A risk of bias gragh, B risk of bias summary(“+”low risk;“?”, unclear risk;“-”,high risk).

<p>A risk of bias gragh, B risk of bias summary(“+”low risk;“?”, unclear risk;“-”,high risk).</p

Short-term efficacy and tolerability of venlafaxine extended release in adults with generalized anxiety disorder without depression: A meta-analysis

<div><p>Background</p><p>Although efficacy of venlafaxine extended release (XR) for generalized anxiety disorder (GAD) has been reported in previous analyses in 2002 and 2004, the sample size was rather small and estimate of safety or tolerability was not clear. The present analysis had the advantage of large sample size and provided evidence for tolerability.</p><p>Methods</p><p>Literature databases were searched, including Pubmed, Embase, Cochrane Central Register of Controlled Trials, Web of science and clinical trials. 10 eligible articles were finally selected and data was extracted and logged into the Review Manager 5.3 by two independent authors. The risk of bias was evaluated by the Cochrane Collaboration’s Risk of Bias Tool and the stability of the results was assessed by sensitivity analysis. The publication bias was assessed by funnel plot and Egger’s/Begg’s test using Stata Version 12.0 software.</p><p>Results</p><p>In the current meta-analysis, 10 articles (14 studies) satisfying the inclusion criteria were analyzed. As efficacy outcomes, our findings indicated venlafaxine XR was significantly more effective than placebo according to mean change of the Hamilton Rating Scale for Anxiety total scores [mean difference = 3.31, 95% confidence interval(CI) 1.44–5.18, P = 0.0005], response [odds ratio(OR) = 1.83, 95%CI 1.58–2.12, P<0.00001], and remission (OR = 2.55, 95%CI 1.36–4.78, P = 0.003). In terms of tolerability, the most frequently reported treatment-emergent adverse events were nausea, dry mouth, dizziness, insomnia, somnolence, and headache. In addition, discontinuation due to all-cause (OR = 1.17, 95%CI 0.92–1.49, P = 0.19) was not significantly different between the two groups, whereas discontinuation due to adverse events was statistically higher in the venlafaxine XR group compared with the placebo treatment (OR = 2.80, 95%CI 2.21–3.54, P<0.00001) and discontinuation due to inefficacy was lower in venlafaxine than placebo treatment (OR = 0.26, 95%CI 0.17–0.40, P<0.00001). There was no significant publication bias and sensitivity analysis showed that our analysis exhibited high stability.</p><p>Conclusion</p><p>We concluded that venlafaxine XR (75–225 mg/day) is an effective and well-tolerated pharmacological treatment option for adult patients with GAD.</p></div

Characteristics of multicentres, randomized, double-blind, placebo-controlled studies included in the meta-analysis.

<p>Characteristics of multicentres, randomized, double-blind, placebo-controlled studies included in the meta-analysis.</p

Funnel plot of publication bias.

<p>Funnel plot of publication bias.</p

Forest plots of discontinuation due to any reason, AEs, and lack of efficacy.

<p>AEs, adverse effects; SD, standard deviation; CI, confidence interval; M-H, Mantel-Haenszel.</p

Forest plots of primary and secondary efficacy outcomes.

<p>SD, standard deviation; CI, confidence interval; M-H, Mantel-Haenszel.</p

Enhancement of cold flowability for high waxy crude oil by the mildly crosslinked poly(styrene-octadecyl acrylate)

The precipitation of wax at low temperature often leads to the viscosity increase of waxy crude oil, and even causes the blockage of pipelines in severe cases. The addition of polymer additives is an effective method for inhibiting wax precipitation. In the present work, poly(styrene-octadecyl acrylate)s with low crosslinking density were prepared through microemulsion polymerization, with styrene and octadecyl acrylate as monomers and N-(hydroxyethyl) acrylamide (NMA) as the crosslinking agent. The chemical structures and molecular weights of polymers were characterized by Fourier transform infrared spectroscopy and gel permeation chromatography, respectively. The crosslinking densities (CLD) of polymers were determined in the range of 1.32 × 10−4 to 4.66 × 10−4 cm3/mol by the dissolution equilibrium method. Waxy model oils were prepared to explore the crosslinked polymers on the wax crystallization behaviors by using X-ray diffraction (XRD) approaches and isothermal crystallization kinetics (ICK). As the CLD of polymers increases to 1.99 × 10−4 cm3/mol, the crystallinity index (CI), grain size, and structural strength of the wax crystals decrease. However, as the CLD of polymers is further increased to 4.66 × 10−4cm3/mol, all of the above parameters increase, due to the deterioration of the co-crystallization ability of polymers. In the ICK tests, The Avrami index n of the model oil samples increases from 1.94 to 2.43 as the CLD increases, implying that the nucleation effect of polymers is increased. The effect of CLD on the cold flowability of Inner Mongolia crude oil was investigated by pour point test, rheology, differential scanning calorimeter (DSC), and polarized light microscopy (PLM). The results show that the pour point, viscosity, yield stress, thixotropic ring area, cumulative wax precipitation and wax crystal size of the crude oil decrease when the CLD of polymers increases to 1.99 × 10−4 cm3/mol. However, if the CLD is further increased to 4.66 × 10−4 cm3/mol, all of the parameters increase. Consequently, the mechanism for the improvement of waxy crude oil by mildly crosslinked polymer is proposed.</p

Meta-analysis of the most frequent TEAEs with a frequency of≥5% in duloxetine-treated patients.

<p>Meta-analysis of the most frequent TEAEs with a frequency of≥5% in duloxetine-treated patients.</p

Efficacy and tolerability of short-term duloxetine treatment in adults with generalized anxiety disorder: A meta-analysis

<div><p>Objective</p><p>To investigate the efficacy and tolerability of duloxetine during short-term treatment in adults with generalized anxiety disorder (GAD).</p><p>Methods</p><p>We conducted a comprehensive literature review of the PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and ClinicalTrials databases for randomized controlled trials(RCTs) comparing duloxetine or duloxetine plus other antipsychotics with placebo for the treatment of GAD in adults. Outcome measures were (1) efficacy, assessed by the Hospital Anxiety and Depression Scale(HADS) anxiety subscale score, the Hamilton Rating Scale for Anxiety(HAM-A) psychic and somatic anxiety factor scores, and response and remission rates based on total scores of HAM-A; (2) tolerability, assessed by discontinuation rate due to adverse events, the incidence of treatment emergent adverse events(TEAEs) and serious adverse events(SAEs). Review Manager 5.3 and Stata Version 12.0 software were used for all statistical analyses.</p><p>Results</p><p>The meta-analysis included 8 RCTs. Mean changes in the HADS anxiety subscale score [mean difference(MD) = 2.32, 95% confidence interval(CI) 1.77–2.88, P<0.00001] and HAM-A psychic anxiety factor score were significantly greater in patients with GAD that received duloxetine compared to those that received placebo (MD = 2.15, 95%CI 1.61–2.68, P<0.00001). However, there was no difference in mean change in the HAM-A somatic anxiety factor score (MD = 1.13, 95%CI 0.67–1.58, P<0.00001). Discontinuation rate due to AEs in the duloxetine group was significantly higher than the placebo group [odds ratio(OR) = 2.62, 95%CI 1.35–5.06, P = 0.004]. The incidence of any TEAE was significantly increased in patients that received duloxetine (OR = 1.76, 95%CI 1.36–2.28, P<0.0001), but there was no significant difference in the incidence of SAEs (OR = 1.13, 95%CI 0.52–2.47, P = 0.75).</p><p>Conclusion</p><p>Duloxetine resulted in a greater improvement in symptoms of psychic anxiety and similar changes in symptoms of somatic anxiety compared to placebo during short-term treatment in adults with GAD and its tolerability was acceptable.</p></div

Funnel plot of publication bias.

<p>Funnel plot of publication bias.</p