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.
Late-life depression has substantial impacts on individuals, families and society. Knowledge gaps remain in estimating the economic impacts associated with late-life depression by symptom severity, which has implications for resource prioritisation and research design (such as in modelling). This study examined the incremental health and social care expenditure of depressive symptoms by severity.
We analysed data collected from 2707 older adults aged 60 years and over in Hong Kong. The Patient Health Questionnaire-9 (PHQ-9) and the Client Service Receipt Inventory were used, respectively, to measure depressive symptoms and service utilisation as a basis for calculating care expenditure. Two-part models were used to estimate the incremental expenditure associated with symptom severity over 1 year.
The average PHQ-9 score was 6.3 (standard deviation, s.d. = 4.0). The percentages of respondents with mild, moderate and moderately severe symptoms and non-depressed were 51.8%, 13.5%, 3.7% and 31.0%, respectively. Overall, the moderately severe group generated the largest average incremental expenditure (US$5886; 95% CI 1126–10 647 or a 272% increase), followed by the mild group (US$3849; 95% CI 2520–5177 or a 176% increase) and the moderate group (US$1843; 95% CI 854–2831, or 85% increase). Non-psychiatric healthcare was the main cost component in a mild symptom group, after controlling for other chronic conditions and covariates. The average incremental association between PHQ-9 score and overall care expenditure peaked at PHQ-9 score of 4 (US$691; 95% CI 444–939), then gradually fell to negative between scores of 12 (US$ - 35; 95% CI - 530 to 460) and 19 (US$ -171; 95% CI - 417 to 76) and soared to positive and rebounded at the score of 23 (US$601; 95% CI -1652 to 2854).
The association between depressive symptoms and care expenditure is stronger among older adults with mild and moderately severe symptoms. Older adults with the same symptom severity have different care utilisation and expenditure patterns. Non-psychiatric healthcare is the major cost element. These findings inform ways to optimise policy efforts to improve the financial sustainability of health and long-term care systems, including the involvement of primary care physicians and other geriatric healthcare providers in preventing and treating depression among older adults and related budgeting and accounting issues across services.
Stratospheric airships are promising aircraft, usually designed as a non-rigid airship. As an essential part of the non-rigid airship, the envelope plays a significant role in maintaining its shape and bearing the external force load. Generally, the envelope material of a flexible airship consists of plain-weave fabric, composed of warp and weft fibre yarn. At present, biaxial tensile experiments are the primary method used to study the stress–strain characteristics of such flexible airship materials. In this work, biaxial tensile testing of UN-5100 material was carried out. The strain on the material under unusual stress and the stress ratio were obtained using Digital Image Correlation (DIC) technology. Also, the stress–strain curve was corrected by polynomial fitting. The slope of the stress–strain curve at different points, the Membrane Structures Association of Japan (MSAJ) standard and the Radial Basis Function (RBF) model were compared to identify the stress–strain characteristics of the materials. Some conclusions on the mechanical properties of the flexible airship material can be drawn and will play a significant role in the design of such envelopes.
Anaphylaxis is a severe allergic reaction that can be life-threatening. The literature indicates that the incidence of anaphylaxis is increasing and that there are deficiencies in both recognition and management. We aimed to examine the magnitude of these gaps in Canadian pediatric emergency medicine (PEM).
We conducted a self-administered survey of the Pediatric Emergency Research Canada (PERC) physician database. The survey tool was developed through a literature review to identify recurring themes of gaps in anaphylaxis diagnosis and management. The final tool contained four scenarios; three scenarios featured each of the National Institute of Allergy and Infectious Diseases (NIAID) anaphylaxis criteria, separately, and a fourth case of non-anaphylactic allergy. Multiple-choice questions associated with each scenario addressed diagnosis, management, and disposition. Additional questions focused on epinephrine prescribing, observation durations, and respondent demographics.
Of the 214 members invited to participate in the survey, 152 (71%) responded. Anaphylaxis was accurately recognized 93%, 82%, and 99% of the time for the NIAID criteria one through three, respectively. When anaphylaxis was recognized, epinephrine was prescribed for each case 96%, 95%, and 72% of the time, respectively. Of all respondents, 115 (76%) accurately diagnosed all three cases of anaphylaxis and 82 (54%) treated anaphylaxis with epinephrine each time it was indicated.
Most respondents recognized cases of anaphylaxis; however, a substantial number demonstrated gaps in management that may adversely impact this vulnerable population. The recognition of anaphylaxis without urticaria or pulmonary findings and treatment of anaphylaxis with epinephrine, where indicated, were the main gaps identified.
Hydrogen production from water electrolysis with renewable energy input has been the focus of tremendous attention, as hydrogen is widely advocated as a clean energy carrier. In order to realize large-scale hydrogen generation from water splitting, it is essential to develop competent and robust electrocatalysts that will substantially decrease the overpotential requirement and improve energy efficiency. Recent advances in electrocatalyst design reveal that interfacial engineering is an effective approach in tuning the adsorption–desorption abilities of key catalytic intermediates on active sites, accelerating electron transfer, and stabilizing the active sites for long-term operation. Consequently, a large number of hybrid electrocatalysts consisting of metal/compound interfaces have been demonstrated to exhibit superior performance for electrocatalytic hydrogen evolution from water. This article highlights examples of these hybrid electrocatalysts, including noble metal and non-noble metal candidates interfaced with a variety of compounds. Specific emphasis is placed on the synthetic methods, reaction mechanisms, and electrocatalytic activities, which are envisioned to inspire the design and development of further improved electrocatalysts for hydrogen evolution from water splitting on an industrial scale.
OBJECTIVES/GOALS: This study’s goal is to examine the feasibility and acceptability of using VRM to impact the APP of adults in the inpatient setting. Aims include examining the: 1) feasibility of VRM for APP management; 2) acceptability of using VRM for APP management; and 3) experience of VRM for APP management. METHODS/STUDY POPULATION: To comprehensively examine participants’ experience of using VRM for APP, this study will employ a convergent mixed-methods design in which living kidney donors (N = 45) will be recruited to serially use VRM during their hospital stay. Feasibility and acceptability will be evaluated using descriptive and inferential statistics evaluating patient-reported outcome (PRO) measures taken pre-, post- and 1-hour post-VRM, PRO measures extracted from the participant’s electronic health record and data on VRM use. Semi-structured interviews will allow formulation of inferences based on participants’ experience of VRM for APP management and their insights on content, deployment, and clinical use of VRM. RESULTS/ANTICIPATED RESULTS: This in-process study expects: 1) an adequate sample of participants undergoing living kidney donor surgery who agree to enroll with retention of >90% of participants (Aim 1); 2) participants to report VRM as an acceptable and suitable treatment, feel “present” and interested in the VR environment, and feel comfortable using VRM in the hospital (Aim 2); and 3) to provide insight into participants’ experience of VRM for APP, understanding of extended VRM use for APP analgesia, examination of key variables affecting participants’ experience of VRM for APP and feedback about VRM procedures and protocol to inform future VRM use for APP management (Aim 3). DISCUSSION/SIGNIFICANCE OF IMPACT: Results of the proposed study will inform future clinical testing and deployment of VRM, guide future use of VRM as an adjunct for inpatient APP management, and provide insight into inpatients’ experience of VRM for APP analgesia.
At present, analysis of diet and bladder cancer (BC) is mostly based on the intake of individual foods. The examination of food combinations provides a scope to deal with the complexity and unpredictability of the diet and aims to overcome the limitations of the study of nutrients and foods in isolation. This article aims to demonstrate the usability of supervised data mining methods to extract the food groups related to BC. In order to derive key food groups associated with BC risk, we applied the data mining technique C5.0 with 10-fold cross-validation in the BLadder cancer Epidemiology and Nutritional Determinants study, including data from eighteen case–control and one nested case–cohort study, compromising 8320 BC cases out of 31 551 participants. Dietary data, on the eleven main food groups of the Eurocode 2 Core classification codebook, and relevant non-diet data (i.e. sex, age and smoking status) were available. Primarily, five key food groups were extracted; in order of importance, beverages (non-milk); grains and grain products; vegetables and vegetable products; fats, oils and their products; meats and meat products were associated with BC risk. Since these food groups are corresponded with previously proposed BC-related dietary factors, data mining seems to be a promising technique in the field of nutritional epidemiology and deserves further examination.
The risk factors of criminal behavior in patients with schizophrenia are not well explored. This study is to explore the risk factors for criminal behavior in patients with schizophrenia in rural China.
We used data from a 14-year prospective follow-up study (1994-2008) of criminal behavior among a cohort (n=510) of patients with schizophrenia in Xinjin County, Chengdu, China.
There were 489 patients (95.9%) who were followed up from 1994 to 2008. The rate of criminal behavior was 13.5% among these patients with schizophrenia during the follow-up period. Compared with female subjects (6 cases, 20.0%), male patients had significantly higher rate of violent criminal behavior (e.g., arson, sexual assault, physical assault, and murder) (24 cases, 80.0%) (p< 0.001). Bivariate analyses showed that the risk of criminal behavior was significantly associated with being unmarried, of younger age, previous violent behavior, homelessness, lower family economic status, no family caregivers, and higher scores on measures (PANSS) of positive, negative, and total symptoms of illness. In multiple logistic regression analyses being unmarried and previous violent behavior were identified as independent predictors of increased criminal behavior in persons with schizophrenia.
The risk factors for criminal behavior among patients with schizophrenia should be understood within a particular social context. Criminal behavior may be predicted by specific characteristics of patients with schizophrenia in rural community. The findings of risk factors for criminal behavior should be considered in planning community mental health care and interventions for high-risk patients and their families.
To evaluate newborn fluoxetine exposure at different period on development and behavior of adult rats.
Male rat pups were randomized to be treated once daily with fluoxetine(s.c.) or saline(s.c.) during postnatal day 1∼7 and postnatal day 8∼21. Recorded the body weight. Starting at 90 days of age, all rats were tested with several experimental facilities, including open field test, elevated-plus maze, novelty- suppressed feeding test and forced swim test.
1 Weight gain of rats with fluoxetine exposure during postnatal day 1∼7 were lower than controls (P<0.05).
2 Exploratory behavior decreased and depression anxiety behavior increased in adult rats with neonatal fluoxetine exposure (P<0.05), and more severe with postnatal day 1∼7 exposure (P<0.05).
Newborn fluoxetine exposure may result badness weight gain and depression anxiety behavior in adult rats, and the earlier exposure may accompany the larger risk.
To explore rearing, coping, attributional style and their relations in depression adolescents.
64 adolescents with depressive disorder and 125 normal subjects of similar age, sex were presented with self-made social demographic scale, Egna Minnen av Barndoms Uppfostran-own memories of parental rearing practices in childhood (EMBU), Children attributional style questionnaire (CASQ) and Coping style questionnaire.
1. As to EMBU, there was a significant deficit in parental emotional warmth (p< 0.001) with depression adolescents, and whose parental punishment and strict (p< 0.05), rejection and denial (p< 0.001) were higher than normal ones.
2. As to CASQ, the differences were significant in self-blame (p< 0.001), asking for help (p< 0.001), daydreaming (p< 0.001) and recession (p< 0.05).
3. The difference of attributional pattern was significant (p< 0.001).
4. Mather’ emotional warmth and rejection and denial were both related to adolescents’ coping style and attributional style.
Depressive adolescents had negative coping style and attributional style, and mother’ rearing style may has relation with them.
To explore the characteristics of cerebral activation during the performance of WCST in first-episode, drug-naive schizophrenic patients by functional magnetic resonance imaging,Wisconsin Card Sorting Test (WCST) and Color Card Sorting Test (CCST).
Twenty healthy adults and twenty schizophrenic patients underwent fMRI with a 1.5T MR imager with gradient echo-EPI sequence during the performance of Wisconsin Card Sorting Test (WCST) and Color Card Sorting Test (CCST). The functional images of two groups were analyzed with analysis software. The active volume of interested brain areas and the performance of WCST were compared between healthy group and patient group. Results:(1) The performance of WCST in first-episode drug-naive schizophrenic group were significantly lower than the performance in healthy group(P<0.01) . (2) The images subtracted the functional images of CCST from those of WCST in healthy group suggested that activations were mainly localized in the bilateral frontal lobe, especially the dorsolateral prefrontal cortex,posterior parietal cortices and anterior cingulate gyrus.(3)The patients group showed less activations in left dorsolateral prefrontal cortex(P<0.01), left anterior cingulated (P<0.05),but more activations in left posterior parietal cortices(P<0.05).
The dorsolateral prefrontal cortex and anterior cingulate of first-episode schizophrenic patients are hypofunction,which maybe involved in the executive function disorder in schizophrenia. The hyperactivity of posterior parietal cortices maybe can compensate the hypofrontality in a certain extent.
Automutilation behavior and Suicidal thinking are common in individuals with bipolar disorder. Few studies have investigated the prevalence of and risk factors for self-injury behavior and Suicidal ideation among adolescent patients.
Patients aged from 13 to 18 years old with bipolar I or II disorder (DSM-IV criteria) diagnosed with structured interviews were evaluated using demographic, parents rearing style and adolescent self-rating life events checklist questionnaires to assess incidence and correlates of automutilation behavior and Suicidal ideation. Demographic and psychosocial characteristics were compared for patients with and without a history of self-injury and suicidal ideation.
More boys attempted self-insult (P= .035)and more girls had suicidal thinking (P= .005). The 44% of patients with a history of automutilation behavior, compared with those without such a history, had more negative life events(P=.000);more paternal punish(P=.024),interfere(P=.004)rejecting and negation(P=.008)and maternal rejecting and negation(P=.020). The 67% of patients with suicidal thinking, compared with those without such a history, had more negative life events(P=.033);more maternal interfere and protection(P=.024).
Our retrospective findings indicate that a history of automutilation behavior and suicidal ideation is associated with a more negative life events and more negative parental rearing style. Greater attention to realizing those at high risks for self-injury behavior and suicidal thinking could have an impact on bipolar disorder among adolescents.
This case-control study aimed to assess the intervention effects of six-session interpersonal psychotherapy (IPT-A) on reducing the severity of anxiety and depression in adolescent victims.
A total of 30 adolescents who had clinical significant level after experiencing bullied experiences were allocated to a six-session course of IPT-A (N = 15) or to treatment as usual (TAU) (N = 15). T test was performed to examine the effect of IPT-A on reducing the severity of anxiety and depression related to the bullied events.
Pre-intervention age, sex, anxiety and depression showed no significant difference between two groups. As the preintervention severity of two groups were no significant different, results showed the IPT-A group to have significantly lower post-intervention severity levels of anxiety and depression (p< .05) than the TAU group. Effective size showed moderate to high level between IPT-A and TAU.
The results of this study support the effectiveness of the IPT-A in improving anxiety symptoms and depression in adolescents experiencing traumatic bullied experiences.
This article presents a brief review of our case studies of data-driven Integrated Computational Materials Engineering (ICME) for intelligently discovering advanced structural metal materials, including light-weight materials (Ti, Mg, and Al alloys), refractory high-entropy alloys, and superalloys. The basic bonding in terms of topology and electronic structures is recommended to be considered as the building blocks/units constructing the microstructures of advanced materials. It is highlighted that the bonding charge density could not only provide an atomic and electronic insight into the physical nature of chemical bond of materials but also reveal the fundamental strengthening/embrittlement mechanisms and the local phase transformations of planar defects, paving a path in accelerating the development of advanced metal materials via interfacial engineering. Perspectives on the knowledge-based modeling/simulations, machine-learning knowledge base, platform, and next-generation workforce for sustainable ecosystem of ICME are highlighted, thus to call for more duty on the developments of advanced structural metal materials and enhancement of research productivity and collaboration.
Apolipoprotein E (APOE) E4 is the main genetic risk factor for Alzheimer’s disease (AD). Due to the consistent association, there is interest as to whether E4 influences the risk of other neurodegenerative diseases. Further, there is a constant search for other genetic biomarkers contributing to these phenotypes, such as microtubule-associated protein tau (MAPT) haplotypes. Here, participants from the Ontario Neurodegenerative Disease Research Initiative were genotyped to investigate whether the APOE E4 allele or MAPT H1 haplotype are associated with five neurodegenerative diseases: (1) AD and mild cognitive impairment (MCI), (2) amyotrophic lateral sclerosis, (3) frontotemporal dementia (FTD), (4) Parkinson’s disease, and (5) vascular cognitive impairment.
Genotypes were defined for their respective APOE allele and MAPT haplotype calls for each participant, and logistic regression analyses were performed to identify the associations with the presentations of neurodegenerative diseases.
Our work confirmed the association of the E4 allele with a dose-dependent increased presentation of AD, and an association between the E4 allele alone and MCI; however, the other four diseases were not associated with E4. Further, the APOE E2 allele was associated with decreased presentation of both AD and MCI. No associations were identified between MAPT haplotype and the neurodegenerative disease cohorts; but following subtyping of the FTD cohort, the H1 haplotype was significantly associated with progressive supranuclear palsy.
This is the first study to concurrently analyze the association of APOE isoforms and MAPT haplotypes with five neurodegenerative diseases using consistent enrollment criteria and broad phenotypic analysis.
With rapid urbanization worldwide, most people now live in cities, but the effects of urbanization on knowledge about the natural environment is not well studied. Due to the importance of Cymbidium to Chinese traditional culture, we tested how urbanization influences the distribution of orchid knowledge across various knowledge domains at risk of loss due to declining orchid populations. Participants in the Cymbidium trade were interviewed in three distinct urbanization-level jurisdictions in Sichuan, China: Puge (low urbanization), Huili (moderate urbanization) and Chengdu (high urbanization). Using photographic cue-cards of nine Cymbidium taxa, we assessed aggregate and specific knowledge held by 91 orchid collectors/traders across the urbanization gradient. Contrary to expectations, we found that urbanization and orchid knowledge were positively related, but this varied by knowledge type, with moderate urbanization showing significantly higher knowledge in two domains. Our findings suggest that a generalizable understanding of how urbanization affects knowledge must account for differences in knowledge types and geographic/cultural scales, with implications for biocultural diversity conservation in an increasingly urban world.
For decades, fructose intake has been recognised as an environmental risk for metabolic syndromes and diseases. Here we comprehensively examined the effects of fructose intake on mice liver transcriptomes. Fructose-supplemented water (34 %; w/v) was fed to both male and female C57BL/6N mice at their free will for 6 weeks, followed by hepatic transcriptomics analysis. Based on our criteria, differentially expressed genes (DEG) were selected and subjected to further computational analyses to predict key pathways and upstream regulator(s). Subsequently, predicted genes and pathways from the transcriptomics dataset were validated via quantitative RT-PCR analyses. As a result, we identified eighty-nine down-regulated and eighty-eight up-regulated mRNA in fructose-fed mice livers. These DEG were subjected to bioinformatics analysis tools in which DEG were mainly enriched in xenobiotic metabolic processes; further, in the Ingenuity Pathway Analysis software, it was suggested that the aryl hydrocarbon receptor (AhR) is an upstream regulator governing overall changes, while fructose suppresses the AhR signalling pathway. In our quantitative RT-PCR validation, we confirmed that fructose suppressed AhR signalling through modulating expressions of transcription factor (AhR nuclear translocator; Arnt) and upstream regulators (Ncor2, and Rb1). Altogether, we demonstrated that ad libitum fructose intake suppresses the canonical AhR signalling pathway in C57BL/6N mice liver. Based on our current observations, further studies are warranted, especially with regard to the effects of co-exposure to fructose on (1) other types of carcinogens and (2) inflammation-inducing agents (or even diets such as a high-fat diet), to find implications of fructose-induced AhR suppression.
Sufficient amino acid (AA) transport is essential to ensure the normal physiological function and growth of growing animals. The processes of AA sensing and transport in humans and murine animals, but rarely in goats, have been arousing great interest recently. This study was conducted to investigate the messenger RNA expression patterns of lysophosphatidic acid receptor 5 (LPAR5), guanine nucleotide-binding protein α-transducing 3 (GNAT3) and important partial AA transporters in digestive tracts, metabolic organs and muscles of growing goats. The results showed that these genes were widely expressed in goats, and had different expression patterns. LPAR5, GNAT3, solute carrier (SLC38A2), SLC7A7, SLC7A1 and SLC3A1 were rarely expressed in the rumen, but were highly expressed in the abomasum and intestine which are the main sites of AA absorption. GNAT3, SLC38A1, SLC38A2, SLC6A19, SLC7A7 and SLC7A1 showed comparatively high expression in the pancreas and the vital digestive glands, and the relatively high expression of these nine genes were noted in the tibialis posterior, the active muscle in energy metabolism. The correlation analysis showed that there were certain positive correlation among most genes. The current results indicate that the AA sensing and transport occur extensively in the abomasum and small intestine, metabolic organs and muscle tissues of ruminants, and that related genes have tissue specificity.
The response of soil microbial communities to soil quality changes is a sensitive indicator of soil ecosystem health. The current work investigated soil microbial communities under different fertilization treatments in a 31-year experiment using the phospholipid fatty acid (PLFA) profile method. The experiment consisted of five fertilization treatments: without fertilizer input (CK), chemical fertilizer alone (MF), rice (Oryza sativa L.) straw residue and chemical fertilizer (RF), low manure rate and chemical fertilizer (LOM), and high manure rate and chemical fertilizer (HOM). Soil samples were collected from the plough layer and results indicated that the content of PLFAs were increased in all fertilization treatments compared with the control. The iC15:0 fatty acids increased significantly in MF treatment but decreased in RF, LOM and HOM, while aC15:0 fatty acids increased in these three treatments. Principal component (PC) analysis was conducted to determine factors defining soil microbial community structure using the 21 PLFAs detected in all treatments: the first and second PCs explained 89.8% of the total variance. All unsaturated and cyclopropyl PLFAs except C12:0 and C15:0 were highly weighted on the first PC. The first and second PC also explained 87.1% of the total variance among all fertilization treatments. There was no difference in the first and second PC between RF and HOM treatments. The results indicated that long-term combined application of straw residue or organic manure with chemical fertilizer practices improved soil microbial community structure more than the mineral fertilizer treatment in double-cropped paddy fields in Southern China.