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The Montreal Cognitive Assessment (MoCA) is a popular and simple-to-administer screening instrument to detect cognitive impairment. The MoCA generates a total score and six domain-specific index scores: (1) Memory, (2) Executive Functioning, (3) Attention, (4) Language, (5) Visuospatial, and (6) Orientation. It is unclear whether these MoCA scores can differentiate between distinct clinical dementia syndromes. This study compared MoCA Index scores between amnestic dementia of the Alzheimer’s type (DAT) and primary progressive aphasia (PPA), a language-based dementia.
Baseline MoCA data were analyzed from 33 DAT, 37 PPA, and 83 cognitively normal individuals enrolled in the Clinical Core of the Northwestern Alzheimer’s Disease Center. A one-way analysis of covariance adjusted for age was used to compare MoCA scores among groups. A logistic regression model was implemented to observe individual likelihood of group affiliation based on MoCA Index scores.
The mean MoCA total score was significantly higher in controls compared to both patient groups (p < .001) but did not differ between DAT and PPA groups. However, in accordance with salient clinical features commonly observed in DAT versus PPA, Memory and Orientation Index scores were lowest in the DAT group (p < .001), whereas Language and Attention Index scores were lowest in the PPA group (p < .001). Multivariate logistic regression analysis showed that the individual effects of Memory (p = .001), Language (p = .002), and Orientation (p = .025) Indices were significant.
MoCA Index scores can help differentiate among distinct cognitive syndromes, suggesting it may be a useful brief screening tool to detect domain-specific cognitive impairment.
Fluid intelligence expresses the capacity for interpretation of novel stimuli and flexible behavioral adaptation to such cues. Phasic dopamine firing closely matches a temporal difference prediction error (PE) signal important for learning and rapid behavioral adaptation. Both fluid intelligence and dopaminergic neurotransmission decline with age. So far, no study investigated the relationship between fluid IQ, PE signal and direct measures of dopaminergic neurotransmission. Here we used a multimodal imaging approach that combines positron emission tomography and functional magnetic resonance imaging.
A group of healthy controls was investigated with both 6-[18F]FluoroDOPA PET and functional MRI with a probabilistic reversal task. The task required a constant behavioral adaptation to changes in reward contingencies, while choosing between two abstract stimuli. A reinforcement learning algorithm was used to compute a trial-by-trial prediction error, which was the used as a regressor in the fMRI data analysis with SPM8.
The prediction error signal was associated with functional activation in the basal ganglia including the ventral striatum and putamen. Fluid intelligence was associated with the PE signal in the ventral striatum, which correlated with age-related changes in dopamine synthesis capacity in the prefrontal cortex.
These findings provide insight into the role of age-related changes in dopaminergic neurotransmission on behavioral adaptation. The multimodal imaging approach allows the characterization of interactions between dopamine metabolism and learning-related neuronal activation and may thus be a useful tool to clarify mechanisms underlying learning and plasticity in old age, which are crucial to our understanding of successful aging.
Adherence problems are an inherent issue with any bio-psycho-social-spiritual prescription for any disease or behvaioural entity. It is all the more important in a patient with severe mental illness like Schizophrenia with limited insight. In several countries various interventions have been studied to address adherence problems in psychosis. Such as compliance therapy, family and psycho educational interventions, telephonic prompting and also legislative measures like Community Treatment Orders (CTO) have to date shown inconsistent and only modest benefits. Incentives based interventions have been tested for both preventive measures and also for adherence problems in chronic diseases. The Institute of Mental Health, Singapore has implemented a Pilot Supervision Programme (PSP) that incentivise patient engagement through quarterly vouchers as well as minimising barriers to accessing service by waiving off certain treatment fees whilst also offering them intensive intervention for one year. Our Pilot Programme, that focused on high risk patients with diagnosis of severe mental illness needing involuntary admission with history of either prolonged or repeated admissions, has begun recruiting patients since October 2012. The comparison was done between pre and post intervention phase. Total of 58 patients (95% suffering from schizophrenia or schizoaffective disorder) accepted into the treatment programme and of that nearly half of them have completed 6 months interventions. The results are promising with more than 50% improvemnt in length of stay, number of admissions and psychiatric emergency room visits, making significant impact on our high risk patients with severe mental illness.
Abnormal effort-based decision-making represents a potential mechanism underlying motivational deficits (amotivation) in psychotic disorders. Previous research identified effort allocation impairment in chronic schizophrenia and focused mostly on physical effort modality. No study has investigated cognitive effort allocation in first-episode psychosis (FEP).
Cognitive effort allocation was examined in 40 FEP patients and 44 demographically-matched healthy controls, using Cognitive Effort-Discounting (COGED) paradigm which quantified participants’ willingness to expend cognitive effort in terms of explicit, continuous discounting of monetary rewards based on parametrically-varied cognitive demands (levels N of N-back task). Relationship between reward-discounting and amotivation was investigated. Group differences in reward-magnitude and effort-cost sensitivity, and differential associations of these sensitivity indices with amotivation were explored.
Patients displayed significantly greater reward-discounting than controls. In particular, such discounting was most pronounced in patients with high levels of amotivation even when N-back performance and reward base amount were taken into consideration. Moreover, patients exhibited reduced reward-benefit sensitivity and effort-cost sensitivity relative to controls, and that decreased sensitivity to reward-benefit but not effort-cost was correlated with diminished motivation. Reward-discounting and sensitivity indices were generally unrelated to other symptom dimensions, antipsychotic dose and cognitive deficits.
This study provides the first evidence of cognitive effort-based decision-making impairment in FEP, and indicates that decreased effort expenditure is associated with amotivation. Our findings further suggest that abnormal effort allocation and amotivation might primarily be related to blunted reward valuation. Prospective research is required to clarify the utility of effort-based measures in predicting amotivation and functional outcome in FEP.
We studied trends in the incidence of health care-associated infections (HAIs) in LTCFs between 2009 and 2015 and determined the effect of participation in our network. Elder-care physicians reported weekly the number of cases of influenza-like illness, gastroenteritis, (probable) pneumonia, urinary tract infections (UTIs) and all-cause mortality. Trends in the incidence of infection and mortality in relation to LTCF characteristics were calculated using multilevel univariate and multivariate logistic regression. Thirty LTCF participated for 3 years or more, 16 for 2 years and the remaining 12 LTCF for 1 year. During the study period, the median number of beds decreased from 158 to 139, whereas the percentage of residents with private bedrooms increased from 14% to 87%. UTIs were the most frequently reported infections, followed by (probable) pneumonia and gastroenteritis. Adjusted for calendar year and season, we observed a statistically significant decrease in the incidence of influenza-like illness (odds ratio (OR) = 0.8, P < 0.01) and (probable) pneumonia (OR = 0.8, P < 0.01) for each extra year an LTCF participated. Although there are other likely contributors, such as more private rooms and enhanced infection control measures, the decreasing trend of HAI in LTCFs participating in surveillance implies that surveillance is a valuable addition to current strategies to optimise infection control.
Better understanding of interplay among symptoms, cognition and functioning in first-episode psychosis (FEP) is crucial to promoting functional recovery. Network analysis is a promising data-driven approach to elucidating complex interactions among psychopathological variables in psychosis, but has not been applied in FEP.
This study employed network analysis to examine inter-relationships among a wide array of variables encompassing psychopathology, premorbid and onset characteristics, cognition, subjective quality-of-life and psychosocial functioning in 323 adult FEP patients in Hong Kong. Graphical Least Absolute Shrinkage and Selection Operator (LASSO) combined with extended Bayesian information criterion (BIC) model selection was used for network construction. Importance of individual nodes in a generated network was quantified by centrality analyses.
Our results showed that amotivation played the most central role and had the strongest associations with other variables in the network, as indexed by node strength. Amotivation and diminished expression displayed differential relationships with other nodes, supporting the validity of two-factor negative symptom structure. Psychosocial functioning was most strongly connected with amotivation and was weakly linked to several other variables. Within cognitive domain, digit span demonstrated the highest centrality and was connected with most of the other cognitive variables. Exploratory analysis revealed no significant gender differences in network structure and global strength.
Our results suggest the pivotal role of amotivation in psychopathology network of FEP and indicate its critical association with psychosocial functioning. Further research is required to verify the clinical significance of diminished motivation on functional outcome in the early course of psychotic illness.
To describe an outbreak of bacteremia caused by vancomycin-sensitive Enterococcus faecalis (VSEfe).
An investigation by retrospective case control and molecular typing by whole-genome sequencing (WGS).
A tertiary-care neonatal unit in Melbourne, Australia.
Risk factors for 30 consecutive neonates with VSEfe bacteremia from June 2011 to December 2014 were analyzed using a case control study. Controls were neonates matched for gestational age, birth weight, and year of birth. Isolates were typed using WGS, and multilocus sequence typing (MLST) was determined.
Bacteremia for case patients occurred at a median time after delivery of 23.5 days (interquartile range, 14.9–35.8). Previous described risk factors for nosocomial bacteremia did not contribute to excess risk for VSEfe. WGS typing results designated 43% ST179 as well as 14 other sequence types, indicating a polyclonal outbreak. A multimodal intervention that included education, insertion checklists, guidelines on maintenance and access of central lines, adjustments to the late onset sepsis antibiotic treatment, and the introduction of diaper bags for disposal of soiled diapers after being handled inside the bed, led to termination of the outbreak.
Typing using WGS identified this outbreak as predominately nonclonal and therefore not due to cross transmission. A multimodal approach was then sought to reduce the incidence of VSEfe bacteremia.
The aim of the study was to investigate any association between extrauterine growth restriction (EUGR) and intestinal flora of <30-week-old preterm infants. A total of 59 preterm infants were assigned to EUGR (n=23) and non-EUGR (n=36) groups. Intestinal bacteria were compared by using high-throughput sequencing of bacterial rRNA. The total abundance of bacteria in 344 genera (7568 v. 13,760; P<0.0001) and 456 species (10,032 v. 18,240; P<0.0001) was significantly decreased in the EUGR group compared with the non-EUGR group. After application of a multivariate logistic model and adjusting for potential confounding factors, as well as false-discovery rate corrections, we found four bacterial genera with higher and one bacterial genus with lower abundance in the EUGR group compared with the control group. In addition, the EUGR group showed significantly increased abundances of six species (Streptococcus parasanguinis, Bacterium RB5FF6, two Klebsiella species and Microbacterium), but decreased frequencies of three species (one Acinetobacter species, Endosymbiont_of_Sphenophorus_lev and one Enterobacter_species) compared with the non-EUGR group. Taken together, there were significant changes in the intestinal microflora of preterm infants with EUGR compared to preterm infants without EUGR.
OBJECTIVES/SPECIFIC AIMS: The objective of this exploratory study is to evaluate the relationship between the individual genetic variants in COMTrs4680 and DRDrs1076560 and relevant alcohol use behaviors (i.e. alcohol consumption and reward processing behaviors) in non-dependent drinkers within experimentally controlled IV-ASA CAIS sessions. The overall goal of this study is to begin gathering data on the influence of individual genetic variants on alcohol consumption and other drinking-related behaviors. This will aid in the creation of a polygenic model of risk for AUD which will provide more insight into how the mesolimbic pathway is affected by alcohol use. METHODS/STUDY POPULATION: Study population: The sample included male and female non-dependent drinkers (N=149). Genotypes for functional polymorphisms in COMT (rs4680) and DRD2 (rs1076560) genes were determined for all subjects from blood samples obtained during screening. Alcohol consumption was assessed using the 90-day Timeline Followback Interviews (TLFB). Study population demographics: Self-reported gender (53.5% identified as male); Self-reported race (61.2% identified as white); Age ranged from 21-46 years old, with 22 years being the mode. Experiment: Free access (open-bar) intravenous alcohol self-administration (IV-ASA) using the computer-assisted alcohol infusion system (CAIS) paradigm; Subjects had the choice of pressing a button ad libitum for IV alcohol infusions during the session, neurobehavioral questionnaires were collected throughout the 2.5-hr alcohol infusion session. Primary outcome measures included: Total Rewards, Peak breath alcohol concentration (BrAC) achieved, and Total Ethanol consumed. Statistical Analyses: Conducted using SPSS IBM Statistics Versions 1.0.0-2482; non-dependent drinkers were organized into two groups based on their genotypes, minor allele carriers and major allele homozygotes. Outcome measures were compared between genotype groups using analysis of variance or non-parametric Mann-Whitney U-test as appropriate. RESULTS/ANTICIPATED RESULTS: -We expect the genetic makeup of the sample to be reflective of larger genome samples that are publically available (e.g. e!Ensembl) - Initial analysis for COMTrs4680 did not reveal significant effects on IV-ASA measures. Specifically, the majo DISCUSSION/SIGNIFICANCE OF IMPACT: Alcohol Use Disorder (AUD) affects millions of men and women globally. The heterogeneity within AUD individuals has made it difficult to identify biological and/or psychological factors that could be targeted for the development of treatments. By using the human laboratory model of free access IV-ASA, this study evaluated the relationship between dopaminergic genetic variants, COMTrs4680 and DRDrs1076560, and alcohol consumption in non-dependent drinkers within a controlled experimental environment. This study will begin to evaluate genetic and behavioral data that can be used to create a polygenic model of risk for AUD, which will provide more insight as to how the mesolimbic reward pathway is affected by alcohol use and contributes to risk for AUD.
OBJECTIVES/SPECIFIC AIMS: Dopamine transporter (DAT1) gene variation is associated with reward-related phenotypes including alcohol response. There is also evidence for a potential moderating role for mu-opioid receptor (OPRM1) gene variation on the relationship between DAT1 variation and alcohol response measures. We aimed at studying the interaction between the DAT1 VNTR and OPRM1 A118G polymorphisms on alcohol consumption and subjective responses among non-dependent drinkers. METHODS/STUDY POPULATION: We employed a progressive ratio (PR) paradigm of intravenous alcohol self-administration (IV-ASA) using the Computer-Assisted Infusion System (CAIS) to assess the motivation for alcohol seeking and consumption in a sample of nondependent drinkers. We used the Drug Effects Questionnaire (DEQ) and Biphasic Alcohol Effects Questionnaire (BAES) to assess subjective response. IV-ASA measures included average breath alcohol concentration (BrAC) and total ethanol infused. Peripheral blood samples were collected for genotyping. Ethics approval was obtained from the NIH Addictions Institutional Review Board. RESULTS/ANTICIPATED RESULTS: Fifty participants completed the PR IV-ASA session after informed consent. There were significant interactions between the DAT1 and OPRM1 genotypes in subjective effects of alcohol. Simple main effects analysis showed that DAT1 10a allele carriers that were also OPRM1 G allele carriers had significantly higher scores for several measures: “feel the drug effects” (F (1,46)=6.573, P = 0.014), “feel intoxicated”(F(1,46)=8.613, P = 0.005) and “feeling high” (F(1,46)=10.889, P = 0.002) in DEQ and higher sedation (F(1,46)=4.575, P = 0.038) in BAES. The genotypes statistically significantly predicted average breath alcohol (F (1,61) =3.295, p=0.044) and total ethanol infused(F(1,61)=3.632, p=0.032. DAT1 VNTR and OPRM1 A118G polymorphisms taken together accounted for 6.9 and 7.8% of variations in average breath alcohol and total ethanol infused respectively. DISCUSSION/SIGNIFICANCE OF IMPACT: Polymorphic variations in DAT1 and OPRM1 interact with each other in determining subjective effects of alcohol in intravenous alcohol infusion assessing motivation for alcohol seeking and consumption in nondependent drinkers. These epistatic interactions in subjective effects of alcohol are salient in the context of predicting and understanding neurobiological effects of alcohol and thereby the therapeutic responses in treating alcohol use disorders.
OBJECTIVES/SPECIFIC AIMS: The primary goal of this project is to verify findings from a murine prostatitis model in the human setting. METHODS/STUDY POPULATION: Methods include primary cell isolation and culture, FACS, adoptive transfer, 3D cell culture, histology, immunofluorescence, xenograft, and tissue recombination. The study population includes patients undergoing HoLEP or radical prostatectomy due to hyperplasia or adjacent bladder or prostate cancer. RESULTS/ANTICIPATED RESULTS: Having verified similar sensitivities to androgen receptor (AR) inhibitors between naive murine and human basal prostate stem cells, we anticipate that autoimmune inflammation in humans affects the response of basal prostate stem cells in a manner similar to the murine setting as well. This includes increased proliferation, increased differentiation, and decreased response to AR inhibitors. DISCUSSION/SIGNIFICANCE OF IMPACT: The identification of survival mechanisms used by basal prostate stem cells in an androgen deprived environment may give insight to the process by which prostate cancer becomes androgen independent. The effect of inflammation on proliferation, survival, and AR signaling in these cells may also provide information relevant to cancer initiation and progression.
The effects of Reynolds number (
) and Stokes number (
) on particle-pair relative velocity (RV) are investigated systematically using a recently developed planar four-frame particle tracking technique in a novel homogeneous and isotropic turbulence chamber. We compare the measured results with direct numerical simulation (DNS), verifying whether the conclusions of the DNS for simplified conditions and limited
are still valid in reality. Two experiments are performed: varying
between 246 and 357 at six
values, and varying
between 0.02 and 4.63 at five
values. The measured mean inward particle-pair RV
as a function of separation distance
is compared with the DNS under closely matched conditions. At all experimental conditions, an excellent agreement is achieved, except when the particle separation distance
is the Kolmogorov length scale), where the experimental
is consistently higher, possibly due to particle polydispersity and finite laser thickness in the experiments (Dou et al., arXiv:1712.07506, 2017). At any fixed
is essentially independent of
, echoing the DNS finding of Ireland et al. (J. Fluid Mech., vol. 796, 2016, pp. 617–658). At any fixed
, showing dominance of the path-history effect in the dissipation range when
, but decreases with
, indicating dominance of inertial filtering. We further compare the
and RV variance
from experiments with DNS and theoretical predictions by Pan & Padoan (J. Fluid Mech., vol. 661, 2010, pp. 73–107). For
match these values well at
, but they are higher than both DNS and theory at
from all three match well, except for
, for which experimental values are higher, while
from experiment and DNS are much higher than theoretical predictions. We discuss potential causes of these discrepancies. What this study shows is the first experimental validation of
effect on inertial particle-pair
in homogeneous and isotropic turbulence.
General life stress has been associated with altered DNA methylation in individuals of African Ancestry, although the relationship between parenting stress and DNA methylation has not been described. The purpose of this study was to examine the relationship between maternal parenting stress and DNA methylation among African Ancestry mother-child dyads.
We evaluated epigenome-wide DNA methylation relative to parenting stress in 74 mother-child dyads using linear mixed models.
Significant variation in maternal DNA methylation at 95 CpG sites was associated with level of parenting stress. Notably, we identified a change in DNA methylation associated with poly (ADP-ribose) polymerase-1, which plays a key role in stress signaling. We did not identify any significant variation in child DNA methylation related to maternal parenting stress.
However, DNA methylation patterns observed in children mirrored patterns observed in their mothers. The results suggest that differential maternal DNA methylation is associated with higher levels of parenting stress.
The lengthy and complex focal article by Tett, Hundley, and Christiansen (2017) is based on a fundamental misunderstanding of the nature of validity generalization (VG): It is based on the assumption that what is generalized in VG is the estimated value of mean rho (
). This erroneous assumption is stated repeatedly throughout the article. A conclusion of validity generalization does not imply that
is identical across all situations. If VG is present, most, if not all, validities in the validity distribution are positive and useful even if there is some variation in that distribution. What is generalized is the entire distribution of rho (
), not just the estimated
or any other specific value of validity included in the distribution. This distribution is described by its mean (
) and standard deviation (SDρ). A helpful concept based on these parameters (assuming ρ is normally distributed) is the credibility interval, which reflects the range where most of the values of ρ can be found. The lower end of the 80% credibility interval (the 90% credibility value, CV =
– 1.28 × SDρ) is used to facilitate understanding of this distribution by indicating the statistical “worst case” for validity, for practitioners using VG. Validity has an estimated 90% chance of lying above this value. This concept has long been recognized in the literature (see Hunter & Hunter, 1984, for an example; see also Schmidt, Law, Hunter, Rothstein, Pearlman, & McDaniel, 1993, and hundreds of VG articles that have appeared in the literature over the past 40 years since the invention of psychometric meta-analysis as a means of examining VG [Schmidt & Hunter, 1977]). The
is the value in the distribution with the highest likelihood of occurring (although often by only a small amount), but it is the whole distribution that is generalized. Tett et al. (2017) state that some meta-analysis articles claim that they are generalizing only
. If true, this is inappropriate. Because
has the highest likelihood in the ρ distribution, discussion often focuses on that value as a matter of convenience, but
is not what is generalized in VG. What is generalized is the conclusion that there is validity throughout the credibility interval. The false assumption that it is
and not the ρ distribution as a whole that is generalized in VG is the basis for the Tett et al. article and is its Achilles heel. In this commentary, we examine the target article's basic arguments and point out errors and omissions that led Tett et al. to falsely conclude that VG is a “myth.”
We characterized evacuations related to Hurricane Sandy, which made landfall in New Jersey on October 29, 2012.
We analyzed data from the 2014 New Jersey Behavioral Risk Factor Survey. The proportion of respondents reporting evacuation was used to estimate the number of New Jersey adults who evacuated. We determined evacuation rates in heavily impacted and less-impacted municipalities, as well as evacuation rates for municipalities under and not under mandatory evacuation orders. We tested associations between demographic and health factors, such as certain chronic health conditions, and evacuation.
Among respondents, 12.7% (95% CI: 11.8%-13.6%) reported evacuating, corresponding to approximately 880,000 adults. In heavily impacted municipalities, 17.0% (95% CI: 15.2%-18.7%) evacuated, compared with 10.1% (95% CI: 9.0%-11.2%) in less-impacted municipalities. In municipalities under mandatory evacuation orders, 42.5% (95% CI: 35.1%-49.8%) evacuated, compared with 11.8% (95% CI: 10.9%-12.9%) in municipalities not under mandatory orders. Female gender (odds ratio [OR]: 1.36; 95% CI: 1.14-1.64), unmarried status (OR: 1.22; 95% CI: 1.02-1.46), shorter length of residence (OR: 1.28; 95% CI: 1.03-1.60), and living in a heavily impacted municipality (OR: 1.84; 95% CI: 1.54-2.20) were significantly associated with evacuation. History of stroke (OR: 1.61; 95% CI: 1.02-2.53) was the only chronic condition associated with evacuation.
Approximately 880,000 New Jersey adults evacuated because of Hurricane Sandy. Those in heavily impacted municipalities and municipalities under mandatory evacuation orders had higher evacuation rates; however, still fewer than half evacuated. These findings can be used for future disaster planning. (Disaster Med Public Health Preparedness. 2017;11:720–728).
Disturbances in Pavlovian valuation systems are reported to follow traumatic stress exposure. However, motivated decisions are also guided by instrumental mechanisms, but to date the effect of traumatic stress on these instrumental systems remain poorly investigated. Here, we examine whether a single episode of severe traumatic stress influences flexible instrumental decisions through an impact on a Pavlovian system.
Twenty-six survivors of the 2011 Norwegian terror attack and 30 matched control subjects performed an instrumental learning task in which Pavlovian and instrumental associations promoted congruent or conflicting responses. We used reinforcement learning models to infer how traumatic stress affected learning and decision-making. Based on the importance of dorsal anterior cingulate cortex (dACC) for cognitive control, we also investigated if individual concentrations of Glx (=glutamate + glutamine) in dACC predicted the Pavlovian bias of choice.
Survivors of traumatic stress expressed a greater Pavlovian interference with instrumental action selection and had significantly lower levels of Glx in the dACC. Across subjects, the degree of Pavlovian interference was negatively associated with dACC Glx concentrations.
Experiencing traumatic stress appears to render instrumental decisions less flexible by increasing the susceptibility to Pavlovian influences. An observed association between prefrontal glutamatergic levels and this Pavlovian bias provides novel insight into the neurochemical basis of decision-making, and suggests a mechanism by which traumatic stress can impair flexible instrumental behaviours.
Better understanding of the complex interplay among key determinants of functional outcome is crucial to promoting recovery in psychotic disorders. However, this is understudied in the early course of illness. We aimed to examine the relationships among negative symptoms, neurocognition, general self-efficacy and global functioning in first-episode psychosis (FEP) patients using structural equation modeling (SEM).
Three hundred and twenty-one Chinese patients aged 26–55 years presenting with FEP to an early intervention program in Hong Kong were recruited. Assessments encompassing symptom profiles, functioning, perceived general self-efficacy and a battery of neurocognitive tests were conducted. Negative symptom measurement was subdivided into amotivation and diminished expression (DE) domain scores based on the ratings in the Scale for the Assessment of Negative Symptoms.
An initial SEM model showed no significant association between functioning and DE which was removed from further analysis. A final trimmed model yielded very good model fit (χ2 = 15.48, p = 0.63; comparative fit index = 1.00; root mean square error of approximation <0.001) and demonstrated that amotivation, neurocognition and general self-efficacy had a direct effect on global functioning. Amotivation was also found to mediate a significant indirect effect of neurocognition and general self-efficacy on functioning. Neurocognition was not significantly related to general self-efficacy.
Our results indicate a critical intermediary role of amotivation in linking neurocognitive impairment to functioning in FEP. General self-efficacy may represent a promising treatment target for improvement of motivational deficits and functional outcome in the early illness stage.
A magnesium–lithium (Mg–Li) hybrid battery consists of an Mg metal anode, a Li+ intercalation cathode, and a dual-salt electrolyte with both Mg2+ and Li+ ions. The demonstration of this technology has appeared in literature for few years and great advances have been achieved in terms of electrolytes, various Li cathodes, and cell architectures. Despite excellent battery performances including long cycle life, fast charge/discharge rate, and high Coulombic efficiency, the overall research of Mg–Li hybrid battery technology is still in its early stage, and also raised some debates on its practical applications. In this regard, we focus on a comprehensive overview of Mg–Li hybrid battery technologies developed in recent years. Detailed discussion of Mg–Li hybrid operating mechanism based on experimental results from literature helps to identify the current status and technical challenges for further improving the performance of Mg–Li hybrid batteries. Finally, a perspective for Mg–Li hybrid battery technologies is presented to address strategic approaches for existing technical barriers that need to be overcome in future research direction.