Systematics,Behavior and Living Environment of Shantungosaurus Giganteus(Dinosauria:Hadrosauridae)

On the basis of the taphonomy, osteological anatomy and ontogenetic variation, Zhuchengosaurus maximus Zhao et al., 2007 is considered to be synonymic with Shantungosaurus giganteus Hu, 1973 herein. This paper also deals with the life behavior of S. giganteus and the environment in which S. giganteus lived. S. giganteus is considered to be a terrestrial and gregarious herbivorous dinosaur and lived in hills and intervales in warm weather with plentiful rain and flourishing vegetation.

Systematics and Species Validity of the Dabieshan Pit Viper Protobothrops dabieshanensis Huang et al. 2012: Evidence from a Mitochondrial Gene Sequence Analysis

Aimed to evaluate the phylogenetic position of the recently described Protobothrops dabieshanensis Huang et al. （2012）, phylogenic relationships of 12 species within Protobothrops based on four mtDNA gene fragments （12S RNA, 16S RNA, ND4 and Cyt b） were reconstructed in our study. The result indicates a clade composed ofP dabiesha- nensis, P. jerdonii and P xiangchengsis with strong support. The genetic distance among P dabieshanensis, P jerdonii and P xiangchengsis was much lower than other congeners. Based on the data from the phylogenetic analysis and pre- viously described morphological differences, we conclude that P dabieshanensis is a valid species with close affinities to P jerdonii and P xiangchengsis.

Selenium and Sulfur Systematics of Mafic Dykes in Western Fujian Province,Southern China

Fifteen samples from three study areas （the Bancun diabase dykes, the Bali hornblende gabbro dykes, the Linzifen gabbro-diabase dykes） were collected and analyzed for selenium （Se）, sulfur （S）, copper （Cu）, major and trace elements. In general, Se, S and Cu do positively correlate to each other. The concentration of S and Se and the S/Se ratio are higher than the corresponding value of primitive mantle （PM）, and the Cu/S ratio falls in a narrow range （0.04-0.29）, which is consistent with that of primitive mantle （0.05-0.20）. The Bancun diabase dykes and the Bali hornblende gabbro dykes were located in an intraplate environment during the Late Mesozoic. Oceanic subduction was closely related to magmatic activities. The magmatic activities play an important role in the transportation mechanism of Se and S. Because those two groups were closer to fault zones, which may affect the distribution of S and Se and other elements. In the two groups, no crustal contamination was observed, indicating that all analyzed elements may come from enriched mantle metasomtism associated with slab subduction. However, the Linzifen gabbro-diabase dykes were located in an intraplate rift environment, and its invading age is older than the other two groups, the primitive magma comes from mantle, and there is an anomalous relation between S, Se and Al2O3, （La/Sm）N, and all these factors could result in higher S and Se concentration.

Combined community ecology and floristics,a synthetic study on the upper montane evergreen broad-leaved forests in Yunnan,southwestern China

The upper montane evergreen broad-leaved forest in Yunnan occurs mainly in the zone of persistent cloud and has a discontinuous,island-like,distribution.It is diverse,rich in endemic species,and likely to be sensitive to climate change.Six 1-ha sampling plots were established across the main distribution area of the upper montane evergreen broad-leaved forest in Yunnan.All trees with d.b.h.>1 cm in each plot were identified.Patterns of seed plant distributions were quantified at the specific,generic and family levels.The forests are dominated by the families Fagaceae,Lauraceae,Theaceae and Magnoliaceae,but are very diverse with only a few species shared between sites.Floristic similarities at the family and generic level were high,but they were low at the specific level,with species complementarity between plots.Diversity varied greatly among sites,with greater species richness and more rare species in western Yunnan than central Yunnan.The flora is dominated by tropical biogeographical elements,mainly the pantropic and the tropical Asian distributions at the family and genus levels.In contrast,at the species level,the flora is dominated by the southwest or the southeast China distributions,including Yunnan endemics.This suggests that the flora of the upper montane forest in Yunnan could have a tropical floristic origin,and has adapted to cooler temperatures with the uplift of the Himalayas.Due to great sensitivity to climate,high endemism and species complementarity,as well as the discontinuous,island-like,distribution patterns of the upper montane forest in Yunnan,the regional conservation of the forest is especially needed.

Rainforests north of the Tropic of Cancer: Physiognomy, floristics and diversity in ‘lowland rainforests’ of Meghalaya, India

The lowland rainforests of Meghalaya, India represent the westernmost limit of the rainforests north of the Tropic of Cancer. These forests, on the Shillong plateau, are akin to Whitmore's ‘tropical lowland evergreen rainforest' formation and exhibit striking similarities and conspicuous differences with the equatorial rainforests in Asia-Pacific as well as tropical seasonal rainforests in southwestern China near the Tropic of Cancer. We found these common attributes of the rainforests in Meghalaya: familial composition with predominance of Euphorbiaceae, Lauraceae, Meliaceae, Moraceae, Myrsiticaceae,Myrtaceae and Rubiaceae; deciduousness in evergreen physiognomy; dominance of mega-and mesophanerophytic life-forms; abundance of species with low frequency of occurrence(rare and aggregated species); low proportional abundance of the abundant species; and truncated lognormal abundance distribution. The levels of stand density and stand basal area were comparable with seasonal rainforests in southwestern China, but were lower than equatorial rainforests. Tropical Asian species predominated flora, commanding 95% of the abundance. The differences include overall low stature(height) of the forest, inconspicuous stratification in canopy, fewer species and individuals of liana, thicker understory,higher proportion of rare species, absence of locally endemic species and relatively greater dominance of Fagaceae and Theaceae. The richness of species per hectare(S) was considerably lower at higher latitudes in Meghalaya than in equatorial rainforests, but was comparable with seasonal rainforests. Shannon's diversity index(H’=4.40 nats for ≥10 cm gbh and 4.25 nats for ≥30 cm gbh) was lower on higher latitudes in Meghalaya in comparison to species-rich equatorial rainforests, but it was the highest among all lowland rainforests near the Tropic of Cancer.

Isotope systematics and metallogenetic age of Zhuanghe gold deposit, Liaoning province, China

Based on the metallogenetic geology conditions, the H, O, C and S isotopic compositions were measured by MAT-251 mass spectrometer, and Pb isotope and Rb-Sr dating were carried with MAT-261 multi-acceptor mass spectrometer. The results show that the δ^180 values of gold-bearing vein quartz from different levels are 1.19%-1.42%. The calculated δ^180 values of ore fluids are 0.55%-0.78%, and 319 values are from -8.64% to -6.66%. The calculated values of δ^34SH2s by the δ^34Spy values in quartz veins display sulfur isotope compositions from -0.053% to ＋0.413%. Carbon isotope compositions of carbonates are from -0.612% to 0.140%. The mole ratios of ^206Pb to ^204Pb, ^207Pb to ^204Pb and ^208Pb to ^204Pb in auriferous quartz vein are 16.987-17.545, 15.342-15.623, and 38.254-38.744, respectively. The age of the Zhuanghe gold deposit determined by Rb-Sr isochron of the fluid inclusions in quartzes is （143.0±5.8） Ma. These isotopic data suggest that the metallogenetic fluids are generated from magmatic hydrotherm and the origin of ore-forming matters is related to the deep-derived magmatic activities. Meanwhile, the metallogenetic epoch of the Zhuanghe gold deposit is in Yanshanian period.

Phylogenetic analysis of combined mitochondrial genome and 32 nuclear genes provides key insights into molecular systematics and historical biogeography of Asian warty newts of the genus Paramesotriton(Caudata: Salamandridae)

The Paramesotriton Chang, 1935 genus of Asian warty newts is the second most diverse genus in the family Salamandridae, currently containing 14recognized species from northern Vietnam to southwest-central and southern China. Although species of this genus have been included in previous phylogenetic studies, the origin and interspecific relationships of the genus are still not fully resolved,especially at key nodes in the phylogeny. In this study, we sequenced mitochondrial genomes and 32nuclear genes from 27 samples belonging to 14species to reconstruct the interspecific phylogenetic relationships within Paramesotriton and explore its historical biogeography in southern China. Both Bayesianinferenceandmaximum-likelihood analyses highly supported the monophyly of Paramesotriton and its two recognized species groups(P. caudopunctatus and P. chinensis groups)and further identified five hypothetical phylogenetic cryptic species. Biogeographic analyses indicated that Paramesotriton originated in southwestern China(Yunnan-Guizhou Plateau/South China) during the late Oligocene. The time of origin of Paramesotriton corresponded to the second uplift of the Himalayan/Qinghai-Xizang(Tibetan) Plateau(QTP), rapid lateral extrusion of Indochina, and formation of karst landscapes in southwestern China.Principal component analysis(PCA), independent sample t-tests, and niche differentiation using bioclimatic variables based on locations of occurrence suggested that Paramesotriton habitat conditions in the three current regions(West, South,and East) differ significantly, with different levels of climatic niche differentiation. Species distribution model(SDM) predictions indicated that the most suitable distribution areas for the P. caudopunctatus and P. chinensis species groups are western and southern/eastern areas of southern China. This study increases our knowledge of the taxonomy,biodiversity, origin, and suitable distribution areas of the genus Paramesotriton based on phylogenetic,biogeographic, and species distribution models.

Predominance of linear Q and μ systematics in randominteraction ensembles

In random-interaction ensembles, the electric quadrupole moments(Q) and magnetic moments(μ) of the Iπ = 11/2-isomers of the Cd isotopes predominantly exhibit a linear correlation with the neutron numbers,corresponding to the recently emphasized linear Q and μsystematics in realistic nuclear systems. Although the seniority scheme enhances such predominance(more essentially for μ), the configuration mixing due to quadrupole-like and δ-force-like proton-neutron(pn) interactions is responsible for the linear Q and μ systematics,respectively, in realistic nuclear system, as well as randominteraction ensembles.

Association between physical activity and risk of gastroesophageal reflux disease:A systematic review and meta-analysis

Background:Lifestyle plays an important role in preventing and managing gastroesophageal reflux disease(GERD).In response to the conflicting results in previous studies,we performed a systematic review and meta-analysis to investigate this association.Methods:Relevant studies published until January 2023 were retrieved from 6 databases,and the prevalence of symptomatic gastroesophageal reflux(GER)or GERD was determined from the original studies.A random effects model was employed to meta-analyze the association by computing the pooled relative risk(RR)with 95%confidence intervals(95%CIs).Furthermore,subgroup and dose-response analyses were performed to explore subgroup differences and the association between cumulative physical activity(PA)time and GERD.Results:This meta-analysis included 33 studies comprising 242,850 participants.A significant negative association was observed between PA and the prevalence of symptomatic GER(RR=0.74,95%CI:0.66-0.83;p<0.01)or GERD(RR=0.80,95%CI:0.76-0.84;p<0.01),suggesting that engaging in PA might confer a protective benefit against GERD.Subgroup analyses consistently indicated the presence of this association across nearly all subgroups,particularly among the older individuals(RR_(<40 years):RR_(≥40 years)=0.85:0.69,p<0.01)and smokers(RR_(smoker):RR_(non-smoker)=0.67:0.82,p=0.03).Furthermore,a dose-response analysis revealed that individuals who engaged in 150 min of PA per week had a 72.09%lower risk of developing GERD.Conclusion:Maintaining high levels of PA decreased the risk of GERD,particularly among older adults and smokers.Meeting the recommended PA level of 150 min per week may significantly decrease the prevalence of GERD.

Systematics, species diversity and new taxa of mesozooplankton in the West Pacific Ocean and its marginal seas: a brief compilation of monographs in China

Research and protection of biodiversity is generally started with species recognizing guided by achievement of cataloguing and illustration obtained through in situ investigation data accumulation and literature learning. Facing the shortage of taxonomist, it is getting harder to maintain important specimen collections and handle loans. The West Pacific Ocean has been operating as a center of the origin of global marine biodiversity result of the richest species diversity of marine taxa found in these waters. The present work is a compilation and summary of systematics, species diversity and new taxa of mesozooplankton major group known in West Pacific Ocean and its marginal seas （0°-45°N, 105°-152°E） according to 6 203 mesozooplankton samples acquired from 701 stations during 1965 and 2008. A total of 2 657 species belonging to 686 genera and 206 families of 10 mesozooplankton groups have been found through taxonomic identification and document consulting. In details, 697 species from 251 genera of 99 families belong to the Medusozoa, 59 species from 22 genera of 12 families to the Ctenophora, 85 species from 36 genera of 14 families to the pelagic Mollusca （Pteropoda and Heteropoda）, 416 species from 91 genera of 8 families to the Ostracoda, 908 species from 156 genera of 51 families to the Copepoda, 202 species from 60 genera of 4 families to the Mysidacea, 56 species from 8 genera of 2 families to the Euphausiacea, 105 species from 23 genera of 8 families to the Decapoda, 48 species from 13 genera of 5 families to the Chaetognatha and 81 species from 26 genera of 5 families to the Tunicata. The dominant species of each group are enumerated. Moreover, 2 new species of Medusozoa, Tubulariidae, Ectopleura, 1 new species of Medusozoa, Protiaridae, Halitiarella, 1 new genus and 1 new species of Medusozoa, Corymorphidae are established. An amount of 806 species are expanded with an increase of 43.5% on the basis of 1 852 species recorded before 2008, including 1.4% increase from tropical sea around equator, 4.0% from the frigid water in high latitude region, and 3.0% of bathypelagic-associated waters. The authors also summarized future prospects into five major areas in marine mesozooplankton research in China. Such information of qualitative phyletic classification could be of high relevance to studies on biodiversity and biogeography of marine mesozooplankton, especially for monographs contributed to make an overall and systematic conclusion on the species of marine life in China after 2008.

Pleistocene Radiolaria from Leg 119 Site 738B (Sections 1H1-1H2): Systematics and Biostratigraphy

This paper presents a record of radiolarian species from the sections (1H1-1H2) Leg 119 Site 738B of Southern Ocean region. Well diversified taxa of typical Antarctic assemblage are present in the sections. Thirty species were identified and illustrated from twenty-nine samples. On the basis of appearance, disappearance and abundance of taxa, viz. Omega and Psi zones are established and systematics of stratigraphically important species is described. These zones are equivalent to NR1 and NR2 of Upper Quaternary.

Li and B Isotope Systematics of Ultrahigh-pressure Metamorphic Rocks from the Chinese Continental Scientific Drilling Program

1 Introduction Recent improvements in the precision of Li and B isotope measurements have demonstrated the potential of these elements in tracing a wide range of geological processes. The Li and B isotope systematics of ultrahigh-pressure (UHP) metamorphic rocks provides a unique opportunity to investigate the behaviour of Li and B during fluid-rock interaction at high temperatures and very high pressures and to constrain the fluid budget and the recycling of subducted crustal materials into the mantle during UHP metamorphism. ……

Systematic review and network meta-analysis of different nonsteroidal anti-inflammatory drugs for juvenile idiopathic arthritis

BACKGROUND Various non-steroidal anti-inflammatory drugs(NSAIDs)have been used for juvenile idiopathic arthritis(JIA).However,the optimal method for JIA has not yet been developed.AIM To perform a systematic review and network meta-analysis to determine the optimal instructions.METHODS We searched for randomized controlled trials(RCTs)from PubMed,EMBASE,Google Scholar,CNKI,and Wanfang without restriction for publication date or language at August,2023.Any RCTs that comparing the effectiveness of NSAIDs with each other or placebo for JIA were included in this network meta-analysis.The surface under the cumulative ranking curve(SUCRA)analysis was used to rank the treatments.P value less than 0.05 was identified as statistically significant.RESULTS We included 8 RCTs(1127 patients)comparing 8 different instructions including meloxicam(0.125 qd and 0.250 qd),Celecoxib(3 mg/kg bid and 6 mg/kg bid),piroxicam,Naproxen(5.0 mg/kg/d,7.5 mg/kg/d and 12.5 mg/kg/d),inuprofen(30-40 mg/kg/d),Aspirin(60-80 mg/kg/d,75 mg/kg/d,and 55 mg/kg/d),Tolmetin(15 mg/kg/d),Rofecoxib,and placebo.There were no significant differences between any two NSAIDs regarding ACR Pedi 30 response.The SUCRA shows that celecoxib(6 mg/kg bid)ranked first(SUCRA,88.9%),rofecoxib ranked second(SUCRA,68.1%),Celecoxib(3 mg/kg bid)ranked third(SUCRA,51.0%).There were no significant differences between any two NSAIDs regarding adverse events.The SUCRA shows that placebo ranked first(SUCRA,88.2%),piroxicam ranked second(SUCRA,60.5%),rofecoxib(0.6 mg/kg qd)ranked third(SUCRA,56.1%),meloxicam(0.125 mg/kg qd)ranked fourth(SUCRA,56.1%),and rofecoxib(0.3 mg/kg qd)ranked fifth(SUCRA,56.1%).CONCLUSION In summary,celecoxib(6 mg/kg bid)was found to be the most effective NSAID for treating JIA.Rofecoxib,piroxicam,and meloxicam may be safer options,but further research is needed to confirm these findings in larger trials with higher quality studies.

Impact of frailty on outcomes of elderly patients undergoing percutaneous coronary intervention: A systematic review and metaanalysis

BACKGROUND Frailty is a common condition in elderly patients who receive percutaneous coronary intervention(PCI).However,how frailty affects clinical outcomes in this group is unclear.AIM To assess the link between frailty and the outcomes,such as in-hospital complic-ations,post-procedural complications,and mortality,in elderly patients post-PCI.METHODS The PubMed/MEDLINE,EMBASE,Cochrane Library,and Web of Science databases were screened for publications up to August 2023.The primary outcomes assessed were in-hospital and all-cause mortality,major adverse cardiovascular events(MACEs),and major bleeding.The Newcastle-Ottawa Scale was used for quality assessment.RESULTS Twenty-one studies with 739693 elderly patients undergoing PCI were included.Frailty was consistently associated with adverse outcomes.Frail patients had significantly higher risks of in-hospital mortality[risk ratio:3.45,95%confidence interval(95%CI):1.90-6.25],all-cause mortality[hazard ratio(HR):2.08,95%CI:1.78-2.43],MACEs(HR:2.92,95%CI:1.85-4.60),and major bleeding(HR:4.60,95%CI:2.89-7.32)compared to non-frail patients.CONCLUSION Frailty is a pivotal determinant in the prediction of risk of mortality,development of MACEs,and major bleeding in elderly individuals undergoing percutaneous coronary intervention.

Effect of remimazolam vs. propofol on hemodynamics during general anesthesia induction in elderly patients: Single-center, randomized controlled trial

The current study aimed to compare the effects between remimazolam and propofol on hemodynamic stability during the induction of general anesthesia in elderly patients.We used propofol at a rate of 60 mg/(kg·h)in the propofol group(group P)or remimazolam at a rate of 6 mg/(kg·h)in the remimazolam group(group R)for the induction.A processed electroencephalogram was used to determine whether the induction was successful and when to stop the infusion of the study drug.We measured when patients entered the operating room(T_(0)),when the induction was successful(T_(1)),and when before(T_(2))and 5 min after successful endotracheal intubation(T_(3)).We found that mean arterial pressure(MAP)was lower at T_(1–3),compared with T_(0) in both groups,but higher at T_(2) in the group R,whileΔMAP_(T0–T2) andΔMAP_(max) were smaller in the group R(ΔMAP_(T0–T2):the difference between MAP at time point T_(0) and T_(2),ΔMAP_(max):the difference between MAP at time point T_(0) and the lowest value from T_(0) to T_(3)).Cardiac index and stroke volume index did not differ between groups,whereas systemic vascular resistance index was higher at T_(1–3) in the group R.These findings show that remimazolam,compared with propofol,better maintains hemodynamic stability during the induction,which may be attributed to its ability to better maintain systemic vascular resistance levels.

Neurophysiological, histological, and behavioral characterization of animal models of distraction spinal cord injury: a systematic review

Distraction spinal cord injury is caused by some degree of distraction or longitudinal tension on the spinal cord and commonly occurs in patients who undergo corrective operation for severe spinal deformity.With the increased degree and duration of distraction,spinal cord injuries become more serious in terms of their neurophysiology,histology,and behavior.Very few studies have been published on the specific characteristics of distraction spinal cord injury.In this study,we systematically review 22 related studies involving animal models of distraction spinal cord injury,focusing particularly on the neurophysiological,histological,and behavioral characteristics of this disease.In addition,we summarize the mechanisms underlying primary and secondary injuries caused by distraction spinal cord injury and clarify the effects of different degrees and durations of distraction on the primary injuries associated with spinal cord injury.We provide new concepts for the establishment of a model of distraction spinal cord injury and related basic research,and provide reference guidelines for the clinical diagnosis and treatment of this disease.

Diversifying on the Ark:multiple new endemic lineages of dwarf geckos from the Western Ghats provide insights into the systematics and biogeography of South Asian Cnemaspis(Reptilia:Squamata)

The highly speciose gekkonid genus Cnemaspis Strauch,1887 is polyphyletic,with three distantly related and geographically isolated clades from Africa,South Asia(SA),and Southeast Asia.At present,there are 85 known species within SA Cnemaspis,although the number continues to increase rapidly with focused surveys and rigorous taxonomic work.Recent studies have provided valuable insights into the diversity and evolutionary history of SA Cnemaspis;however,most of these studies lack sufficient sampling in the Western Ghats(WG),where the genus has its greatest diversity.We addressed this research gap by conducting extensive sampling across the WG and re-examining museum specimens,thus providing a systematic account of various extant Cnemaspis species along with their distribution and natural history.We described 12 new species and a southern WG endemic clade of SA Cnemaspis.Ten of the newly described species are endemic to the forests of the southern WG.We also identified 10 well-supported subclades that can be separated across morphological,geographic,and phylogenetic axes.A time-calibrated phylogeny and ancestral area reconstructions confirmed the Paleocene origin of SA Cnemaspis in the WG and provide insights into its evolutionary history and biogeography.The discovery of multiple endemic and deeply divergent lineages further highlights the evolutionary significance of the WG for lizards.

Problems in the Field of Systematics and Investigation of Conifers in Russia

The largest and most important family in Russian conifers is Pinaceae （27-29 species）. The most important problems in the field of systemitics concern some critical taxa. In the result of author＇s research, the new signs of vegetative and reproductive organs have been checked out and elaborated. It leads to the clarifying of new taxonomic status and geographical distribution of certain critical taxa. A set of species are threatened and need special measures which are included into the Red Data Book of Russian Federation. for their conservation. There are 13 species and one variety

Establishing delivery route-dependent safety and efficacy of living biodrug mesenchymal stem cells in heart failure patients

BACKGROUND Mesenchymal stem cells(MSCs)as living biopharmaceuticals with unique properties,i.e.,stemness,viability,phenotypes,paracrine activity,etc.,need to be administered such that they reach the target site,maintaining these properties unchanged and are retained at the injury site to participate in the repair process.Route of delivery(RoD)remains one of the critical determinants of safety and efficacy.This study elucidates the safety and effectiveness of different RoDs of MSC treatment in heart failure(HF)based on phase II randomized clinical trials(RCTs).We hypothesize that the RoD modulates the safety and efficacy of MSCbased therapy and determines the outcome of the intervention.AIM To investigate the effect of RoD of MSCs on safety and efficacy in HF patients.METHODS RCTs were retrieved from six databases.Safety endpoints included mortality and serious adverse events(SAEs),while efficacy outcomes encompassed changes in left ventricular ejection fraction(LVEF),6-minute walk distance(6MWD),and pro-B-type natriuretic peptide(pro-BNP).Subgroup analyses on RoD were performed for all study endpoints.RESULTS Twelve RCTs were included.Overall,MSC therapy demonstrated a significant decrease in mortality[relative risk(RR):0.55,95%confidence interval(95%CI):0.33-0.92,P=0.02]compared to control,while SAE outcomes showed no significant difference(RR:0.84,95%CI:0.66-1.05,P=0.11).RoD subgroup analysis revealed a significant difference in SAE among the transendocardial(TESI)injection subgroup(RR=0.71,95%CI:0.54-0.95,P=0.04).The pooled weighted mean difference(WMD)demonstrated an overall significant improvement of LVEF by 2.44%(WMD:2.44%,95%CI:0.80-4.29,P value≤0.001),with only intracoronary(IC)subgroup showing significant improvement(WMD:7.26%,95%CI:5.61-8.92,P≤0.001).Furthermore,the IC delivery route significantly improved 6MWD by 115 m(WMD=114.99 m,95%CI:91.48-138.50),respectively.In biochemical efficacy outcomes,only the IC subgroup showed a significant reduction in pro-BNP by-860.64 pg/mL(WMD:-860.64 pg/Ml,95%CI:-944.02 to-777.26,P=0.001).CONCLUSION Our study concluded that all delivery methods of MSC-based therapy are safe.Despite the overall benefits in efficacy,the TESI and IC routes provided better outcomes than other methods.Larger-scale trials are warranted before implementing MSC-based therapy in routine clinical practice.