Efficacy of Eating Disorder Focused Family Therapy for Adolescents With Anorexia Nervosa: A Systematic Review and Meta-Analysis.

OBJECTIVE: To systematically review and evaluate the efficacy of eating disorder focused family therapy (FT-ED) in comparison to all other forms of psychotherapy for children and adolescents with anorexia nervosa. A secondary aim is to assess the relative efficacy of different variations of FT-ED (e.g., shorter vs. longer dose, parent-focused). METHODS: A search with relevant terms was systematically conducted on four databases. Twenty-three publications across 18 randomized controlled trials met inclusion criteria. Outcomes of interest included variables related to weight, eating psychopathology, and remission status. Study quality was assessed, and data were extracted by two independent researchers. RESULTS: Adolescents receiving FT-ED gained significantly more weight by the end of treatment in comparison to those receiving individual psychotherapy. FT-ED that was delivered just to parents or to parents and child separately offered preferable weight outcomes and rates of recovery at the end of treatment in comparison to conjoint FT-ED. No other outcomes tested in the meta-analysis were statistically significant at the end of treatment or follow-up. DISCUSSION: Currently available data suggest the use of FT-ED in its conjoint or separated/parent focused format is the best outpatient treatment option for adolescents with anorexia nervosa when immediate weight gain is paramount. The variability of outcome measurement, including the tools used and timepoints chosen, limit comparison among no more than a handful of studies. The field would benefit from the standardization of measurement and reporting guidelines for future clinical trials. TRIAL REGISTRATION: PROSPERO number: CRD42023396263.

OBJETIVO: Revisar y evaluar sistemáticamente la eficacia de la terapia familiar centrada en el trastorno de conducta alimentaria (TF­TCA; FT­ED por sus siglas en inglés) en comparación con todas las demás formas de psicoterapia para niños y adolescentes que padecen anorexia nerviosa. Un objetivo secundario es evaluar la eficacia relativa de diferentes variaciones de la TF­TCA (por ejemplo, dosis más corta vs. más larga, centrada en los padres). MÉTODOS: Se realizó una búsqueda sistemática con términos relevantes en cuatro bases de datos. Veintitrés publicaciones de 18 ensayos controlados aleatorios cumplieron con los criterios de inclusión. Los resultados de interés incluyeron variables relacionadas con el peso, la psicopatología alimentaria y el estado de remisión. La calidad del estudio fue evaluada y los datos fueron extraídos por dos investigadores independientes. RESULTADOS: Los adolescentes que recibieron TF­TCA ganaron significativamente más peso al final del tratamiento en comparación con aquellos que recibieron psicoterapia individual. La TF­TCA que se administró solo a los padres o a padres e hijos por separado ofreció mejores resultados en el peso y tasas de recuperación al final del tratamiento en comparación con la TF­TCA conjunta. Ningún otro resultado probado en el metaanálisis fue estadísticamente significativo al final del tratamiento o durante el seguimiento. DISCUSIÓN: Los datos disponibles actualmente sugieren que el uso de la TF­TCA en su formato conjunto o separado/centrado en los padres es la mejor opción de tratamiento ambulatorio para adolescentes que padecen anorexia nerviosa cuando la ganancia de peso inmediata es primordial. La variabilidad en la medición de los resultados, incluyendo las herramientas utilizadas y los puntos temporales elegidos, limita la comparación entre no más de un puñado de estudios. El campo se beneficiaría de la estandarización de la medición y las directrices de reporte para futuros ensayos clínicos.

Investigation of the photocatalytic and optical properties of the SrMoO4/g-C3N4 heterostructure obtained via sonochemical synthesis with temperature control.

In this work, nanomaterials of the SrMoO4/g-C3N4 heterostructure were synthesized in a single step by the sonochemical method with controlled temperatures. Structural and morphological investigations indicate the formation of heterojunctions, revealing the presence of g-C3N4 (CN) in the heterostructures and an interface region between the phases. Optical analyzes show broadening of the wavelength absorption range and a decrease in the photoluminescence (PL) intensity of the heterojunctions compared to the CN emission spectrum, proving a decrease in the recombination of the photogenerated charges. The results of the photocatalytic tests indicate that the insertion of CN promoted photocatalytic degradation of the Methylene Blue (MB), Rhodamine B (RhB) and Crystal Violet (CV) organic contaminants, up to 99.58%, 100% and 98.65%, respectively. The mixture of dyes used and reuse cycles was performed to analyze the applicability of the compounds in a real situation.

Integration of experiment and computational modeling on the Tb doping process in CaMoO4 obtained by USP method: An efficient way to obtain photoluminescent materials.

In this paper, we present a combined experimental and theoretical study to disclose, the structure, electronic and optical properties of CaMoO 4 :xTb 3+ ( x = 1%, 2%, and 4%) microspheres. The microspheres were prepared by ultrasonic spray pyrolysis method and characterized by experimental and theoretical techniques. Theoretical calculations and XRD patterns indicate that these crystals have a scheelite-type tetragonal structure. The morphology of the CaMoO 4 :xTb 3+ ( x = 1%, 2% and 4% mol) samples were investigated from the FEG-SEM results and the formation of microspheres with a spherical shape were observed. The optical properties were investigated by UV-Vis and PL spectroscopy, as well as the chromaticity coordinates of these compounds. This also allowed us to understand the charge transfer process that happens in the singlet state and the excited states, generating the photoluminescence emissions of the Tb doping process in CaMoO 4 microspheres.

Effects of adaptation diet and exogenous enzymes on true metabolizable energy and cecal microbial ecology, short-chain fatty acid profile, and enzyme activity in roosters fed barley and rye diets.

Three experiments evaluated effects of adaptation diet and exogenous ß-glucanase and xylanase on TMEn of barley and rye. Single Comb White Leghorn roosters were fed adaptation diets based on corn/soybean meal (SBM), barley/SBM with and without ß-glucanase, or rye/corn/SBM with and without xylanase for 4 wk. In Experiments 1 and 2, after the adaptation period, TMEn was determined using a 48 h precision-fed rooster assay for 100% barley or 100% rye diets with or without ß-glucanase or xylanase, respectively. Experiment 3 consisted only of feeding adaptation diets for 4 wk. Cecal samples were collected at the end of experiments for microbial ecology, short-chain fatty acid (SCFA) profiles, and enzyme activity analyses. In Experiments 1 and 2, ß-glucanase increased (P < 0.05) TMEn of barley, and there was no significant effect of adaptation diet on TMEn values. Total cecal Eubacteria and Ruminococcaceae were decreased (P < 0.05) and Escherichia coli were increased (P < 0.05) at the end of the TMEn assay compared with the end of the adaptation period (with no TMEn assay). There was a large decrease (P < 0.05) for most cecal SCFA at the end of the TMEn assay compared with the end of the adaptation period. Both cecal ß-glucanase and xylanase activity were increased for birds fed adaptation diets containing the respective enzyme. In Experiment 3, there were no consistent effects of adaptation diet on cecal microbial profiles or SCFA but cecal ß-glucanase activity was increased (P < 0.05) by exogenous ß-glucanase for barley and cecal xylanase activity was increased (P < 0.05) by exogenous xylanase for rye. Overall, the results indicated that TMEn of barley was increased by exogenous ß-glucanase, adaptation diet did not significantly influence the TMEn response to the dietary enzymes, and cecal fermentation (based on cecal SCFA) was greatly reduced by the TMEn assay. Cecal ß-glucanase and xylanase activity, however, were often increased by feeding high barley and high rye diets containing exogenous enzymes.

Evaluation of the precision-fed rooster assay for detecting effects of supplemental enzymes on metabolizable energy.

The precision-fed rooster assay has been used extensively to determine nitrogen-corrected true metabolizable energy (TMEn) of feed ingredients for poultry. However, this assay has not generally been used to evaluate effects of supplemental enzymes for this purpose. Therefore, 2 precision-fed rooster assays were conducted to evaluate several different carbohydrase enzymes on TMEn for a corn/soybean meal diet, a pearled barley diet, and diets containing different inclusion levels of rye/corn. In both rooster assays, Single Comb White Leghorn roosters were fasted for 26 h and then crop intubated with either 25 or 30 g of the test diets, depending on the assay. Excreta were then collected quantitatively for 48 h after feeding. In the first rooster assay with 56 birds, 6 carbohydrase combinations and/or levels (xylanase/alpha-galactosidase were evaluated using a corn/soybean meal control diet. All carbohydrase additions either numerically or significantly (P < 0.05) increased TMEn and the mean increase for the enzyme treatments was 66 kcal/kg DM compared with the corn/soybean meal control diet. The second assay consisted of twenty dietary treatments; 120 roosters were crop-intubated with 25 g of diets that were composed of 100% barley, 100% rye, 50% rye: 50% corn, or 25% rye: 75% corn. The diets were fed with and without inclusion of 2 different levels of either ß-glucanase, xylanase, or a multi-carbohydrase combination. Both ß-glucanase and the multi-carbohydrase significantly (P < 0.05) increased TMEn of the 100% barley diet, with the multi-carbohydrase increasing it from 3,722 to 4,086 kcal/kg DM at the highest inclusion rate. The xylanase and multi-carbohydrase either numerically or significantly (P < 0.05) increased TMEn of the 100% rye diet, with the multi-carbohydrase increasing it from 3,581 to 3,909 kcal/kg DM at the highest inclusion rate. The magnitude of enzyme response decreased as the level of rye in the diets decreased. Overall, results of this study indicated that the precision-fed rooster assay can detect effects of enzymes, primarily carbohydase, on TMEn of diets containing corn/soybean meal, pearled barley, and/or rye.

Spiral T1 Spin-Echo for Routine Postcontrast Brain MRI Exams: A Multicenter Multireader Clinical Evaluation.

BACKGROUND AND PURPOSE: Spiral MR imaging has several advantages compared with Cartesian MR imaging that can be leveraged for added clinical value. A multicenter multireader study was designed to compare spiral with standard-of-care Cartesian postcontrast structural brain MR imaging on the basis of relative performance in 10 metrics of image quality, artifact prevalence, and diagnostic benefit. MATERIALS AND METHODS: Seven clinical sites acquired 88 total subjects. For each subject, sites acquired 2 postcontrast MR imaging scans: a spiral 2D T1 spin-echo, and 1 of 4 routine Cartesian 2D T1 spin-echo/TSE scans (fully sampled spin-echo at 3T, 1.5T, partial Fourier, TSE). The spiral acquisition matched the Cartesian scan for scan time, geometry, and contrast. Nine neuroradiologists independently reviewed each subject, with the matching pair of spiral and Cartesian scans compared side-by-side, and scored on 10 image-quality metrics (5-point Likert scale) focused on intracranial assessment. The Wilcoxon signed rank test evaluated relative performance of spiral versus Cartesian, while the Kruskal-Wallis test assessed interprotocol differences. RESULTS: Spiral was superior to Cartesian in 7 of 10 metrics (flow artifact mitigation, SNR, GM/WM contrast, image sharpness, lesion conspicuity, preference for diagnosing abnormal enhancement, and overall intracranial image quality), comparable in 1 of 10 metrics (motion artifacts), and inferior in 2 of 10 metrics (susceptibility artifacts, overall extracranial image quality) related to magnetic susceptibility (P < .05). Interprotocol comparison confirmed relatively higher SNR and GM/WM contrast for partial Fourier and TSE protocol groups, respectively (P < .05). CONCLUSIONS: Spiral 2D T1 spin-echo for routine structural brain MR imaging is feasible in the clinic with conventional scanners and was preferred by neuroradiologists for overall postcontrast intracranial evaluation.

Practical implementation of robust MR-thermometry during clinical MR-guided microwave ablations in the liver at 1.5 T.

Practical non-invasive equipment modifications and effective acquisition methods to achieve robust and reliable real-time MR thermometry for monitoring of clinical hepatic microwave ablations were implemented. These included selection of the microwave generator location (inside versus outside the MR scan room), the number of radiofrequency chokes added to the microwave generator's coaxial lines, and the use of copper wool to maximize their electrical grounding. Signal-to-noise ratio (SNR) of MR thermometry images of a small fluid-filled phantom acquired during activation of microwave antenna were used to evaluate image quality as a function of each modification. SNR measurements corresponding to both locations of the microwave generator were comparable and so it was located outside the MR scan room. For this location, addition of one RF choke on the power and four chokes on the sensor coaxial lines was found to be optimal, corresponding to a 68% increase in SNR. Furthermore, image quality strongly depended on the proper electrical grounding of the power and sensor lines. SNR ratio (relative to SNR of baseline images) during activation of microwave generator was found to be 0.49 ±â€¯0.28 without adequate grounding, and 0.88 ±â€¯0.08 with adequate grounding (p = 0.002, Student's t-test). These SNR measurements were sufficiently sensitive to detect issues related to equipment performance and hence formed part of the quality assurance testing performed prior to each clinical treatment. Incorporating these non-invasive approaches resulted in significant improvements to image quality and, importantly while maintaining the clinical integrity of the microwave system which is of paramount importance in a highly regulated healthcare environment.

Microplastics in personal care products: Exploring perceptions of environmentalists, beauticians and students.

Microplastics enter the environment as a result of larger plastic items breaking down ('secondary') and from particles originally manufactured at that size ('primary'). Personal care products are an important contributor of secondary microplastics (typically referred to as 'microbeads'), for example in toothpaste, facial scrubs and soaps. Consumers play an important role in influencing the demand for these products and therefore any associated environmental consequences. Hence we need to understand public perceptions in order to help reduce emissions of microplastics. This study explored awareness of plastic microbeads in personal care products in three groups: environmental activists, trainee beauticians and university students in South West England. Focus groups were run, where participants were shown the quantity of microbeads found in individual high-street personal care products. Qualitative analysis showed that while the environmentalists were originally aware of the issue, it lacked visibility and immediacy for the beauticians and students. Yet when shown the amount of plastic in a range of familiar everyday personal care products, all participants expressed considerable surprise and concern at the quantities and potential impact. Regardless of any perceived level of harm in the environment, the consensus was that their use was unnatural and unnecessary. This research could inform future communications with the public and industry as well as policy initiatives to phase out the use of microbeads.

Fractures of the medial infraorbital rim.

Fractures of the medial infraorbital rim may occur independently or in conjunction with fractures of the nose and zygoma. Infraorbital fractures are frequently associated with anesthesia in the distribution area of infraorbital nerve and can produce palpable "step-off" deformities. Because roentgenographic and clinical indications of these fractures are often subtle, such injuries may go unrecognized in the presence of more obvious nasal fractures or may be misdiagnosed as "tripod" fractures. A proper recognition of these fractures is necessary for correct diagnosis and treatment. Three cases are presented and seven cases are summarized.

Techniques to enhance utilization of advancement flaps.

Utilization of advancement flaps to cover facial defects is potentially limited by the secondary distortion of adjacent anatomical landmarks, expansion of any residual lesion, and the vascular embarrassment of wound closure under tension. In this study, advancement flaps are raised in piglets, and the first stage in the serial excision of a hypothetical skin lesion is simulated. It is demonstrated that undermining of the lesion-bearing skin results in expansion of the lesion and is counterproductive. If, however, a separate layer of hypodermis and fascia is mobilized deep to the lesion and sutured to the advancing flap, skin closure can be accomplished with minimal tension. This results in maximal recruitment of the advancement flap and minimal expansion of the residual lesion as the defect is bridged.

Microfolding: conformational probability map for the alanine dipeptide in water from molecular dynamics simulations.

A direct attack on the protein-folding problem has been initiated with the free energy perturbation methods of molecular dynamics. The complete conformational probability map for the alanine dipeptide is presented. This work uses the SPC model for the explicit hydration of the dipeptide. Free energy differences for the four observed minima (beta, alpha R, alpha L, C7ax) are given, and the free energy barriers between minima are outlined.

Differential helix propensity of small apolar side chains studied by molecular dynamics simulations.

A series of oligoalanine molecules with single amino acid replacements in the middle of the chain has been studied by molecular dynamics simulations. Differences in stability of the alpha-helix (as free energies delta delta G degrees) were estimated for the following series of residues: alpha-aminoisobutyric acid, alanine, alpha-amino-n-butyric acid, valine, glycine, D-alanine, t-leucine (= alpha-amino-beta,beta-dimethyl-n- butyric acid), and proline, arranged here in decreasing order of helix-forming potential. (The results for proline and valine had been reported earlier.) No experimental results were available for alpha-amino-n-butyric acid, D-alanine, and t-leucine at the time these calculations were done. The values of delta delta G degrees, including the three predictions, are in striking agreement with recent experimental results. A combination of free dynamics, dynamics with forced conformational change, and dynamics with forced molecular replacement was used. Conformational distributions were calculated for the peptide backbone of the dipeptides and, where appropriate, for the side chains of the dipeptide and the alpha-helix. The results demonstrate an unexpected level of accuracy for the all-atom model used to represent atomic interactions in the simulations. The simulations permit a detailed analysis of different factors responsible for conformational preferences and differences in stability. These conclusions drawn from this analysis agree with accepted qualitative explanations and allow these explanations to be quantitated to an extent not heretofore possible.

Effects of ionic and nonionic detergents on antigen-antibody reactions.

Using highly sensitive and quantitative radioimmunoassay procedures we have measured the effects of different concentrations of three commonly used detergents, SDS, DOC, and Triton X-100, on antibody-antigen reactions. Triton X-100, had a relatively mild effect on primary antigen-antibody bindings, the precipitin reaction, and a double antibody RIA as evidenced by only an 8 to 10% inhibition of binding or precipitation. These results were not detergent concentration dependent, as Triton concentrations ranging from 5 to 0.1% had virtually no differential effects. Sodium deoxycholate (DOC) had a more profound effect on both primary antigen-antibody binding and the precipitin reaction than did Triton X-100, and its effects, unlike those of Triton X-100, were concentration dependent. There was a direct relationship between concentration of DOC and degree of inhibition of both primary binding and immune precepitation especially in antigen excess. Sodium dodecylsulfate (SDS), at concentrations 10- to 100-fold less than either Triton X-100 or DOC, had profound inhibitory effects on primary antigen-antibody binding, the precipitin reaction, and a double antibody radioimmunoassay. Generally, at concentrations greater that 0.01% SDS, almost all immunochemical reactivity is destroyed.