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More than 50% patients with major depressive disorder (MDD) have severe functional impairment. The restoration of patient functioning is a critical therapeutic goal among patients with MDD. We conducted a systematic review and network meta-analysis to evaluate the efficacy of pharmacological treatments on self-rated functional outcomes using the Sheehan Disability Scale in adults with MDD in randomized clinical trials.
PubMed, EMBASE, PsycINFO, Cochrane Library, and ClinicalTrials.gov were searched from inception to December 10, 2019. Summary statistics are reported as weighted mean differences with 95% confidence intervals. Interventions were ranked using the surface under the cumulative ranking probabilities.
We included 42 randomized controlled trials (RCTs) (n = 18 998) evaluating the efficacy of 13 different pharmacological treatments on functional outcomes, as measured by the Sheehan Disability Scale (SDS). Duloxetine was the most effective pharmacological agent on functional outcomes, followed by (ranked by efficacy): paroxetine, levomilnacipran, venlafaxine, quetiapine, desvenlafaxine, agomelatine, escitalopram, amitriptyline, bupropion, sertraline, vortioxetine, and fluoxetine. Serotonin and norepinephrine reuptake inhibitors were more effective than other drug classes. Additionally, the comparison-adjusted funnel plot suggested the publication bias between small and large studies was relatively low.
Our results indicate that there may be differences across antidepressant agents and classes with respect to self-reported functional outcomes. Validation and replication of these findings in large-scale RCTs are warranted. Our research results will be clinically useful for guiding psychiatrists in treating patients with MDD and functional impairment. PROSPERO registration number CRD42018116663.
Cardiac fibroma is a rare benign primary tumour of the heart. In the paediatric population, it has been reported as the second most common benign cardiac tumour following rhabdomyoma. However, the prevalence of cardiac fibroma is rarely reported in the adult population. Signs and symptoms are nonspecific, including palpitations, cardiac murmur, arrhythmias, dyspnoea, cyanosis, chest pain, and sudden mortality, whereas, a number of patients with cardiac fibroma are asymptomatic. Surgical resection should be considered as the best option in symptomatic patients. This study reported four surgical cases of adults with cardiac fibroma arising from the left ventricle and a literature review regarding the clinical and pathological features, diagnostic modalities, therapeutic aspects, and prognosis of this rare entity.
The sea cucumber Apostichopus japonicus is a deposit-feeder and vital for marine benthic ecosystems. Hypoxia can influence the behaviour and even lead to massive mortality in A. japonicus in the wild. It is important to understand the molecular responses of A. japonicus when exposed to acute changes in dissolved oxygen (DO) concentration. In this study, RNA-seq provided a general overview of the gene expression profiles of the respiratory tree of A. japonicus exposed to DO of 8 mg l−1 (DO8), 4 mg l−1 (DO4) and 2 mg l−1 (DO2) conditions. Differentially expressed genes (DEGs) screening with the NOISeq method identified 51, 59 and 61 DEGs according to the criteria of fold change ≥2 and divergence probability ≥0.8 in the comparisons of DO2 vs DO4, DO2 vs DO8 and DO4 vs DO8, respectively. Gene ontology analysis showed that ‘cellular process’ and ‘binding’ had the most enriched DEGs in the categories of ‘biological process’ and ‘molecular function’, respectively (catalytic activity also had the most enriched DEGs in the category of ‘molecular function’ based on the comparison of DO2 vs DO8), while ‘cell’ and ‘cell part’ had the most enriched DEGs in the category of ‘cellular component’. The DEGs were mapped to 79, 81 and 104 pathways in the KEGG database, and 8, 29 and 16 pathways were significantly enriched, respectively. The DO-specific DEGs identified in this study of the respiratory tree are important targets for further research into the biochemical mechanisms involved in the response of the sea cucumber to changes in the DO concentration.
To retrospectively analyze the rescue and treatment of pediatric patients by the Chinese Red Cross medical team during the Nepal earthquake relief.
The medical team set up a field hospital; the pediatric clinic consisted of 1 pediatrician and several nurses. Children younger than 18 years old were placed in the pediatric clinic for injury examination and treatment.
During the 7-day period of medical assistance (the second to third week after the earthquake), a total of 108 pediatric patients were diagnosed and treated, accounting for 2.8% of the total patients. The earthquake-related injuries mainly required surgical dressing and debridement. No severe limb fractures or traumatic brain injuries were found. Infection of the respiratory tract, the gastrointestinal tract, and the skin were the most common ailments, accounting for 42.3%, 18.5%, and 16.7%, respectively, of the total treated patients.
Two to 3 weeks after the earthquake, the admitted pediatric patients mainly displayed respiratory and gastrointestinal infections. When developing a rescue plan and arranging medical resources, we should consider the necessity of treating non–disaster-related conditions. (Disaster Med Public Health Preparedness. 2016;page 1 of 4)
Crack propagation behaviors in a precracked single crystal Ag under mode I loading at different temperatures are studied by molecular dynamics simulation. The simulation results show that the crack propagation behaviors are sensitive to external temperature. At 0 K, the crack propagates in a brittle manner. Crack tip blunting and void generation are first observed followed by void growth and linkage with the main crack, which lead to the propagation of the main crack and brittle failure immediately without any microstructure evolution. As the temperature gets higher, more void nucleations and dislocation emissions occur in the crack propagation process. The deformation of the single crystal Ag can be considered as plastic deformation due to dislocation emissions. The crack propagation dynamics characterizing the microstructure evolution of atoms around the crack tip is also shown. Finally, it is shown that the stress of the single crystal Ag changes with the crack length synchronously.
Melanin-concentrating hormone (MCH) is a neuropeptide and its receptor is extensively expressed throughout the brain. MCH has been suggested to regulate the rewarding and reinforcing effects of psychostimulants by potentiating the dopaminergic system within the midbrain. Moreover, MCH and its receptor can regulate ERK activity. The present study investigated the role of MCH in the nucleus accumbens (NAc) in rats behaviourally sensitized to methamphetamine (Meth). We found that the development of Meth-induced locomotor sensitization was attenuated by MCH infused into the NAc shell but not core. Moreover, the elevation of ERK phosphorylation in the NAc shell induced by Meth was inhibited by locally infused MCH. Infusion of the MCH receptor 1 (MCHR1) antagonist SNAP 94847 into the NAc shell but not core augmented the initiation of locomotor sensitization and amplitude of elevated phosphorylated ERK levels induced by Meth. The expression of Meth-induced locomotor sensitization and ERK alterations after 1 wk withdrawal were not affected by either MCH or SNAP 94847 infused into the NAc shell or core. These results indicate that MCH in the NAc shell plays a critical role in the development but not expression of Meth-induced locomotor sensitization in rats, which might be mediated by the ERK signalling pathway. Our study suggests that MCH might be a potential target for the treatment of Meth addiction.
In 2008 January the 24th Chinese expedition team successfully deployed the Chinese Small Telescope ARray (CSTAR) to Dome A, the highest point on the Antarctic plateau. CSTAR consists of four 14.5cm optical telescopes, each with a different filter (g, r, i and open) and has a 4.5°×4.5° field of view (FOV). Based on the CSTAR data, initial statistics of astronomical observational site quality and light curves of variable objects were obtained. To reach higher photometric quality, we are continuing to work to overcome the effects of uneven cirrus cloud cirrus, optical “ghosts” and intra-pixel sensitivity. The snow surface stability is also tested for further astronomical observational instrument and for glaciology studies.
The purpose of the present study was to evaluate the impact of a lifestyle intervention programme, combined with a daily low-glycaemic index meal replacement, on body-weight and glycaemic control in subjects with impaired glucose regulation (IGR). Subjects with IGR were randomly assigned to an intervention group (n 46) and a control group (n 42). Both groups received health counselling at baseline. The intervention group also received a daily meal replacement and intensive lifestyle intervention to promote healthy eating habits during the first 3 months of the study, and follow-up visits performed monthly until the end of the 1-year study. Outcome measurements included changes in plasma glucose, glycated Hb (HbA1c), plasma lipids, body weight, blood pressure and body composition (such as body fat mass and visceral fat area). The results showed that body-weight loss after 1 year was significant in the intervention group compared with the control group ( − 1·8 (sem 0·35) v.− 0·6 (sem 0·40) 2·5 kg, P< 0·05). The 2 h plasma glucose concentration decreased 1·24 mmol/l in the intervention group and increased 0·85 mmol/l in the control group (P< 0·05) compared with their baseline, respectively. A 5 kg body-weight loss at 1 year was associated with a decrease of 1·49 mmol/l in 2 h plasma glucose (P< 0·01). The incidence of normal glucose regulation (NGR) in the two groups was significantly different (P= 0·001). In conclusion, the combination of regular contact, lifestyle advice and meal replacement is beneficial in promoting IGR to NGR.
The aims of the present study were to examine the serum amino acid profiles in obese and non-obese women and investigate the relationships between the serum amino acids and inflammation and oxidative stress in a human case–control study. Serum amino acids, inflammatory biomarkers (C-reactive protein and IL-6) and oxidative biomarkers (superoxide dismutase, malondialdehyde and glutathione peroxidase) were measured and compared in 235 obese women and 217 non-obese controls. The relationships between serum amino acids and inflammatory and oxidative biomarkers were examined using multiple linear regression. Among the amino acids determined, serum histidine, arginine, threonine, glycine, lysine and serine were found to be significantly lower in obese women as compared to non-obese controls (P < 0·001). The difference was the greatest for histidine (P < 0·001). In obese women, both histidine and arginine were negatively associated with inflammation and oxidative stress. In non-obese controls, histidine was negatively associated with oxidative stress. The findings in this study indicate that the metabolism of amino acids is abnormal in obese women in whom histidine and arginine have close relationships with inflammation and oxidative stress.
PLATO is a fully-robotic observatory designed for operation in
Antarctica. It generates its own electricity (about 1 kW), heat
(sufficient to keep two 10-foot shipping containers comfortably above
0°C when the outside temperature is at -70°C), and
connects to the internet using the Iridium satellite system (providing
~30 MB/day of data transfer). Following a successful first year of
operation at Dome A during 2008, PLATO was upgraded with
new instruments for 2009.
In January 2005, members of a Chinese expedition team were the first
humans to visit Dome A on the Antarctic plateau, a site
predicted to be one of the very best astronomical sites on earth. In 2006, the Chinese Center for Antarctic Astronomy (CCAA) was founded
to promote the development of astronomy in Antarctica, especially at
Dome A. CCAA has since taken part in two traverses to Dome A, organized
by the Polar Research Institute of China (PRIC), in the austral
summers of 2007/2008 and 2008/2009. These traverses resulted in the
installation of many site-testing and science instruments, supported
by the PLATO observatory. The Chinese Small Telescope ARray (CSTAR)
has produced excellent results from Dome A. Our future plans include further site-testing work, and the following
full-scale science instruments: three 0.5-m Antarctic Schmidt
Telescopes (AST3), and a proposed 4-m telescope for wide-field
infrared high spatial-resolution surveys. The first AST3 telescope is
under construction and is scheduled for installation in 2011.
The THz spectral region includes a number of important transitions which
allow us to trace the evolution of the interstellar medium. Because of the
opacity of the atmosphere in this spectral range, the best sites for
ground-based THz observations are on the Antarctic Plateau; of these sites,
Dome A is expected to be the best. THz survey science can be carried out
with small telescopes, easing logistical constraints. By deploying a
submillimetre-wave tipper/ telescope to Dome A, we have trialled several
technologies for such an instrument, and we are able to test whether the
site quality is sufficient for THz surveys.
PLATO is a 6 tonne completely self-contained robotic observatory that provides its own heat, electricity, and satellite communications. It was deployed to Dome A in Antarctica in January 2008 by the Chinese expedition team, and is now in its second year of operation. PLATO is operating four 14.5cm optical telescopes with 1k × 1k CCDs, a wide-field sky camera with a 2k × 2k CCD and Sloan g, r, i filters, a fibre-fed spectrograph to measure the UV to near-IR sky spectrum, a 0.2m terahertz telescope, two sonic radars giving 1m resolution data on the boundary layer to a height of 180m, a 15m tower, meteorological sensors, and 8 web cameras. Beginning in 2010/11 PLATO will be upgraded to support a Multi Aperture Scintillation Sensor and three AST3 0.5m schmidt telescopes, with 10k × 10 CCDs and 100TB/annum data requirements.
The successful synthesis of ZnS hollow microspheres by a solvothermal route is reported. The synthesis was achieved by a proper selection of a sulfur source, i.e., Na2S2O3⋅5H2O or (NH2)2CS, to react with Zn(CH3COO)2⋅2H2O in mixed solvents of ethylene glycol and deionized water. The ZnS products were characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM), transmission electron microscopy (TEM), and photoluminescence spectroscopy. XRD identified the ZnS products to have either zinc blende or wurtzite structure. SEM images revealed hollow ZnS microspheres with 1 to 2 μm diameters and 100 to 200 nm shell thicknesses. TEM images confirmed that the hollow ZnS microspheres were assembled by ZnS crystalline nanocrystallites. The room-temperature photoluminescence spectrum of the zinc blende hollow microspheres showed a strong green emission at 514 nm and weak emission at 379 nm.
CdTe thin films were grown on indium tin oxide glass substrates by a closed-space sublimation method using a resistor heater. Crystalline structure, morphology, and band gaps of the films were characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM), and optical absorption, respectively. The XRD analysis showed that the textures of the films were found to depend on the rate of increase in the heating current. The CdTe thin film had an (111) texture when the heating current rate was 2.0 A/min. The SEM analysis revealed that the film is composed of polyhedral grains of microns size. However, the (111) texture of the CdTe thin film observed by XRD decreased with the appearance of (220), (311), (400), (331), (422), and (511) peaks of the fcc CdTe phase when the heating current rate increased to 4.5 A/min. The (111) texture disappeared when the heating current was increased immediately from 0 A to the target current of 70 A. SEM results revealed that the grains in the film are round and the grain size is smaller than 1 μm. Optical absorption analysis showed that there is no distinctive difference in the band gaps of the films.
Dome A, the summit of the Antarctic plateau, is expected to have even
better atmospheric conditions for ground-based astronomy than Dome C.
Instruments to evaluate and exploit Dome A's astronomical potential
must operate within logistical constraints, which are currently
very stringent. Instrumentation now at Dome A exemplifies the
techniques and solutions required by this environment. Future
instrumentation and infrastructure will allow the qualities of the site
to be exploited much more fully.
To increase our understanding of the relationships of trunk fat mass (FMtrunk) and four anthropometric indices in Chinese males, 1090 males aged 20–40 years were randomly recruited from the city of Changsha, China. Waist circumference (WC) and hip circumference (HC) were measured using standardized equipment, and three other anthropometric indices of BMI, waist:hip ratio (WHR) and conicity index (CoI) were calculated using weight, height, HC and WC. FMtrunk (in kg) was measured using a Hologic QDR 4500 W dual-energy X-ray absorptiometry scanner. There was an increasing trend of FMtrunk, %FMtrunk (percentage of FMtrunk) and BMI, WC, WHR, CoI in successively older age groups (e.g. the mean FMtrunk values were 4·63 (sd 2·58), 5·39 (sd 2·74), 5·93 (sd 2·82), 6·57 (sd 2·94) in four 5-year age groups, respectively). FMtrunk and %FMtrunk were significantly correlated with four anthropometric indices with the Pearson's correlation coefficients ranging from 0·25 to 0·86. Principal component analysis was performed to form three principal components that interpreted over 99·5% of the total variation of four related anthropometric indices in all age groups, with over 65% of the total variation accounted by principal component 1. Multiple regression analyses showed that three principal components explained a greater variance (R2 70·0–80·1%) in FMtrunk than did BMI or WC alone (R2 57·8–74·1%). The present results suggest that there is an increasing trend of FMtrunk and four anthropometric indices in successively older age groups; that age has important effects on the relationships of FMtrunk and studied anthropometric indices; and that the accuracy of predicting FMtrunk using four anthropometric indices is higher than using BMI or WC alone.
The performance of a fluidized cracking catalyst additive prepared from caustic-modified kaolin microspheres for gasoline S reduction was investigated using N2 adsorption, infrared acid-site characterization, X-ray diffraction and small-scale fluid bed reactor tests. The additive exhibited improved coke selectivity and yield distribution, and the S content of cracked gasoline was reduced significantly. The results indicated that a reactive mesoporous structure was formed in the modified kaolin.
Template-directed co-condensation was used to synthesize phenyl-modified MSU-1 and bi-functionalized MSU-1 silica containing binary moieties of covalently linked phenyl along with methyl or ureidopropyl [H2NCONH(CH2)3]. The texture properties of these materials from x-ray diffraction, Fourier transform infrared, nuclear magnetic resonance, scanning electron microscopy, high-resolution transmission electron microscopy, N2 adsorption, thermogravimetric analysis data, varied with the type of alkoxylsilane precursor and the amount of organosiloxane in the mixture. Small-angle x-ray scattering results, for the as-synthesized and surfactant-extracted organo-modified MSU-X, showed that the templates remaining in the mesostructures gave positive deviation from Porod's law while the incorporated organic groups led to a negative deviation, which formed an interfacial layer between the pore and silica matrix.
Using the pulsed laser ablation (PLA) technique, conductive LaNiO3 thin films have been successfully grown on (001) Si substrates. The XRD θ-2θ scan patterns indicate a preferential (110) orientation, and the electron probe microanalyzer (EPMA) investigations show that the three elements La, Ni, and O distribute uniformly in the films. The resistivity of the as-deposited LaNiO3 films display a metallic character. Polycrystalline PbTiO3films are deposited by metalorganic chemical vapor deposition (MOCVD) on these LaNiO3 electrodes. Ferroelectricity measurements of the PbTiO3/LaNiO3 heterostructure prove LaNiO3 to be a promising electrode material in the integration of ferroelectrics and Si wafer.
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