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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.
Working memory (WM) can be thought of as the limited memory capacity that allows us to hold a very small amount of information (e.g., the several digits of our telephone numbers) in our mind and to simultaneously manipulate this information for completing some cognitive tasks in our daily life (Baddeley, 1986; Cowan, 1988). Since the inception of the seminal WM model by the British psychologists Baddeley and Hitch (1974), the concept has received considerable enthusiasm from multiple subfields of cognitive sciences, spanning from such disciplines as psychology, linguistics, neuroscience, biology, and computer science, to anthropology and philosophy (Miller, 2003; Carruthers, 2013; 2015). Concerted efforts are being poured in continuously from diverse research camps, which subsequently give rise to the propagation of a dozen theoretical models of WM (Miyake & Shah, 1999), notwithstanding lingering debates and controversies over the nature and structure of this key construct of human cognition (e.g., Baddeley, 2012; 2017; Cowan, 2014; 2017).
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.
We assessed inheritance of resistance to sugarcane brown rust (Puccinia melanocephala) in selfing F1 populations of wild sugarcane germplasm Erianthus rockii ‘Yundian 95-19’ and E. rockii ‘Yundian 95-20’. We tested parent and selfing F1 individuals for the brown rust resistance gene, Bru1, that has been shown to confer resistance to brown rust in sugarcane. The Bru1 gene was not detected in E. rockii ‘Yundian 95-19’, E. rockii ‘Yundian 95-20’ or their selfing F1 individuals, and we found there was segregation of resistance in the two selfing F1 populations (segregation ratio: 3:1). The results confirmed resistance in E. rockii ‘Yundian 95-19’ and E. rockii ‘Yundian 95-20’ to sugarcane brown rust is controlled by a novel, single dominant gene.
Siliceous-sulphate rock coatings were observed at Zhenzhu Spring, an acid sulphate hot spring in the Tengchong volcanic field, China. These rock coatings are mainly formed of gypsum and amorphous silica. Some alum-(K), voltaite, α-quartz and muscovite were also found. Four different laminae are developed in the rock coatings: gypsum layer, tight siliceous layer, tabular siliceous layer and siliceous debris layer. The gypsum layer is located at the top of the rock coatings, while other siliceous layers appear below the gypsum layer. Geochemical modelling of the fluids was performed to identify the mechanisms responsible for the formation of gypsum and amorphous silica. The results indicated that the occurrence of gypsum is related to the acid-fog deposition and amorphous silica mainly originates from spring water. Fog deposition provided the rock coatings with abundant SO42− and Ca, and the subsequent complete evaporation of the condensed fluids produced gypsum. Seasonal climate change (especially variation in rainfall) determines the fluctuations of capillary action and dissolution. Rainfall events in the wet season led to periods of non-precipitating gypsum and promoted the capillary rise of the spring water. Slightly diluted capillary water (a small amount of rainwater) covered the rock coatings, formed a tight siliceous layer on the rock-coating surface and/or filled the pores among the gypsum crystals forming many tabular siliceous aggregates. Heavy rainfall (high dilution), however, resulted in non-precipitating amorphous silica and accelerated the gypsum dissolution, leaving tabular pores around tabular siliceous aggregates and forming a tabular siliceous layer.
Major depressive disorder (MDD) is highly heterogeneous and can be classified as treatment-resistant depression (TRD) or antidepressant-responsive depression (non-TRD) based on patients' responses to antidepressant treatment. Methods for distinguishing between TRD and non-TRD are critical clinical concerns. Deficits of cortical inhibition (CI) have been reported to play an influential role in the pathophysiology of MDD. Whether TRD patients' CI is more impaired than that of non-TRD patients remains unclear.
Paired-pulse transcranial magnetic stimulation (ppTMS) was used to measure cortical inhibitory function including GABAA- and GABAB-receptor-related CI and cortical excitatory function including glutamate-receptor-related intracortical facilitation (ICF). We recruited 36 healthy controls (HC) and 36 patients with MDD (non-TRD, n = 16; TRD, n = 20). All participants received evaluations for depression severity and ppTMS examinations. Non-TRD patients received an additional ppTMS examination after 3 months of treatment with the SSRI escitalopram.
Patients with TRD exhibited reduced short-interval intracortical inhibition (SICI) and long-interval intracortical inhibition (LICI), as shown by abnormally higher estimates, than those with non-TRD or HC (F = 11.030, p < 0.001; F = 10.309, p < 0.001, respectively). After an adequate trial of escitalopram treatment, the LICI of non-TRD reduced significantly (t = − 3.628, p < 0.001), whereas the ICF remained lower than that of HC and showed no difference from pretreatment non-TRD.
TRD was characterized by relatively reduced CI, including both GABAA- and GABAB-receptor-mediated neurons while non-TRD preserved partial CI. In non-TRD, SSRIs may mainly modulate GABAB-receptor-related LICI. Our findings revealed distinguishable features of CI in antidepressant-resistant and responsive major depression.
Novel NiMoO4-integrated electrode materials were successfully prepared by solvothermal method using Na2MoO4·2H2O and NiSO4·6H2O as main raw materials, water, and ethanol as solvents. The morphology, phase, and structure of the as-prepared materials were characterized by SEM, XRD, Raman, and FT-IR. The electrochemical properties of the materials in supercapacitors were investigated by cyclic voltammetry, constant current charge–discharge, and electrochemical impedance spectroscopy techniques. The effects of volume ratio of water to ethanol (W/E) in solvent on the properties of the product were studied. The results show that the pure phase monoclinic crystal NiMoO4 product can be obtained when the W/E is 2:1. The diameter and length are 0.1–0.3 µm and approximately 3 µm, respectively. As an active material for supercapacitor, the NiMoO4 nanorods material delivered a discharge specific capacitance of 672, 498, and 396 F/g at a current density of 4, 7, and 10 A/g, respectively. The discharge specific capacitance slightly decreased from 815 to 588 F/g with a retention of 72% after 1000 cycles at a current density of 1 A/g. With these superior capacitance properties, the novel NiMoO4 integrated electrode materials could be considered as promising material for supercapacitors.
In this work, atomic layer deposition (ALD), as a novel strategy, has been applied to deposit MgO on nano-sized porous Si (pSi) dendrites obtained by etching Al–Si alloy for LIBs. The reversible specific capacity of pSi@MgO electrode is 969.4 mA h/g after 100 cycles at 100 mA/g between 0.01 and 1.5 V, and it presents the discharge specific capacities of 1253.0, 885.5, 642.4, 366.2, and 101.4 mA h/g at 100, 500, 1000, 2000, and 5000 mA/g, respectively. What is more, it delivers a high reversible capacity of 765.1 mA h/g even at 500 mA/g after 200 cycles. The performance improvement can be attributed to the protection of the MgO layer and built-in space of porous Si for volume expansion upon cycling. These results illustrate that ALD derived coating is a powerful strategy to enhance electrical properties of anode materials with huge volume change for lithium-ion batteries.
Clozapine treatment increases the risk of agranulocytosis, but findings on the epidemiology of agranulocytosis have been inconsistent. This meta-analysis examined the prevalence of agranulocytosis and related death in clozapine-treated patients.
A literature search in the international (PubMed, PsycINFO, and EMBASE) and Chinese (WanFang, Chinese National Knowledge Infrastructure, and Sinomed) databases was conducted. Prevalence estimates of agranulocytosis and related death in clozapine-treated patients were synthesized with the Comprehensive Meta-Analysis program using the random-effects model.
Thirty-six studies with 260 948 clozapine-treated patients published between 1984 and 2018 were included in the meta-analysis. The overall prevalence of agranulocytosis and death caused by agranulocytosis were 0.4% (95% CI 0.3–0.6%) and 0.05% (95% CI 0.03–0.09%), respectively. The prevalence of agranulocytosis was moderated by sample size, study quality, year of publication, and that of data collection.
The prevalence of clozapine-associated agranulocytosis is low. Agranulocytosis-related death appears rare.
To examine urban–rural disparity in childhood stunting, wasting and malnutrition at national and subnational levels in Chinese primary-school children in 2010 and 2014.
Data were obtained from two nationwide cross-sectional surveys conducted in 2010 and 2014. Malnutrition was classified using the Chinese national ‘Screening Standard for Malnutrition of Children’.
All twenty-seven mainland provinces and four municipalities of mainland China.
Children aged 7–12 years (n 215 214; 107 741 in 2010 and 107 473 in 2014) from thirty-one provinces.
Stunting, wasting and malnutrition prevalence were 1·9, 12·3 and 13·7 % in 2010, but decreased to 1·0, 9·4 and 10·2 % in 2014, respectively. The prevalence of stunting, wasting and malnutrition in both urban and rural children was higher in western provinces, while lower in eastern provinces. Although the prevalence of wasting and malnutrition was higher in rural children than their urban counterparts, the urban–rural disparity in both wasting and malnutrition decreased from 2010 to 2014 (prevalence OR: wasting, 1·35 to 1·16; malnutrition, 1·50 to 1·27). A reversal occurred in 2014 in several eastern provinces where the prevalence of wasting and malnutrition in urban children surpassed their rural peers. The urban–rural disparity was larger in western provinces than eastern provinces.
The shrinking urban–rural disparity and the reversal in wasting and malnutrition suggest that the malnutrition situation has improved during the post-crisis period, especially in the western provinces. Region-specific policies and interventions can be useful to sustainably mitigate malnutrition in Chinese children, especially in rural areas and the western provinces.
Little is known of the olfactory mechanisms of host detection in the ovipositors of endoparasitoids and ectoparasitoids. An endoparasitoid Aprostocetus causalis La Salle & Wu (Hymenoptera: Eulophidae) and an ectoparasitoid Quadrastichus mendeli Kim & La Salle (Hymenoptera: Eulophidae: Tetrastichinae) are the two parasitoids of the eucalyptus gall wasp Leptocybe spp. Structures and sense organs of ovipositors of A. causalis and Q. mendeli were studied using scanning and transmission electron microscopy, which provided essential information for exploring the mechanism of host detection by endoparasitoid and ectoparasitoid. The ovipositors of two parasitoids consisted of the first and second valvulae and ended in a pointed tip. There were three types of microtrichia, two types of sensilla chaetica, and one type of sensilla campaniformia on the ovipositors of A. causalis and Q. mendeli. However, Q. mendeli has the fourth type of microtrichia on the ovipositor. The morphology, types, distribution, length, and width of these sensilla and microtrichia were described, and their possible functions are discussed in conjunction with the stinging, oviposition, and the host selection process.
The Zhenzhu Spring, located in the Tengchong volcanic field, Yunnan, China, is an acid hot spring with high SO42− concentrations and intense acid aerosol generation. In order to understand the formation mechanism of sulfate minerals at the Zhenzhu Spring and provide a better insight into the sulfur isotope geochemistry of the associated Rehai hydrothermal system, we investigated the spring water hydrochemistry, mineralogy and major-element geochemistry of sulfate minerals at the Zhenzhu Spring together with the sulfur-oxygen isotope geochemistry of sulfur-containing materials at the Rehai geothermal field and compared the isotope results with those in other steam-heated environments. Subaerial minerals include a wide variety of sulfate minerals (gypsum, alunogen, pickeringite, tamarugite, magnesiovoltaite and a minor Mg–S–O phase) and amorphous SiO2. The δ34S values of the subaerial sulfate minerals at the Zhenzhu Spring varied subtly from –0.33 to 1.88‰ and were almost consistent with the δ34S values of local H2S (–2.6 to 0.6‰) and dissolved SO42− (–0.2 to 5.8‰), while the δ18O values (–8.94 to 20.1‰) were between that of the spring waters (–10.19 to –6.7‰) and atmospheric O2 (~23.88‰). The results suggest that most of the sulfate minerals are derived from the oxidation of H2S, similar to many sulfate minerals from modern steam-heated environments. However, the rapid environmental change (different ratio of atmospheric and water oxygen) at the Zhenzhu Spring accounts for the large variation of δ18O. The formation of subaerial sulfate minerals around the Zhenzhu Spring is related to acid aerosols (vapour and acid water droplets). The intense activity of spring water around vents supply the aerosol with H2SO4 (H2S oxidation and acid water droplets formed by bubble bursting) and few cations. Deposition of the acid sulfate aerosol forms the acid condensate, which attacks the underlying rocks and releases many cations and anions to form subaerial sulfate minerals at the Zhenzhu Spring.
Microbial-induced calcite precipitation (MICP) has gained much attention in soil improvement studies, where it can enhance the physical properties of sandy soil. Small-scale sand cylinder tests were conducted to investigate the formation and failure of calcium carbonate precipitation bonding between individual sand particles. Bonding formation by precipitation was examined by scanning electron microscopy. Energy-dispersive X-ray spectroscopy analysis verified the existence of calcium, carbon, and oxygen, which could form CaCO3 after MICP-treatment. Focused-ion-beam milling was applied to study the interior structure of calcium carbonate precipitation during the MICP process.
Bipolar disorder is a highly heritable mental illness that transmits intergeneratively. Previous studies supported that first-degree relatives (FDRs), such as parents, offspring, and siblings, of patients with bipolar disorder, had a higher risk of bipolar disorder. However, whether FDRs of bipolar patients have an increased risk of schizophrenia, major depressive disorder (MDD), autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD) remains unclear.
Among the entire population in Taiwan, 87 639 patients with bipolar disorder and 188 290 FDRs of patients with bipolar disorder were identified in our study. The relative risks (RRs) of major psychiatric disorders were assessed among FDRs of patients with bipolar disorder.
FDRs of patients with bipolar disorder were more likely to have a higher risk of major psychiatric disorders, including bipolar disorder (RR 6.12, 95% confidence interval (CI) 5.95–6.30), MDD (RR 2.89, 95% CI 2.82–2.96), schizophrenia (RR 2.64, 95% CI 2.55–2.73), ADHD (RR 2.21, 95% CI 2.13–2.30), and ASD (RR 2.10, 95% CI 1.92–2.29), than the total population did. These increased risks for major psychiatric disorders were consistent across different familial kinships, such as parents, offspring, siblings, and twins. A dose-dependent relationship was also found between risk of each major psychiatric disorder and numbers of bipolar patients.
Our study was the first study to support the familial coaggregation of bipolar disorder with other major psychiatric disorders, including schizophrenia, MDD, ADHD, and ASD, in a Taiwanese (non-Caucasian) population. Given the elevated risks of major psychiatric disorders, the public health government should pay more attention to the mental health of FDRs of patients with bipolar disorder.
This paper introduces a novel 2R1T parallel manipulator redundantly actuated by pneumatic muscles for lower-limb rehabilitation. First, the conceptual design of the proposed 3-DOF parallel mechanism is presented. Then, the inverse kinematics and the generalized Jacobian analysis are carried out. Based on the generalized Jacobian and the constraint characteristics of the mechanism, the force/motion transmissibility of the redundantly actuated parallel mechanism is investigated via four individual cases without actuation redundancy, leading to a suitable local transmission index for the evaluation of kinematic performance of the proposed mechanism. Finally, the design variables are optimized by maximizing the mean value of the local transmission index with the aid of genetic algorithm. The numerical result shows that the proposed parallel mechanism can achieve a good kinematic performance in its task workspace.
Global Navigation Satellite System (GNSS) safety issues of have been of concern for some time. Spoofing attacks have received much attention as they can be difficult to detect and have the potential to cause disruption at best and major damage in extremis. To mitigate such threats, a spoofing detection method based on the consistency check of Doppler positioning fixes and pseudorange positioning fixes is proposed. The primary contributions of this paper include establishing a Generalised Likelihood Ratio Test (GLRT)-based statistical detection model for the introduced spoofing detection method and efficiently improving the accuracy of the Doppler positioning method as well as the performance of the detection approach by a modified α-filter-based Doppler smoothing technique. Theoretical performance of the proposed detection model is analysed. Monte Carlo simulations were also conducted to verify the theoretical analysis. Moreover, grounded on the developed test statistic and the optimised threshold, a consistency check module was specifically realised in both software defined and real-time GNSS receivers. Additionally, a Doppler smoothing technique was applied to the receivers. Spoofing attack experiments on both software defined and real-time platforms validated the effectiveness of the statistical spoofing detection model.
Combining density functional theory calculations and temperature programmed desorption (TPD) experiments, the adsorption behavior of various sulfur containing compounds, including C2H5SH, CH3SCH3, tetrahydrothiophene, thiophene, benzothiophene, dibenzothiophene, and their derivatives on the coordinately unsaturated sites of Mo27Sx model nanoparticles, are studied systematically. Sulfur molecules with aromaticity prefer flat adsorption than perpendicular adsorption. The adsorption of nonaromatic molecules is stronger than the perpendicular adsorption of aromatic molecules, but weaker than the flat adsorption of them. With gradual hydrogenation (HYD), the binding affinity in the perpendicular adsorption modes increases, while in flat adsorption modes it increases first, then decreases. Significant steric effects on the adsorption of dimethyldibenzothiophene were revealed in perpendicular adsorption modes. The steric effect, besides weakening adsorption, could also activate the S–C bonds through a compensation effect. Finally, by comparing the theoretical adsorption energies with the TPD results, we suggest that HYD and direct-desulfurization path may happen simultaneously, but on different active sites.