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After MRI studies suggested the efficacy of ethyl-EPA in reducing the progressive brain atrophy in Huntington disease (HD), trials were conducted to test its efficacy as a treatment for HD. Trials that continued for 6 months did not find any significant improvement, urging discontinuation of the drug. However, trials that continued for 12 months indicated improvement of motor functions in these patients.
We searched 12 electronic databases to find randomised clinical trials relevant to our inclusion criteria. After screening, only five papers were included. Continuous and binary variables were analysed to compute the pooled mean difference (MD) and risk ratio (RR), respectively. Quality effect model meta-analysis was used as a post hoc analysis for studies at 12 months.
Meta-analysis indicated that ethyl-eicosapentaenoic acid (EPA) has no significant effect on any scale of HD at 6 months. At 12 months, two studies suggested significant improvements of the Total Motor Score and Total Motor Score–4 in both fixed and quality effect models [MD = −2.720, 95% CI (−4.76, –.68), p = 0.009; MD = −2.225, 95% CI (−3.842, −0.607), p = 0.007], respectively. Maximal chorea score showed significant results [MD = −1.013, 95% CI (−1.793, −0.233), p = 0.011] in only fixed-effect model, while no improvement was detected for Stroop colour naming test or symbol digit modality.
Meta-analysis indicated a significant improvement of motor scores only after 12 months. These results should be interpreted cautiously because only two studies had assessed the efficacy of ethyl-EPA after 12 months with one of them having a 6-month open-label phase.
Microstructures of epitaxial Ca0.33CoO2 thin films, which were grown on m plane and c(0001) plane of α–Al2O3 by the reactive solid-phase epitaxy (R-SPE) method and the subsequent ion-exchange treatment, were investigated in detail by using selected-area electron diffraction, high-resolution transmission electron microcopy, spherical-aberration-corrected high-angle annular dark-field scanning transmission electron microscopy (Cs-corrected HAADF-STEM), and electron energy-loss spectroscopy (EELS). Detailed electron diffraction analyses reveal that the orientation relationships between Ca0.33CoO2 thin film and substrate are and , having an angle of about 43° with for the film deposited on m plane, and and for the film deposited on c(0001) plane though a Ca–Al–O amorphous layer formed between them. CoO seed layer near the interface and residual Co3O4 phase inside the films were observed and identified by HAADF-STEM and EELS in both samples. Such microstructural configuration indicates that the processes of film growth during R-SPE are (i) oxidation of CoO into Co3O4 with residual CoO layer near the interface and (ii) intercalation of Na+ layer into Co3O4 to achieve the layered NaxCoO2 film while forming Na–Al–O amorphous layer at the interface.
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