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Treatment effects between monotherapy of donepezil versus combination with memantine for Alzheimer disease: A meta-analysis
This is the first meta-analysis to compare the treatment effects and safety of administering donepezil alone versus a combination of memantine and donepezil to treat patients with moderate to severe Alzheimer Disease, particularly regarding cognitive functions, behavioral and psychological symptoms in dementia (BPSD), and global functions.
PubMed, Medline, Embase, PsycINFO, and Cochrane databases were used to search for English and non-English articles for inclusion in the meta-analysis to evaluate the effect size and incidence of adverse drug reactions of different treatments.
Compared with patients who received donepezil alone, those who received donepezil in combination with memantine exhibited limited improvements in cognitive functions (g = 0.378, p < .001), BPSD (g = -0.878, p < .001) and global functions (g = -0.585, p = .004). Gradual titration of memantine plus a fixed dose and gradual titration of donepezil as well as a fixed dose and gradual titration of memantine resulted in limited improvements in cognitive functions(g = 0.371, p = .005), BPSD(g = -0.913, p = .001), and global functions(g = -0.371, p = .001).
Both in the 24th week and at the final evaluation point, the combination of donepezil and memantine led to greater improvement in cognitive functions, BPSD, and global functions than did donepezil alone in patients with moderate to severe Alzheimer Disease.
Journal Article
Reflections for the twenty-first century
\"Reflections for the twenty-first century explores the present state of Earth and Homo sapiens, looking at past events and circumstances that have brought us to where we are today, where we are headed in the future, and how we can each play a role in a more sustainable existence. The first part of this collection of essays, articles, and poetry reflects on activist Jean Pi Lee's experiences in ecology and the environment--while the second section examines the species of Homo sapiens, its evolution, potential, communicative abilities, and more. With exercised to get you enthusiastic about saving the earth, as well as an abundance of additional reading resources to broaden your subject knowledge, Reflections for the twenty-first century is sure to embolden you to take action today!\"--Back cover.
Book
The impact of blockchain adoption on supply chain financing and E-commerce platform dynamics
The integration of blockchain technology is reshaping e-commerce supply chains and creating new dynamics for financially constrained firms. This study investigates the operational and financial implications of blockchain adoption within a supply chain consisting of a financially constrained manufacturer and a dominant e-commerce platform. Our analysis spans three common entry modes—self-operated, Fulfillment by Platform (FBP), and Sales on Platform (SOP)—and considers two key financing schemes: bank financing and equity financing. Using a game-theoretic framework, we find that while blockchain generally enhances profitability, its strategic value is highly contingent upon the chosen entry mode. Specifically, the self-operated mode grants the platform greater flexibility in pricing and service, whereas the FBP and SOP modes lead to more stable operational decisions. Our analysis further reveals a critical interplay between financing and operations: platforms maximize their gains by pairing the self-operated mode with equity financing, while a manufacturer’s optimal financing strategy shifts from bank to equity as production costs rise. These findings offer actionable insights for managers on leveraging blockchain to optimize financing choices and enhance competitive advantage. This study is, however, limited by certain simplifying assumptions, including linear demand and a uniform consumer response to blockchain, and its scope is restricted to bank and equity financing.
Journal Article
Alternative Chinese Opera in the age of globalization : performing zero
\"Bringing the study of Chinese theatre into the 21st-century, Lei discusses ways in which traditional art can survive and thrive in the age of modernization and globalization. Building on her previous work, this new book focuses on various forms of Chinese \"opera\" in locations around the Pacific Rim, including Hong Kong, Taiwan and California\"-- Provided by publisher.
Book
Collaborative Control for a Robot Manipulator via Interaction-Force-Based Impedance Method and Extremum Seeking Optimization
This paper introduces an adaptive impedance control strategy for robotic manipulators, developed through the extremum seeking technique. A model-based disturbance observer (DOB) is employed to estimate contact forces, removing the dependency on torque sensors. An impedance vector is constructed to correct the errors arising from motor uncertainties and unknown couplings, without considering the threshold value of the control parameters. Joint tracking errors and fluctuations in contact force are incorporated into the cost function. For various tasks, suitable control parameters are adaptively optimized in real time using an extremum seeking approach, which continuously evaluates the cost function. A rigorous analysis is conducted on the stability of the proposed controller. Compared to conventional approaches, the proposed adaptive impedance control offers a more streamlined design for adjusting the manipulator’s contact impedance. Experimental results confirm that the extremum seeking strategy successfully tuned the controller parameters online according to variations in the cost function.
Journal Article
Effects of aromatherapy on sleep quality: A systematic review and meta-analysis
•Aromatherapy is a good practiced for improving sleep quality.•This study revealed the efficacy and safety of aromatherapy on sleep quality.•High degree of heterogeneity among participants and intervention methods were noted across included studies.
The objective of this study was to conduct a systematic review and meta-analysis to examine the effects of aromatherapy on sleep improvements.
A search of randomized controlled trials was conducted in four English and two Chinese medical electronic databases. Two authors independently performed the search, assessed the methodological quality, and extracted data. Then, final studies were selected after consensus with the third author.
In total, 31 trials met the inclusion criteria, of which four had low risk, while the overall bias in 26 was uncertain in terms of methodological quality. The heterogeneity was high among the trials (Q = 341.544, p < 0.001, I2 = 91.216%). There was a significant effect of aromatherapy on sleep quality (Hedges's g = 1.103 (95% confidence interval: 0.813˜1.393, p < 0.001). There was a publication bias (Egger’s regression intercept = 7.127, t = 3.055, p = 0.004 and Begg test, Kendall’s tau with continuity correction, tau = 0.335 and Z = 2.651, p = 0.008). The subgroup analysis showed that there was a significant difference in the methodological quality among different studies (Q = 18.350, p < 0.001). Sensitivity analyses still revealed high heterogeneity after omitting one study at a time.
The results showed that aromatherapy can be applied by clinical staff to effectively improve sleep quality. However, because there was a high degree of heterogeneity among studies, the inferences of the results need to be applied with caution.
Journal Article
Extremum-Seeking Control for a Robotic Leg Prosthesis with Sensory Feedback
By sensing changes in the contact force between the leg and level ground, humans can perceive their walking speed and adjust leg stiffness to accommodate walking terrains. To realize this natural regulation mechanism on the lower limb amputee, noninvasive functional electrical stimulation (nFES) was used to assist the subject in sensing the change in contact force between the leg and level ground, allowing for the adjustment of control parameters in the prosthetic leg. The cost function was designed to combine the tracking errors of the joints and changes in the stimulating current. For different walking terrains, an extremum-seeking control (ESC) method was employed to search for suitable control parameters in real time by monitoring the changes in the cost function. The stability of the proposed controller with extremum-seeking dynamics was demonstrated. The experimental results demonstrated that the extremum-seeking method effectively adjusted the control parameters of the prosthetic leg in response to changes in the cost function.
Journal Article