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To explore whether and how group cognitive-behavioural therapy (GCBT) plus medication differs from medication alone for the treatment of generalized anxiety disorder (GAD).
170 patients were randomly assigned to the GCBT plus duloxetine (n=89) or duloxetine group (n=81). The primary outcomes were Hamilton Anxiety Scale (HAMA) response and remission rates. The explorative secondary measures included score reductions from baseline in the HAMA total, psychic and somatic anxiety subscales (HAMA-PA, HAMA-SA), the Hamilton Depression Scale (HAMD), the Severity Subscale of Clinical Global Impression Scale (CGI-S), Global Assessment Function (GAF), and the 12-item Short-Form Health Survey (SF-12). Assessments were conducted at baseline, 4-weeks, 8-weeks and 3-monthsfollow-up.
At 4-weeks, HAMA response (GCBT group 57.0% vs. control group 24.4%, p=0.000, Cohen d=0.90) and remission rates (GCBT group 21.5%vs. control group 6.2%, p=0.004; d=0.51), and most secondary outcomes (all p<0.05, d=0.36-0.77) showed that the combined therapy was superior. At 8-weeks, all the primary and secondary significant differences found at 4-weeks were maintained with smaller effect sizes (p<0.05, d=0.32-0.48) . At 3-months follow-up, the combined therapy was only significantly superior in the HAMA total (p<0.045, d=0.43) and HAMA-PA score reductions (p<0.001, d=0.77). Logistic regression showed superiority of the combined therapy for HAMA response rates (OR=2.12, 95% CI 1.02-4.42, p=0.04); and remission rates (OR=2.80, 95% CI 1.27-6.16, p=0.01).
Compared with duloxetine alone, GCBT plus duloxetine showed significant treatment response for GAD over a shorter period of time, particularly for psychic anxiety symptoms, which may suggest GCBT was effective in changing cognitive style.
The study of the relationship among the manufacturing process, the structure and the property of materials can help to develop the new materials. The material images contain the microstructures of materials, therefore, the quantitative analysis for the material images is the important means to study the characteristics of material structures. Generally, the quantitative analysis for the material microstructures is based on the exact segmentation of the materials images. However, most material microstructures are shown with various shapes and complex textures in images, and they seriously hinder the exact segmentation of the component elements. In this research, machine learning method and complex networks method are adopted to the challenge of automatic material image segmentation. Two segmentation tasks are completed: on the one hand, the images of the titanium alloy are segmented based on the pixel-level classification through feature extraction and machine learning algorithm; on the other hand, the ceramic images are segmented with the complex networks theory. In the first task, texture and shape features near each pixel in titanium alloy image are calculated, such as Gabor filters, Hu moments and GLCM (Gray-Level Co-occurrence Matrix) etc.. The feature vector for the pixel can be obtained by arraying these features. Then, classification is performed with the random forest model. Once each pixel is classified, the image segmentation is completed. In the second task, a complex network structure is built for the ceramic image. Then, a clustering algorithm of complex network is used to obtain network connection area. Finally, the clustered network structure is mapped back to the image and getting the contours among the component elements. The experimental results demonstrate that these methods can accurately segment material images.
In a model where investors disagree about the fundamentals of two stocks, the state-price density depends on investor disagreements for both stocks, especially the larger stock. This implies that disagreement among investors in a large firm has a spillover effect on the pricing of other stocks owned by these investors. The pricing effects of investor disagreements crucially depend on the average belief biases. Empirical findings support the novel model prediction of a disagreement spillover effect and help reconcile some mixed evidence in the literature.
The aim of this study was to determine whether vitamin D supplementation and maintaining vitamin D sufficiency are associated with changes in inflammatory and metabolic biomarkers in patients with knee osteoarthritis (OA) and vitamin D deficiency. A total of 413 participants with symptomatic knee OA and vitamin D deficiency were enrolled in a randomised, placebo-controlled trial and received 1·25 mg vitamin D3 or placebo monthly for 24 months across two sites. In this post hoc analysis, 200 participants from one site (ninety-four from the placebo group and 106 from the vitamin D group; mean age 63·1 (sd 7·3) years, 53·3 % women) were randomly selected for measurement of serum levels of inflammatory and metabolic biomarkers at baseline and 24 months using immunoassays. In addition, participants were classified into two groups according to serum 25-hydroxyvitamin D (25(OH)D) levels at months 3 and 24: (1) not consistently sufficient (25(OH)D≤50 nmol/l at either month 3 or 24, n 61), and (2) consistently sufficient (25(OH)D>50 nmol/l at both months 3 and 24, n 139). Compared with placebo, vitamin D supplementation had no significant effect on change in serum high-sensitive C-reactive protein, IL-6, IL-8, IL-10, leptin, adiponectin, resistin, adipsin and apelin. Being consistently vitamin D sufficient over 2 years was also not associated with changes in these biomarkers compared with not being consistently sufficient. Vitamin D supplementation and maintaining vitamin D sufficiency did not alter serum levels of inflammatory and metabolic biomarkers over 2 years in knee OA patients who were vitamin D insufficient, suggesting that they may not affect systemic inflammation in knee OA patients.
Monosized spherical Cu–20% Sn (wt%) alloy particles with diameter ranging from 70.6 to 334.0 μm were prepared by the pulsated orifice ejection method (termed “POEM”). Fully dense without pores and bulk inclusions, the cross-sectional micrographs of the spherical alloy particles indicate an even distribution of Cu and Sn. These spherical Cu–Sn alloy particles exhibit a good spherical shape and a narrow size distribution, suggesting that the liquid Cu–Sn alloy can completely break the balance between the surface tension and the liquid static pressure in the crucible micropores and accurately control the volume of the droplets. Furthermore, the cooling rate of spherical Cu–20% Sn alloy particles is estimated by a Newton’s cooling model. The cooling rate of the Cu–20% Sn alloy particle decreases gradually with the particle diameter increasing. Smaller particles have higher cooling rates and when the particle diameter is less than 70 μm, the cooling rate of particles can reach more than 3.3 × 104 K/s. The secondary dendrite arm spacing has strong dependence on particle diameter which increases gradually with the increase of particle diameter. The results demonstrate that POEM is an effective route for fabrication of high-quality monosized Cu–20% Sn alloy particles.
Although many studies worldwide have focused on the relationship between vitamin D and insulin resistance, results remain controversial. Furthermore, concentrations of serum 25-hydroxyvitamin D (25(OH)D) in the Chinese population are unclear. We aimed to investigate vitamin D status and its correlation with insulin resistance among a Chinese adult population.
Serum 25(OH)D, fasting blood glucose, fasting insulin, glycated Hb (HbA1c) and other metabolic parameters were assessed. Neck circumference, waist circumference, hip circumference, weight and height were also measured. Lifestyle factors including smoking and drinking status were obtained. Diabetes mellitus was diagnosed by HbA1c according to the 2010 American Diabetes Association criteria.
Of 7200 residents included, 6597 individuals were ultimately analysed.
We enrolled 2813 males (mean age 52·7 (sd 13·5) years) and 3784 females (52·3 (sd 13·5) years); mean serum 25(OH)D concentration was 43·1 (sd 11·6) and 39·6 (sd 9·8) nmol/l, respectively. Additionally, 83·3 % of participants were 25(OH)D deficient. A significant difference in 25(OH)D was observed between males and females in winter and spring (P<0·001). Furthermore, 25(OH)D concentrations were inversely associated with the homeostasis model assessment of insulin resistance (HOMA-IR) in the overweight and pre-diabetic populations. After adjusting for several variables, 25(OH)D was significantly associated with HOMA-IR in winter. When 25(OH)D values were categorized into quartiles, HOMA-IR was significantly associated with decreasing 25(OH)D.
The majority of the Chinese population was vitamin D deficient and this deficiency was negatively associated with insulin resistance, particularly in the overweight and pre-diabetic populations. Moreover, these associations might be more evident in the winter.
We test the hypothesis that investment constraints in delegated portfolio management may distort demand for stocks, leading to price underreaction to news and stock return predictability. We find that institutions tend not to buy more of a stock with good news that they already overweight; they are reluctant to sell a stock with bad news that they already underweight. Stocks with good news overweighted by institutions subsequently significantly outperform stocks with bad news underweighted by institutions. The impact of institutional investment constraints sheds new light on asset pricing anomalies such as stock price momentum and post–earnings announcement drift.
To conduct a pilot study to assess the feasibility of modifying food truck meals to meet the My Plate guidelines as well as the acceptability of healthier meals among consumers.
We recruited the owners of Latino food trucks (loncheras) in 2013–2014 and offered an incentive for participation, assistance with marketing and training by a bilingual dietitian. We surveyed customers and we audited purchases to estimate sales of the modified meals.
City of Los Angeles, CA, USA.
Owners or operators of Latino food trucks (loncheras) and their customers.
We enrolled twenty-two lonchera owners and eleven completed the intervention, offering more than fifty new menu items meeting meal guidelines. Sales of the meals comprised 2 % of audited orders. Customers rated the meals highly; 97 % said they would recommend and buy them again and 75 % of participants who completed the intervention intended to continue offering the healthier meals. However, adherence to guidelines drifted after several months of operation and participant burden was cited as a reason for dropout among three of eleven lonchera owners who dropped out.
Lonchera owners/operators who participated reported minimal difficulty in modifying menu items. Given the difficulty in enrolment, expanding this programme and ensuring adherence would likely need to be accomplished through regulatory requirements, monitoring and feedback, similar to the methods used to achieve compliance with sanitary standards. A companion marketing campaign would be helpful to increase consumer demand.
Changes in soil chemistry in response to varying climatic regimes can alter the equilibria of soil systems and result in different clay minerals. Variations in phyllosilicate clay composition can reflect temporal and spatial climatic changes, such as summer/winter monsoon cycles. The objective of this research was to investigate the mineralogy of the clay fractions as a proxy for determining variations in the East Asian monsoon climate, based on a section at Chaoyang in China spanning the last 0.423 Ma BP. The clay mineralogy record in the Chaoyang section was compared with other proxies as recorded in this section and with other palaeoclimatic indicators, including oxygen isotopes from oceanic sediments and loess–palaeosol sections on the Chinese Loess Plateau (CLP). The results from clay mineralogy and related climatic studies show that the summer monsoon has a trend of four increased stages and four decreased stages; whereas the winter monsoon displays the opposite trend. During the last 0.423 Ma BP, the strongest winter monsoon occurred around 0.243–0.311 Ma BP. During this period, which included an intense winter monsoon, the soil in the section had the least illite, one of the smallest kaolinite and illite/Chlorite (I/C) indices and an overall decreasing clay content. The period 0.225–0.243 Ma BP had the strongest summer monsoon over the last 0.423 Ma BP. This period had the greatest amount of illite, the highest I/C index, greater overall clay content and the strongest magnetic susceptibility signal. Additionally, this section contained the smallest mean grain size. The multi-monsoon climate cycles of alternating cold-dry and warm-moist conditions as recorded in the Chaoyang section corresponded well with multiple glaciation cycles based on deep sea sediments. This indicates that the Chaoyang section provides a record of palaeoclimate changes in northeast China that can be linked to mineralogical suites to assist in reconstructing the palaeoclimate over the Late Middle Pleistocene, and complements the global palaeoclimate records in the CLP.
Paired radiocarbon and stable carbon analyses have been carried out on aragonite shells and organic soft bodies of snails from the Chinese Loess Plateau in order to explore the possibility of using these kinds of samples as environmental and chronological indicators. Results show that the soft bodies exhibit 14C concentrations similar to those of plant leaves, indicating that carbon in the soft bodies is fixed from organic diets. The aragonite shells are depleted in 14C compared to the soft bodies due to ingestion of 14C-depleted carbonate. This depletion shows a consistent pattern across the Chinese Loess Plateau, implying a good potential for the snail shells to be applicable for 14C dating with a simple correction. The δ13C values measured for aragonite shells display a linear relationship with those obtained for the soft bodies with a constant offset. In addition, the carbon derived from organic diets accounts for more than 70% of the total shell carbon. This fact suggests that stable carbon isotope composition of aragonite shells mainly reflects that of organic diet, and could be used as a reliable indicator of paleodiet in the Chinese Loess Plateau.
Recent studies have suggested an association between vitamin D and non-alcoholic fatty liver disease (NAFLD); however, some results are subject to debate. This study was carried out to evaluate the correlation between NAFLD and vitamin D in men and women in East China. The data were obtained from a cross-sectional study that focused on the health and metabolic status of adults in sixteen areas of East China. According to ultrasonic assessments, the patients were divided into normal and NAFLD groups. Demographic characteristics and biochemical measurements were obtained. Binary logistic regression analysis was used to explore the association. In total, 5066 subjects were enrolled, and 2193 (43·3 %) were diagnosed with NAFLD; 84·56 % of the subjects showed vitamin D deficiency. Subjects with high vitamin D levels had a lower prevalence of NAFLD, particularly male subjects. Within the highest quartile of vitamin D levels, the prevalence of NAFLD was 40·8 %, whereas the lowest quartile of vitamin D levels showed a prevalence of 62·2 %, which was unchanged in women across the vitamin D levels. Binary logistic analysis showed that decreased vitamin D levels were associated with an increased risk of NAFLD (OR 1·54; 95 % CI 1·26, 1·88). This study suggests that vitamin D levels are significantly associated with NAFLD and that vitamin D acts as an independent factor for NAFLD prevalence, particularly in males in East China. Vitamin D interventional treatment might be a new target for controlling NAFLD; elucidating the mechanism requires further research.
The interaction of two laser-induced bubbles in bulk water is investigated. The strength and direction of the emerging liquid jets can be controlled by adjusting the relative bubble positions, the time difference between bubble generation, and the laser pulse energies determining the bubble sizes. Experimental and numerical studies are performed for millimetre-sized bubble pairs. Taking bubbles of equal energy, a maximum jet velocity is found for close anti-phase bubbles, i.e. when the second bubble is produced at the maximum volume of the first one and the bubble walls are almost touching and not merging. Under these conditions, one bubble produces a fast jet with a peak velocity of about
that reaches a distance into the surrounding liquid of at least three times the maximum bubble radius. Collapse of the other bubble results in a slow jet of large mass that rapidly converts into a ring vortex. Correspondingly, the interaction with adjacent structures is dominated either by localized jet impact or by shear stresses extending over a larger area. Furthermore, interactions between micrometre-sized bubble pairs are investigated numerically to understand and predict how the effects of the physical parameters on bubble dynamics would change when the bubbles become smaller. The results are discussed with respect to micropumping and opto-injection.
The process of laser-induced brazing constitutes a potential option for connecting several ceramic components (n- and p-type ceramic bars and ceramic substrate) of a thermoelectric generator (TEG) unit. For the construction of the TEGs, TiOx and BxC were used as thermoelectric bars and AlN was used as substrate material. The required process time for joining is well below that of conventional furnace brazing processes and, furthermore, establishes the possibility of using a uniform filler system for all contacting points within the thermoelectric unit. In the work reported here, the application-specific optimization of the laser-joining process is presented as well as the adapted design of the thermoelectric modules. The properties of the produced bonding were characterized by using fatigue strength and microstructural investigations. Furthermore, the operational reliability of the modules was verified.
To assess correlations between cruciferous vegetable intake and urinary isothiocyanate (ITC) level, in addition to glutathione S-transferase (GST) genotypes and other individual factors.
The study included cohort participants whose urinary ITC levels had been previously ascertained. Urinary ITC was assessed using HPLC. Usual dietary intake of cruciferous vegetables was assessed using a validated FFQ and total dietary ITC intake was calculated. Recent cruciferous vegetable intake was determined. GST genotypes were assessed using duplex real-time quantitative PCR assays. Spearman correlations were calculated between the covariates and urinary ITC levels and linear regression analyses were used to calculate the mean urinary ITC excretion according to GST genotype.
Urban city in China.
The study included 3589 women and 1015 men from the Shanghai Women’s and Men’s Health Studies.
Median urinary ITC level was 1·61 nmol/mg creatinine. Self-reported usual cruciferous vegetable intake was weakly correlated with urinary ITC level (rs=0·1149; P<0·0001), while self-reported recent intake was more strongly correlated with urinary ITC (rs=0·2591; P<0·0001). Overall, the GST genotypes were not associated with urinary ITC level, but significant differences according to genotype were observed among current smokers and participants who provided an afternoon urine sample. Other factors, including previous gastrectomy or gastritis, were also related to urinary ITC level.
The study suggests that urinary secretion of ITC may provide additional information on cruciferous vegetable intake and that GST genotypes are related to urinary ITC level only in some subgroups.
Error-prone repair of radiation-induced DNA double-strand breaks (DSBs) results in DNA mutation that is essential for mutation breeding. Non-homologous end joining might be the principal DSB repair mechanism in eukaryotes, which is mediated and activated by Ku protein, a heterodimer of 70 and 80 kDa subunits. In this study, on the basis of complementary DNA (cDNA), the genomic sequences of TaKu70 and TaKu80 genes in all the three genomes of wheat were characterized. Only single-nucleotide substitutions and no insertions or deletions were detected in the exons of TaKu70 and TaKu80 genes. The size of the introns exhibited a slight variation between the sequences. Yeast two-hybrid analysis demonstrated that TaKu70 and TaKu80 formed a heterodimer, and electrophoretic mobility shift assays revealed that this heterodimer bound to double-stranded DNA, but not to single-stranded DNA. The quantitative polymerase chain reaction analysis revealed that the expression of TaKu70 and TaKu80 genes was up-regulated under γ-ray irradiation in a dose-dependent manner in the seedlings of wheat. These results suggest that TaKu70 and TaKu80 form a functional heterodimer and are associated with the repair of the induced DSBs in wheat.
In the present study, twenty-four Duroc × Landrance × Yorkshire (initial body weight (BW) of 21·82 (sem 2·06) kg) cross-bred pigs were used to determine whether dietary vitamin D supplementation could confer protection against viral infections through the retinoic acid-inducible gene I (RIG-I) signalling pathway in pigs. Experimental treatments were arranged in a 2 × 2 factorial manner with the main effects of immune challenge (control v. porcine rotavirus (PRV) challenge) and dietary concentrations of vitamin D (200 and 5000 IU; where 1 IU of vitamin D is defined as the biological activity of 0.025 mg of cholecalciferol). The pigs were fed a diet containing 200 or 5000 IU vitamin D in the first week of the study period. On day 8, the pigs were orally dosed with 4 ml of Dulbecco's modified Eagle's medium/Ham's F-12 medium containing PRV or essential medium (control). Serum samples were collected on day 8 (pre-challenge), and 6 d after the PRV challenge, the pigs were killed to evaluate intestinal morphology and tissue gene expression following the last blood collection. Pigs challenged with PRV had decreased BW gain (P< 0·01), feed intake (P< 0·01), villus height (P< 0·01), faecal consistency (P< 0·05), and serum 1,25-dihydroxyvitamin D concentration (P< 0·01) and increased (P< 0·01) serum IL-2, IL-6 and interferon (IFN)-β concentrations. Vitamin D supplementation mitigated these effects. The mRNA expression of RIG-I (P< 0·01), IFN-β promoter stimulator 1 (P< 0·01), IFN-β (P< 0·01) and interferon-stimulated gene 15 (ISG15) (P< 0·01) was up-regulated by the PRV challenge and vitamin D supplementation in the intestine. In conclusion, vitamin D supplementation could activate the RIG-I signalling pathway and thus alleviate the negative effects caused by PRV challenge.
This paper examines the characteristics and pricing of stocks that are actively traded by speculative retail investors. We find that stocks with high retail trading proportion (RTP) have strong lottery features and they attract retail investors with strong gambling propensity. Furthermore, these stocks tend to be overpriced and earn significantly negative alpha. The average monthly return differential between the extreme RTP quintiles is −0.60%. This negative RTP premium is stronger among stocks that have lottery features or arelocated in regions where people exhibit stronger gambling propensity. Collectively, these results indicate that speculative retail trading affects stock prices.
The electrical and physical quality of gate and passivation dielectrics significantly impacts the device performance of thin film transistors (TFTs). The passivation dielectric also needs to act as a barrier to protect the TFT device. As low temperature TFT processing becomes a requirement for novel applications and plastic substrates, there is a need for materials innovation that enables high quality plasma enhanced chemical vapor deposition (PECVD) gate dielectric deposition. In this context, this paper discusses structure-property relationships and strategies for precursor development in silicon nitride, silicon oxycarbide (SiOC) and silicon oxide films. Experiments with passivation SiOC films demonstrate the benefit of a superior precursor (LkB-500) and standard process optimization to enable lower temperature depositions. For gate SiO2 deposition (that are used with polysilicon TFTs for example), organosilicon precursors containing different types and amounts of Si, C, O and H bonding were experimentally compared to the industry standard TEOS (tetraethoxysilane) at different process conditions and temperatures. Major differences were identified in film quality especially wet etch rate or WER (correlating to film density) and dielectric constant (k) values (correlating to moisture absorption). Gate quality SiO2 films can be deposited by choosing precursors that can minimize residual Si-OH groups and enable higher density stable moisture-free films. For e.g., the optimized precursor AP-LTO® 770 is clearly better than TEOS for low temperature PECVD depositions based on density, WER, k charge density (measured by flatband voltage or Vfb); and leakage and breakdown voltage (Vbd) measurements. The design and development of such novel precursors is a key factor to successfully enable manufacturing of advanced low temperature processed devices.