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To explore whether and how group cognitive-behavioural therapy (GCBT) plus medication differs from medication alone for the treatment of generalised anxiety disorder (GAD).
Hundred and seventy 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, the Severity Subscale of Clinical Global Impression Scale, Global Assessment of Functioning, and the 12-item Short-Form Health Survey. Assessments were conducted at baseline, 4-week, 8-week, and 3-month follow-up.
At 4 weeks, HAMA response (GCBT group 57.0% vs. control group 24.4%, p=0.000, Cohen’s 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-month 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 [odds ratio (OR)=2.12, 95% confidence interval (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 that GCBT was effective in changing cognitive style.
The landscape of antimicrobial resistance (AMR) surveillance is changing rapidly. The primary objective of this study was to assess the benefit of linking population-based infection prevention and control surveillance data on methicillin-resistant Staphylococcus aureus (MRSA) to hospital discharge abstract data (DAD). We assessed the value of this novel data linkage for the characterization of hospital-acquired (HA) and community-acquired MRSA (CA-MRSA) cases.
Incident inpatient MRSA surveillance data for all adults (≥18 years) from 4 acute-care facilities in Calgary, Alberta, between April 1, 2011, and March 31, 2017, were linked to DAD. Personal health number (PHN) and gender were used to identify specific individuals, and specimen collection time-points were used to identify specific hospitalization records. A third common variable on admission date between these databases was used to validate the linkage process. Descriptive statistics were used to characterize HA-MRSA and CA-MRSA cases identified through the linkage process.
A total of 2,430 surveillance records (94.6%) were successfully linked to the correct hospitalization period. By linking surveillance and administrative data, we were able to identify key differences between patients with HA- and CA-MRSA. These differences are consistent with previously reported findings in the literature. Data linkage to DAD may be a novel tool to enhance and augment the details of base surveillance data.
Conclusion and recommendations:
This is the first Canadian study linking a frontline healthcare-associated infection AMR surveillance database to an administrative population database. This work represents an important methodological step toward complementing traditional AMR surveillance data practices. Data linkage to other data types, such as primary care, emergency, social, and biological data, may be the basis of achieving more precise data focused around AMR.
Genome-wide association studies (GWAS) have consistently revealed that a variant of microRNA 137 (MIR137) shows a quite significant association with schizophrenia. Identifying the network of genes regulated by MIR137 could provide insights into the biological processes underlying schizophrenia. In addition, DLPFC functional connectivity, a robust correlate of MIR137, may provide plausible endophenotypes. However, the regulatory role of the MIR137 gene network in the disrupted functional connectivity remains unclear. Here, we tested the effects of the MIR137 regulated genes on the risk for schizophrenia and DLPFC functional connectivity.
To evaluate the additive effects of the MIR137 regulated genes (N = 1274), we calculated a MIR137 polygenic risk score (PRS) for schizophrenia and tested its association with the risk for schizophrenia in the genomic data of a Han Chinese population that included schizophrenia patients (N = 589) and normal controls (N = 575). We then investigated the association between MIR137 PRS and DLPFC functional connectivity in two independent young healthy cohorts (N = 356 and N = 314).
We found that the MIR137 PRS successfully captured the differences in genetic structure between the patients and controls, but the single gene MIR137 did not. We then consistently found that a higher MIR137 PRS was correlated with lower functional connectivities between the DLPFC and both the superior parietal cortex and the inferior temporal cortex in two independent cohorts.
The findings suggested that these two functional connectivities of the DLPFC could be important endophenotypes linking the MIR137-regulated genetic structure to schizophrenia.
Schizophrenia is a complex mental disorder with high heritability and polygenic inheritance. Multimodal neuroimaging studies have also indicated that abnormalities of brain structure and function are a plausible neurobiological characterisation of schizophrenia. However, the polygenic effects of schizophrenia on these imaging endophenotypes have not yet been fully elucidated.
To investigate the effects of polygenic risk for schizophrenia on the brain grey matter volume and functional connectivity, which are disrupted in schizophrenia.
Genomic and neuroimaging data from a large sample of Han Chinese patients with schizophrenia (N = 509) and healthy controls (N = 502) were included in this study. We examined grey matter volume and functional connectivity via structural and functional magnetic resonance imaging, respectively. Using the data from a recent meta-analysis of a genome-wide association study that comprised a large number of Chinese people, we calculated a polygenic risk score (PGRS) for each participant.
The imaging genetic analysis revealed that the individual PGRS showed a significantly negative correlation with the hippocampal grey matter volume and hippocampus–medial prefrontal cortex functional connectivity, both of which were lower in the people with schizophrenia than in the controls. We also found that the observed neuroimaging measures showed weak but similar changes in unaffected first-degree relatives of patients with schizophrenia.
These findings suggested that genetically influenced brain grey matter volume and functional connectivity may provide important clues for understanding the pathological mechanisms of schizophrenia and for the early diagnosis of schizophrenia.
This paper is concerned with the travelling waves for a class of non-local dispersal non-cooperative system, which can model the prey-predator and disease-transmission mechanism. By the Schauder's fixed-point theorem, we first establish the existence of travelling waves connecting the semi-trivial equilibrium to non-trivial leftover concentrations, whose bounds are deduced from a precise analysis. Further, we characterize the minimal wave speed of travelling waves and obtain the non-existence of travelling waves with slow speed. Finally, we apply the general results to an epidemic model with bilinear incidence for its propagation dynamics.
The design and engineering of the size and shapes of photoactive building blocks enable the fabrication of functional nanocrystals, especially for applications in light harvesting, photocatalytic synthesis, water splitting, and photodegradation. Synthesis of such nanocrystals has been demonstrated recently through noncovalent interactions such as π–π stacking and ligand coordination using optically active porphyrin as a functional building block. Depending on the kinetic conditions, the resulting nanocrystals exhibit well-defined one- to three-dimensional shapes such as spheres, nanowires, and nano-octahedra. These well-defined porphyrin nanocrystals show interesting size- and shape-dependent photocatalytic activity. This article reviews the synthesis and formation of porphyrin nanocrystals with controlled size and shape. Important photocatalytic processes such as photodegradation of organic pollutants, photocatalytic water splitting and hydrogen production, and photosynthesis of metallic fuel-cell catalysts are highlighted. Insights on size- and shape-dependent properties are discussed.
Hepatitis B constitutes a severe public health challenge in China. The Community-based Collaborative Innovation hepatitis B (CCI-HBV) project is a national epidemiological study of hepatitis B and has been conducting a comprehensive intervention in southern Zhejiang since 2009.
The comprehensive intervention in CCI-HBV areas includes the dynamic hepatitis B screening in local residents, the normalised treatment for hepatitis B infections and the upcoming full-aged hepatitis B vaccination. After two rounds of screening (each round taking for 4 years), the initial epidemiological baseline of hepatitis B in Qinggang was obtained, a coastal community in east China. By combining key data and system dynamics modelling, the regional hepatitis B epidemic in 20 years was predicted.
There were 1041 HBsAg positive cases out of 12 228 people in Round 1 indicating HBV prevalence of 8.5%. Of the 13 146 people tested in Round 2, 1171 people were HBsAg positive, with a prevalence of 8.9%. By comparing the two rounds of screening, the HBV incidence rate of 0.192 per 100 person-years was observed. By consulting electronic medical records, the HBV onset rate of 0.533 per 100 person-years was obtained. We generated a simulated model to replicate the real-world situation for the next two decades. To evaluate the effect of interventions on regional HBV prevalence, three comparative experiments were conducted.
In this study, the regional hepatitis B epidemic in 20 years was predicted and compared with HBV prevalence under different interventions. Owing to the existing challenges in research methodology, this study combined HBV field research and simulation to provide a system dynamics model with close-to-real key data to improve prediction accuracy. The simulation also provided a prompt guidance for the field implementation.
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.
This paper is concerned with the global dynamics and spreading speeds of a partially degenerate non-local dispersal system with monostable nonlinearity in periodic habitats. We first obtain the existence of the principal eigenvalue for a periodic eigenvalue problem with partially degenerate non-local dispersal. Then we study the coexistence and extinction dynamics. Finally, the existence and characterization of spreading speeds are considered. In particular, we show that the spreading speed is linearly determinate. Overall, we extend the existing results on global dynamics and spreading speeds for the degenerate reaction–diffusion system to the degenerate non-local dispersal case. The extension is non-trivial and meaningful.
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.
With electronic warfare increasingly complicated and military confrontations increasingly intense, the potential security threat to satellite navigation has become a difficult issue to deal with. Traditional satellite navigation anti-interference technology generally refers to jamming, but less consideration has been given to spoofing. It should be noted that the potential risk induced by spoofing interference is worse than that caused by jamming as the loss of positioning integrity may not be immediately obvious. This paper introduces a spoofing detection method based on a two-antenna structure using fraction parts of double-difference carrier phase observables. If all spoofing signals are transmitted by one single antenna, a spoofing detection hypothesis test can be carried out through the normalisation of double-difference carrier phase observables, without need to consider the integer ambiguity problem, measure the baseline vector and estimate the real directions of signals. The detection scheme adopts an M of N algorithm (if M or more of the test values exceed the threshold, the algorithm declares the presence of a spoofing signal), integrating carrier phase measurements of all the available satellites. Finally, the proposed method is verified by real experiments. This spoofing detection method can easily be applied to GNSS anti-spoofing receivers without changing their architecture and has simple and effective characteristics.
A novel synthetic air data estimation method without using air data sensors is presented, and the method only relies on the information from the Navigation System (NS) and Flight Control System (FCS). The aircraft's aerodynamic model is also required to make a connection between the FCS control parameters and the NS measurements. The airspeed, angle of attack and sideslip, angular velocity and wind speed are defined as state vectors, and state equations are established through the aircraft's aerodynamic model and dynamics. Linear velocity and angular velocity provided by the navigation system are considered as the measurement vector. To deal with variable wind fields, a novel Initialised Three-step Extended Kalman Filter (ITEKF), which considers the wind speed as an unknown input, is developed to track the variation of wind speed. Simulation results based on a Generic Hypersonic Vehicle (GHV) model are presented and compared with an existing method. Factors affecting the method's accuracy include the navigation system accuracy and the aerodynamic model error, are also discussed.
A new ternary compound Al5NdNi2 was prepared by melting a stoichiometric mixture of aluminum, neodymium, and nickel in an arc furnace and annealing in vacuum. The crystal structure of Al5NdNi2 was studied by X-ray powder diffraction technique and Rietveld analysis. All diffraction lines of Al5NdNi2 were indexed, and the lattice parameters were refined with an orthorhombic structure type of space group Immm (No.71) using Rietveld analysis program DBWS-9807. The lattice parameters are presented, a = 7.0508(1) Å, b = 9.5690(1) Å, c = 3.9792(1) Å, V = 268.47 Å3, Z = 2, ρ = 4.91 g cm−3, and RIR = 1.23.
We report a cavity-dumped 1123 nm laser with narrow pulse width and high peak power by an MgO: LN crystal electro-optic (EO) modulator. Based on the structural optimization design of a folded biconcave cavity using the 808 nm pulsed laser diode (LD) side-pumped ceramic Nd: YAG rod, output pulses with maximum pulse energy and peak power up to 39.6 mJ and 9.73 MW were obtained, corresponding to 100 Hz repetition rate and 4.07 ns pulse width. The instabilities of pulse width and pulse energy were
2.06%, respectively. At the highest repetition rate of 1 kHz, the pulse energy, pulse width, and peak power were 11.3 mJ, 5.05 ns, and 2.24 MW, respectively. The instabilities of pulse width and pulse energy were
Structural hierarchy is ubiquitous in nature and quite important for optimizing the properties of functional materials. Carbon nanomaterials, owing to their unique and tunable physical and chemical properties, have been regarded as promising candidates for various energy storage systems. Constructing hierarchically structured carbon nanomaterials (HSCNs) can boost electrochemical performance of nanocarbons. Therefore, HSCNs have attracted tremendous research attentions in recent years. In this review, we summarized the recent progress in hierarchical structure design of carbon nanomaterials and their potential applications in different energy storage technologies. First we give a brief introduction about carbon nanomaterials and the hierarchical structure merits. Subsequently, recent research works on hierarchical structure design of carbon nanomaterials was summarized and classified according to applications in lithium-ion batteries, sodium-ion batteries, supercapacitors and lithium–sulfur batteries, respectively. In addition, the challenges of HSCNs in different applications were also concluded and reviewed. At last, design principles of HSCNs were summarized and future development trends were prospected.
Disarticulated net-like plates of the lobopod Microdictyon had a near cosmopolitan distribution from the early to middle Cambrian but are yet to be documented from the North China Platform. Here we report isolated plates of Microdictyon from the lower Cambrian Xinji Formation (Stage 4, Series 2) of the North China Platform, extending the paleogeographic distribution of Microdictyon in the early Cambrian. The plates of Microdictyon from the Xinji Formation are similar to those of other species established on the basis of isolated plates but do bear some new characters, such as mushroom-shaped nodes with a single inclined platform-like apex and an upper surface that displays radial lines. However, the plates documented here are left under open nomenclature due to inadequate knowledge of intraspecific and ontogenetic variation and low specimen numbers. Through comparison of the node shapes of the isolated plates of different Microdictyon species, we consider that low mushroom-shaped nodes could be a primitive and conservative character of Microdictyon while tall mushroom-shaped nodes may be a derived character. Subtle differences in shape and number of node apices may also represent intraspecific or ontogenetic variation.
Surface elevation data for sea ice in the northwesternty - Weddell Sea, Antarctica, collected by a helicopter-borne laser altimeter during the Winter Weddell Outflow Study 2006, were used to estimate the form drag on pressure ridges and its contribution to the total wind drag, and the air-ice drag coefficient at a reference height of 10 m under neutral stability conditions (Cdn(10)). This was achieved by partitioning the total wind drag into two components: form drag on pressure ridges and skin drag over rough sea-ice surfaces. The results reveal that for the compacted ice field, the contribution of form drag on pressure ridges to the total wind drag increases with increasing ridging intensity Ri (where Ri is the ratio of mean ridge height to spacing), while the contribution decreases with increasing roughness length. There is also an increasing trend in the air-ice drag coefficient Cdn(10) as ridging intensity Ri increases. However, as roughness length increases, Cdn(10) increases at lower ridging intensities (Ri < 0.023) but decreases at lower ridging intensities (0.023 < Ri < 0.05). These opposing trends are mainly caused by the dominance of the form drag on pressure ridges and skin drag over rough ice surfaces. Generally, the form drag becomes dominant only when the ridging intensity is sufficiently large, while the skin drag is the dominant component at relatively larger ridging intensities. These results imply that a large value of Cdn(10) is caused not only by the form drag on pressure ridges, but also by the skin drag over rough ice surfaces. Additionally, the estimated drag coefficients are consistent with reported measurements in the northwestern Weddell Sea, further demonstrating the feasibility of the drag partition model.
The Datong pluton, the largest early Palaeozoic granitoid in the Western Kunlun Orogenic Belt (WKOB) in NW China, is a typical appinite-granite complex. It consists of diorites, quartz diorites, monzodiorites, quartz monzodiorites, monzonites, quartz monzonites, syenites, granodiorites and monzogranites. Laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS) zircon U–Pb dating yielded crystallization ages of 459 ± 3 Ma for the quartz monzonites and 452 ± 5 Ma for the monzogranites (Late Ordovician). The rocks possess a wide range of SiO2 (56.0–73.4 wt %), MgO (0.17–4.55 wt %) and Mg no. (25–60), with high K2O (2.83–5.29 wt %) contents, exhibiting high-K calc-alkaline to shoshonitic traits. They are characterized by enrichments in large-ion lithophile elements (LILEs) and light rare Earth elements (LREEs), as well as depletions in high-field-strength elements (HFSEs). The rocks have initial 87Sr/86Sr ratios of 0.7086–0.7185, negative εNd(t) values of –3.72 to –1.79 and εHf(t) values vary from –1.6 to +4.7. These features are modelled to show that they were most likely derived from an enriched lithospheric mantle source and that fractional crystallization with minor crustal contamination was involved in their petrogenetic process. Considering the distribution and chronology of the Palaeozoic intrusions – such as Kegang, Bulong, Qiukesu, Yierba, North Kudi, Dongbake, Buya, Ayilixi and Warengzilafu granitoid plutons with ages of c. 420–530 Ma – in conjunction with the Palaeozoic metamorphic overprinting in the WKOB, we propose a divergent double-subduction model to explain the destruction of the Proto-Tethys Ocean and suggest that the Datong pluton was likely emplaced in a post-collisional setting following the termination of subduction in response to slab break-off.
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 reconstructed the centennial climate changes for the period of 9–7 cal ka BP in the upper region of the Changjiang (Yangtze) River Delta plain. A general warming and wetting trend from 8560 to 7220 cal yr BP was indicated by the decrease in Quercus (deciduous) and increases in Quercus (evergreen), Pinus, and Polypodiaceae spores. However, there were several brief climate fluctuations. A notable palynological change, from regional assemblages dominated by arboreal pollen to local assemblages mainly consisting of nonarboreal pollen, reflects climate fluctuations. The key indices of Quercus (deciduous), Pinus, herbs, fern spores, and palynological concentrations showed similar signs of centennial climate fluctuations. We suggest that the climate changes of the Dongge Cave and Yangtze River Delta regions were mainly affected by the East Asian summer monsoon (EASM) during the period of 9–7 cal ka BP. The general warming trend may be associated with an intensified EASM, and solar activity may be one of the important factors driving the centennial climate changes. The ~8.2 ka event was also recorded in the Yangtze River Delta region, which suggests that there was a close relationship between the EASM and Greenland climate during the early Holocene.