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There was no previous meta-analysis investigating the efficacy/tolerability of psychostimulants for symptoms of attention-deficit hyperactivity disorder (ADHD) in preschool children.
Databases including PubMed, the Cochrane Library, EMBASE, ScienceDirect, and ClinicalTrials.gov were searched from inception to March 2022 for randomized controlled trials (RCTs) on therapeutic efficacy of psychostimulants against ADHD symptoms in preschool children (age ≤6 years) compared with placebos. Primary outcomes were (a) changes in ADHD symptoms evaluated by validated rating scales from parents’/teacher’s observation, or (b) post-intervention improvements in neuropsychological performance. Secondary outcomes were risks of adverse events.
Meta-analysis of nine eligible trials including 544 preschool children (mean age=4.86 years, female=11.98%, median treatment duration=4.33 weeks) supported the efficacy of psychostimulants against global symptoms from observations of parents (Hedges’ g=0.6152, p<0.0001) and teachers (Hedges’ g=0.6563, p=0.0039). Efficacy of psychostimulants was also noted against symptoms of inattention and hyperactivity/impulsivity, especially the latter (i.e., main symptoms in preschool children). Moreover, male gender, older age, and longer treatment duration were associated with better efficacy. Regarding adverse events, only the risk of poor appetite was higher in the psychostimulant group (odds ratio [OR]=2.39). However, the qualities of evidence were low to very low, indicating potential discrepancy between the true and estimated effect.
Our results showed that psychostimulants might be beneficial for preschool children with ADHD, especially hyperactivity/impulsivity from teachers’ observation, with tolerable side effects. Nevertheless, the true magnitude of the effect needs to be confirmed with more research due to low to very low certainty of the evidence.
This study aimed to explore the constructs related to teachers’ competence in immediately intervening in school bullying (CIISB) in order to develop a valid intervention process. In this study, 16 secondary school teachers in Taiwan with experience of dealing with school bullying were interviewed. In total, 26 interview transcripts were analysed. The results highlight two key constructs that are central to CIISB. The first is structuring prompt management of school bullying. This involves three phases: identifying the incident, stabilising the incident, and clarifying incidents as well as implementing incidental and intentional learning. The second construct is setting the appropriate atmosphere. This refers to teachers’ capacity to build a positive relationship with students by maintaining a calm, serious and fair attitude, and creating a positive atmosphere to implement an immediate intervention. The results suggest that teachers should master the above constructs of CIISB, thereby providing a suitable immediate intervention when school bullying occurs.
Little research has considered fuzzy scheduling and sequencing problem in operating rooms. Multiple-period fuzzy scheduling and sequencing of patients in operating rooms optimization models are proposed in this research taking into consideration patient‘s preference. The objective of the scheduling optimization model is obtaining minimal undertime and overtime and maximum patients' satisfaction about the assigned date. The objective of sequencing the optimization model is both to minimize overtime and to maximize patients' satisfaction about the assigned time. A real-life case study from a hospital that offers comprehensive surgical procedures for all surgical specialties is considered for illustration. Research results showed that the proposed models efficiently scheduled and sequenced patients while considering their preferences and hospitals operating costs. In conclusion, the proposed optimization models may result in improving patient satisfaction, utilizing hospital's resources efficiently, and providing assistance to decision makers and planners in solving effectively fuzzy scheduling and sequencing problems of operating rooms.
Carbon/carbon composites (C/C composites) possess superior characteristics of low density, high strength, extremely low coefficient of thermal expansion, high fatigue resistance. In carbonization process, the high temperature pyrolysis made of carbon, hydrogen, oxygen and other elements, results in a lot of voids and cavities generated in the interior of C/C composites. Therefore, the C/C composites are densified to fill the void by using repeated impregnation. But densification is a time-wasting and complex process, which increases production costs in the manufacturing process.
In this study, the Multi-Wall Carbon Nanotubes (MWNTs) were adopted as reinforcement material for C/C composites to reduce the existence of voids or cavities and enhance the mechanical properties of C/C composites under environment aging effects. Three different temperature with high moisture conditions are used to be tested, including high temperature (150°C/ 90%RH), room temperature (25°C/90%RH), and low temperature (-15°C/90%RH) to analyze the mechanical properties of C/C composites, such as flexural and Interlaminar Shear Strength (ILSS).
This research proposes a procedure for solving the multiresponse problem in the Taguchi method utilizing two data envelopment analysis (DEA) approaches, including comparisons of efficiency between different systems (CEBDS) and bilateral comparisons. In this procedure, each experiment in Taguchi's orthogonal array (OA) is treated as a decision-making unit (DMU) with the multiresponses as the inputs and outputs for all DMUs. For each factor of OA, the DMUs are divided into groups, each at the same factor level. Then, DMU's efficiency is separately evaluated by the CEBDS approach and the bilateral comparisons approach for each factor. The level efficiency, or the average of the efficiencies obtained by the CEBDS and the bilateral comparisons approaches for that factor level, is then used to determine the optimal factor levels for multiresponses. Three case studies are provided for illustration; in all, the proposed procedure provides the largest total anticipated improvements. Hence, it should be considered the most effective among all approaches applied in the case studies, including principal component analysis, DEA-based ranking approach, and others. In addition, the proposed procedure is more effective and requires less computational effort when the DMU's efficiency is evaluated by the bilateral comparisons approach instead of the CEBDS approach. In conclusion, the proposed procedure will provide great assistance to practitioners for solving the multiresponse problems in manufacturing applications on the Taguchi method.
In this study, non-invasive molecular methods were used to investigate the abundance and spatial organisation of otters (Lutra lutra) in Kinmen. DNA samples were extracted from fresh spraints collected seasonally along two streams from February to November 2001 and genotyped using a panel of 7 microsatellites and the SRY gene. Out of 343 spraints, 222 were successfully genotyped and 38 different genotypes (19 females and 19 males) were identified. Thirteen of these were residents that were identified in more than one season and 25 were floaters that were only identified in a single season. The average number of otters per km found along the two streams (1.5–1.8 for all otters, or 0.8–1.1 for residents only) was higher than that estimated in other studies. Female residents lived in exclusive group ranges and the ranges of male residents overlapped with no more than one group range of female residents. Otters appearing in the same range tended to be more closely related to each other. This study demonstrates that non-invasive molecular methods can be used to reveal a more comprehensive estimation of size and structure in an otter population.
The aim of this paper is to develop a CFD solver that used to simulate the transient flow phenomena in a reflected shock tunnel. The transient flow phenomena in a shock tunnel include the reflected shock/boundary layer interaction and the starting process of nozzle flow that can affect the duration of test flow in actual conditions. To numerically simulate these transient flow features, a full-size, axisymmetric reflected shock tunnel model is used. The governing equations are a full Navier-Stokes equation, a species equation and a simplified polynomial correlation to simulate the real gas effects. The numerical code is developed based on the finite volume method coupled with the upwind Roe's scheme and the total variation diminishing (TVD) method. To increase the calculation efficiency, a multi-block and multi-mesh grid generation technique is employed in a huge computational domain. The present computational results have not only confirmed the theoretical characteristics of a shock tube, but have also qualitatively presented the phenomena of reflected shock/boundary layer interaction and the starting process of nozzle flow. This numerical code is a useful tool to demonstrate the actual flow phenomena and to assist the design of experiments.
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