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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.
Paediatric Mycoplasma pneumoniae pneumonia (MPP) is a major cause of community-acquired pneumonia in China. Data on epidemiology of paediatric MPP from China are little known. This study retrospectively collected data from June 2006 to June 2016 in Beijing Children's Hospital, Capital Medical University of North China and aims to explore the epidemiological features of paediatric MPP and severe MPP (SMPP) in North China during the past 10 years. A total of 27 498 paediatric patients with pneumonia were enrolled. Among them, 37.5% of paediatric patients had MPP. In this area, an epidemic took place every 2–3 years at the peak, and the positive rate of MPP increased during these peak years over time. The peak age of MPP was between the ages of 6 and 10 years, accounting for 75.2%, significantly more compared with other age groups (χ2 = 1384.1, P < 0.0001). The epidemics peaked in September, October and November (χ2 = 904.9, P < 0.0001). Additionally, 13.0% of MPP paediatric patients were SMPP, but over time, the rate of SMPP increased, reaching 42.6% in 2016. The mean age of paediatric patients with SMPP (6.7 ± 3.0 years old) was younger than that of patients with non-SMPP (7.4 ± 3.2 years old) (t = 3.60, P = 0.0001). The prevalence of MPP and SMPP is common in China, especially in children from 6 to 10 years old. Paediatric patients with SMPP tend to be younger than those with non-SMPP. MPP outbreaks occur every 2–3 years in North China. September, October and November are the peak months, unlike in South China. Understanding the epidemiological characteristics of paediatric MPP can contribute to timely treatment and diagnosis, and may improve the prognosis of children with SMPP.
be a prime, let
be a complete discrete valuation field of characteristic
with a perfect residue field of characteristic
, and let
be the Galois group. Let
be a fixed uniformizer of
be the extension by adjoining to
a system of compatible
th roots of
, and let
be the Galois closure of
. Using these field extensions, Caruso constructs the
-modules, which classify
-adic Galois representations of
. In this paper, we study locally analytic vectors in some period rings with respect to the
-adic Lie group
, in the spirit of the work by Berger and Colmez. Using these locally analytic vectors, and using the classical overconvergent
-modules, we can establish the overconvergence property of the
Trypophloeus klimeschi Eggers (Coleoptera: Curculionidae: Scolytinae) was first discovered in China in 2003, and it exhibits strong species specificity to Populus alba var. pyramidalis Bunge (Salicaceae). To screen plant volatile compounds for monitoring and trapping T. klimeschi, the electroantennogram responses of adult T. klimeschi to eight plant volatiles, including nonanal, 2-methylbutanal, decanal, 2-hydroxybenzaldehyde, (Z)-3-hexen-1-ol benzoate, methyl benzoate, methyl salicylate, and geraniol were tested at various concentrations. Behavioural responses of female and male adults to various concentrations of these eight plant volatiles were also determined using a Y-tube olfactometer. We then tested the effectiveness of these compounds as lures for trapping T. klimeschi in the field. Electroantennogram tests showed that T. klimeschi possesses olfactory sensitivity for eight compounds. Additionally, walking T. klimeschi exhibited attraction to low concentrations (≤ 1 μg/μL) of all eight compounds in Y-tube olfactometer. Field experiment results indicated that baits composed of each volatile compound alone were more attractive to greater numbers of T. klimeschi than the control. The methyl benzoate bait was better attracted by T. klimeschi than other tested volatiles. These results suggest that these compounds could be used in attraction of this stem-boring pest. This study could have important implications for the development of an effective semiochemical-based management tool for T. klimeschi in the field.
Environment can impact the wear behavior of metals and alloys substantially. The tribological properties of Al0.6CoCrFeNi high-entropy alloys (HEAs) were investigated in ambient air, deionized water, simulated acid rain, and simulated seawater conditions at frequencies of 2–5 Hz. The as-cast alloy was composed of simple face-centered cubic and body-centered cubic phases. The wear rate of the as-cast HEA in the ambient air condition was significantly higher than that in the liquid environment. The wear resistance in seawater was superior to that in ambient air, deionized water, and acid rain. Both the friction coefficient and wear rate in seawater were the lowest due to the formation of oxidation film, lubrication, and corrosion action in solution. The dominant wear mechanism in the ambient air condition and deionized water was abrasive wear, delamination wear, and oxidative wear. By contrast, the wear mechanism in acid rain and seawater was mainly corrosion wear, adhesive wear, abrasive wear, and oxidative wear.
Associations between ferritin and insulin sensitivity have been described in recent studies. The possible association showed conflicting results by sex and menopausal status. We aimed to investigate the cross-sectional association of ferritin levels with insulin resistance and β-cell function. A total of 2518 participants (1033 men, 235 pre-menopausal women and 1250 post-menopausal women) were enrolled from the Changfeng Study. A standard interview was conducted, as well as anthropometric measurements and laboratory analyses, for each participant. The serum ferritin level was measured using electrochemiluminescence immunoassay. Insulin resistance and β-cell function indices were derived from a homeostasis model assessment. The results showed that the serum ferritin levels were 250·4 (sd 165·2), 94·6 (sd 82·0) and 179·8 (sd 126·6) ng/ml in the men, pre-menopausal and post-menopausal women, respectively. In fully adjusted models (adjusting for age, current smoking, BMI, waist:hip ratio, systolic blood pressure, diastolic blood pressure, TAG, HDL-cholesterol, LDL-cholesterol, log urine albumin:creatinine ratio, leucocytes, alanine aminotransferase, aspartate aminotransferase and γ-glutamyl transpeptidase), serum ferritin concentrations are significantly associated with insulin resistance in men and post-menopausal females, and the null association was observed in pre-menopausal females. Interestingly, an increased β-cell function associated with higher ferritin was observed in post-menopausal participants, but not in male participants. In conclusion, these results suggested that elevated serum ferritin levels were associated with surrogate measures of insulin resistance among the middle-aged and elderly male and post-menopausal women, but not in pre-menopausal women.
Human adenovirus type 55 (HAdV-55) has recently caused multiple outbreaks. This study examined polymorphisms in CD46 to determine their involvement in HAdV-55 infection.
A total of 214 study subjects infected with HAdV-55 were included in our study. The study subjects were divided into those with silent infections (n=91), minor infections (n=85), and severe infections (n=38). Ten single nucleotide polymorphisms (SNPs) from CD46 were examined.
Compared with the AA genotype, the TT genotype at rs2724385 (CD46, A/T) was associated with a protective effect against disease occurrence, with an odds ratio (95% confidence interval) of 0.20 (0.04-0.97) (P=0.038). There were no significant differences between the patients with minor and severe infection and those who had silent HAdV-55 infection in the other CD46 SNPs. We next compared the polymorphisms of these genes according to disease severity in HAdV-55-infected patients with clinical symptoms. The results showed that there were no significant differences between minor infections and severe infections.
Our results suggested that the CD46 SNP at rs2724385 is associated with the occurrence of disease in HAdV-55-infected patients. A much larger number of samples is required to understand the role of CD46 polymorphisms in the occurrence and progression of infection by HAdV-55. (Disaster Med Public Health Preparedness. 2018;12:427–430)
To explore the 3-tiered treatment model for medical treatment after an earthquake.
Based on the practices of the national emergency medical rescue services in the Lushan earthquake zone, the 3-tiered treatment classification approach was retrospectively reviewed.
Medical rescue teams assembled and reported quickly to the disaster areas after the earthquake. The number of injured people had reached 25,176 as of April 30; of these, 18,611 people were treated as outpatients, 6565 were hospitalized, and 977 were seriously or severely injured.
The 3-tiered treatment model was the main approach used by rescue services after the Lushan earthquake. Primary and secondary treatments were of the highest importance and formed the basis of the Lushan model of earthquake rescue and treatment. (Disaster Med Public Health Preparedness. 2018; 12: 301–304)
The six-legged robot Octopus is designed for nuclear disaster relief missions. When the robot suffers from failures, its performance can be significantly affected. Thus, fault tolerance is essential for walking and operating in environments inaccessible to humans. The current fault-tolerant gaits for legged robots usually either initially lock the entire broken leg or just abandon the broken leg, but then fail to take full advantage of the normal actuators on the broken leg and add extra constraints. As the number of broken legs increases, the robot will no longer be able to walk using the existing fault-tolerant gaits. To solve this problem, screw theory is used for analyzing the remaining mobility after failure. Based on the analysis, a method of motion planning through fault-tolerant Jacobian matrices, which are linear, is presented. This method can enable the robot to accomplish desired movement using broken legs along with other certain concomitant motions as compensation. Finally, experiments and simulations of multiple faults demonstrate the real effects on the Octopus robot.
To determine dynamic changes in clinical characteristics by examining an outbreak of adenovirus infection that occurred from December 20, 2012, to February 25, 2013, in Tianjin, China.
Active surveillance for febrile respiratory illnesses was conducted, and medical records of patients were collected. Real-time quantitative polymerase chain reaction and sequencing were used for pathogen identification and viral genome study, respectively. Student’s t-test was used to compare the mean values of normally distributed continuous variables. Mann-Whitney U or Kruskal-Wallis tests were used if continuous variables were not normally distributed. Pearson’s chi-square test or Fisher’s exact test was used to compare categorical variables.
The outbreak was sourced from the index case diagnosed as the common cold on December 20, 2012; a total of 856 cases were reported in the following 66 days. The pathogen was identified as human adenovirus (HAdV) 55. The symptoms manifested differently in severe and mild cases. Routine blood examinations, liver function indexes, and heart function indexes showed different dynamic patterns over time in hospitalized patients.
Clinical characteristics and laboratory examinations may reveal unique patterns over the course of HAdV-55 infection. (Disaster Med Public Health Preparedness. 2018;12:464–469)
Single-walled carbon nanotube (SWNT) and conductive polymer composite were studied as a potential electrode candidate for plastic electronic devices such as organic light-emitting diodes (OLEDs) and solar cells. A novel conductive polymer, poly(2,7–9,9(di(oxy-2,5,8-trioxadecane))fluorene) (PFO), was synthesized and characterized as a surfactant to disperse SWNTs in solutions. The ethylene oxide (EO) side chain of rigid PFO backbone acts as a template to wrap around SWNTs in solution. Up to 0.02% (by weight) of SWNTs are stabilized and well separated in the solution phase. The carbon nanotube can be dispersed in solutions for over 4 mo. Transmission electron microscopy (TEM) images of solvent cast film suggest highly uniformed SWNT distribution incorporated in the conductive polymer matrix. Transmittance characterization shows the film is as transparent as indium tin oxide conducting glass. Conductivity measurement shows SWNTs can effectively inject charges into the PFO polymer matrix at low voltage. The current versus voltage profile of the SWNT/PFO composite film (2% SWNT in PFO by weight) shows that the majority current conducting is carried by SWNTs.
Postmenopausal women are at increased risk of CVD: the increased serum ferritin level may be involved in the pathogenesis. The aim of the present study is to investigate the relationship of ferritin and carotid atherosclerosis in postmenopausal women. A total of 1178 postmenopausal women (mean age, 60·8 years) were enrolled from the Changfeng Study. A standard interview, anthropometric measurements and laboratory analyses were performed for each participant. Bilateral CIMT (carotid intima–media thickness) were measured using ultrasonography, and the presence of carotid plaques was assessed. Serum ferritin was measured using electrochemiluminescence immunoassay. The results showed that serum ferritin was 181·9 (sd 65·8) ng/ml in the postmenopausal women. Multivariate, linear, stepwise regression analysis demonstrated that age (standardised β = 0·233, P< 0·001), alanine transaminase (standardised β = 0·194, P< 0·001), log homeostasis model assessment index for insulin resistance (standardised β = 0·181, P< 0·001), TAG (standardised β = 0·083, P= 0·003), Hb (standardised β = 0·080, P= 0·004) and PPG (2-h glucose levels following a 75-g oral glucose challenge) (standardised β = 0·079, P= 0·004) were independently associated with serum ferritin. Compared with the ferritin level of subjects in the first quartile, that in the fourth quartile had greater CIMT, and higher prevalence of carotid plaque. After adjusting for conventional CVD risk factors, Hb, leucocytes, log urine albumin:creatinine ratio and liver function, the ferritin level of postmenopausal women in the fourth quartile had a 1·587-fold increased risk of carotid plaques relative to those in the lowest quartile. In conclusion, these results suggest that serum ferritin is independently and positively associated with carotid atherosclerosis in postmenopausal women and that ferritin may be implicated in atherosclerosis.
The present study aimed to translate the English version of the Nutritional Form For the Elderly into Simplified Chinese, as well as to test the reliability (homogeneity and stability) and validity (content and construct validity) of the Chinese version of the Nutritional Form For the Elderly (NUFFE-CHI).
The study adopted a cross-sectional design. The English version of the NUFFE was translated into Simplified Chinese and a questionnaire survey was conducted. The data were analysed with statistical methods to estimate the homogeneity, stability, content and construct validity.
Jinzhou City, China.
A total number of 701 community-dwelling older adults answered the questionnaire, including background variables and the NUFFE-CHI. A small group of the participants (n 50) completed the NUFFE-CHI twice for test–retest reliability.
Cronbach’s α was 0·65 and the split-half reliability was 0·67. Item-to-total correlation analyses showed that the scale has sufficient internal consistency. The test–retest reliability regarding the total scores of NUFFE-CHI was reflected in an intra-class correlation coefficient of 0·88. The intra-class correlation coefficients between the test and retest of the NUFFE-CHI items varied between 0·43 and 0·98. A content validity index of 0·83 explained good content validity. Construct validity was demonstrated in an exploratory factor analysis with a six-factor solution, explaining 57·65 % of the variance.
This first testing of the NUFFE-CHI indicates sufficient evidence for reliability, content and construct validity. Further testing studies regarding homogeneity, concurrent validity, sensitivity and specificity are required before the NUFFE-CHI can be used as a screening instrument in clinical settings and in research.
There is growing concern in West Africa about the spread of the Ebola hemorrhagic fever virus. With the increasing global public health risk, a coordinated international response is necessary. The Chinese government is prepared to work in collaboration with West African countries to assist in the containment and control of the epidemic through the contribution of medical expertise and mobile laboratory testing teams. Nationally, China is implementing prevention programs in major cities and provinces, the distribution of Ebola test kits, and the deployment of a new national Ebola research laboratory. (Disaster Med Public Health Preparedness. 2015;0:1-2)
Fault tolerance is a very important issue for legged robots, especially in some harsh environments. One of the most fragile parts is the actuation system. There are two common faults of robot actuators: (1) the motor is locked and could not move anymore; (2) the motor is uncontrollable and can be treated as a passive joint. In this paper, we first discuss all fault combinations of a single leg of a hexapod walking robot with parallel-parallel mechanism topology. Then, the leg tolerable criterion is brought out, which defines whether a leg is fault tolerant. After that, the fault tolerance of the whole robot is researched, and we found that the robot can walk with one tolerable leg or two opposite tolerable legs. Finally, relative simulation results are given, which show the robot walk with one or two broken legs.
A crucial problem is the risk that a manipulator arm would be damaged by twisting or bending during and after contacting a target satellite. This paper presents a solution to minimize the risk of damage to the arm and thereby enhance contact performance. First, a hand-eye servo controller is proposed as a method for accurately tracking and capturing a target satellite. Next, a motion planning strategy is employed to obtain the best-fit contacting moments. Also, an impedance control law is implemented to increase protection during operation and to ensure more accurate compliance. Finally, to overcome the challenge of verifying algorithms for a space manipulator while on the ground, a novel experimental system with a 6-DOF (degree of freedom) manipulator on a chaser field robot is presented and implemented to capture a target field robot; the proposed methods are then validated using the experimental platform.