Aim
In this review, the author focused on anticraving therapy for alcohol use disorder (AUD) defined by DMS‐5. A comprehensive review was carried out on the available published papers on anticraving ...drugs for treating AUD patients.
Methods
The author described all drugs with anticraving benefits for treating AUD patients approved by the Food and Drug Administration of the United States (US FDA) and European Medicines Agency of the European Union. Then, the commonly prescribed anticraving drugs and those under development were also described.
Results
The US FDA‐approved anticraving drugs included acamprosate and naltrexone, and those approved by European Medicines Agency were gamma‐hydroxybutyrate and nalmefene. The author also highlighted topiramate, gabapentin, ondansetron, LY196044, ifenprodil, varenicline, ABT‐436, mifepristone, citicoline, and baclofen. The putative mechanisms of action of and the use in clinical practice of those anticraving drugs were also described.
Conclusion
Although slowly developing, the field of anticraving drugs is getting into shape as a promising entity of a pharmaceutical class of drugs. Then, the author addressed on the underused issues of those recommended, and suggested anticraving drugs by the practice guideline of the American Psychiatric Association. The author urges that clinicians should be more “adventurous” in prescribing those promising drugs because benefits of those anticraving drugs are far‐outweighing the possible side effects of anticraving drugs, or the harms of untreated AUD itself.
Steam reforming, partial oxidation, and oxidative steam reforming of ethanol over Ir/CeO2 catalysts were studied to elucidate the reaction pathway and determine catalytic stability. ...Temperature-programmed desorption and surface reaction revealed that ethoxy species were immediately formed on ethanol adsorption at room temperature, and were mainly further oxidized to acetate and carbonate species that finally decomposed into CH4/CO and CO2, respectively. Under reaction conditions, acetaldehyde was the primary product below 673 K, which decomposed mainly to methane and carbon monoxide at higher temperatures, whereas methane reforming and the water-gas shift were the major reactions above 773 K. The Ir/CeO2 catalyst demonstrated rather high stability for the reactions at 823 and 923 K with no apparent deactivation for 60 h on stream; the mean size of Ir particles was stable at around 2-3 nm, but the ceria particles sintered significantly from 6-8 to 14-27 nm. CeO2 likely prevented the highly dispersed Ir particles from sintering and inhibited coke deposition through strong Ir-CeO2 interactions. PUBLICATION ABSTRACT
In this study, the detonation diffraction and re-initiation processes around a single cuboid were studied experimentally. Experiments were performed in a 6-m-long duct with a cross section of 112 mm ...× 112 mm filled with stoichiometric methane–oxygen mixtures at initial pressures between 10 and 30 kPa. A cuboid was placed in the duct to form two perpendicular passages between the cuboid and the walls. Soot foils fixed on the side wall and bottom wall were used to characterize the cellular structure evolution process, from which the diffraction and re-initiation behavior of a detonation could be analyzed. The effects of the spacing between the cuboid and the top wall (
δ
) and the spacing between the cuboid and the side wall (
σ
) on diffraction and re-initiation were investigated systematically. It is shown that the diffraction and re-initiation of a detonation were influenced significantly by introducing a perpendicular channel. Compared with the unidirectional scenario, the boundary between the diffraction wave and the re-initiation region was not so sharp. Depending on the channel scale and mixtures sensitivity (or cell size,
λ
), two re-initiation modes could be observed. For more sensitive mixtures (
δ
/
λ
>
2
or
σ
/
λ
>
2
), an overdriven detonation occurs first. The overdriven detonation propagates toward the edge, generating a secondary overdriven detonation near the wall through detonation reflection. The new one propagates forward and decays to a steady-state detonation. On the other hand, only one overdriven detonation occurs for less sensitive mixtures. For a given channel width, it was demonstrated that the diffraction area could be narrowed as the perpendicular channel width was increased. The inverse feedback mechanism between the two perpendicular diffraction waves was analyzed.
Summary
Background
The cingulate cortex is the main area in the brain involved in pruritus processing and is deactivated after scratching. Lichen simplex chronicus (LSC) is a common pruritic skin ...disorder characterized by skin lichenification following excessive scratching. Psychological factors may contribute to both the development and persistence of LSC.
Objectives
To estimate the hazard ratio (HR) of LSC in people with anxiety disorders compared with the general population.
Methods
In this nationwide population‐based retrospective cohort study we identified a total of 69 386 people, who formed the anxiety cohort, by using the Taiwan National Health Insurance Research Database from 2000 to 2009. The comparison cohort was composed of randomly selected people frequency matched for age (within 5‐year intervals), sex and index date (the date of anxiety diagnosis) based on a 1 : 2 ratio. The risk of LSC was estimated as HRs and 95% confidence intervals (CIs) using the Cox proportional hazards model.
Results
After adjusting for age, sex and LSC‐associated comorbidities, the people with anxiety had a 1·41‐fold greater risk of developing LSC compared with the people in the comparison cohort (HR 1·41, 95% CI 1·30–1·52, P < 0·0001). In particular, individuals with obsessive–compulsive disorder had a significantly increased risk of developing LSC (HR 1·72, 95% CI 1·03–2·88, P = 0·0395).
Conclusions
This study demonstrates that having an anxiety disorder is associated with an increased risk of LSC. Psychological factors were found to contribute to LSC. We recommend combining the management of LSC and psychological disorders to achieve favourable outcomes.
What's already known about this topic?
Lichen simplex chronicus (LSC) is a common skin disorder characterized by skin lichenification following excessive scratching.
LSC is not a life‐threatening disease, but it can result in psychosocial problems and impair quality of life through sleep disturbance and sexual dysfunction.
What does this study add?
This study demonstrates that people with anxiety, especially those aged < 40 years, are at an increased risk of having LSC. Psychological factors were found to contribute to LSC.
We recommend combining the management of LSC and psychological disorders to achieve favourable outcomes.
The precipitation legacy effect, defined as the impact of historical precipitation (PPT) on extant ecosystem dynamics, has been recognized as an important driver in shaping the temporal variability ...of dryland aboveground net primary production (ANPP) and soil respiration. How the PPT legacy influences whole ecosystem-level carbon (C) fluxes has rarely been quantitatively assessed, particularly at longer temporal scales. We parameterized a process-based ecosystem model to a semiarid savanna ecosystem in the southwestern USA, calibrated and evaluated the model performance based on 7 years of eddy-covariance measurements, and conducted two sets of simulation experiments to assess interdecadal and interannual PPT legacy effects over a 30-year simulation period. The results showed that decreasing the previous period/year PPT (dry legacy) always increased subsequent net ecosystem production (NEP) whereas increasing the previous period/year PPT (wet legacy) decreased NEP. The simulated dry-legacy impacts mostly increased subsequent gross ecosystem production (GEP) and reduced ecosystem respiration (Re), but the wet legacy mostly reduced GEP and increased Re. Although the direction and magnitude of GEP and Re responses to the simulated dry and wet legacies were influenced by both the previous and current PPT conditions, the NEP responses were predominantly determined by the previous PPT characteristics including rainfall amount, seasonality and event size distribution. Larger PPT difference between periods/years resulted in larger legacy impacts, with dry legacies fostering more C sequestration and wet legacies more C release. The carryover of soil N between periods/years was mainly responsible for the GEP responses, while the carryovers of plant biomass, litter and soil organic matter were mainly responsible for the Re responses. These simulation results suggest that previous PPT conditions can exert substantial legacy impacts on current ecosystem C balance, which should be taken into account while assessing the response of dryland ecosystem C dynamics to future PPT regime changes.
Transferrin receptor has been an important protein for many of the advances made in understanding the intricacies of the intramolecular sorting pathways of endocytosed molecules. The unique ...internalization and recycling functions of transferrin receptor have also made it an attractive choice for drug targeting and delivery of large protein-based therapeutics and toxins. Recent advances in elucidating the role of the intracellular controllers of transferrin recycling and sorting, such as Rab proteins and their effectors, have led to enhancement of transferrin receptor as a drug delivery vehicle. This review focuses on the use of transferrin receptor as an agent for facilitating drug delivery and targeting, and the role that mechanisms of transferrin receptor sorting and transcytosis play in these events.
Summary
The association between potential long‐term effects of previous schistosome infection (PSI) and the development of metabolic syndrome remains unknown. Therefore, we aimed to evaluate the ...association between them. Participants were from regions which were all reportedly heavily endemic for S. japonicum in China 40 years ago. One thousand five hundred and ninety‐seven men were enrolled. Among these, 465 patients with PSI were selected as study subjects and 1132 subjects served as controls. We found PSI significantly correlated with lower prevalences of metabolic syndrome and its components, including central obesity, hypertriglyceridemia and low high‐density lipoprotein cholesterol, which indicates that the potential long‐term effects of PSI may reduce the risk of metabolic syndrome. However, further studies are needed to investigate the protective immune effects of PSI.
► A mesomechanical model is proposed for clayey rocks with plastic porous clay matrix. ► Associated and non-associated plastic flow rules are investigated for compressible matrix. ► Effects of ...inter-particular porosity are taken into account. ► Numerical results with non-associated model agree well with experimental data.
This paper is devoted to mesomechanical modeling of plastic deformation in a clayey rock. The material contains linear-elastic mineral grains embedded in a porous clay matrix at mesoscale. The clay matrix itself is composed of a solid phase containing spherical micropores. A two-step homogenization procedure, from micro to meso and from meso to macro, is proposed to estimate the macroscopic elastoplastic behavior of the clayey rock. The meso–macro upscaling is performed considering the incremental approach initially proposed by Hill (1965) which allows to account for the effects of mineral inclusions. For the micro–meso transition, the pressure sensitive behavior of the solid phase of clay matrix is described using a Drucker–Prager yield criterion and an associate flow rule. The effects associated with the presence of micropores are taken into account using a limit analysis-based homogenization approach. It is shown that, although the macroscopic model based on an associated plastic solid phase correctly predicts the non linear response and failure stress of the clayey rock under conventional triaxial compression tests, it fails to quantitatively reproduce volumetric deformation. By considering a non-associated flow rule for the solid phase, the agreement with experimental data is significantly improved. Comparisons between the numerical results and experimental data show that the proposed micro–macro model is able to capture the main features of mechanical behavior of heterogeneous clayey rocks.
Postoperative delirium (POD) is a common postoperative complication in elderly patients, and it greatly affects the short-term and long-term prognosis of patients. The purpose of this study was to ...develop a machine learning model to identify preoperative, intraoperative and postoperative high-risk factors and predict the occurrence of delirium after nonbrain surgery in elderly patients.
A total of 950 elderly patients were included in the study, including 132 patients with POD. We collected 30 characteristic variables, including patient demographic characteristics, basic medical history, preoperative examination characteristics, type of surgery, and intraoperative information. Three machine learning algorithms, multilayer perceptron (MLP), extreme gradient boosting (XGBoost), and k-nearest neighbor algorithm (KNN), were applied to construct the model, and the k-fold cross-validation method, ROC curve, calibration curve, decision curve analysis (DCA) and external validation were used for model evaluation.
XGBoost showed the best performance among the three prediction models. The ROC curve results showed that XGBoost had a high area under the curve (AUC) value of 0.982 in the training set; the AUC value in the validation set was 0.924, and the prediction model was highly accurate. The k-fold cross-validation method was used for internal validation, and the XGBoost model was stable The calibration curve showed high predictive power of the XGBoost model. The DCA curve showed a higher benefit rate for patients who received interventional treatment under the XGBoost model. The AUC value for the external validation set was 0.88, indicating that the predictive model was extrapolative.
The prediction model of POD derived from the machine learning algorithm in this study has high prediction accuracy and clinical utility, which is beneficial for clinicians to diagnose and treat patients in a timely manner.
Maximizing fat loss while preserving lean tissue mass and function is a central goal of modern obesity treatments. A widely cited rule guiding expected loss of lean tissue as fat‐free mass (FFM) ...states that approximately one‐fourth of weight loss will be FFM (i.e. ΔFFM/ΔWeight = ∼0.25), with the remaining three‐fourths being fat mass. This review examines the dynamic relationships between FFM, fat mass and weight changes that follow induction of negative energy balance with hypocaloric dieting and/or exercise. Historical developments in the field are traced with the ‘Quarter FFM Rule’ used as a framework to examine evolving concepts on obesity tissue, excess weight and what is often cited as ‘Forbes' Rule’. Temporal effects in the fractional contribution of FFM to changes in body weight are examined as are lean tissue moderating effects such as ageing, inactivity and exercise that frequently accompany structured low‐calorie diet weight loss protocols. Losses of lean tissue with dieting typically tend to be small, raising questions about study design, power and applied measurement method reliability. Our review elicits important questions related to the fractional loss of lean tissues with dieting and provides a foundation for future research on this topic.
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