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Evidence indicates that manic symptoms, below the threshold for hypomania (mixed features), are common in individuals with major depressive disorder (MDD).
To evaluate the effect of lurasidone on specific depressive and manic symptoms, based on Montgomery Asberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS) items, in patients with MDD with mixed features.
Patients meeting DSM-IV-TR criteria for MDD, who presented with 2–3 protocol-specified manic symptoms, were randomized to 6 weeks of double-blind treatment with lurasidone monotherapy 20–60 mg/d (n = 109) or placebo (n = 100). Change from baseline in the MADRS total, MADRS-6 core depression subscale, individual MADRS items, and total and individual items of the YMRS were analyzed by MMRM, and Cohen's d effect sizes (d) were calculated for week 6 change scores.
Lurasidone improved depressive symptoms at week 6 in the MADRS total score (–20.5 vs. –13.0; P < 0.0001; d = 0.8) and MADRS-6 core depression score (–13.0 vs. –8.5; P < 0.0001; d = 0.7). Significant improvement on lurasidone was observed at week 6 on all ten MADRS items (d = 0.36–0.78). Effect sizes for the MADRS-6 core depression subscale items ranged from 0.36 to 0.78 at week 6. Treatment with lurasidone was associated with significantly greater week 6 improvement on the YMRS (–7.0 vs. –4.9; P < 0.0001). Effect sizes for the 5 YMRS items with baseline item severity ≥ 2 ranged from 0.32 to 0.48.
In this study of MDD with mixed features, lurasidone was effective in treating the range of depressive and manic symptoms that patients presented with.
Sponsored by Sunovion Pharmaceuticals Inc.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
This paper reported the designed approaches of cycloidal mechanisms, studied its dynamic forces and failure characteristics using finite element methods (FEM). A simplified cycloidal mechanism (CM) is constructed to fulfill dynamic analysis and reliability evaluation. The studied results show that the loads of the mechanism are shared mainly by a half of the outer rollers and the inner pins. The possible failures of the mechanism will occur at the inner pins caused by the bending stress, and at the cycloid disc induced by the contacting stress. The failure of the inner pins will dominate the damage of the mechanism. A method of evaluating stress variation is proposed for fulfilling reliability design. The stress variations are derived according to the data in dynamic analysis by regression analysis. The methods of design modification are reported for improve the reliabilities. The allowable loads of the CM can be decided accordingly based on the analyzed information.
Origami, the ancient paper folding art has inspired the engineering equipment and design for decades. The basic concept of origami is very general, which leads to applications ranging from small scale to large scale. Recently, researchers are interested in being able to create self-folding structures. Such a structure enables kinematic manipulation by external forces or moments without folding and/or unfolding operations. This is a beneficial application for many fields including aerospace systems, robots, small devices and self-assembly systems. In this paper, the investigation and analyses of the previous literatures on the key driving force of the actuation structure, including the heat, light, electricity, gas and other actuation methods. The aims are to provide researchers and practitioners with the support to systematically understand the latest technologies in this important and evolving field, with inspiration and direction for follow-up.
In the recent years, the development of wind turbines has been so hectic in Taiwan. The design of the turbine blades directly impacts power effectiveness. In this study, the effects of manufacturing parameters and environmental factors on the mechanical properties of carbon fiber/epoxy composites that are used in turbine blades are discussed. Parameters of the manufacturing process affect the mechanical properties. Carbon composites made by a different numbers of layers are tested on various aspects of performance such as mechanical strength and corrosion resistance.
This study investigated the flow bifurcations of flows driven by a pressure gradient in a rectangular curved tube. When fluid flows within a curved tube, due to the centrifugal effect, secondary vortices can be induced in the cross section of the tube. The secondary flow states are dependent on the magnitude of the pressure gradient (q) and the aspect ratio (γ). In this study, the continuation method was applied to investigate the flow bifurcations in a curved tube with increasing pressure gradient (1 < q < 6000) and aspect ratio (0.9 < γ < 1.4).
The bifurcation diagrams are composed of solution branches, which are linked by limiting points or bifurcation points. The flow states in a solution branch belong to the same group. The ranges of the flow states and the relationship between the states can also be derived from the bifurcation diagrams. In this study, two types of bifurcation were found, one in the range of 0.9 < γ < 1.17, and another in the range of 1.18 < γ < 1.4. The ranges of stable flow solutions and the distributions of limit and bifurcation points in both pressure gradient and aspect ratio are derived in this study.
The aim of the study was to evaluate the comparative risk of self-harm associated with the use of different antidepressants.
A cohort study was conducted using data from Taiwan's National Health Insurance Research Database from 2001 to 2012. A total of 751 606 new antidepressant users with depressive disorders were included. The study outcome was hospitalization due to self-harm (International Classification of Diseases, Ninth Revision, Clinical Modification codes: E950–E958 and E980–E988). Cox proportional hazards models with stratification of the propensity score deciles were used to estimate the hazard ratios of self-harm hospitalization during the first year following the initiation of antidepressant treatment.
There were 1038 hospitalization episodes due to self-harm that occurred during the follow-up of 149 796 person-years, with an overall incidence rate of 6.9 [95% confidence interval (CI) 6.5–7.4] per 1000. Compared with fluoxetine, the risk of self-harm hospitalization was higher for maprotiline [adjusted hazard ratio (aHR) = 3.00, 95% CI 1.40–6.45], milnacipran (aHR = 2.34, 95% CI 1.24–4.43) and mirtazapine (aHR = 1.40, 95% CI 1.06–1.86), lower for bupropion (aHR = 0.51, 95% CI 0.30–0.86), and similar level of risk was found for other selective serotonin reuptake inhibitors (citalopram, escitalopram, fluvoxamine, paroxetine and sertraline).
The risk of self-harm may vary across different antidepressant drugs. It would be of importance to conduct further research to investigate the influence of antidepressant use on self-harm behaviors.
EVA foams, like all other polymers, also exhibit strain-rate effects and hysteresis. However, currently available approaches for predicting the mechanical response of polymeric foam subjected to an arbitrarily imposed loading history and strain-rate effect are highly limited. Especially, the strain rates in the intermediate rate domain (between 100 and 102 s–1) are extremely difficult to study. The use of data generated through the drop tower technique for implementation in constitutive equations or numerical models has not been considered in past studies. In this study, an experiment including a quasi-static compression test and drop impact tests with a high speed camera was conducted. An inverse analysis technique combined with a finite element model for material parameter identification was developed to determine the stress–strain behavior of foam at different specific strain rates. It was used in this study to simulate multiple loading and unloading cycles on foam specimens, and the results were compared with experimental measurements.
Reducers are extensively used in many machines for reducing the speeds of mechanism. This paper proposed a new design of speed reducers to meet the performance requirements in high rigidness and large speed-reduction ratios. The movements of the reducer are designed based on the principles of differential displacements of the deceleration gear rings. The geometric models of the related components were designed using CAD software. The motions of mechanism were simulated for identifying the feasibility of designing including acquiring the kinematic properties. The mathematical models of structural stresses analysis were proposed so that the bending and contact stresses of the gear rings could be evaluated, accordingly. Finite element methods (FEM) were also used to analyze the structural stresses of the reducer. The studied results showed that the bending fracture of the gear rings would prior to its contacting fracture. The allowable loading of the reducer was then established according to the analyzed results of the maximum stresses on various transmitted torques. The methods of reliability evaluation were reported for considering the strength variation and calculating the reliabilities of the reducer at various loadings. The studied results are useful in structural design, stress analysis and reliability evaluation for developing high speed-reduction mechanisms.
Voice restoration after laryngopharyngectomy can be achieved with an autologous ileocolic flap. We have observed that the length of the flap influences vocal outcome. This investigation aimed to evaluate the association between ileocolic flap length and vocal quality after laryngopharyngectomy.
The charts of patients who underwent voice rehabilitation with an ileocolic flap after laryngopharyngectomy between 1 January 2011 and 30 December 2012 were abstracted. The length of ileum segment in the ileocolic flap was stratified, and voice outcome was evaluated three months post-operatively, while adjusting for confounding variables.
There was a significant association between flap length and loudness, maximum phonation time and sound pressure level (p < 0.05). All three parameters were best in the 10 cm length group.
Voice rehabilitation after laryngopharyngectomy is possible with an ileocolic flap. The optimal ileocolic flap contains a 10 cm ileum segment. Complications are frequent but amenable to revision surgery.
This work is to present a formulation of cloaking or concentrating device in acoustics in which the transformed material could be either having uniform bulk modulus or having homogeneous density tensor. The transformed material parameters, depending on the mapping of physical and virtual coordinates, are often position-varying and anisotropic. This often adds substantial complexity in practical implementation. Here we present a theoretical algorithm that allows us to design a transformation field that could have either uniform bulk modulus or constant density tensor. For cloaking devices with constant bulk modulus, analytical and numerical results are presented for circular as well as for non-circular cloaking devices. Specifically, elliptical and twin-cloak devices are exemplified. To achieve the effect of constant density tensor, we consider only circular geometry. Devices with cloaking or concentrating effects can be exactly formulated. We note, however, that it seems unlikely at this moment to have a transformation device that has constant bulk modulus and constant density tensor at the same time. Nevertheless, we remark the present results are of still sufficient merit in that the uniform material parameters, in either set of material parameters, indeed greatly simplify the practice in real implementations.
In this study the Maximum Likelihood Estimator is utilized to identify the characteristics of failure of class-H insulation by considering accelerated life test data under censored situations from Nelson. The hazard rate function is considered in terms of the reliability, h(R), so-called AE model. The AE model is used to model the failures which are expressed as the serial connection between three modes, namely the turn, phase, and ground. This is the so-called competing failure. The main concern in the present investigation relates to the characteristic of changes in cumulative damage with temperature. The characteristic of the damage process basically change, with less capability of cumulation. The failure tends to be unpredictable in a constant hazard rate situation in much higher temperature environments. The parameters of the model are related to the temperature and follow the Arrhenius law. The numerical results indicate that the AE model is well fitted to the data and gives more information to identify the failure modes with fewer parameters. This is better than the using Weibull distribution with both parameters varied with temperature. According to the predicted lifetime, the turn needs to be rearranged primarily, followed by the phase. The ground mode only has influence on the failure at much higher temperatures.
In this study, the fictitious time integration method (FTIM) is applied to investigate wave propagation over an arbitrary bathymetry with measured uncertainty. The FTIM is used to convert the higher-order elliptic mild-slope equation (EMSE) into a FTIM like EMSE (FTIMEMSE). It has the advantage to describe wave transformation from deep water to shallow water region in a large coastal area with numerical efficiency. The validity of the noise resistance for the measured uncertainty of the bathymetry is also studied. In addition, typical examples for waves propagating over an elliptic shoal rest on a horizontal and sloping bottom is presented. It is concluded that the FTIM is robust in the numerical stability and capable of against the noise of the measurement.
This study introduces an equilibrium approach to price mortality-linked securities in a discrete time economy, assuming that the mortality rate has a transformed normal distribution. This pricing method complements current studies on the valuation of mortality-linked securities, which only have discrete trading opportunities and insufficient market trading data. Like the Wang transform, the valuation relationship is still risk-neutral (preference-free) and the mortality-linked security is priced as the expected value of its terminal payoff, discounted by the risk-free rate. This study provides an example of pricing the Swiss Re mortality bond issued in 2003 and obtains an approximated closed-form solution.
Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an independent risk factor for CVD and has been proposed as a marker of vascular inflammation. Polyunsaturated n-3 fatty acids (FA) and several n-6 FA are known to suppress inflammation and may influence Lp-PLA2 mass and activity. The associations of n-3 and n-6 plasma FA with Lp-PLA2 mass and activity were analysed using linear regression analysis in 2246 participants of the Multi-Ethnic Study of Atherosclerosis; statistical adjustments were made to control for body mass, inflammation, lipids, diabetes, and additional clinical and demographic factors. Lp-PLA2 mass and activity were significantly lower in participants with the higher n-3 FA EPA (β = − 4·72, P< 0·001; β = − 1·53; P= 0·023) and DHA levels (β = − 4·47, β = − 1·87; both P< 0·001). Those in the highest quintiles of plasma EPA and DHA showed 12·71 and 19·15 ng/ml lower Lp-PLA2 mass and 5·7 and 8·90 nmol/min per ml lower Lp-PLA2 activity than those in the first quintiles, respectively. In addition, lower Lp-PLA2 mass and activity were associated with higher levels of n-6 arachidonic acid (β = − 1·63, β = − 1·30; both P< 0·001), while γ-linolenic acid was negatively associated with activity (β = − 27·7, P= 0·027). Lp-PLA2 mass was significantly higher in participants with greater plasma levels of n-6 linoleic (β = 0·828, P= 0·011) and dihomo-γ-linolenic acids (β = 4·17, P= 0·002). Based on their independent associations with Lp-PLA2 mass and activity, certain n-3 and n-6 FA may have additional influences on CVD risk. Intervention studies are warranted to assess whether these macronutrients may directly influence Lp-PLA2 expression or activity.
We investigated gustatory changes in patients with chronic otitis media, before and after middle-ear surgery.
This prospective study included 38 patients with unilateral chronic otitis media. We used taste testing solutions to evaluate each patient's taste function. Intra-operative assessments of the chorda tympani nerve were also compared and analysed.
Patients with chronic otitis media had significantly worse ipsilateral perception of sour, bitter and salty tastes. In patients with good intra-operative preservation of the chorda tympani nerve, there was significant improvement in gustatory function one month post-operatively, compared with the pre-operative baseline. In patients who sustained intra-operative chorda tympani nerve injury, one month post-operative gustatory function was the same as the pre-operative baseline.
Middle-ear surgery for chronic otitis media not only treats the ear but also improves gustatory function in the majority of patients. In patients with intra-operative injury to the chorda tympani nerve, post-operative taste decline is only temporary.
We report production of a self-injected, collimated (8 mrad divergence), 600 pC bunch of electrons with energies up to 350 MeV from a petawatt laser-driven plasma accelerator in a plasma of electron density ne = 1017 cm−3, an order of magnitude lower than previous self-injected laser-plasma accelerators. The energy of the focused drive laser pulse (150 J, 150 fs) was distributed over several hot spots. Simulations show that these hot spots remained independent over a 5 cm interaction length, and produced weakly nonlinear plasma wakes without bubble formation capable of accelerating pre-heated (~1 MeV) plasma electrons up to the observed energies. The required pre-heating is attributed tentatively to pre-pulse interactions with the plasma.
We report formation of thin silicon oxide films on the silicon surfaces by combination of oxygen radical and high pressure H2O vapor heat treatment for passivation of silicon surfaces at a low temperature. Oxygen plasma was generated by 13.56 MHz radio frequency induction-coupled remote plasma with mixed gases of O2 and Ar at 2 sccm, 2x10-2 Pa and at a power of 50 W. Oxygen radical was produced from the plasma via a metal mesh closing plasma in the reactor. The top surfaces of 20 Wcm n-type silicon substrates with the rear surface coated by thermally grown SiO2 layers were exposed by oxygen radical from 1 to 5 min to oxidize the silicon surface. The samples were subsequently annealed with 9.0x105 Pa H2O vapor heat treatment at 260oC for 3 h. The effective minority carrier lifetime estimated using photo-induced carrier microwave absorption system in the case of 635 nm light illumination at 1.5 mW/cm2 to the top surface increased from 1.3x10-4 to 5.1x10-4s as the oxygen radical treatment duration increased from 1 to 5 min. The recombination velocity decreased from 380 to 90 cm/s. 500 kHz capacitance response with bias gate voltages characteristics of metal oxide semiconductor structure resulted in the effective oxide thicknesses (EOT) ranging from 1.3 to 1.7 nm. These results indicate a capability of thin oxide formation and effective passivation of silicon surfaces at a low temperature.
There is significant interest in optical sensors whose fabrication process is fully compatible with existing flat panel display thin film transistor (TFT) technology. Here, we report a field-effect phototransistor with a channel comprising a thin nanocrystalline silicon (nc-Si:H) transport layer and a thicker hydrogenated amorphous silicon (a-Si:H) absorption layer. The implementation of nc-Si:H layer improves device stability in comparison with a-Si:H phototransistors, resulting in reduced threshold voltage shift. Semiconductor and dielectric layers were deposited by radio-frequency plasma enhanced chemical vapor deposition at 280°C. The device characterization included the dark and light transfer characteristics, spectral-response and dynamic measurements. The external quantum efficiency was measured as a function of incident photon flux at different biasing conditions. The phototransistor with channel length of 24 microns and photosensitive area of 1.4 mm2shows an off-current of about 1 pA, and photo-conductive gain up to 200 at low incident intensities. Thus, the results demonstrate the feasibility of the phototransistor for low light level detection.
The dark current-voltage characteristics of PIN structures are studied and analyzed for PV samples as for integral device without taking account the performance of the different elements typically used in equivalent circuit model such as diode n-factor, shunt and series resistances. The contribution of all these elements is very important in the development of devices because they determine the performance characteristics. In this work we have studied and compared the temperature dependence of current-voltage characteristics in μc-Si:H and pm-Si:H p-i-n structures having approximately the same efficiencies with emphasis on their different electronic characteristics such as shunt (Rsh) and series (Rs) resistance, ideality factor (n), and the saturation current (Is), which give us some ideas on role of these elements. In the pm-Si:H cell it was observed that the Rs increases with the increase of the temperature in contrast to the μc-Si:H structures, where the series resistance reduces with temperature change from T = 300 up to 480K. In both the pm-Si:H and μc-Si:H samples Rshreduces with temperature change from 300 up to 480 K. The ideality factor in the pm-Si:H structure shows an increase, and in μc-Si:H a reduction, when temperature increases. Saturation current in both cases increases with temperature as it was expected. From the saturation current it was obtained the build-in potential. Analysis behavior of both saturation current and n-factor with temperature shows that build-in potential increases with temperature in the pm-Si:H, but reduces in μc-Si:H structure.