Randomized controlled trials of serotonin-norepinephrine reuptake inhibitor in treating major depressive disorder in children and adolescents: a meta-analysis of efficacy and acceptability

New generation antidepressant therapies, including serotonin-norepinephrine reuptake inhibitor (SNRIs), were introduced in the late 1980s; however, few comprehensive studies have compared the benefits and risks of various contemporary treatments for major depressive disorder (MDD) in young patients. A comprehensive literature search of PubMed, Cochrane, Embase, Web of Science, and PsycINFO databases was conducted from 1970 to January 2015. Only clinical trials that randomly assigned one SNRI or placebo to patients aged 7 to 18 years who met the diagnostic criteria for major depressive disorder were included. Treatment success, dropout rate, and suicidal ideation/attempt outcomes were measured. Primary efficacy was determined by pooling the risk ratios (RRs) of treatment response and remission. Acceptability was determined by pooling the RRs of dropouts for all reasons and for adverse effects as well as suicide-risk outcomes. Five trials with a total of 973 patients were included. SNRIs were not significantly more effective than placebo for treatment response but were for remission. The comparison of patients taking SNRIs that dropped out for all reasons and those taking placebo did not reach statistical significance. Significantly more patients taking SNRIs dropped out for adverse effects than those taking placebo. No significant difference was found in suicide-related risk outcomes. SNRI therapy does not display a superior efficacy and is not better tolerated compared to placebo in these young patients. However, duloxetine has a potential beneficial effect for depression in young populations, showing a need for further research.

Creating better customer experiences: Service Design effects on customer experience

Pro gradu –tutkielman tavoitteena oli tutkia, kuinka palvelumuotoilua voidaan käyttää parempien asiakaskokemusten luomisessa. Tutkimuksen teoreettisessa osuudessa keskityttiin tutkimaan palvelumuotoilun ja asiakaskokemuksen käsitteitä. Tutkielman empiirinen osuus tehtiin laadullisena tutkimuksena, jossa vertailtiin asiakaskokemuksia kahdessa Espoon kaupungin yhteispalvelupisteessä: Leppävaarassa sijaitseva yhteispalvelupiste oli hiljattain suunniteltu uudelleen käyttäen palvelumuotoilun periaatteita; Matinkylän palvelupiste oli alkuperäisessä muodossaan tutkimuksen aikana. Tutkimuksen yhtenä tavoitteena oli myös selvittää, oliko palvelumuotoilun menetelmin tehty muotoiluprojekti Leppävaaran yhteispalvelupisteessä onnistunut, kun sitä arvioitiin asiakaskokemuksen näkökulmasta. Tutkielman aineisto kerättiin suoran havainnoinnin ja haastattelun keinoin. Yhteensä 33 yksittäistä asiakasta havannoitiin ja haastateltiin tutkimusta varten toukokuussa 2015. Vastaajat valikoituivat satunnaisesti havannointipäivien asiakkaista. Heitä havainnoitiin koko asiakaspolun ajan minkä jälkeen heitä haastateltiin. Tutkimuksen tulokset ovat kaksiosaiset. 1) Arvioitaessa asiakkaiden kokemuksia liittyen palvelutilan toimivuuteen ja aineelliseen ympäristöön todettiin, että palvelumuotoilulla saavuttettiin parempi asiakaskokemus, ja täten Leppävaaran muotoiluprojekti oli onnistunut tavoitteissaan. 2) Kun taas tuloksia tarkasteltiin asiakaspalvelutilanteiden näkökulmasta, projekti ei ollut päässyt tavoitteisiin ja palvelumuotoilun menetelmillä ei pystytty parantamaan asiakaskokemuksta. Espoon kaupungin muotoiluprojekti on vielä kesken, tulosten perusteella tutkija ehdotti jatkotoimenpiteenä muun muassa lisäkoulutusta palveluhenkilökunnalle.

Effects of internationalization on packaging decisions of manufacturing companies

The world has witnessed a great deal of globalization and a rise in international activities in recent years compared to decades ago. This has contributed to an upsurge in competition among manufacturing firms resulting in the use of different marketing strategies to survive. Packaging is one of the tools that has been used by marketers to make products different and appealing to both local and international customers. The purpose of this research work was to investigate more on packaging as a marketing tool and how internationalization affects the decisions management makes in relation to it. To this effect, a qualitative research was conducted using five manufacturing companies as case studies and data collected through semi-structured interviews and also personal observation. Secondary sources were also used in order to get deeper insight into the case companies under study. The study revealed that there are many advantages that internationalization provides firms. The general revelations made by the firms that were researched did not point to a negative impact of internationalization on their packaging decisions. Internationalization has provided positive improvements on their packaging and made them more competitive. This proves that for packaging decisions to improve better, one key enabler will be exposure to the international environment since it provides a wider array of options for package improvements for firms.

Evaluation of thermotolerant capacity of lactic acid bacteria isolated from commercial sausages and the effects of their addition on the quality of cooked sausages

The thermotolerant capacity of several lactic acid bacteria strains isolated from cooked commercial sausages was determined. Four strains were positively identified as Lactobacillus plantarum, Lactobacillus curvatus, Pediococcus pentosaceus and Pediococcus acidilacti, after surviving thermal treatment (70 °C during 60 minutes). Thermotolerant strains were inoculated in sausage batters before cooking in order to determine their effect on color, texture, acceptance and inhibition of Enterobacteria during 12 days at 8 °C. No significant effect of the inoculated strains was detected on color parameters. Textural profile parameters, cohesiveness and resilience, were not affected by the inoculation of thermotolerant lactic acid bacteria, but L. curvatus sausages resulted softer than the rest of the treatments. Samples inoculated with L. curvatus also obtained the lowest scores for the sensory attributes evaluated, with the remaining treatments causing no unfavorable effects on sausage acceptance. There was a reduction in enterobacterial counts after 12 days of cold storage in inoculated samples. The performance of inoculated lactic acid bacteria strains can be explained in a similar way as that of starter cultures in dry-fermented sausages, where the growth in nests impairs other pathogenic microorganisms present in the rest of the sausage, since environmental conditions and the early inoculation of these thermotolerant strains favor them to become the dominant flora.

Effects of Fin Parameters on Gas-Side Heat Transfer Performance of H-Type Finned Tube Bundle in a Waste Heat Recovery Boiler

Alfa Laval Aalborg Oy designs and manufactures waste heat recovery systems utilizing extended surfaces. The waste heat recovery boiler considered in this thesis is a water-tube boiler where exhaust gas is used as the convective heat transfer medium and water or steam flowing inside the tubes is subject to cross-flow. This thesis aims to contribute to the design of waste heat recovery boiler unit by developing a numerical model of the H-type finned tube bundle currently used by Alfa Laval Aalborg Oy to evaluate the gas-side heat transfer performance. The main objective is to identify weaknesses and potential areas of development in the current H-type finned tube design. In addition, numerical simulations for a total of 15 cases with varying geometric parameters are conducted to investigate the heat transfer and pressure drop performance dependent on H-type fin geometry. The investigated geometric parameters include fin width and height, fin spacing, and fin thickness. Comparison between single and double tube type configuration is also conducted. Based on the simulation results, the local heat transfer and flow behaviour of the H-type finned tube is presented including boundary layer development between the fins, the formation of recirculation zone behind the tubes, and the local variations of flow velocity and temperature within the tube bundle and on the fin surface. Moreover, an evaluation of the effects of various fin parameters on heat transfer and pressure drop performance of H-type finned tube bundle has been provided. It was concluded that from the studied parameters fin spacing and fin width had the most significant effect on tube bundle performance and the effect of fin thickness was the least important. Furthermore, the results suggested that the heat transfer performance would increase due to enhanced turbulence if the current double tube configuration is replaced with single tube configuration, but further investigation and experimental measurements are required in order to validate the results.

Effects of different concentrations of passion fruit peel (Passiflora edulis) on the glicemic control in diabetic rat

Diabetes mellitus, an endocrine disorder, is the major cause of morbidity in developing countries, and it is considered the fourth leading cause of death worldwide. The conventional therapy for diabetes is insulin treatment. The peel of the Passion fruit is rich in fiber and prevents the absorption of carbohydrates, and thus can control and reduce the blood sugar rate. The objective of this study was to analyze the effect of the passion fruit peel flour on the glicemia of diabetic rats, as well as to study the probable action mechanisms. Wistar rats were used in the experiment and were offered the flours of the passion fruit peel in three concentrations: 5, 10, and 15%, and a casein diet as control. The most significant effect on the reduction of the glicemic rate was obtained with the 5% diet. The best values of hepatic glycogen were found in the 5 and 10% diets. The results of this study suggest that the 5% passion fruit flour diet was the one that provided the best reduction of blood glucose levels (59%) and the higher increase of the hepatic glycogen level (71%). The conversion of blood glucose into hepatic glycogen was considered the probable action mechanism involved.

Investigation of the effects of peppermint (Mentha piperita) on the biochemical and anthropometric profile of university students

The hypolipidemic effects of several medicinal plants have already been demonstrated, but many plants commonly used to treat diseases still need to be studied. Peppermint (Mentha piperita) is widely consumed by the population for different purposes, but not for the treatment of dyslipidemias. The objective of this study was to examine the effects of this plant on human biochemical and anthropometric profiles and blood pressure, based on the administration of peppermint juice twice daily for 30 days. Blood samples were collected before and after the treatment in order to determine the glycemic and lipid profiles, and the Body Mass Index (BMI) analysis was performed. Results indicated that 41.5% of the subjects showed a reduction in glycemia, 66.9% in total cholesterol levels, 58.5% in triacylglycerides, 52.3% in LDL-c (low-density lipoproteins) indices, 70% in GOT (glutamic-oxaloacetic transaminase) levels, 74.5% in GPT (glutamic-pyruvic transaminase) levels, and that 52% presented an increase in HDL-c (high-density lipoprotein cholesterol) indices. Also, 52.5% showed a decrease in blood pressure and 48.7% in BMI. The use of peppermint by humans can be considered beneficial in the prevention and treatment of risk factors of chronic degenerative diseases.

Effects of heat treatment and storage temperature on the use of açaí drink by nutraceutical and beverage industries

This study assesses the storage temperature effect on the anthocyanins of pasteurized and unpasteurized açaí pulp. The data was obtained using a pasteurized and lyophilized pulp (PLP) to evaluate the temperature effect (0, 25, and 40 °C). Part of non-pasteurized frozen pulp (NPP) was pasteurized (NPP-P) at 90 °C for 30 seconds; both pulps were stored at 40 °C. The anthocyanin content reduction in the drink was evaluated from the half-life time (t1/2), activation energy (Ea), temperature quotient (Q10), and the reaction rate constant (k). The t1/2 of the PLP anthocyanins stored at 40 °C was 1.8 times less than that stored at 25 °C and 15 times less than that stored at 0 °C; therefore, the higher temperatures decreased the stability of anthocyanins. The pasteurization increased the t1/2 by 6.6 times (10.14 hours for NPP and 67.28 hours for NPP-P). The anthocyanin degradation on NPP-P followed a first order kinetic, while NPP followed a second order kinetic; thus it can be said that the pasteurization process can improve the preservation of anthocyanins in the pulp.

Coolability of porous core debris beds : Effects of bed geometry and multi-dimensional flooding

This thesis addresses the coolability of porous debris beds in the context of severe accident management of nuclear power reactors. In a hypothetical severe accident at a Nordic-type boiling water reactor, the lower drywell of the containment is flooded, for the purpose of cooling the core melt discharged from the reactor pressure vessel in a water pool. The melt is fragmented and solidified in the pool, ultimately forming a porous debris bed that generates decay heat. The properties of the bed determine the limiting value for the heat flux that can be removed from the debris to the surrounding water without the risk of re-melting. The coolability of porous debris beds has been investigated experimentally by measuring the dryout power in electrically heated test beds that have different geometries. The geometries represent the debris bed shapes that may form in an accident scenario. The focus is especially on heap-like, realistic geometries which facilitate the multi-dimensional infiltration (flooding) of coolant into the bed. Spherical and irregular particles have been used to simulate the debris. The experiments have been modeled using 2D and 3D simulation codes applicable to fluid flow and heat transfer in porous media. Based on the experimental and simulation results, an interpretation of the dryout behavior in complex debris bed geometries is presented, and the validity of the codes and models for dryout predictions is evaluated. According to the experimental and simulation results, the coolability of the debris bed depends on both the flooding mode and the height of the bed. In the experiments, it was found that multi-dimensional flooding increases the dryout heat flux and coolability in a heap-shaped debris bed by 47–58% compared to the dryout heat flux of a classical, top-flooded bed of the same height. However, heap-like beds are higher than flat, top-flooded beds, which results in the formation of larger steam flux at the top of the bed. This counteracts the effect of the multi-dimensional flooding. Based on the measured dryout heat fluxes, the maximum height of a heap-like bed can only be about 1.5 times the height of a top-flooded, cylindrical bed in order to preserve the direct benefit from the multi-dimensional flooding. In addition, studies were conducted to evaluate the hydrodynamically representative effective particle diameter, which is applied in simulation models to describe debris beds that consist of irregular particles with considerable size variation. The results suggest that the effective diameter is small, closest to the mean diameter based on the number or length of particles.

Immunomodulatory effects of supercritical fluid CO2 extracts from freeze-dried powder of Tenebrio molitor larvae (yellow mealworm)

Abstract In order to take full advantage of Tenebrio molitor larvae (yellow mealworm) resources, the supercritical CO2 fluid freeze-dried powder of T. molitor larvae (fdTML) extraction on the immune systems of mice was carried out. The results about the effects of supercritical CO2 fluid fdTML extraction on carbon expurgation and phagocytosis of peritoneal macrophages experiments of mice indicated that the fdTML extraction enhanced observably carbon expurgatory index, phagocytic rate and phagocytic index. The fdTML extraction could stimulate response of delayed hypersensitivity. The proliferation of ConA-induced mitogenic reponse for spleen lymphocyte was also increased. The amount of hemolytic antibody in mice serum increased compared with those of the control group mice. The half of hemolysis values in serum of treated mice increased compared to the control group. Furthermore, serum NO content in all treatment groups was higher than that of the control group whereas acid phosphatase and alkaline phosphatase activity was only significantly higher relative to the control group. Our findings suggest that supercritical CO2 fluid the fdTML extraction has potential as a health food supplement.

Effects of Fabrication Processes on the Behavior of S960 Ultra High Strength Steel (UHSS)

Strenx® 960 MC is a direct quenched type of Ultra High Strength Steel (UHSS) with low carbon content. Although this material combines high strength and good ductility, it is highly sensitive towards fabrication processes. The presence of stress concentration due to structural discontinuity or notch will highlight the role of these fabrication effects on the deformation capacity of the material. Due to this, a series of tensile tests are done on both pure base material (BM) and when it has been subjected to Heat Input (HI) and Cold Forming (CF). The surface of the material was dressed by laser beam with a certain speed to study the effect of HI while the CF is done by bending the specimen to a certain angle prior to tensile test. The generated results illustrate the impact of these processes on the deformation capacity of the material, specially, when the material has HI experience due to welding or similar processes. In order to compare the results with those of numerical simulation, LS-DYNA explicit commercial package has been utilized. The generated results show an acceptable agreement between experimental and numerical simulation outcomes.

The effects of fiscal policy after the global recession: assessing the evidences

This paper offers a commented review of the most recent empirical studies of the effects of fiscal contraction on economic growth, which have helped underpin the prescription that fiscal policy should be expansionary in coming years in order to contain economic semi-stagnation in the developed countries. The paper shows that there is ample literature showing that fiscal expansion helps the economy grow, and that fiscal contraction tends to reduce output and employment in the short term.

Promoting Healthy Lifestyles with Personalized, APOE Genotype Based Health Information: The Effects on Psychological-, Health Behavioral and Clinical Factors

There is an increasing demand for individualized, genotype-based health advice. The general population-based dietary recommendations do not always motivate people to change their life-style, and partly following this, cardiovascular diseases (CVD) are a major cause of death in worldwide. Using genotype-based nutrition and health information (e.g. nutrigenetics) in health education is a relatively new approach, although genetic variation is known to cause individual differences in response to dietary factors. Response to changes in dietary fat quality varies, for example, among different APOE genotypes. Research in this field is challenging, because several non-modifiable (genetic, age, sex) and modifiable (e.g. lifestyle, dietary, physical activity) factors together and with interaction affect the risk of life-style related diseases (e.g. CVD). The other challenge is the psychological factors (e.g. anxiety, threat, stress, motivation, attitude), which also have an effect on health behavior. The genotype-based information is always a very sensitive topic, because it can also cause some negative consequences and feelings (e.g. depression, increased anxiety). The aim of this series of studies was firstly to study how individual, genotype-based health information affects an individual’s health form three aspects, and secondly whether this could be one method in the future to prevent lifestyle-related diseases, such as CVD. The first study concentrated on the psychological effects; the focus of the second study was on health behavior effects, and the third study concentrated on clinical effects. In the fourth study of this series, the focus was on all these three aspects and their associations with each other. The genetic risk and health information was the APOE gene and its effects on CVD. To study the effect of APOE genotype-based health information in prevention of CVD, a total of 151 volunteers attended the baseline assessments (T0), of which 122 healthy adults (aged 20 – 67 y) passed the inclusion criteria and started the one-year intervention. The participants (n = 122) were randomized into a control group (n = 61) and an intervention group (n = 61). There were 21 participants in the intervention Ɛ4+ group (including APOE genotypes 3/4 and 4/4) and 40 participants in the intervention Ɛ4- group (including APOE genotypes 2/3 and 3/3). The control group included 61 participants (including APOE genotypes 3/4, 4/4, 2/3, 3/3 and 2/2). The baseline (T0) and follow-up assessments (T1, T2, T3) included detailed measurements of psychological (threat and anxiety experience, stage of change), and behavioral (dietary fat quality, consumption of vegetables, - high fat/sugar foods and –alcohol, physical activity and health and taste attitudes) and clinical factors (total-, LDL- HDL cholesterol, triglycerides, blood pressure, blood glucose (0h and 2h), body mass index, waist circumference and body fat percentage). During the intervention six different communication sessions (lectures on healthy lifestyle and nutrigenomics, health messages by mail, and personal discussion with the doctor) were arranged. The intervention groups (Ɛ4+ and Ɛ4-) received their APOE genotype information and health message at the beginning of the intervention. The control group received their APOE genotype information after the intervention. For the analyses in this dissertation, the results for 106/107 participants were analyzed. In the intervention, there were 16 participants in the high-risk (Ɛ4+) group and 35 in the low-risk (Ɛ4-) group. The control group had 55 participants in studies III-IV and 56 participants in studies I-II. The intervention had both short-term (≤ 6 months) and long-term (12 months) effects on health behavior and clinical factors. The short-term effects were found in dietary fat quality and waist circumference. Dietary fat quality improved more in the Ɛ4+ group than the Ɛ4- and the control groups as the personal, genotype-based health information and waist circumference lowered more in the Ɛ4+ group compared with the control group. Both these changes differed significantly between the Ɛ4+ and control groups (p<0.05). A long-term effect was found in triglyceride values (p<0.05), which lowered more in Ɛ4+ compared with the control group during the intervention. Short-term effects were also found in the threat experience, which increased mostly in the Ɛ4+ group after the genetic feedback (p<0.05), but it decreased after 12 months, although remaining at a higher level compared to the baseline (T0). In addition, Study IV found that changes in the psychological factors (anxiety and threat experience, motivation), health and taste attitudes, and health behaviors (dietary, alcohol consumption, and physical activity) did not directly explain the changes in triglyceride values and waist circumference. However, change caused by a threat experience may have affected the change in triglycerides through total- and HDL cholesterol. In conclusion, this dissertation study has given some indications that individual, genotypebased health information could be one potential option in the future to prevent lifestyle-related diseases in public health care. The results of this study imply that personal genetic information, based on APOE, may have positive effects on dietary fat quality and some cardiovascular risk markers (e.g., improvement in triglyceride values and waist circumference). This study also suggests that psychological factors (e.g. anxiety and threat experience) may not be an obstacle for healthy people to use genotype-based health information to promote healthy lifestyles. However, even in the case of very personal health information, in order to achieve a permanent health behavior change, it is important to include attitudes and other psychological factors (e.g. motivation), as well as intensive repetition and a longer intervention duration. This research will serve as a basis for future studies and its information can be used to develop targeted interventions, including health information based on genotyping that would aim at preventing lifestyle diseases. People’s interest in personalized health advices has increased, while also the costs of genetic screening have decreased. Therefore, generally speaking, it can be assumed that genetic screening as a part of the prevention of lifestyle-related diseases may become more common in the future. In consequence, more research is required about how to make genetic screening a practical tool in public health care, and how to efficiently achieve long-term changes.

Effects of bank supervision and regulation on bank risk

In the last few decades, banking has strongly internationalized and become more complex. Hence, bank supervision and regulation has taken global perspective, too. The most important international regulation are the Basel frameworks by the Basel committee on banking supervision. This study examines the effects of bank supervision and regulation, especially the Basel II, on bank risk and risk-taking. In order to separate and recognize the efficiency of these effects, the co-effects of many supervisory and regulatory tools together with other relevant factors must be taken into account. The focus of the study is on the effects of asymmetric information and banking procyclicality on the efficiency of the Basel II. This study tries to find an answer, if the Basel II, implemented in 2008, has decreased bank risk in banks of European Union member states. This study examines empirically, if the volatility on bank stock returns have changed after the implementation of the Basel II. Panel data consists of 62 bank stock returns, bank-specific variables, economic variables and variables concerning regulatory environment between 2003 and 2011. Fixed effects regression is used for panel data analysis. Results indicate that volatility on bank stock returns has increased after 2008 and the implementation of the Basel II. Result is statistically very significant and robustness has been verified in different model specifications. The result of this study contradicts with the goal of the Basel II about banking system stability. Banking procyclicality and wrong incentives for regulatory arbitrage under asymmetric information explained in theoretical part may explain this result. On the other hand, simultaneously with the implementation of the Basel II, the global financial crisis emerged and caused severe losses in banks and increased stock volatility. However, it is clear that supervision and regulation was unable to prevent the global financial crisis. After the financial crisis, supervision and regulation have been reformed globally. The main problems of the Basel II, examined in the theoretical part, have been recognized in order to prevent problems of procyclicality and wrong incentives in the future.

An investigative study on the effects of black fly (diptera: simuliidae) sugar meals on reproductive success and parasite transmission /

Black flies are opportunistic sugar-feeders. They take sugar meals from Homopteran honeydew secretions or plant nectars, depending on availability. Homopteran honeydew secretions contain both simple and complex carbohydrates while plant nectars contain primarily simple carbohydrates. In order to determine whether honeydew secretions offer more energy than plant nectars to their insect visitors a study of wild-caught black flies was undertaken in Algonquin Provincial Park, Canada during the spring of 1 998 and 1 999. It was hypothesized that female black flies maintained on honeydew sugars will survive longer, produce more eggs and have a greater parasite vectoring potential than those maintained on artificial nectar or distilled water. Results demonstrated that: (1) host-seeking female Prosimulimfuscum/mixtum and Simulium venustum maintained on artificial honeydew did not survive longer than those maintained on artificial nectar when fed ad libitum; (2) fiiUy engorged S. venustum and Simulium rugglesi maintained on artificial honeydew did not produce more eggs than those maintained on artificial nectar when fed ad libitum; and (3) S. rugglesi did not have a greater vectoring potential of Leucocytozoon simondi when maintained on artificial honeydew as opposed to artificial nectar when fed ad libitum. However, all flies maintained on the two sugars (artificial honeydew and artificial nectar) survived longer, produce more eggs and had greater vectoring potential than those maintained on distilled water alone.