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We previously found that guar gum (GG) and chickpea flour (CPF) added to flatbread wheat flour lowered postprandial blood glucose (PPG) and insulin responses dose dependently. However, rates of glucose influx cannot be determined from PPG, which integrates rates of influx, tissue disposal and hepatic glucose production. The objective was to quantify rates of glucose influx and related fluxes as contributors to changes in PPG with GG and CPF additions to wheat-based flatbreads. In a randomised cross-over design, twelve healthy males consumed each of three different 13C-enriched meals: control flatbreads (C), or C incorporating 15 % CPF with either 2 % (GG2) or 4 % (GG4) GG. A dual isotope technique was used to determine the time to reach 50 % absorption of exogenous glucose (T50 %abs, primary objective), rate of appearance of exogenous glucose (RaE), rate of appearance of total glucose (RaT), endogenous glucose production (EGP) and rate of disappearance of total glucose (RdT). Additional exploratory outcomes included PPG, insulin, glucose-dependent insulinotropic peptide and glucagon-like peptide 1, which were additionally measured over 4 h. Compared with C, GG2 and GG4 had no significant effect on T50 %abs. However, GG4 significantly reduced 4-h AUC values for RaE, RaT, RdT and EGP, by 11, 14, 14 and 64 %, respectively, whereas GG2 showed minor effects. Effect sizes over 2 and 4 h were similar except for significantly greater reduction in EGP for GG4 at 2 h. In conclusion, a soluble fibre mix added to flatbreads only slightly reduced rates of glucose influx, but more substantially affected rates of postprandial disposal and hepatic glucose production.
During and after hospitalisation, older adults are recommended to consume 1·2–1·5 g of protein/kg body weight per d (g/kg per d) to improve recovery. This randomised controlled trial studied the effectiveness of a 12-week intervention with protein-enriched foods and drinks by following-up seventy-five older patients (mean age: 76·8 (sd 6·9) years) during their first 6 months after hospital discharge. Primary outcomes were protein intake and physical performance (measured with Short Physical Performance Battery (SPPB)). Secondary outcomes for physical recovery were gait speed, chair-rise time, leg-extension strength, hand-grip strength, body weight, nutritional status (Mini Nutritional Assessment), independence in activities of daily living (ADL) and physical activity. The intervention group consumed more protein during the 12-week intervention period compared with the control group (P<0·01): 112 (sd 34) g/d (1·5 (sd 0·6) g/kg per d) v. 78 (sd 18) g/d (1·0 (sd 0·4) g/kg per d). SPPB total score, gait speed, chair-rise time, body weight and nutritional status improved at week 12 compared with baseline (time effect P<0·05), but were not different between groups. Leg-extension strength, hand-grip strength and independence in ADL did not change. In conclusion, protein-enriched products enabled older adults to increase their protein intake to levels that are higher than their required intake. In these older adults with already adequate protein intakes and limited physical activity, protein enrichment did not enhance physical recovery in the first 6 months after hospital discharge.
This study presents secondary analyses of a recently published trial in which post-traumatic stress disorder (PTSD) patients with psychosis (n = 108) underwent 8 sessions of trauma-focused treatment, either prolonged exposure (PE) or eye movement desensitisation and reprocessing (EMDR) therapy. 24.1% fulfilled the criteria for the dissociative subtype, a newly introduced PTSD subtype in DSM-5. Treatment outcome was compared for patients with and without the dissociative subtype of PTSD. Patients with the dissociative subtype of PTSD showed large reductions in clinician-administered PTSD scale (CAPS) score, comparable with patients without the dissociative subtype of PTSD. It is concluded that even in a population with severe mental illness, patients with the dissociative subtype of PTSD do benefit from trauma-focused treatments without a pre-phase of emotion regulation skill training and should not be excluded from these treatments.
In patients with psychotic disorders, the effects of psychological post-traumatic stress disorder (PTSD) treatment on symptoms of psychosis, depression and social functioning are largely unknown
In a single-blind randomized controlled trial (RCT) 155 outpatients in treatment for psychosis (61.3% schizophrenic disorder, 29% schizoaffective disorder) were randomized to eight sessions prolonged exposure (PE; n = 53) or eye movement desensitization and reprocessing (EMDR) (n = 55), or a waiting-list condition (WL, n = 47) for treatment of their co-morbid PTSD. Measures were performed on (1) psychosis: severity of delusions (PSYRATS-DRS), paranoid thoughts (GPTS), auditory verbal hallucinations (PSYRATS-AHRS), and remission from psychotic disorder (SCI-SR-PANSS); (2) depression (BDI-II); (3) social functioning (PSP). Outcomes were compared at baseline, post-treatment, 6-month follow-up and over all data points.
Both PE and EMDR were significantly associated with less severe paranoid thoughts post-treatment and at 6-month follow-up, and with more patients remitting from schizophrenia, at post-treatment (PE and EMDR) and over time (PE). Moreover, PE was significantly associated with a greater reduction of depression at post-treatment and at 6-month follow-up. Auditory verbal hallucinations and social functioning remained unchanged.
In patients with chronic psychotic disorders PE and EMDR not only reduced PTSD symptoms, but also paranoid thoughts. Importantly, in PE and EMDR more patients accomplished the status of their psychotic disorder in remission. Clinically, these effects are highly relevant and provide empirical support to the notion that delivering PTSD treatment to patients with psychotic disorders and PTSD deserves increasing recognition and acceptance among clinicians.
Post-traumatic stress disorder (PTSD) is highly prevalent in patients with a psychotic disorder. Because a PTSD diagnosis is often missed in patients with psychosis in routine care, a valid screening instrument could be helpful.
To determine the validity of the Trauma Screening Questionnaire (TSQ) as a screening tool for PTSD among individuals with psychotic disorders.
Among 2608 patients with a psychotic disorder, the rate of trauma exposure was determined and the TSQ was administered to screen for PTSD. PTSD status was verified in 455 patients using the Clinician-Administered PTSD Scale (trial registration: ISRCTN 79584912).
Trauma exposure was reported by 78.2% of the 2608 patients. PTSD prevalence was estimated at 16% (95% CI 14.6–17.4%) compared with 0.5% reported in the patients' clinical charts. A TSQ cut-off score of six predicted PTSD with 78.8% sensitivity, 75.6% specificity, 44.5% correct positives and 93.6% correct negatives.
The TSQ seems to be a valid screening tool for PTSD in patients with a psychotic disorder.
In this paper we present a first supercloseness analysis for higher-order Galerkin FEM applied to a singularly perturbed convection-diffusion problem. Using a solution decomposition and a special representation of our finite element space, we are able to prove a supercloseness property of p + 1/4 in the energy norm where the polynomial order p ≥ 3 is odd.
If a photovoltaic (PV) technology is assessed today in a technical framework, then efficiency is the most commonly addressed parameter, followed by service lifetime. Cost, as the third parameter of the "magic triangle", is even less often reported. However, if a new technology is prepared to enter a market, other important parameters have to be considered, especially if non-standard PV applications are targeted.
Organic photovoltaic (OPV) is a well known but young PV technology of the so called third generation, which offers unique advantages for integrated products such as building integrated photovoltaics (BIPV). In this contribution we would like to highlight some of the advantages and challenges which are specific to the application of OPV in the field of building integration. Architectural design features of OPV include the ability to adapt semi-transparency, color and shape of the module. Moreover, glass-laminated OPV modules are deemed suitable for BIPV because of their ease of integration, good fire resistance, high energy harvest per nominal watt-peak and long lifetimes.
Aims: Advances in medical treatment have resulted in increased life expectancy in congenital heart disease. Consequently, the focus of management has shifted from reducing mortality to reducing long-term morbidity with the goal of improving quality of life. A predictor of quality of life might be N-terminal pro-brain natriuretic peptide, a well-established marker for heart failure. We aimed to determine the association between N-terminal pro-brain natriuretic peptide and quality of life in patients with congenital heart disease. Methods: We collected blood samples from consecutive patients who were initially operated between 1968 and 1980 (47.8% women; mean age 40.2±5.4 years). The 36-item Short-Form Health Survey was completed to assess subjective health status as a measure of quality of life. Analysis was performed for the entire group and for subgroups defined as simple versus complex congenital heart diseases. Median N-terminal pro-brain natriuretic peptide level was 15.2 pmol/L (overall range 1.3–299.3 pmol/L). N-terminal pro-brain natriuretic peptide levels were associated with the subdomain physical functioning (β=−0.074, p=0.031). This association remained significant after adjustment for age and sex (β=−0.071, p=0.038) and after adjustment for age, sex, body mass index, left ventricular function, and renal function (β=−0.069, p=0.048). In complex congenital heart disease, the association between N-terminal pro-brain natriuretic peptide and physical functioning remained significant in multivariable analysis (β=−0.076, p=0.046). No associations were found in the simple congenital heart disease group or on the other health status subdomains. Conclusion: In adults operated for congenital heart disease, N-terminal pro-brain natriuretic peptide is associated with the subdomain physical, primarily in the complex subgroup.
Depressive symptoms are prominent psychopathological features of Huntington's disease (HD), making a negative impact on social functioning and well-being.
We compared the frequencies of a history of depression, previous suicide attempts and current subthreshold depression between 61 early-stage HD participants and 40 matched controls. The HD group was then split based on the overall HD group's median Hospital Anxiety and Depression Scale-depression score into a group of 30 non-depressed participants (mean 0.8, s.d. = 0.7) and a group of 31 participants with subthreshold depressive symptoms (mean 7.3, s.d. = 3.5) to explore the neuroanatomy underlying subthreshold depressive symptoms in HD using voxel-based morphometry (VBM) and diffusion tensor imaging (DTI).
Frequencies of history of depression, previous suicide attempts or current subthreshold depressive symptoms were higher in HD than in controls. The severity of current depressive symptoms was also higher in HD, but not associated with the severity of HD motor signs or disease burden. Compared with the non-depressed HD group DTI revealed lower fractional anisotropy (FA) values in the frontal cortex, anterior cingulate cortex, insula and cerebellum of the HD group with subthreshold depressive symptoms. In contrast, VBM measures were similar in both HD groups. A history of depression, the severity of HD motor signs or disease burden did not correlate with FA values of these regions.
Current subthreshold depressive symptoms in early HD are associated with microstructural changes – without concomitant brain volume loss – in brain regions known to be involved in major depressive disorder, but not those typically associated with HD pathology.
DHA deficiency has been related to skeletal malformations in fish, but high DHA levels have produced controversial results that could relate to the oxidative status of fish tissues in the different reports. In the present study, gilthead seabream (Sparus aurata) larvae were fed deficient, adequate or high DHA levels, or high DHA levels supplemented with the antioxidant α-tocopherol. Larvae fed deficient DHA levels tended to be smaller, and showed the highest incidence of urinary bladder calculi, lordosis and kyphosis and the lowest number of mineralised vertebrae for any given size class. Elevation of dietary DHA increased larval growth and significantly enhanced the expression of the insulin-like growth factor 1 (IGF-1) gene. However, a DHA level increase up to 5 % raised the degree of lipid oxidation in larval tissues and deformities in cranial endochondral bones and in axial skeletal haemal and neural arches. The increase in dietary α-tocopherol supplementation in high-DHA feeds reduced again the occurrence of skeletal deformities. Moreover, the expression of genes coding for specific antioxidants such as catalase, superoxide dismutase or glutathione peroxidase, which neutralised reactive oxygen substances formed by increased dietary DHA, was significantly decreased in larvae fed high α-tocopherol levels. These results denoted the importance of DHA for early bone formation and mineralisation. Low dietary DHA levels delay early mineralisation and increase the risk of cranial and axial skeletal deformities. Excessive DHA levels, without an adequate balance of antioxidant nutrients, increase the production of free radicals damaging cartilaginous structures before bone formation.
The effect of hydrogenation on DX centers was evaluated for both Si- and Se-doped AlxGa1-xAs (x=0.26 and 0.23). MBE-grown AIGaAs:Si and MOCVD-grown AIGaAs:Se epilayers were hydrogenated with either monatomic hydrogen or deuterium from a remote plasma at 250°C for 1h. The passivation and subsequent reactivation kinetics were studied with C-V and DLTS techniques. Reactivation was investigated in the space-charge layer of Schottky diodes under different bias conditions. While the Group VI and Group IV deep donors respond similarly to passivation, they display significantly different reactivation kinetics, with thermal dissociation energies of 1.5 eV and 1.2 eV for Se-H and Si-H, respectively. These values are close to the energies previously determined for reactivation of the Si and Se shallow donors in both AIGaAs and GaAs. Therefore, they are not significantly dependent on the Al concentration (x < 0.30) even for donors residing on the As sublattice. Our results are consistent with the Chang-Chadi model of DX centers.
The passivation and reactivation of As donor dopants in n-type Si was studied with both monatomic hydrogen and deuterium. Hydrogenated Schottky diodes were characterized with C-V and DLTS measurements. The reactivation kinetics of the As-H and As-D complexes were studied in the space-charge layer of reverse biased diodes in the temperature range from 60°C to 120°C. These bias-anneals yield dissociation time constants for As-H, from which an averaged activation energy of 1.17±0.1 eV was determined. Although the dissociation of the As-H complex is appreciably slower than that previously measured for P-H, the activation energy is within about 0.05 eV of that determined previously for the P-H complex (1.2 eV). The depth redistribution of the As-H complexes after bias-annealing agrees with the previous conclusion that hydrogen can assume a negative charge state in n-type Si.
The effect of the diffusion of monatomic hydrogen into InGaAs/AlGaAs quantum wells has been investigated using photoluminescence (PL) and Secondary Ion Mass Spectroscopy (SIMS). The structures were grown by molecular beam epitaxy and hydrogenated with a remote plasma. For In0.2Ga0.8AlxGA1-xAs quantum wells, hydrogenation significant increases the integrated PL intensity from bound excitons at 77 K. The enhancement of the PL is ascribed to removal of nonradiative recombination centers by hydrogen passivation of defects either at the heterojunction interface or within the epilayers. This PL enhancement (and defect passivation) increases as the Al concentration in the AlGaAs layers increases from 0 to 33 at%. A 50% increase of PL intensity is observed for InGaAs/GaAs. For 33 at%, the increase is a factor of 9. We also diffused deuterium into these InGaAs/AlGaAs quantum wells. The enhancement of the PL by deuteration was similar to that by hydrogenation. The isotopie substitution permits the determination of the depth distribution of deuterium in the multilayered structure by SIMS. SIMS results support the conclusion that more defects are passivated in the higher Al concentration samples.
Hydrogen passivation and thermal reactivation of Si donors and Be acceptors were investigated in In0.52Al0.48As grown by molecular beam epitaxy. The semiconducting alloy was passivated by exposure to monatomic hydrogen or deuterium from a remote microwave plasma. The passivation was achieved by exposing the samples to monatomic hydrogen at temperatures between 200 and 250 °C for 1h. The electrical activity of the dopants was monitored by spreading resistance and C-V measurements. The samples were homogeneously doped to concentrations of 1.5×1016 or 6×1017 Si / cm3 and 6×1017 Be / cm3. Both dopants were passivated by more than two orders of magnitude through the epitaxial layers. An additional annealing step (440°C, 5 min) resulted in a complete reactivation of the passivated dopants. In addition to the electrical measurements, secondary ion mass spectroscopy showed that for both the Be- and the Si-doped layers the hydrogen profiles were essentially identical to the dopant profiles throughout the epilayers. This behaviour suggests that hydrogen migration is a dopant-trapping-limited process in n-and p-type In0.52Al0.48As.
Chalcogen (S,Se,Te) -doped silicon samples were hydrogen neutralized by different passivation techniques. The electrically active double-donor densities were determined by DLTS measurements. DLTS spectra reveal that both donor levels recover simultaneously. The activation energy for re-activation of neutralized isolated and pure pair sulphur double-donors is Ea(So/+) = 2,13 ± 0,15 eV and Ea(S2o/+) = 2,1 ± 0,15 eV, respectively.
The effect of planar Si doping on the DX center in AlGaAs is investigated using Capacitance-Voltage and Deep Level Transient Spectroscopy techniques. We observe an increase of approximately six orders of magnitude in the DX center capture cross section in Al.26Ga.74As with planar doped Si spikes of 2×1012cm−2 as compared to conventional homogeneous Si doped Al.26Ga.74As. We also observe a small increase in the DX activation energy which was initiated at a lower planar doping of 4×1011 cm−2 and remained constant for the higher planar doping case. We believe the DX center concentration is not changed by the planar doping levels studied here. A model is proposed to explain the increase in capture cross section based on a biaxial stress state in the planar doped AlGaAs region.
We have characterized particulates from a 1993 11.1 Detroit Diesel Series 60 engine with electronic unit injectors operated using fuels with and without methylcyclopentadienyl manganese tricarbonyl (MMT) and overbased calcium sulfonate added. x-ray photoabsorption (XAS) spectroscopy was used to characterize the diesel particulates. Results reveal a mixture of primarily Mn-phosphate with some Mn-oxide, and Ca-sulfate on the surface of the filtered particulates from the diesel engine.