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Although psychological treatments have been found to be effective for depression in adults, many individuals with depression do not actively seek help. It is currently unclear whether psychological treatments are effective among those not actively seeking help. Besides, little is known about the proportion of patients who completed a screening questionnaire who end up in a clinical trial. Therefore, we conducted a meta-analysis of 52 randomized trials comparing psychotherapies for adults with a diagnosis or elevated symptoms of depression against control conditions (care-as-usual, waiting list, and other inactive treatment). Only studies recruiting participants who do not actively seek help (participants who have been recruited through screening instead of advertisements and clinical referrals) were included. To obtain an overall effect estimate of psychotherapy, we pooled all post-test differences with a random-effects model. We found that psychological treatments had a moderate to high effect on reducing depressive symptoms compared to control groups [g = 0.55; 95% confidence interval (CI) 0.41–0.69]. Heterogeneity was high (I2 = 75%; 95% CI 68–80). At 12 months' follow-up, the effects were small but significant (6–8 months: g = 0.33; 95% CI 0.14–0.52; 9–12 months: g = 0.24; 95% CI 0.11–0.37). As a secondary outcome, we found that 13% of patients who completed a screening questionnaire met the inclusion criteria for depression and agreed to be randomized in the trial. Based on the current evidence, psychological treatments for depression might be effective for depressed patients who are not actively seeking help.
Resonant response of water waves in a narrow gap, the so-called gap resonance, is a hydrodynamic phenomenon with practical applications. When coupled to body motions, the physics becomes rather complicated, involving body motions, fluid resonance and damping that determines the response amplitude. Gap resonances between two identical elongated bodies, with one held fixed and the other floating, are investigated experimentally for unidirectional waves with broadside incidence. Transient wave groups with different maximum surface elevations are generated, to examine the nonlinear physics. Sub- and super-harmonics, which can be substantially larger than the linear component, are observed in the responses. When going from the diffraction problem (both bodies fixed) to the coupled problem (allowing one body to move), the gap responses are significantly amplified, i.e. by a factor of 2. The first resonant mode that dominates the diffraction problem disappears in the coupled problem. A new resonant mode, which is shown to arise from body motions, is excited inside the gap through nonlinear processes. This mode features a double-humped ‘camel-back’ shape, leading to remarkably large responses. The floating body is observed to oscillate in sway with significant amplitudes at two distinct natural frequencies that are far apart. This is of great interest for the design of mooring lines connecting the two bodies, as it appears to cause resonances at the wave frequencies in addition to the low frequencies. A semi-analytical model is developed to investigate the multiple natural frequencies in sway, yielding further insight into gap resonances.
Uniaxial and isothermal compression tests of kaolinite were carried out using molecular dynamics simulations. Five different temperatures (300, 400, 500, 600 and 700 K) and pressures ranging from 0.0001 to 50 GPa were selected to study the temperature and pressure effects on the mechanical properties of kaolinite. As kaolinite may undergo a phase transition at ~1572 K, a highest temperature of 700 K was chosen to avoid such structural change. The Young's modulus, strength and elastic constants of kaolinite under various temperatures were calculated, and the relative change of the elastic constant C33 with temperature was found to be almost 12 times greater than the relative change of the interlayer constant C11. The microstructures under various compressive strains were tracked and they exhibited various failure modes in three directions. The temperature and pressure effects on the mechanical properties of three crystal directions were analysed. The results showed that the Young's modulus of the z-direction is the most affected by temperature; however, the influence of temperature on the strengths of the three crystal directions was the same. In addition, the structure of the z-direction was the most sensitive to temperature under the same hydrostatic pressure due to the weak interactions between layers.
Mental health regional differences during pregnancy through the COVID-19 pandemic is understudied.
Objectives
We aimed to quantify the impact of the COVID-19 pandemic on maternal mental health during pregnancy.
Methods
A cohort study with a web-based recruitment strategy and electronic data collection was initiated in 06/2020. Although Canadian women, >18 years were primarily targeted, pregnant women worldwide were eligible. The current analysis includes data on women enrolled 06/2020-11/2020. Self-reported data included mental health measures (Edinburgh Perinatal Depression Scale (EPDS), Generalized Anxiety Disorders (GAD-7)), stress. We compared maternal mental health stratifying on country/continents of residence, and identified determinants of mental health using multivariable regression models.
Results
Of 2,109 pregnant women recruited, 1,932 were from Canada, 48 the United States (US), 73 Europe, 35 Africa, and 21 Asia/Oceania. Mean depressive symptom scores were lower in Canada (EPDS 8.2, SD 5.2) compared to the US (EPDS 10.5, SD 4.8) and Europe (EPDS 10.4, SD 6.5) (p<0.05), regardless of being infected or not. Maternal anxiety, stress, decreased income and access to health care due to the pandemic were increasing maternal depression. The prevalence of severe anxiety was similar across country/continents. Maternal depression, stress, and earlier recruitment during the pandemic (June/July) were associated with increased maternal anxiety.
Conclusions
In this first international study on the impact of the COVID-19 pandemic, CONCEPTION has shown significant country/continent-specific variations in depressive symptoms during pregnancy, whereas severe anxiety was similar regardless of place of residence. Strategies are needed to reduce COVID-19’s mental health burden in pregnancy.
Steinernema populi n. sp. was recovered by baiting from beneath poplar trees in China. Morphological and molecular features provided evidence for placing the new species into the Kushidai clade. The new species is characterized by the following morphological features: third-stage infective juveniles (IJ) with a body length of 1095 (973–1172) μm, a distance from the anterior end to excretory pore of 77 (70–86) μm and a tail length of 64 (55–72) μm. The Body length/Tail length (c) ratio and Anterior end to Excretory pore/ Tail length × 100 (E%) of S. populi n. sp. are substantially greater than those of all other ‘Feltiae–Kushidai–Monticolum’ group members. The first-generation males can be recognized by a spicule length of 66 (57–77) μm and a gubernaculum length of 46 (38–60) μm. The new species is further characterized by sequences of the internal transcribed spacer and partial 28S regions of the ribosomal DNA. Phylogenetic analyses show that Steinernema akhursti and Steinernema kushidai are the closest relatives to S. populi n. sp.
To summarise and describe the clinical presentations, diagnostic approaches and airway management techniques in children with laryngotracheal trauma.
Methods
The clinical data related to laryngotracheal trauma diagnosed and treated at the Beijing Children's Hospital, between January 2013 and July 2018, were retrospectively reviewed. Disease diagnosis, treatment, management and outcomes were analysed.
Results
A total of 13 cases were enrolled, including 7 cases of penetrating laryngotracheal trauma. The six cases of blunt laryngotracheal trauma were caused by collisions with hard objects. In all cases, voice, airway and swallowing outcomes were graded as ‘good’, except for one patient who had residual paralysis of the vocal folds.
Conclusion
Flexible fibre-optic laryngoscopy and computed tomography can play an important role in diagnosing laryngotracheal trauma. The airway should be secured and, if necessary, opened by tracheal intubation or tracheostomy.
We study several parameters of a random Bienaymé–Galton–Watson tree
$T_n$
of size
$n$
defined in terms of an offspring distribution
$\xi$
with mean
$1$
and nonzero finite variance
$\sigma ^2$
. Let
$f(s)=\mathbb{E}\{s^\xi \}$
be the generating function of the random variable
$\xi$
. We show that the independence number is in probability asymptotic to
$qn$
, where
$q$
is the unique solution to
$q = f(1-q)$
. One of the many algorithms for finding the largest independent set of nodes uses a notion of repeated peeling away of all leaves and their parents. The number of rounds of peeling is shown to be in probability asymptotic to
$\log n/\log (1/f'(1-q))$
. Finally, we study a related parameter which we call the leaf-height. Also sometimes called the protection number, this is the maximal shortest path length between any node and a leaf in its subtree. If
$p_1 = \mathbb{P}\{\xi =1\}\gt 0$
, then we show that the maximum leaf-height over all nodes in
$T_n$
is in probability asymptotic to
$\log n/\log (1/p_1)$
. If
$p_1 = 0$
and
$\kappa$
is the first integer
$i\gt 1$
with
$\mathbb{P}\{\xi =i\}\gt 0$
, then the leaf-height is in probability asymptotic to
$\log _\kappa \log n$
.
Ascaridia galli (Nematoda: Ascaridiidae) is the most common intestinal roundworm of chickens and other birds with a worldwide distribution. Although A. galli has been extensively studied, knowledge of the genetic variation of this parasite in detail is still insufficient. The present study examined genetic variation in the mitochondrial cytochrome c oxidase subunit 1 (cox1) gene among A. galli isolates (n = 26) from domestic chickens in Hunan Province, China. A portion of the cox1 (pcox1) gene was amplified by polymerase chain reaction separately from adult A. galli individuals and the amplicons were subjected to sequencing from both directions. The length of the sequences of pcox1 is 441 bp. Although the intra-specific sequence variation within A. galli is 0–7.7%, the inter-specific sequence differences among other members of the infraorder Ascaridomorpha were 11.4–18.9%. Phylogenetic analyses based on the maximum likelihood method using the sequences of pcox1 confirmed that all of the Ascaridia isolates were A. galli, and also resolved three distinct clades. Taken together, the findings suggest that A. galli may represent a complex of cryptic species. Our results provide an additional genetic marker for the management of A. galli in chickens and other birds.
The incidence of scarlet fever has increased dramatically in recent years in Chongqing, China, but there has no effective method to forecast it. This study aimed to develop a forecasting model of the incidence of scarlet fever using a seasonal autoregressive integrated moving average (SARIMA) model. Monthly scarlet fever data between 2011 and 2019 in Chongqing, China were retrieved from the Notifiable Infectious Disease Surveillance System. From 2011 to 2019, a total of 5073 scarlet fever cases were reported in Chongqing, the male-to-female ratio was 1.44:1, children aged 3–9 years old accounted for 81.86% of the cases, while 42.70 and 42.58% of the reported cases were students and kindergarten children, respectively. The data from 2011 to 2018 were used to fit a SARIMA model and data in 2019 were used to validate the model. The normalised Bayesian information criterion (BIC), the coefficient of determination (R2) and the root mean squared error (RMSE) were used to evaluate the goodness-of-fit of the fitted model. The optimal SARIMA model was identified as (3, 1, 3) (3, 1, 0)12. The RMSE and mean absolute per cent error (MAPE) were used to assess the accuracy of the model. The RMSE and MAPE of the predicted values were 19.40 and 0.25 respectively, indicating that the predicted values matched the observed values reasonably well. Taken together, the SARIMA model could be employed to forecast scarlet fever incidence trend, providing support for scarlet fever control and prevention.
Public health measures associated with coronavirus disease (COVID-19) have accelerated the adoption of virtual health care across Canada. We explore the opportunities that virtual care presents in achieving the Quadruple Aim and challenges to navigate, through the lens of care for older adults. In particular, we recommend virtual care-related policies related to older adults that address (a) limited uptake among the socio-economically disadvantaged, (b) user-centered design of virtual care technologies, and (c) integration of iterative evaluations to ensure equitable and efficient achievement of desired outcomes. As virtual care accelerates forward, we must not leave older Canadians behind.
A shock-induced separation loss reduction method, using local blade suction surface shape modification (smooth ramp structure) with constant adverse pressure gradient with the consideration of radial equilibrium effect to split a single shock foot into multiple weaker shock wave configuration, is investigated on the NASA Rotor 37 for promoting aerodynamic performance of a transonic compressor rotor. Numerical investigation on baseline blade and improved one with blade modification on suction side has been conducted employing the Reynolds-averaged Navier–Stokes method to reveal flow physics of ramp structure. The results indicate that the passage shock foot of baseline is replaced with a family of compression waves and a weaker shock foot generating moderate adverse pressure gradient on ramp profile, which is beneficial for mitigating the shock foot and shrinking flow separation region as well. In addition, the radial secondary flow of low-momentum fluids within boundary layer is decreased significantly in the region of passage shock-wave/boundary-layer interaction on blade suction side, which mitigates the mass flow and mixing intensity of tip leakage flow. With the reduction of flow separation loss induced by passage shock, the adiabatic efficiency and total pressure ratio of improved rotor are superior to baseline model. This study herein implies a potential application of ramp profile in design method of transonic and supersonic compressors.
This study investigated the audiometric and sound localisation results in patients with conductive hearing loss after bilateral Bonebridge implantation.
Method
Eight patients with congenital microtia and atresia supplied with bilateral Bonebridge devices were enrolled in this study. Hearing tests and sound localisation were tested under unaided, unilateral and bilateral aided conditions.
Results
Mean functional gain was higher with a bilateral fitting than with a unilateral fitting, especially at 1.0–4.0 kHz (p < 0.05, both). The improvement in speech reception threshold in noise with a bilateral fitting was a 2.3 dB higher signal-to-noise ratio compared with unilateral fitting (p < 0.05). Bilateral fitting had better sound localisation than unilateral fitting (p <0.001). Four participants who attended follow up showed improved sound localisation ability after one year.
Conclusion
Patients demonstrated better hearing threshold, speech reception thresholds in noise and directional hearing with bilateral Bonebridge devices than with a unilateral Bonebridge device. Sound localisation ability with bilateral Bonebridge devices can be improved through long-term training.
Intrinsically photosensitive retinal ganglion cells (ipRGCs) signal not only anterogradely to drive behavioral responses, but also retrogradely to some amacrine interneurons to modulate retinal physiology. We previously found that all displaced amacrine cells with spiking, tonic excitatory photoresponses receive gap-junction input from ipRGCs, but the connectivity patterns and functional roles of ipRGC-amacrine coupling remained largely unknown. Here, we injected PoPro1 fluorescent tracer into all six types of mouse ipRGCs to identify coupled amacrine cells, and analyzed the latter’s morphological and electrophysiological properties. We also examined how genetically disrupting ipRGC-amacrine coupling affected ipRGC photoresponses. Results showed that ipRGCs couple with not just ON- and ON/OFF-stratified amacrine cells in the ganglion-cell layer as previously reported, but also OFF-stratified amacrine cells in both ganglion-cell and inner nuclear layers. M1- and M3-type ipRGCs couple mainly with ON/OFF-stratified amacrine cells, whereas the other ipRGC types couple almost exclusively with ON-stratified ones. ipRGCs transmit melanopsin-based light responses to at least 93% of the coupled amacrine cells. Some of the ON-stratifying ipRGC-coupled amacrine cells exhibit transient hyperpolarizing light responses. We detected bidirectional electrical transmission between an ipRGC and a coupled amacrine cell, although transmission was asymmetric for this particular cell pair, favoring the ipRGC-to-amacrine direction. We also observed electrical transmission between two amacrine cells coupled to the same ipRGC. In both scenarios of coupling, the coupled cells often spiked synchronously. While ipRGC-amacrine coupling somewhat reduces the peak firing rates of ipRGCs’ intrinsic melanopsin-based photoresponses, it renders these responses more sustained and longer-lasting. In summary, ipRGCs’ gap junctional network involves more amacrine cell types and plays more roles than previously appreciated.
The aim of the present study was to perform a retrospective review of the lesion sites in congenital middle-ear cholesteatoma and any accompanying ossicular defects, as well as to explore the possible aetiology of congenital middle-ear cholesteatoma associated with such ossicular chain defects.
Method
The clinical characteristics and pathogenic mechanisms of ossicular chain defects were investigated in 10 patients with early-stage congenital middle-ear cholesteatoma confirmed by surgery, from August 2011 to February 2019.
Results
Monofocal cholesteatoma was located in the anterosuperior quadrant in 3 cases and in the posterosuperior quadrant in 7 cases; all 10 cases showed an absence of the long crus of incus, and 8 cases showed a complete or partial absence of stapes superstructure. The lesions were confined to the vestibular window and the stapes region and had no contact with the long crus of the incus or stapes in nine cases. None of the 10 patients had any recurrence of cholesteatoma.
Conclusion
Although cholesteatoma can cause erosion of ossicles, the present cases suggest that residual epithelium of the cholesteatoma may coexist with ossicular malformations. Therefore, the aetiology of the clinical characteristics in these patients may derive from residual epithelial hinderance of ossicle development.
We use a continuous wavelet transform to analyse the daily hemispheric sunspot area data from the Greenwich Royal Observatory during cycles 12–24 and then study the cause of the appearance or disappearance of the Rieger-type periodicity in the northern and southern hemispheres during a certain cycle. The Rieger-type periodicity in the northern and southern hemispheres should be developed independently in the two hemispheres. This periodicity in the northern hemisphere is generally anti-correlated with the long-term variations in the mean solar cycle strength of hemispheric activity, but the correlation of the two parameters in the southern hemisphere shows a weak correlation. The appearance or disappearance of Rieger-type periodicity in the northern and southern hemispheres during a certain solar cycle is not directly correlated with their corresponding hemispheric mean activity strength but should be related to the strength of the hemispheric activity during sunspot maximum times, which hints the Rieger-type periodicity is more related to temporal evolution of toroidal magnetic field. The Rieger-type periodicity in the two hemispheres disappears in those solar cycles with relatively weak hemispheric activity during sunspot maximum times. The reason for the disappearance of this periodicity may be due to the combined influence of relatively weak toroidal magnetic fields and torsional oscillations, the differential rotation parameters vary through the solar cycle and may not remain more or less unchanged during some time, which does not permit the strong growth of magnetic Rossby waves.
This paper reports the dangers of an ingested metal wire bristle from a barbeque brush, which resulted in oesophageal perforation.
Case report
A 49-year-old gentleman presented to the emergency department with foreign body sensation and odynophagia after having consumed barbequed lamb for lunch. Computed tomography of the neck demonstrated a thin linear opacity near the thoracic inlet. The object could not be visualised on emergent rigid oesophagoscopy. Subsequent neck exploration enabled localisation of a retropharyngeal abscess and a thin wire bristle from a barbeque brush.
Conclusion
Always consider the utensils employed in food preparation as a differential in ingested foreign bodies. Thin wire objects have a high propensity to migrate and result in complications, hence urgent intervention is vital.
The current study investigated associations between variation in the bovine perilipin-2 gene (PLIN2) and milk traits (milk fat content, milk protein content, milk yield and milk fatty acid (FA) component levels) in 409 New Zealand pasture-grazed Holstein-Friesian × Jersey-cross (HF × J-cross or Kiwicross™) cows. Five nucleotide sequence variants were found in three regions of the gene, including c.17C>T in exon 2, c.53A>G in exon 3, c.595+23G>A and c.595+104_595+108del in intron 5, and c.*302T>C in the 3′-untranslated region. The c.*302T>C substitution produces two nucleotide sequence variants (A5 and B5), and this variation was associated with variation in milk protein content and milkfat composition for C10:0, C11:0, C12:0, C13:0 and C16:0 FA and medium-chain fatty acid (MCFA) and long-chain fatty acid (LCFA) groups. After correcting for the effect of variation in the diacylglycerol acyl-CoA acyltransferase 1 gene (DGAT1) that results in the amino acid substitution p.K232A, variation in the FA binding protein 4 gene (FABP4) and variation in the stearoyl-CoA desaturase (Δ-9-desaturase) gene (SCD) that results in the amino acids substitution p.A293V, significant differences between A5A5 and B5B5 cows were found for C10:0, C11:0, C12:0, C13:0, C16:0, and the MCFA, LCFA, total saturated FA and C10:1 index groups. This suggests that nucleotide sequence variation in PLIN2 may be affecting milk FA component levels.
An acute gastroenteritis (AGE) outbreak caused by a norovirus occurred at a hospital in Shanghai, China, was studied for molecular epidemiology, host susceptibility and serological roles. Rectal and environmental swabs, paired serum samples and saliva specimens were collected. Pathogens were detected by real-time polymerase chain reaction and DNA sequencing. Histo-blood group antigens (HBGA) phenotypes of saliva samples and their binding to norovirus protruding proteins were determined by enzyme-linked immunosorbent assay. The HBGA-binding interfaces and the surrounding region were analysed by the MegAlign program of DNAstar 7.1. Twenty-seven individuals in two care units were attacked with AGE at attack rates of 9.02 and 11.68%. Eighteen (78.2%) symptomatic and five (38.4%) asymptomatic individuals were GII.6/b norovirus positive. Saliva-based HBGA phenotyping showed that all symptomatic and asymptomatic cases belonged to A, B, AB or O secretors. Only four (16.7%) out of the 24 tested serum samples showed low blockade activity against HBGA-norovirus binding at the acute phase, whereas 11 (45.8%) samples at the convalescence stage showed seroconversion of such blockade. Specific blockade antibody in the population played an essential role in this norovirus epidemic. A wide HBGA-binding spectrum of GII.6 supports a need for continuous health attention and surveillance in different settings.
Coronavirus disease 2019 (COVID-19) pandemic is a major public health concern all over the world. Little is known about the impact of COVID-19 pandemic on mental health in the general population. This study aimed to assess the mental health problems and associated factors among a large sample of college students during the COVID-19 outbreak in China.
Methods
This cross-sectional and nation-wide survey of college students was conducted in China from 3 to 10 February 2020. A self-administered questionnaire was used to assess psychosocial factors, COVID-19 epidemic related factors and mental health problems. Acute stress, depressive and anxiety symptoms were measured by the Chinese versions of the impact of event scale-6, Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7, respectively. Univariate and hierarchical logistic regression analyses were performed to examine factors associated with mental health problems.
Results
Among 821 218 students who participated in the survey, 746 217 (90.9%) were included for the analysis. In total, 414 604 (55.6%) of the students were female. About 45% of the participants had mental health problems. The prevalence rates of probable acute stress, depressive and anxiety symptoms were 34.9%, 21.1% and 11.0%, respectively. COVID-19 epidemic factors that were associated with increased risk of mental health problems were having relatives or friends being infected (adjusted odds ratio = 1.72–2.33). Students with exposure to media coverage of the COVID-19 ≥3 h/day were 2.13 times more likely than students with media exposure <1 h/day to have acute stress symptoms. Individuals with low perceived social support were 4.84–5.98 times more likely than individuals with high perceived social support to have anxiety and depressive symptoms. In addition, senior year and prior mental health problems were also significantly associated with anxiety or/and depressive symptoms.
Conclusions
In this large-scale survey of college students in China, acute stress, anxiety and depressive symptoms are prevalent during the COVID-19 pandemic. Multiple epidemic and psychosocial factors, such as family members being infected, massive media exposure, low social support, senior year and prior mental health problems were associated with increased risk of mental health problems. Psychosocial support and mental health services should be provided to those students at risk.