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To examine the Efficacy and side effects of modified electroconvulsive therapy (MECT) combined with antipsychotic medication in treatment-refractory schizophrenia(TRS).
the 39 patients with TRS who had received antipsychotic medication were assigned to receive MECT, and the Positive and Negtive Syndrome Scale (PANSS) ,Treatment Emergent Symptoms Scale (TESS) and Wechsler Memory Scale were used to measure therapeutic efficacy ,side effects and memory function.
The PANSS scores decreased significantly at 1,4,12 weeks after MECT (P<0.01), and the efficacy ratio of MECT at 1,4,12 weeks treatment was 5%,26%,23% respectively. No significant difference was found on the scores of TESS between before and after endpoint treatment of MECT. The WMS scores decreased significantly at 1 day after endpoint of MECT, but there was no significant difference between before and after 1,2 weeks of endpoint treatment of MECT.
MECT was effective in TRS case, and it had little side effects and a little effect on memory temporarily.
Restless legs syndrome (RLS) is a neurological disorder characterized by an urge to move and uncomfortable sensations. Genetic studies have identified polymorphisms in up to 19 risk loci, including MEIS1 and BTBD9. Rodents deficient in either homolog show RLS-like phenotypes. However, whether MEIS1 and BTBD9 interact in vivo is unclear. Here, with C. elegans, we observed that the hyperactive egg-laying behavior caused by loss of BTBD9 homolog was counteracted by knockdown of MEIS1 homolog. This was further investigated in mutant mice with Btbd9, Meis1, or both knocked out. The double knockout mice showed an earlier onset of the motor deficit in a wheel running test but did not have increased sensitivity to heat stimuli as observed in single knock outs. Meis1 protein level was not influenced by Btbd9 deficiency, and Btbd9 transcription was not affected by Meis1 haploinsufficiency. Our results demonstrate that MEIS1 and BTBD9 do not regulate each other.
Many clinical trials showed favorable effects of high-doses supplemental n-3 polyunsaturated fatty acids (PUFA) on cardio-metabolic risk factors. However, limited studies examined the prospective associations of circulating n-3 PUFA with body fat and its distribution, metabolic syndrome (MS), carotid atherosclerosis, and nonalcoholic fatty liver disease (NAFLD) in subjects with habitual diets containing low levels of n-3 PUFA.
Materials and Methods
This community-based prospective study enrolled 4048 participants (40–75 years) at baseline (2008–2010, 2013) from Guangzhou, China. They were followed-up approximately once every 3 years. Fatty acids in erythrocyte membranes were measured at baseline. We determined metabolic syndrome factors, body fat by DXA scanning, carotid intima-media thickness (IMT) and NAFLD by ultrasound at the visits. General information, anthropometric indices, habitual dietary intake and other covariates were assessed at each visit.
Among the total 4048 subjects, 3075 and 2671 subjects had erythrocyte n-3 PUFA data and completed the first and second follow-ups. Generally, erythrocyte n-3 PUFA were favorably associated with body fat (particularly at abdomen) and its changes, and with the presence and incidence of MS, type 2 diabetes, carotid IMT thickening. The participants with the highest (vs lowest) quartile of n-3 PUFA were associated with -5.81% fat mass (p < 0.001) and -2.11% of fat mass change at the abdomen (Android) area. The adjusted hazards ratios (95% CI) for the highest (vs. lowest) group were 0.74 (0.61, 0.89) (total n-3 PUFA), 0.71 (0.59, 0.86) (docosahexaenoic acid, DHA), 0.78 (0.65, 0.95) (docosapentaenoic acid, DPA), 1.96 (1.60, 2.40) (gamma-linolenic acid, GLA) for MS; 0.70(0.55, 0.90) (total n-3 PUFA), 0.67(0.52,0.87) (DHA) and 0.73(0.57,0.93) (DPA) for bifurcation IMT thickening, 0.57(0.38, 0.86) (eicosapentaenoic acid, EPA) and 0.63 (0.41, 0.95) (DPA) for type 2 diabetes, and 1.18 (1.09, 1.33) (DHA) for alleviated NAFLD. Both higher levels of total and individual marine n-3 PUFAs (DHA, EPA and DPA) were associated with lower blood pressure at baseline and lower changes in diastolic and systolic blood pressure over the follow-up period. Plant n-3 PUFA (α-linolenic acid, ALA) largely had less significant association with the above-mentioned indices as compared with marine n-3 PUFAs.
Higher proportions of erythrocyte n-3 PUFA (particularly marine sources) was associated with lower body fat, blood pressure and their changes, and lower risks of MS, type 2 diabetes and bifurcation IMT thickening, but higher chance of alleviated NAFLD in middle-aged and older adults.
1819 represents a highly charged moment in the Singapore imagination. It marks the birth of our modern city-state, yet it also signals the beginning of our colonisation: the domination of Malay and other Asian cultures by Western powers. Artists have thus responded to the event with widely variant attitudes, ranging from E.W. Jesudason's laudatory Raffles Institution Anthem (c.1963–66) to Isa Kamari's stridently anti-colonial novel, Duka Tuan Bertakhta / 1819 (2011). The prevailing sentiment, however, has been one of playful ambivalence. While accepting the fact of colonisation, artists have rejected a founding myth that glorifies our primary colonist, Sir Stamford Raffles. Instead, we have lampooned him in works like Robert Yeo's play The Eye of History (1991) and Colin Goh's film Talking Cock: The Movie (2002); raised ourselves to the height of his statue in Lee Wen's art event Untitled (Raffles) (2001); highlighted narratives of overlooked figures in the drama of colonisation: William Farquhar, Sophia Raffles, Nonio Clement, Sultan Hussein Shah, Munsyi Abdullah, and Sang Nila Utama. As a cultural researcher and author of the biographical drama The Last Temptation of Stamford Raffles (2008), I shall examine trends behind these divergent representations of our colonisation. I argue that artists have chosen to retell 1819 not as a year of conquest, but as a polymorphous moment of transformative contact between East and West; one in which we may view ourselves, not as the victims of change, but as its agents.
Maternal supraphysiological estradiol (E2) environment during pregnancy leads to adverse perinatal outcomes. However, the influence of oocyte exposure to high E2 levels on perinatal outcomes remains unknown. Thus, a retrospective cohort study was conducted to explore the effect of high E2 level induced by controlled ovarian stimulation (COH) on further outcomes after frozen embryo transfer (FET). The study included all FET cycles (n = 10,581) between 2014 and 2017. All cycles were categorized into three groups according to the E2 level on the day of the human Chorionic Gonadotropin trigger. Odds ratios (ORs) and their confidence intervals (CIs) were calculated to evaluate the association between E2 level during COH and pregnancy outcomes and subsequent neonatal outcomes. From our findings, higher E2 level was associated with lower percentage of chemical pregnancy, clinical pregnancy, ongoing pregnancy, and live birth as well as increased frequency of early miscarriage. Preterm births were more common among singletons in women with higher E2 level during COH (aOR1 = 1.93, 95% CI: 1.22–3.06; aOR2 = 2.05, 95% CI: 1.33–3.06). Incidence of small for gestational age (SGA) was more common in both singletons (aOR1 = 2.01, 95% CI: 1.30–3.11; aOR2 = 2.51, 95% CI: 1.69–3.74) and multiples (aOR1 = 1.58, 95% CI: 1.03–2.45; aOR2 = 1.99, 95% CI: 1.05–3.84) among women with relatively higher E2 level. No association was found between high E2 level during COH and the percentage of macrosomia or large for gestational age. In summary, oocyte exposure to high E2 level during COH should be brought to our attention, since the pregnancy rate decreasing and the risk of preterm birth and SGA increasing following FET.
Previous studies have shown that the Dietary Approaches to Stop Hypertension (DASH) diet might contribute to managing risk factors of non-alcoholic fatty liver disease (NAFLD), but evidence is limited. We examined the association of DASH diet score (DASH-DS) with NAFLD, as well as the intermediary effects of serum retinol-binding protein-4 (RBP4), serum high-sensitivity C-reactive protein (hs-CRP), serum TAG, homeostasis model assessment of insulin resistance (HOMA-IR) and BMI.
We performed a cross-sectional analysis of a population-based cohort study. Dietary data and lifestyle factors were assessed by face-to-face interviews and the DASH-DS was then calculated. We assessed serum RBP4, hs-CRP and TAG and calculated HOMA-IR. The presence and degree of NAFLD were determined by abdominal sonography.
Guangzhou Nutrition and Health Study participants, aged 40–75 years at baseline (n 3051).
After adjusting for potential covariates, we found an inverse association between DASH-DS and the presence of NAFLD (Ptrend = 0·009). The OR (95 % CI) of NAFLD for quintiles 2–5 were 0·78 (0·62, 0·98), 0·74 (0·59, 0·94), 0·69 (0·55, 0·86) and 0·77 (0·61, 0·97), respectively. Path analyses indicated that a higher DASH-DS was associated with lower serum RBP4, hs-CRP, TAG, HOMA-IR and BMI, which were positively associated with the degree of NAFLD.
Adherence to the DASH diet was independently associated with a marked lower prevalence of NAFLD in Chinese adults, especially in women and those without abdominal obesity, and might be mediated by reducing RBP4, hs-CRP, TAG, HOMA-IR and BMI.
We examine the effects of a temporary suspension of short-sale price tests on the options market. Consistent with the notion that put option trading substitutes for short selling, we find a significant reduction in put option volume. In addition, pressure on put option prices significantly declines, violations of the put-call parity become significantly less frequent, and option volume becomes less informed. Our findings add clarity to a long-standing debate on whether investors use options to circumvent equity short-selling restrictions.
Discovering knowledge from data is a quantum jump from quantity to quality, which is the characteristic and the spirit of the development of science. Symbolic regression (SR) is playing a greater role in the discovery of knowledge from data, specifically in this era of exponential data growth, because SRs are able to discover mathematical formulas from data. These formulas may provide scientifically meaningful models, especially when combined with domain knowledge. This article provides an overview of SR applications in the field of materials science and engineering. Integrating domain knowledge with SR is the key and a crucial approach, which allows gaining knowledge from data quickly, accurately, and scientifically. In the data-driven paradigm, SR allows for uncovering the underlying mechanisms of materials behavior, properties, and functions, in a wide range of areas from basic academic research to industrial applications, including experiments and computations, by providing explicit interpretable models from data, in comparison with other machine-learning “black-box” models. SR will be a powerful tool for rational and automatic materials development.
Population-based colorectal cancer (CRC) screening programs that use a fecal immunochemical test (FIT) are often faced with a noncompliance issue and its subsequent waiting time (WT) for those FIT positives complying with confirmatory diagnosis. We aimed to identify factors associated with both of the correlated problems in the same model.
A total of 294,469 subjects, either with positive FIT test results or having a family history, collected from 2004 to 2013 were enrolled for analysis. We applied a hurdle Poisson regression model to accommodate the hurdle of compliance and also its related WT for undergoing colonoscopy while assessing factors responsible for the mixture of the two outcomes.
The effect on compliance and WT varied with contextual factors, such as geographic areas, type of screening units, and level of urbanization. The hurdle score, representing the risk score in association with noncompliance, and the WT score, reflecting the rate of taking colonoscopy, were used to classify subjects into each of three groups representing the degree of compliance and the level of health awareness.
Our model was not only successfully applied to evaluating factors associated with the compliance and the WT distribution, but also developed into a useful assessment model for stratifying the risk and predicting whether and when screenees comply with the procedure of receiving confirmatory diagnosis given contextual factors and individual characteristics.
For the first time, an experiment has been conducted to investigate synthetic jet laminar vortex rings impinging onto porous walls with different geometries by time-resolved particle image velocimetry. The geometry of the porous wall is changed by varying the hole diameter on the wall (from 1.0 mm to 3.0 mm) when surface porosity is kept constant (
). The finite-time Lyapunov exponent and phase-averaged vorticity field derived from particle image velocimetry data are presented to reveal the evolution of the vortical structures. A mechanism associated with vorticity cancellation is proposed to explain the formation of downstream transmitted vortex rings; and both the vortex ring trajectory and the time-mean flow feature are compared between different cases. It is found that the hole diameter significantly influences the evolution of the flow structures on both the upstream and downstream sides of the porous wall. In particular, for a porous wall with a small hole diameter (
, 0.10 and 0.133), the transmitted finger-type jets will reorganize into a well-formed transmitted vortex ring in the downstream flow. However, for the case of a large hole diameter of
, the transmitted vortex ring is not well formed because of insufficient vorticity cancellation. Additionally, the residual vorticity gradually evolves into discrete jet-like structures downstream, which further weaken the intensity of the transmitted vortex ring. Consequently, the transmitted flow structures for the
case would lose coherence more easily (or probably even transition to turbulence), resulting in a faster decay of the axial velocity and stronger entrainment of the transmitted jet. For all porous wall cases, the velocity profile of the transmitted jet exhibits self-similar behaviour in the far field (
), which agrees well with the velocity distribution of free synthetic jets. With the help of the control-volume approach, the time-mean drag of the porous wall is evaluated experimentally for the first time. It is shown that the porous wall drag increases with the decrease in the hole diameter. Moreover, for a porous wall with a small hole diameter (
, 0.10 and 0.133), it appears that the porous wall drag mainly derives from the viscous effect. However, as
increases to 0.20, the form drag associated with the porous wall geometry becomes significant.
Index mining is a new discipline that aims to search for the composite measures or indices most relevant to the contexts or outcomes. After reviewing three frailty indices and principal component (PC)-based indices, we hereby show certain occasions that can lead to ineffective indices, which consist of bias or fail to represent the theories.
We reproduced and reviewed the three frailty indices and the 134,689 PC (principal component) -based indices from previous publications. The impact of aggregating the input variables on the final indices was analyzed using forward stepwise regression.
Several methods to combine the input variables were related to ineffective projection of information onto the indices. The most common causes leading to ineffective summation of input variables were shown in three examples involving different types of input variables, which were positively or negatively correlated or uncorrelated to the outcome. Ineffective indices were created often because of the summation of redundant information or uncorrelated variables.
The creation of ineffective indices can be avoided if the relationships between input variables and outcomes are properly scrutinized. The creation of composite measures and indices is still a discipline under active development. The three examples we identified are the mistakes that may be repeated unintentionally and need to be addressed with explicit rules. A reporting guide for the creation of composite measures has been proposed. A proper review of index objectives, data characteristics, and data limitations before creating composite measures or indices is recommended.
Principal component analysis (PCA) is important to summarize data or reduce dimensionality. However, one disadvantage of using PCA is the interpretability of the principal components (PCs), especially in a high-dimensional database. This study aims to analyze the patterns of variance accumulation according to PCA loadings and to approximate PCs with input variables from sample data sets.
There were three data sets of various sizes used to understand the performance of PC approximation: Hitters; SF-12v2 subset of the 2004 to 2011 Medical Expenditure Panel Survey (MEPS); and, the full set of 1996 to 2011 MEPS data. The variables in three data sets were first centered and scaled before PCA. PCs approximation was studied with two approaches. First, the PC loadings were squared to estimate the variance contribution by variables to PCs. The other method was to use forward-stepwise regression to approximate PCs with all input variables.
The first few PCs represented large portions of total variances in each data set. Approximating PCs using stepwise regression could more efficiently identify the input variables that explain large portions of PC variances than approximating according to PCA loadings in three data sets. It required few numbers of variables to explain more than eighty percent of the PC variances.
Approximating and interpreting PCs with stepwise regression is highly feasible. Approximating PCs can help i) interpret PCs with input variables, ii) understand the major sources of variances in data sets, iii) select unique sources of information and iv) search and rank input variables according to the proportions of PC variance explained. This is an approach to systematically understand databases and search for variables that are highly representative of databases.
Composite measures and indices are used in medical research to represent certain concepts that cannot be measured with one variable. They can be used to predict outcomes or serve as outcomes in trials. The creation of innovative indices is important to increase publications and secure research funding. However, some assumptions and problems are prevalent among indices. We aim to develop a reporting guide and an appraisal tool for indices based on the issues we identified.
We reproduced the three frailty indices from a previous publication and 134,689 principal component-based indices. We reviewed the index assumptions, bias introduced by data processing, relationships between input variables. We interpreted the indices with input variables.
We identified four major issues to be addressed in a reporting guide: constraints imposed by index creation on the input variables; data processing without evidence base; indices poorly linked to input variables; and, relatively inferior predictive power. We demonstrated a flow diagram and a checklist to report and review these four issues related to innovative indices.
A reporting and critical appraisal tool for innovative indices is lacking and needed. These four issues that need to be explicitly considered are previously neglected. This guide is the first attempt to improve the quality and generalizability of innovative indices. This guide can be used to lead further discussion with other experts and review committees.
Principal component analysis (PCA) is used for dimension reduction and data summary. However, principal components (PCs) cannot be easily interpreted. To interpret PCs, this study compares two methods to approximate PCs. One uses the PCA loadings to understand how input variables are projected to PCs. The other uses forward-stepwise regression to determine the proportions of PC variances explained by input variables.
Two data sets derived from the Canadian Health Measures Survey (CHMS) were used to test the concept of PC approximation: a spirometry subset with the measures from the first trial of spirometry; and, full data set that contained representative variables. Variables were centered and scaled. PCA were conducted with 282 and twenty-three variables respectively. PCs were approximated with two methods.
The first PC (PC1) could explain 12.1 percent and 50.3 percent of total variances in respective data sets. The leading variables explained 89.6 percent and 79.0 percent of the variances of PC1 in respective data sets. It required one and two variables to explain more than 80 percent of the variances of PC1, respectively. Measures related to physical development were the leading variables to approximate PC1 and lung function variables were leading to approximate PC2 in the full data set. The leading variable to approximate PC1 of the spirometry subset were forced expiratory volume (FEV) 0.5/forced vital capacity (FVC) (percent) and FEV1/FVC (percent).
Approximating PCs with input variables were highly feasible and helpful for the interpretation of PCs, especially for the first PCs. This method is also useful to identify major or unique sources of variances in data sets. The variables related to physical development are the variables related to the most variations in the full data set. The leading variable in the spirometry subset, FEV0.5/FVC (percent), is not well studied for its application in clinical use.
Apathy is a condition characterized by a lack of motivation that manifests in emotional, behavioral, and cognitive domains. Although previous studies have indicated that apathy is associated with frontal lesions, few studies have focused on the different subdomains of apathy, and no in vivo human biochemical data have been obtained to examine the neurochemical changes related to apathy in patients with Alzheimer's disease (AD). Thus, we investigated the frontal neurochemical alterations related to apathy among patients with AD using proton magnetic resonance spectroscopy (1H MRS).
Apathy was assessed through the Apathy Evaluation Scale (AES). 1H MRS was performed to measure neurochemical metabolite levels in the anterior cingulate region and right orbitofrontal region. Associations between neurochemical metabolites and the total score and subscores of each domain of the AES were analyzed.
Altogether, 36 patients completed the study. Patients with lower N-acetylaspartate/creatine ratios (NAA/Cr) in the anterior cingulate region demonstrated higher total apathy scores (β = −0.56, p = 0.003) with adjustments for age, gender, educational level, dementia severity, and depression severity. In a further analysis, a lower NAA/Cr in the anterior cingulate region was associated with all subdomains of apathy, including cognition (β = −0.43, p = 0.028), behavior (β = −0.55, p = 0.002), and emotion (β = −0.50, p = 0.005). No statistically significant associations were discovered in the right orbitofrontal region.
Our results suggest that apathy, in each of its cognitive, behavioral, or emotional subdomains is associated with brain neurochemical alterations in the anterior cingulate region. Abnormal neuronal integrity over the anterior cingulate cortex may exhibit a central role in causing all aspects of apathy in patients with AD.
The predictability of modified constitutive model, based on Arrhenius type equation, for illustrating the flow behavior of Fe–36%Ni Invar alloy was investigated via isothermal hot compression tests. The hot deformation tests were carried out in a temperature range of 850–1100 °C and strain rates from 0.01 to 10 s−1. True stress-true strain curves exhibited the dependence of the flow stress on deformation temperatures and strain rates, which then described in Arrhenius-type equation by Zener–Holloman parameter. Moreover, the related material constants and hot deformation activation energy (Q) in the constitutive model were calculated by considering the effect of strain as independent function on them and employing sixth polynomial fitting. Subsequently, the performance of the modified constitutive equation was verified by correlation coefficient and average absolute relative error which were estimated in accordance with experimental and predicted data. The results showed that the modified constitutive equation possess reliable and stable ability to predict the hot flow behavior of studied material under different deformation conditions. Meanwhile, Zener–Holloman parameter map was established according to the modified constitutive equation and used to estimate the extent of dynamic recrystallization.