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To explore whether and how group cognitive-behavioural therapy (GCBT) plus medication differs from medication alone for the treatment of generalised anxiety disorder (GAD).
Hundred and seventy patients were randomly assigned to the GCBT plus duloxetine (n=89) or duloxetine group (n=81). The primary outcomes were Hamilton Anxiety Scale (HAMA) response and remission rates. The explorative secondary measures included score reductions from baseline in the HAMA total, psychic, and somatic anxiety subscales (HAMA-PA, HAMA-SA), the Hamilton Depression Scale, the Severity Subscale of Clinical Global Impression Scale, Global Assessment of Functioning, and the 12-item Short-Form Health Survey. Assessments were conducted at baseline, 4-week, 8-week, and 3-month follow-up.
At 4 weeks, HAMA response (GCBT group 57.0% vs. control group 24.4%, p=0.000, Cohen’s d=0.90) and remission rates (GCBT group 21.5% vs. control group 6.2%, p=0.004; d=0.51), and most secondary outcomes (all p<0.05, d=0.36−0.77) showed that the combined therapy was superior. At 8 weeks, all the primary and secondary significant differences found at 4 weeks were maintained with smaller effect sizes (p<0.05, d=0.32−0.48). At 3-month follow-up, the combined therapy was only significantly superior in the HAMA total (p<0.045, d=0.43) and HAMA-PA score reductions (p<0.001, d=0.77). Logistic regression showed superiority of the combined therapy for HAMA response rates [odds ratio (OR)=2.12, 95% confidence interval (CI) 1.02−4.42, p=0.04] and remission rates (OR=2.80, 95% CI 1.27−6.16, p=0.01).
Compared with duloxetine alone, GCBT plus duloxetine showed significant treatment response for GAD over a shorter period of time, particularly for psychic anxiety symptoms, which may suggest that GCBT was effective in changing cognitive style.
Owing to the development of new technologies, the epigenome, a second dimensional method for genome analysis has emerged. Epigenetic mechanisms, including DNA methylation, histone modifications and noncoding RNAs, regulate gene expression without changing the genetic sequence. These epigenetic mechanisms normally modulate gene expression, trans-generational effects and inherited expression states in various biological processes. Abnormal epigenetic patterns typically cause pathological conditions, including cancers, age-related diseases, and specific cartilage and bone diseases. Facing the rapidly developing epigenetic field, we reviewed epigenetic mechanisms and their involvement with the skeletal system and their role in skeletal development, homeostasis and degeneration. Finally, we discuss the prospects for the future of epigenetics.
The Chinese Solar and Geophysical Data (CSGD) was first issued at the Beijing Astronomical Observatory, Chinese Academy of Sciences (now the headquarter of the National Astronomical Observatories, Chinese Academy of Sciences) in 1971, when China’s satellite-industry was booming. CSGD covers the observational data (observations of the sunspots, solar flares, solar radio bursts, ionospheric storm and geomagnetic storm) from a couple of domestic observatories and the forecast data. The compiler of CSGD still keeps the data exchange with other institutes worldwide. The type of the dataset includes texts, tables, figures and so on. Up to now, we have electronized all the historic archives, making them easily accessible to people who are interested in them.
Kawasaki disease, which is characterised by systemic vasculitides accompanied by acute fever, is regularly treated by intravenous immunoglobulin to avoid lesion formation in the coronary artery; however, the mechanism of intravenous immunoglobulin therapy is unclear. Hence, we aimed to analyse the global expression profile of serum exosomal proteins before and after administering intravenous immunoglobulin.
Two-dimensional electrophoresis coupled with mass spectrometry analysis was used to identify the differentially expressed proteome of serum exosomes in patients with Kawasaki disease before and after intravenous immunoglobulin therapy.
Our analysis revealed 69 differential protein spots in the Kawasaki disease group with changes larger than 1.5-fold and 59 differential ones in patients after intravenous immunoglobulin therapy compared with the control group. Gene ontology analysis revealed that the acute-phase response disappeared, the functions of the complement system and innate immune response were enhanced, and the antibacterial humoral response pathway of corticosteroids and cardioprotection emerged after administration of intravenous immunoglobulin. Further, we showed that complement C3 and apolipoprotein A-IV levels increased before and decreased after intravenous immunoglobulin therapy and that the insulin-like growth factor-binding protein complex acid labile subunit displayed reverse alteration before and after intravenous immunoglobulin therapy. These observations might be potential indicators of intravenous immunoglobulin function.
Our results show the differential proteomic profile of serum exosomes of patients with Kawasaki disease before and after intravenous immunoglobulin therapy, such as complement C3, apolipoprotein A-IV, and insulin-like growth factor-binding protein complex acid labile subunit. These results may be useful in the identification of markers for monitoring intravenous immunoglobulin therapy in patients with Kawasaki disease.
Children may influence household spending through ‘pester power’. The present study examined pestering through parent–child food shopping behaviours in relation to children’s diet and weight status.
Cross-sectional and prospective analyses drawn from the IDEFICS study, a cohort study of parents and their children. Children’s height and weight were measured and their recent diets were reported by parental proxy based on the Children’s Eating Habits Questionnaire-FFQ at baseline and 2-year follow-up. Parents also completed questionnaires at both time points about pestering, including whether the child goes grocery shopping with them, asks for items seen on television and is bought requested food items.
Participants were recruited from eight European countries for the IDEFICS study (non-nationally representative sample).
Study participants were children aged 2–9 years at enrolment and their parents. A total of 13 217 parent–child dyads were included at baseline. Two years later, 7820 of the children were re-examined.
Most parents (63 %) at baseline reported ‘sometimes’ acquiescing to their children’s requests to purchase specific foods. Pestering was modestly associated with weight and diet. At baseline, children whose parents ‘often’ complied consumed more high-sugar and high-fat foods. Children who ‘often’ asked for items seen on television were likely to become overweight after 2 years (OR=1·31), whereas ‘never’ asking protected against overweight (OR=0·72).
Pestering was modestly related to diet and weight in cross-sectional, but not longitudinal analyses. Asking for items seen on television had the most robust relationships across child outcomes and over time.
The non-equilibrium chemical reacting combustion flows of a proposed long slender scramjet system were numerically studied by solving the turbulent Reynolds averaged Navier-Stokes (RANS) equations. The Spalart-Allmaras one equation turbulence model is used which produces better results for near wall and boundary layer flow field problems. The lower-upper symmetric Gauss-Seidel implicit scheme, which enables results converge efficiently under steady state condition, is combined with the weighted essentially non-oscillatory (WENO) scheme to yield an accurate simulation tool for scramjet combustion flow field analysis. Using the WENO schemes high-order accuracy and its non-oscillatory solution at flow discontinuities, better resolution of the hypersonic flow problems involving complex shock-shock/shock-boundary layer interactions inside the flow path, can be achieved. Two types of scramjet combustor with cavity-based and strut-based fuel injector were considered as the testing models. The flow characteristics with and without combustion reactions of the two types combustor model were studied with a transient hydrogen/oxygen combustion model. The detailed results of aerodynamic data are obtained and discussed, moreover, the combustion properties of varying the equivalent ratio of hydrogen, including the concentration of reacting species, hydrogen and oxygen, and the reacting products, water, are demonstrated to study the combustion process and performance of the combustor. The comparisons of flow field structures, pressure on wall and velocity profiles between the experimental data and the solutions of the present algorithms, showed qualitatively as well as the quantitatively in good agreement, and validated the adequacy of the present simulation tool for hypersonic scramjet reacting flow analysis.
In this paper, the hole carrier mobility of organic semiconductor N,N′-diphenyl-N,N′bis(1,1′-biphenyl)-4,4′-diamine (NPD) was researched by negative differential susceptance spectra (−ΔB = −w(C − Cgeo) ~ f). Under the condition of space charge limited current (SCLC), through solving the drift current equation and Poisson equation and simulating the spectra −ΔB = −w(C − Cgeo) ~ f, the relationship between the peak of −ΔB = −w(C − Cgeo) ~ f spectra (1/ƒp = τp) and the transfer time of carrier (τdc) could be achieved to be τdc = k × τp. So the hole-only device of ITO/NPD/Ag was fabricated to determine the capacitance spectra, and through which its −ΔB = −w(C − Cgeo) ~ f could be plotted. According to the relationship of τdc = k × τp, where k was determined to be 0.56, the transfer time and further the carrier mobility could be obtained. The carrier mobility depended on the electric field according to Poole-Frenkel model was further investigated in this report.
This study aimed to describe the frequency and temporal profile of acute cerebral infarction (ACI) using a continuous glucose monitoring system (CGMS) in patients with and without type 2 diabetes mellitus (T2DM) and explore the impact of blood glucose fluctuations on the short-term prognosis of ACI.
The subjects were divided into four groups: T2DM with acute cerebral infarction (DMCI, Group A, n=56); T2DM without acute cerebral infarction (DM-NCI, Group B, n=36); Acute cerebral infarction patients without T2DM (NDM-CI, Group C, n=54); Healthy control group (NG, Group D, n=36). The National Institutes of Health Stoke Scale (NIHSS) and modified Rankin scale (mRs) were collected in Group A and C. All subjects were monitored for 72 hours using the CGMS. Indices such as fasting blood glucose (FBG) and mean amplitude of glycemic excursions (MAGE) were calculated. Glycemic excursions were compared between Group A, B, C and Group D, respectively. Multiple linear regression analysis and logistic analysis was applied.
MAGE is related to NIHSS, homocysteine (HCY), HOMA-IR, FBG, CRP and IMT, while NIHSS is related to CRP, HCY, HOMA-IR, IMT. The factors impacting the short-term prognosis of ACI were NIHSS, HBA1C and MAGE.
Larger glucose fluctuations are associated with more stroke risk factors and are associated with a poorer short-term prognosis. More attention should be paid to glucose fluctuations in patients with ACI and a history of T2DM.
Three iterative stabilised finite element methods based on local Gauss integration are proposed in order to solve the steady two-dimensional Smagorinsky model numerically. The Stokes iterative scheme, the Newton iterative scheme and the Oseen iterative scheme are adopted successively to deal with the nonlinear terms involved. Numerical experiments are carried out to demonstrate their effectiveness. Furthermore, the effect of the parameters Re (the Reynolds number) and δ (the spatial filter radius) on the performance of the iterative numerical results is discussed.
Energy intake and renal function decrease with age. In patients with chronic kidney disease (CKD), spontaneous food intake decreases in parallel with the loss of renal function. The objective of the present study was to evaluate a possible relationship between renal dysfunction and energy intake in elderly community-dwelling men. A cross-sectional study including 1087 men aged 70 years from the Uppsala Longitudinal Study of Adult Men (ULSAM) community-based cohort was carried out. Dietary intake was assessed using 7 d food records, and glomerular filtration rate was estimated from serum cystatin C concentrations. Energy intake was normalised by ideal body weight, and macronutrient intake was energy-adjusted. The median normalised daily energy intake was 105 (interquartile range 88–124) kJ, and directly correlated with estimated glomerular filtration rate (eGFR) as determined by univariate analysis. Across the decreasing quartiles of eGFR, a significant trend of decreasing normalised energy intake was observed (P =0·01). A multivariable regression model including lifestyle factors and co-morbidities was used for predicting total energy intake. In this model, regular physical activity (standardised β = 0·160; P =0·008), smoking (standardised β = − 0·081; P =0·008), hypertension (standardised β = − 0·097; P =0·002), hyperlipidaemia (standardised β = − 0·064; P =0·037) and eGFR (per sd increase, standardised β = 0·064; P =0·04) were found to be independent predictors of energy intake. Individuals with manifest CKD (eGFR < 60 ml/min per 1·73 m2) were more likely to have lower energy intake than those without. In conclusion, there was a direct and independent correlation between renal function and energy intake in a population-based cohort of elderly men. We speculate on a possible link between renal dysfunction and malnutrition in the elderly.
Acid mine drainage (AMD) commonly contains elevated concentrations of As(III) and/or As(V) due to oxidation of arsenic-containing sulfides. Bone char has been used as a low-cost filling material for passive treatment. The breakthrough curves of As(III) and As(V) were studied in column experiments conducted at different flow rates, adsorption cycle times, and with different coexisting cations and anions to compare their transport behaviours. The experimental data were fitted by the Convection- Diffusion Equation (CDE) and Thomas model with the aim of obtaining retardation factors of As(III) and As(V) and their maximum adsorption capacities, respectively. The maximum adsorption capacities of As(III) and As(V) are 0.214 and 0.335 mg/g, respectively. Coexisting Mn2+ and Al3+ ions can shorten the equilibrium time of As(V) adsorption from 25 h to 8 h, but they have little effect on As(III). The retardation factors of As(III) and As(V) calculated by the CDE model decrease with adsorption cycles from 37 to 20 and 51 to 32, respectively. The Mn2+ and Al3+ ions could enhance retention ability with adsorption cycle time, especially Mn2+ for As(V). Secondary adsorption phenomena were observed only in breakthrough curves of As(V) in the presence of Mn2+ and Al3+. The competitive influences of coexisting arsenic species is As(V) > As(III). Regeneration experiments using distilled water and NaOH solution were completed to quantify the degree of desorption of both As(III) and As(V). The results show that As(V) adsorbed on bone char has better desorption performance than As(III), and the average degrees of desorption of As(III) and As(V) for three desorption experiments are 75% and 31%, respectively.
A meta-analysis was conducted to reach a pooled estimate of the diagnostic accuracy of the SCOFF. The 15 selected studies represented a total of 882 cases and 4350 controls. The main criterion for inclusion was that the primary study had provided diagnostic classification with both a diagnostic reference and with the SCOFF (with five items and a cut-off point of two). The pooled estimates were .80 (sensitivity) and .93 (specificity). The moderator variables gender and type of measure for the diagnostic reference (interview versus psychometric tests) account for part of the observed variability. For diagnostic references based on interviews the estimate of the efficacy improves significantly. For the studies that match this criterion the sensitivity is .882 and the specificity .925 (diagnostic odds ratio, 92.19). The main conclusion was that the five questions of the SCOFF constitute a very useful screening tool, in several languages; it is highly recommended for screening purposes.
Due to the rapid advances in micro-electro-mechanical systems (MEMS), the study of microflows becomes increasingly important. Currently, the molecular-based simulation techniques are the most reliable methods for rarefied flow computation, even though these methods face statistical scattering problem in the low speed limit. With discretized particle velocity space, a unified gas-kinetic scheme (UGKS) for entire Knudsen number flow has been constructed recently for flow computation. Contrary to the particle-based direct simulation Monte Carlo (DSMC) method, the unified scheme is a partial differential equation-based modeling method, where the statistical noise is totally removed. But, the common point between the DSMC and UGKS is that both methods are constructed through direct modeling in the discretized space. Due to the multiscale modeling in the unified method, i.e., the update of both macroscopic flow variables and microscopic gas distribution function, the conventional constraint of time step being less than the particle collision time in many direct Boltzmann solvers is released here. The numerical tests show that the unified scheme is more efficient than the particle-based methods in the low speed rarefied flow computation. The main purpose of the current study is to validate the accuracy of the unified scheme in the capturing of non-equilibrium flow phenomena. In the continuum and free molecular limits, the gas distribution function used in the unified scheme for the flux evaluation at a cell interface goes to the corresponding Navier-Stokes and free molecular solutions. In the transition regime, the DSMC solution will be used for the validation of UGKS results. This study shows that the unified scheme is indeed a reliable and accurate flow solver for low speed non-equilibrium flows. It not only recovers the DSMC results whenever available, but also provides high resolution results in cases where the DSMC can hardly afford the computational cost. In thermal creep flow simulation, surprising solution, such as the gas flowing from hot to cold regions along the wall surface, is observed for the first time by the unified scheme, which is confirmed later through intensive DSMC computation.
The ability of silver (Ag)-containing borate bioactive glass (BG) coatings to improve the biocompatibility and antibacterial properties of titanium (Ti) implants was investigated in vitro and in vivo in a rabbit tibial fracture model. Dense coatings of borate BG (thickness ≈ 20 μm) containing 0, 0.75, and 1.0 wt% Ag2O were prepared by depositing a layer of particles on Ti plates, followed by sintering at 900 °C. The as-prepared coatings had an adhesive strength of 10 ± 1 MPa, and when immersed in an aqueous phosphate (K2HPO4) solution, the coatings converted to hydroxyapatite, releasing Ag+ ions continuously for over 4 wk. After implantation of BG-coated Ti constructs in a rabbit tibial fracture model and of methicillin-resistant Staphylococcus aureus-induced osteomyelitis, the BG coating doped with 1.0 wt% Ag2O was most effective for the simultaneous eradication of the infection and fracture fixation. Implants coated with Ag-containing BG coatings could provide an approach for reducing implant-related bone infection.
With discretized particle velocity space, a multi-scale unified gas-kinetic scheme for entire Knudsen number flows has been constructed based on the kinetic model in one-dimensional case [J. Comput. Phys., vol. 229 (2010), pp. 7747-7764]. For the kinetic equation, to extend a one-dimensional scheme to multidimensional flow is not so straightforward. The major factor is that addition of one dimension in physical space causes the distribution function to become two-dimensional, rather than axially symmetric, in velocity space. In this paper, a unified gas-kinetic scheme based on the Shakhov model in two-dimensional space will be presented. Instead of particle-based modeling for the rarefied flow, such as the direct simulation Monte Carlo (DSMC) method, the philosophical principal underlying the current study is a partial-differential-equation (PDE)-based modeling. Since the valid scale of the kinetic equation and the scale of mesh size and time step may be significantly different, the gas evolution in a discretized space is modeled with the help of kinetic equation, instead of directly solving the partial differential equation. Due to the use of both hydrodynamic and kinetic scales flow physics in a gas evolution model at the cell interface, the unified scheme can basically present accurate solution in all flow regimes from the free molecule to the Navier-Stokes solutions. In comparison with the DSMC and Navier-Stokes flow solvers, the current method is much more efficient than DSMC in low speed transition and continuum flow regimes, and it has better capability than NS solver in capturing of non-equilibrium flow physics in the transition and rarefied flow regimes. As a result, the current method can be useful in the flow simulation where both continuum and rarefied flow physics needs to be resolved in a single computation. This paper will extensively evaluate the performance of the unified scheme from free molecule to continuum NS solutions, and from low speed micro-flow to high speed non-equilibrium aerodynamics. The test cases clearly demonstrate that the unified scheme is a reliable method for the rarefied flow computations, and the scheme provides an important tool in the study of non-equilibrium flow.
The roles of hydrogen plasma radicals on passivation of several kinds of crystallized poly-Si thin films were investigated using optical emission spectroscopy (OES) combined with Hall mobility, Raman spectra, and absorption coefficient spectra. It was found that different kinds of hydrogen plasma radicals are responsible for passivation of dissimilar poly-Si crystallized by different method. Radicals Hα with lower energy are mainly responsible for passivating the poly-Si crystallized by solid phase crystallization (SPC) whose crystallization precursor was made by plasma enhanced chemical vapor deposition (PECVD). Higher energy radicals H* are more effective in passivating defects left over by Ni in poly-Si crystallized by Metal Induced Crystallization (MIC). The highest energy radicals Hβ and Hγ are needed to passivate the defects in poly-Si crystallized by SPC but whose precursor was made by low pressure CVD (LPCVD).
A technique to improve and accelerate aluminum induced crystallization (AIC) by hydrogen plasma is proposed in this paper. Raman spectroscopy and Secondary Ion Mass Spectrometry of crystallized poly-Si thin films show that hydrogen plasma radicals reduce the crystallization time of AIC. This technique shortens the annealing time from 10 hours to 4 hours and increases the Hall mobility from 22.1 cm2/V·s to 42.5 cm2/V·s. The possible mechanism of AIC assisted by hydrogen radicals will also be discussed.