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Exposure to adverse childhood experiences (ACEs) is not only associated with one's adverse health outcomes in adulthood but also increases the risk of child developmental problems in offspring. However, the mechanisms involved in the transmission of the effects of maternal ACEs to the offspring largely remain unexplored. This study sought to identify possible psychosocial pathways of intergenerational effects of maternal ACEs on child development at 6 months. Data from a longitudinal study on maternal childhood adversity and maternal psychosocial risk during pregnancy as well as maternal mental health problems and child development at 6 months postnatal were used. Structural equation modeling with bootstrapping was used to estimate the indirect effects of maternal ACEs on child development at 6 months. The model showed that maternal ACEs indirectly influenced offspring's development via maternal stressful events during pregnancy and pre- and postnatal mental health problems. This finding highlights the possible interventions at the prenatal and postnatal periods. Early identification of women who have ACEs or who are at psychosocial risk during pre- and postnatal periods is critical to provide interventions to buffer those negative effects on offspring's development. Future studies are needed to longitudinally assess the effects of maternal ACEs on child development over time.
Sample geometry effects on mechanical strengths of gold micro-cantilevers are evaluated by a micro-bending test. Six micro-cantilevers with the same length of 50 μm are prepared, and the width and the thickness are varied to examine individual effects on the yield stress. The yield stress increases from 428 to 519 MPa when the thickness decreases from 11.1 to 6.0 μm. No obvious dependency is observed when varying the width. The results reveal that the thickness and the width each has a different influence on the yield stresses of micro-cantilevers evaluated by the bending test, which is the sample geometry effect.
To develop an equation that can estimate the 24-h urinary Na excretion by using casual spot urine specimen for older hypertensive participants in rural Ningxia and further to compare with the INTERSALT method, Kawasaki method and Tanaka method.
Older hypertensive participants in rural Ningxia provided their casual spot urine samples and 24-h urine samples between January 2015 and February 2017. Sex-specific equation was developed using linear forward stepwise regression analysis. Model fit was assessed using adjusted R2. Approximately half of all participants were randomly selected to validate the equation. Mean differences, intraclass correlation coefficients and Bland–Altman plots were used to evaluate the performance of all methods.
Pingluo County and Qingtongxia County in Ningxia Hui Autonomous Region, China.
Older hypertensive participants in rural Ningxia.
Totally, 807 of 1120 invited participants provided qualified 24-h urine samples and spot urine samples. There was no statistical difference comparing the laboratory-based method against the new method and the INTERSALT method, while Kawasaki method had the largest bias with a mean difference of 40·81 g/d (95 % CI 39·27, 42·35 g/d). Bland–Altman plots showed similar pattern of the results.
The INTERSALT method and the new equation have the potential to estimate the 24-h urinary Na excretion in this study population. However, the extrapolation of the results to other population needs to be careful. Future research is required to establish a more reliable method to estimate 24-h urinary Na excretion.
The authors propose an alternative route to circumvent the limitation of neutron flux using the recent deep learning super-resolution technique. The feasibility of accelerating data collection has been demonstrated by using small-angle neutron scattering (SANS) data collected from the EQ-SANS instrument at Spallation Neutron Source (SNS). Data collection time can be reduced by increasing the size of binning of the detector pixels at the sacrifice of resolution. High-resolution scattering data is then reconstructed by using a deep learning-based super-resolution method. This will allow users to make critical decisions at a much earlier stage of data collection, which can accelerate the overall experimental workflow.
Given the concerns of health inequality associated with mental illnesses, we aimed to reveal the extent of which general mortality and life expectancy at birth in people with schizophrenia, bipolar disorder and depressive disorder varied in the 2005 and 2010 nationally representative cohorts in Taiwan.
Two nationally representative samples of individuals with schizophrenia, bipolar disorder and depressive disorder were identified from Taiwan's national health insurance database in 2005 and 2010, respectively, and followed-up for consecutive 3 years. The database was linked to nationwide mortality registry to identify causes and date of death. Age-, gender- and cause-specific mortality rates were generated, with the average follow-up period of each age- and gender-band applied as ‘weighting’ for the calculation of expected number of deaths. Age- and gender-standardised mortality ratios (SMRs) were calculated for these 3-year observation periods with Taiwanese general population in 2011/2012 as the standard population. The SMR calculations were then stratified by natural/unnatural causes and major groups of death. Corresponding life expectancies at birth were also calculated by gender, diagnosis of mental disorders and year of cohorts for further elucidation.
The general differential in mortality rates for people with schizophrenia and bipolar disorder remained wide, revealing an SMR of 3.65 (95% confidence interval (CI): 3.55–3.76) for cohort 2005 and 3.27 (3.18-3.36) for cohort 2010 in schizophrenia, and 2.65 (95% CI: 2.55–2.76) for cohort 2005 and 2.39 (2.31-2.48) for cohort 2010 in bipolar disorder, respectively. The SMRs in people with depression were 1.83 (95% CI: 1.81–1.86) for cohort 2005 and 1.59 (1.57-1.61) for cohort 2010. SMRs due to unnatural causes tended to decrease in people with major mental illnesses over the years, but those due to natural causes remained relatively stable. The life expectancies at birth for schizophrenia, bipolar disorder and depression were all significantly lower than the national norms, specifically showing 14.97–15.50 years of life lost for men and 15.15–15.48 years for women in people with schizophrenia.
Compared to general population, the differential in mortality rates for people with major mental illnesses persisted substantial. The differential in mortality for unnatural causes of death seemed decreasing over the years, but that due to natural causes remained relatively steady. Regardless of gender, people with schizophrenia, bipolar disorder and depression were shown to have shortened life expectancies compared to general population.
The WHO’s (2001) International Classification of Functioning, Disability, and Health (ICF) model conceptualizes health from an ecological perspective. It has been implemented by many professionals as the standard health classification framework that guides providers’ decisions regarding assessment tools and targeted interventions. Despite this model’s prevalence among many healthcare providers, the ICF framework remains largely underutilized by many in the counseling fields. This conceptual paper provides an overview of the strengths of the ICF model and ICF-based measurements, and demonstrates its clinical, research, and educational value. A case study is presented to guide counselors and counselor educators through application of the ICF model in various contexts to encourage expanded use of the model. Use of the ICF model among counseling professionals, educators, and researchers is recommended as one way to enhance measurement of clinical outcomes.
Previous studies have shown that the Dietary Approaches to Stop Hypertension (DASH) diet might contribute to managing risk factors of non-alcoholic fatty liver disease (NAFLD), but evidence is limited. We examined the association of DASH diet score (DASH-DS) with NAFLD, as well as the intermediary effects of serum retinol-binding protein-4 (RBP4), serum high-sensitivity C-reactive protein (hs-CRP), serum TAG, homeostasis model assessment of insulin resistance (HOMA-IR) and BMI.
We performed a cross-sectional analysis of a population-based cohort study. Dietary data and lifestyle factors were assessed by face-to-face interviews and the DASH-DS was then calculated. We assessed serum RBP4, hs-CRP and TAG and calculated HOMA-IR. The presence and degree of NAFLD were determined by abdominal sonography.
Guangzhou Nutrition and Health Study participants, aged 40–75 years at baseline (n 3051).
After adjusting for potential covariates, we found an inverse association between DASH-DS and the presence of NAFLD (Ptrend = 0·009). The OR (95 % CI) of NAFLD for quintiles 2–5 were 0·78 (0·62, 0·98), 0·74 (0·59, 0·94), 0·69 (0·55, 0·86) and 0·77 (0·61, 0·97), respectively. Path analyses indicated that a higher DASH-DS was associated with lower serum RBP4, hs-CRP, TAG, HOMA-IR and BMI, which were positively associated with the degree of NAFLD.
Adherence to the DASH diet was independently associated with a marked lower prevalence of NAFLD in Chinese adults, especially in women and those without abdominal obesity, and might be mediated by reducing RBP4, hs-CRP, TAG, HOMA-IR and BMI.
Little is known about long-term employment outcomes for patients with first-episode schizophrenia-spectrum (FES) disorders who received early intervention services.
We compared the 10-year employment trajectory of patients with FES who received early intervention services with those who received standard care. Factors differentiating the employment trajectories were explored.
Patients with FES (N = 145) who received early intervention services in Hong Kong between 1 July 2001 and 30 June 2002 were matched with those who entered standard care 1 year previously. We used hierarchical clustering analysis to explore the 10-year employment clusters for both groups. We used the mixed model test to compare cluster memberships and piecewise regression analysis to compare the employment trajectories of the two groups.
There were significantly more patients who received the early intervention service in the good employment cluster (early intervention: N = 98 [67.6%]; standard care: N = 76 [52.4%]; P = 0.009). In the poor employment cluster, there was a significant difference in the longitudinal pattern between early intervention and standard care for years 1–5 (P < 0.0001). The number of relapses during the first 3 years, months of full-time employment during the first year and years of education were significant in differentiating the clusters of the early intervention group.
Results suggest there was an overall long-term benefit of early intervention services on employment. However, the benefit was not sustained for all patients. Personalisation of the duration of the early intervention service with a focus on relapse prevention and early vocational reintegration should be considered for service enhancement.
We incorporate deep learning (DL) into tiled aperture coherent beam combining (CBC) systems for the first time, to the best of our knowledge. By using a well-trained convolutional neural network DL model, which has been constructed at a non-focal-plane to avoid the data collision problem, the relative phase of each beamlet could be accurately estimated, and then the phase error in the CBC system could be compensated directly by a servo phase control system. The feasibility and extensibility of the phase control method have been demonstrated by simulating the coherent combining of different hexagonal arrays. This DL-based phase control method offers a new way of eliminating dynamic phase noise in tiled aperture CBC systems, and it could provide a valuable reference on alleviating the long-standing problem that the phase control bandwidth decreases as the number of array elements increases.
Evidence regarding the relationships between the socioeconomic status and
long-term outcomes of individuals with bipolar affective disorder (BPD)
We aimed to estimate the effects of baseline socioeconomic status on
A national cohort of adult participants with newly diagnosed BPD was
identified in 2008. The effects of personal and household socioeconomic
status were explored on outcomes of hospital treatment, mortality and
healthcare costs, over a 3-year follow-up period (2008–2011).
A total of 7987 participants were recruited. The relative risks of
hospital treatment and mortality were found elevated for the ones from
low-income households who also had higher healthcare costs. Low premium
levels did not correlate with future healthcare costs.
Socioeconomic deprivation is associated with poorer outcome and higher
healthcare costs in BPD patients. Special care should be given to those
with lower socioeconomic status to improve outcomes with potential
benefits of cost savings in the following years.
We present possible conceptual designs of a laser system for driving table-top free-electron lasers based on terahertz acceleration. After discussing the achievable performances of laser amplifiers with Yb:YAG at cryogenic and room temperature and Yb:YLF at cryogenic temperature, we present amplification modules with available results and concepts of amplifier chains based on these laser media. Their performances are discussed in light of the specifications for the tasks within the table-top light source. Technical and engineering challenges, such as cooling, control, synchronization and diagnostics, are outlined. Three concepts for the laser layout feeding the accelerator are eventually derived and presented.
To secure the reliability of flexible electronics, the effect of multicomponent stress on the device properties during complex mechanical deformation needs to be thoroughly understood. The electrical resistances of metal interconnects are investigated by in situ monitoring at different twisting angles and with different pattern positions. As the twisting angle increased, the electrical resistance increased earlier. Furthermore, in the line pattern located far from the central axis, severe electrical degradation and fatigue damage formation were observed. Multicomponent stress evolution during twisting was analyzed by the finite-element simulation method. For easy practical application for estimating the representative twisting strain, an analytic solution of twisting deformation was formulated and compared with the simulation. Using the equivalent strain, the fatigue lifetime was fitted, and the exponents were obtained for lifetime expectation. This systematic study provides the guidelines for highly reliable flexible devices and the tools for determining the expected fatigue lifetime.
The flow and the turbulence structure generated by a circular porous cylinder of diameter
containing solid cylinders of diameter
placed in an open channel of depth
are investigated using eddy-resolving simulations which resolve the wakes past the individual solid cylinders in the array. The solid cylinders extend from the bed through the water surface. This geometrical set-up is directly relevant to understand the physics of flow past an emerged patch of aquatic vegetation developing in a river channel or over its floodplain. Simulations are conducted with different solid volume fractions (SVFs) of the porous cylinder (
), relative diameters of the solid cylinders (
and 0.06) and with flat and equilibrium scour bathymetry corresponding to the start and respectively the end of the erosion and deposition process. Comparison with the limiting case of a solid cylinder (
) is also discussed. The bed shear stress distributions and the turbulent flow fields are used to explain the sediment erosion mechanisms inside and around the porous cylinder. Simulations of the flat-bed cases reveal that for sufficiently large SVF values (
), necklace vortices form around the upstream face of the cylinder, the downflow penetrates partially inside the porous cylinder and a region of strong flow acceleration forms on the sides of the porous cylinder. These flow features are used to explain the development of scour around high-SVF porous cylinders. The effects of the SVF and
on generating ‘corridors’ of strong flow acceleration in between the solid cylinders and energetic eddies in the wake of these cylinders are discussed, as these flow features control the amplification of the bed shear stress inside the porous cylinder. Simulations results are also used to quantify the time-averaged drag forces on the cylinders in the array, to identify the regions where these forces are comparable to those induced on an isolated cylinder and the percentage of cylinders in the array subject to relatively large mean drag forces. A logarithmic decrease of the mean time-averaged streamwise drag coefficient of the solid cylinders,
, with increasing non-dimensional frontal area per unit volume of the porous cylinder,
, is observed. Behind the cylinder, the eddies shed in the separated shear layers (SSLs) of the porous cylinder, and, for sufficiently large SVFs, the von Kármán wake billows are the main coherent structures responsible for the amplification of the bed shear stress and sediment entrainment. This paper also analyses the vertical non-uniformity of the mean flow and turbulent kinetic energy, and discusses how the SVF and bathymetry affect the spatial extent of the wake region (e.g. length of the SSLs and steady wake, total wake length) and other relevant variables (e.g. strength of the bleeding flow, dominant wake frequencies, turbulence amplification in the near wake). For the relatively shallow flow conditions (
) considered, the simulation results show that the antisymmetric (von Kármán) shedding of wake billows behind the porous cylinder is greatly weakened once equilibrium scour conditions are approached. Comparison with data from laboratory experiments and from 3-D and 2-D simulations conducted for long porous cylinders (no bed) is also discussed.
A sediment core (14DH-C01) obtained from the mouth of Gomso Bay, on the west coast of South Korea, was used to obtain high-resolution palynomorph, grain-size, and 14C age data to investigate the Holocene sedimentary environment. The results indicated a transgressive depositional process with four stages controlled by sea-level change, as follows: river-dominated fluvial deposition from the early Holocene to 8.48 cal ka BP; tide-dominated tidal channel fill transgression from 8.48 to 8.08 cal ka BP; tide- to wave-dominated tidal channel fill transgression from 8.08 to 6.98 cal ka BP; and wave-dominated marine transgression from 6.98 cal ka BP to the present. Tidal channel filling was the primary mid-Holocene depositional process, accounting for the high sedimentation rate observed. The different hydrodynamics of the river-dominated, tide-dominated, tide- to wave-dominated, and wave-dominated processes following the changes in sea level may have controlled the transgressive depositional process. This transgressive sedimentary model differs from those of other large river mouth areas (e.g., the Changjiang River) since the mid-Holocene, perhaps resulting from the limited sediment supply in the study area.