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We aimed to test a mindfulness-based psychoeducation group (MBPEG), v. a conventional psychoeducation group (CPEG) v. treatment as usual (TAU), in patients with schizophrenia-spectrum disorders over a 24-month follow-up.
This single-blind, multi-site, pragmatic randomized controlled trial was conducted in six community treatment facilities across three countries (Hong Kong, mainland China and Taiwan). Patients were randomly allocated to one of the treatment conditions, and underwent 6 months of treatment. The primary outcomes were changes in duration of re-hospitalizations and mental state (Positive and Negative Syndrome Scale; PANSS) between baseline and 1 week, and 6, 12 and 18 months post-treatment.
A total of 300 patients in each country were assessed for eligibility between October 2013 and 30 April 2014, 38 patients per country (n = 342) were assigned to each treatment group and included in the intention-to-treat analysis. There was a significant difference in the length of re-hospitalizations between the three groups over 24 months (F2,330 = 5.23, p = 0.005), with MBPEG participants having a shorter mean duration of re-hospitalizations than those in the other groups. The MBPEG and CPEG participants had significant differential changes in proportional odds ratios of complete remission (all individual PANSS items <3) over the 24-month follow-up (37 and 26%, respectively), as opposed to only 7.2% of the TAU group (χ2 = 8.9 and 8.0, p = 0.001 and 0.003, relative risk = 3.5 and 3.1, 95% confidence interval 2.0–7.2 and 1.6–6.3).
Compared with TAU and CPEG, MBPEG improves remission and hospitalization rates of people with schizophrenia spectrum disorders over 24 months.
Dentinogenesis imperfecta type II (DGI-II) lacks intrafibrillar mineral with severe compromise of dentin mechanical properties. A Dspp knockout (Dspp–/–) mouse, with a phenotype similar to that of human DGI-II, was used to determine if poly-L-aspartic acid [poly(ASP)] in the “polymer-induced liquid-precursor” (PILP) system can restore its mechanical properties. Dentin from six-week old Dspp–/– and wild-type mice was treated with CaP solution containing poly(ASP) for up to 14 days. Elastic modulus and hardness before and after treatment were correlated with mineralization from Micro x-ray computed tomography (Micro-XCT). Transmission electron microscopy (TEM)/Selected area electron diffraction (SAED) were used to compare matrix mineralization and crystallography. Mechanical properties of the Dspp–/– dentin were significantly less than wild-type dentin and recovered significantly (P < 0.05) after PILP-treatment, reaching values comparable to wild-type dentin. Micro-XCT showed mineral recovery similar to wild-type dentin after PILP-treatment. TEM/SAED showed repair of patchy mineralization and complete mineralization of defective dentin. This approach may lead to new strategies for hard tissue repair.
This study aimed to identify the pattern of post-operative drainage following partial superficial parotidectomy with and without the use of a bipolar vessel-sealing device.
Of the 49 patients undergoing parotidectomies, a bipolar vessel-sealing device was used for 20. Predictive factors included in the analysis were age, sex, body weight, operating time, tumour pathology, and diabetes mellitus, hypertension and smoking status.
In multivariate analyses, body weight (p = 0.026) and non-use of a bipolar vessel-sealing device (p = 0.009) were significantly associated with increased post-operative drainage after 24 hours. There was also a trend towards increased drainage in diabetic patients. Operating times were significantly shorter in the bipolar vessel-sealing device group.
Although 24-hour drainage appears adequate for most patients, in obese and diabetic individuals there is a risk of requiring increased drainage. Therefore, the drain should be left in place for a longer period. The bipolar vessel-sealing device is safe and time-efficient, and decreases the post-operative drainage period.
An uneven neurocognitive profile is a hallmark of autism spectrum disorder (ASD). Studies focusing on the visual memory performance in ASD have shown controversial results. We investigated visual memory and sustained attention in youths with ASD and typically developing (TD) youths.
We recruited 143 pairs of youths with ASD (males 93.7%; mean age 13.1, s.d. 3.5 years) and age- and sex-matched TD youths. The ASD group consisted of 67 youths with autistic disorder (autism) and 76 with Asperger's disorder (AS) based on the DSM-IV criteria. They were assessed using the Cambridge Neuropsychological Test Automated Battery involving the visual memory [spatial recognition memory (SRM), delayed matching to sample (DMS), paired associates learning (PAL)] and sustained attention (rapid visual information processing; RVP).
Youths with ASD performed significantly worse than TD youths on most of the tasks; the significance disappeared in the superior intelligence quotient (IQ) subgroup. The response latency on the tasks did not differ between the ASD and TD groups. Age had significant main effects on SRM, DMS, RVP and part of PAL tasks and had an interaction with diagnosis in DMS and RVP performance. There was no significant difference between autism and AS on visual tasks.
Our findings implied that youths with ASD had a wide range of visual memory and sustained attention impairment that was moderated by age and IQ, which supports temporal and frontal lobe dysfunction in ASD. The lack of difference between autism and AS implies that visual memory and sustained attention cannot distinguish these two ASD subtypes, which supports DSM-5 ASD criteria.
A novel allergy biosensor is designed and fabricated by using thin film bulk acoustic resonator (TFBAR) devices with shear mode ZnO piezoelectric thin films. To fabricate TFBAR devices, the off-axis RF magnetron sputtering method for the growth of piezoelectric ZnO piezoelectric thin films is adopted. The influences of the relative distance and sputtering parameters are investigated. In this report, the piezoelectric ZnO thin films with tilting angle are set by controlling the deposition parameters. The properties of the shear mode ZnO thin films are investigated by X-ray diffraction and scanning electron microscopy. The frequency response is measured using an HP8720 network analyzer with a CASCADE probe station. The resonance frequency of the shear mode is 796.75 MHz. The sensitivity of the shear mode is calculated to be 462.5 kHz·cm2/ng.
Numerical simulations of acoustic radiation from a jet engine inlet are performed using advanced computational aeroacoustics algorithms and high-quality numerical boundary treatments. As a model of modern commercial jet engine inlets, the inlet geometry of the NASA Source Diagnostic Test is used. Fan noise consists of tones and broadband sound. This investigation considers the radiation of tones associated with upstream-propagating duct modes. The primary objective is to identify the dominant physical processes that determine the directivity of the radiated sound. Two such processes have been identified. They are acoustic diffraction and refraction. Diffraction is the natural tendency for an acoustic duct mode to follow a curved solid surface as it propagates. Refraction is the turning of the direction of propagation of a duct mode by mean flow gradients. Parametric studies on the changes in the directivity of radiated sound due to variations in forward flight Mach number, duct mode frequency, azimuthal mode number and radial mode number are carried out. It is found there is a significant difference in directivity for the radiation of the same duct mode from an engine inlet when operating in static condition versus one in forward flight. It will be shown that the large change in directivity is the result of the combined effects of diffraction and refraction.
We study efficient spectral-collocation and continuation methods (SCCM) for rotating two-component Bose-Einstein condensates (BECs) and rotating two-component BECs in optical lattices, where the second kind Chebyshev polynomials are used as the basis functions for the trial function space. A novel two-parameter continuation algorithm is proposed for computing the ground state and first excited state solutions of the governing Gross-Pitaevskii equations (GPEs), where the classical tangent vector is split into two constraint conditions for the bordered linear systems. Numerical results on rotating two-component BECs and rotating two-component BECs in optical lattices are reported. The results on the former are consistent with the published numerical results.
In clinical practice, cam-out failure at the recess-screwdriver interfaces may occur when tightening or removing a bone screw. For titanium-based periarticular fixation, the literature reports have revealed that cold welding at the plate-screw interfaces makes the screw recess especially prone to cam-out failure during screw removal. In this study, the effects of the four recess shapes (cross, hexagon, star, and crest), three torque value (0.8, 1.0, and 1.2N-m), and the three interfacial misfits (0.00, 0.05, and 0.10mm) on the cam-out failure were numerically evaluated. The free-rotation angle, torque-recess angle, slippage-resisting length, and interfacial stress distribution were defined and chosen as comparison indices for the twelve recess-misfit variations. The results revealed that the interfacial slippage, torque transfer, and stress distribution are highly related to both recess shape and interfacial misfit. The stresses of all recesses and screwdrivers consistently initiate at the contact sites. However, the recess profile significantly affects the stress propagation. The stress patterns of the recess and screwdriver are quite different between the cross-star and hexagon-crest groups. The cross-star group is superior to the hexagon-crest group in terms of the torque-recess angle and slippage-resisting length over. This makes the recess of the cross-star group less stressed than its counterpart. However, the volumes of the cross and the star screwdriver are more highly stressed than the hexagon due to the irregular shape and the thinner flange, respectively. The greater torque and misfit increase the performance difference between the four recess designs. In conclusion, the geometry of the cross and star groups provide the better performance of the screw recess in terms of torque-transferring efficiency and slippage-resisting ability. If the screwdriver material is properly strengthened and the stress-concentrating corners are modified, the cross and star groups would be the optimal designs that protects and extends the lifetime of both recess and reused screwdriver.
Modulation of the cellular response by the administration of probiotic bacteria may be an effective strategy for preventing or inhibiting tumour growth. We orally pre-inoculated mice with probiotics Lactobacillus acidophilus NCFM (La) for 14 d. Subcutaneous dorsal-flank tumours and segmental orthotopic colon cancers were implanted into mice using CT-26 murine colon adenocarcinoma cells. On day 28 after tumour initiation, the lamina propria of the colon, mesenteric lymph nodes (MLN) and spleen were harvested and purified for flow cytometry and mRNA analyses. We demonstrated that La pre-inoculation reduced tumour volume growth by 50·3 %, compared with untreated mice at 28 d after tumour implants (2465·5 (sem 1290·4) v. 4950·9 (sem 1689·3) mm3, P < 0·001). Inoculation with La reduced the severity of colonic carcinogenesis caused by CT-26 cells, such as level of colonic involvement and structural abnormality of epithelial/crypt damage. Moreover, La enhanced apoptosis of CT-26 cells both in dorsal-flank tumour and segmental orthotopic colon cancer, and the mean counts of apoptotic body were higher in mice pre-inoculated with La (P < 0·05) compared with untreated mice. La pre-inoculation down-regulated the CXCR4 mRNA expressions in the colon, MLN and extra-intestinal tissue, compared with untreated mice (P < 0·05). In addition, La pre-inoculation reduced the mean fluorescence index of MHC class I (H-2Dd, -Kd and -Ld) in flow cytometry analysis. Taken together, these findings suggest that probiotics La may play a role in attenuating tumour growth during CT-26 cell carcinogenesis. The down-regulated expression of CXCR4 mRNA and MHC class I, as well as increasing apoptosis in tumour tissue, indicated that La may be associated with modulating the cellular response triggered by colon carcinogenesis.
Knowledge of the control of the musculoskeletal system in patients with knee osteoarthritis (OA) during gait is helpful for the development of intervention programs in the management of these patients. The current study aimed to investigate the leg and joint stiffness, aswell as the associated joint kinematics and kinetics, in patients with bilateral medial knee OA during gait. Joint angles, moments and stiffness, as well as leg stiffness from fifteen patients with bilateral knee OA and fifteen normal controls during level walking, were obtained and their values at the beginning and end of single leg stance were compared using a t-test.
Patients with knee OA were found to modulate their leg and joint stiffness through acquired specific biomechanical strategies in order to maintain normal temporal-spatial patterns of gait. During weight acceptance, they increased their leg stiffness with increased knee stiffness but unalterd hip and ankle stiffness. During weight release, they modulated their hip and ankle kinetics with increased knee and ankle stiffness to improve the control stability of the limb with unaltered leg stiffness. It is suggested that muscle strengthening exercise intervention and/or rehabilitation for patients with knee OA should focus on activities that develop and/or maintain functions not only of the knee, but also of the overall lower extremity.
Many patients undergoing allogeneic blood and bone marrow transplantation are expected to survive decades after the procedure, many of whom will develop chronic graft versus host disease (GVHD) and respiratory complications. Contrary to acute GVHD of the Lung where the syndrome is not common or universally recognized, cryptogenic organizing pneumonia (COP, also known as with bronchiolitis obliterans organizing pneumonia or BOOP) and bronchiolitis obliterans syndrome (BOS) are well-recognized complications that are associated with chronic GVHD. BOS and COP can become extremely disabling disorders, resulting in high morbidity and mortality. Therefore, the clinician caring for transplant patients should be familiar with these syndromes.
Recently, the National Institutes of Health Consensus Conference on chronic GVHD published a set of comprehensive recommendations for supportive care of patients with chronic GVHD. These guidelines included recommendations for patients with COP and BOS. The purpose of this chapter is to provide additional details regarding the clinical features, diagnostic approach, and management of these complicated syndromes.
A 49-year-old female with chronic myelogenous leukemia underwent a human leukocyte antigen (HLA)-matched bone marrow transplant from a sibling after failure to respond to imatinib. Her GVHD prophylaxis consisted of methotrexate and cyclosporine, but cyclosporine was switched to tacrolimus due to severe nausea. She did not develop acute GVHD but 7 months posttransplant presented with chronic GVHD (overlap acute-chronic according to the National Institute of Health [NIH] classification) involving the skin, which was treated with oral corticosteroids and tacrolimus.
A linear stability analysis is performed on the interface that forms during directional solidification of a dilute binary alloy in the presence of time-periodic growth rates. The basic state, in which the flat crystal-melt interface advances at a steady rate with an oscillation superimposed, is solved analytically by expanding the governing equations in terms of the assumed-small amplitude of modulation. We find that there is a frequency window of stabilization, in which the Mullins-Sekerka instability can be stabilized synchronously. Outside of the window, large input frequencies may destabilize the Mullins-Sekerka mode. The subharmonic mode, which occurs with small wave numbers, is stabilized with increasing the frequency. As for the modulation amplitude, larger amplitude tends to reduce the synchronous mode while enhance the subharmonic mode.
To describe a series of five patients with isolated fracture of the manubrium of the malleus.
Retrospective case series.
Five patients aged 44–64 years with isolated fracture of the manubrium who presented to our institution over a five-year period (2000–2005).
All patients presented with a history of digitally manipulating the external auditory canal, leading to the manubrial fracture, which we presume was due to a suction-type mechanism. Otomicroscopy often revealed a break in the smooth contour of the manubrium. All patients had air–bone gaps on audiometry, especially at higher frequencies. Tympanometry showed hypermobility of the tympanic membrane in four patients who were tested. Laser-Doppler vibrometry revealed increased umbo velocity in four out of five patients. Four patients were treated conservatively. One patient underwent exploratory tympanotomy with successful ossiculoplasty.
Isolated fracture of the manubrium is a rare condition which may present as sudden-onset hearing loss after digital manipulation of the external auditory canal. The diagnosis can be made on the basis of otomicroscopy, audiometry, tympanometry and laser-Doppler vibrometry. Conservative treatment is often successful.
One of the key predictions of hierarchical galaxy formation models is that a significant fraction of elliptical galaxies form in late merging events. One of the most important diagnostics of such an assembly is the existence of blue spheroidal galaxies, which have spheroid-dominated morphologies and blue colors indicating recent star formation, as an intermediate step in the evolution of elliptical galaxies.
Family intervention in schizophrenia can reduce patient relapse and improve medication adherence, but few studies on this have involved a Chinese population.
To examine the effects of a mutual support group for Chinese families of people with schizophrenia, compared with psychoeducation and standard care.
Randomised controlled trial in Hong Kong with 96 families of out-patients with schizophrenia, of whom 32 received mutual support, 33 psychoeducation and 31 standard care. The psychoeducation group included patients in all the sessions, the mutual support group did not. Intervention was provided over 6 months, and patient- and family-related psychosocial outcomes were compared over an 18-month follow-up.
Mutual support consistently produced greater improvement in patient and family functioning and caregiver burden over the intervention and follow-up periods, compared with the other two conditions. The number of readmissions did not decrease significantly, but their duration did.
Mutual support for families of Chinese people with schizophrenia can substantially benefit family and patient functioning and caregiver burden.
The dielectric response of La- and Dy- doped BiFeO3 thin films to electric- and magnetic fields was measured at microwave frequencies (up to 12GHz) in a temperature range from 25 °C to 300 °C. Interesting phenomena were observed. Significant oscillations in the C(f) characteristic which were unaffected by the electric field or by elevated temperature but which were dampened by a magnetic field. We also observed ‘N’-type I-V characteristics. A possible explanation for this mesoscopic response is the presence of structural features that cause resonance (e.g. grains, grain-boundaries, domains, domain walls etc), with a contribution strong enough to be averaged by the system. The exact origin of these features is unknown at present.
In this paper, location-controlled Silicon crystal grains are fabricated by a novel excimer laser crystallization method. An array of 1.8-μm-sized disk-liked grains are formed by this method, and the high-performance n-channel LTPS TFTs with field-effect-mobility reaching 308 cm2/Vs can be fabricated owing to the artificially-controlled lateral grain growth. This position-manipulated Silicon grains are essential to high performance and good uniformity thin film transistors.