Dense Cranial Electroacupuncture Stimulation for Major Depressive Disorder—A Single-Blind, Randomized, Controlled Study

BACKGROUND: Previous studies suggest that electroacupuncture possesses therapeutic benefits for depressive disorders. The purpose of this study was to determine whether dense cranial electroacupuncture stimulation (DCEAS) could enhance the antidepressant efficacy in the early phase of selective serotonin reuptake inhibitor (SSRI) treatment of major depressive disorder (MDD). METHODS: In this single-blind, randomized, controlled study, patients with MDD were randomly assigned to 9-session DCEAS or noninvasive electroacupuncture (n-EA) control procedure in combination with fluoxetine (FLX) for 3 weeks. Clinical outcomes were measured using the 17-item Hamilton Depression Rating Scale (HAMD-17), Clinical Global Impression-severity (CGI-S), and Self-rating Depression Scale (SDS) as well as the response and remission rates. RESULTS: Seventy-three patients were randomly assigned to n-EA (n = 35) and DCEAS (n = 38), of whom 34 in n-EA and 36 in DCEAS group were analyzed. DCEAS-treated patients displayed a significantly greater reduction from baseline in HAMD-17 scores at Day 3 through Day 21 and in SDS scores at Day 3 and Day 21 compared to patients receiving n-EA. DCEAS intervention also produced a higher rate of clinically significant response compared to n-EA procedure (19.4% (7/36) vs. 8.8% (3/34)). The incidence of adverse events was similar in the two groups. CONCLUSIONS: DCEAS is a safe and effective intervention that augments the antidepressant efficacy. It can be considered as an additional therapy in the early phase of SSRI treatment of depressed patients. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN88008690

Development and validation of creatinine-based estimates of the Glo- Merular Filtration rate equation from Chromium Edta Imaging in the multi-racial Malaysian population

Background Glomerular filtration rate (GFR) is a reliable parameter for assessing kidney function. It is estimated from equations such as Cockcroft–Gault (CG), Modification of Diet in Renal Disease (MDRD), and Chronic Kidney Disease- Epidemiology Collaboration (CKD-EPI). However, these equations were derived using Western population demo- graphic data and had different performances when applied to other populations. Objectives. We developed a new equation (NE) based on the 51Cr EDTA measured GFR that can be used explicitly in the Malaysian multiracial population. Methods This was a cross-sectional study using the Electronic Medical Record (EMR) of pa- tients who underwent 51Cr-EDTA imaging at the Nuclear Medicine Centre, University Malaya Medical Centre (UMMC), from 2013 to 2021. This study had obtained approval from the Medical Research Ethics Committee, UMMC. Results Total data of 209 patients were recruited in this study. 105 were randomised in the development cohort, while 104 were in the validation cohort. A NE was developed based on data in the development cohort and then tested its performance in the validation cohort. The result showed that CKD-EPI had the highest correlation to 51Cr EDTA imaging measured GFR (r-value 0.82), followed by the NE (r-value 0.76). CG had the lowest bias (mean bias of 2.49), followed by the NE (mean bias of 3.52). CKD-EPI had the highest precision in estimating GFR (SD of 22.04ml/min), followed by the NE (SD of 25.05ml/min). CKD-EPI also had the highest accuracy (85.58% in P30 and 100% in P50, followed by MDRD (81.73% in P30 and 96.15% in P50). Conclusion The NE was less accurate than CKD-EPI and MDRD equation but generally has a rel- atively low bias of 3.52 ml/min. The limitation of the small sample size may limit the accuracy of the NE. Future studies with a larger sample size are needed to generate a more robust equation

A strategic management approach to country club management : case study on Raffles Marina Limited.

Our objectives for this case study are: i. to understand the workings of a Raffles Marina Country Club (RML), ii. to use and apply various strategic management frameworks to understand what factors contribute to a member's perception of RML and how these models can be used to improve the member's satisfaction, iii. how RML can use these factors to help improve their members’ satisfaction

Improved mechanical and thermomechanical properties of alumina substrate via iron doping

We present a method to improve the overall properties of sintered alumina substrate via iron doping that has a higher fracture toughness, lower thermal conductivity, lower thermal expansion coefficient and comparable dielectric constant to pure alumina. Such properties are beneficial for harsh environment electronic packages. X-Ray and electron probe micros analysis concluded that toughening are likely contributed by multiple phases strengthening and ruled out crack bridging or grain boundary strengthening.Accepted versio

MicroRNAs regulating cluster of differentiation 46 (CD46) in cardioembolic and non-cardioembolic stroke.

Ischemic stroke is a major cause of mortality and morbidity globally. Among the ischemic stroke subtypes, cardioembolic stroke is with poor functional outcome (Modified Rankin score ≥ 2). Early diagnosis of cardioembolic stroke will prove beneficial. This study examined the microRNAs targeting cluster of differentiation 46 (CD46), a potential biomarker for cardioembolic stroke. CD46 mRNA level was shown to be differentially expressed (p < 0.001) between cardioembolic stroke (median = 1.32) and non-cardioembolic stroke subtypes (large artery stroke median = 5.05; small vessel stroke median = 6.45). Bioinformatic search showed that miR-19a, -20a, -185 and -374b were found to target CD46 mRNA and further verified by luciferase reporter assay. The levels of miRNAs targeting CD46 were significantly reduced (p < 0.05) in non-cardioembolic stroke patients (large artery stroke median: miR-19a = 0.63, miR-20a = 0.42, miR-185 = 0.32, miR-374b = 0.27; small artery stroke median: miR-19a = 0.07, miR-20a = 0.06, miR-185 = 0.07, miR-374b = 0.05) as compared to cardioembolic stroke patients (median: miR-19a = 2.69, miR-20a = 1.36, miR-185 = 1.05, miR-374b = 1.23). ROC curve showed that the miRNAs could distinguish cardioembolic stroke from non-cardioembolic stroke with better AUC value as compared to CD46. Endogenous expression of CD46 in Human Umbilical Vein Endothelial Cells (HUVECs) were found to be regulated by miR-19a and miR-20a. Thus implicating that miR-19a and -20a may play a role in pathogenesis of cardioembolic stroke, possibly via the endothelial cells

Dense Cranial Electroacupuncture Stimulation for Major Depressive Disorder-A Single-Blind, Randomized, Controlled Study

Abstract Background: Previous studies suggest that electroacupuncture possesses therapeutic benefits for depressive disorders. The purpose of this study was to determine whether dense cranial electroacupuncture stimulation (DCEAS) could enhance the antidepressant efficacy in the early phase of selective serotonin reuptake inhibitor (SSRI) treatment of major depressive disorder (MDD)

Study of metal additives to alumina ceramics substrate for high temperature and pressure application

In this work, we present systematical characterizations of iron doped alumina substrates produced by solid state sintering of ball milled powders. It was found that the doped samples have higher fracture toughness, lower thermal conductivity, smaller coefficient of thermal expansion and higher relative dielectric constant than undoped ones. A reduction in thermal conductivity could arguably give extra protection to the package chip in a high temperature application environment and can be attributed to an increase in phonon scattering. Furthermore, the decrease in coefficient of thermal expansion also helps to reduce thermal induced stress between the substrates and device chip. The observed improvement in fracture toughness cannot be explained by the common toughening mechanism, such as crack bridging or due to the increase in crystallite size, and is the subject of further investigation.Accepted versio

Predicted targets of miR-19a, -20a, -185 and -374b in complement and coagulation cascade.

<p>Predicted targets of miR-19a, -20a, -185 and -374b in complement and coagulation cascade.</p

<i>CD46</i> mRNA level in cardioembolic and non-cardioembolic (large artery and small vessel stroke) patients and miRNAs targeting <i>CD46</i>.

<p><b>A</b>. <i>CD46</i> mRNA level in patients. Data expressed as relative expression with respect to control samples, with the number of patients and controls indicated. <b>CE</b> represents cardioembolic stroke. <b>LA</b> represents large artery stroke. <b>SV</b> represents small vessel stroke. Data in <b>A</b> are shown as relative expression. <b>B</b>. miRNA binding sites and binding energies. Nucleotides in bold denoted the seed region. <b>C</b>. Luciferase assay. <b>D</b>. miRNA levels in transfected HeLa cells. Data in <b>C</b> and <b>D</b> are shown as mean ± SD. All experiments were performed in n = 3. * denotes significant difference (<i>p</i> < 0.05) against control (<b>A</b> and <b>C</b>) using Mann-Whitney U test. # denotes significance between cardioembolic and non cardioembolic stroke (<b>A</b>) using Mann-Whitney U test.</p

Patients’ demography.

<p>Patients’ demography.</p