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Distinguishing a disorder of persistent and impairing grief from normative grief allows clinicians to identify this often undetected and disabling condition. As four diagnostic criteria sets for a grief disorder have been proposed, their similarities and differences need to be elucidated.
Participants were family members bereaved by US military service death (N = 1732). We conducted analyses to assess the accuracy of each criteria set in identifying threshold cases (participants who endorsed baseline Inventory of Complicated Grief ⩾30 and Work and Social Adjustment Scale ⩾20) and excluding those below this threshold. We also calculated agreement among criteria sets by varying numbers of required associated symptoms.
All four criteria sets accurately excluded participants below our identified clinical threshold (i.e. correctly excluding 86–96% of those subthreshold), but they varied in identification of threshold cases (i.e. correctly identifying 47–82%). When the number of associated symptoms was held constant, criteria sets performed similarly. Accurate case identification was optimized when one or two associated symptoms were required. When employing optimized symptom numbers, pairwise agreements among criteria became correspondingly ‘very good’ (κ = 0.86–0.96).
The four proposed criteria sets describe a similar condition of persistent and impairing grief, but differ primarily in criteria restrictiveness. Diagnostic guidance for prolonged grief disorder in International Classification of Diseases, 11th Edition (ICD-11) functions well, whereas the criteria put forth in Section III of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) are unnecessarily restrictive.
Silk and carbon nanomaterials, such as graphene oxide, graphene, and carbon nanotubes, have complementary mechanical properties that feature superior toughness and strength, respectively. Different strategies have been devoted to developing silk/carbon nanocomposites, but challenges remain to fully integrate the mechanical advantages of these two components into one synergistic material system. In this article, we provide a critical summary of structure–mechanics relationships in silk/carbon nanocomposites and highlight the impact of the interaction between silk and carbon nanomaterials on mechanical properties of the hybrid materials. We describe the challenges involved and directions for future designs of silk/carbon nanocomposites.
To investigate a Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak event involving multiple healthcare facilities in Riyadh, Saudi Arabia; to characterize transmission; and to explore infection control implications.
Cases presented in 4 healthcare facilities in Riyadh, Saudi Arabia: a tertiary-care hospital, a specialty pulmonary hospital, an outpatient clinic, and an outpatient dialysis unit.
Contact tracing and testing were performed following reports of cases at 2 hospitals. Laboratory results were confirmed by real-time reverse transcription polymerase chain reaction (rRT-PCR) and/or genome sequencing. We assessed exposures and determined seropositivity among available healthcare personnel (HCP) cases and HCP contacts of cases.
In total, 48 cases were identified, involving patients, HCP, and family members across 2 hospitals, an outpatient clinic, and a dialysis clinic. At each hospital, transmission was linked to a unique index case. Moreover, 4 cases were associated with superspreading events (any interaction where a case patient transmitted to ≥5 subsequent case patients). All 4 of these patients were severely ill, were initially not recognized as MERS-CoV cases, and subsequently died. Genomic sequences clustered separately, suggesting 2 distinct outbreaks. Overall, 4 (24%) of 17 HCP cases and 3 (3%) of 114 HCP contacts of cases were seropositive.
We describe 2 distinct healthcare-associated outbreaks, each initiated by a unique index case and characterized by multiple superspreading events. Delays in recognition and in subsequent implementation of control measures contributed to secondary transmission. Prompt contact tracing, repeated testing, HCP furloughing, and implementation of recommended transmission-based precautions for suspected cases ultimately halted transmission.
Plasma levels of very-long-chain SFA (VLCSFA) are associated with the metabolic syndrome (MetS). However, the associations may vary by different biological activities of individual VLCSFA or population characteristics. We aimed to examine the associations of VLCSFA and MetS risk in Chinese adults. Totally, 2008 Chinese population aged 35–59 years were recruited and followed up from 2010 to 2012. Baseline MetS status and plasma fatty acids data were available for 1729 individuals without serious diseases. Among 899 initially metabolically healthy individuals, we identified 212 incident MetS during the follow-up. Logistic regression analysis was used to estimate OR and 95 % CI. Cross-sectionally, each VLCSFA was inversely associated with MetS risk; comparing with the lowest quartile, the multivariate-adjusted OR for the highest quartile were 0·18 (95 % CI 0·13, 0·25) for C20 : 0, 0·26 (95 % CI 0·18, 0·35) for C22 : 0, 0·19 (95 % CI 0·13, 0·26) for C24 : 0 and 0·16 (0·11, 0·22) for total VLCSFA (all Pfor trend<0·001). The associations remained significant after further adjusting for C16 : 0, C18 : 0, C18 : 3n-3, C22 : 6n-3, n-6 PUFA and MUFA, respectively. Based on follow-up data, C20 : 0 or C22 : 0 was also inversely associated with incident MetS risk. Among the five individual MetS components, higher levels of VLCSFA were most strongly inversely associated with elevated TAG (≥1·7 mmol/l). Plasma levels of VLCSFA were significantly and inversely associated with MetS risk and individual MetS components, especially TAG. Further studies are warranted to confirm the findings and explore underlying mechanisms.
The search for lead-free alternatives to Pb(Zr,Ti)O3 (PZT) piezoelectric ceramics has become a major topic in functional materials research due to legislation in many countries that restricts the use of lead alloys and compounds in commercial products. This article examines both the necessity for regulation and the impacts those regulations have created in the context of piezoelectric materials. It reviews the toxicity of lead, describes current legislation to control the spread of lead in the environment, and attempts to define the risks associated with the manufacture, use, and disposal of lead-based piezoelectric materials. The consequences of current legislation, both intended and unintended, are examined.
This paper presents new water-soluble bio-polyelectrolyte-based nanoparticles, formed from lanthanide-induced polysaccharide aggregates (LIPAs). These new nano-aggregates are formed by coordinating a photoluminescent lanthanide–ligand complex to a single polyelectrolyte [i.e. polyanionic hyaluronic acid (HA)] or to two oppositely charged polyelectrolytes [i.e. HA and polycationic chitosan (CHI)]. We demonstrate that photoluminescent Eu3+–ligand complexes, which are dispersed homogeneously in aqueous solution by the association with water-soluble HA. The polysaccharide supermolecular assembly can be tuned to obtain nanoparticles of different sizes and surface charges. The preparation of stable and water-soluble lanthanide complexes via Eu3+–LIPAs opens opportunities for use of luminescent lanthanides in aqueous environments, for biosensing and bioimaging applications.
TiO2 nanomaterials with platelet or nanosheet morphologies can offer improved properties for photocatalytic applications, but established methods to produce them typically require structure-directing agents since anatase-phase TiO2 does not have a layered structure. In the present work, the preparation of TiO2 nanosheets by the chemical oxidation of TiS2 nanosheets is demonstrated. Electrochemical exfoliation of bulk TiS2 into TiS2 nanosheets, followed by the hydrothermal treatment at 180 °C for 14 h is performed. The results show that polycrystalline TiO2 nanosheets with the anatase structure are formed, and that the nanosheet morphology can still be maintained after the hydrothermal treatment. The TiO2 nanosheets show good photocatalytic activity for the degradation of methylene blue, but the performance is negatively affected by the residual carbon black that was needed in the TiS2 electrode to enable electrochemical exfoliation. These results show that conversion of TiS2 nanosheets to TiO2 nanosheets is a promising synthetic strategy but highlights how the interfacial properties of the obtained materials could be affected by ancillary components in the preparation method.
Dengue is the fastest spreading mosquito-transmitted disease in the world. In China, Guangzhou City is believed to be the most important epicenter of dengue outbreaks although the transmission patterns are still poorly understood. We developed an autoregressive integrated moving average model incorporating external regressors to examine the association between the monthly number of locally acquired dengue infections and imported cases, mosquito densities, temperature and precipitation in Guangzhou. In multivariate analysis, imported cases and minimum temperature (both at lag 0) were both associated with the number of locally acquired infections (P < 0.05). This multivariate model performed best, featuring the lowest fitting root mean squared error (RMSE) (0.7520), AIC (393.7854) and test RMSE (0.6445), as well as the best effect in model validation for testing outbreak with a sensitivity of 1.0000, a specificity of 0.7368 and a consistency rate of 0.7917. Our findings suggest that imported cases and minimum temperature are two key determinants of dengue local transmission in Guangzhou. The modelling method can be used to predict dengue transmission in non-endemic countries and to inform dengue prevention and control strategies.
Previously known to form only under high pressure synthetic conditions, here we report that the T′-type 214-structure cuprate based on the rare earth atom Tb is stabilized for ambient pressure synthesis through partial substitution of Pd for Cu. The new material is obtained in purest form for mixtures of nominal composition Tb1.96Cu0.8Pd0.2O4. The refined formula, in orthorhombic space group Pbca, with a = 5.5117(1) Å, b = 5.5088(1) Å, and c = 11.8818(1) Å, is Tb2Cu0.83Pd0.17O4. An incommensurate structural modulation is seen along the a axis by electron diffraction and high resolution imaging. Magnetic susceptibility measurements reveal long-range antiferromagnetic ordering at 7.9 K, with a less pronounced feature at 95 K; a magnetic moment reorientation transition is observed to onset at a field of approximately 1.1 T at 3 K. The material is an n-type semiconductor.
Here we report our recent prediction of the solar cycle 25 based on a newly developed scheme, which is used to investigate the predictability of the solar cycle over one cycle. The scheme is a combination of the empirical properties of solar cycles and a surface flux transport model to get the possible axial dipole moment evolution at a few years before cycle minimum, by which to get the subsequent cycle strength based on the correlation between the axial dipole moment at cycle minimum and the subsequent cycle strength. We apply this scheme to predict the large-scale field evolution since 2018 onwards. The results show that the northern polar field will keep on increasing, while the southern polar field almost keeps flat by the end of cycle 24. This leads to the cycle 25 strength of 125 ± 32, which is about 10% stronger than cycle 24 according to the mean value.
This paper proposes an adaptive guidance law for attacking a ground target based on motion camouflage strategy. The coefficients of normal and bi-normal feedback guidance law are given according to the relative motion relationship under Frenet frame. Utilizing the coefficients, the motion camouflage proportional guidance law is derived. In order to improve the initial overload characteristic of the missile, an adaptive feedback coefficient is introduced. Then, the adaptive guidance law is applied to a longitudinal plane interception problem with impact-angle constraint. Finally, the validity of this guidance law for air-to-ground missiles is proved by simulations.
Lake-calving Yakutat Glacier in southeast Alaska, USA, is undergoing rapid thinning and terminus retreat. We use a simplified glacier model to evaluate its future mass loss. In a first step we compute glacier-wide mass change with a surface mass-balance model, and add a mass loss component due to ice flux through the calving front. We then use an empirical elevation change curve to adjust for surface elevation change of the glacier and finally use a flotation criterion to account for terminus retreat due to frontal ablation. Surface mass balance is computed on a daily timescale; elevation change and retreat is adjusted on a decadal scale. We use two scenarios to simulate future mass change: (1) keeping the current (2000–10) climate and (2) forcing the model with a projected warming climate. We find that the glacier will disappear in the decade before 2110 or 2070 under constant or warming climates, respectively. For the first few decades, the glacier can maintain its current thinning rates by retreating and associated loss of high-ablating, low-elevation areas. However, once higher elevations have thinned substantially, the glacier can no longer counteract accelerated thinning by retreat and mass loss accelerates, even under constant climate conditions. We find that it would take a substantial cooling of 1.5°C to reverse the ongoing retreat. It is therefore likely that Yakutat Glacier will continue its retreat at an accelerating rate and disappear entirely.