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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.
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.
To estimate changes in taxed and untaxed beverages by volume of beverage purchased after a sugar-sweetened beverage (SSB) tax was introduced in 2014 in Mexico.
We used household purchase data from January 2012 to December 2015. We first classified the sample into four groups based on pre-tax purchases of beverages: (i) higher purchases of taxed beverages and lower purchases of untaxed beverages (HTLU-unhealthier); (ii) higher purchases of both types of beverages (HTHU); (iii) lower purchases of taxed and untaxed beverages (LTLU); and (iv) lower purchases of taxed beverages and higher purchases of untaxed beverages (LTHU-healthier). Next, we estimated differences in purchases after the tax was implemented for each group compared with a counterfactual based on pre-tax trends using a fixed-effects model.
Areas with more than 50 000 residents in Mexico.
Households (n 6089).
The HTLU-unhealthier and HTHU groups had the largest absolute and relative reductions in taxed beverages and increased their purchases of untaxed beverages. Households with lower purchases of untaxed beverages (HTLU-unhealthier and LTLU) had the largest absolute and relative increases in untaxed beverages. We also found that among households with higher purchases of taxed beverages, the group with lowest socio-economic status had the greatest reduction in purchases of taxed beverages.
Evidence associating the SSB tax with larger reductions among high purchasers of taxed beverages prior to the tax is relevant, as higher SSB purchasers have a greater risk of obesity, diabetes and other cardiometabolic outcomes.
(i) To determine the current state of online grocery shopping, including individuals’ motivations for shopping for groceries online and types of foods purchased; and (ii) to identify the potential promise and pitfalls that online grocery shopping may offer in relation to food and beverage purchases.
PubMed, ABI/INFORM and Google Scholar were searched to identify published research.
To be included, studies must have been published between 2007 and 2017 in English, based in the USA or Europe (including the UK), and focused on: (i) motivations for online grocery shopping; (ii) the cognitive/psychosocial domain; and (iii) the community or neighbourhood food environment domain.
Our search yielded twenty-four relevant papers.
Findings indicate that online grocery shopping can be a double-edged sword. While it has the potential to increase healthy choices via reduced unhealthy impulse purchases, nutrition labelling strategies, and as a method to overcome food access limitations among individuals with limited access to a brick-and-mortar store, it also has the potential to increase unhealthy choices due to reasons such as consumers’ hesitance to purchase fresh produce online.
Additional research is needed to determine the most effective ways to positively engage customers to use online grocery shopping to make healthier choices.
Sedative–hypnotic medication use has been related to severe adverse events and risks. This study investigated the prevalence of and characteristics associated with the use of sedatives and hypnotics among community-dwelling elderly persons aged 65 years and over in Taiwan.
A representative sample of community-dwelling adults was recruited. Clinical and sociodemographic data were collected for assessing physical, mental, and cognitive functioning and disorders. Sedatives and hypnotics use was determined via both self-reporting and prescription records. Logistic regression modeling was used to evaluate associations between sedative–hypnotic use and demographic and health status.
Among the 3,978 participants aged 65 years and over, the rate of sedative–hypnotic use was 19.7% (n = 785). 4.5% (n = 35) of users reported sedative–hypnotic use without a doctor's prescription. Several sociodemographic characteristics were positively associated with sedative and hypnotic use, including older age, female gender, higher education level, married status, unemployment, and current alcohol consumption. Comorbid chronic and cardiovascular diseases, mental illness, depression, pain, and sleep problems also increased the likelihood of sedative–hypnotic use.
This study is one of the largest pioneer studies to date to survey sedatives–hypnotics use among community-dwelling elderly. One in five community-dwelling older adults reported sedative–hypnotic drugs use in Taiwan, and about 5% of sedative and/or hypnotics usage was without a doctor's prescription. Findings could be helpful for drug-use safety interventions to identify target geriatric patients who are in general at higher risk of downstream harm associated with sedative–hypnotic use in geriatric patients.
Background: Among patients with schizophrenia, there is evidence of a negative association between self-stigma and subjective quality of life (SQoL), and self-esteem was an important mediator in the association. We attempted to use a longitudinal study to investigate the aforementioned mediation on a sample with schizophrenia. Methods: We used longitudinal data retrieved from medical records of a psychiatric centre between June 2014 and December 2015. In the data, we retrieved information of self-stigma using the Self-Stigma Scale — Short; SQoL, using the WHO questionnaire on the Quality of Life — Short Form; and self-esteem, using the Rosenberg Self-Esteem Scale. All the measures were evaluated five times. Linear mixed-effect models accompanied by Sobel tests were used to tackle the mediating effects. Results: Data from 74 patients (57 males) with schizophrenia were eligible for analysis; their mean (SD) age was 39.53 (10.67); mean age of onset was 22.95 (8.38). Self-esteem was a mediator for patients in physical (p = .039), psychological (p = .003), and social SQoL (p = .004), but not in environment SQoL (p = .051). Conclusion: Based on our findings, mental health professionals could tailor different programs to patients with schizophrenia, such as self-stigma reduction and self-esteem improvement programs. However, treatment as a whole should be sensitive to both self-stigma and self-esteem. Also, we should consider individuals’ health and wellbeing from social perspectives of disability rather than the medical model of disability emphasising symptoms and medications.
This paper is aimed at the risk assessment of operational safety for oil tankers. Based on the operational features of oil tankers and relevant literature, the Risk Factors (RFs) of operational safety were first identified. A revised risk matrix based on a fuzzy Analytical Hierarchy Process (AHP) approach was then proposed to assess the risk classes of the RFs. Finally, to validate the research model, the oil tanker fleet of Chinese Petroleum Corporation (CPC) in Taiwan was empirically investigated. The results can provide practical information for oil carriers to improve their ships' operational safety. Furthermore, the revised risk matrix may provide a theoretical reference for methodological researches in safety risk assessments.
In this paper, we propose a novel and simple technique to construct effective difference schemes for solving systems of singularly perturbed convection-diffusion-reaction equations, whose solutions may display boundary or interior layers. We illustrate the technique by taking the Il'in-Allen-Southwell scheme for 1-D scalar equations as a basis to derive a formally second-order scheme for 1-D coupled systems and then extend the scheme to 2-D case by employing an alternating direction approach. Numerical examples are given to demonstrate the high performance of the obtained scheme on uniform meshes as well as piecewise-uniform Shishkin meshes.
The paper aims to develop an effective preconditioner and conduct the convergence analysis of the corresponding preconditioned GMRES for the solution of discrete problems originating from multi-group radiation diffusion equations. We firstly investigate the performances of the most widely used preconditioners (ILU(k) and AMG) and their combinations (Bco and Bco), and provide drawbacks on their feasibilities. Secondly, we reveal the underlying complementarity of ILU(k) and AMG by analyzing the features suitable for AMG using more detailed measurements on multiscale nature of matrices and the effect of ILU(k) on multiscale nature. Moreover, we present an adaptive combined preconditioner Bcoα involving an improved ILU(0) along with its convergence constraints. Numerical results demonstrate that Bcoα-GMRES holds the best robustness and efficiency. At last, we analyze the convergence of GMRES with combined preconditioning which not only provides a persuasive support for our proposed algorithms, but also updates the existing estimation theory on condition numbers of combined preconditioned systems.
What reasoning rules can be used for the deduction of bisimulation formulas in coalgebraic specifications is problematic because those rules used in algebraic specifications possibly cannot be applied to bisimulation formulas. Although some categorical bisimulation proof methods for coalgebras have been proposed, they are not based on specification languages of coalgebras so that they cannot be used as reasoning rules. In this paper, a specification language based on paths of polynomial functors is proposed to specify polynomial coalgebras. Paths of polynomial functors give detailed observations and transitions on the state space of coalgebras so that the techniques used in transition system specifications can be applied to such a path-based language. In particular, because bisimulations can be characterized by paths, the notions of progressions, respectful functions and faithful contexts can be defined based on paths, and then bisimulation up-to proof techniques, including bisimulation up-to bisimilarities and up-to contexts for transition systems can be transformed into reasoning rules in the language. Several examples illustrate how to reason syntactically about bisimulations in the language by using the rules induced by the bisimulation proof techniques.
This paper is devoted to a new high-accuracy finite difference scheme for solving reaction-convection-diffusion problems with a small diffusivity ε. With a novel treatment for the reaction term, we first derive a difference scheme of accuracy O(εh2+εh2+h3) for the 1-D case. Using the alternating direction technique, we then extend the scheme to the 2-D case on a nine-point stencil. We apply the high-accuracy finite difference scheme to solve the 2-D steady incompressible Navier-Stokes equations in the stream function-vorticity formulation. Numerical examples are given to illustrate the effectiveness of the proposed difference scheme. Comparisons made with some high-order compact difference schemes show that the newly proposed scheme can achieve good accuracy with a better stability.
Polycrystalline Ba8Ga16MgxGe30−x compounds were synthesized by combining solid-state reaction with spark plasma sintering (SPS) method. The structural and electronic properties of Mg-substituted Ge type-I clathrate phase Ba8Ga16MgxGe30−x (x = 1, 2, 3, 4) were investigated experimentally and theoretically. Theoretically structural and electronic properties of Ba8Ga16MgxGe30−x were calculated by first-principles method based on the density-functional theory. The results indicate a strong preference for the occupation of the 6c sites by Mg. It is found that Mg substitution for Ge can lower the melting points and bulk modulus of this system. The formation energies and the binding energies decrease with increasing Mg content, suggesting that the Mg-doped Ba8Ga16Ge30 clathrates are stable in a limited range of composition. The calculated results show that these alloys are all indirect gap semiconductors and the values of band gap increase with the increase of Mg content. All specimens exhibit the behavior of the p-type conduction, which is originated from the presence of a shallow acceptor energy level. The electrical conductivity and the room-temperature carrier mobility decrease with increasing Mg content, while the room-temperature carrier concentration increases with increasing Mg content.
The electrode materials for VRFB should possess higher electric conductivity, corrosion resistance and hydrophilic properties in sulfuric acid. The characteristics of the electrode materials affect the stability and the energy efficiency of VRFB. Carbon materials are the best suited for VRFB applications. In this study, the calcined treatment, acid treatment and ozone treatment were used to modify the surface of carbon papers. The redox reaction of [VO]2+/[VO2]+ on the modified carbon papers was evaluated by cyclic voltammetry (CV). The surface compositions of carbon materials were analyzed by X-ray photoelectron spectrometry (XPS). The experimental results reveal that three oxidative methods enhance the redox reaction of [VO]2+/[VO2]+. The calcined treatments and acid treatments also enhanced hydrolysis reaction. The mole ratio of O/C apparently increased, but the binding energy of C1s and O1s were not chemically shifted in the acid treatment. The intensity of binding energy of O1s, between 532 eV and 534 eV, apparently increased in the ozone and calcined treatments. The Ox treated samples were more hydrophilic than the Oz treated samples. In the Ox treated samples, the decrease of Rct value indicates that was contributed from the redox reaction of [VO]2+/[VO2]+ and hydrolysis reaction. It does not completely benefit the energy efficiency of VRFB. The 5 x 5 cm2 modified carbon papers were used as electrode materials in the VRFB. The voltage efficiency, coulomb efficiency and energy efficiency reached 93 %, 90 % and 83 %, respectively, at a current density of 12 mA．cm-2 at 0.8-1.8 V.
The intensity of pupal diapause in the cotton bollworm, Helicoverpa armigera (Hübner) was investigated under both laboratory and natural conditions. By transferring diapausing pupae induced under LD 11:13, LD 12:12 and LD 13:11 at 20, 22 and 25 °C to 25 °C combined with LD 15:9 to terminate diapause the rearing day length of 11 h evoked greater intensity of diapause than did 12 and 13 h at 25 °C; whereas the rearing temperature of 25 °C evoked more intense diapause than did 20 and 22 °C under LD 11:13. By transferring diapausing pupae induced under LD 12:12 at 20 and 22 °C to six temperatures of 18, 20, 22, 25, 28 and 31 °C combined with LD 15:9 to terminate diapause, the duration of diapause was significantly shortened from 146 days at 18 °C to 24 days at 31 °C, showing that high temperatures significantly accelerate diapause development. Furthermore, the duration of diapause was significantly longer at the rearing temperature of 22 °C than that at 20 °C when the diapause-terminating temperatures were 20 and 22 °C. Chilling at 5 °C did not shorten the duration of diapause but lengthened it when chilling period was included. However, chilling plays an important role in synchronizing adult emergence. Rearing temperature of 22 °C also evoked more intense diapause than did 20 °C in most chilling treatments. When the overwintering pupae were transferred at different times from natural temperatures to 25 °C, it was found that the earlier the transfer took place, the earlier the adults emerged when the time spent under natural conditions was included. However, cool temperatures before March showed an enhanced effect on diapause development at 20 °C, suggesting that the high diapause-terminating temperature can offset the effect of chilling on diapause development. The result of diapause termination under natural conditions suggests that the developmental threshold for post-diapause development in H. armigera should be around 17.5 °C.
The stability of the negative electrode electrolyte affects the efficiency and capacity of energy storage in the vanadium redox flow battery (VRFB) system. To explore the stability of vanadium electrolytes, the study prepared five types of V(II) electrolytes that were exposed to air in a fixed open area and monitored the charge state of vanadium ions over time by UV/Visible spectrophotometer. This study succeeded in preparing pure V(II) electrolytes. Five characteristics are found in the UV/Visible spectra, respectively, during the oxidation process from V(II) electrolytes to V(III) electrolytes and V(III) electrolytes to V(IV) electrolytes. The experimental results show that the oxidation rate of a solution of 1 M V(II) electrolytes to V(III) electrolytes and 1 M V(III) electrolytes to V(IV) electrolytes under an atmosphere of air is 4.79 and 0.0089 mol/h per square meter. The oxidation rates of 0.05-1 M V(II) electrolytes to V(III) electrolytes are approximately 96-538 times than that of V(III) electrolytes to V(IV) electrolytes.
The junction characteristics between ZnO:Ga (GZO) film and p-Si substrate are discussed in the research. For the transparent semiconductor ZnO, the element Ga is chosen to be the dopant source to produce a high quality n-type ZnO thin film. The ZnO:Ga (GZO) film shows a average transmittance is 84.7% (above 400 nm), a bandgap energy of 3.37 eV, a carrier concentration of 7.29×1013 cm−3and a resistivity of 118 Ω-cm. For the GZO/p-Si junction, it shows a junction barrier height of 0.54 eV with an ideality factor of 1.24. The capacitance-voltage measurement shows that it has a uniform reverse bias depletion layer. The Cheung function is also brought to discussion the diode characteristics.
We present new imaging data and archival multiwavelength observations of the little-studied emission nebula K 1-6 and its central star. Narrow-band images inHα (+[N II]) and [O III] taken with the Faulkes Telescope North reveal a stratified, asymmetric, elliptical nebula surrounding a central star which has the colours of a late G or early K-type subgiant or giant. GALEX ultraviolet images reveal a very hot subdwarf or white dwarf coincident in position with this star. The cooler, optically dominant star is strongly variable with a period of 21.312± 0.008 days, and is possibly a high-amplitude member of the RS CVn class, although an FK Com classification is also possible. Archival ROSAT data provide good evidence that the cool star has an active corona. We conclude that K 1-6 is most likely an old bona fide planetary nebula at a distance of ∼1.0 kpc, interacting with the interstellar medium, and containing a binary or ternary central star. The observations and data analyses reported in this paper were conducted in conjunction with Year 11 high school students as part of an Australian Research Council Linkage Grant science education project, denoted Space To Grow, conducted jointly by professional astronomers, educational researchers, teachers, and high-school students.
Dietary pattern changes may be one of the key factors associated with increasing asthma prevalence. Observational studies have found negative associations between fruit, vegetable and fish consumption and risk of asthma. Experimental studies have also shown that probiotics can modulate the immune system. However, each dietary component exhibits a modest effect. The objective of the present study was to investigate the joint effect of multiple beneficial dietary components on asthma. We designed a 16-week school-based double-blind placebo-controlled randomised trial. The supplement group received fruit plus vegetable concentrate, fish oil and probiotics (FVFP supplement), while the control group received placebos. A total of 192 asthmatic children aged 10–12 years were recruited from elementary schools in metropolitan Taipei. Pulmonary function, medication usage, Paediatric Asthma Quality of Life Questionnaire (PAQLQ) score and the Childhood Asthma Control Test score were evaluated at baseline, and at weeks 8 and 16. Compared with the placebo group, the supplement group showed significant improvement in pulmonary function parameters (91 v. 178 ml for forced vital capacity (FVC), 40 v. 107 ml for forced expiratory volume in 1 s (FEV1) and 1·6 v. 4·8 % for FEV1:FVC ratio; all P values < 0·01) and had a significantly reduced proportion of those using short-acting inhaled bronchodilators and inhaled corticosteroids. However, the PAQLQ score and the Childhood Asthma Control Test score were not significantly different between the two groups, possibly because the majority of the children were treated routinely. FVFP supplements reduced medication use and improved pulmonary function in asthmatic children. The present study supports an adjuvant intervention with a combination of fruit, vegetable, fish and probiotic foods.