an effective platform for culture and analysis of primary macrophages, the topography and hydrophilicity of the culture surface within these systems should be considered in the planning and analysis of any macrophage experiments in which phenotype is relevant.

Interações Hidrofóbicas e Hidrofílicas , Dispositivos Lab-On-A-Chip , Macrófagos/citologia , Diferenciação Celular , Polaridade Celular , Proliferação de Células , Regulação da Expressão Gênica , Humanos , Macrófagos/metabolismo , Fenômenos Mecânicos , Propriedades de Superfície