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Guangxi, a province in southwestern China, has the second highest reported number of HIV/AIDS cases in China. This study aimed to develop an accurate and effective model to describe the tendency of HIV and to predict its incidence in Guangxi. HIV incidence data of Guangxi from 2005 to 2016 were obtained from the database of the Chinese Center for Disease Control and Prevention. Long short-term memory (LSTM) neural network models, autoregressive integrated moving average (ARIMA) models, generalised regression neural network (GRNN) models and exponential smoothing (ES) were used to fit the incidence data. Data from 2015 and 2016 were used to validate the most suitable models. The model performances were evaluated by evaluating metrics, including mean square error (MSE), root mean square error, mean absolute error and mean absolute percentage error. The LSTM model had the lowest MSE when the N value (time step) was 12. The most appropriate ARIMA models for incidence in 2015 and 2016 were ARIMA (1, 1, 2) (0, 1, 2)12 and ARIMA (2, 1, 0) (1, 1, 2)12, respectively. The accuracy of GRNN and ES models in forecasting HIV incidence in Guangxi was relatively poor. Four performance metrics of the LSTM model were all lower than the ARIMA, GRNN and ES models. The LSTM model was more effective than other time-series models and is important for the monitoring and control of local HIV epidemics.
Inappropriate use of antibiotics is contributing to a serious antimicrobial resistance problem in Asian hospitals. Despite resource constraints in the region, all Asian hospitals should implement antimicrobial stewardship (AMS) programs to optimize antibiotic treatment, improve patient outcomes, and minimize antimicrobial resistance. This document describes a consensus statement from a panel of regional experts to help multidisciplinary AMS teams design programs that suit the needs and resources of their hospitals. In general, AMS teams must decide on appropriate interventions (eg, prospective audit and/or formulary restriction) for their hospital, focusing on the most misused antibiotics and problematic multidrug-resistant organisms. This focus is likely to include carbapenem use with the goal to reduce carbapenem-resistant gram-negative bacteria. Rather than initially trying to introduce a comprehensive, hospital-wide AMS program, it would be practical to begin by pilot testing a simple program based on 1 achievable core intervention for the hospital. AMS team members must work together to determine the most suitable AMS interventions to implement in their hospitals and how best to put them into practice. Continuous monitoring and feedback of outcomes to the AMS teams, hospital administration, and prescribers will enhance sustainability of the AMS programs.
Due to the lack of basic information on water required by maize (Zea mays L.) in Brazil, the large amount of water applied usually exceeds crop requirements, wasting water and energy. In this study, we measured crop evapotranspiration (ETc) as evaporative heat flux from a centre pivot-irrigated maize plantation in Southern Brazil during winter and summer seasons, using the Bowen ratio method to evaluate how the degree of canopy-atmosphere coupling affects crop water needs and irrigation management. Irrigation requirements were determined by comparing ETc with reference evapotranspiration (ETo), derived from the Penman–Monteith equation and expressed as the ETc/ETo (Kc) ratio. In this study, the average Kc values obtained were 1.31 and 0.90 for the winter and summer, respectively. Using aerodynamic and canopy resistance measurements, the decoupling factor (Ω) was computed. Ω values tending to zero (0.09 and 0.20 for winter and summer, respectively) showed that strong coupling of maize plants to the atmosphere and sensitivity to high air temperatures, vapour pressure deficits and wind speed caused variations in Kc in relation to ETo ranges. During the experimental period, the Kc value ranged from 0.92 when the ETo exceeded 4 mm d−1 to 1.64 when the ETo was less than 2 mm d−1.
Nighttime eating is often associated with a negative impact on weight management and cardiometabolic health. However, data from recent acute metabolic studies have implicated a benefit of ingesting a bedtime snack for weight management. The present study compared the impact of ingesting a milk snack containing either 10 (BS10) or 30 g (BS30) protein with a non-energetic placebo (BS0) 30 min before bedtime on next morning metabolism, appetite and energy intake in mildly overweight males (age: 24·3 (sem 0·8) years; BMI: 27·4 (sem 1·1) kg/m2). Next morning measurements of RMR, appetite and energy intake were measured using indirect calorimetry, visual analogue scales and an ad libitum breakfast, respectively. Bedtime milk ingestion did not alter next morning RMR (BS0: 7822 (sem 276) kJ/d, BS10: 7482 (sem 262) kJ/d, BS30: 7851 (sem 261) kJ/d, P=0·19) or substrate utilisation as measured by RER (P=0·64). Bedtime milk ingestion reduced hunger (P=0·01) and increased fullness (P=0·04) during the evening immediately after snack ingestion, but elicited no effect the next morning. Next morning breakfast (BS0: 2187 (sem 365) kJ, BS10: 2070 (sem 336) kJ, BS30: 2582 (sem 384) kJ, P=0·21) and 24 h post-trial (P=0·95) energy intake was similar between conditions. To conclude, in mildly overweight adults, compared with a non-energetic placebo, a bedtime milk snack containing 10 or 30 g of protein does not confer changes in next morning whole-body metabolism and appetite that may favour weight management.
Neural mass models are ubiquitous in large-scale brain modelling. At the node level, they are written in terms of a set of ordinary differential equations with a non-linearity that is typically a sigmoidal shape. Using structural data from brain atlases, they may be connected into a network to investigate the emergence of functional dynamic states, such as synchrony. With the simple restriction of the classic sigmoidal non-linearity to a piecewise linear caricature, we show that the famous Wilson–Cowan neural mass model can be explicitly analysed at both the node and network level. The construction of periodic orbits at the node level is achieved by patching together matrix exponential solutions, and stability is determined using Floquet theory. For networks with interactions described by circulant matrices, we show that the stability of the synchronous state can be determined in terms of a low-dimensional Floquet problem parameterised by the eigenvalues of the interaction matrix. Moreover, this network Floquet problem is readily solved using linear algebra to predict the onset of spatio-temporal network patterns arising from a synchronous instability. We further consider the case of a discontinuous choice for the node non-linearity, namely the replacement of the sigmoid by a Heaviside non-linearity. This gives rise to a continuous-time switching network. At the node level, this allows for the existence of unstable sliding periodic orbits, which we explicitly construct. The stability of a periodic orbit is now treated with a modification of Floquet theory to treat the evolution of small perturbations through switching manifolds via the use of saltation matrices. At the network level, the stability analysis of the synchronous state is considerably more challenging. Here, we report on the use of ideas originally developed for the study of Glass networks to treat the stability of periodic network states in neural mass models with discontinuous interactions.
The aims of this study were to replicate previously published experiments and to modify the protocol to detect the effects of chronic antidepressant treatment in mice.
Male Swiss mice (n=6–8/group) housed in reversed light/dark cycle were randomly assigned into receive vehicle (10% sucrose), sub-effective doses (1 and 3 mg/kg) or effective doses (10 and 30 mg/kg) of bupropion, desipramine, and fluoxetine and a candidate antidepressant, sodium butyrate (1–30 mg/kg) per gavage (p.o.) 1 h before the forced swim test (FST). Treatments continued daily for 7 and 14 days during retests 1 and 2, respectively. In an additional experiment, mice received fluoxetine (20 mg/kg) or vehicle (10% sucrose or 0.9% saline) p.o. or i.p. before the FST. Mice housed in reversed or standard light/dark cycles received fluoxetine (20 mg/kg) prior FST. Video recordings of behavioural testing were used for blind assessment of the outcomes.
According to the expected, doses of antidepressants considered sub-effective failed to affect the immobility time of mice in the FST. Surprisingly, acute and chronic treatment with the high doses of bupropion, desipramine, and fluoxetine or sodium butyrate also failed to reduce the immobility time of mice in the FST. Fluoxetine 20 mg/kg was also ineffective in the FST when injected i.p. or in mice housed in normal light/dark cycle.
Data suggest the lack of efficacy of orally administered bupropion, desipramine, fluoxetine in the FST in Swiss mice. High variability, due to high and low immobility mice, may explain the limited effects of the treatments.
Functional near-infrared spectroscopy (fNIRS) has been used in healthcare and medical research for the past two decades. In particular, the use of fNIRS in academic and clinical psychiatry has increased rapidly owing to its advantages over other neuroimaging modalities. fNIRS is a tool that can potentially supplement clinical interviews and mental state examinations to establish a psychiatric diagnosis and monitor treatment progress. This article provides a review of the theoretical background of fNIRS, key principles of its applications in psychiatry and its limitations, and shares a vision of its future applicability in psychiatric research and clinical practice.
• Understand the theoretical background, mechanism of action and clinical applications of fNIRS and compare it to other neuroimaging modalities
• Understand the use of fNIRS in academic and clinical psychiatry through current research findings
• Be able to evaluate the future potential of fNIRS and formulate new ideas for using fNIRS in academic and clinical psychiatry
In this chapter, we assess the core empirical predictions developed in Chapter 5 – namely, that public participation in policy formulation contributes to less contentious and more effective policy outcomes. Previous work has hinted at such predictions but has forgone testing them empirically due to the difficulty of measuring participation and policy outcomes. Determined to create such measures, we combed through government websites, almanacs, and national archives for records of participatory activity. Specifically, we focus on public consultation, a form of participation that allows members of the public to critique government policies in a less confrontational manner. Armed with original data on public consultation, we looked for effects on mass contestation, popular grievances, and policy compliance contained in official reports and yearbooks. Comparing across provinces and over time, we show that higher rates of consultation are associated with less contestation and greater compliance. Focusing on labor policy, we find that more consultation is associated with fewer labor disputes. With regard to environmental policy, we find little support for the claim that consultation improves implementation, although we do find evidence that provinces with denser civil society networks and higher rates of consultation perform better in wastewater management. These findings are the first step in clarifying the opaque role of public participation in China’s unique model of authoritarian governance.
Beyond the headline findings, five additional themes emerged from our research. First, Chinese governance reforms must be understood on their own terms and in the context of the Chinese policymaking process. Second, Chinese reforms were only partially successful. Many were not fully implemented or failed to achieve the full extent of the outcomes envisioned for them. Third, there is no single Chinese model; approaches to governance varied widely over time and across Chinese provinces. Fourth, reforms were most successful when accompanied by other reform initiatives. Fifth, Chinese governance reforms were intentionally not embedded in permanent and self-reinforcing institutions. After reviewing these themes, we reflect on the implications of our research for the future of the Chinese regime. Our analysis draws from the burgeoning literatures on authoritarian institutions, regime transition, and democratization. We offer the provocative perspective that these reforms may pave the way for successful democratization in two respects. First, the legacy of a high-quality bureaucracy and strong governance has been shown to influence the success of democratic transitions. Second, enhanced legitimacy may enable the Chinese Communist Party (CCP), like other single-party regime, to concede from a position of strength – allowing multiparty competition because it believes it can win in a free and fair contest.
China is widely viewed as a global powerhouse that has achieved a remarkable economic transformation with little political change. Less well known is that China's leaders have also implemented far‐reaching governance reforms designed to promote government transparency and increase public participation in official policymaking. What are the motivations behind these reforms and, more importantly, what impact are they having? This puzzle lies at the heart of Chinese politics and could dictate China's political trajectory for years to come. This extensive collaborative study not only documents the origins and scope of these reforms across China, but offers the first systematic assessment by quantitatively and qualitatively analyzing the impact of participation and transparency on important governance outcomes. Comparing across provinces and over time, the authors argue that the reforms are resulting in lower corruption and enhanced legal compliance, but these outcomes also depend on a broader societal ecosystem that includes an active media and robust civil society.
The final chapter on public decision-making extends our empirical inquiry into China’s consultative decision-making process by addressing selection biases and mapping causal mechanisms. By comparing three provinces, each with varying capacity and resources for dealing with policy challenges, we clarify the conditions under which Chinese policymakers rely on public consultation as well as the conditions under which consultation contributes to more effective policy choices. Looking closely at Sichuan, Jiangsu, and Chongqing we find that public participation is tool of necessity, not convenience. That is, policymakers turn to consultation when faced with the sort of policy challenges for which traditional top-down authority is ill-equipped to deal with. For example, policymakers in both Sichuan and Jiangsu experimented with consultation to resolve labor and environmental policy challenges resulting from mass privatization and disasters, both natural and man-made. By contrast, Chongqing’s municipal authorities relied on large public expenditures and propaganda to win over public opinion.
The final chapter in our study of transparency and corruption examines the causal pathway through case studies of two Chinese localities. In the early 2000s, the well-known leaders of Guangdong and Chongqing pioneered sharply contrasting methods for economic reform and anticorruption. Through archival research and first person interviews, we look at how Guangzhou, the capital of Guangdong, adopted OGI policies early and was consequently more successful at limiting abuses of authority. In sharp contrast, we show how the state-led, aggressive approach of Chongqing ultimately foundered due to its inability to properly police the guardians.