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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.
Disturbances in lipid metabolism are at the core of several health issues facing modern society, including fatty liver and obesity. The SREBP-1 is one important transcription factor regulating lipid metabolism, but the relevant mechanism still remains unknown. The present study determined the transcriptional regulation of SREBP-1 and its target genes (including accα, fas and scd1) in a freshwater teleost, grass carp Ctenopharyngodon idella. We cloned and characterized the 1988 bp, 2043 bp, 1632 bp and 1889 bp sequences of srebp-1, accα, scd1, and fas promoters, respectively. A cluster of putative binding sites of transcription factors, such as SP, YY1, NF-Y, SREs and E-box element, were predicted on their promoter regions. nSREBP-1 overexpression reduced srebp-1 promoter activity, increased scd1 and fas promoter activity, but did not influence accα promoter activity. The site mutation and EMSA analysis indicated that srebp-1, fas and scd1 promoters, but not accα promoter, possessed SREs. In CIK cells of grass carp, nSREBP-1 overexpression significantly reduced srebp-1 mRNA expression, and up-regulated miR-29 mRNA expression. The 3’UTR of srebp-1 possessed the potential miR-29 binding site and miR-29 up-regulated the luciferase activity of srebp-1 3’UTR and srebp-1 mRNA expression, implying a self-activating loop of SREBP-1 and miR-29 in grass carp. Based on these results above, we found two novel transcriptional mechanisms for SREBP-1 in grass carp: (1) the auto-regulation sited on the SREBP-1 promoter regions was suppressive; (2) there was a self-activating loop of SREBP-1 and miR-29.
Extant medusozoans (phylum Cnidaria) are dominated by forms showing tetraradial symmetry, but stem-group medusozoans of early Cambrian age collectively exhibit tetra-, bi-, penta-, and hexaradial symmetry. Moreover, the developmental and evolutionary relationships between four-fold and other types of radial symmetry in medusozoans remain poorly understood. Here we describe a new hexangulaconulariid, Septuconularia yanjiaheensis new genus new species, from Bed 5 of the Yanjiahe Formation (Cambrian Stage 2) in the Three Gorges area of Hupei Province, China. The laterally compressed, biradially symmetrical periderm of this species possesses 14 gently tapered faces, the most of any hexangulaconulariid described thus far. The faces are bordered by longitudinal ridges and crossed by short, irregularly spaced transverse ribs. Longitudinally, the periderm consists of three regions that probably correspond, respectively, to an embryonic stage, a transient juvenile stage, and a long adult stage. Septuconularia yanjiaheensis may have been derived from six-faced Hexaconularia (Fortunian Stage), which is morphologically intermediate between Septuconularia yanjiaheensis and Arthrochites. Furthermore, conulariids sensu stricto, carinachitids, and hexangulaconulariids may constitute a monophyletic group united by possession of an organic or organophosphatic periderm exhibiting longitudinal (corner) sulci, a facial midline, and offset of transverse ribs along the facial midline.
We support Jaswal & Akhtar's interrogation of social motivational accounts of autism and discuss two sources of bias that contribute to how others construe autistic people's communications: (1) an experience-based bias that limits our ability to discern the speaker's action as communicative and (2) a prejudice against the credibility of certain speakers that limits a listener's willingness to believe their testimony.
In recent decades, there has been significant growth in the capital market for mortality- and longevity-linked bonds. Therefore, modeling and forecasting the mortality indexes underlying these bonds have crucial implications for risk management in life insurance companies. In this paper, we propose a hierarchical reconciliation approach to constructing probabilistic forecasts for mortality bond indexes. We apply this approach to analyzing the Swiss Re Kortis bond, which is the first “longevity trend bond” introduced in the market. We express the longevity divergence index associated with the bond’s principal reduction factor (PRF) in a hierarchical setting. We first adopt time-series models to obtain forecasts on each hierarchical level, and then apply a minimum trace reconciliation approach to ensure coherence of forecasts across all levels. Based on the reconciled probabilistic forecasts of the longevity divergence index, we estimate the probability distribution of the PRF of the Kortis bond, and compare our results with those stated in Standard and Poor’s report on pre-sale information. We also illustrate the strong performance of the approach by comparing the reconciled forecasts with unreconciled forecasts as well as those from the bottom-up approach and the optimal combination approach. Finally, we provide first insights on the interest spread of the Kortis bond throughout its risk period 2010–2016.
In this chapter, the air pollution trends in historical London (1950 – 66) and contemporary Beijing (2000 – 16) are compared. In both cases, coal is the main source of air pollution, due to coal-fired electricity generation and coal-burning activities that provide heating. In London, the Clean Air Act of 1956 marked a successful milestone in the history of air pollution abatement in the UK. In Beijing, various policies have been introduced but air qualities in China have not been improved substantially. By examining the effectiveness of respective pollution control regulations/policies in a broader socioeconomic context, policy implications on respective jurisdictions are drawn. For effective implementation of air pollution control policies at the local level, it would be good for China to move beyond simply introducing stringent policies and regulations at the central or the provincial level. More resources can be re-directed to resolving the competing interests of stakeholders across different levels of jurisdictions.
This study aimed to determine whether increased carotenoids intake was associated with reduced risk of gestational diabetes mellitus (GDM). We performed a cross-sectional analysis using data from Tongji Maternal and Child Health Cohort study. The dietary carotenoids intake of 1978 pregnant women was assessed using a researcher-administered FFQ before undertaking an oral glucose tolerance test at 24–28 weeks. Multivariate logistic and linear regression analyses were used to obtain the effect estimates. Participants in the highest quartile of lycopene intake showed a lower risk of GDM (OR 0·50; 95 % CI 0·29, 0·86; Pfor trend = 0·007) compared with those in the lowest quartile; each 1 mg increase in lycopene consumption was associated with a 5 % (95 % CI 0·91, 0·99; Pfor trend = 0·020) decrease in GDM risk. No significant association was found between α-carotene, β-carotene, β-cryptoxanthin, lutein/zeaxanthin intake and GDM risk. Multiple linear regression analysis suggested an inverse association between lycopene intake and fasting blood glucose (FBG) (Pfor trend < 0·001); each 1 mg increase in lycopene intake was associated with 0·005 (95 % CI 0·002, 0·007; Pfor trend < 0·001) mmol/l decrease in FBG. Interaction analysis indicated consistent effect on each age or pre-BMI subgroup; however, a stronger protective effect of lycopene intake against GDM was observed among primigravid women (OR 0·20; 95 % CI 0·07, 0·55 in the highest v. the lowest quartile of intake; Pfor interaction = 0·036). In conclusion, dietary lycopene intake was mainly assumed via reducing FBG to decrease GDM risk, and the protection was relatively increased among primigravid women.
In order to increase the speed, precision and robustness against the engine failure in solving optimal endo-atmospheric ascent trajectory of a launch vehicle, a rapid multi-layer solving method with improved numerical algorithms was proposed. The proposed method is capable of decomposing a large number of intervals into multiple layers with advantageous convergence property. Firstly, the problem of solving optimal endo-atmospheric ascent trajectory, which was subjected to path constraints and terminal constraints, was transformed into a Hamilton Two Point Boundary Value Problem (TPBVP). Then, through the finite difference method and numerical solving algorithm, the Hamilton TPBVP was iteratively solved with fewer initial discrete intervals. The initial values of higher-layer iterations were obtained by interpolating convergent solutions at sparse nodes into the doubly discrete nodes of high layers. The process was repeatedly performed until the solving precision met the requirements. To decrease the calculation load in solving TPBVPs, two improved solving algorithms without and with fewer Jacobian calculations were studied, respectively the Derivative-free Spectral Algorithm for Nonlinear Equations(DF-SANE) combined with the improved derivative-free nonmonotone line search strategy, and the Modified Newton method with a relaxation factor in combination with the Inverse Broyden Quasi-Newton method, denoted as ‘MN-IBQ’. Simulation verifications showed that the multi-layer method had significantly higher solving speed than the single-layer method. For the improved numerical algorithms, the DF-SANE was trapped in the local convergence problem. While using the proposed MN-IBQ can further increase the solving rate. Typical engine failure simulations showed that the multi-layer method with the MN-IBQ algorithm had not only significantly higher solving speed but also stronger robustness, where the traditional single-layer method could not adapt. In addition, the thrust loss tolerance limits for the multi-layer solving method were given for different engine failure times. The results show promising potential of the proposed approach in trajectory online generation and closed-loop guidance of launch vehicles at the endo-atmospheric ascent stage.
Cordierite foams were prepared by thermo-foaming of alumina–microsilica–talc powder dispersions in molten D-glucose anhydrous followed by reaction sintering at 1400 °C, which exhibited an interconnected cellular morphology and three-dimensional porous cell walls. The cordierite foam had a porosity of up to 96%, and its corresponding thermal conductivity was as low as 0.057 W/(m·K). The foam structures showed a great promise for gas filtration and gas catalytic support. The formation of interconnected cellular morphology, the variations of cell wall thickness, and cell size were explained from the perspective of viscosity and weak points in this paper. The linear shrinkage of cordierite foams having a density of 0.102–0.226 g/cm3 was in the range of 13.0–6.9%. And the compressive strength (0.05–0.28 MPa) was determined by the large cell size (1.1–1.3 mm), ultra-high porosity (91–96%), and characteristic of cordierite.
The development of reliable, yet computationally efficient interatomic forcefields is key to facilitate the modeling of glasses. However, the parameterization of novel forcefields is challenging as the high number of parameters renders traditional optimization methods inefficient or subject to bias. Here, we present a new parameterization method based on machine learning, which combines ab initio molecular dynamics simulations and Bayesian optimization. By taking the example of glassy silica, we show that our method yields a new interatomic forcefield that offers an unprecedented agreement with ab initio simulations. This method offers a new route to efficiently parameterize new interatomic forcefields for disordered solids in a non-biased fashion.
Childhood maltreatment (CM) plays an important role in the development of major depressive disorder (MDD). The aim of this study was to examine whether CM severity and type are associated with MDD-related brain alterations, and how they interact with sex and age.
Within the ENIGMA-MDD network, severity and subtypes of CM using the Childhood Trauma Questionnaire were assessed and structural magnetic resonance imaging data from patients with MDD and healthy controls were analyzed in a mega-analysis comprising a total of 3872 participants aged between 13 and 89 years. Cortical thickness and surface area were extracted at each site using FreeSurfer.
CM severity was associated with reduced cortical thickness in the banks of the superior temporal sulcus and supramarginal gyrus as well as with reduced surface area of the middle temporal lobe. Participants reporting both childhood neglect and abuse had a lower cortical thickness in the inferior parietal lobe, middle temporal lobe, and precuneus compared to participants not exposed to CM. In males only, regardless of diagnosis, CM severity was associated with higher cortical thickness of the rostral anterior cingulate cortex. Finally, a significant interaction between CM and age in predicting thickness was seen across several prefrontal, temporal, and temporo-parietal regions.
Severity and type of CM may impact cortical thickness and surface area. Importantly, CM may influence age-dependent brain maturation, particularly in regions related to the default mode network, perception, and theory of mind.
Antenna-pattern measurements obtained from a double-metal supra-terahertz-frequency (supra-THz) quantum cascade laser (QCL) are presented. The QCL is mounted within a mechanically micro-machined waveguide cavity containing dual diagonal feedhorns. Operating in continuous-wave mode at 3.5 THz, and at an ambient temperature of ~60 K, QCL emission has been directed via the feedhorns to a supra-THz detector mounted on a multi-axis linear scanner. Comparison of simulated and measured far-field antenna patterns shows an excellent degree of correlation between beamwidth (full-width-half-maximum) and sidelobe content and a very substantial improvement when compared with unmounted devices. Additionally, a single output has been used to successfully illuminate and demonstrate an optical breadboard arrangement associated with a future supra-THz Earth observation space-borne payload. Our novel device has therefore provided a valuable demonstration of the effectiveness of supra-THz diagonal feedhorns and QCL devices for future space-borne ultra-high-frequency Earth-observing heterodyne radiometers.
BeiDou signals are modulated with a Neumann-Hofman (NH) code of 1 kbps. The frequent bit transitions lead to a sensitivity attenuation of classic acquisition algorithms. In order to increase acquisition sensitivity for weak BeiDou signals, a novel algorithm based on modified zero-padding and differential correlation is proposed. First, a zero-padding method is used to weaken the effect of NH code. Second, the differential coherent delay time is modified to 20 ms to remove the influence of data bit transitions. The integration time is extended to 10 ms to increase acquisition sensitivity. Finally, Monte Carlo simulations and real data tests are conducted to analyse the performance of the proposed algorithm. Simulated results show that the proposed acquisition algorithm outperforms traditional algorithms under a Carrier-to-Noise ratio (C/N0s) of 20~38 dB-Hz. The sensitivity of the proposed algorithm is about 10dB higher than traditional 6 ms repeated search algorithms. Real data test results show that the proposed algorithm outperforms the traditional method with weak signals. This algorithm can remove the effect of NH code and effectively increase the acquisition sensitivity. The proposed algorithm is suitable for acquisition of weak BeiDou signals.