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Major depressive disorder (MDD) is a leading cause of disability and premature mortality. This study compared the overall survival (OS) between patients with MDD and non-MDD controls stratified by gender, age, and comorbidities.
Methods
This nationwide population-based cohort study utilized longitudinal patient data (01/01/2010 – 12/31/2020) from the Hungarian National Health Insurance Fund database, which contains healthcare service data for the Hungarian population. Patients with MDD were selected and matched 1:1 to those without MDD using exact matching. The rates of conversion from MDD to bipolar disorder (BD) or schizophrenia were also investigated.
Results
Overall, 471,773 patients were included in each of the matched MDD and non-MDD groups. Patients with MDD had significantly worse OS than non-MDD controls (hazard ratio [HR] = 1.50; 95% CI: 1.48−1.51; males HR = 1.69, 95% CI: 1.66–1.72; females HR = 1.40, 95% CI: 1.38–1.42). The estimated life expectancy of patients with MDD was 7.8 and 6.0 years less than that of controls aged 20 and 45 years, respectively. Adjusted analyses based on the presence of baseline comorbidities also showed that patients with MDD had worse survival than non-MDD controls (adjusted HR = 1.29, 95% CI: 1.28–1.31). After 11 years of follow-up, the cumulative conversions from MDD to BD and schizophrenia were 6.8 and 3.4%, respectively. Converted patients had significantly worse OS than non-converted patients.
Conclusions
Compared with the non-MDD controls, a higher mortality rate in patients with MDD, especially in those with comorbidities and/or who have converted to BD or schizophrenia, suggests that early detection and personalized treatment of MDD may reduce the mortality in patients diagnosed with MDD.
The purpose of this study was to explore the electroencephalogram (EEG) features sensitive to situation awareness (SA) and then classify SA levels. Forty-eight participants were recruited to complete an SA standard test based on the multi-attribute task battery (MATB) II, and the corresponding EEG data and situation awareness global assessment technology (SAGAT) scores were recorded. The population with the top 25% of SAGAT scores was selected as the high-SA level (HSL) group, and the bottom 25% was the low-SA level (LSL) group. The results showed that (1) for the relative power of $\beta$1 (16–20Hz), $\beta$2 (20–24Hz) and $\beta$3 (24–30Hz), repeated measures analysis of variance (ANOVA) in three brain regions (Central Central-Parietal, and Parietal) × three brain lateralities (left, midline, and right) × two SA groups (HSL and LSL) showed a significant main effect for SA groups; post hoc comparisons revealed that compared with LSL, the above features of HSL were higher. (2) for most ratio features associated with $\beta$1 ∼ $\beta$3, ANOVA also revealed a main effect for SA groups. (3) EEG features sensitive to SA were selected to classify SA levels with small-sample data based on the general supervised machine learning classifiers. Five-fold cross-validation results showed that among the models with easy interpretability, logistic regression (LR) and decision tree (DT) presented the highest accuracy (both 92%), while among the models with hard interpretability, the accuracy of random forest (RF) was 88.8%, followed by an artificial neural network (ANN) of 84%. The above results suggested that (1) the relative power of $\beta$1 ∼ $\beta$3 and their associated ratios were sensitive to changes in SA levels; (2) the general supervised machine learning models all exhibited good accuracy (greater than 75%); and (3) furthermore, LR and DT are recommended by combining the interpretability and accuracy of the models.
This paper documents the design and construction of MUSE, the world's first permanent magnet (PM) stellarator and the first quasi-axisymmetric experiment. The purpose of MUSE is to develop and assess a new way of building optimised stellarators that uses simple planar coils PMs. Our PM optimisation algorithm consists of initialising a geometry to pack dipoles densely, running the FAMUS code to minimise surface field error subject to PM constraints and applying discrete jumps to reach a physically realisable solution. FAMUS treats the PM system as a set of ideal point dipoles. From there we construct finite-volume magnet towers to be housed in 3D-printed PM holders. We describe the design of the PM holders, which were validated by laser metrology. We analyse the effects of finite permeability, sensitivity to perturbations and magnetostatic forces. An exact analytic formula for the magnetic field from a finite-volume PM tower is presented to compute PM–PM forces and stress on the PM holder. Stellarator construction is complete and experiments are underway.
A machine learning model was created to predict the electron spectrum generated by a GeV-class laser wakefield accelerator. The model was constructed from variational convolutional neural networks, which mapped the results of secondary laser and plasma diagnostics to the generated electron spectrum. An ensemble of trained networks was used to predict the electron spectrum and to provide an estimation of the uncertainty of that prediction. It is anticipated that this approach will be useful for inferring the electron spectrum prior to undergoing any process that can alter or destroy the beam. In addition, the model provides insight into the scaling of electron beam properties due to stochastic fluctuations in the laser energy and plasma electron density.
The goal for many PhD students in archaeology is tenure-track employment. Students primarily receive their training by tenure-track or tenured professors, and they are often tacitly expected—or explicitly encouraged—to follow in the footsteps of their advisor. However, the career trajectories that current and recent PhD students follow may hold little resemblance to the ones experienced by their advisors. To understand these different paths and to provide information for current PhD students considering pursuing a career in academia, we surveyed 438 archaeologists holding tenured or tenure-track positions in the United States. The survey, recorded in 2019, posed a variety of questions regarding the personal experiences of individual professors. The results are binned by the decade in which the respondent graduated. Evident patterns are discussed in terms of change over time. The resulting portraits of academic pathways through the past five decades indicate that although broad commonalities exist in the qualifications of early career academics, there is no singular pathway to obtaining tenure-track employment. We highlight the commonalities revealed in our survey to provide a set of general qualifications that might provide a baseline set of skills and experiences for an archaeologist seeking a tenure-track job in the United States.
To investigate the downstream rim seal gas ingestion characteristics of a 1.5-stage turbine, the URANS equations were solved numerically using the SST turbulence model. The effects of different purge flow rates and the second vane on the ingestion characteristics of the aft cavity and the nonuniform fluctuations of the main gas path pressure are analysed. The results showed that the aft cavity is affected by the combined effects of the blade and the second vane, and the potential field at the leading edge of the second vane greatly influence the airflow variation in the aft cavity, which enhances the ingress of the mainstream into the wheel-space. The front purge flow weakens the egress between the suction side of the blade and the suction side of the second vane. The potential field at the leading edge of the second vane suppresses the nonuniform distribution of airflow in the aft cavity caused by the rotational effect of the blade.
We report on experimental observation of non-laminar proton acceleration modulated by a strong magnetic field in laser irradiating micrometer aluminum targets. The results illustrate the coexistence of ring-like and filamentation structures. We implement the knife edge method into the radiochromic film detector to map the accelerated beams, measuring a source size of 30–110 μm for protons of more than 5 MeV. The diagnosis reveals that the ring-like profile originates from low-energy protons far off the axis whereas the filamentation is from the near-axis high-energy protons, exhibiting non-laminar features. Particle-in-cell simulations reproduced the experimental results, showing that the short-term magnetic turbulence via Weibel instability and the long-term quasi-static annular magnetic field by the streaming electric current account for the measured beam profile. Our work provides direct mapping of laser-driven proton sources in the space-energy domain and reveals the non-laminar beam evolution at featured time scales.
Food manufacturers are under increasing pressure to limit the amount of free sugars in their products. Many have reformulated products to replace sucrose, glucose and fructose with alternative sweeteners, but some of these have been associated with additional health concerns. Rare sugars are ‘monosaccharides and their derivatives that hardly exist in nature’, and there is increasing evidence that they could have health benefits. This review aimed to scope the existing literature in order to identify the most commonly researched rare sugars, to ascertain their proposed health benefits, mechanisms of action and potential uses and to highlight knowledge gaps. A process of iterative database searching identified fifty-five relevant articles. The reported effects of rare sugars were noted, along with details of the research methodologies conducted. Our results indicated that the most common rare sugars investigated are d-psicose and d-tagatose, with the potential health benefits divided into three topics: glycaemic control, body composition and CVD. All the rare sugars investigated have the potential to suppress postprandial elevation of blood glucose and improve glycaemic control in both human and animal models. Some animal studies have suggested that certain rare sugars may also improve lipid profiles, alter the gut microbiome and reduce pro-inflammatory cytokine expression. The present review demonstrates that rare sugars could play a role in reducing the development of obesity, type 2 diabetes and/or CVD. However, understanding of the mechanisms by which rare sugars may exert their effects is limited, and their effectiveness when used in reformulated products is unknown.
Dorsal root ganglia (DRG) at all levels of the spinal cord are a prominent target of Friedreich ataxia (FA). The lesions include hypoplasia of neurons, proliferation of satellite cells, infiltration by IBA- 1-reactive monocytes, and formation of residual nodules. Paucity and smallness of DRG neurons account for the lack of large myelinated axons in dorsal roots and sensory peripheral nerves. The lack of myelin in dorsal roots can be attributed to low levels of neuregulin 1 type III (NRG1[III]). Lysates of 13 DRG of genetically confirmed FA patients were analyzed by antibody microarray with 878 different validated antibodies that target structural and signaling proteins, and by Western blots. KIT and mTOR, two proteins involved in cellular proliferation, were significantly upregulated in the DRG of FA. KIT is a transmembrane receptor that dimerizes when it binds two molecules of stem cell factor (SCF) in its extracellular domain and becomes activated as protein tyrosine kinase. Immunohistochemistry with anti-KIT generated reaction product in satellite cells of normal DRG and prominent labeling of these cells in FA that co-localized with SCF on double- label immunofluorescence; SCF was present in S100-positive satellite cells rather than monocytes. Immunohistochemical reaction product of mTOR and other mTOR complex proteins, such as hamartin (TSC1), tuberin (TSC2), raptor (mTOR complex 1) and rictor (mTOR complex 2) was also present in satellite cells of normal DRG and DRG of FA. Antibodies to two downstream proteins that are considered to be indicators of mTOR activity, P70 S6K and 4E-binding protein 1, revealed no reaction product in DRG of FA. TSC1, TSC2, and mTOR are best known from their roles in tuberous sclerosis, but expression of these proteins, and KIT, in DRG may contribute to signaling cascades underlying the proliferation of satellite cells in FA.
LEARNING OBJECTIVES
This presentation will enable the learner to:
1. Discuss cellular proliferation in the pathogenesis of the DRG lesion in Friedreich ataxia
CONFLICT OF INTEREST
AHK is a consultant to PTC Therapeutics of South Plainfield, NJ USA. SP and CS are majority owners of Kinexus.
Few topics within the study of creativity and innovation incite as much passion as assessment or measurement, the process of gathering data representing one’s aptitudes, knowledge, attitudes, cognition, or potential. This appears to be especially true when the topic is discussed among non-academics who work in creative fields: A colleague once shared a story concerning his speaking about creativity with designers at a major entertainment company. He off-handedly mentioned measurement and … suffice it to say, he did not find the kingdom to be so magical from that point forward. The conventional wisdom is that creativity is too difficult to measure and many people are surprised to learn that creativity assessment has a long, rich history.
Precise instrumental calibration is of crucial importance to 21-cm cosmology experiments. The Murchison Widefield Array’s (MWA) Phase II compact configuration offers us opportunities for both redundant calibration and sky-based calibration algorithms; using the two in tandem is a potential approach to mitigate calibration errors caused by inaccurate sky models. The MWA Epoch of Reionization (EoR) experiment targets three patches of the sky (dubbed EoR0, EoR1, and EoR2) with deep observations. Previous work in Li et al. (2018) and (2019) studied the effect of tandem calibration on the EoR0 field and found that it yielded no significant improvement in the power spectrum (PS) over sky-based calibration alone. In this work, we apply similar techniques to the EoR1 field and find a distinct result: the improvements in the PS from tandem calibration are significant. To understand this result, we analyse both the calibration solutions themselves and the effects on the PS over three nights of EoR1 observations. We conclude that the presence of the bright radio galaxy Fornax A in EoR1 degrades the performance of sky-based calibration, which in turn enables redundant calibration to have a larger impact. These results suggest that redundant calibration can indeed mitigate some level of model incompleteness error.
Increasing evidence supports that 5HTTLPR polymorphism of the serotonin transporter gene(5HTTLPR) might associate to bipolar disorder and affective temperaments as measured by TEMPS-A. But the results are discrepant, furthermore, there are no data from Chinese population.
Objectives:
The present study was designed to investigate association between 5HTTLPR and bipolar disorder and affective temperaments of patients with bipolar disorder in the specific Chinese population and add new evidence to the field.
Methods:
There hundred and five patients with bipolar disorder and 272 normal controls were included in the present case-control study⌧Temperament Evaluation of Memphis, Pisa, Paris and San Diego -autoquestionnaire version (TEMPS-A) in Chinese was used to assess affective temperament. Chi-square test, T test, Nonparametric test and ANOVA were employed to explore association between 5HTTLPR polymorphism and bipolar disorder and affective temperament of patients with bipolar disorder.
Results:
5-HTTLPR L/S polymorphism was associated with bipolar disorder in female (genotype χ2 = 6.769⌧P = 0.034⌧allele χ2 = 6.028⌧P = 0.014) and the S allele was associated with anxious temperament (t = 8.248⌧P = 0.005) in patients with bipolar disorder. the LA allele of 5-HTTLPR rs25531 A/G polymorphism was associated with hyperthymic temperament in patients with bipolar disorder (Z = −2.205⌧P = 0.027).
Conclusions:
5-HTTLPR might have an effect on the prevalence of bipolar disorder in female and regulate affective temperaments of patients with bipolar disorder in some degree in Chinese population.
To explore the relationship between resilience and social support, coping style of children in two middle schools for providing an evidence for improving childrens’resilience.
Methods:
Six hundred childrens were surveyed with the Connor-Davidson resilience questionnaire(CD-RISC), perceived social support scale(PSSS)and coping style questionnaire (CSQ).
Results:
Resilience had significant difference between male and female children.
The resilience was positively correlated with social support and two factors of coping style: seeking help and solving problem, but negatively correlated with the other factors in coping style questionnaire.
Conclusion:
Children with high score in Connor-Davidson resilience questionnaire are more tend to the positive coping style.
Social support is an important factor of resilience in children.
This chapter provides an overview of creativity assessment, which is typically grouped into four different types or areas: creative processes, creative persons, creative products, and creative environments. The most widely used, as well as newly developed, creativity measures in each area are summarized and analyzed with regard to their reliability and validity evidence. Strengths and weaknesses of creativity assessment as a whole are also provided at the end of the chapter to help researchers and educators better understand the current state of creativity assessment and needed future research.
We document that a firm’s culture, specifically, its religiosity, affects its cost of debt. Firms in higher-religiosity counties have higher credit ratings and lower debt costs. The impact of religiosity is stronger for firms with greater information asymmetry and during recessions. Further, religiosity has additional explanatory power for the cost of bank loans (but not the cost of public bonds) beyond its impact through ratings. This supports the argument that banks have superior abilities in pricing soft information, such as corporate culture. Finally, the impact of religiosity is stronger when the lender is a small bank.
We re-analyzed OJ287 in 120 Very Long Baseline Array (VLBA, MOJAVE) observations (at 15 GHz) covering the time span between Apr. 1995 and Apr. 2017. We find that the radio jet motion over the sky is consistent with a precessing and nutating jet source. The variability of the radio flux-density can be explained by Doppler beaming due to a change in the viewing angle. We suggest that part of the optical emission is due to synchrotron emission related to the jet radiation. We find a strikingly similar scaling for the timescales for precession and nutation as indicated for SS433 with a factor of roughly 50 times longer in OJ287.
Spatiotemporal analysis is an important tool to monitor changes of tuberculosis (TB) epidemiology, identify high-risk regions and guide resource allocation. However, there are limited data on the contributing factors of TB incidence. This study aimed to investigate the spatiotemporal pattern of TB incidence and its associated factors in mainland China during 2005–2013. Global Moran's I test, Getis-Ord Gi index and heat maps were used to examine the spatial clustering and seasonal patterns. Generalized Linear Mixed Model was applied to identify factors associated with TB incidence. TB incidence presented high geographical variations with two main hot spots, while a generally consistent seasonal pattern was observed with a peak in late winter. Furthermore, we found province-level TB incidence increased with the proportion of the elderly but decreased with Gross Demographic Product per capita and the male:female ratio. Meteorological factors also influenced TB incidence. TB showed obvious spatial clustering in mainland China and both the demographic and socio-economic factors and meteorological measures were associated with TB incidence. These results provide the related information to identify the high-risk districts and the evidence for the government to develop corresponding control measures.
We investigated the first presence of qnrA among Shigella sonnei clinical isolates in Jiangsu Province, China. The qnrA-positive isolates coexisted with the mutation in gyrA at codon 83, these isolates were resistant to nalidixic acid and 22·2% (2 of 9) of them were resistant to norfloxacin.
Introduction: The Calgary Stampede is a two-week mass gathering occurring annually in July. Clinicians have anecdotally noted increases in emergency department (ED) and urgent care (UC) visits, especially for complaints related to substance misuse and violence. Our objectives were: 1) to determine if there is an increase in overall visits to EDs and UCs during the Stampede, and 2) to determine if there are increases in presentations related to trauma, violence, or intoxication. Methods: This observational study used prospectively collected administrative data from five EDs and two UCs in Calgary. For the years 2013 to 2016, daily average data during Stampede dates were compared to the data from the 21 days immediately preceding and following the event. Dates were selected to incorporate a similar proportion of weekends and weekdays in the Stampede and non-Stampede periods. The primary outcome was daily average ED and UC utilization. Secondary outcomes included time of arrival, utilization by demographic groups, complaint category at triage, or International Statistical Classification of Diseases, 10th revision (ICD-10) diagnosis. Results: The study period included 263 380 individual ED and UC visits (34 492 Stampede and 228 888 non-Stampede visits). Daily average ED and UC visits increased by 2.1% (p<0.0001) during the Stampede period. Increases in utilization were identified in specific subgroups: male, ambulance arrival, and nighttime arrival between 2000 and 0400 (all p<0.05). The Stampede period saw a marked increase in CTAS 1 visits (16.2%, p<0.01), triage complaints of lacerations (12.4%, p<0.0001) and blunt trauma (19.4%, p<0.0001), and the ICD-10 diagnosis of substance misuse (23.9%, p=0.01). Visits triaged to the minor treatment areas increased by 9.5% (p<0.0001), again most markedly at night (15.3%, p<0.0001).No differences were detected for triage complaints of altered level of consciousness, sexual assault, head or neck injury, limb injury, or social problems. Conclusion: The Calgary Stampede provokes appreciable changes in overall ED and UC utilization, with marked increases in nighttime visits, visits by men, trauma or substance abuse-related complaints, and minor treatment visits. This data may be useful in manpower planning to ensure optimal patient flow and service delivery during mass gatherings.
The E2F transcription factor family is distributed widely in eukaryotes and has been well studied among mammals. In the present study, the E2F transcription factor 4 (E2F4) gene was isolated from fat bodies of Antheraea pernyi and sequenced. E2F4 comprised a 795 bp open reading frame encoding a deduced amino acid sequence of 264 amino acid residues. The recombinant protein was expressed in Escherichia coli (Transetta DE3), and anti-E2F4 antibodies were prepared. The deduced amino acid sequence displayed significant homology to an E2F4-like protein from Bombyx mori L. Quantitative real-time polymerase chain reaction analysis revealed that E2F4 expression was highest in the integument, followed by the fat body, silk glands, and haemocytes. The expression of E2F4 was upregulated in larvae challenged by bacterial (Escherichia coli, Micrococcus luteus), viral (nuclear polyhedrosis virus), and fungal (Beauveria bassiana) pathogens. These observations indicated that E2F4 is an inducible protein in the immune response of A. pernyi and probably in other insects.