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To explore whether and how group cognitive-behavioural therapy (GCBT) plus medication differs from medication alone for the treatment of generalized anxiety disorder (GAD).
170 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 (HAMD), the Severity Subscale of Clinical Global Impression Scale (CGI-S), Global Assessment Function (GAF), and the 12-item Short-Form Health Survey (SF-12). Assessments were conducted at baseline, 4-weeks, 8-weeks and 3-monthsfollow-up.
At 4-weeks, HAMA response (GCBT group 57.0% vs. control group 24.4%, p=0.000, Cohen 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-months 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 (OR=2.12, 95% 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 GCBT was effective in changing cognitive style.
To estimate changes in taxed and untaxed beverages by volume of beverage purchased after a sugar-sweetened beverage (SSB) tax was introduced in 2014 in Mexico.
We used household purchase data from January 2012 to December 2015. We first classified the sample into four groups based on pre-tax purchases of beverages: (i) higher purchases of taxed beverages and lower purchases of untaxed beverages (HTLU-unhealthier); (ii) higher purchases of both types of beverages (HTHU); (iii) lower purchases of taxed and untaxed beverages (LTLU); and (iv) lower purchases of taxed beverages and higher purchases of untaxed beverages (LTHU-healthier). Next, we estimated differences in purchases after the tax was implemented for each group compared with a counterfactual based on pre-tax trends using a fixed-effects model.
Areas with more than 50 000 residents in Mexico.
Households (n 6089).
The HTLU-unhealthier and HTHU groups had the largest absolute and relative reductions in taxed beverages and increased their purchases of untaxed beverages. Households with lower purchases of untaxed beverages (HTLU-unhealthier and LTLU) had the largest absolute and relative increases in untaxed beverages. We also found that among households with higher purchases of taxed beverages, the group with lowest socio-economic status had the greatest reduction in purchases of taxed beverages.
Evidence associating the SSB tax with larger reductions among high purchasers of taxed beverages prior to the tax is relevant, as higher SSB purchasers have a greater risk of obesity, diabetes and other cardiometabolic outcomes.
Salt, promoting oxidative stress, contributes to insulin resistance, whereas K, inhibiting oxidative stress, improves insulin sensitivity. Oxidative stress activation of NLRP3 inflammasome is a central player in the induction of insulin resistance. Therefore, we hypothesised that NLRP3 inflammasome may mediate the effects of salt and K on insulin resistance. In all, fifty normotensive subjects were recruited from a rural community of Northern China. The protocol included a low-salt diet for 7 d, then a high-salt diet for 7 d and a high-salt diet with K supplementation for another 7 d. In addition, THP-1 cells were cultured in different levels of Na with and without K. The results showed that salt loading elevated fasting blood glucose, insulin and C-peptide levels, as well as insulin resistance, whereas K supplementation reversed them. Meanwhile, additional K reversed the active effects of high salt on NLRP3 inflammasome in both the subjects and THP-1 cells, and the change of insulin resistance index notably related with the alteration of plasma IL-1β, the index of NLRP3 inflammasome activation, during intervention in the subjects. Additional K ameliorated oxidative stress induced by high salt in both the subjects and cultured THP-1 cells, and the change of oxidative stress related with the alteration of plasma IL-1β during intervention in the subjects. In vitro, antioxidant N-acetyl-l-cysteine significantly prevented the active effects of high Na or oxidant Rosup on NLRP3 inflammasome, so did K. Our study indicates that oxidative stress modulation of NLRP3 inflammasome may be involved in the impacts of Na and K on insulin resistance.
This study aimed to determine the effects of supplementing the diet of adult Nile tilapia Oreochromis niloticus with phosphatidylcholine (PC) on growth performance, body composition, fatty acid composition and gene expression. Genetically Improved Farmed Tilapia fish with an initial body weight of 83·1 (sd 2·9) g were divided into six groups. Each group was hand-fed a semi-purified diet containing 1·7 (control diet), 4·0, 6·5, 11·5, 21·3 or 41·0 g PC/kg diet for 68 d. Supplemental PC improved the feed efficiency rate, which was highest in the 11·5 g PC/kg diet. Weight gain and specific growth rate were unaffected. Dietary PC increased PC content in the liver and decreased crude fat content in the liver, viscera and body. SFA and MUFA increased and PUFA decreased in muscle with increasing dietary PC. Cytoplasmic phospholipase A2 and secreted phospholipase A2 mRNA expression were up-regulated in the brain and heart in PC-supplemented fish. PC reduced fatty acid synthase mRNA expression in the liver and visceral tissue but increased expression in muscle. Hormone-sensitive lipase and lipoprotein lipase expression increased in the liver with increasing dietary PC. Growth hormone mRNA expression was reduced in the brain and insulin-like growth factor-1 mRNA expression in liver reduced with PC above 6·5 g/kg. Our results demonstrate that dietary supplementation with PC improves feed efficiency and reduces liver fat in adult Nile tilapia, without increasing weight gain, representing a novel dietary approach to reduce feed requirements and improve the health of Nile tilapia.
The purpose of this study is to highlight the effectiveness and necessity of the computational methods applications for architecture conceptual designs and improve the use of advanced simulation tools in urban planning. The results can provide the urban designers, planners and other decision makers with useful design information for assessing human wind comfort of the surrounding open spaces of public buildings in an urban area. Among different kinds of public buildings, museum architecture is of significant social value and importance for the augmentation of urban image. Using the Guggenheim Museum Bilbao for the case study, this investigation performed CFD simulations of the airflow over the museum to characterize the wind environments around the buildings. The predicted wind speed distributions were used to determine the wind comfort level of the featured spots around the museum for evaluating the suitability allowing visitors to sit or stand at the pedestrian plane for extended periods.
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.
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.
the goal of this study was to identify important prognostic variables affecting placement of a percutaneous endoscopic gastrostomy (Peg) tube after acute stroke.
We retrospectively reviewed our patient database to identify acute ischemic stroke patients who placed Peg or nasogastric tube (Ngt) tube, but were free of other confounding conditions affecting swallowing. A total of 340 patients were involved in our study. We assessed the influence of age, National Institutes of Health stroke scale (NIHss) score, infarct volume, stroke subtype based on the toAst criteria, swallowing disorders, bilateral lesions in cerebrum and length of stay (los) in a logistic regression analysis.
In univariate analysis, age (p=0.048), NIHss score (p<0.0001), lesion volume (p<0.0001), los (p<0.0001), stroke location (p=0.045), and swallowing disorders (p<0.0001) were found to be the primary predictors of placing Peg. the presence of lesions in bilateral cerebral was included in the final model based on clinical considerations. After multivariate adjustment, only NIHss score (odds ratio [oR], 4.055; 95% confidence interval [CI], 2.398-6.857; p=0.0001), lesion volume (oR, 1.69; 95%CI, 1.09–4.39; p=0.014), swallowing disorders (oR, 1.151; 95% CI, 1.02-1.294; p=0.047), los (oR, 0.955; 95% CI, 0.914-0.998; p=0.0415) and bilateral lesions (oR, 2.8; 95% CI, 1.666-4.705; p=0.0001) remained significant.
our data shows that NIHss score, lesion volume, swallowing disorders, los and bilateral lesions in cerebrum can predict the requiring of Peg tube insertion in patients after stroke.
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.
To obtain highly dispersed and highly active catalysts by impregnating of active species onto the monolith directly, cordierite honeycomb ceramics were modified by nitric acid solution of 68wt%. Effects of acid treatment temperature and time on the performance of cordierite were investigated. Specific surface area, pore size distribution, morphology and structure of cordierite were characterized by N2-physical adsorption, SEM, XRD, respectively. Concentrations of ions in the acid solution were measured by AAS. It is shown that the corrosion content of cordierite increases and more micropores are generated with increasing time of acid treatment, leading to an upward trend of specific surface area. The coefficient of thermal expansion and compression strength decrease obviously at a higher temperature, which is mainly attributed to the removal of Al and Mg ions from the silicate structure and delayed formation of free amorphous silica on the surface of the cordierite. The optimal modification process of cordierite matrix acid erosion is at 110°C for 6 h.
The expression of the YUCAA1 gene and the amount of endogenous indole acetic acid (IAA) in rice (Oryza sativa subsp. japonica) plants and rice suspension cells infected by Rice stripe virus (RSV) were investigated by real-time reverse transcriptase–polymerase chain reaction (RT-PCR) and high-performance liquid chromatography, respectively. The results showed that the expression of the YUCAA1 gene and the amount of endogenous IAA increased at various times (16, 32, 48 and 64 h) after infection of rice suspension cells by RSV. In rice plants infected with RSV, the expression of the YUCAA1 gene and the amount of endogenous IAA increased, in comparison with healthy rice plants, at 4–8 days after infection, and decreased at 12 and 16 days. These results indicated that RSV infection could regulate auxin biosynthesis in rice. Additionally, the expression of the RSV gene CP increased 2.9 times in rice plants after they were treated with a KPSC buffer to deplete the endogenous auxins, and decreased 45% after treatment with 30 μmol/l IAA. All of these results suggest that auxin may play a role in RSV replication in rice plants.
Using microsatellite markers, the genetic structure of nine domestic duck (Anas platyrhynchos) populations in eastern China was analysed. The results showed that the heterozygosity was high in these populations, ranging from 0.5137 to 0.6055, with an average heterozygosity of 0.5523, reflecting the rich diversity. Considerable breed differentiation was observed and 25.65% of the total genetic variation came from breed differences; this low differentiation result affirmed that each breed has its own genetic diversity. The DA genetic distances suggested that greater differentiation existed between populations. The duck populations were clustered into four groups based on neighbour joining (NJ) clustering, and the clustering results showed relationships with duck breed distributions and economic utilization.
Total body fat mass (TBFM) and total body lean mass (TBLM) are the major components of the human body. Although these highly correlated phenotypic traits are frequently used to characterize obesity, the specific shared genetic factors that influence both traits remain largely unknown. Our study was aimed at identifying common quantitative trait loci (QTLs) contributing to both TBFM and TBLM. We performed a whole genome-linkage scan study in a large sample of 3255 subjects from 420 Caucasian pedigrees. Bivariate linkage analysis was carried out in both the entire sample and gender-specific subsamples. Several potentially important genomic regions that may harbour QTLs important for TBFM and TBLM were identified. For example, 20p12-11 achieved a LOD score of 2·04 in the entire sample and, in the male subsample, two genomic regions, 20p12 (LOD=2·08) and 3p26-25 (LOD=1·92), showed suggestive linkage. In addition, two-point linkage analyses for chromosome X showed suggestive linkages on Xp22 in the entire sample (LOD=2·14) and significant linkage on Xp22 in the female subsample (LOD=3·05). Complete pleiotropy was suggested for 20p12 and 3p26-25 in males. Our results suggest that QTLs on chromosomes 20p12, 3p26-25 and Xp22 may jointly influence TBFM and TBLM. Further fine mapping and gene identification studies for these pleiotropic effects are needed.
The genetic diversity of dinitrogen-fixing bacteria associated with rice (Oryza sativa) was assessed by a polymerase chain reaction–restriction fragment length polymorphism (PCR–RFLP) approach on the nifH gene amplified directly from DNA extracted from washed rice roots and rhizospheric soil. Restriction digestion with the enzymes MnlI and HaeIII was performed to characterize 54 cloned nifH PCR products. RFLP profiles were clustered and analysed with the UPGMA program. Eight pairs of similar RFLP patterns (similarity>50%) and two pairs of homologous RFLP patterns (100% identity) were found from the washed roots and the rhizospheric soil, respectively. Three specific diazotrophic patterns were found from rhizospheric soil and rice roots. The analyses have revealed the presence of different nifH types, which appear to be significant components of the diazotrophic community in paddy fields, indicating that some of the diazotrophs may colonize the inside and the surface of the rice roots.
The rabbit defensin gene NP-1 was introduced into embryonic callus cultures of three maize (Zea mays L.) hybrid lines by particle bombardment, and transgenic plants were obtained. Genomic PCR and DNA dot blot analyses confirmed that the NP-1 gene was integrated into the genome of the regenerated T0 maize plants. Genomic PCR and Southern blotting results revealed that the NP-1 gene was transmitted stably from the T0 to the T1 generation. RNA dot blot analysis verified the transcription of the NP-1 gene in T1 plants. When challenged with northern corn leaf blight (Helminthosporium turcicum Pass), the T1 plants expressing the NP-1 gene showed greatly improved resistance to the fungal disease compared with the wild-type maize plants.