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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 three-dimensional flow characteristics of the compressible vortex ring generated by under-expanded circular jets with two typical pressure ratios, i.e.
(moderate) and 4.0 (high), are investigated numerically with the use of large-eddy simulations. Our results illustrate that these two pressure ratios correspond to different shock structures (shock cell and Mach disc, respectively) within the jet. These two typical types of flow structures and characteristics are discussed and validated with experiments, and the different generation mechanisms of the secondary vortex rings are compared. Moreover, detailed information about the evolution of the secondary vortex ring, primary vortex ring and turbulence transition features, including the radial and azimuthal modes, is investigated. The geometric features and mixing effects of the jets are also explored.
The antibacterial hydrogels can be widely used in the biomedical area owing to their excellent properties. The main limitation of antibacterial hydrogels is their poor mechanical strength. In this study, the novel hydrogels were fabricated with a mixture of silk fibroin (SF), chitosan (CH), agarose (AG), and silver nanoparticles (SNPs) via facile reaction condition without inorganic substances. The mechanical property of these fabricated hydrogels can be modulated by the concentration of SF or AG. The rheological studies demonstrated enhanced elasticity of CH-doped hydrogels. Because of the presence of CH and Ag in hydrogels, the antimicrobial property against gram-positive and gram-negative bacteria was exhibited. Cytocompatibility test proved the very low toxic nature of the hydrogels. In addition, these composite hydrogels have a smaller porosity, higher swelling ratio, and good compatibility, indicating their great potential for biomedical application.
On January 13, 2018, a false ballistic missile alert that lasted 38 minutes was issued across Oahu, Hawaii, United States. As a result of a system failure, an erroneous text message was sent that stated, “Ballistic missile threat inbound to Hawaii. Seek immediate shelter.”
The research team wanted to know the degree of reported anxiety triggered by the event and if knowledge, attitudes, or behaviors for individual/family emergency preparedness (EP) changed post-event.
A 50-question survey that asked about individual and family EP pre- and post-event, and the level of anxiety triggered by the event, was administered to a convenience sample of full-time adult residents of Oahu. The study was conducted over a 6-8 week period post-event. Statistical analysis was used to identify factors associated with an increasing level of EP post-event and reported event-triggered anxiety.
209 participants completed the survey (29% male, 71% female) with about one half living with children. One third were essential workers. Key factors that correlate with increasing various areas of EP post-event include higher educational, receipt of electronic emergency alerts, prior emergency training, and higher reported connectedness to community. Those with higher event anxiety were more likely to develop and practice an EP plan post-event, encourage EP with friends, and report a higher level of community connectedness. The elderly were more likely to have higher levels of EP before and after the event but were less likely to receive emergency alert notifications or have EP training.
While the event was very unfortunate, it did seem to stimulate citizen disaster EP among some groups. Additional research should explore the utility of increasing EP education for communities immediately after disasters, tailoring this education for groups, and targeting the elderly for participation in the emergency alert system.
CrFeNiTix (x = 0.2, 0.3, 0.4, 0.5, and 0.6 molar ratio) compositionally complex alloys were fabricated by vacuum arc melting to investigate the microstructure, hardness, and compressive properties. The results revealed that CrFeNiTix alloys consisted of the principal face-centered cubic (FCC) phase and body-centered cubic (BCC) solid solution, with an amount of (Ni, Ti)-rich hexagonal close-packed phase. CrFeNiTix alloys exhibited the typical dendrite. Ti0.2 and Ti0.3 alloys were composed of FCC and BCC solid solutions in the dendrite, as well as ε (Ni3Ti) and R (Ni2.67Ti1.33) phases in the inter-dendrite, simultaneously. For Ti0.4, Ti0.5, and Ti0.6 alloys, (Fe, Cr)-rich solid solution separated out and ε phase transformed into R phase gradually. Meanwhile, TEM analysis indicated that Ti0.4 alloy matrix consisted of the principal FCC phase containing (Ni, Ti)-rich intragranular nanoprecipitates. The hardness values of CrFeNiTix alloys were increased with the addition of Ti content and the high compressive strength of CrFeNiTix alloys was maintained, which was attributed to the solid solution strengthening and precipitation hardening.
Few studies have examined the association of various types of Fe with colorectal cancer risk. The aim of this study was to investigate different forms and sources of Fe in relation to colorectal cancer risk in a Chinese population. A total of 2138 patients with colorectal cancer and 2144 sex- and age-matched (5-year interval) controls were recruited from July 2010 to November 2017. Dietary information was assessed by face-to-face interviews using a validated FFQ. Multivariable logistic regression was used to estimate the OR and 95 % CI on models. Intake of Fe from plants and Fe from white meat were inversely associated with the risk of colorectal cancer, while haem Fe and Fe from red meat were positively associated with colorectal cancer risk. The multivariable OR for the highest quartile v. the lowest quartile were 0·72 (95 % CI 0·59, 0·87, Ptrend<0·001) for Fe from plants, 0·54 (95 % CI 0·45, 0·66, Ptrend<0·001) for Fe from white meat, 1·26 (95 % CI 1·04, 1·53, Ptrend=0·005) for haem Fe and 1·83 (95 % CI 1·49, 2·24, Ptrend<0·001) for Fe from red meat intake, respectively. However, no significant association was found between the consumption of total dietary Fe, non-haem Fe, Fe from meat and colorectal cancer risk. This study showed that lower intake of Fe from plants and white meat, as well as higher intake of haem Fe and Fe from red meat, were associated with colorectal cancer risk in a Chinese population.
In this paper, we consider a nonlinear elliptic system which is an extension of the single equation derived by investigating the stationary states of the nonlinear Schrödinger equation. We establish the existence and uniqueness of solutions to the Dirichlet problem on the ball and entire space as the parameters within certain regions. In addition, a complete structure of different types of solutions for the radial case is also provided.
Dilated Cardiomyopathy is a serious heart disorder that may induce sudden cardiac death and heart failure. Significant progress has been made in understanding the molecular basis of dilated cardiomyopathy. In previous studies, mutations in more than fifty genes have been identified in dilated cardiomyopathy patients. The purpose of this study was to detect the genetic lesion in a family from the central south of China affected by severe dilated cardiomyopathy.
Whole-exome sequencing combined with cardiomyopathy-related genes list were used to analyse the mutations of the proband. Co-segregation analysis was performed by Sanger sequencing.
Results and conclusions
Two novel heterozygous mutations – Myosin Binding Protein C: p.L1014RfsX6 and Titin: p.R9793X – were identified in the proband. The deletion mutation c.3041delT/p.L1014RfsX6 caused a premature stop codon at position 1020 in exon 28 of the Myosin Binding Protein C. The nonsense mutation, c.29377 C>T/ p. R9793X, of Titin was located in the highly evolutionarily conserved domain, resulting in truncation of the Titin protein as well. Co-segregation analysis further revealed that the Myosin Binding Protein C mutation came from his mother and the Titin mutation came from his father. Both mutations are reported in dilated cardiomyopathy patients for the first time. Our study not only provides a unique example of the genes and molecular mechanisms involved in dilated cardiomyopathy but also expands the spectrum of Myosin Binding Protein C and Titin mutations and contributes to the genetic diagnosis and counselling of dilated cardiomyopathy patients.
The role of the cerebellum in obsessive-compulsive disorder (OCD) has drawn increasing attention. However, the functional connectivity between the cerebellum and the cerebral cortex has not been investigated in OCD, nor has the relationship between such functional connectivity and clinical symptoms.
A total of 27 patients with OCD and 21 healthy controls (HCs) matched on age, sex and education underwent magnetic resonance imaging (MRI). Seed-based connectivity analyses were performed to examine differences in cerebellar-cerebral connectivity in patients with OCD compared with HCs. Associations between functional connectivity and clinical features in OCD were analyzed.
Compared with HCs, OCD patients showed significantly decreased cerebellar-cerebral functional connectivity in executive control and emotion processing networks. Within the OCD group, decreased functional connectivity in an executive network spanning the right cerebellar Crus I and the inferior parietal lobule was positively correlated with symptom severity, and decreased connectivity in an emotion processing network spanning the left cerebellar lobule VI and the lingual gyrus was negatively correlated with illness duration.
Altered functional connectivity between the cerebellum and cerebral networks involved in cognitive-affective processing in patients with OCD provides further evidence for the involvement of the cerebellum in the pathophysiology of OCD, and is consistent with impairment in executive control and emotion regulation in this condition.
Ga2−xFexO3 (GFO) bulks with x from 0.7 to 1.3 have been fabricated using the classic solid-state route. The structural, optical, and magnetic properties have been investigated systematically. X-ray diffraction spectra and FULLPROF profile fitting indicate that GFO bulks belong to the orthorhombic structure with the space group Pc21n. Phase separation appears at the Fe content of x = 1.3. The optical bandgap decreases almost linearly with the increase of iron content, which means that the bandgap of GFO bulks can be controlled by adjusting the Fe content in the samples. The magnetic property measurements suggest that GFO is ferromagnetic, and the magnetic properties are enhanced compared with other reported works, exhibiting the application in ferromagnetic semiconductors devices.
A carbohydrate-rich diet results in hyperglycaemia and hyperinsulinaemia; it may further induce the carcinogenesis of colorectal cancer. However, epidemiological evidence among Chinese population is quite limited. The aim of this study was to investigate total carbohydrate, non-fibre carbohydrate, total fibre, starch, dietary glycaemic index (GI) and glycaemic load (GL) in relation to colorectal cancer risk in Chinese population. A case–control study was conducted from July 2010 to April 2017, recruiting 1944 eligible colorectal cancer cases and 2027 age (5-year interval) and sex frequency-matched controls. Dietary information was collected by using a validated FFQ. The OR and 95 % CI of colorectal cancer risk were assessed by multivariable logistic regression models. There was no clear association between total carbohydrate intake and colorectal cancer risk. The adjusted OR was 0·85 (95 % CI 0·70, 1·03, Ptrend=0·08) comparing the highest with the lowest quartile. Total fibre was related to a 53 % reduction in colorectal cancer risk (adjusted ORquartile 4 v. 1 0·47; 95 % CI 0·39, 0·58). However, dietary GI was positively associated with colorectal cancer risk, with an adjusted ORquartile 4 v. 1 of 3·10 (95 % CI 2·51, 3·85). No significant association was found between the intakes of non-fibre carbohydrate, starch and dietary GL and colorectal cancer risk. This study indicated that dietary GI was positively associated with colorectal cancer risk, but no evidence supported that total carbohydrate, non-fibre carbohydrate, starch or high dietary GL intake were related to an increased risk of colorectal cancer in a Chinese population.
The present study explored the mechanisms of dietary Zn influencing Zn and lipid deposition in the fore- and mid- intestine in yellow catfish Pelteobagrus fulvidraco, and investigated whether the mechanism was intestinal-region dependent. For this purpose, yellow catfish were fed three diets containing Zn levels of 8·83, 19·20 and 146·65 mg Zn/kg, respectively. Growth performance, intestinal TAG and Zn contents as well as activities and mRNA expression of enzymes and genes involved in Zn transport and lipid metabolism in the fore- and mid-intestine were analysed. Dietary Zn increased Zn accumulation as well as activities of Cu-, Zn-superoxide dismutase and ATPase in the fore- and mid-intestine. In the fore-intestine, dietary Zn up-regulated mRNA levels of ZnT1, ZnT5, ZnT7, metallothionein (MT) and metal response element-binding transcription factor-1 (MTF-1), but down-regulated mRNA levels of ZIP4 and ZIP5. In the mid-intestine, dietary Zn up-regulated mRNA levels of ZnT1, ZnT5, ZnT7, MT and MTF-1, but down-regulated mRNA levels of ZIP4 and ZIP5. Dietary Zn reduced TAG content, down-regulated activities of 6-phosphogluconate dehydrogenase (6PGD), glucose-6-phosphate dehydrogenase (G6PD), malic enzyme (ME) and fatty acid synthase (FAS) activities, and reduced mRNA levels of 6PGD, G6PD, FAS, PPARγ and sterol-regulator element-binding protein (SREBP-1), but up-regulated mRNA levels of carnitine palmitoyltransferase IA, hormone-sensitive lipase (HSLa), adipose TAG lipase (ATGL) and PPARα in the fore-intestine. In the mid-intestine, dietary Zn reduced TAG content, activities of G6PD, ME, isocitrate dehydrogenase and FAS, down-regulated mRNA levels of 6PGD, G6PD, FAS, acetyl-CoA carboxylase a, PPARγ and SREBP-1, but up-regulated mRNA expression of HSLa, ATGL and PPARγ. The reduction in TAG content following Zn addition was attributable to reduced lipogenesis and increased lipolysis, and similar regulatory mechanisms were observed between the fore- and mid-intestine.
More than 200 molecular clouds were newly found distributed beyond the Outer arm in the extreme outer Galaxy (EOG) region by MWISP. Those MCs roughly following the HI′s distribution well delineate the outermost spiral structure (the Outer Scutum-Centaurus arm) and warp of our Galaxy. Besides, those MCs show different σv-Radius relation and exhibit higher value of αvir than MCs in the inner Galaxy.
A study in rodent models showed that phytosterols protected against colon carcinogenesis, probably by inhibiting dysregulated cell cycle progression and inducing cellular apoptosis. However, epidemiological studies on the relationship between phytosterols and colorectal cancer risk are quite limited. The aim of this study was to investigate dietary phytosterol intake in relation to colorectal cancer risk in the Chinese population. A case–control study was conducted from July 2010 to June 2016, recruiting 1802 eligible colorectal cancer cases plus 1813 age (5-year interval) and sex frequency-matched controls. Dietary information was collected by using a validated FFQ. The OR and 95 % CI of colorectal cancer risk were assessed by multivariable logistic regression models. A higher total intake of phytosterols was found to be associated with a 50 % reduction in colorectal cancer risk. After adjusting for various confounders, the OR of the highest quartile intake compared with the lowest quartile intake was 0·50 (95 % CI 0·41, 0·61, Ptrend<0·01) for total phytosterols. An inverse association was also found between the consumption of β-sitosterol, campesterol, campestanol and colorectal cancer risk. However, stigmasterol intake was related to an increased risk of colorectal cancer. No statistically significant association was found between β-sitostanol and colorectal cancer risk. Stratified analysis by sex showed that the positive association of stigmasterol intake with colorectal cancer risk was found only in women. These data indicated that the consumption of total phytosterols, β-sitosterol, campesterol and campestanol is inversely associated with colorectal cancer risk in a Chinese population.
Al1.3CrFeNi eutectic high entropy alloy was designed and prepared by arc-melting to investigate the microstructure and oxidation behaviors at 1000 °C. The XRD pattern shows that this alloy had a double bcc/B2 structure. SEM images indicates that the microstructure of the alloy is composed of two precipitates of [Cr, Fe] solid solution and NiAl intermetallic, which form the typical eutectic structure. To explore the thermal application of Al1.3CrFeNi alloy, the oxidation behavior of Al1.3CrFeNi alloy at 1000 °C was investigated. From XRD and SEM results, it could be concluded that Al2O3 and Cr2O3 were the predominant oxides during the oxidation process. In addition, spinel like FeCr2O4 was also observed in the oxide scale. According to the analysis of oxide precipitates, the whole process of oxides’ formation was discussed and a simplified oxidation dynamic model of Al1.3CrFeNi alloy at 1000 °C was obtained. This could promote the development of thermal applications in multi-component alloys field.
In traditional antenna design, metal components are not placed in the central part of the antenna as they change the characteristics of near field radiation. However, we show that placing a metal ring in the centre of the strip lines, which connect the ends of folded high-frequency dipoles, does not damage the performance of the feed. Instead it significantly improves the voltage standing wave ratio of the feed whilst other performance indicators are not compromised. Thus, our findings show an excellent way of improving the wide band feed. Based on this foundation, a new circularly polarised feed for operation between 0.4 to 2 GHz is introduced for the Chinese Spectral Radioheliograph in this paper. The issue of a feed impedance matching network is investigated. By optimising the impedance matching, the performance of the feed is enhanced with respect to the previous realisations of the Eleven feed. The simulation and experimental results show that the gain of the feed is about 10 dBi, and the VSWR is less than 2:1. In addition, the feed has a low axial ratio, fixed phase centre location, and constant beam width in the range of 0.4 to 2 GHz.
Multimodality imaging revealed a left circumflex coronary artery–left ventricle fistula in a 4-year-old boy. MRI tissue tracking revealed a slight abnormality in the left ventricular myocardial strain. Early surgery was suggested to avoid serious complications.
The aim of the present work was to determine maternal and fetal outcomes of intrahepatic cholestasis of pregnancy (ICP) in twin pregnancies. All twin pregnancies delivered above 28 gestational weeks in West China Second University Hospital from January 2013 to May 2015 were included. Data on maternal demographics and obstetric complications together with fetal outcomes were collected. The risk of adverse maternal and fetal outcomes were determined in relation to ICP by crude odds ratios (OR) and adjusted ORs (aOR) with 95% confidence intervals (CI). Subgroup analysis concentrated on the effect of assisted reproductive technology (ART), ICP severity, and onset time. A total of 1,472 twin pregnancies were included, of which 362 were cholestasis patients and 677 were conceived by ART. Higher rates of preeclampsia (aOR 1.96; 95% CI 1.35, 2.85), meconium-stained amniotic fluid (aOR 3.10; 95% CI 2.10, 4.61), and preterm deliveries (aOR 3.20; 95% CI 2.35, 4.37) were observed in ICP patients. Subgroup analysis revealed higher incidences of adverse outcomes in severe and early onset ICP groups. In conclusion, adverse maternal and fetal outcomes were strongly associated with ICP in twin patients. Active management and close antenatal monitoring are needed, especially in the early onset and severe groups.
The acquisition and tracking strategies of the BeiDou navigation satellite signals are affected by the modulation of Neumann-Hoffman code (NH code), which increases the complexity of receiver baseband signal processing. Based on the analysis of probability statistics of the NH code, a special sequence of incoming signals is proposed to evade the bit transitions caused by the NH code, and an NH Code Evasion and Stripping method (NCES) based on the NH-pre-modulated code is proposed. The NCES can be applied in both 20-bit NH code and 10-bit NH code. The fine acquisition eliminates the impact of NH code on the traditional tracking loop. These methods were verified with a BeiDou PC-based software-defined receiver using the actual sampled signals. Compared with other acquisition schemes which try to determine or ignore the NH code phase, the NCES needs fewer incoming signals and the actual runtime is greatly reduced without sacrificing much time to search in the secondary code dimension, and the success rate of acquisition is effectively improved. An extension of Fast Fourier Transform (FFT)-based parallel code-phase search acquisition gives the NCES an advantage in engineering applications.