Liquid-like properties of cyclopentadienyl complexes of barium: molecular dynamics simulations of nanoscale droplets.

Cyclopentadienyl complexes of barium have great utility in materials science and engineering, in particular, as precursors in the atomic layer deposition processes, which are required to be fluidic as well as thermally stable and volatile. Here, we investigated the liquid-like properties of cyclopentadienyl barium complexes including (Me5C5)2Ba, (tBu3C5H2)2Ba, (iPr4C5H)2Ba, (iPr5C5)2Ba, and [(SiMe3)3C5H2]2Ba, using molecular dynamics simulations of nanoscale droplets. The compounds were modeled using a recently developed generic force field, GFN-FF. Nanoscale droplets with about 5.0 nm diameters were formed by aggregating 96 molecules of each compound. Simulation results reveal that substituting methyl groups of (Me5C5)2Ba with other alkyl and silyl moieties has a non-negligible effect on the intra- and intermolecular structure and dynamics. In particular, in contrast to more flexible (Me5C5)2Ba, the substitution with five iso-propyl groups to form (iPr5C5)2Ba adds rigidity to the complex with restricted orientational fluctuations for two cyclopentadienyl ligands and arranges molecules parallel to each other with greater probability. In addition, comparison between (tBu3C5H2)2Ba, with three tert-butyl groups, and its silyl analogue, [(SiMe3)3C5H2]2Ba, reveals that intermolecular interactions between the molecules with silyl groups are softer than those with tert-butyl groups and result in broader radial distribution functions, whereas the dynamic properties are similar for both compounds. This work suggests that molecular dynamics simulations contribute to molecular-level understanding of the effect of chemical substitution in organometallic compounds on the intra- and intermolecular properties of molecular liquids.

Longitudinal analysis of symptom-based clustering in patients with primary Sjogren's syndrome: a prospective cohort study with a 5-year follow-up period.

BACKGROUND: Sjogren's syndrome (SS) is a heterogenous disease with various phenotypes. We aimed to provide a relevant subclassification based on symptom-based clustering for patients with primary (p) SS. METHODS: Data from patients in a prospective pSS cohort in Korea were analysed. Latent class analysis (LCA) was performed using patient reported outcomes, including pain, fatigue, dryness, and anxiety/depression. Clinical and laboratory differences between the classes were analysed. Latent transition analysis (LTA) was applied to the longitudinal data (annually for up to 5 years) to assess temporal stability of the classifications. RESULTS: LCA identified three classes among 341 patients with pSS (i.e., 'high symptom burden', 'dryness dominant', 'low symptom burden'). Each group had distinct laboratory and clinical phenotypes. LTA revealed that class membership remained stable over time. Baseline class predicted future salivary gland function and damage accrual represented by a Sjogren's syndrome disease damage index. CONCLUSION: Symptom-based clustering of heterogenous patients with primary Sjogren's syndrome provided a relevant classification supported by temporal stability over time and distinct phenotypes between the classes. This clustering strategy may provide more homogenous groups of pSS patients for novel treatment development and predict future phenotypic evolvement.

Deep Spinal Infection after Outpatient Epidural Injections for Pain: A Retrospective Sample Cohort Study Using a Claims Database in South Korea.

BACKGROUND: Deep spinal infection is a devastating complication after epidural injection. This study aimed to investigate the incidence of deep spinal infection primarily after outpatient single-shot epidural injection for pain. Secondarily, this study assessed the national trends of the procedure and risk factors for said infection. METHODS: Using South Korea's National Health Insurance Service sample cohort database, the 10-yr national trend of single-shot epidural injections for pain and the incidence rate of deep spinal infection after the procedure with its risk factors were determined. New-onset deep spinal infections were defined as those occurring within 90 days of the most recent outpatient single-shot epidural injection for pain, needing hospitalization for at least 1 night, and receiving at least a 4-week course of antibiotics. RESULTS: The number of outpatient single-shot epidural injections per 1,000 persons in pain practice doubled from 40.8 in 2006 to 84.4 in 2015 in South Korea. Among the 501,509 injections performed between 2007 and 2015, 52 cases of deep spinal infections were detected within 90 days postprocedurally (0.01% per injection). In multivariable analysis, age of 65 yr or more (odds ratio, 2.91; 95% CI, 1.62 to 5.5; P = 0.001), living in a rural area (odds ratio, 2.85; 95% CI, 1.57 to 5.0; P < 0.001), complicated diabetes (odds ratio, 3.18; 95% CI, 1.30 to 6.7; P = 0.005), multiple epidural injections (three times or more) within the previous 90 days (odds ratio, 2.34; 95% CI, 1.22 to 4.2; P = 0.007), and recent use of immunosuppressants (odds ratio, 2.90; 95% CI, 1.00 to 6.7; P = 0.025) were significant risk factors of the infection postprocedurally. CONCLUSIONS: The incidence of deep spinal infection after outpatient single-shot epidural injections for pain is very rare within 90 days of the procedure (0.01%). The data identify high-risk patients and procedure characteristics that may inform healthcare provider decision-making.

Inhibition of Photoconversion Activity in Self-Assembled ZnO-Graphene Quantum Dots Aggregated by 4-Aminophenol Used as a Linker.

The aggregation of zinc oxide nanoparticles leads to an increased absorbance in the ultraviolet-visible region by an induced light scattering effect. Herein, we demonstrate the inhibition of photoconversion activity in ZnO-graphene core-shell quantum dots (QD) (ZGQDs) agglomerated by 4-aminophenol (4-AP) used as a linker. The ZnO-graphene quantum dots (QD) aggregates (ZGAs) were synthesized using a facile solvothermal process. The ZGAs revealed an increased absorbance in the wavelengths between 350 and 750 nm as compared with the ZGQDs. Against expectation, the calculated average photoluminescence lifetime of ZGAs was 7.37 ns, which was 4.65 ns longer than that of ZGQDs and was mainly due to the high contribution of a slow (τ2, τ3) component by trapped carriers in the functional groups of graphene shells and 4-AP. The photoelectrochemical (PEC) cells and photodetectors (PDs) were fabricated to investigate the influence of ZGAs on the photoconversion activity. The photocurrent density of PEC cells with ZGAs was obtained as 0.04 mA/cm2 at 0.6 V, which was approximately 3.25 times lower than that of the ZGQDs. The rate constant value of the photodegradation value of rhodamine B was also decreased by around 1.4 times. Furthermore, the photoresponsivity of the PDs with ZGAs (1.54 µA·mW-1) was about 2.5 times as low as that of the PDs with ZGQDs (3.85 µA·mW-1). Consequently, it suggests that the device performances could be degraded by the inhibition phenomenon of the photoconversion activity in the ZGAs due to an increase of trap sites.

The Association Between Temperament and Microbiota in Healthy Individuals: A Pilot Study.

OBJECTIVE: The purpose of this study was to examine whether enterotypes in the gut microbiome could be determined by clustering validity indexes and whether these enterotypes were associated with individual differences in temperament traits. METHODS: Sixty healthy Korean participants (21 men; 27.5 [8.1] years, 39 women; 34.5 [14.3] years) were asked to answer 60 temperament questions (novelty seeking, harm avoidance, reward dependence, and persistence) from the Korean version of the Temperament and Character Inventory-125. The participants' stool samples were submitted, and relative operational taxonomic units were calculated using 16S rRNA gene-based microarrays. Differences between sexes and age-related effects on the temperament and operational taxonomic unit abundances were determined, and optimal clustering numbers related to enterotypes were examined using connectivity and silhouette width (SW) indexes. Finally, the differences in temperament between enterotypes were examined. RESULTS: There was no significant effect of sex or age on gut microbiota and temperament scores. The hierarchical dendrogram, connectivity, and SW analysis indicated bimodal enterotypes. Bacteroidaceae were more abundant in enterotype 1 (46.24%, N = 45), whereas Prevotellaceae were more abundant in enterotype 2 (43.83%, n = 15). Among the four temperament dimensions, novelty seeking and reward dependence scores were higher in enterotype 1 (10.82 [2.99] and 8.07 [2.51] points) than in enterotype 2 (8.87 [2.42] and 5.73 [1.03] points). CONCLUSIONS: The results suggest an association between temperament and enterotypes in healthy Korean adults. It is conceivable that this association may develop early in life as a result of biological processes catalyzed by the gut microbiota during infancy.

Feasibility study of transfer function model on electrocardiogram change caused by acupuncture.

BACKGROUND: Acupuncture treatments that regulate the heart are used to treat various clinical disorders and conditions. Although many studies have been conducted to measure quantitatively the effects of acupuncture, thus far, models that describe these effects have not been established. The purpose of this study was to derive a transfer function model of acupuncture stimulation within the electrocardiograms based on the periods before, during, and after acupuncture. METHODS: Fourteen healthy subjects were included in this clinical trial. Five-minute electrocardiograms were captured before, during, and after acupuncture at HT7. For each period, signal-averaged electrocardiograms were created from all of the subjects' 5-min electrocardiograms for that period. Individual transfer functions, which has the highest average goodness of fit, were derived for each period pair. By averaging individual transfer functions, generalized transfer functions were derived. RESULTS: The transfer function with the highest average goodness of fit was a fraction with 4th order numerator and 5th order denominator. Fourteen individual transfer functions were derived separately for each pair of periods: before and during acupuncture, during and after acupuncture, and before and after acupuncture. Three generalized transfer functions were derived by averaging individual transfer functions for each period pair. CONCLUSION: The three generalized transfer functions that were derived may reflect the electrocardiogram changes caused by acupuncture. However, this clinical trial included only 14 subjects. Further studies with control groups and more subjects are needed. This clinical trial has been registered on the Clinical Research Information Service, Republic of Korea (No. KCT0001944). The first enrolment of subject started at 2 June 2015 and this trial was retrospectively registered at 14 June 2016.

Reliability and validity of tongue color analysis in the prediction of symptom patterns in terms of East Asian Medicine.

OBJECTIVE: To examine whether color parameters of tongue inspection (TI) using a digital camera was reliable and valid, and to examine which color parameters serve as predictors of symptom patterns in terms of East Asian medicine (EAM). METHODS: Two hundred female subjects' tongue substances were photographed by a mega-pixel digital camera. Together with the photographs, the subjects were asked to complete Yin deficiency, Phlegm pattern, and Cold-Heat pattern questionnaires. Using three sets of digital imaging software, each digital image was exposure- and white balance-corrected, and finally L* (luminance), a* (red-green balance), and b* (yellow-blue balance) values of the tongues were calculated. To examine intra- and inter-rater reliabilities and criterion validity of the color analysis method, three raters were asked to calculate color parameters for 20 digital image samples. Finally, four hierarchical regression models were formed. RESULTS: Color parameters showed good or excellent reliability (0.627-0.887 for intra-class correlation coefficients) and significant criterion validity (0.523-0.718 for Spearman's correlation). In the hierarchical regression models, age was a significant predictor of Yin deficiency (ß = 0.192), and b* value of the tip of the tongue was a determinant predictor of Yin deficiency, Phlegm, and Heat patterns (ß = - 0.212, - 0.172, and - 0.163). Luminance (L*) was predictive of Yin deficiency (ß = -0.172) and Cold (ß = 0.173) pattern. CONCLUSION: Our results suggest that color analysis of the tongue using the L*a*b* system is reliable and valid, and that color parameters partially serve as symptom pattern predictors in EAM practice.

The Effect of General Anesthesia on Aminotransferase Levels in Patients with Elevated Aminotransferase Levels: A Single-Center 5-Year Retrospective Study.

BACKGROUND: The effect of commonly used anesthetics on postoperative aminotransferase levels in patients with preoperatively elevated values is unclear. METHODS: The medical records of 25,567 adult patients undergoing elective general anesthesia were retrospectively reviewed. Patients were classified into normal (≤ 40 IU/L), mild (41-119 IU/L), moderate (120-199 IU/L), and marked elevation (200+ IU/L) groups according to their preoperative alanine aminotransferase levels. Changes in these levels before and after general anesthesia were compared according to the anesthetics used. RESULTS: Among the patients with preoperative mild or moderate elevation, 97.8% (2589/2647) did not show a higher alanine aminotransferase level after surgery. Compared with total IV anesthesia (TIVA), sevoflurane showed adjusted odds ratios (95% confidence interval) of 1.27 (1.10-1.46) for mild, 1.33 (0.86-2.05) for moderate, and 3.35 (1.58-7.04) for marked postoperatively elevated levels of alanine aminotransferase versus normal levels. Similarly, compared with TIVA, desflurane showed adjusted odds ratios (95% confidence interval) of 1.21 (0.96-1.53) for mild, 1.44 (0.70-2.94) for moderate, and 3.18 (1.14-8.89) for marked postoperatively elevated levels of alanine aminotransferase versus normal levels (P = 0.05). CONCLUSIONS: In most cases, postoperative alanine aminotransferase levels did not worsen even in patients with preoperatively elevated levels. Sevoflurane was associated with increased odds for postoperative elevation of these levels after general surgery compared with TIVA.

Individual characteristics of reliable lumbar coupling motions.

INTRODUCTION: Coupling motions (CMs) are the motions occurring in different directions around the primary motion. As low back pain (LBP) is known to be associated with lumbar CMs, some studies measured lumbar CMs using the microelectromechanical system inertial measurement unit (MEMS-IMU) because of its low cost and small size. This study aimed to examine the reliability of lumbar CM measurements using the MEMS-IMU and to classify the individual characteristics of lumbar CMs. METHODS: MEMS-IMUs were attached to the two lumbar points (L1, L5) of 19 male volunteers (age, 24.3 ± 1.2 years). Following an instructional video and audio recording, they conducted the six lumbar movements three times: flexion and extension, left and right lateral bending, and left and right rotation. The six lumbar movements were repeated after 1 h. Raw data were transformed into angle data using MATLAB. Intraclass correlation coefficients (ICCs) were calculated to evaluate intratest repeatability and test-retest reliability. Finally, angle data were analyzed to examine whether individual characteristics of lumbar CMs could be identified. RESULTS: Lumbar CM measurements showed fair to good or excellent intratest repeatability and test-retest reliability, ranging from 0.669 to 0.997 of the ICCs. All lumbar CMs could be categorized into six types, and flexion and extension CMs were more prominent than other CMs. CONCLUSIONS: Lumbar CM measurements obtained using the MEMS-IMU are reliable, and identifying the individual variations of lumbar CMs may be helpful for alleviating chronic or recurrent LBP.

c-Myb negatively regulates Ras signaling through induction of dual phosphatase MKP-3 in NIH3T3 cells.

Mitogen-activated protein kinase phosphatase-3 (MKP-3) negatively regulates ERK1/2 MAPK in a feedback loop. However, little is known about the molecular mechanism by which Ras signaling induces MKP-3 expression. In the present study, we demonstrate that exogenous expression of constitutively active H-Ras increases the level of MKP-3 mRNA. A transfection study using a series of MKP-3 promoter deletion constructs revealed that the c-Myb binding site is required for Ras-induced transcriptional activation of the MKP-3 gene promoter. Furthermore, we show that c-Myb directly binds to the MKP-3 promoter, as revealed by electrophoretic mobility shift assay and chromatin immunoprecipitation. Knock-down of c-Myb expression using siRNA abrogated Ras-induced MKP-3 promoter activity. These findings propose a novel mechanism through which Ras signaling activates c-Myb-dependent transcriptional activation of the MKP-3 gene.

Size dependence of silica nanospheres embedded in 385 nm ultraviolet light-emitting diodes on a far-field emission pattern.

We demonstrate that the use of silica nanospheres (SNs) with sizes close to the emission wavelength of light-emitting diodes (LEDs) can enhance the light output power and manipulate the far-field emission pattern. Near-ultraviolet (NUV)-LEDs grown on a patterned sapphire substrate embedded with 300 nm SNs show a three times higher light output power than that without SNs, when measured through the top side. For far-field emission measurements, the LEDs embedded with 300 nm SNs show the significant increase of front emission due to the improved crystal quality of epitaxial films as well as the increase of Mie scattering effect of SNs. These experimental results indicate the important role of the size of embedded SNs in enhancing the light output power for NUV-LEDs.

Development of the Short-Form Yin Deficiency Scale Using Three Item Reduction Approaches.

Background: Yin deficiency (YD) is a pathological condition characterized by emaciation, afternoon fever, dry mouth, and night sweats. The incidence of YD is 23.3%. A 27-item Yin Deficiency Scale (YDS) was developed to estimate the clinical severity of YD. This study aimed to develop three short-form YDS versions to reduce the burden of response time, using three item-reduction approaches: Rasch, equidiscriminatory item-total correlation (EITC), and factor-based analyses. Methods: Two datasets were analyzed from previous studies (169 outpatients from May to June 2009 and 237 healthy college students from January to April 2016). The optimal response category was examined using Rasch analysis. Items with higher item-total correlations were determined using the EITC. Using a factor-based approach, the items were reduced, while maintaining the original YDS construct. Reliability was estimated using the person separation index (PSI) and Cronbach's α values. The predictive accuracy was examined using the area under the curve (AUC). Finally, the relationship between YD and dysfunctional breathing (DB) was examined using factor scores from the YDS and the Korean version of the Nijmegen Questionnaire (KNQ). Results: We developed two 14-item YDS versions using the Rasch and EITC approaches, and a 16-item YDS version using a factor-based approach. Rasch analysis suggested an optimal response category of five points. The PSI of Rasch and Cronbach's α of the EITC and factor-based versions were 2.19, 0.855, and 0.827. The AUCs of the three short-form YDS were 0.812, 0.811, and 0.818. The sensitivity of the EITC-YDS was 0.632, which was lower than its specificity of 0.875. The fatigue-related scores of the factor-based YDS were fairly correlated with the factor scores of the KNQ estimating the DB (r = 0.349-0.499). Conclusion: The 14-item Rasch- and 16-item factor-based YDS may replace the original YDS during YD's primary screening, epidemiological surveys, and health checkups.

What Makes Deviant Places?

Urban safety plays an essential role in the quality of citizens' lives and in the sustainable development of cities. In recent years, researchers have attempted to apply machine learning techniques to identify the role of location-specific attributes in the development of urban safety. However, existing studies have mainly relied on limited images (e.g., map images, single- or four-directional images) of areas based on a relatively large geographical unit and have narrowly focused on severe crime rates, which limits their predictive performance and implications for urban safety. In this work, we propose a novel method that predicts "deviance," which includes formal deviant crimes (e.g., murders) and informal deviant behaviors (e.g., loud parties at night). To do this, we first collect a large-scale geo-tagged dataset consisting of incident report data for seven metropolitan cities, along with corresponding sequential images around incident sites obtained from Google Street View. We then design a convolutional neural network that learns spatio-temporal visual attributes of deviant streets. Experimental results show that our framework is able to reliably recognize real-world deviance in various cities. Furthermore, we analyze which visual attribute is important for deviance identification and severity estimation with respect to social science as well as activated feature maps in the neural network. We have released our dataset and source codes on https://github.com/JinhwiPark/DevianceNet/.

Air-ring microstructure arrays for enhanced light extraction from a face-up light-emitting diode.

In this Letter, a light-emitting diode (LED) with prism-shaped-air-ring microstructures (PSAMs) formed on flat sapphire substrate is demonstrated as an alternative design to face-up LEDs on patterned sapphire substrate (PSS) for enhanced light extraction efficiency. In this LED design, the emitted photons can be deflected to the top of the chip for its effective extraction, contrary to the PSS-LED wherein photons are guided to sapphire and get absorbed by packaging materials. The PSAM-LED showed an enhancement in the radiometric power as high as 10% with a low far-field angle of 129° over that of a PSS-LED under an injection current of 20 mA.

Association between blood glucose levels and arterial stiffness marker: comparing the second derivative of photoplethysmogram and cardio-ankle vascular index scores.

Objective: This study aimed to compare the association between fasting plasma glucose (FPG) and glycosylated hemoglobin A1c (HbA1c) levels using the second derivative of photoplethysmogram (SDPTG) index and the cardio-ankle vascular index (CAVI). Methods: Electronic medical records of 276 participants (160 men, 116 women) who visited the health promotion center of a university hospital were examined. Age, sex, body mass index (BMI), blood pressure, and lipid profile were considered as risk factors for arterial stiffness, together with the FPG, HbA1c, CAVI, and SDPTG indices. Hierarchical regression models were constructed, and all participants were divided into low-normal, high-normal, prediabetic, and diabetic groups to examine the group-based differences in CAVI and SDPTG indices. Results: FPG and HbA1c were independently predictive of increased CAVI, and their predictive powers for CAVI were equivalent (ß = 0.214 and 0.200, respectively). Risk factors, including age, BMI, and male sex, were also predictive of CAVI (ß= 0.593-0.630, -0.256 - -0.280, and 0.142-0.178, respectively). None of the FPG and HbA1c values were predictive of the SDPTG indices. The CAVI was higher in the diabetes group than in the other three groups according to HbA1c level, while the d/a index of the SDPTG decreased in the prediabetes group and increased in the diabetes group. Conclusions: CAVI may not be substituted for SDPTG indices when evaluating arterial stiffness based on the glucose level. Moreover, the progression rate of arterial stiffness may differ between the diabetic and nondiabetic stages.

Harmonic components of photoplethysmography and pathological patterns: A cross-sectional study.

This study aimed to examine whether the 3 harmonic components (HCs) of photoplethysmography (PTG) - total harmonic distortion (THD), harmonic power (HP), and normalized harmonic amplitude (HA) - have aging effects and may serve as an arterial stiffness marker and examine the relationship between HCs and clinical severity of pathological patterns. This study had a retrospective chart review design, and electronic medical records of 173 female patients (age: 38.57 ± 11.64 years) were reviewed. Patients were asked to complete the phlegm, blood stasis (BS), and food retention (FR) pattern questionnaires and underwent PTG and the second derivative of PTG measurements. THD, HP, and HA data were extracted till the 12th HCs from the raw PTG data. THD and HA had an aging effect (ß: -0.179 to -0.278) and were related to b/a (r: -02.76 to -0.455) and d/a (r: 0.265-0.360) of the second derivative of PTG. In the younger group (≤33 years), HP and HA were positively correlated with phlegm, BS, and FR patterns (r: 0.257-0.370), while HP was positively correlated with the FR pattern (r: 0.278-0.315) in the middle age group (34-45 years). In the older group (≥46 years), HP and HA were positively or negatively correlated with the phlegm pattern (r: ±0.263 to ±0.440). HCs may serve as an arterial stiffness marker, and may be partially related to phlegm, BS, and FR patterns. Aging effect needs to be considered when utilizing HCs as an indicator of phlegm, BS, and FR patterns.

High performance of InGaN light-emitting diodes by air-gap/GaN distributed Bragg reflectors.

The effect of air-gap/GaN DBR structure, fabricated by selective lateral wet-etching, on InGaN light-emitting diodes (LEDs) is investigated. The air-gap/GaN DBR structures in LED acts as a light reflector, and thereby improve the light output power due to the redirection of light into escape cones on both front and back sides of the LED. At an injection current of 20 mA, the enhancement in the radiometric power as high as 1.91 times as compared to a conventional LED having no DBR structure and a far-field angle as low as 128.2° are realized with air-gap/GaN DBR structures.

Improving the optical performance of InGaN light-emitting diodes by altering light reflection and refraction with triangular air prism arrays.

The effect of triangular air prism (TAP) arrays with different distance-to-width (d/w) ratios on the enhancement of light extraction efficiency (LEE) of InGaN light-emitting diodes (LEDs) is investigated. The TAP arrays embedded at the sapphire/GaN interface act as light reflectors and refractors, and thereby improve the light output power due to the redirection of light into escape cones on both the front and back sides of the LED. Enhancement in radiometric power as high as 117% and far-field angle as low as 129° are realized with a compact arrangement of TAP arrays compared with that of a conventional LED made without TAP arrays under an injection current of 20 mA.

A polymorphism in the YWHAH gene encoding 14-3-3 eta that is not associated with sporadic Creutzfeldt-Jakob disease (CJD).

14-3-3 proteins are abundantly expressed in the brain, particularly neuronal tissue and are thought to serve multiple biological functions involved in neuronal development and cell growth and death. Recent studies have shown associations of 14-3-3 genes with neurodegenerative disorders based on their chromosomal linkage to these diseases and to regulatory functions for the nervous system. Although the role of 14-3-3 proteins in the pathogenesis of prion diseases remains unknown, the detection of altered levels of isoforms of the 14-3-3 protein in the cerebrospinal fluid is considered a biomarker for diagnosis of sporadic Creutzfeldt-Jakob disease (sCJD). To identify other susceptibility genes for prion disease, we examined nucleotide variations in YWHAH, a gene encoding 14-3-3 eta. This case-control study included 182 sCJD patients and 206 healthy Koreans. Polymerase chain reaction was used to amplify open reading frame and some 3'-untranslated region (UTR) in exon 2, and direct sequencing was carried out. One polymorphism, 753 G/A, was detected in the 3'-UTR of exon 2 on the YWHAH. The genotype distribution and allele frequencies of the YWHAH 753 G/A polymorphism were not significantly different between controls and sCJD patients. This finding indicates that YWHAH 753 G/A polymorphism is unlikely to be linked to genetic susceptibility or have a modifying effect in sCJD. On analysis stratified by the prion protein gene 129 or 219 genotype, no significant relation was found in genotype and allele frequencies of the YWHAH 753G/A. This is the first genetic association study of YWHAH with sCJD populations.

Comparative effectiveness of a low-calorie diet combined with acupuncture, cognitive behavioral therapy, meal replacements, or exercise for obesity over different intervention periods: A systematic review and network meta-analysis.

Objective: The aim of this study was to evaluate the comparative effectiveness of a low-calorie diet (LCD) combined with acupuncture, cognitive behavioral therapy (CBT), meal replacements (MR), and exercise on weight loss. Methods: The electronic databases MEDLINE, EMBASE, CENTRAL, CNKI, RISS, and KISS were searched systematically. Randomized controlled trials (RCTs) that directly compared the effect of a low-calorie diet (LCD)-combined acupuncture, CBT, and exercise and an MR-based diet on weight loss with LCD-alone for adults with simple obesity (body mass index [BMI] > 25) published before August 2021 were included in the study. Two investigators extracted and coded the data using a template. Any disagreements between investigators were resolved through discussion. Changes in BMI or weight were transformed to Hedges' g values with a 95% CI, and network meta-analyses using a Bayesian random-effects model were conducted. Results: A total of thirty-two trials involving 3,364 patients were finally included in the study. The effect sizes of four interventions were medium, in the order of acupuncture (Hedges' g = 0.48, 95% CI = 0.25 - 0.71), CBT (Hedges' g = 0.42, 95% CI = 0.20 - 0.63), MR (Hedges' g = 0.32, 95% CI = 0.19 - 0.45), and exercise (Hedges' g = 0.27, 95% CI = 0.06 - 0.46).In terms of intervention period, acupuncture was effective in the short period (≤ 12 weeks, Hedges' g = 0.39, 95% CI = 0.12 - 0.67) and the long period (>12 weeks, Hedges' g = 0.89, 95% CI = 0.37 - 1.40), whereas CBT (Hedges' g = 0.51, 95% CI = 0.26 - 0.76) and exercise (Hedges' g = 0.37, 95% CI = 0.12 - 0.59) were effective only in the long period. MR was effective only in the short period (Hedges' g = 0.35, 95% CI = 0.18 - 0.53). Conclusions: This study suggests that acupuncture, CBT, MR, and exercise for simple obesity show a medium effect size, and their effectiveness differs according to the intervention period.