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Women with schizophrenia frequently discontinue antipsychotic medications during pregnancy. However, evidence on the risk of postpartum relapse associated with antipsychotic use during pregnancy is lacking.
Aims
To investigate the within-individual association between antipsychotic continuation during pregnancy and postpartum relapse in women with schizophrenia.
Method
This retrospective cohort study used data of women with schizophrenia who gave live birth between 2007 and 2018 identified from the National Health Information Database of South Korea. Women were classified according to antipsychotic use patterns during the 12 months before delivery as non-users, discontinuers and continuers. Relapse was defined as admission for psychosis (ICD-10, F20–29). The incidence rate ratio (IRR) for admission for psychosis in the 6-month postpartum period was estimated using conditional Poisson regression, with the reference period set between 2 and 1 years before delivery. Additionally, we calculated the relative risk ratios (RRRs) for the IRRs of different antipsychotic use patterns.
Results
Among the 3026 women included in the analysis (median age 34 years, interquartile range 31–37), the within-individual risk of admission for psychosis in the 6-month postpartum period was 0.56 times (RRR, 95% CI 0.36–0.87) lower in continuers (IRR = 1.31, 95% CI 0.89–1.72) than in discontinuers (IRR = 2.34, 95% CI 1.87–2.91). Among discontinuers, the IRRs of admission for psychosis in the 6-month postpartum period did not change significantly with the timing of discontinuation (trend P = 0.946).
Conclusions
Antipsychotic continuation during pregnancy was associated with a reduced risk of postpartum relapse in women with schizophrenia. Continuing antipsychotics during pregnancy would be recommended after a risk–benefit assessment.
This study investigates the flow structures and combustion regimes in an axisymmetric cavity-based scramjet combustor with a total temperature of 1800 K and a high Reynolds number of approximately 1 × 107. The hydroxyl planar laser-induced fluorescence technique, along with the broadband flame emission and CH* chemiluminescence, is employed to visualize the instantaneous flame structure in the optically accessible cavity. The jet-wake flame stabilization mode is observed, with intense heat release occurring in the jet wake upstream of the cavity. A hybrid Reynolds-averaged Navier–Stokes/large-eddy simulation approach is performed for the 0.18-equivalent-ratio case with a pressure-corrected flamelet/progress variable model. The combustion regime is identified mainly in the corrugated or wrinkled flamelet regime (approximately 102 < Da < 104, 103 < Ret < 105 where $Da$ is the Damköhler number and $Re_t$ is the turbulent Reynolds number). The combustion process is jointly dominated by supersonic combustion (which accounts for approximately 58 %) and subsonic combustion, although subsonic combustion has a higher heat release rate (peak value exceeding 1 × 109 J (m3s)−1). A partially premixed flame is observed, where the diffusion flame packages a considerable quantity of twisted premixed flame. The shockwave plays a critical role in generating vorticity by strengthening the volumetric expansion and baroclinic torque term, and it can facilitate the chemical reaction rates through the pressure and temperature surges, thereby enhancing the combustion. Combustion also shows a remarkable effect on the overall flow structures, and it drives alterations in the vorticity of the flow field. In turn, the turbulent flow facilitates the combustion and improves the flame stabilization by enhancing the reactant mixing and increasing the flame surface area.
Ridge B is one of the least studied areas in Antarctica but has been considered to be a potential location for the oldest ice on Earth. Among important parameters for calculating where very old ice may exist, geothermal heat flux (GHF) is critical but poorly understood. Here, GHF is determined by quantifying the transitions between dry and wet basal conditions using a radioglaciological method applied to airborne radio-echo sounding data. GHF is then constrained by a thermodynamic model matched to the transitions. The results show that GHF in Ridge B varies locally and ranges from 48.5 to 65.1 mW m−2, with an average value of 58.0 mW m−2, which is consistent with the current known GHF constrained by subglacial lakes and derived from Vostok ice core temperature measurements. Our work highlights the value of considering local GHF when locating the oldest ice in this potential region or other regions.
This paper retrospectively analysed the prevalence of macrolide-resistant Mycoplasma pneumoniae (MRMP) in some parts of China. Between January 2013 and December 2019, we collected 4,145 respiratory samples, including pharyngeal swabs and alveolar lavage fluid. The highest PCR-positive rate of M. pneumoniae was 74.5% in Beijing, the highest resistance rate was 100% in Shanghai, and Gansu was the lowest with 20%. The highest PCR-positive rate of M. pneumoniae was 74.5% in 2013, and the highest MRMP was 97.4% in 2019; the PCR-positive rate of M. pneumoniae for adults in Beijing was 17.9% and the MRMP was 10.48%. Among the children diagnosed with community-acquired pneumonia (CAP), the PCR-positive and macrolide-resistant rates of M. pneumoniae were both higher in the severe ones. A2063G in domain V of 23S rRNA was the major macrolide-resistant mutation, accounting for more than 90%. The MIC values of all MRMP to erythromycin and azithromycin were ≥ 64 μg/ml, and the MICs of tetracycline and levofloxacin were ≤ 0.5 μg/ml and ≤ 1 μg/ml, respectively. The macrolide resistance varied in different regions and years. Among inpatients, the macrolide-resistant rate was higher in severe pneumonia. A2063G was the common mutation, and we found no resistance to tetracycline and levofloxacin.
Recently, studies on the use of polymer nanomaterial composites as pour-point depressants (PPD) have drawn much attention, but the crystallization properties and improved rheological performance of waxy crude oils using nanoclay-based composite PPDs have rarely been reported. In this paper, montmorillonite (Mnt) was first organically modified using octadecyltrimethylammonium chloride (C21H46NCl, or stearyltrimethylammonium chloride) in aqueous solution. Then, the organically modified Mnt (OMnt) material was dispersed into a polyoctadecylacrylate (POA) matrix to prepare a POA/OMnt composite PPD by melt blending. The composition, structure, and morphology of Mnt, OMnt, and the POA/OMnt composite PPDs were investigated. The results showed that the OMnt and POA were compatible and that the OMnt was exfoliated into several sheets in the POA matrix. Subsequently, the isothermal crystallization kinetics of the POA/OMnt composite PPDs showed that small amounts of OMnt had a dramatic impact on POA chain motion during crystallization and facilitated POA crystallization. After it was added to a waxy crude oil, the POA/OMnt composite PPDs produced better rheological properties and performance than identical concentrations of the neat POA. The POA/OMnt composite PPDs can act as wax nucleation sites for wax molecule precipitation and result in larger and more compact wax crystal flocs, which adversely affect the formation of a wax crystal network and, thus, favor the improvement of waxy crude oil rheology.
The preparation and characterization of intercalated kaolinite is important for industries such as those using nanocomposites, but the number of compounds that can be intercalated into these clay minerals is rather limited. The purpose of this study was to expand the range of possible intercalants by developing intercalation precursors using both single and multiple (co-intercalation) precursor agents. Characterization of the resulting precursors was by X-ray powder diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), thermogravimetric analysis (TGA), and differential thermal analysis (DTA). The results show that the most successful single intercalation agent was DMSO and, among the co-intercalation agents, the DMSO/CH3OH system was the best. The preparation and characterization of kao-DMSO-KAc showed that the displacement reaction is the most efficient way to expand the interlayer spacing of kaolinite. At the same time, the lateral-bilayer arrangement of the Ac− in the interlayers was proven by study of de-intercalation of kao-KAc under high temperature.
Constraining the timing and extent of Quaternary glaciations in the Tibetan Plateau (TP) is significant for the reconstruction of paleoclimatic environment and understanding the interrelationships among climate, tectonics, and glacial systems. We investigated the late Quaternary glacial history of the Qinggulong and Juequ valleys in the Taniantaweng Mountains, southeastern TP, using cosmogenic 10Be surface exposure dating. Four major glacial events were identified based on 26 10Be ages. The exposure ages of the oldest late Quaternary glaciation correspond to Marine Oxygen Isotope Stage (MIS) 6. The maximum glacial extent was dated to 48.5–41.1 ka (MIS 3), during the last glaciation, and was more advanced than that of the last glacial maximum (LGM). Geochronology and geomorphological evidence indicate that multiple glacial fluctuations occurred in the study area during the Early–Middle Holocene. These glacial fluctuations likely were driven by the North Atlantic climate oscillations, summer solar insolation variability, Asian summer monsoon intensity, and CO2 concentration.
To alleviate the growth inhibition, and intestinal damage of Chinese mitten crab (Eriocheir sinensis) induced by low fishmeal diets (LF), an 8-week feeding trial was conducted to evaluate the addition of dietary soybean-derived bioactive peptides (SBP) in LF diets on the regulation of growth, digestion and intestinal health. The crabs were fed isonitrogenous and isoenergetic conventional diet and LF diets (10 % fishmeal replaced by soybean meal, LF) supplemented with 0, 1 %, 2 %, 4 % and 6 % SBP, respectively. The results showed that LF diet inhibited growth while inclusion of SBP quadratically remitted the growth inhibition induced by LF. For digestive function, increasing addition level of SBP quadratically improved the α-amylase and trypsin activities. For antioxidant function, LF group significantly increased the malondialdehyde content, while SBP linearly decreased the malondialdehyde level and cubically increased the anti-superoxide anion activity and total antioxidant capacity level. For intestinal health, the peritrophic membrane (PM) almost completely separated from the inner wall of the intestinal lumen, the epithelial cells reduced, the muscularis became thinner and the apoptotic signals increased in LF group; with SBP addition, the intestinal morphology was improved, with the PM adhering to the inner wall of the intestinal lumen, an increase in the number of epithelial cells and an increase in the thickness of the muscularis. Additionally, there was a decrease in apoptotic signals. Dietary SBP also increased the expression of PT and Crustin1 quadratically and decreased the expression of ALF1 linearly, ALF3 and ILF2 quadratically.
Adverse market events can affect credit supply not only by hurting financial fundamentals but also by changing the risk-taking behaviors of individual decision-makers. We provide micro-level evidence of this individual decision-making channel in the U.S. mortgage market. We find that mortgage application rejection rates are more sensitive to foreclosure intensity when loan officers are more exposed to foreclosure news, despite the same housing market and bank fundamentals. Loans originated from the affected branches have lower ex post default rates, consistent with higher lending standards being applied. In the aggregate, this effect results in tighter credit supply during housing market downturns.
We analyze a model in which an anomaly is unknown to arbitrageurs until its discovery, and test the model implications on both asset prices and arbitrageurs’ trading activities. Using data on 99 anomalies documented in the existing literature, we find that the discovery of an anomaly reduces the correlation between the returns of its decile-1 and decile-10 portfolios. This discovery effect is stronger if the aggregate wealth of hedge funds is more volatile. Finally, hedge funds increase (reverse) their positions in exploiting anomalies when their aggregate wealth increases (decreases), further suggesting that these discovery effects operate through arbitrage trading.
We report VLBI monitoring observations of the 22 GHz H2O masers toward the Mira variable BX Cam. Data from 37 epochs spanning ∼3 stellar pulsation periods were obtained between May 2018 and June 2021 with a time interval of 3–4 weeks. In particular, the VERA dual-beam system was used to measure the kinematics and parallaxes of the H2O maser features. The obtained parallax, 1.79±0.08 mas, is consistent with Gaia EDR3 and previous VLBI measurements. The position of the central star was estimated relied on Gaia EDR3 data and the center position of the 43 GHz SiO maser ring imaged with KVN. Analysis of the 3D maser kinematics revealed an expanding circumstellar envelope with a velocity of 13±4 km s−1 and significant spatial and velocity asymmetries. The H2O maser animation achieved by our dense monitoring program manifests the propagation of shock waves in the circumstellar envelope of BX Cam.
We report that vertical vibration with small amplitude and high frequency can tame convective heat transport in Rayleigh–Bénard convection in a turbulent regime. When vertical vibration is applied, a dynamically averaged ‘anti-gravity’ results that stabilizes the thermal boundary layer and inhibits the eruption of thermal plumes. This eventually leads to the attenuation of the intensity of large-scale mean flow and a significant suppression of turbulent heat transport. Accounting for both the thermally led buoyancy and the vibration-induced anti-gravitational effects, we propose an effective Rayleigh number that helps to extend the Grossmann–Lohse theory to thermal vibrational turbulence. The prediction of the reduction on both the Nusselt and Reynolds numbers obtained by the extended model is found to agree well with the numerical data. In addition, vibrational influences on the mean flow structure and the temporal evolution of Nusselt and Reynolds numbers are investigated. The non-uniform characteristic of vibration-induced ‘anti-gravity’ is discussed. The present findings provide a powerful basis for studying thermal vibrational turbulence and put forward a novel strategy for actively controlling thermal turbulence.
To generate optical vortex with multiple topological charges, a simple scheme based on the phase mask shaping technique is proposed and applied in a seeded free electron laser. With a tailored phase mask, an extreme-ultraviolet (EUV) vortex with multiple topological charges can be produced. To prove the feasibility of this method, an eight-step phase mask is designed to shape the seed laser. The simulation results demonstrate that 100-MW, fully coherent EUV vortex pulses with topological charge 2 can be generated based on the proposed technique. We have also demonstrated the possibility of generating higher topological charges by using a phase mask with more steps.
Nutritional Risk Screening index is a standard tool to assess nutritional risk, but epidemiological data are scarce on controlling nutritional status (CONUT) as a prognostic marker in acute haemorrhagic stroke (AHS). We aimed to explore whether the CONUT may predict a 3-month functional outcome in AHS. In total, 349 Chinese patients with incident AHS were consecutively recruited, and their malnutrition risks were determined using a high CONUT score of ≥ 2. The cohort patients were divided into high-CONUT (≥ 2) and low-CONUT (< 2) groups, and primary outcomes were a poor functional prognosis defined as the modified Rankin Scale (mRS) score of ≥ 3 at post-discharge for 3 months. Odds ratios (OR) with 95 % confidence intervals (CI) for the poor functional prognosis at post-discharge were estimated by using a logistic analysis with additional adjustments for unbalanced variables between the high-CONUT and low-CONUT groups. A total of 328 patients (60·38 ± 12·83 years; 66·77 % male) completed the mRS assessment at post-discharge for 3 months, with 172 patients at malnutrition risk at admission and 104 patients with a poor prognosis. The levels of total cholesterol and total lymphocyte counts were significantly lower in high-CONUT patients than low-CONUT patients (P = 0·012 and < 0·001, respectively). At 3-month post discharge, there was a greater risk for the poor outcome in the high-CONUT compared with the low-CONUT patients at admission (OR: 2·32, 95 % CI: 1·28, 4·17). High-CONUT scores independently predict a 3-month poor prognosis in AHS, which helps to identify those who need additional nutritional managements.
To explore the accuracy of estimated 24-h urinary iodine excretion (24-h UIEest) in assessing iodine nutritional status.
Design:
Fasting venous blood, 24-h and spot urine samples were collected during the day. The urinary iodine concentration (UIC) and urinary creatinine concentration (UCrC) were measured, and the urinary iodine-to-creatinine ratio (UI/Cr), 24-h UIEest, and 24-h urinary iodine excretion (24-h UIE) were calculated. At the population level, correlation and consistency between UIC, UI/Cr, 24-h UIEest and 24-h UIE were assessed using correlation analysis and Bland–Altman plots. At the individual level, receiver operating characteristic (ROC) curves were used to analyse the accuracy of the above indicators for evaluating insufficient and excessive iodine intake. The reference interval of 24-h UIEest was established based on percentile values.
Setting:
Indicator can accurately evaluate individual iodine nutrition during pregnancy remains controversial.
Participants:
Pregnant women (n 788).
Results:
Using 24-h UIE as standard, the correlation coefficients of 24-h UIEest from different periods of the day ranged from 0·409 to 0·531, and the relative average differences ranged from 4·4 % to 10·9 %. For diagnosis of insufficient iodine intake, the area under the ROC curve of 24-h UIEest was 0·754, sensitivity and specificity were 79·6 % and 65·4 %, respectively. For diagnosis of excessive iodine intake, the area of 24-h UIEest was 0·771, sensitivity and specificity were 66·7 % and 82·0 %, respectively. The reference interval of 24-h UIEest was 58·43–597·65 μg.
Conclusions:
Twenty-four-hour UIEest can better indicate iodine nutritional status at a relatively large sample size in a given population of pregnant women. It can be used for early screening at the individual level to obtain more lead time for pregnant women.
Spatial profiles of impurity emission measurements in the extreme ultraviolet (EUV) spectroscopic range in radiofrequency (RF)-heated discharges are combined with one-dimensional and three-dimensional transport simulations to study the effects of resonant magnetic perturbations (RMPs) on core impurity accumulation at EAST. The amount of impurity line emission mitigation by RMPs appears to be correlated with the ion Z for lithium, carbon, iron and tungsten monitored, i.e. stronger suppression of accumulation for heavier ions. The targeted effect on the most detrimental high-Z impurities suggests a possible advantage using RMPs for impurity control. Profiles of transport coefficients are calculated with the STRAHL one-dimensional impurity transport code, keeping $\nu /D$ fixed and using the measured spatial profiles of $\textrm{F}{\textrm{e}^{20 + }}$, $\textrm{F}{\textrm{e}^{21 + }}$ and $\textrm{F}{\textrm{e}^{22 + }}$ to disentangle the transport coefficients. The iron diffusion coefficient ${D_{\textrm{Fe}}}$ increases from $1.0- 2.0\;{\textrm{m}^2}\;{\textrm{s}^{ - 1}}$ to $1.5- 3.0\;{\textrm{m}^2}\;{\textrm{s}^{ - 1}}$ from the core region to the edge region $(\rho \gt 0.5)$ after the onset of RMPs. Meanwhile, an inward pinch of iron convective velocity ${\nu _{\textrm{Fe}}}$ decreases in magnitude in the inner core region and increases significantly in the outer confined region, simultaneously contributing to preserving centrally peaked $\textrm{Fe}$ profiles and exhausting the impurities. The ${D_{\textrm{Fe}}}$ and ${\nu _{\textrm{Fe}}}$ variations lead to reduced impurity contents in the plasma. The three-dimensional edge impurity transport code EMC3-EIRENE was also applied for a case of RMP-mitigated high-Z accumulation at EAST and compared to that of low-Z carbon. The exhaust of ${\textrm{C}^{6 + }}$ toward the scrape-off layer accompanying an overall suppression of heavier ${\textrm{W}^{30 + }}$ is observed when using RMPs.
Stable isotope ratios (δ18O and δD) in Antarctic snow and ice are basic proxy indices of climate in ice core studies. The relation between the ratios has important indicative significance for moisture sources. In general, the fractionation characteristics of the two isotopes vary with different meteorological and topographical conditions. This paper presents the spatial and temporal distribution of meteoric water line (MWL) slopes along a traverse from the Zhongshan Station (ZSS) to Dome A in East Antarctica. It is found that the slopes decrease with the increasing distance inland from the coast and the lowest slope occurred at Dome A, where the long-range transported moisture dominates and clear sky snowing have an influence. The slopes in different layers of the snowpack showed a decreasing trend with depth and this is attributed to the fractionation during the interstitial sublimation and re-condensation processes of the water vapor. Frost flower development on the interior plateau surface can greatly alter the depth evolution of the MWL slope. The coastal snow pits also go through the post-depositional smoothing effect, but their influences are not so significant as the inland regions.
During the last few decades, bed-elevation profiles from radar sounders have been used to quantify bed roughness. Various methods have been employed, such as the ‘two-parameter’ technique that considers vertical and slope irregularities in topography, but they struggle to incorporate roughness at multiple spatial scales leading to a breakdown in their depiction of bed roughness where the relief is most complex. In this article, we describe a new algorithm, analogous to wavelet transformations, to quantify the bed roughness at multiple scales. The ‘Self-Adaptive Two-Parameter’ system calculates the roughness of a bed profile using a frequency-domain method, allowing the extraction of three characteristic factors: (1) slope, (2) skewness and (3) coefficient of variation. The multi-scale roughness is derived by weighted-summing of these frequency-related factors. We use idealized bed elevations to initially validate the algorithm, and then actual bed-elevation data are used to compare the new roughness index with other methods. We show the new technique is an effective tool for quantifying bed roughness from radar data, paving the way for improved continental-wide depictions of bed roughness and incorporation of this information into ice flow models.
To estimate the prevalence of thinness, overweight and obesity among Tibetan adolescents aged 12–17 years.
Design:
Cross-sectional survey.
Setting:
Shigatse City of Tibet municipality, with an average altitude of more than 4000 m.
Participants:
Study participants included 2642 adolescents aged 12–17 years selected from six schools using a convenient cluster sampling method.
Results:
The prevalence of thinness/overweight/obesity among Tibetan adolescents was 9·4 %/5·4 %/1·4 % (China definition), 14·7 %/4·4 %/0·7 % (International Obesity Task Force (IOTF) definition), and 2·8 %/5·7 %/0·9 % (WHO definition). The prevalence of thinness and overweight was significantly different between both sexes based on each of three BMI classification criteria (P < 0·001). There was no significant difference in the prevalence of obesity between both sexes according to each of three BMI criteria. There was no clear trend in the prevalence of thinness across ages according to the China or IOTF definition (both P > 0·05), whereas an upward trend was observed for thinness in boys according to the IOTF definition (Pfor trend <0·05). In contrast, the prevalence of thinness tended to decrease with increasing age in girls according to the IOTF definition and in total sample according to the WHO definition (Pfor trend <0·05).
Conclusions:
Among Tibetan adolescents, the prevalence of overweight and obesity is relatively low, while the prevalence of thinness is high, especially in boys. These data suggest urgent attention is needed to control adolescent thinness in Tibet.