Dimitrios C. Karaiskos

Duloxetine Versus Citalopram and Sertraline in the Treatment of Poststroke Depression, Anxiety, and Fatigue

The authors sought to determine the relative efficacy and tolerability of duloxetine versus citalopram and sertraline in the treatment of poststroke depression (PSD), anxiety, and fatigue. A group of 60 patients with PSD were assigned to receive duloxetine, citalopram, or sertraline and were assessed over a 3-month period for depression, anxiety, and fatigue. Improvement of depression and anxiety, but not fatigue, was observed in all study groups. Duloxetine was well tolerated and significantly more effective than citalopram and sertraline for the treatment of anxiety symptoms in PSD patients. None of the antidepressants used was effective for reducing symptoms of fatigue.

Insights on the drivers and inhibitors of Mobile Data Services uptake

Studying the adoption and acceptance of Mobile Data Services (MDS) has been an intriguing endeavour for quite some time. Much of the related literature is inspired by the technology acceptance model and its heirs. The study presented in this paper adopts an alternative perspective and proposes the study of MDS actual usage patterns under the lens of the Triandis theory of explaining human behaviour. To this end, we adjust the concepts included in the original Triandis model to the MDS context and construct a model predicting MDS use. The model is empirically validated through a survey (N = 365) and tested for its predictive capacity against four different MDS categories (m-commerce, communication, information and entertainment services). Results suggest that the uptake of each of the four service categories is contingent upon a limited set of factors. In addition, financial barriers emerge as a universal inhibitor over and above specific service groupings.

Affective and social determinants of mobile data services adoption

Technology acceptance theories predict user intentions to use services tailored for organisational needs. However, in this paper, we postulate that the aforementioned theories do not apply when investigating intentions towards the use of mobile data services (MDS), as the latter encompasses supplementary characteristics, such as fun and enjoyment, which are not taken into account under available models of user acceptance. The incorporation of the affective dimension is proposed by reintroducing the Triandis theory of human behaviour to the MDS domain. A web-based survey (N = 219) was conducted to investigate our research hypotheses and validate our model of MDS usage intention. Results showed that the MDS usage intention can be predicted by cognitive and affective factors under the lens of social influences. Additionally, the main antecedents of MDS actual use are perceived usefulness, perceived value and intention to use MDS.

Delineating ‘pervasiveness’ in pervasive information systems: a taxonomical framework and design implications

Pervasive Information Systems (IS) exemplify a paradigm where Information Technology is embedded in the physical environment, capable of accommodating user needs and wants when desired. Pervasive IS differ from IS that are based on the desktop paradigm in that they encompass a complex, dynamic environment composed of multiple artifacts, capable of perceiving contextual information and supporting user mobility. Building on the novel properties of pervasive IS, we propose a taxonomical framework assessing the level of ‘pervasiveness’ in a given information system. The framework consists of three interweaving dimensions, namely ubiquity (encompassing mobility and heterogeneity), diffusion (encompassing invisibility and interactivity) and contextual awareness. The framework may be employed either to prospectively inform the design of pervasive IS (by pointing towards pertinent design considerations) or to retrospectively assess the pervasiveness of a system and identify improvement opportunities. We demonstrate both uses, firstly by discussing design priorities for ex ante IS evaluation and secondly by showcasing ex post assessments of a domestic and a corporate pervasive IS.

Pregabalin augmentation of antidepressants in older patients with comorbid depression and generalized anxiety disorder-an open-label study.

The objective of this 12‐week open‐label study was to evaluate the efficacy, safety, and tolerability of pregabalin as an adjunctive treatment to antidepressants in older patients suffering from depression and comorbid generalized anxiety disorder (GAD).

Motives and Barriers Affecting the Use of Mobile Data Services

Studying the adoption and acceptance of mobile data services (MDS) has been an intriguing endeavour for quite some time. Much of the related literature is inspired by the technology acceptance model and its heirs. The study presented in this paper adopts an alternative perspective and proposes the study of MDS actual usage patterns under the lens of the Triandis theory of explaining human behaviour. To this end, we adjust the concepts included in the original Triandis model to the MDS context and construct a model predicting MDS use. The model is empirically validated through a survey (N=365) and tested for its predictive capacity against four different MDS categories (m-commerce, communication, information, and entertainment services). Results suggest that the uptake of each of the four service categories is contingent upon a limited set of factors. In addition, financial barriers emerge as a universal inhibitor over and above specific service groupings.

Understanding the Adoption of Mobile Data Services: Differences among Mobile Portal and Mobile Internet Users

This study attempts to investigate the potential differences among individual adoption patterns between m-portal and m-internet services usage. A theoretical model that reflects a set of unique predominant factors of IS usage was developed. The model was empirically tested using data collected on mobile data services adoption. The results indicate that there are differences among the adoption behavior of mobile portal users and mobile internet users. Specifically, mobile internet use is likely to be driven by utilitarian expectations and overall usefulness of accessing the web through this alternative medium. On the contrary, mobile portals use is likely to be dependent on the users’ current state of innovativeness and not being affected by the actual utility of the mobile data service. The paper concludes with theoretical and practical implications of our findings.

Triglycerides, Depression, and Risk of Ischemic Stroke

depression is an important condition that is associated with increased risk of morbidity and mortality in patients with heart disease and that warrants effective response by clinicians. The recent AHA science advisory concluded that routine depression screening in heart disease patients would accomplish that, but this recommendation was not based on a careful review of potential benefits and harms that is customary for a statement of this type. Carney et al do not find fault with the quality or rigor of our systematic review. Yet they support the AHA recommendation even though our review did not find any clinical trial that assessed whether depression screening improves depression or cardiac outcomes in heart disease patients or any other evidence that depression screening would likely benefit patients with cardiovascular disease. Carney et al question how physicians will identify patients with depression and heart disease if they do not screen for depression. Unfortunately, there are many examples of screening programs implemented based solely on the desire to do good or out of fear and concern rather than on evidence of benefit to patients. Many such programs are later found to be unhelpful or even to cause harm. Recommending routine depression screening is not just a cry for greater awareness; it is a call for a significant deployment of health care resources when there are already considerable health care expenditures and a limited number of mental health clinicians. A higher standard must apply to such a recommendation, one that directly links screening with improved mental health or cardiac outcomes and one that weighs the magnitude of potential benefits and harms, typically based on a systematic review of the literature. The call for routine depression screening in patients with cardiovascular disease falls well short of this standard. It is not clear how many patients would be detected by routine screening who would otherwise not be identified and who have severe enough symptoms of depression to benefit from treatment. Even if some otherwise unrecognized patients would be identified, others would be inaccurately labeled and potentially inappropriately treated in the absence of sufficient mental health resources to address high numbers of false-positive screens. These potential harms, as well as those resulting from treatment even when appropriate (eg, medication adverse effects), must be balanced against modest improvements in depressive symptoms to assess the overall effects of depression screening. The potential effect of misdirecting limited resources to patients inappropriately identified as depressed by screening, rather than addressing gross inadequacies in the routine care of already identified depressed patients, is daunting. To call for routine screening is to make a huge leap across a wide gap in current evidence. We advise looking carefully before making that leap, recommend further study of the potential harms and costs of routine screening, and urge reconsideration of the AHA science advisory.

Cognitive and Affective Antecedents of Mobile Data Services Usage Intention

Technology acceptance theories predict user intentions to use services tailored for organizational needs. However, in this paper we postulate that the aforementioned theories do not apply when investigating intentions towards the use of mobile data services (MDS), as the latter encompass supplementary characteristics, such as fun and enjoyment, which are not taken into account under available models of user acceptance. The incorporation of the affective dimension is proposed by re-introducing the Triandis theory of human behavior to the MDS domain. A large-scale (N=219) Web-based survey was conducted to investigate our research hypotheses and validate our model of MDS usage intention. Results showed that the MDS usage intention can be predicted by cognitive and affective factors under the lens of social influences.

IGF-I and IGFBP-3 before and after inpatient alcohol detoxification in alcohol-dependent subjects

Summary Background It is unclear whether alcohol detoxification has an effect on factors that are involved in growth, metabolic functions and cell proliferation. Alcohol abuse is associated with low IGF-I levels that tend to rise after alcohol withdrawal. There is a paucity of studies on the course of IGFBP-3 (the main binding protein for IGF-I) after alcohol detoxification. Material/Methods We prospectively assessed IGF-I and IGFBP-3 changes at the time of admission and after 4 to 6 weeks of detoxification in an inpatient alcohol detoxification facility in 118 alcohol-dependent subjects given a regular hospital diet. No participants dropped out of the study. Results Changes in IGF-I after alcohol detoxification showed a marked dimorphism in altered hepatic biochemistry upon admission, with a rise in those with normal liver enzymes upon admission (p=0.016, Kruskall-Wallis) and a drop in those with elevated liver enzymes upon admission (p=0.05); the latter was noted in subjects that had consumed alcohol close to the time of admission. Overall, however, IGF-I and IGFBP-3 were within normal limits for most subjects both upon admission and after alcohol detoxification; no significant differences were detected among the examined parameters in men vs. women, and there were no significant correlations of IGF-I, IGFBP-3 or the IGF-I/IGFBP-3 molar ratio with BMI or age. Conclusions Regardless of hepatic enzymes’ elevation, alcohol detoxification had overall slight effects on IGF-I and IGFBP-3.