Controlled Study Research Articles

Reaction Time in Fibromyalgia Patients.

Fibromyalgia has unknown aetiology and is associated with reduced information processing speed and therefore prolonged reaction time. However, the processes underlying this are unknown. First, to compare the reaction time in a cohort of fibromyalgia patients and a matched group of normal controls. Second, to assess whether detailed symptoms of pain and autonomic function, as well as measures of tinnitus, fatigue, daytime sleepiness and Mycoplasma pneumoniae infection are predictors of reaction time in fibromyalgia. The between-groups mean serial five-choice reaction time difference was assessed in a cohort of fibromyalgia patients and in a matched group of normal controls in an analytical casecontrolled study. With the mean serial five-choice reaction time as the dependent variable for the fibromyalgia group, a mixed stepwise multiple linear regression was performed with inputs relating to pain, dysautonomia, tinnitus, fatigue, daytime sleepiness and Mycoplasma pneumoniae infection. The mean (standard error) serial five-choice reaction time for the fibromyalgia group was 448.4 (23.0) ms, compared with 386.3 (8.3) ms for the control group (p = 0.007). The final multiple linear regression model (p < 0.001; adjusted R2 = 0.772) contained 13 predictors: eight sensory pain and three affective pain parameters, and Mycoplasma pneumoniae IgG and IgA assay results. Certain sensory and affective pain parameters, as well as Mycoplasma pneumoniae infection, appear to be predictors of reaction time in fibromyalgia. Further research into the pathophysiological mechanisms by which they affect information processing is warranted and may shed light on the aetiology of fibromyalgia.

Fuel recycling feedback control via real-time boron powder injection in EAST with full metal wall

Abstract A feedback control of fuel recycling via real-time boron powder injection, addressing the issue of continuously increasing recycling in long-pulse plasma discharges, has been successfully developed and implemented on EAST tokamak. The feedback control system includes four main parts: the impurity powder dropper (IPD), a diagnostic system measuring fuel recycling level represented by Dα emission, a plasma control system (PCS) implementing the Proportional Integral Derivative (PID) algorithm, and a signal converter connecting the IPD and PCS. Based on this control system, both active control and feedback control experiments have recently been performed on EAST with a full metal wall. The experimental results show that the fuel recycling can be gradually reduced to lower level as PCS control voltage increases. In the feedback control experiments, it is also observed that the Dα emission is reduced to the level below the target Dα value by adjusting boron injection flow rate, indicating successful implementation of the fuel recycling feedback control on EAST. This technique provides a new method for fuel recycling control of long pulse and high parameter plasma operations in future fusion devices.

Does Vitamin E Supplementation Alter Hormonal Levels in Polycystic Ovary Syndrome: A Systematic Review of Randomized Controlled Trials

Background: Vitamin E influences hormonal parameters in women, but the evidence concerning its effectiveness in polycystic ovarian syndrome (PCOS) are constrained. Objective: The objective of this systematic review is to perceive the mechanism behind the hormonal effects of vitamin E in PCOS and explore the effectiveness of vitamin E by analyzing the clinical studies. Methods: Electronic bibliographic databases, such as PubMed, Scopus, ProQuest, DOAJ, ScienceDirect, and Cochrane Library, were searched for clinical studies scrutinizing the effect of vitamin E supplementation on PCOS. The systematic review protocol is registered in PROSPERO (CRD42021272963) and was performed as per the PRISMA guidelines. Records analyzing the hormonal parameters were included. For individual study, the risk of bias was ascertained with NHLBI protocol for controlled randomized studies. Results: There were 1438 records identified, of which seven records were retrieved which met the inclusion criteria. Bibliographic details, number of participants, the dose of vitamin E, duration of the treatment and trial, parameters analyzed, and outcome of each study were extracted comprehensively. In the review, the majority of the studies embraced high-quality studies, which included double-blinded controlled trials, open-label controlled studies, and cohort studies. Conclusion: Vitamin E implies having a progesterone-like impression with estrogenic and androgenic properties. Furthermore, the ability of vitamin E as an antioxidant is also advantageous in PCOS women. However, there is a lack of empirical evidence on its mechanism, and the inadequacy of large-scale concerns about different age groups against PCOS is requisite.

Success Rate of Temporal Inverted ILM Flap Versus ILM Peel in Macular Hole Larger Than 400 µm in Size: A Non Randomized Clinical Study

Objective: To compare the efficacy of the temporal inverted ILM flap technique versus ILM peeling for better visual outcomes and closure of macular holes larger than 400 µm. Methodology: This was a non randomized controlled study conducted in the Department of Eye Unit 3, Institute of Ophthalmology, Mayo Hospital Lahore from January 2019 to December 2019. Twenty eyes with large macular holes were included; ten eyes were treated with the Temporal Inverted ILM Flap technique, and ten eyes were treated with ILM Peeling. Preoperatively all macular holes in both groups were assessed for visual acuity and size of macular hole on Optical Coherence Tomography (OCT). Postoperatively, one week, one month, three months, and six months, best corrected visual acuity (BCVA) was measured using the logarithm of the minimum angle of resolution (logMAR) scale and macular hole (MH) closure was assessed on OCT. The chi-square test was applied taking p-values &lt; 0.05 a significant. Results: Initially, both groups had an average BCVAof 0.54 ± 0.1 logMAR. After 6 months, the group that underwent Temporal Inverted ILM Flap surgery showed a notable enhancement in BCVA(0.30 ± 0.08 logMAR) in comparison to the group that underwent ILM Peeling surgery (0.40 ± 0.08 logMAR, p = 0.012). There was a higher rate of Type 1 closure (90% compared to 60%, p = 0.011) and better continuity of the ellipsoid zone (100% compared to 80%, p = 0.12) in the group that utilized the temporal inverted flap method as compared to simple ILM peel. Conclusion: Temporal Inverted ILM Flap approach is more effective than ILM peeling in terms of better visual acuity, higher type 1 closure rate, and better continuity of the ellipsoid zone. Keywords: ILM Peeling, Macular Hole, Retinal Surgery, Temporal Inverted ILM Flap, Visual Acuity

Efficacy and Safety of Acupuncture in the Treatment of Radicular Cervical Spondylosis: A Systematic Review and Meta-Analysis.

Cervical spondylotic radiculopathy is a serious and common degenerative disease of the cervical spine due to irritation and compression of the nerve roots of the cervical spine, resulting in a series of clinical symptoms based on sensory, motor and reflex disorders, such as numbness and pain in the neck, shoulders, upper limbs and fingers. Acupuncture is highly effective in treating CSR and has become a common treatment accepted by patients. This study aims to systematically review and analyze existing randomized controlled trials (RCTs) to evaluate the efficacy and safety of acupuncture in the treatment of CSR. We used the following eight databases for literature data search: PubMed, EMBASE, The Cochrane Library, Web of Science, China National Knowledge Infrastructure, China Biology Medicine Disc ( CBMdisc), Wanfang Database and China Science and Technology Journal Database (VIP). The search consisted of randomized controlled studies of acupuncture for CSR between 2000 and 2020 and the methodological quality of the included studies was assessed according to the Cochrane Collaboration's "Risk of Bias Assessment Tool."RevMan 5.4 software was used for statistical analysis only. Study screening, data extraction and statistics, and assessment of the risk of bias of the included studies were performed independently by two reviewers. 27 studies with 3124 patients were included. The results of the meta-analysis of the total efficiency index for acupuncture for CSR were [RR = 1.14,95% CI (1.09,1.19)]. The results of the meta-analysis of the PPI index were [MD = -0.35, 95% CI (-0.61,-0. 09)]. The results of META analysis of the total effective rate, VAS score, PRI(A) score, PRI(S) score and PRI(T) score showed heterogeneity in the studies included for each outcome index, and sources of heterogeneity were sought through subgroup analysis and sensitivity analysis to ensure more stable and reliable data results. The results of the combined meta-analysis showed that the treatment group was significantly more effective than the control group and more effective in lowering the nerves to reduce the pain index in patients with CSR, with a statistically significant difference (P<0.05). This indicates that acupuncture treatment is superior to traction for CSR. Acupuncture is significantly more effective than traction therapy in the treatment of cervical spondylosis and can reduce the pain index of patients with CSR.

Robot-assisted radical nephroureterectomy using the KangDuo Surgical Robot-01 System versus the da Vinci System: a multicenter prospective randomized controlled trial.

We aim to compare the safety and effectiveness of the KangDuo (KD)-Surgical Robot-01 (KD-SR-01) system and the da Vinci (DV) system for robot-assisted radical nephroureterectomy (RARNU). This multicenter prospective randomized controlled trial was conducted between March 2022 and September 2023. Group 1 included 29 patients undergoing KD-RARNU. Group 2 included 29 patients undergoing DV-RARNU. Patient demographic and clinical characteristics, perioperative data, and follow-up outcomes were collected prospectively and compared between the two groups. There were no significant differences in patient baseline demographic and preoperative characteristics between the two groups. The success rates in both groups were 100% without conversion to open or laparoscopic surgery or positive surgical margins. No significant difference was observed in docking time [242 (120-951) s vs 253 (62-498) s, P = 0.780], console time [137 (55-290) min vs 105 (62-220) min, P = 0.114], operative time [207 (121-460) min vs 185 (96-305) min, P = 0.091], EBL [50 (10-600) mL vs 50 (10-700) mL, P = 0.507], National Aeronautics and Space Administration Task Load Index scores, and postoperative serum creatinine levels between the two groups. None of the patients showed evidence of distant metastasis, local recurrence, or equipment-related adverse events during the four-week follow-up. One (3.4%) patient in Group 2 experienced postoperative enterovaginal and enterovesical fistulas (Clavien-Dindo grade III). The KD-SR-01 system is safe and effective for RARNU compared to the DV Si or Xi system. Further randomized controlled studies with larger sample sizes and longer durations are required.

Assessment of traumatic brain injury treatment guided by continuous monitoring of intracranial pressure and brain tissue oxygen partial pressure: A single-center pilot study

Severe traumatic brain injury (TBI) is a leading cause of death and disability. Monitoring intracranial pressure (ICP) is recommended, but the data on the outcomes are conflicting. Adding continuous brain tissue oxygen partial pressure (PbtO2) monitoring may have some benefit but the OXY-TC suggested it did not improve 6-month neurological outcomes. This single-center pilot randomized controlled study aimed to evaluate whether adding PbtO2 monitoring was feasible and could improve the prognosis of severe TBI. The participants were randomized into either an ICP alone or an ICP + PbtO2 group for 7 days, with treatment protocols based on existing guidelines. Clinical parameters were collected hourly. The primary outcome was the feasibility of using PbtO2 monitoring. The secondary outcomes were 6-month survival, analyzed by the log-rank test, the 3- and 6-month Glasgow Outcome Scale (GOS) scores, compared between groups by chi-squared test. Seventy patients were included (36 ICP, 34 ICP + PbtO2). The ICP + PbtO2 group had lower mean daily ICP (13.4 vs. 18.2 mmHg, P = 0.0024) and higher mean daily cerebral perfusion pressure (82.1 vs. 74.5 mmHg, P = 0.0055). The ICP + PbtO2 group had higher 6-month survival (79.4 % vs. 55.6 %, P = 0.0337) and more favorable outcomes at 3 months (67.6 % vs. 38.9 %, P = 0.0160) and 6 months (70.6 % vs. 41.7 %, P = 0.0149). Adding PbtO2 monitoring to ICP monitoring is feasible in patients with severe TBI and could maybe improve the intermediate-term outcomes. The results will serve to design larger trials.

Meta-analysis of electrical stimulation promoting recovery of gastrointestinal function after gynecological abdominal surgery

BACKGROUND The effects of electrical stimulation on gastrointestinal function recovery after gynecological abdominal surgery was not clear. AIM To systematically evaluate the effects of electrical stimulation on gastrointestinal function recovery after gynecological abdominal surgery. METHODS The Cochrane Library, Web of Science, PubMed, ProQuest, and the Chinese biomedical literature databases Wanfang, Weipu, and CNKI were used to search for relevant studies on controlled trials of electrical stimulation in gynecological abdominal surgery patients from self-established databases to May 2024. The RevMan software (version 5.3) was used to analyze the included literature and explore the heterogeneity of each study. RESULTS Seven controlled trials, involving 520 patients, were included. The results of meta-analysis showed that electrical stimulation could shorten the recovery time of intestinal sound after gynecological abdominal surgery [odds ratio (OR): -5.11, 95%CI: -5.84 to -4.38, P &lt; 0.00001] and improve the time of first anal exhaust (OR: -1.19, 95%CI: -1.38 to -0.99, P &lt; 0.00001), improved the time of first anal defecation (OR: -0.98, 95%CI: -1.19 to -0.78, P &lt; 0.00001), The difference is significant. According to the funnel plot, if the scatter is symmetrical, it indicates that the funnel plot is unbiased. CONCLUSION Electrical stimulation can shorten this reduces the length of time it takes for the patient to recover from bowel sounds and also affects the time to first anal voiding and defecation to some extent, thereby promoting gastrointestinal function recovery after gynecological abdominal surgery. The quality of the studies included in this review was poor, which may have affected the final results. It is necessary to conduct a randomized controlled study with higher quality and more samples to further confirm the promoting effect of electrical stimulation on gastrointestinal function recovery to guide clinical treatment.

Copper(I)‐Catalyzed Asymmetric 1,4‐Hydroarsination of α,β‐Unsaturated Compounds

Herein, a copper(I)‐catalyzed asymmetric 1,4‐hydroarsination of β‐substituted α,β‐unsaturated esters is achieved in moderate to excellent yields with high to excellent enantioselectivity, based on the proposed nucleophilic [Cu]‐AsPh2 species. As for α‐substituted α,β‐unsaturated esters, a 1,4‐hydroarsination/enantioselective protonation event occurs smoothly in satisfying results. Furthermore, β‐substituted α,β‐unsaturated ketone, α,β‐unsaturated amide, and α,β‐unsaturated phosphine sulfide are well applied in the present catalytic system. Finally, some control experiments show that HAsPh2 is activated through coordination with the copper(I) catalyst and HAsPh2 exhibits inferior soft Lewis basicity to HPPh2 in the presence of a copper(I)‐bisphosphine complex.

Copper(I)‐Catalyzed Asymmetric 1,4‐Hydroarsination of α,β‐Unsaturated Compounds

Herein, a copper(I)‐catalyzed asymmetric 1,4‐hydroarsination of β‐substituted α,β‐unsaturated esters is achieved in moderate to excellent yields with high to excellent enantioselectivity, based on the proposed nucleophilic [Cu]‐AsPh2 species. As for α‐substituted α,β‐unsaturated esters, a 1,4‐hydroarsination/enantioselective protonation event occurs smoothly in satisfying results. Furthermore, β‐substituted α,β‐unsaturated ketone, α,β‐unsaturated amide, and α,β‐unsaturated phosphine sulfide are well applied in the present catalytic system. Finally, some control experiments show that HAsPh2 is activated through coordination with the copper(I) catalyst and HAsPh2 exhibits inferior soft Lewis basicity to HPPh2 in the presence of a copper(I)‐bisphosphine complex.

Improvement of the Endotracheal Intubation Skill of Nurse Anesthesia Students Using Visual Self-evaluation in Iran: A Randomized Controlled Study

Background: One of the feedback methods is visual self-evaluation, which is a type of immediate feedback provided after a task. It is at the level of self-regulation. Mastery in learning requires accurate evaluation of clinical skills, and visual self-evaluation can help learners to master the stages of skill implementation. Objectives: The present study investigated the effect of visual self-evaluation on the endotracheal intubation skill of nurse anesthesia students of Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Methods: This randomized controlled study was conducted in April and May of 2023. 63 second- and third-year nurse anesthesia students were allocated to the intervention (visual self-evaluation) and control (conventional methods) groups according to the academic year, using stratified random sampling. The skill of endotracheal intubation was taught using visual self-evaluation method in the intervention group while the same skill was taught in the control group based on the conventional methods, i.e. lecture, practical training, and practice on the mannequin under the supervision of the instructor. Visual self-evaluation and conventional teaching methods were compared in terms of learning outcomes. The endotracheal intubation skill evaluation checklist developed by hart was used to evaluate endotracheal intubation skill. The students of the intervention group also completed a questionnaire to measure their satisfaction with the visual self-evaluation method. Results: The students with a mean age of 21.53 ± 3.65 years, participated in this study. About 73% of the participants were women. The mean scores of students in the post-test compared to the pre-test in both intervention (23.56 ± 2.68 at baseline and increased to 28.87 ± 4.80) and control (24.03 ± 2.22 at baseline and increased to 25.19 ± 2.46) groups increased significantly (P &lt; 0.001), but the mean post-test scores of the intervention group were significantly higher than those of the control group (P &lt; 0.001). Also, the mean satisfaction score in the intervention group was 40.79 ± 1.22 out of a maximum of 50, which indicates a very high satisfaction with the adoption of visual self-evaluation method in clinical education. Conclusions: The use of visual self-evaluation not only had a significant effect on improving the clinical skill of nurse anesthesia students but also was effective in helping them learn self-regulation and achieve mastery and independence. This method is recommended as a low-cost and effective method to be used along with other educational methods.

Efficacy of indirect intense pulsed light irradiation on meibomian gland dysfunction: a randomized controlled study

AIM: To investigate the efficacy and mechanisms of indirect intense pulsed light (IPL) irradiation on meibomian gland dysfunction (MGD). METHODS: A total of 60 MGD patients was included in this prospective randomized controlled trial. Patients were randomly assigned 1:1 into two groups (3-mm group and 10-mm group) in which IPL was applied at distances from the lower eyelid margin of 3 and 10 mm, respectively. Both groups received three times treatment with 3-week interval. Meibomian gland yield secretion score (MGYSS), standard patient evaluation of eye dryness (SPEED) questionnaire, tear break-up time (TBUT), corneal fluorescein staining (CFS), and in vivo confocal microscopy were performed at baseline and after every treatment. RESULTS: After three IPL treatments, both groups had significant improvement in MGYSS (both P&amp;#x003C;0.05). The non-inferiority test showed that improvement in 10-mm group was not inferior to that in 3-mm group (P&amp;#x003C;0.001). In both groups, temporal regions of both upper and lower eyelids showed significant improvement in MGYSS. Scores of SPEED questionnaire in both groups declined significantly (both P&amp;#x003C;0.001) and changes of SPEED had no difference between two groups (P=0.57). Density of central corneal subepithelial nerves and TBUTs showed no statistically significant changes. The 3-mm group had improvement on corneal fluorescein staining (P=0.048) and meibomian gland morphology (acini wall thickness P=0.003, hyperreflective points P=0.024) while the 10-mm group had not. CONCLUSION: The efficacy of IPL indirect irradiation in improving meibomian gland secretion and alleviating dry eye symptoms remains unchanged with increase in treatment distance. IPL may primarily act on the functional improvement of the meibomian glands and corneal nerves.

Long-Term Efficacy and Safety of Acoramidis in ATTR-CM: Initial Report From the Open-Label Extension of the ATTRibute-CM Trial

Background: In the phase 3 randomized controlled study, ATTRibute-CM, acoramidis, a transthyretin (TTR) stabilizer, demonstrated significant efficacy on the primary endpoint. Participants with transthyretin amyloid cardiomyopathy (ATTR-CM) who completed ATTRibute-CM were invited to enroll in an open-label extension study (OLE). We report efficacy and safety data of acoramidis in participants who completed ATTRibute-CM and enrolled in the ongoing OLE. Methods: Participants who previously received acoramidis through Month 30 (M30) in ATTRibute-CM continued to receive it (continuous acoramidis), and those who received placebo through M30 were switched to acoramidis (placebo to acoramidis). Participants who received concomitant tafamidis in ATTRibute-CM were required to discontinue it to be eligible to enroll in the OLE. Clinical efficacy outcomes analyzed through Month 42 (M42) included time to event for all-cause mortality (ACM) or first cardiovascular-related hospitalization (CVH), ACM alone, first CVH alone, ACM or recurrent CVH, change from baseline in N-terminal pro-B-type natriuretic peptide (NT-proBNP), 6-minute walk distance (6MWD), serum TTR, and the Kansas City Cardiomyopathy Questionnaire Overall Summary score (KCCQ-OS). Safety outcomes were analyzed through M42. Results: Overall, 438 of 632 participants in ATTRibute-CM completed treatment and 389 enrolled in the ongoing OLE (263 continuous acoramidis, 126 placebo to acoramidis). The hazard ratio (HR) (95% CI) for ACM or first CVH was 0.57 (0.46, 0.72) at M42 based on a stratified Cox proportional hazards model ( P -value &lt; 0.0001) favoring continuous acoramidis. Similar analyses were performed on ACM alone and first CVH alone, with HRs (95% CI) of 0.64 (0.47, 0.88) and 0.53 (0.41, 0.69), respectively, at M42. Treatment effects for NT-proBNP and 6MWD also favored continuous acoramidis. Upon initiation of open-label acoramidis in the placebo-to-acoramidis arm there was a prompt increase in serum TTR. Quality of life assessed by KCCQ-OS was well preserved in continuous acoramidis participants compared with the placebo to acoramidis participants. No new clinically important safety issues were identified in this long-term evaluation. Conclusions: Early initiation and continuous use of acoramidis in the ATTRibute-CM study through M42 of the ongoing OLE study was associated with sustained clinical benefits in a contemporary ATTR-CM cohort, with no clinically important safety issues newly identified.

Weight discrimination ability during an action observation task is dependent on the type of muscle contraction

AbstractConcentric and eccentric contractions show different patterns of neural activity at both peripheral and cortical levels, which are thought to influence the perception of action properties such as the weight of objects moved by others. The aim of this study was to investigate how the type of muscle contraction influences weight estimation during action observation.Forty‐eight volunteers completed the Main experiment and the Control experiment. In the Main experiment, they performed a weight discrimination video task in which they watched videos of an actor moving two objects, a comparison, and a reference box, executing concentric or eccentric contractions and they had to indicate which box was the heaviest. Sensitivity analysis and psychometric functions were used to analyse the data. In the Control experiment, observers judged the actor's effort in moving the boxes.The results of the Main experiment showed that the weight discrimination sensitivity was higher in the eccentric condition for the light boxes. Conversely, for the heaviest boxes, discrimination sensitivity was higher in the concentric condition. These results were confirmed by the psychometric function analysis. The control experiment showed that the perceived difference in effort between the comparison and reference stimuli was greater in the eccentric than in the concentric condition for light stimuli.These results showed that the ability to evaluate the weight of the object involved in the observed action was influenced by the type of contraction and the amount of weight. The effort attributed to the actor influenced the observer's perception.

Oral Health Complications of SCUBA Diving

OBJECTIVE This review aims to assess the specific oral health complications associated with SCUBA diving, including barodontalgia, barosinusitis, and temporomandibular joint (TMJ) disorders, and to examine the dental implications of hyperbaric oxygen therapy (HBOT) used in decompression sickness treatment. Additionally, this review identifies gaps in the literature and suggests areas for further research to improve dental care guidelines for divers. MATERIALS AND METHODS A systematic literature search was conducted using PubMed and Scopus databases from 2004 to 2024, focusing on terms such as "barodontalgia," "dental barotrauma," and "diving dentistry." From 77 initial articles, 25 studies were selected based on relevance to pressure-induced oral complications, diving-related barotrauma, and dental management for SCUBA divers. RESULTS The review identifies barodontalgia as a prevalent issue, commonly triggered by untreated caries or defective restorations, with symptoms intensified by pressure changes. TMJ disorders, linked to prolonged clenching on diving mouthpieces, and sinus-related barotrauma also emerged as significant concerns. Preventive measures, including regular dental checkups, use of resin-based cements, and customized mouthpieces, are recommended to reduce risks. Furthermore, the review highlights a need for larger, controlled studies across diverse diver populations to validate current recommendations and develop accessible guidelines, especially for recreational divers who may lack access to specialized dental care.

MOBILE APPLICATIONS AND SUICIDE: A SYSTEMATIC ANALYSIS ON THE EFFECTIVENESS OF MOBILE APPLICATIONS FOR SUICIDE PREVENTION

MOBILE APPLICATIONS AND SUICIDE: A SYSTEMATIC ANALYSIS ON THE EFFECTIVENESS OF MOBILE APPLICATIONS FOR SUICIDE PREVENTION ABSTRACT Objective: This study aimed to evaluate the effectiveness of mobile applications designed to prevent suicide. Design: Within the scope of the study, open access Turkish and English articles published in online databases (Web of Science, PubMed (MEDLINE), WİLEY, Taylor &amp; Francis Online, Science Direct) between 2019 and August 2024 were reviewed. Randomized controlled trials on mobile applications whose role in preventing suicide was clearly stated in the articles were included in the study. Results: As a result of the screening, seven studies that met the inclusion criteria were included in this study. In four of the included studies, a routine intervention (awareness training, psychotherapy or medical treatment) was compared with an additional mobile application; in three studies, a routine intervention was compared with a mobile application. As a result of the evaluation, different results were obtained in terms of the effectiveness, acceptability and usability of mobile applications. It was concluded that mobile applications with psychotherapy content, especially applied together with face-to-face interventions, provided more positive results in reducing the risk of suicide. However, the level of effectiveness may vary depending on the content of the application, the characteristics of the sample, and whether it is a treatment support. At the same time, it has been determined that mobile applications are usable but that there is limited data on their acceptability. Conclusion: Mobile applications aimed at preventing suicide are potential tools that can be used in preventing suicide. However, there is no definitive result regarding their effectiveness. It is important to increase randomized controlled studies with a large sample, long follow-up period, and high level of evidence. Keywords: Mental health, mobile application, suicide

The effect of singing or playing melodica on disease symptoms, self-efficacy level and exercise capacity in chronic obstructive pulmonary patients: a randomized controlled study.

The aim of this randomized controlled experimental study is to determine the effect of singing or playing melodica activity applied to COPD patients on their symptoms, self-efficacy levels, and exercise capacities. The study was carried out in the chest diseases polyclinics of a hospital in Turkey between September 2020 and August 2021 with 30 patients: 15 in the control group and 15 in the song/melodica group. The data were collected with a patient information form and the scales examining disease symptoms, self-efficacy, and exercise capacity. The physical symptom, anxiety, Borg dyspnea, and fatigue scores of the disease in the post-test were significantly lower in the patients in the song/melodica group than those in the control group. In the post-test, the self-efficacy level, walking distance values were found to be significantly higher in the song/melodica group than in the control group. It is concluded that singing or playing melodica was an effective method in reducing the symptoms of the disease and enhancing the level of self-efficacy and exercise capacity in COPD patients.

Carbon-silicon-switch effect in enantioselective construction of silicon-stereogenic center from silacyclohexadienones.

Carbon-silicon-switch strategy, replacing one specific carbon atom in organic molecules with a silicon, has garnered significant interest for developing new functional molecules. However, the influence of a reaction regarding its selectivity and reactivity by carbon-silicon-switch strategy has far less been investigated. Here we discover an unusual carbon-silicon-switch effect in the enantioselective construction of silicon-stereogenic center. It is found that there has been a significant change in the desymmetrization reaction of silacyclohexadienones using asymmetric conjugate addition or oxidative Heck reaction with aryl/alkyl nucleophiles when compared with their carbon analogues cyclohexadienones. Specifically, the carbon-silicon-switch leads to a reversal in enantioselectivity with arylzinc as the nucleophile by the same chiral catalyst, and results in totally different reactivity with arylboronic acid as the nucleophile. Control experiments and density functional theory (DFT) calculations have shown that the unusual carbon-silicon-switch effect comes from the unique stereoelectronic feature of silicon.

An Extreme Predecessor Rain Event in Central China Amplified by Upper-Level Jet Streak

Abstract A comprehensive study is conducted on a predecessor rain event (PRE) closely associated with the upper-level jet (ULJ) in central China during July 2021, utilizing the Weather Research and Forecasting Model (WRF). The ULJ and precipitation patterns are reasonably reproduced in the control experiment. In the sensitivity experiment (NOULJ), the ULJ is largely suppressed by the piecewise potential vorticity inversion method. The comparison of the two simulations indicates that the ULJ promotes the development of secondary circulation, lower-level jet (LLJ), moisture transport, and atmospheric instability. Synergistic effects among these processes amplify this PRE. The strong updrafts in the precipitation region are closely associated with the inverse secondary circulation that develops on the south side of ULJ entrance. The upper-level mass divergence associated with the ULJ enhances the lower-level convergence, promoting the development of lower-level vorticity and LLJ. The LLJ facilitates moisture transport into the precipitation region and increasing atmospheric instability. In contrast, the precipitation in NOULJ is decreased by 34% due to the weakening of favorable conditions.

Enantioselective synthesis of inherently chiral sulfur-containing calix[4]arenes via chiral sulfide catalyzed desymmetrizing aromatic sulfenylation.

Inherently chiral calixarenes hold great potential for applications in chiral recognition, sensing, and asymmetric catalysis due to their unique structures. However, due to their special structures and relatively large sizes, the catalytic asymmetric synthesis of inherently chiral calixarenes is challenging with very limited examples available. Here, we present an efficient method for the enantioselective synthesis of inherently chiral sulfur-containing calix[4]arenes through the desymmetrizing electrophilic sulfenylation of calix[4]arenes. This catalytic asymmetric reaction is enabled by a chiral 1,1'-binaphthyl-2,2'-diamine-derived sulfide catalyst and hexafluoroisopropanol. Various inherently chiral sulfur-containing calix[4]arenes are obtained in moderate to excellent yields with high enantioselectivities. Control experiments indicate that the thermodynamically favored C-SAr product is formed from the kinetically favored N-SAr product and the combination of the chiral sulfide catalyst and hexafluoroisopropanol is crucially important for both enantioselectivity and reactivity.