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Subthreshold depression (sD) negatively impacts well-being and psychosocial function and is more prevalent compared with major depressive disorder (MDD). However, as adults with sD are less likely to seek face-to-face intervention, internet-based cognitive-behavioral therapy (ICBT) may overcome barriers of accessibility to psychotherapy. Although several trials explored the efficacy of ICBT for sD, the results remain inconsistent. This study evaluated whether ICBT is effective in reducing depressive symptoms among Chinese adults with sD.
A randomized controlled trial was performed. The participants were randomly assigned to 5 weeks of ICBT, group-based face-to-face cognitive-behavioral therapy (CBT), or a waiting list (WL). Assessments were conducted at baseline, post-intervention and at a 6-month follow-up. The primary outcome measured depressive symptoms using the Center for Epidemiological Studies Depression Scale (CES-D). Outcomes were analyzed using a mixed-effects model to assess the effects of ICBT.
ICBT participants reported greater reductions on all the outcomes compared to the WL group at post-intervention. The ICBT group showed larger improvement on the Patient Health Questionnaire-9 (PHQ-9) at post-intervention (d = 0.12) and at follow-up (d = 0.10), and with CES-D at post-intervention (d = 0.06), compared to the CBT group.
ICBT is effective in reducing depressive symptoms among Chinese adults with sD, and improvements in outcomes were sustained at a 6-month follow-up. Considering the low rates of face-to-face psychotherapy, our findings highlight the considerable potential and implications for the Chinese government to promote the use of ICBT for sD in China.
This study aims to explore clinicians’ practices and attitudes regarding advance care planning (ACP) in mainland China.
This study was a multicenter cross-sectional survey. Clinicians from tertiary hospitals in Beijing, Guangxi, and Inner Mongolia were invited to participate in the study. A questionnaire was formulated based on related literature to obtain information including demographic characteristics, and practices and attitudes toward ACP.
The total number of participants included 285 clinicians. The data response rate was 84.57%. Most of the clinicians had an inadequate understanding of ACP. Only a few clinicians had experience in participating or witnessing an ACP or related end-of-life discussions. Among 285 clinicians, 69.82% of clinicians were willing to introduce ACP to patients. Two hundred and thirty-eight (83.51%) clinicians wanted more education on ACP. Almost all clinicians believed that patients had the right to know about their diagnosis, prognosis, and available care options. Most clinicians (82.11%) regarded that ACP was partially feasible in mainland China. If clinicians had a serious illness, almost everyone was willing to find out their true health status and decide for themselves, and 81.40% wanted to institute an ACP for themselves. The biggest barriers to the use of ACP in mainland China were cultural factors. Statistical analysis revealed that some or good understanding level (P = 0.0052) and practical experience (P = 0.0127) of ACP were associated with the positive willingness.
Significance of results
ACP is still in its infancy in mainland China. Clinicians had inadequate understanding and minimal exposure to ACP. Most clinicians recognized the value and significance of ACP and had a positive attitude toward ACP. Clinicians need to be provided with education and training to promote their ACP practices. Culturally appropriate ACP processes and documents need to be developed based on Chinese culture and Chinese needs.
To improve the corrosion resistance and to increase the hardness of copper substrate in marine environment, the Cu-Ni/Ni-P composite coatings were prepared on the copper substrate using the galvanostatic electrolytic deposition method. The deposition current densities were explored to find the optimized deposition conditions for forming the composite coatings. Corrosion resistance properties were analyzed using the polarization curves and electrochemical impedance spectroscopy (EIS). Considering the corrosion resistance and hardness, the −20 mA/cm2 was selected to deposit Cu-Ni coatings on copper substrate and the −30 mA/cm2 was selected to deposit Ni-P coating on the Cu-Ni layer. The Cu-Ni/Ni-P composite coatings not only exhibited superior corrosion resistance compared to single Cu-Ni coating in 3.5 wt.% NaCl solution, but also showed much better mechanical properties than single Cu-Ni coating.
This research automates edge detection for perovskite crystal grains using machine learning (ML). Once the edges of the crystal grains are located, a flood-fill algorithm can be used to find the distribution of crystal grain areas. The ML algorithm uses GNU Octave to run a regularized logistic regression algorithm that classifies each pixel of an input image as part of an edge or not part of an edge. The basic features used for the algorithm are each pixel’s grayscale intensity, its Sobel derivative. Higher order Sobel derivatives, higher degree polynomial terms, and intensities convolved by various kernels were used as additional features to improve the program’s accuracy and true-positive rate. Training data is obtained by using non-ML Canny Edge Detection to annotate the edges an SEM image of a pure perovskite solar cell (PSC). The classifier exhibits an 85.58% accuracy and produces an edge mask that clearly outlines the crystals visually. The ML edge mask exhibits far fewer false-positive mis-classifications for pixels in the middle of the crystals than Canny. However, the ML mask’s edges are fainter, owing to a lower true-positive classification rate. Using more kernels, higher order derivatives, and higher degree polynomial terms all significantly increased the true positive rate of the classifier, leading to thicker edges. This algorithm can greatly accelerate perovskite solar cell research (and potentially any research requiring particle size analysis), automating a process scientists previously had to perform by hand. This will facilitate the search for a solution for the world’s growing demands for renewable energy.
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