To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
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.
North-east China occupies an important geographic position for understanding the process of Neolithisation in East Asia. Although archaeologists have long debated the trajectory of change in this region, a lack of intensive survey and excavation has precluded convincing interpretations. This article presents research on the newly excavated sites of Huayang and Taoshan in the southern Lesser Khingan Mountains, with a particular focus on the lithic assemblages. Comparative and environmental analyses demonstrate the largely uniform trajectory of lithic technologies across north-east China and close correspondence with Late Glacial palaeoclimatic and palaeoenvironmental changes.
In order to reveal the quantitative relationship between fatigue crack deflection path and cross-sectional grain boundary (GB) arrangement of metallic nanolayered composites (NLCs), a stochastic model was established based on the interface-dominant fatigue damage for the ultrafine-scale NLCs. The model indicates that the crack deflection length decreases with decreasing GB arrangement deviation and grain size of constituent layers. The observation and quantitative analysis of fatigue cracking behavior of the Cu/W multilayers with a layer thickness of 5 and 20 nm was conducted to verify the model.
Schizophrenia is a complex mental disorder with high heritability and polygenic inheritance. Multimodal neuroimaging studies have also indicated that abnormalities of brain structure and function are a plausible neurobiological characterisation of schizophrenia. However, the polygenic effects of schizophrenia on these imaging endophenotypes have not yet been fully elucidated.
To investigate the effects of polygenic risk for schizophrenia on the brain grey matter volume and functional connectivity, which are disrupted in schizophrenia.
Genomic and neuroimaging data from a large sample of Han Chinese patients with schizophrenia (N = 509) and healthy controls (N = 502) were included in this study. We examined grey matter volume and functional connectivity via structural and functional magnetic resonance imaging, respectively. Using the data from a recent meta-analysis of a genome-wide association study that comprised a large number of Chinese people, we calculated a polygenic risk score (PGRS) for each participant.
The imaging genetic analysis revealed that the individual PGRS showed a significantly negative correlation with the hippocampal grey matter volume and hippocampus–medial prefrontal cortex functional connectivity, both of which were lower in the people with schizophrenia than in the controls. We also found that the observed neuroimaging measures showed weak but similar changes in unaffected first-degree relatives of patients with schizophrenia.
These findings suggested that genetically influenced brain grey matter volume and functional connectivity may provide important clues for understanding the pathological mechanisms of schizophrenia and for the early diagnosis of schizophrenia.
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.
Paediatric Mycoplasma pneumoniae pneumonia (MPP) is a major cause of community-acquired pneumonia in China. Data on epidemiology of paediatric MPP from China are little known. This study retrospectively collected data from June 2006 to June 2016 in Beijing Children's Hospital, Capital Medical University of North China and aims to explore the epidemiological features of paediatric MPP and severe MPP (SMPP) in North China during the past 10 years. A total of 27 498 paediatric patients with pneumonia were enrolled. Among them, 37.5% of paediatric patients had MPP. In this area, an epidemic took place every 2–3 years at the peak, and the positive rate of MPP increased during these peak years over time. The peak age of MPP was between the ages of 6 and 10 years, accounting for 75.2%, significantly more compared with other age groups (χ2 = 1384.1, P < 0.0001). The epidemics peaked in September, October and November (χ2 = 904.9, P < 0.0001). Additionally, 13.0% of MPP paediatric patients were SMPP, but over time, the rate of SMPP increased, reaching 42.6% in 2016. The mean age of paediatric patients with SMPP (6.7 ± 3.0 years old) was younger than that of patients with non-SMPP (7.4 ± 3.2 years old) (t = 3.60, P = 0.0001). The prevalence of MPP and SMPP is common in China, especially in children from 6 to 10 years old. Paediatric patients with SMPP tend to be younger than those with non-SMPP. MPP outbreaks occur every 2–3 years in North China. September, October and November are the peak months, unlike in South China. Understanding the epidemiological characteristics of paediatric MPP can contribute to timely treatment and diagnosis, and may improve the prognosis of children with SMPP.
Addition of carbon nanotubes (CNTs) to copper materials significantly enhances their properties. However, the performance of CNTs/Cu composites is often not as good as expected mainly because of difficulties in controlling growth and uniform dispersion of CNTs in the matrix. Our study provides an effective way to prepare CNTs/CuCr and CNTs/CuCrY composites using chemical vapor deposition. The morphology and structure of these composites were characterized by scanning electron microscope, X-ray diffraction, X-ray photoelectron spectroscopy, and Raman spectroscopy to understand how Y incorporation affects properties of these composites. Our results showed that addition of 0.1 wt% Y enhances the catalytic properties of Cr and helps to obtain purer and pristine Cu substrate. We also studied tensile strength, electric conductivity, corrosion, and wear resistance of these composites. When Y was added, composite properties improved significantly. Tensile strength and corrosion resistance increased by 35.21 and 53.28%, respectively. Electric conductivity increased to 90.9% International Annealed Copper Standard and the coefficient of friction reduced to 0.3.
The language history questionnaire (LHQ) is an important tool for assessing the linguistic background and language proficiency of multilinguals or second language learners. Previously we developed a generic LHQ based on the most commonly asked questions in published studies (Li, Sepanski & Zhao, 2006) and provided a web-based interface (LHQ 2.0) that has flexibility in functionality, accuracy in data recording, and privacy for users and data (Li, Zhang, Tsai & Puls, 2014). LHQ3 (version 3) introduces new functions, developed in response to many comments/requests from users. One important improvement is the addition of an automatic scoring system, in that the new interface automatically calculates aggregated scores for language proficiency, language dominance, and language immersion levels. Finally, LHQ3 allows researchers to assign different weights to the modules when calculating the aggregated scores, addressing the issue of different focuses that different researchers put on multilingual speakers’ language usage and background.
A cost-effective fabrication method to engineer metamaterial structures with micrometersize features and novel mechanical properties, which are suitable for terahertz applications, is reported herein. The effective metamaterial parameter extraction procedure is employed with the Kramers-Kronig relation to analyze the effective parameters of single- and multilayer metamaterial structures.
FM-to-AM (frequency modulation-to-amplitude modulation) conversion caused by nonuniform spectral transmission of broadband beam is harmful to high-power laser facility. Smoothing by spectral dispersion (SSD) beam is a special broadband beam for its monochromatic feature at the given time and space on the near field. The traditional method which uses the optical spectral transfer function as filters cannot accurately describe its AM characteristics. This paper presents the theoretical analysis of the etalon effect for SSD beam. With a low-order approximation, the analytic model of the temporal shape of SSD beam is obtained for the first time, which gives the detailed AM characteristics at local and integral aspects, such as the variation of ripples width and amplitude in general situation. We also analyze the FM-to-AM conversion on the focal plane; in the focusing process, the lens simply acts as an integrator to smooth the AM of SSD beam. Because AM control is necessary for the near field to avoid optics damage and for the far field to ensure an optimal interaction of laser–target, our investigations could provide some important phenomena and rules for pulse shape control.
Toxigenic Clostridium difficile (C. difficile) carriers represent an important source in the transmission of C. difficile infection (CDI) during hospitalisation, but its prevalence and mode in patients with hepatic cirrhosis are not well established. We investigated longitudinal changes in carriage rates and strain types of toxigenic C. difficile from admission to discharge among hepatic cirrhosis patients. Toxigenic C. difficile was detected in 104 (19.8%) of 526 hepatic cirrhosis patients on admission, and the carriage status changed in a portion of patients during hospitalisation. Approximately 56% (58/104) of patients lost the colonisation during their hospital stay. Among the remaining 48 patients who remained positive for toxigenic C. difficile, the numbers of patients who were positive at one, two, three and four isolations were 10 (55.6%), three (16.7%), two (11.1%) and three (16.7%), respectively. Twenty-eight patients retained a particular monophyletic strain at multiple isolations. The genotype most frequently identified was the same as that frequently identified in symptomatic CDI patients. A total of 25% (26/104) of patients were diagnosed with CDI during their hospital stay. Conclusions: Colonisation with toxigenic C. difficile strains occurs frequently in cirrhosis patients and is a risk factor for CDI.
Compared with commercial polyolefin membranes, polyacrylonitrile (PAN) membrane prepared by electrostatic spinning has higher porosity, electrolyte uptake, thermal stability, and lithium-ion conductivity, etc. However, poor mechanical performance has largely limited the application of electrospun PAN separators. In this study, PAN/polyimide (PI) composite membrane is prepared by electrostatic spinning to improve the mechanical and electrochemical performances. Scanning electron microscopy, thermal analysis method, and electrochemical methods were used for evaluation of the electrospun composite membrane. The results show that the composite membrane possesses good thermal stability and exhibits better mechanical performance than pristine PAN membrane (increasing by 1.1 times in tension strength). The addition of PI can increase porosity and fluid absorption rate obviously. In addition, the composite membrane has high ionic conductivity (18.77 × 10−4 S/cm), wide electrochemical window (about 4.0 V), and excellent cycling performance. It can retain a discharge specific capacity of 153 mA h/g even after 50 cycles at 0.5 C. The electrospun PAN/PI membrane may be a promising candidate for lithium-ion battery separators.
In this paper, we reported both the experimental demonstration and theoretical analysis of a Raman fiber laser based on a master oscillator–power amplifier configuration. The Raman fiber laser adopted the dual-wavelength bidirectional pumping configuration, utilizing 976 nm laser diodes and 1018 nm fiber lasers as the pump sources. A 60-m-long
ytterbium-doped fiber was used to convert the power from 1070 to 1124 nm, realizing a maximum power output of 3.7 kW with a 3 dB spectral width of 6.8 nm. Moreover, we developed a multi-frequency model taking into consideration the Raman gain spectrum and amplified spontaneous emission. The calculated spectral broadening of both the forward and backward laser was in good agreement with the experimental results. Finally, a 1.5 kW, 1183 nm second-order Raman fiber laser was further experimentally demonstrated by the addition of a 70-m-long germanium-doped passive fiber.
M3:2 high-speed steel (HSS) billets with or without Nb addition were prepared by spray deposition. The effects of Nb and post-thermal-mechanical processing (decomposition treatment and hot forging), as well as heat treatment, on the microstructure and properties of M3:2 HSS were investigated. The microstructure of the as-deposited M3:2 HSS consisted of equiaxed grains with a mean size of approximately 25 μm and discontinuous plate-like M2C and irregular MC carbides distributed along grain boundaries. 0.5% Nb addition can refine the M2C plates and spheroidize MC carbides. With 2% Nb addition, the refined grains with a mean size of approximately 12 μm and continuous net of M6C and a uniform distribution of NbC carbides were obtained. The decomposition of metastable M2C carbides can be accelerated with 0.5% Nb addition due to the refined size and lower thermodynamic stability of M2C plates. With the increased degree of decomposition of M2C carbide, the M6C and MC carbides became refined and more uniformly distributed after optimal thermal-mechanical processing and heat treatment, which leads to a significant increase in bend strength and toughness.
Research suggests an association between metabolic disorders, such as type 2 diabetes mellitus (T2DM), and schizophrenia. However, the risk of metabolic disorders in the unaffected siblings of patients with schizophrenia remains unclear.
Using the Taiwan National Health Insurance Research Database, 3135 unaffected siblings of schizophrenia probands and 12,540 age-/sex-matched control subjects were included and followed up to the end of 2011. Individuals who developed metabolic disorders during the follow-up period were identified.
The unaffected siblings of schizophrenia probands had a higher prevalence of T2DM (3.4% vs. 2.6%, p = 0.010) than the controls. Logistic regression analyses with the adjustment of demographic data revealed that the unaffected siblings of patients with schizophrenia were more likely to develop T2DM (odds ratio [OR]: 1.39, 95% confidence interval [CI]: 1.10–1.75) later in life compared with the control group. Moreover, only female siblings of schizophrenia probands had an increased risk of hypertension (OR: 1.47, 95% CI: 1.07–2.01) during the follow-up compared with the controls.
The unaffected siblings, especially sisters, of schizophrenia probands had a higher prevalence of T2DM and hypertension compared with the controls. Our study revealed a familial link between schizophrenia and T2DM in a large sample. Additional studies are required to investigate the shared pathophysiology of schizophrenia and T2DM.
In this paper, we consider optimal components grouping in series–parallel and parallel–series systems composed of k subsystems. All components in each subsystem are drawn from a heterogeneous population consisting of m different subpopulations. Firstly, we show that when one allocation vector is majorized by another one, then the series–parallel (parallel–series) system corresponding to the first (second) vector is more reliable than that of the other. Secondly, we study the impact of changes in the number of subsystems on the system reliability. Finally, we study the influence of the selection probabilities of subpopulations on the system reliability.
In this paper, we review the status of the multifunctional experimental platform at the National Laboratory of High Power Laser and Physics (NLHPLP). The platform, including the SG-II laser facility, SG-II 9th beam, SG-II upgrade (SG-II UP) facility, and SG-II 5 PW facility, is operational and available for interested scientists studying inertial confinement fusion (ICF) and a broad range of high-energy-density physics. These facilities can provide important experimental capabilities by combining different pulse widths of nanosecond, picosecond, and femtosecond scales. In addition, the SG-II UP facility, consisting of a single petawatt system and an eight-beam nanosecond system, is introduced including several laser technologies that have been developed to ensure the performance of the facility. Recent developments of the SG-II 5 PW facility are also presented.