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This study aimed to develop a predictive tool for identifying individuals with high antibody titers crucial for recruiting COVID-19 convalescent plasma (CCP) donors and to assess the quality and storage changes of CCP. A convenience sample of 110 plasma donors was recruited, of which 75 met the study criteria. Using univariate logistic regression and random forest, 6 significant factors were identified, leading to the development of a nomogram. Receiver operating characteristic curves, calibration plots, and decision curve analysis (DCA) evaluated the nomogram’s discrimination, calibration, and clinical utility. The nomogram indicated that females aged 18 to 26, blood type O, receiving 1 to 2 COVID-19 vaccine doses, experiencing 2 symptoms during infection, and donating plasma 41 to 150 days after symptom onset had higher likelihoods of high antibody titres. Nomogram’s AUC was 0.853 with good calibration. DCA showed clinical benefit within 9% ~ 90% thresholds. CCP quality was qualified, with stable antibody titres over 6 months (P > 0.05). These findings highlight developing predictive tools to identify suitable CCP donors and emphasize the stability of CCP quality over time, suggesting its potential for long-term storage.
The maser instability associated with the loss-cone distribution has been widely invoked to explain the radio bursts observed in the astrophysical plasma environment, such as aurora and corona. In the laboratory plasma of a tokamak, events reminiscent of these radio bursts have also been frequently observed as an electron cyclotron emission (ECE) burst in the microwave range ($\mathrm{\sim }2{f_{\textrm{ce}}}$ near the last closed flux surface) during transient magnetohydrodynamic events. These bursts have a short duration of ~10 μs and display a radiation spectrum corresponding to a radiation temperature ${T_{e,\textrm{rad}}}$ of over $30\ \textrm{keV}$ while the edge thermal electron temperature ${T_e}$ is only in the range of $1\ \textrm{keV}$. Suprathermal electrons can be generated through magnetic reconnection, and a loss-cone distribution can be generated through open stochastic field lines in the magnetic mirror of the near-edge region of a tokamak plasma. Radiation modelling shows that a sharp distribution gradient $\partial f/\partial {v_ \bot } > 0$ at the loss-cone boundary can cause a negative absorption of ECE radiation through the maser instability. The negative absorption then amplifies the radiation so that the microwave intensity is significantly stronger than the thermal value. The significant ${T_{e,\textrm{rad}}}$ from the simulations suggests the potential role of the loss-cone maser instability in generating the ECE burst in a tokamak.
Compacted bentonite, used as an engineering barrier for permanent containment of high-level radioactive waste, is susceptible to mineral evolution resulting in compromise of the expected barrier performance due to alkaline–thermal chemical interaction in the near-field. To elucidate the mineral-evolution mechanisms within bentonite and the transformation of the nuclide adsorption properties during that period, experimental evolution of bentonite was conducted in a NaOH solution with a pH of 14 at temperatures ranging from 60 to 120°C. The results showed that temperature significantly affects the stability of minerals in bentonite under alkali conditions. The dissolution rate of fine-grained cristobalite in bentonite exceeds that of smectite, with the phase-transition products of smectite being temperature-dependent. As the temperature rises, smectite experiences a three-stage transformation: initially, at 60°C, the lattice structure thins due to the collapse of the octahedral sheets; at 80°C, the lattice disintegrates and reorganizes into a loose framework akin to albite; and by 100°C, it further reorganizes into a denser framework resembling analcime. The adsorption properties of bentonite exhibit a peak inflection point at 80°C, where the dissolution of the smectite lattice eliminates interlayer pores and exposes numerous polar or negatively charged sites which results in a decrease in specific surface area and an increase in cation exchange capacity and adsorption capacity of Eu3+. This research provides insights into the intricate evolution of bentonite minerals and the associated changes in radionuclide adsorption capacity, contributing to a better understanding of the stability of bentonite barriers and the effective long-term containment of nuclear waste.
A novel theoretical model for bubble dynamics is established that simultaneously accounts for the liquid compressibility, phase transition, oscillation, migration, ambient flow field, etc. The bubble dynamics equations are presented in a unified and concise mathematical form, with clear physical meanings and extensibility. The bubble oscillation equation can be simplified to the Keller–Miksis equation by neglecting the effects of phase transition and bubble migration. The present theoretical model effectively captures the experimental results for bubbles generated in free fields, near free surfaces, adjacent to rigid walls, and in the vicinity of other bubbles. Based on the present theory, we explore the effect of the bubble content by changing the vapour proportion inside the cavitation bubble for an initial high-pressure bubble. It is found that the energy loss of the bubble shows a consistent increase with increasing Mach number and initial vapour proportion. However, the radiated pressure peak by the bubble at the collapse stage increases with decreasing Mach number and increasing vapour proportion. The energy analyses of the bubble reveal that the presence of vapour inside the bubble not only directly contributes to the energy loss of the bubble through phase transition but also intensifies the bubble collapse, which leads to greater radiation of energy into the surrounding flow field due to the fluid compressibility.
Early-season rice often faces limited market competition due to its lower quality, which diminishes farmers' incentives to cultivate it. Developing specific early-season rice varieties tailored for rice noodle production represents a practical solution to this challenge. However, limited information exists on the varietal differences regarding the yield and quality of noodles produced from early-season rice and their determinants. To address this gap, this study conducted field experiments with 15 early-season rice varieties during 2022 and 2023. The results revealed significant varietal differences in rice noodle yield per unit of land area and cooking and eating (texture) qualities of the noodles, with the variety Zhuliangyou 4024 standing out for its ability to produce rice noodles that are both high yielding and of superior cooking and eating qualities. Correlation analysis showed the yield of rice noodles per unit of land area was significantly related to grain yield per unit of land, which in turn was linked to grain weight. Additionally, the analysis showed the cooking loss rate of rice noodles and their chewiness were significantly correlated with both amylose and amylopectin content, whereas the hardness, springiness, and resilience of cooked rice noodles were significantly correlated only with amylose content. However, partial correlation analysis indicated that all these quality traits were significantly correlated solely with amylose content when controlling the influence of other chemical properties. These findings indicate that selecting early-season rice varieties with high grain weight and high amylose content can lead to the production of high-yield and high-quality rice noodles.
Inconsistent results regarding the risk of relapse and better subjective outcomes of previous antipsychotic dose reduction trials in patients with remitted psychosis have not been verified using therapeutic drug monitoring (TDM). This study examined plasma drug concentrations of a dose-tapering trial which exhibited the potential of successful maintenance under lower antipsychotic dosages.
Methods
A 2-year open-label randomized prospective trial recruited remitted patients to undergo guided antipsychotic tapering. Blood samples were collected at baseline, annually, and after each dose reduction. Plasma aripiprazole/dehydroaripiprazole concentrations were determined using LC–MS/MS. The relationship between the dose and serum drug levels was examined using Spearman's correlation. Divided at 120 ng/mL, relapse rate, global function, quality of life, and psychopathology were compared between high- and low- drug level groups.
Results
A total of 126 blood samples were collected, after excluding13 samples due of non-adherence. The correlation coefficients between dosage and drug level were 0.853 (aripiprazole) and 0.864 (dehydroaripiprazole), and the dose and concentration plots were parallel along the tapering trajectories, except patients with non-adherence. The concentration-to-dose ratio of aripiprazole in this cohort, 17.79 ± 7.23 ng/mL/mg, was higher than that in Caucasian populations. No significant differences were observed in the clinical outcomes between the high- and low-level groups. Remarkably, 12 of 15 patients maintained remission at plasma aripiprazole concentrations of <120 ng/mL.
Conclusions
The lower-than-expected doses reached in our antipsychotic tapering trial were substantiated to provide adequate prophylactic effects by TDM results in a subset of patients treated with aripiprazole, even considering the differences in pharmacogenomics between ethnicities.
Understanding the yield attributes of rice crops grown at super high-yielding sites is useful for identifying how to achieve super high yield in rice. In this study, field experiments were conducted in 2021 and 2022 to compare grain yield and yield attributes of ten high-yielding hybrid rice varieties between Xingyi (a super high-yielding site) and Hengyang (a site with typical yields). Results showed that Xingyi produced an average grain yield of 13.4 t ha−1 in 2021 and 14.0 t ha−1 in 2022, which were, respectively, 20% and 44% higher than those at Hengyang. Higher panicles per m2 and higher grain weight were responsible for the higher grain yield at Xingyi compared to Hengyang. The higher values of panicles per m2 and grain weight at Xingyi compared to Hengyang were due to greater source capacity resulting from improved pre-heading biomass production. This study suggests that simultaneously increasing panicle number and grain weight through improving pre-heading biomass production is a potential way to achieve super high yield in rice.
Digitaria ciliaris var. chrysoblephara (Fig. & De Not.) R.R. Stewart is an annual xeromorphic weed that severely infests direct-seeded rice fields in China. Herbicide resistance is emerging in D. ciliaris var. chrysoblephara owing to extensive and recurrent use of the acetyl-CoA carboxylase (ACCase)-inhibiting herbicide metamifop. In this study, a total of 53 D. ciliaris var. chrysoblephara populations randomly sampled from direct-seeded rice fields across Jiangsu Province were investigated for metamifop resistance and potential resistance-endowing mutations. Single-dose assays revealed that 17 (32.1%) populations evolved resistance to metamifop and 5 (9.4%) populations were in the process of developing resistance. The resistance index (RI) of metamifop-resistant populations ranged from 2.7 to 32.1. Amino acid substitutions (Ile-1781-Leu, Trp-2027-Cys/Ser, and Ile-2041-Asn) in ACCase genes were detected in resistant D. ciliaris var. chrysoblephara plants and caused various cross-resistance patterns to ACCase-inhibiting herbicides. All of four resistant populations (YC07, YZ09, SQ03, and HA06), with different ACCase mutations, exhibited cross-resistance to the aryloxyphenoxypropionate (APP) herbicides cyhalofop-butyl (RI values: 10.0 to 19.9), fenoxaprop-P-ethyl (RI values: 53.7 to 132.8), and haloxyfop-P-methyl (RI values: 6.2 to 62.6), and the phenylpyrazoline (DEN) pinoxaden (RI values: 2.3 to 5.4), but responded differently to the cyclohexanedione (CHD) herbicides clethodim and sethoxydim. It is noteworthy that four postemergence herbicides used for rice cropping, including bispyribac-sodium, pyraclonil, quinclorac, and anilofos, showed poor control effect against D. ciliaris var. chrysoblephara, suggesting few alternations for managing this weed in rice fields except ACCase inhibitors. In conclusion, this work demonstrated that the D. ciliaris var. chrysoblephara had developed resistance to ACCase-inhibiting herbicides in rice cultivation of China, and target-site amino acid substitutions in ACCase were primarily responsible for metamifop resistance.
The zosterophyllopsids had a widespread distribution and constituted a dominant component in many plant assemblages during the Early Devonian. Although a large number of zosterophyllopsids have been documented, knowledge about the paleogeographic distribution of different genera/species remains to be expanded by further fossil evidence. In this article, new material assigned to the genus Gosslingia Heard, 1927 and designated as Gosslingia cf. G. breconensis Heard, 1927 is described from a new locality of the Lower Devonian of Guizhou Province, China. The Guizhou material shows main axes that are pseudomonopodially branched, pseudomonopodial lateral branching systems, subaxillary tubercle branches, circinate apices, elliptical xylem strand, exarch maturation of xylem, and G-type tracheids, and exhibits considerable similarities with the type and only species of Gosslingia, Gosslingia breconensis. Our finding represents the first report of Gosslingia in the South China Block and the most convincing occurrence of this genus outside of Wales, UK. Gosslingia adds to the diversity of genera shared among the Early Devonian floras of South China, western Europe, and North America, along with Distichophytum Mägdefrau, Estinnophyton Fairon-Demaret, Zosterophyllum Penhallow, and others, and indicates that the dispersal of early vascular plants among different paleocontinents was more common than previously appreciated.
Based on 30 high-resolution U-Th dating controls, we reconstruct stalagmite δ18O records from 45 to 15 thousand years ago (ka B.P., before AD 1950) from the Shizhu Cave, which is located in southwestern China under the influence of both the Indian Summer Monsoon (ISM) and the East Asian Summer Monsoon (EASM). By integrating with the other stalagmite δ18O records in Asia during the middle to late last glacial, our results reveal two main moisture trajectories: one from the Indian Ocean, through the Shizhu Cave towards central China, and the other from the Pacific Ocean to central and northern China. The systematic decrease of the average values of stalagmite δ18O records from oceans to inland China reveals a spatial pattern of water vapour fractionation and moisture trajectory during the middle to late last glacial. In contrast, the variation amplitude, which is defined as the departures apart from the background δ18O records during Heinrich stadials 1 to 4 (HS1–HS4), show an increasing trend from the coastal oceans to mid-latitude inland China, presenting a ‘coastal-inland’ pattern, which can be interpreted by the enhanced East Asian Winter Monsoon (EAWM) and the weakened EASM. More specifically, the enriched stalagmite δ18O records in the EASM region during HS1 to HS4 are caused by the decreased summer rainfall amount or/and the increased proportion of summer moisture resources from the Pacific Ocean. These new observations deepen our understanding of the complicated stalagmite δ18O records in the EASM region.
Halloysite nanotubes (HNTs) have attracted much attention as delivery carriers for various drugs, but the loading of one such drug, quercetin, on HNTs has been investigated only rarely and usually involved cyclic vacuum pumping. The main objective of the present study was to develop a novel carrier system based on HNTs for quercetin delivery without a vacuum process and to investigate the effect of chemical modification of HNTs on the loading and release of quercetin. For this purpose, comparative studies of five chemical modification reagents (sodium lauroamphoacetate, cocoamidopropyl betaine, 1-hydroxyethyl 2-nonyl imidazoline betaine, triethanolamine, and dipicolinic acid) functionalized on HNTs were investigated for quercetin loading and in vitro release. Characterization of raw halloysite, modified halloysite, and quercetin-loaded halloysite were done by X-ray diffraction (XRD), Fourier-transform infrared spectrometry (FTIR), thermogravimetric analysis (TGA), and transmission electron microscopy (TEM). The results indicated that chemical modification could improve the interactions between HNTs and quercetin. After chemical modification, quercetin was anchored to both the inner and outer surfaces of HNTs by electrostatic attraction, hydrogen bonding, and van der Waals forces. Sodium lauroamphoacetate-modified HNTs were given the highest loading of 1.96 wt.% among the five reagents. Cocamidopropyl betaine-modified HNTs exhibited the best sustained-release profile with only 29.07% for initial burst release and 480 h of consecutive release. Carboxyl groups of the modification reagent improved the loading capacity of quercetin. Amide groups prolonged drug release due to the strong affinity between amine and phenolic hydroxyl groups of quercetin. The release of quercetin from the cocamidopropyl betaine-modified HNTs fitted a first-order kinetics model well. The present study suggested that cocamidopropyl betaine-modified HNTs offer promise as vehicles for delivery of quercetin and for extending the application of quercetin.
Polycarboxylate superplasticizer (PCE) is a widely used water-reducing agent that can reduce significantly the water demand of concrete, which reduces the porosity and enhances the strength and durability of the concrete. (The PCE consists of a single backbone with many long PEO side chains.) Generally, aggregate occupies >70 wt.% of concrete; clay minerals are ubiquitous in nature and are difficult to avoid in mined aggregates. Clay minerals in aggregate often render the PCE ineffective and give rise to rapid loss of the fluidity of the concrete; this phenomenon is referred to as ‘poor clay tolerance of PCE.’ Though the poor clay tolerance of PCE is known widely, the relationship between the clay tolerance and the molecular structure of the PCE, in particular the effect of the side-chain structures, on clay tolerance is not understood completely. The objective of the present study was to determine the effect of different grafting densities of polyethylene oxide (PEO) side chains on the clay tolerance of PCE. The raw materials included mainly PCE, which was synthesized using acrylic acid and isopentenol polyoxyethylene ether, and a natural montmorillonite (Mnt), one of the most common clay minerals. The loss of fluidity of the cement paste was tested to assess the clay tolerance; total organic carbon was used to measure the amount of PCE adsorbed; X-ray diffraction, transmission electron microscopy, Fourier-transform infrared spectroscopy, and thermogravimetric analysis were used to investigate the microstructure of the intercalated Mnt. The results showed that preventing the superficially adsorbed PCE from being intercalated into Mnt was of great importance in terms of the improvement in clay tolerance of PCE, which increased with greater grafting density of PEO in the side chain of the PCE. The results also suggested the possibility that polymers which intercalate preferentially into the Mnt could improve significantly the clay tolerance of the PCE system.
Organo-montmorillonite (OMnt) has wide applications in paints, clay-polymer nanocomposites, biomaterials, etc. In most cases, the dispersibility and swellability of OMnt dictate the performance of OMnt in the target products. Previous studies have revealed that the properties can be improved when multiple organic species are co-introduced into the interlayer space of montmorillonite (Mnt). In the present study, single surfactant erucylamide (EA), dual-surfactants cetyltrimethyl ammonium bromide (CTAB) and octadecyltrimethyl ammonium chloride (OTAC), and ternary-surfactants EA, CTAB, and OTAC were co-introduced into Mnt by solution intercalation. The resulting OMnts were characterized by powder X-ray diffraction (XRD), Fourier-transform infrared (FTIR) spectroscopy, thermogravimetry-differential thermogravimetry (TG-DTG), water contact-angle tests, scanning electronic microscopy (SEM), laser particle-size analysis, and swelling indices. Mnt co-modified by ternary CTAB, OTAC, and EA led to a large d001 value (4.20 nm), surface hydrophobicity with a contact angle of 95.6°, swellability (50 mL/g) with small average particle sizes (2.1−2.8 μm) in xylene, and >99% of the OMnt particles were kept as <5 μm in deionized water. The formation of EA-modified-Mnt was proposed according to hydrophobic affinity, hydrogen bonding, and van der Waals forces. The nanoplatelets of the CTA+, OTA+, and EA co-modified OMnts in xylene were assembled into a house-of-cards structure by face-to-edge and edge-to-edge associations. The electrostatic attractions, electrostatic and steric repulsions, and hydrophobic interactions were responsible for the good dispersibility of OMnt in xylene. The ternary surfactant co-modified OMnt with high dispersion and swellability will make OMnt better suited for real-world applications.
In this study, mean velocity and temperature profiles for turbulent vertical convection (VC) confined in an infinite channel are investigated theoretically. The analysis starts from the governing equations of the thermal flow, with Reynolds shear stress and turbulent heat flux closed by the mixing length theory. Employing a three-sublayer description of the mean fields, the mean velocity and temperature profiles are found to be linear laws near the channel wall (viscosity-dominated sublayer), and they follow power laws close to the channel centre (turbulence-dominated sublayer). The characteristic scales of velocity, temperature and length in the present profiles arise naturally from the system normalisation, rather than from scaling analyses, thus ensuring a sound mathematical description. The derived profiles are verified fully via various literature data available in the classical regime; further, they are compared with the reported profiles, and the results indicate that the present profiles are the only ones with the ability to interpret data accurately from different sources, demonstrating much better versatility. Meanwhile, we provide analytical arguments showing that in the ultimate regime, the mean profiles in VC may remain in power laws, rather than the log laws inferred by analogy with Rayleigh–Bénard convection (RBC) systems. The power profiles recognised in this study are induced by the effect of buoyancy, which is in parallel with the mean flow in VC and contributes to the streamwise momentum transport, whereas in RBC systems, buoyancy is perpendicular to the mean flow, and does not influence the streamwise momentum transport, resulting in log profiles, being similar to the case of wall shear flows.
We aimed to assess the burden and trend of the HIV/AIDS epidemic among older adults over the past three decades at different geographical levels, based on the data collected from the Global Burden of Diseases (GBD) study 2019. This assessment identified the average annual percentage changes (AAPCs) using Joinpoint regression analysis. Globally, the incidence of HIV/AIDS has decreased (AAPC = −3.107); however, the overall prevalence has consistently increased (AAPC = 5.557). Additionally, both mortality (AAPC = 2.166) and disability-adjusted life years (DALYs; AAPC = 2.429) have increased. The highest increasing trends in female HIV/AIDS incidence and prevalence were observed in the Central Asia region. However, for males, these trends were observed in the Oceania region and the high-income Asia Pacific region, respectively. In recent decades, females aged 70–74 years had the highest incidence and prevalence, while males aged 70–74 years had highest mortality and DALYs in low social development index (SDI) regions. Unsafe sex resulted in 15 381.16 deaths, accounting for 90.73% of all HIV/AIDS deaths, and 331 140.56 DALYs, accounting for 91.12% of all HIV/AIDS DALYs. The HIV/AIDS disease burden differs by region, age, and sex among older adults. Sexual health education and targeted screening for older adults are recommended.
Anxiety disorder is a common psychological disorder in modern life, which has had a huge impact on people’s lives. Reasonable architectural environment design can alleviate the anxiety of individuals with psychological anxiety and help alleviate their discomfort.
Subjects and Methods
500 survey questionnaires on the impact of building environment on residents and GAD-2 questionnaire were selected from a certain city population in June 2021. Among them, there are 275 males and 225 females. The residential questionnaire includes five aspects of residents’ anxiety about residential area, floor height, bedroom layout, residential orientation, and building type. The GAD-2 questionnaire includes residents’ anxiety level. The collected information was statistically analyzed using SPSS3.0 software.
Results
According to the correlation analysis results of SPSS software, there is a negative correlation between residential area and anxiety level. There is no correlation between floor height and anxiety level, with a p-value greater than 0.05. There is a correlation between bedroom layout and anxiety level, with a p-value less than 0.05. There is a correlation between residential orientation and anxiety level, with a p-value less than 0.05. There is a correlation between building type and anxiety level, with a p-value less than 0.05. Moreover, the anxiety level of residents in residential areas is lower than that of residents in apartment buildings.
Conclusions
Reasonable architectural environment design has a positive impact on individuals with psychological anxiety. By introducing reasonable lighting design, spatial layout, and functional zoning, the tension and anxiety of anxious individuals can be reduced.
Aging plays a crucial role in the mechanisms of the impacts of genetic and environmental factors on blood pressure and serum lipids. However, to our knowledge, how the influence of genetic and environmental factors on the correlation between blood pressure and serum lipids changes with age remains to be determined. In this study, data from the Chinese National Twin Registry (CNTR) were used. Resting blood pressure, including systolic and diastolic blood pressure (SBP and DBP), and fasting serum lipids, including total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TGs) were measured in 2378 participants (1189 twin pairs). Univariate and bivariate structural equation models examined the genetic and environmental influences on blood pressure and serum lipids among three age groups. All phenotypes showed moderate to high heritability (0.37–0.59) and moderate unique environmental variance (0.30–0.44). The heritability of all phenotypes showed a decreasing trend with age. Among all phenotypes, SBP and DBP showed a significant monotonic decreasing trend. For phenotype-phenotype pairs, the phenotypic correlation (Rph) of each pair ranged from −0.04 to 0.23, and the additive genetic correlation (Ra) ranged from 0.00 to 0.36. For TC&SBP, TC&DBP, TG&SBP and TGs&DBP, both the Rph and Ra declined with age, and the Ra difference between the young group and the older adult group is statistically significant (p < .05). The unique environmental correlation (Re) of each pair did not follow any pattern with age and remained relatively stable with age. In summary, we observed that the heritability of blood pressure was affected by age. Moreover, blood pressure and serum lipids shared common genetic backgrounds, and age had an impact on the phenotypic correlation and genetic correlations.
Given a Borel probability measure µ on $\mathbb{R}^n$ and a real matrix $R\in M_n(\mathbb{R})$. We call R a spectral eigenmatrix of the measure µ if there exists a countable set $\Lambda\subset \mathbb{R}^n$ such that the sets $E_\Lambda=\big\{{\rm e}^{2\pi i \langle\lambda,x\rangle}:\lambda\in \Lambda\big\}$ and $E_{R\Lambda}=\big\{{\rm e}^{2\pi i \langle R\lambda,x\rangle}:\lambda\in \Lambda\big\}$ are both orthonormal bases for the Hilbert space $L^2(\mu)$. In this paper, we study the structure of spectral eigenmatrix of the planar self-affine measure $\mu_{M,D}$ generated by an expanding integer matrix $M\in M_2(2\mathbb{Z})$ and the four-elements digit set $D = \{(0,0)^t,(1,0)^t,(0,1)^t,(-1,-1)^t\}$. Some sufficient and/or necessary conditions for R to be a spectral eigenmatrix of $\mu_{M,D}$ are given.
Patients with remitted psychosis wish to reduce antipsychotic doses yet facing increased risks of relapse. Examining dose-tapering processes may provide insights to re-evaluate the risk-to-benefit balance. We aimed to depict and subgroup tapering trajectories, and explore factors associated with different dose-reduction patterns.
Methods
A 2-year open-label randomized prospective comparative trial from August 2017 to September 2022 in Taiwan. Patients with a history of schizophrenia-related psychotic disorders under stable medications and symptoms were eligible, randomizing a proportion to conduct guided dose reduction. We depicted the trajectories of individual patients and named subgroups based on dose-tapering patterns. Predictors of baseline characteristics for designated subgroups were examined by logistic regression analysis; changes in outcomes were compared by paired t-test.
Results
Fifty-one patients undergoing guided dose reduction, 18 (35.3%) reduced 4 steps consecutively (sequential reducers, SR), 14 (27.5%) reduced 1 to 3 steps (modest reducers, MR), 3 (5.9%) re-escalated to previous level (alert reducers, AR), 7 (13.7%) returned to baseline level (baseline returners, BR), 6 (11.7%) relapsed (failed reducers, FR) and 3 (5.9%) withdrew without relapse (early exits, EE). Patients with a history of relapse assumed a conservative dose-tapering pace; only the SR subgroup exhibited significant improvements in functioning and quality of life while failing to identify variables for predicting who would become SR or FR.
Conclusions
Guided dose reduction comprises dynamic processes with differences between individual trajectories. The proposed naming of dose-tapering patterns/subgroups provides a framework depicting patients undergoing dose-tapering. Longer-term observation and more flexible tapering approaches are anticipated to reveal favorable outcomes.
Straightplasma channels are widely used to guide relativistic intense laser pulses over several Rayleigh lengths for laser wakefield acceleration. Recently, a curved plasma channel with gradually varied curvature was suggested to guide a fresh intense laser pulse and merge it into a straight channel for staged wakefield acceleration [Phys. Rev. Lett. 120, 154801 (2018)]. In this work, we report the generation of such a curved plasma channel from a discharged capillary. Both longitudinal and transverse density distributions of the plasma inside the channel were diagnosed by analyzing the discharging spectroscopy. Effects of the gas-filling mode, back pressure and discharging voltage on the plasma density distribution inside the specially designed capillary are studied. Experiments show that a longitudinally uniform and transversely parabolic plasma channel with a maximum channel depth of 47.5 μm and length of 3 cm can be produced, which is temporally stable enough for laser guiding. Using such a plasma channel, a laser pulse with duration of 30 fs has been successfully guided along the channel with the propagation direction bent by 10.4°.