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Treating comorbid anxiety and depression: Psychosocial and pharmacological approaches

World journal of Psychiatry 2015年第4期5卷 366-378页

作者： jeremy D Coplan cindy j aaronson Venkatesh Panthangi Younsuk Kim Department of Psychiatry Division of Neuro- psychopharmacology State University of New York Downstate Medical Center Department of Psychiatry Icahn School of Medicine at Mount Sinai State University of New York Downstate Medical Center

Comorbid anxiety with depression predicts poor outcomes with a higher percentage of treatment resistance than either disorder occurring alone. Overlap of anxiety and depression complicates diagnosis and renders treatment challenging. A vital step in treatment of such comorbidity is careful and comprehensive diagnostic assessment. We attempt to explain various psychosocial and pharmacological approaches for treatment of comorbid anxiety and depression. For the psychosocial component, we focus only on generalized anxiety disorder based on the following theoretical models:(1) "the avoidance model";(2) "the intolerance of uncertainty model";(3) "the meta-cognitive model";(4) "the emotion dysregulation model"; and(5) "the acceptance based model". For depression, the following theoretical models are explicated:(1) "the cognitive model";(2) "the behavioral activation model"; and(3) "the interpersonal model". Integration of these approaches is suggested. The treatment of comorbid anxiety and depression necessitates specific psychopharmacological adjustments as compared to treating either condition alone. Serotonin reuptake inhibitors are considered first-line treatment in uncomplicated depression comorbid with a spectrum of anxiety disorders. Short-acting benzodiazepines(BZDs) are an important "bridging strategy" to address an acute anxiety component. In patients with comorbid substance abuse, avoidance of BZDs is recommended and we advise using an atypical antipsychotic in lieu of BZDs. For mixed anxiety and depression comorbid with bipolar disorder, we recommend augmentation of an antidepressant with either lamotrigine or an atypical agent. Combination and augmentation therapies in the treatment of comorbid conditions vis-à-vis monotherapy may be necessary for positive outcomes. Combination therapy with tricyclic antidepressants, gabapentin and selective serotonin/norepinephrine reuptake inhibitors(e.g., duloxetine) are specifically useful for comorbid chronic pain syndro

关键词： Generalized anxiety disorder Cognitive behavioral therapy Treatment-resistant mood disorders Bipolar disorder comorbid with anxiety Augmentation strategies Major depressive disorder

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Pre-operative visceral adipose tissue radiodensity is a potentially novel prognostic biomarker for early endoscopic post-operative recurrence in Crohn’s disease

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World journal of Gastrointestinal Surgery 2024年第3期16卷 740-750页

作者： Phillip Gu Shishir Dube Norman Gellada So Yung Choi Susan Win Yoo jin Lee Shaohong Yang Talin Haritunians Gil Y Melmed Eric A Vasiliauskas Niru Bonthala Gaurav Syal Andres j Yarur David Ziring Shervin Rabizadeh Phillip Fleshner cindy Kallman Suzanne Devkota Stephan R Targan Dalin Li Dermot PB McGovern Department of Medicine Cedars-Sinai Medical CenterLos AngelesCA 90048United States Department of Imaging Cedars-Sinai Medical CenterLos AngelesCA 90048United States Department of Biostatistics Shared Resource Cedars-Sinai Medical CenterLos AngelesCA 90048United States Department of Internal Medicine Keimyung University School of MedicineDaegu 42601South Korea Department of Medicine University of California at Los AngelesLos AngelesCA 90095United States Department of Medicine University of California at San DiegoSan DiegoCA 92093United States Department of Pediatrics Cedars-Sinai Medical CenterLos AngelesCA 90048United States Department of Surgery Cedars-Sinai Medical CenterLos AngelesCA 90048United States

BACKGROUND Evidence suggests inflammatory mesenteric fat is involved in post-operative recurrence(POR)of Crohn’s disease(CD).However,its prognostic value is INTRODUCTION Crohn’s disease(CD)is a debilitating chronic immune-mediated inflammatory disease(IMID)of the gastrointestinal tract that is increasing in incidence and prevalence globally[1].CD patients often undergo surgery for disease-related complic-ations and/or medically refractory ***,surgery is not curative,and many patients develop post-operative recurrence(POR)of CD with a significant proportion eventually requiring additional *** advances in early detection and therapeutics,the contemporary 10-year risk of surgery has improved from 50%to 26%,but the risk of recurrent surgery has remained unchanged at 30%,suggesting a need to improve post-operative management strategies[2].Presently,there are two accepted strategies to mitigate POR,but each have potential ***,patients start early post-operative pharmacologic prophylaxis within 4-6 wk after *** strategy can potentially overtreat a subset of patient who may not develop long-term disease recurrence off ***,these patients are at risk of medication-related adverse events and the direct and indirect costs associated with therapy with little or no benefit[3].The second strategy is performing early colonoscopy within 6-12 months after surgery and escalating therapy based on FOOTNOTES Author contributions:Gu P is the guarantor of the article and was involved in concept and design,data collection,statistical analysis,drafting of manuscript,and final approval of manuscript;Dube S and Choi SY were involved in statistical analysis,drafting of the manuscript,and final approval of manuscript;Gellada N,Win S,Lee Yj and Yang S were involved in the data collection,drafting of the manuscript,and final approval of manuscript;Haritunians T and Li D were involved in data analysis and interpretation,drafting

关键词： Crohn’s disease Surgery Visceral adipose tissue Mesenteric adipose tissue Creeping fat Computed tomography

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A historical review of the development of verification and validation theories for simulation models

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International journal of Modeling, Simulation, and Scientific Computing 2017年第2期8卷 1-24页

作者： Phillip j.Durst Derek T.Anderson cindy L.Bethel U.S.Army Engineer Research and Development Center 3909 Halls Ferry Road Vicksburg MS 39180USA Mississippi State University Department of Electrical and Computer Engineering Mississippi StateMS 39759USA Mississippi State University Department of Computer Science and Engineering Mississippi StateMS 39759USA

Modeling and simulation(M&S)play a critical role in both engineering and basic research ***-based models have existed since the 1950s,and those early models have given way to the more complex computational and physics-based simula-tions used *** such,a great deal of research has been done to establish what level of trust should be given to simulation outputs and how to verify and validate the mod-els used in these *** paper presents an overview of the theoretical work done to date defining formal definitions for,and methods of,verification and validation(V&V)of computer *** models are broken down into three broad cate-gories:analytical and simulation models,computational and physics-based models,and simulations of autonomous systems,and the unique theories and methods developed to address V&V of these models are *** paper also presents the current prob-lems in the theoretical field of V&V for models as simulations move from single system models and simulations to more complex simulation *** particular,this paper high-lights the lack of agreed-upon methods for V&V of simulations of autonomous systems,such as an autonomous unmanned vehicles,and proposes some next steps needed to address this problem.

关键词： Verification and validation simulation models computational models physics-based simulations autonomous systems.

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Natural nest substrates influence squamate embryo physiology but have little effect on hatchling phenotypes

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Integrative Zoology 2022年第4期17卷 550-566页

作者： joshua M.HALL jocelyn MIRACLE cindy D.SCRUGGS Daniel A.WARNER Department of Biological Sciences Auburn UniversityAuburnAlabamaUSA

Vertebrate embryos require access to water;however,many species nest in terrestrial habitats that vary considerably in moisture ***,non-avian reptiles have served as models to understand how environmental factors,like moisture availability,influence development because eggs are often exposed to prevailing environments in the absence of parental *** much research demonstrates the importance of water absorption by eggs,many ecological factors that influence moisture availability in natural nests have received little *** example,the type of substrate in which nests are constructed is *** experimentally incubated eggs of the brown anole lizard(Anolis sagrei)in 2 naturally occurring nest substrates that were treated with varying amounts of water to determine how natural substrates influence development at different moisture *** substrate consisted of sand and crushed seashells and the other was mostly organic material(*** plant material).Both are common nesting substrates at our field *** controlling for water uptake by eggs,we found that egg survival and hatchling phenotypes were similar between substrates;however,embryos developed more quickly in the sand/shell substrate than the organic substrate,indicating substrate-specific effects on embryo *** results demonstrate that different natural substrates can result in similar developmental outcomes if the water available to eggs is comparable;however,some aspects of development,like developmental rate,are affected by the type of substrate,independent of water *** study is required to determine how natural substrates influence embryo physiology independent of water content.

关键词： developmental plasticity egg incubation hydric conditions nesting behavior nest-site selection

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Chinese journal of Cancer 2014年第1期33卷 40-45页

作者： Linda Dirven Neil K.aaronson jan j.Heimans Martin j.B.Taphoorn Department of Neurology VU University Medical CenterPO Box 7057 1007 MB Amsterdam Netherlands Division of Psychosocial Research and Epidemiology The Netherlands Cancer InstitutePO Box 90203 1006 BE Amsterdam Netherlands Department of Neurology Medical Center HaaglandenPO Box 432 2501 CK The Hague Netherlands

Gliomas are malignant primary brain tumors and yet incurable. Palliation and the maintenance or improvement of the patient's quality of life is therefore of main importance. For that reason, health-related quality of life(HRQoL) has become an important outcome measure in clinical trials, next to traditional outcome measures such as overall and progression-free survivals, and radiological response to treatment. HRQoL is a multidimensional concept covering physical, psychological, and social domains, as well as symptoms induced by the disease and its treatment. HRQoL is assessed by using self-reported, validated questionnaires. Various generic HRQoL questionnaires, which can be supplemented with a brain tumor- specific module, are available. Both the tumor and its treatment can have a negative effect on HRQoL. However, treatment with surgery, radiotherapy, chemotherapy, and supportive treatment may also improve patients' HRQoL, in addition to extending survival. It is expected that the impact of HRQoL measurements in both clinical trials and clinical practice will increase. Hence, it is important that HRQoL data are collected, analyzed, and interpreted correctly. Methodological issues such as selection bias and missing data may hamper the interpretation of HRQoL data and should therefore be accounted. In clinical trials, HRQoL can be used to assess the benefits of a new treatment strategy, which should be weighed carefully against the adverse effects of that treatment. In daily clinical practice, HRQoL assessments of an individual patient can be used to inform physicians about the impact of a specific treatment strategy, and it may facilitate the communication between the physicians and the patients.

关键词：生活质量胶质瘤健康患者放射治疗临床试验质量评估临床实践

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优秀的人都是聪明的勤奋者

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2019年

作者： juno，cindy

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The combined role of MRI prostate and prostate health index in improving detection of significant prostate cancer in a screening population of Chinese men

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Asian journal of Andrology 2023年第6期25卷 674-679页

作者： Peter KF Chiu Thomas YT Lam Chi-Fai Ng jeremy YC Teoh Carmen CM Cho Hiu-Yee Hung cindy Hong Monique j Roobol Winnie CW Chu Samuel YS Wong joseph jY Sung SH Ho Urology Centre Department of SurgeryThe Chinese University of Hong KongHong Kong SARChina The jockey Club School of Public Health and Primary Care The Chinese University of Hong KongHong Kong SARChina Department of Imaging and Interventional Radiology The Chinese University of Hong KongHong Kong SARChina Erasmus MC Cancer Institute Erasmus Medical UniversityRotterdam 3015The Netherlands Lee Kong Chian School of Medicine Nanyang Technological UniversitySingapore 308232Singapore

Using prostate-specific antigen(PSA)for prostate cancer(PCa)screening led to overinvestigation and overdiagnosis of indolent *** aimed to investigate the value of prostate health index(PHI)and magnetic resonance imaging(MRI)prostate in an Asian PCa screening *** aged 50–75 years were prospectively recruited from a community-based PSA screening *** with PSA 4.0–10.0 ng ml^(−1) had PHI result *** prostate was offered to men with PSA 4.0–50.0 ng ml−1.A systematic prostate biopsy was offered to men with PSA 4.0–9.9 ng ml^(−1) and PHI≥35,or PSA 10.0–50.0 ng ml^(−1).Additional targeted prostate biopsy was offered if they had PI-RADS score≥*** significant PCa(csPCa)was defined as the International Society of Urological Pathology(ISUP)grade group(GG)≥2 or ISUP GG 1 with involvement of≥30%of total systematic *** total,12.8%(196/1536)men had PSA≥4.0 ng ml^(−1).Among 194 men with PSA 4.0–50.0 ng ml^(−1),187(96.4%)received MRI *** them,28.3%(53/187)had PI-RADS≥3 ***,7.0%(107/1536)men were indicated for biopsy and 94.4%(101/107)men received *** the men received biopsy,PCa,ISUP GG≥2 PCa,and csPCa was diagnosed in 42(41.6%),24(23.8%),and 34(33.7%)men,*** with PSA/PHI pathway in men with PSA 4.0–50.0 ng ml^(−1),additional MRI increased diagnoses of PCa,ISUP GG≥2 PCa,and csPCa by 21.2%(from 33 to 40),22.2%(from 18 to 22),and 18.5%(from 27 to 32),*** benefit of additional MRI was only observed in PSA 4.0–10.0 ng ml^(−1),and the number of MRI needed to diagnose one additional ISUP GG≥2 PCa was 20 in PHI≥35 and 94 in PHI<*** them,45.4%(89/196)men with PSA≥4.0 ng ml^(−1) avoided unnecessary biopsy with the use of PHI and MRI.A screening algorithm with PSA,PHI,and MRI could effectively diagnose csPCa while reducing unnecessary *** benefit of MRI prostate was mainly observed in PSA 4.0–9.9 ng ml^(−1) and PHI≥35 *** was an important risk stratification step for PCa

关键词： magnetic resonance imaging prostate prostate cancer prostate health index prostate-specific antigen screening

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Regulation of Wnt/β-catenin signaling by herpesviruses

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World journal of Virology 2016年第4期5卷 144-154页

作者： Kevin j Zwezdaryk joseph A Combs cindy A Morris Deborah E Sullivan Department of Microbiology and Immu-nology Tulane University School of Medicine

The Wnt/β-catenin signaling pathway is instrumental in successful differentiation and proliferation of mammalian cells. It is therefore not surprising that the herpesvirus family has developed mechanisms to interact with and manipulate this pathway. Successful coexistence with the host requires that herpesviruses establish a lifelong infection that includes periods of latency and reactivation or persistence. Many herpesviruses establish latency in progenitor cells and viral reactivation is linked to host-cell proliferation and differentiation status. Importantly, Wnt/β-catenin is tightly connected to stem/progenitor cell maintenance and differentiation. Numerous studies have linked Wnt/β-catenin signaling to a variety of cancers, emphasizing the importance of Wnt/β-catenin pathways in development, tissue homeostasis and disease. This review details how the alpha-, beta-, and gammaherpesviruses interact and manipulate the Wnt/β-catenin pathway to promote a virus-centric agenda.

关键词： Herpesvirus Herpes simplex virus-1 Varicella zoster virus Cytomegalovirus Epstein-Barr virus Kaposi’s sarcoma-associated herpesvirus Wnt/β-catenin Glycogen synthase kinase-3 Axin

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残存银杏群落的结构及种群更新特征

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生态学报 2011年第21期31卷 6396-6409页

作者：杨永川穆建平 TANG cindy Q 杨轲重庆大学三峡库区生态环境教育部重点实验室重庆400045 重庆大学城市建设与环境工程学院重庆400045 云南大学生态学与地植物学研究所昆明650091

银杏是现存裸子植物中最古老的孑遗植物,也是银杏纲植物现存的唯一种,但其自然群落和种群生态学特征至今尚未明晰。对分布于贵州省和重庆市交界的大娄山区7个地点的残存银杏群落的物种组成、垂直结构、主要组成种的种群大小级结构等群... 详细信息

银杏是现存裸子植物中最古老的孑遗植物,也是银杏纲植物现存的唯一种,但其自然群落和种群生态学特征至今尚未明晰。对分布于贵州省和重庆市交界的大娄山区7个地点的残存银杏群落的物种组成、垂直结构、主要组成种的种群大小级结构等群落结构特征以及银杏种群更新特征进行了研究。林木层共记录到82个种,其中常绿针叶树3种,常绿阔叶树和落叶阔叶树分别为37种和42种;各群落中相对优势度均以落叶阔叶树为高,银杏在7个样方中为顶极优势种,其中在6个样方中为单优势种。银杏群落林木层在垂直结构上一般可分为3层,银杏为乔木层的主要成分。各个群落中银杏种群的大小级结构均为逆-j型或多峰型,更新连续,而其余种类多为单峰型。不同微地形单元上银杏具有不同的萌枝特性,沟谷生境中银杏的萌枝率显著高于下部边坡和崖锥,有萌个体率的差异是主要的贡献因子,而银杏的萌枝能力与主干的胸径无显著关联。残存银杏群落为典型的发育在不稳定立地上的落叶阔叶林地形顶级群落,银杏通过萌枝维系种群的长期存留和群落的相对稳定。群落中银杏、红豆杉(Taxus chinensis)、红椿(Toona ciliata)和川黄檗(Phellodendron chinense)等多种珍稀濒危植物共存,有必要从群落层次上加强对残存银杏群落的保护。

关键词：种群结构萌枝微地形干扰更新策略

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The Effects of a Primary Nutritional Deficiency (Vitamin B study)

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Food and Nutrition Sciences 2012年第9期3卷 1238-1244页

作者： Hugh D. Riordan Nina Mikirova Paul R. Taylor cindy A. Feldkamp joseph j. Casciari The Riordan Clinic Research Institute Riordan Clinic Wichita Kansas USA

It has long been understood there is a link between a nutrient deficiency and visually measurable health. In separate studies, Sprague Dawley or Fischer 344 rats were fed diets lacking 100% of one B-Vitamin until a single mortality occurred. Vitamins studied were thiamin, riboflavin, niacin, pyridoxine, pantothenic acid, cobalamin and folate. Body mass, food consumption and images were recorded at weekly intervals. Rats were euthanized and liver, kidney, heart and brain samples for histological analysis were prepared. Liver and brain tissues were chosen as markers because of the high need of that organ for B vitamins and the likelihood of secondary lesion development. Correlation of deficiency symptoms with one missing nutrient was explored.

关键词： Essential Nutrients B Vitamins Deficiency Symptoms Animal Study

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