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To explore whether and how group cognitive-behavioural therapy (GCBT) plus medication differs from medication alone for the treatment of generalized anxiety disorder (GAD).
170 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 (HAMD), the Severity Subscale of Clinical Global Impression Scale (CGI-S), Global Assessment Function (GAF), and the 12-item Short-Form Health Survey (SF-12). Assessments were conducted at baseline, 4-weeks, 8-weeks and 3-monthsfollow-up.
At 4-weeks, HAMA response (GCBT group 57.0% vs. control group 24.4%, p=0.000, Cohen 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-months 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 (OR=2.12, 95% 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 GCBT was effective in changing cognitive style.
For a skew-symmetrizable cluster algebra
with principal coefficients at
, we prove that each seed
is uniquely determined by its
-matrix, which was proposed by Fomin and Zelevinsky (Compos. Math. 143 (2007), 112–164) as a conjecture. Our proof is based on the fact that the positivity of cluster variables and sign coherence of
-vectors hold for
, which was actually verified in Gross et al. (Canonical bases for cluster algebras, J. Amer. Math. Soc. 31(2) (2018), 497–608). Further discussion is provided in the sign-skew-symmetric case so as to obtain a weak version of the conjecture in this general case.
To develop a theoretical model explaining the longitudinal changes in the caregiving process for family caregivers of persons with mild cognitive impairment (MCI) in Taiwan.
A longitudinal, grounded theory approach using in-depth face-to-face interviews and an open-ended interview guide. We conducted 42 interviews over a two-year period; each participant was interviewed at least once every six months. All participants were interviewed in their home. The participants total of 13 family caregivers of persons with MCI.
One core theme emerged: “protective preparation.” This reflected the family caregiving process of preparation for a further decline in cognitive function, and protection from the impact of low self-esteem, accidents, and symptoms of comorbidities for the family member with MCI. Protective preparation contained three components: ambivalent normalization, vigilant preparation, and protective management.
Interventions to help family caregivers manage the changes in persons with MCI can reduce caregiver burden. Our findings could provide a knowledge base for use by healthcare providers to develop and implement strategies to reduce caregiver burden for family caregivers of persons with MCI.
A new plasmonic photocatalyst Ag/Bi7Ta3O18 was fabricated by photodeposition-hydrothermal method. The phase composition, microstructure, surface areas, average pore size, UV-vis diffuse reflection spectra, and photocatalytic activities of composite photocatalysts were investigated in detail. The results of the measurements indicated that the Ag0 nanoparticle successfully loads on the surface of Bi7Ta3O18, and the 0.06 Ag/Bi7Ta3O18 photocatalysts exhibited the best photocatalytic activity for the degradation of Rhodamine B (RhB). The improved photocatalytic activity could be contributed to the localized surface plasmon resonance caused by the collective oscillation of the surface electrons of Ag nanoparticles. Additionally, the photocatalytic reaction mechanism was studied by photoluminescence photocurrent, and electron spin resonance analysis. As a result, the Ag nanoparticles onto the Bi7Ta3O18 surface enlarged the electron–hole separation, and the (˙OH) was the dominated active species of degradation RhB in the photocatalytic process.
In Taiwan the discussion of civil society emerged in the 1980s and peaked in the early 1990s, when the society underwent political democratization. Civil society was considered a public sphere, enjoying relatively autonomy from the control of the state or the market. The birth of civil society in Taiwan came about by the proliferation of non-profit organizations, community organizations, and professional and voluntary groups through continuous social mobilization. Lawmaking was indispensable for the consolidation of civil society. New ordinances, ranging from human rights, environmental regulation to cultural preservation, were brought to the agenda. The emergence of civil society allowed people to leverage themselves from the control of the state and the market. In addition to this, the new Taiwanese identity that took shape in the 1990s reinforced the civil society that was in the making. However, across the turn of the millennium, as the state– society relationship reconfigured, civil society also differentiated. Both the market and the state tried to entrench civil society, which more often than not led to many different voices within civil society. Conflicts among various social groups have become a noticeable feature in the debates and decision-making processes of public affairs.
Against this backdrop we would like to trace the early history of the development of the idea of heritage preservation in Taiwan. The emergence of the heritage preservation movement and related policies is closely intertwined with the changing cultural politics that reflect the contested meanings of national and local identities in Taiwan. Before the lifting of martial law in 1987, civil society had played a significant role in heritagemaking. Since 1987, civil society has further pushed the state to change the laws and policies governing heritage preservation.
The first piece of legislation in this area, the Cultural Heritage Preservation Act, was promulgated in Taiwan in 1982, while the country was still under authoritarian rule. The implementation of the Heritage Act and associated cultural policies inevitably reflected the Chinese nationalist historical narrative; however, at the same time, it created negotiable spaces for diverse narratives through the imported notion of “cultural heritage”, which could be seen as an indirect challenge to the dominant narrative.
Hepatocellular carcinoma (HCC) is a primary liver malignancy that mainly occurs in patients with chronic liver disease and cirrhosis. Risk factors for HCC include hepatitis B virus (HBV) infection. However, the specific role of HBV infection in HCC development is not yet completely understood. In order to reveal the effects of HBV on HCC, we compare the genes of HCC patients infected with HBV with those who are not infected.
We encoded the genes of these two types of HCC in databases using enrichment scores of Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway terms. A random forest algorithm was employed in order to distinguish these two types in the classifier, and a series of feature selection approaches was used in order to select their optimal features. Novel HBV-associated and -non-associated HCC genes were predicted, respectively, based on their optimal features in the classifier. A shortest-path algorithm was also employed in order to find all of the shortest-paths genes connecting the known related genes.
A total of 54 different features between HBV-associated and -non-associated HCC genes were identified. In total, 1236 and 881 novel related genes were predicted for HBV-associated and -non-associated HCC, respectively. By integrating the predicted genes and shortest path genes in their gene interaction network, we identified 679 common genes involved in the two types of HCC.
We identified the significantly different genetic features between two types of HCC. We also predicted related genes for the two types based on their specific features. Finally, we determined the common genes and features that were involved in both of these two types of HCC.
Background: Patients with the postural instability and gait difficulty (PIGD) subtype of Parkinson disease (PD) are at a higher risk of dysfunction and are less responsive to dopamine replacement therapy. The PIGD subtype was found to largely associate with white matter lesions, but details of the diffusion changes within these lesions have not been fully investigated. Voxel-based analysis for diffusion tensor imaging data is one of the preferred measures to compare diffusion changes in each voxel in any part of the brain. Methods: PD patients with the PIGD (n=12) and non-PIGD subtypes (n=12) were recruited to compare diffusion differences in fractional anisotropy, axial diffusivity, and radial diffusivity with voxel-based analysis. Results: Significantly reduced fractional anisotropy in bilateral superior longitudinal fasciculus, bilateral anterior corona radiata, and the left genu of the corpus callosum were shown in the PIGD subtype compared with the non-PIGD subtype. Increased radial diffusivity in the left superior longitudinal fasciculus was found in the PIGD subtype with no statistical differences in axial diffusivity found. Conclusions: Our study confirms previous findings that white matter abnormalities were greater in the PIGD subtype than in the non-PIGD subtype. Additionally, our findings suggested: (1) compared with the non-PIGD subtype, loss of white matter integrity was greater in the PIGD subtype; (2) bilateral superior longitudinal fasciculus may play a critical role in microstructural white matter abnormalities in the PIGD subtype; and (3) reduced white matter integrity in the PIGD subtype could be mainly attributed to demyelination rather than axonal loss.
The fabrication of a temperature sensor based on graphene nanoplatelets (GNPs) is reported. A preheat process was carried out and the micrographs of both original and preheat-treated GNPs are observed and compared. Nonlinear temperature variation of resistance is observed and humidity interference is found to be negligible. Region of 10–60 °C (the linear region) is selected as the sensor range and further studied. High sensitivity of GNPs can be seen and the temperature coefficient of resistance (TCR) of 0.0371 is calculated, higher than that of multiwall carbon nanotubes (MWCNTs) and many other materials reported in references. Great repeatability and small hysteresis are obtained. The time constant of the GNPs film is about 5 s, much shorter than that of MWCNTs film. The result suggests that GNPs have potential applications for use in highly sensitive and fast-response temperature sensors.
The crystal structure of a-plane GaN/ZnO heterostructures on r-plane sapphire was investigated by using the XRD and TEM measurment. It was found the formation of (220) ZnGa2O4 and crystal orientation of semipolar (10
3) GaN at GaN/ZnO interface. The epitaxial relation of normal surface direction are the sapphire (1
02) // a-GaN (11
0) and ZnGa2O4 (220) // semi-polar GaN (10
). Beside, the emission peak energy of ZnO appears shift about 60 meV in the GaN/ZnO/GaN heterostructures due to the re-crystallization of ZnO layer with Ga or N atom and the formation of the localized state.
This study identifies the influencing processes that underlie the effect of the three paternalistic leadership dimensions on subordinates' work performance/ organizational citizenship behaviours. The results, based on data collected from private firms in China, showed that perceived interactional justice mediated the effects of moral leadership and benevolent leadership on trust-in-supervisor. However, perceived interactional justice did not mediate the relationship between authoritarian leadership and trust-in-supervisor. In addition, trust-in-supervisor was found to be positively associated with work performance and organizational citizenship behaviours. Cultural and practical implications and future research directions are also discussed.
Ronnie Vernooy, Senior Programme Specialist, International Development Research Centre (IDRC), Canada,Li Xiaoyun, Senior Programme Specialist, International Development Research Centre (IDRC), Canada,Xu Xiuli, Senior Programme Specialist, International Development Research Centre (IDRC), Canada,Lu Min, Senior Programme Specialist, International Development Research Centre (IDRC), Canada,Qi Gubo, Senior Programme Specialist, International Development Research Centre (IDRC), Canada
To investigate the potential reservoir and mode of transmission of pandrug-resistant (PDR) Acinetobacter baumannii in a 7-day-old neonate who developed PDR A. baumannii bacteremia that was presumed to be the iceberg of a potential outbreak.
Outbreak investigation based on a program of prospective hospital-wide surveillance for nosocomial infection.
A 24-bed neonatal intensive care unit in a 2,200-bed major teaching hospital in Taiwan that provides care for critically ill neonates born in this hospital and those transferred from other hospitals.
Samples from 33 healthcare workers' hands and 40 samples from the environment were cultured. Surveillance cultures of anal swab specimens and sputum samples were performed for neonates on admission to the neonatal intensive care unit and every 2 weeks until discharge. The PDR A. baumannii isolates, defined as isolates resistant to all currently available systemic antimicrobials except polymyxin B, were analyzed by pulsed-field gel electrophoresis. Control measures consisted of implementing contact isolation, reinforcing hand hygiene adherence, cohorting of nurses, and environmental cleaning.
One culture of an environmental sample and no cultures of samples from healthcare workers' hands grew PDR A. baumannii. The positive culture result involved a sample obtained from a ventilation tube used by the index patient. During the following 2 months, active surveillance identified PDR A. baumannii in 8 additional neonates, and isolates from 7 had the same electrokaryotype. Of the 9 neonates colonized or infected with PDR A. baumannii, 1 died from an unrelated condition. Reinforcement of infection control measures resulted in 100% adherence to proper hand hygiene protocol. The outbreak was stopped without compromising patient care.
In the absence of environmental contamination, transient hand carriage by personnel who cared for neonates colonized or infected with PDR A. baumannii was suspected to be the mode of transmission. Vigilance, prompt intervention and strict adherence to hand hygiene protocol were the key factors that led to the successful control of this outbreak. Active surveillance appears to be an effective measure to identify potential transmitters and reservoirs of PDR A. baumannii.
In this paper we prove that minimal 3-spheres of CR type with constant sectional curvature c in the complex projective space CPn are all equivariant and therefore the immersion is rigid. The curvature c of the sphere should be c = 1/(m2-1) for some integer m≥ 2, and the full dimension is n = 2m2-3. An explicit analytic expression for such an immersion is given.
To evaluate the efficacy of the angiogenesis inhibitor AGM-1470 for the experimental treatment of nasopharyngeal carcinoma (NPC).
A NPC human tumour model was built by tumour-bearing nude mice using the NPC cell line CNE-2. Twenty-one BALB/c nude mice bearing CNE-2 xenografts were randomized into a treatment group and a control group. In the treatment group, AGM-1470 was injected 30 mg/kg subcutaneously every other day; while the vehicle (three per cent ethanol solution in 0.9 per cent saline) was given to the mice in control group. Tumour volumes and animal weights were measured every third day. Autopsy was performed after 18 days of treatment. The tumour tissue as well as the murine tissues of heart, kidney, and liver in each mouse were removed for formalin fixation and routine HE staining. Pathological evaluation was performed in these tissues.
There was a significant difference in tumour volume between the two groups at day 9 of treatment and this increased thereafter. At day 15 of treatment, the tumour volume was 4251 ± 559 mm3 (n = 10) in the control group versus 3122 ± 967 mm3 (n = 11) in the AGM-1470 treated group (p = 0.004); and T:C ratio (mean tumour volume of treated/mean tumour volume of control) was 0.73, resulting in a 27 per cent decrease in tumour growth. Central necrosis and consequential shrinkage of tumours occurred in both groups at the end of experiment. Physical toxicity and histological toxicity of heart, liver, and kidney did not result from AGM-1470 therapy.
AGM-1470 suppresses the growth of the human NPC cell line CNE-2. Treatment by AGM-1470 has no physical nor histological toxicity. Angiogenesis inhibitors may be effective in the treatment of the local lesion of NPC.
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