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.
Hubei province in China has had the most confirmed coronavirus disease 2019 (COVID-19) cases and has reported sustained transmission of the disease. Although Lu'an city is adjacent to Hubei province, its community transmission was blocked at the early stage, and the impact of the epidemic was limited. Therefore, we summarised the overall characteristics of the entire epidemic course in Lu'an to help cities with a few imported cases better contain the epidemic. A total of 69 confirmed COVID-19 cases and 11 asymptomatic carriers were identified in Lu'an during the epidemic from 12 January to 21 February 2020. Fifty-two (65.0%) cases were male, and the median age was 40 years. On admission, 56.5% of cases had a fever as the initial symptom, and pneumonia was present in 89.9% of cases. The mean serial interval and the mean duration of hospitalisation were 6.5 days (95% CI: 4.8–8.2) and 18.2 days (95% CI: 16.8–19.5), respectively. A total of 16 clusters involving 60 cases (17 first-generation cases and 43 secondary cases) were reported during the epidemic. We observed that only 18.9% (7/37) index cases resulted in community transmission during the epidemic in Lu'an, indicating that the scale of the epidemic was limited to a low level in Lu'an city. An asymptomatic carrier caused the largest cluster, involving 13 cases. Spread of COVID-19 by asymptomatic carriers represents an enormous challenge for countries responding to the pandemic.
Bipolar disorder (BD) is associated with social cognition (SC) impairments even during remission periods although a large heterogeneity has been described. Our aim was to explore the existence of different profiles on SC in euthymic patients with BD, and further explore the potential impact of distinct variables on SC.
Hierarchical cluster analysis was conducted using three SC domains [Theory of Mind (ToM), Emotional Intelligence (EI) and Attributional Bias (AB)]. The sample comprised of 131 individuals, 71 patients with BD and 60 healthy control subjects who were compared in terms of SC performance, demographic, clinical, and neurocognitive variables. A logistic regression model was used to estimate the effect of SC-associated risk factors.
A two-cluster solution was identified with an adjusted-performance group (N = 48, 67.6%) and a low-performance group (N = 23, 32.4%) with mild deficits in ToM and AB domains and with moderate difficulties in EI. Patients with low SC performance were mostly males, showed lower estimated IQ, higher subthreshold depressive symptoms, longer illness duration, and poorer visual memory and attention. Low estimated IQ (OR 0.920, 95% CI 0.863–0.981), male gender (OR 5.661, 95% CI 1.473–21.762), and longer illness duration (OR 1.085, 95% CI 1.006–1.171) contributed the most to the patients clustering. The model explained up to 35% of the variance in SC performance.
Our results confirmed the existence of two discrete profiles of SC among BD. Nearly two-thirds of patients exhibited adjusted social cognitive abilities. Longer illness duration, male gender, and lower estimated IQ were associated with low SC performance.
Old Chinese refers to the Chinese language before the Qin dynasty (Mandarin: xiānqín 先秦). Unlike later periods, there is no systematic record of an entire phonology. The phonology of Old Chinese must be completely reconstructed, based on various pieces of unrelated source materials. The reconstruction of Old Chinese represents the most difficult work in the study of the Chinese historical phonology. It also should be noted that the source materials often have unclear information regarding the time and geographical locations about the language. The source materials mainly include the rhyming words of ancient poetry, the Chinese characters that share phonetic components, and reconstructions based on both the phonology of Middle Chinese, which is itself based on rhyme dictionaries with complete phonological information, and the pronunciation of modern Chinese dialects. Although Old Chinese phonology must appear first according to chronology, it would be very helpful to read Part III (Middle Chinese) first before coming back to read this part, as linguists studying Old Chinese use Middle Chinese phonology as their main reference point in the reconstruction of phonology. A good understanding of Middle Chinese phonology, and especially the terminologies involved, will benefit the reading of this part.
Identifying profiles of people with mental and substance use disorders who use emergency departments may help guide the development of interventions more appropriate to their particular characteristics and needs.
To develop a typology for the frequency of visits to the emergency department for mental health reasons based on the Andersen model.
Questionnaires were completed by patients who attended an emergency department (n = 320), recruited in Quebec (Canada), and administrative data were obtained related to sociodemographic/socioeconomic characteristics, mental health diagnoses including alcohol and drug use, and emergency department and mental health service utilization. A cluster analysis was performed, identifying needs, predisposing and enabling factors that differentiated subclasses of participants according to frequency of emergency department visits for mental health reasons.
Four classes were identified. Class 1 comprised individuals with moderate emergency department use and low use of other health services; mostly young, economically disadvantaged males with substance use disorders. Class 2 comprised individuals with high emergency department and specialized health service use, with multiple mental and substance use disorders. Class 3 comprised middle-aged, economically advantaged females with common mental disorders, who made moderate use of emergency departments but consulted general practitioners. Class 4 comprised older individuals with multiple chronic physical illnesses co-occurring with mental disorders, who made moderate use of the emergency department, but mainly consulted general practitioners.
The study found heterogeneity in emergency department use for mental health reasons, as each of the four classes represented distinct needs, predisposing and enabling factors. As such, interventions should be tailored to different classes of patients who use emergency departments, based on their characteristics.
Methionine is a limiting amino acid (AA) in fish diets, particularly in those containing high levels of plant protein (PP), and is key in the immune system. Accordingly, outcome on the fish immune mechanisms of methionine-deficient and methionine-supplemented diets within the context of 0 % fishmeal formulation, after a short and prolonged feeding period, was studied in European seabass (Dicentrarchus labrax). For this, seabass juveniles were fed a (i) fishmeal-free diet, meeting AA requirements, but deficient in methionine (MET0·65); (ii) as control, the MET0·65 supplemented with l-methionine at 0·22 % of feed weight (CTRL); (iii) two diets, identical to MET0·65 but supplemented at 0·63 and 0·88 % of feed weight of l-methionine (MET1·25 and MET1·5, respectively); and (iv) a fishmeal-based diet (FM), as positive control. After 2 and 12 weeks of feeding, blood and plasma were sampled for leucocyte counting and humoral parameter assays and head-kidney collected for gene expression. After 2 weeks of feeding, a fishmeal-free diet supplemented with methionine led to changes in the expression of methionine- and leucocyte-related genes. A methionine immune-enhancer role was more evident after 12 weeks with an increased neutrophil percentage and a decreased expression of apoptotic genes, possibly indicating an enhancement of fish immunity by methionine dietary supplementation. Furthermore, even though CTRL and FM present similar methionine content, CTRL presented a reduced expression of several immune-related genes indicating that in a practical PP-based diet scenario, the requirement level of methionine for an optimal immune status could be higher.
Heterogeneity in cognitive functioning among major depressive disorder (MDD) patients could have been the reason for the small-to-moderate differences reported so far when it is compared to other psychiatric conditions or to healthy controls. Additionally, most of these studies did not take into account clinical and sociodemographic characteristics that could have played a relevant role in cognitive variability. This study aims to identify empirical clusters based on cognitive, clinical and sociodemographic variables in a sample of acute MDD patients.
In a sample of 174 patients with an acute depressive episode, a two-step clustering analysis was applied considering potentially relevant cognitive, clinical and sociodemographic variables as indicators for grouping.
Treatment resistance was the most important factor for clustering, closely followed by cognitive performance. Three empirical subgroups were obtained: cluster 1 was characterized by a sample of non-resistant patients with preserved cognitive functioning (n = 68, 39%); cluster 2 was formed by treatment-resistant patients with selective cognitive deficits (n = 66, 38%) and cluster 3 consisted of resistant (n = 23, 58%) and non-resistant (n = 17, 42%) acute patients with significant deficits in all neurocognitive domains (n = 40, 23%).
The findings provide evidence upon the existence of cognitive heterogeneity across patients in an acute depressive episode. Therefore, assessing cognition becomes an evident necessity for all patients diagnosed with MDD, and although treatment resistant is associated with greater cognitive dysfunction, non-resistant patients can also show significant cognitive deficits. By targeting not only mood but also cognition, patients are more likely to achieve full recovery and prevent new relapses.
The present study evaluated the effects of dietary Zn level on growth performance, serum and hepatopancreas metabolites, expression of genes involved in lipid and energy metabolism, and the signalling pathway of dietary Zn-induced lipolysis. Five isonitrogenous and isolipidic diets were formulated to contain different Zn levels: 46·4 (basal diet), 77·2, 87·0, 117·1 and 136·8 mg/kg, respectively. The results indicated that shrimp fed the diet containing Zn at 117·1 mg/kg had higher weight gain and specific growth rate, and the lowest feed intake and feed conversion rate, than shrimp fed the other diets. The deposition rate of Zn in whole body significantly decreased with increasing dietary Zn level. Dietary Zn prevented the accumulation of free radicals and improved antioxidant activities by increasing Cu/Zn superoxide dismutase and reducing malondialdehyde in hepatopancreas. Dietary Zn supplementation enhanced lipase activity and adiponectin, which could promote TAG breakdown and fatty acid oxidation and lead to reduced lipid in hepatopancreas. The mRNA expressions of ob-rb, adipor, camkkβ, ampk, cd36, mcd and cpt1 involved in Zn-induced lipid catabolism were up-regulated, and the expressions of srebp, acc, fas and scd1 were down-regulated. The mRNA levels of SLC39 family genes (zip3, zip9, zip11 and zip14) in hepatopancreas were up-regulated with increasing dietary Zn level. The results demonstrated that dietary Zn level could significantly affect growth performance, tissue deposition of Zn, lipid metabolites and expression of genes involved in lipogenesis and lipolysis in Litopenaeus vannamei.
The physical origins of entropy are explained. Configurational entropy in the point approximation was used previously, but Chapter 7 shows how configurational entropy can be calculated more accurately with cluster expansion methods, and the pair approximation is developed in some detail. Atom vibrations are usually the largest source of entropy in materials, and the origin of vibrational entropy is explained in Section 7.4. Vibrational entropy is used in new calculations of the critical temperatures of ordering and unmixing, which were done in Chapter 2 with configurational entropy alone. For metals there is a heat capacity and entropy from thermal excitations of electrons near the Fermi surface, and this increases with temperature. At high temperatures, electron excitations can alter the vibrational modes, and there is some discussion about how the different types of entropy interact.
This commentary presents some reflections on the peculiar position obsessive-compulsive personality disorder (OCPD) has among Cluster C PDs. Based on epidemiological, factor-analytic, and cognitive considerations, it is argued that OCPD deviates from avoidant and dependent PD. First, epidemiological research shows that in the general population OCPD is not associated with markers of poor functioning and unfortunate living circumstances. On the contrary, positive associations between OCPD and such markers are found. Moreover, disproportionally few people with OCPD seek mental health care. Second, based on a second-order factor analysis on a large data set that confirms the cluster structure in PDs, it is argued that OCPD has a deviant position, relatively weakly loading on the cluster-C factor. Third, research on cognitive processes and structures in PDs indicates that OCPD deviates from avoidant and dependent PD in several ways, including sharing an interpretation style with nonpatients, and in not reporting vulnerable cognitive-emotional states. Dysfunctional cognitive characteristics might be pushed out of awareness by powerful overcompensatory strategies that are more characteristic for Cluster B than for Cluster C. Alternatively, OCPD is characterized more by deviant cognitive processes than by specific content of schemas. OCPD’s dysfunctional core should be clarified.
In the DSM-5 main section for clinical diagnoses, psychopathology in Cluster C (Anxious-Fearful) is represented by three personality disorders: Avoidant, Dependent, and Obsessive-Compulsive. However, characterization of persistent anxious-fearful psychopathology has varied historically, and it appears that the cluster formation may not be retained with the next iteration of personality disorder diagnoses. This chapter examines the historical development of anxious-fearful personality disorders, and examines the different ways that associated symptoms and problems have been characterized and grouped to elucidate core features in order to clarify visions looking forward. There is an emphasis on avoidant behaviors, when describing the clinical manifestation of these personality disorders, and it is suggested that focusing on mechanisms for this kind of personality pathology, as well as explicitly addressing the issue of grain size, would enhance continuing efforts to improve diagnostic conceptualizations of personality pathology involving anxiety, fear, and avoidance.
This rejoinder responds to commentaries offered by Cain (this volume) and Arntz (this volume). The authors reiterate their view that incorporating mechanisms into research will open new pathways for understanding the nature of anxious fearful personality pathology and for improving diagnosis. They agree with and value the interpersonal theory for better understanding personality disorders, and for guiding treatment. They further argue that particular attention be paid to grain size in the study and conceptualization of anxious fearful personality pathology.
The theory of global urban governance fields asserts that coordination in city-networks rests on convergence around a common set of ideas and practices that shape how member cities understand themselves as global climate governors. This chapter applies cluster analysis to a dataset containing both 10,000-plus unique climate governance actions, as well as the climate governance profiles (type and content of emissions reduction target, scope and methodology of emissions inventory, focus and scope of climate action plan) of all C40 cities, to infer the governance norms and collective identity around which the C40 governance field has been organized. The analysis posits two core ideational components – what kind of agency do cities possess, and how do they orient themselves to the global effort – and identifies convergence over time and space around two distinct responses: governance norms of autonomous agency and global accountability. These norms, in concert with practices of standardization, transparency, accounting, and disclosure, constitute a collective identity: the globally accountable urban governor. The chapter provides empirical referents for this process of normative and identity convergence, and establishes the connection between these and observations of increased coordination and collective effort.
We introduce and investigate new invariants of pairs of modules
over quantum affine algebras
by analyzing their associated
-matrices. Using these new invariants, we provide a criterion for a monoidal category of finite-dimensional integrable
-modules to become a monoidal categorification of a cluster algebra.
Currently, the prevention and treatment of CVD have been a global focus since CVD is the number one cause of mortality and morbidity. In the pathogenesis of CVD, it was generally thought that impaired cholesterol homeostasis might be a risk factor. Cholesterol homeostasis is affected by exogenous factors (i.e. diet) and endogenous factors (i.e. certain receptors, enzymes and transcription factors). In this context, the number of studies investigating the potential mechanisms of dietary fatty acids on cholesterol homeostasis have increased in recent years. As well, the cluster of differentiation 36 (CD36) receptor is a multifunctional membrane receptor involved in fatty acid uptake, lipid metabolism, atherothrombosis and inflammation. CD36 is proposed to be a crucial molecule for cholesterol homeostasis in various mechanisms including absorption/reabsorption, synthesis, and transport of cholesterol and bile acids. Moreover, it has been reported that the amount of fatty acids and fatty acid pattern of the diet influence the CD36 level and CD36-mediated cholesterol metabolism principally in the liver, intestine and macrophages. In these processes, CD36-mediated cholesterol and lipoprotein homeostasis might be impaired by dietary SFA and trans-fatty acids, whereas ameliorated by MUFA in the diet. The effects of PUFA on CD36-mediated cholesterol homeostasis are controversial depending on the amount of n-3 PUFA and n-6 PUFA, and the n-3:n-6 PUFA ratio. Thus, since the CD36 receptor is suggested to be a novel nutrient-sensitive biomarker, the role of CD36 and dietary fatty acids in cholesterol metabolism might be considered in medical nutrition therapy in the near future. Therefore, the novel nutritional target of CD36 and interventions that focus on dietary fatty acids and potential mechanisms underlying cholesterol homeostasis are discussed in this review.
We prove that any skew-symmetrizable cluster algebra is unistructural, which is a conjecture by Assem, Schiffler and Shramchenko. As a corollary, we obtain that a cluster automorphism of a cluster algebra
is just an automorphism of the ambient field
which restricts to a permutation of the cluster variables of
We administered the Personality Disorder Examination (PDE) to 31 patients meeting DSM III criteria for obsessive-compulsive disorder (OCD) and to an age-and sex-matched healthy control group. Seventeen patients (54.8%) and four controls (12.9%) met criteria for one or more DSM III Axis II diagnoses. The most frequent Axis II diagnoses in patients were avoidant, passive-aggressive and compulsive personality disorder. Compulsive personality disorder was diagnosed in 6 OCD patients (19.3%). The prevalence of this disorder did not change according to sex, age of onset or duration of OCD, and severity of obsessive-compulsive symptoms.
This chapter demonstrates the varied role the foot has played in shaping phonological and morphophonological patterns across the Germanic languages. Data from German and Dutch dialects highlight how features are licensed differently in strong versus weak branches of feet paving the way for a range of patterns including medial consonant cluster simplification and consonant lenition which often result in worsened phonetic cues. The trochee is shown to shape morphological processes such as Dutch and German plural formation via prosodic templates in both the standard languages and dialects. Lastly, vowel balance in Frisian and Scandinavian, a process often argued to result from stress patterns and stem shapes, is reinterpreted in terms of the trochaic foot. The foot-based approach provides a unified account for various manifestations of vowel balance across the dialects. Scratching the surface of Germanic phenomena, the chapter serves to invite the reader to consider other patterns which may also be prosodically driven in terms of the foot and foot-based templates.
The distribution of 282 Research Diagnostic Criteria (RDC) and of 224 DSM-III-R schizophrenic patients, respectively, by month of their birth was studied. The winter-spring birth rate excess was confirmed with a maximum from January to March. Winterborn and summer-born schizophrenics were compared. No convincing differences were found with regard to a larger set of demographic, psychosocial and clinical variables in univariate comparisons, nor did we succeed in separating and identifying a special winter-born schizophrenia subgroup using the method of cluster analysis. Negative results were obtained in spite of the fact that many of the included variables reflected the course of the illness and the degree of chronicity. Either the set of the variables we used has not been ‘correct’ enough or the separation of a winter-born subgroup is not clinically feasible.