Metropolitan State University

Abstract: Background: Atypical antipsychotic medications are widely prescribed for the adjunctive treatment of depression, yet their total risk–benefit profile is not well understood. We thus conducted a systematic review of the efficacy and safety profiles of atypical antipsychotic medications used for the adjunctive treatment of depression. Methods and Findings: We included randomized trials comparing adjunctive antipsychotic medication to placebo for treatmentresistant depression in adults. Our literature search (conducted in December 2011 and updated on December 14, 2012) identified 14 short-term trials of aripiprazole, olanzapine/fluoxetine combination (OFC), quetiapine, and risperidone. When possible, we supplemented published literature with data from manufacturers’ clinical trial registries and US Food and Drug Administration New Drug Applications. Study duration ranged from 4 to 12 wk. All four drugs had statistically significant effects on remission, as follows: aripiprazole (odds ratio [OR], 2.01; 95% CI, 1.48–2.73), OFC (OR, 1.42; 95% CI, 1.01–2.0), quetiapine (OR, 1.79; 95% CI, 1.33–2.42), and risperidone (OR, 2.37; 95% CI, 1.31–4.30). The number needed to treat (NNT) was 19 for OFC and nine for each other drug. All drugs with the exception of OFC also had statistically significant effects on response rates, as follows: aripiprazole (OR, 2.07; 95% CI, 1.58–2.72; NNT, 7), OFC (OR, 1.30, 95% CI, 0.87–1.93), quetiapine (OR, 1.53, 95% CI, 1.17–2.0; NNT, 10), and risperidone (OR, 1.83, 95% CI, 1.16–2.88; NNT, 8). All four drugs showed statistically significant effects on clinician-rated depression severity measures (Hedges’ g ranged from 0.26 to 0.48; mean difference of 2.69 points on the Montgomery–Asberg Depression Rating Scale across drugs). On measures of functioning and quality of life, these medications produced either no benefit or a very small benefit, except for risperidone, which had a small-to-moderate effect on quality of life (g=0.49). Treatment was linked to several adverse events, including akathisia (aripiprazole), sedation (quetiapine, OFC, and aripiprazole), abnormal metabolic laboratory results (quetiapine and OFC), and weight gain (all four drugs, especially OFC). Shortcomings in study design and data reporting, as well as use of post hoc analyses, may have inflated the apparent benefits of treatment and reduced the apparent incidence of adverse events. Conclusions: Atypical antipsychotic medications for the adjunctive treatment of depression are efficacious in reducing observer-rated depressive symptoms, but clinicians should interpret these findings cautiously in light of (1) the small-tomoderate-sized benefits, (2) the lack of benefit with regards to quality of life or functional impairment, and (3) the abundant evidence of potential treatment-related harm. Please see later in the article for the Editors’ Summary.

Abstract: This paper reviews the literature related to the learning and teaching of debugging computer programs. Debugging is an important skill that continues to be both difficult for novice programmers to learn and challenging for computer science educators to teach. These challenges persist despite a wealth of important research on the subject dating back as far as the mid 1970s. Although the tools and languages novices use for writing programs today are notably different from those employed decades earlier, the basic problem-solving and pragmatic skills necessary to debug them effectively are largely similar. Hence, an understanding of the previous work on debugging can offer computer science educators insights into how to improve contemporary learning and teaching of debugging and may suggest directions for future research into this important area. This overview of the debugging literature is organized around four questions relevant to computer science educators and education researchers: What causes bugs to o...

Abstract: Debugging is often difficult and frustrating for novices. Yet because students typically debug outside the classroom and often in isolation, instructors rarely have the opportunity to closely observe students while they debug. This paper describes the details of an exploratory study of the debugging skills and behaviors of contemporary novice Java programmers. Based on a modified replication of Katz and Anderson's study of novices, we sought to broadly survey the modern landscape of novice debugging abilities. As such, this study reports general quantitative results and fills in the picture with qualitative detail from a relatively small, but varied sample. Comprehensive interviews involving both a programming and a debugging task, followed by a semi-structured interview and a questionnaire, were conducted with 21 CS2 students at seven colleges and universities. While many subjects successfully debugged a representative set of typical CS1 bugs, there was a great deal of variation in their success at the p...

Abstract: We examined spatial patterns of trends in ice phenology and duration for 65 waterbodies across the Great Lakes region (Minnesota, Wisconsin, Michigan, Ontario, and New York) during a recent period of rapid climate warming (1975–2004). Average rates of change in freeze (3.3 d decade21) and breakup (22.1 d decade21) dates were 5.8 and 3.3 times more rapid, respectively, than historical rates (1846–1995) for Northern Hemisphere waterbodies. Average ice duration decreased by 5.3 d decade 21 . Over the same time period, average fall through spring temperatures in this region increased by 0.7uC decade 21 , while the average number of days with snow decreased by 5.0 d decade 21 , and the average snow depth on those days decreased by 1.7 cm decade 21 . Breakup date and ice duration trends varied over the study area, with faster changes occurring in the southwest. Trends for each site were compared to static waterbody characteristics and meteorological variables and their trends. The trend toward later freeze date was stronger in large, low-elevation waterbodies; however, freeze date trends had no geographic patterns or relationships to meteorological variables. Variability in the strength of trends toward earlier breakup was partially explained by spatial differences in the rate of change in the number of days with snow cover, mean snow depth, air temperature (warmer locations showed stronger trends), and rate of change in air temperature. Differences in ice duration trends were explained best by a combination of elevation and the local rate of change in either temperature or the number of days with snow cover.