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This real-world study aimed to characterize patients with schizophrenia who achieve sustained good functional outcomes after antipsychotic discontinuation and to develop the Functional Remission in Schizophrenia after Antipsychotic Discontinuation (FURSAD) predictive model.
Methods
We retrospectively identified individuals aged 18–65 years with schizophrenia (ICD-10) from the Shanghai Mental Health Center discharge database. Patients who discontinued antipsychotics for ≥1 year were classified as functional remission (FR) or functional non-remission (FNR) based on functioning assessments. Sociodemographic, clinical, and treatment-related data were extracted blindly from hospital records and structured interviews.
Results
Among 4,166 discharged patients screened, 180 met the inclusion criteria (FR: 116; FNR: 64). Six independent predictors were identified: total disease course, Clinical Global Impression-Severity (CGI-S) score, Positive and Negative Syndrome Scale (PANSS) emotional distress subscale score, use of first-generation antipsychotics, discontinuation due to treatment benefits, and discontinuation due to lack of insight. The logistic regression model showed strong predictive performance (AUC = 0.867, 95% CI 0.813–0.921), with 82.8% sensitivity and 81.9% specificity. Internal validation was performed via 10-fold cross-validation.
Conclusion
Discontinuation motives and illness trajectory are relevant in predicting long-term functional outcomes. A limitation is that a substantial number of patients could not be recontacted or declined participation, which may introduce selection bias. The FURSAD nomogram may help clinicians estimate the probability of FR 4.5 years post-antipsychotic discontinuation in patients previously on antipsychotics for ≥3 years.
This research presents AMS radiocarbon dating results obtained from recently excavated burials and dwellings at three sites—Xiaxinguang, Wulasitai, and Daxigougoukou—located in the Wulasitai Valley of the Middle Tian Shan Mountains and attributed to the Chawuhu culture. The Bayesian modeling of these data yields a high-resolution chronological framework for Early Iron Age activity in the valley. The results identify a tripartite sequence comprising an Early Stage (cal 900–750 BC), a Middle Stage (cal 750–400 BC), and a Late Stage (cal 400–100 BC), with potential continuity into the turn of the Common Era. The δ13C and δ15N values suggest C3 plant–based diets with moderate animal protein intake, though some individuals show nearly pure plant consumption. Furthermore, through the integration of radi ocarbon data and contextual analysis, the research underscores that the Early Stage of the Chawuhu culture was contemporaneous with the Early Iron Age occupations of eastern Kazakhstan and the Altai region. Particular attention is drawn to the significance of residential graves at Xiaxinguang and Daxigougoukou, where child burials were intentionally integrated into domestic architecture, reflecting complex social and ritual practices. Additionally, radiocarbon evidence indicates that the transition from single to multiple interments occurred between the Early and Middle Stages. These discoveries offer important insights into settlement organization, mortuary practices, and cultural dynamics in the region during the Early Iron Age.
Greater consumption of red meat has been linked to a higher risk of mortality and chronic diseases, including diabetes. We aim to examine the associations between total, processed and unprocessed red meat intake and diabetes and to evaluate the substitution effects of other protein sources for red meat on diabetes. This population-based cross-sectional study utilised data from the National Health and Nutrition Examination Survey (NHANES) 2003–2016. Diabetes was defined as a self-reported diagnosis by a physician or other health professional, having a fasting plasma glucose of 126 mg/dl or higher, an HbA1c level of 6·5 % or higher, or the use of antidiabetic drugs. Multivariable logistic regression models were conducted. The study included 34 737 adult participants (mean (sd) age of 45·8 (17·5) years) from NHANES 2003–2016. After adjusting for major confounders, compared with the first quintile, higher intakes of total, processed and unprocessed red meat were positively associated with higher odds of diabetes, with adjusted OR of 1·49 (95 % CI 1·22, 1·81), 1·47 (95 % CI 1·17, 1·84) and 1·24 (95 % CI 1·06, 1·44), respectively. The corresponding P-trend values were (< 0.001, 0.001, and 0.006). In this nationally representative sample of US adults, participants in the highest quintiles of total, processed and unprocessed red meat intake had higher odds of diabetes than those in the lowest quintile. Substituting 1 serving/d of dietary protein from foods of plant origin (including nuts, seeds, legumes and soya) for total, processed or unprocessed red meat was associated with 9 % to 14 % lower odds of diabetes.
Alterations in hypothalamic–pituitary–adrenal axis function may underlie the relation between childhood maltreatment and nonsuicidal self-injury (NSSI) behaviors. This study examined how co-occurring patterns of maltreatment types influenced adolescent NSSI behaviors and the mediating role of diurnal cortisol, using a longitudinal design. The sample included 295 Chinese adolescents (Mage = 10.79 years, SD = 0.84 years; 67.1% boys). The study employed latent profile analysis to identify childhood maltreatment patterns and conducted path analysis to examine the mediating mechanism. Four maltreatment patterns were identified: Low Maltreatment (67.8%), High Neglect (15.6%), Moderate Maltreatment (10.2%), and High Abuse with Moderate Neglect (6.4%). Furthermore, compared to the Low Maltreatment profile, adolescents in the High Neglect profile were at increased risk for later NSSI behaviors through higher waking cortisol levels, while those in the High Abuse with Moderate Neglect profile were at increased risk through a steeper diurnal slope. Disturbances in diurnal cortisol rhythm serve as a pathway through which childhood maltreatment “gets under the skin” to lead to adolescent NSSI behaviors. These findings offer promise for identifying maltreated youth at risk for NSSI behaviors and informing targeted prevention strategies.
This study aimed to update the incidence of device-associated healthcare-associated infections (DA-HAIs), and to characterize pathogen distribution and carbapenem-resistant Enterobacteriaceae (CRE) detection among ICU patients in Shanghai, China.
Methods:
Prospective surveillance in 223 ICUs using standardized International Nosocomial Infection Control Consortium methodology (INICC) protocols collected patient-level data on demographics, microbiology, device use, and DA-HAIs. Trends, annual percent change (APC) and average annual percent change (AAPC) were estimated using Joinpoint regression models.
Results:
The overall DA-HAIs incidence density in ICUs was 1.67 per 1000 catheter-days for catheter-associated urinary tract infection (CAUTI) (95% CI: 1.62–1.73), 0.59 per 1000 central line-days for central line-associated bloodstream infection (CLABSI) (95% CI: 0.56–0.63), and 4.63 per 1000 ventilator-days for ventilator-associated pneumonia (VAP) (95% CI: 4.51–4.76). Significant reductions were observed in VAP (AAPC: −15.36%; P < 0.001) and CLABSI (AAPC: −11.23%; P < 0.001). Pathogen distributions varied by infection type, with Enterococcus faecium (17.22%) and Klebsiella pneumoniae (16.63%) predominating in CAUTI patients, Klebsiella pneumoniae (26.87%) in CLABSI patients, and Acinetobacter baumannii (37.60%) in VAP patients. The overall CRE detection rate was 33.67% in CAUTI patients, 37.56% in CLABSI patients, and 35.24% in VAP patients.
Conclusions:
Although DA-HAI rates showed significant declines, the persistently high CRE prevalence underscores substantial antimicrobial resistance challenges in Chinese ICUs.
Studies highlight the thalamus as a key region distinguishing early- from late-onset obsessive-compulsive disorder (OCD). While structural thalamic correlates with OCD onset age are well-studied, resting-state functional connectivity (rsFC) remains largely unexplored. This study examines thalamic subregional rsFC to elucidate pathophysiological differences in OCD based on different onset times.
Methods
The study comprised 85 early-onset OCD (EO-OCD) patients, 94 late-onset OCD (LO-OCD) patients, and 94 age- and sex-matched healthy controls (HCs). rsFC analysis was conducted to assess thalamic connectivity across seven subdivisions among the groups.
Results
Both EO-OCD and LO-OCD patients exhibited increased rsFC between the primary motor thalamus and the posterior central gyrus and between the thalamic premotor and the supplementary motor areas. EO-OCD patients showed significantly stronger rsFC between the prefrontal thalamus (Ptha) and the middle frontal gyrus (MFG) compared to both LO-OCD patients and HCs. In contrast, LO-OCD patients demonstrated reduced rsFC between the Ptha and the inferior parietal lobule (IPL) compared to EO-OCD patients and HCs. Additionally, the rsFC between the Ptha and both the MFG and IPL was negatively correlated with age of onset, with earlier onset linked to stronger connectivity.
Conclusion
These findings reveal both shared and distinct thalamic connectivity patterns in EO-OCD and LO-OCD patients. Sensory-motor networks exhibiting thalamic hyperconnectivity are critical for the manifestation of OCD, regardless of age of onset. The frontal–parietal network and thalamic hyperconnectivity may present a compensatory mechanism in EO-OCD patients, while hypoconnectivity with the frontoparietal network may reflect a neural mechanism underlying LO-OCD.
We investigate the dynamics of close-contact melting (CCM) on ‘gas-trapped’ hydrophobic surfaces, with specific focus on the effects of geometrical confinement and the liquid–air meniscus below the liquid film. By employing dual-series and perturbation methods under the assumption of small meniscus deflections, we obtain numerical solutions for the effective slip lengths associated with velocity $\lambda$ and temperature $\lambda _t$ fields, across various values of aspect ratio $\Lambda$ (defined as the ratio of the film thickness $h$ to the structure’s periodic length $l$) and gas–liquid fraction $\phi$. Asymptotic solutions of $\lambda$ and $\lambda _t$ for $\Lambda \ll 1$ and $\Lambda \gg 1$ are derived and summarised for different surface structures, interface shapes and $\Lambda$, which reveal a different trend of $\lambda$ for $\Lambda \ll 1$ and depending on the presence of a meniscus. In the context of constant-pressure CCM, our results indicate that longitudinal grooves can enhance heat transfer under the effects of confinement and a meniscus when $\Lambda \lesssim 0.1$ and $\phi \lt 1 - 0.5^{2/3} \approx 0.37$. For gravity-driven CCM, the parameters of $l$ and $\phi$ determine whether the melting rate is enhanced, reduced or nearly unaffected. We construct a phase diagram based on the parameter matrix $(\log _{10} l, \phi )$ to delineate these three regimes. Lastly, we derive two asymptotic solutions for predicting the variation in time of the unmelted solid height.
This study aimed to investigate the intake of dairy products during pregnancy in women with gestational diabetes mellitus (GDM) and its impacts on neonatal birth weight and pregnancy outcomes. A total of 386 women with GDM during the second trimester pregnancy participated in this prospective cohort study. We evaluated dairy products intake through the FFQ. Pregnancy outcomes were obtained from the delivery data. Participants were divided into insufficient and sufficient intake of milk and dairy products groups (< 300 g/d and ≥ 300 g/d, respectively). The average intake of dairy products during the second trimester pregnancy in women with GDM was 317·8 ± 179·5 g/d, and the total energy intake was 1635·4 ± 708·7 kcal/d. However, 76·68 % of them did not meet the recommended total energy intake of women with GDM. After adjusting for confounding factors, women with GDM who consumed ≥ 300 g/d of dairy products had an average reduction in birth weight of 93·1 g compared with women who consumed < 300 g/d of dairy products (95 % CI −171·343, −14·927). Women with GDM in sufficient intake group was also associated with lower risk of macrosomia (95 % CI 0·043, 0·695) and caesarean section (95 % CI 0·387, 0·933) and not related to low birth weight infant (95 % CI 0·617, 14·502) and preterm birth (95 % CI 0·186, 1·510) when compared with participants in insufficient intake group. Under the premise of insufficient total energy intake, the intake of dairy products during the second trimester pregnancy in women with GDM might be related to the decrease of neonatal birth weight.
To address the issues of low positioning accuracy and weak robustness of prior visual simultaneous localization and mapping (VSLAM) systems in dynamic environments, a semantic VSLAM (Sem-VSLAM) approach based on deep learning is proposed in this article. The proposed Sem-VSLAM algorithm adds semantic segmentation threads in parallel based on the open-source ORB-SLAM2’s visual odometry. First, while extracting the ORB features from an RGB-D image, the frame image is semantically segmented, and the segmented results are detected and repaired. Then, the feature points of dynamic objects are eliminated by using semantic information and motion consistency detection, and the poses are estimated by using the remaining feature points after the dynamic feature elimination. Finally, a 3D point cloud map is constructed by using tracking information and semantic information. The experiment uses Technical University of Munich public data to show the usefulness of the Sem-VSLAM algorithm. The experimental results show that the Sem-VSLAM algorithm can reduce the absolute trajectory error and relative attitude error of attitude estimation by about 95% compared to the ORB-SLAM2 algorithm and by about 14% compared to the VO-YOLOv5s in a highly dynamic environment and the average time consumption of tracking each frame image reaches 61 ms. It is verified that the Sem-VSLAM algorithm effectively improves the robustness and positioning accuracy in high dynamic environment and owning a satisfying real-time performance. Therefore, the Sem-VSLAM has a better mapping effect in a highly dynamic environment.
Previous studies have suggested that the habenula (Hb) may be involved in the mechanism of obsessive-compulsive disorder (OCD). However, the specific role of Hb in OCD remains unclear. This study aimed to explore the structural and functional abnormalities of Hb in OCD and their relationship with the clinical symptoms.
Methods
Eighty patients with OCD and 85 healthy controls (HCs) were recruited as the primary dataset. The grey matter volume, resting-state functional connectivity (FC), and effective connectivity (EC) of the Hb were calculated and compared between OCD group and HCs. An independent replication dataset was used to verify the stability and robustness of the results.
Results
Patients with OCD exhibited smaller Hb volume and increased FC of right Hb-left hippocampus than HCs. Dynamic causal model revealed an increased EC from left hippocampus to right Hb and a less inhibitory causal influence from the right Hb to left hippocampus in the OCD group compared to HCs. Similar results were found in the replication dataset.
Conclusions
This study suggested that abnormal structure of Hb and hippocampus-Hb connectivity may contribute to the pathological basis of OCD.
Dyes are toxic and considered to be extremely hazardous to natural environments. Hence, adsorbents to remove dyes from contaminated water are needed. To develop adsorbents with a high adsorption capacity for different dyes, easy separation, and low cost, a novel dye adsorbent was prepared by activating fly ash with NaOH. The adsorbent morphology, structure, and specific surface area were characterized using scanning electron microscopy, X-ray powder diffraction, and surface area measurements using N2 adsorption-desorption. The adsorption abilities of the synthesized adsorbents were examined based on methylene blue and acid fuchsin adsorption from water. The capabilities of the adsorbents as a function of adsorbent use, dye type, dye concentration, time, and pH were investigated and compared. The results for methylene blue and acid fuchsin adsorption were modeled using pseudo-second order kinetics and the Langmuir adsorption isotherm, respectively. These modified adsorbents synthesized from fly ash may provide a promising solution to purify dye-contaminated waste water with the advantages of high efficiency and low cost.
Product graphics interchange formats (GIFs) employ this format to show the features of the product and make up for the lack of physical experience online. These GIFs have been widely applied in domains such as e-shopping and social media, aiming to interest and impress viewers. Contrary to this wide application, most designers in this domain lack expertise and produce GIFs of varied quality. Moreover, the knowledge of techniques to enhance viewers’ engagement with product GIFs is also lacking. To bridge the gap, we conducted a series of studies. First, we collected and summarized seven design factors referring to existing literature and semi-structured interviews. Then, the impacts of these design factors were revealed through an online study with 106 product GIFs among 307 participants. The results showed that visual-related factors such as color contrast and moving intensity mainly impact viewers’ interest, while content-related factors such as scenario and style matching impact viewers’ impressions. The simplicity of GIFs also impressed viewers with a quick viewing mode. Finally, we conducted a workshop and verified that these results support large-scale production of product GIFs. Our studies might support the codesign methods of product GIFs and enhance their quality in design practice.
The Qieganbulake deposit associated with a mafic–ultramafic–carbonatite complex in the Kuluketage block is not only the world’s second-largest vermiculite deposit, but also a medium-size carbonatite-related phosphate deposit. Field observations, radiometric dating results and Sr–Nd–Hf isotopes reveal that the parental magmas of the carbonatite and mafic–ultramafic rocks are cogenetic and formed synchronously at c. 810 Ma. Geochemical characteristics and Sr–Nd–Hf–S isotopes ((87Sr/86Sr)i = 0.70581–0.70710; ϵNd(t) = −0.20 to −11.80; ϵHf(t) = −7.5 to −10.3; δ34S = +0.7 ‰ to +3.0 ‰ (some sulfides with high δ34S values (+3.2 to +6.6) were formed by late hydrothermal sulfur)), in combination with mineral compositions and previous research, strongly indicate that the Qieganbulake mafic–ultramafic–carbonatite complex formed via extensive crystal fractionation/cumulation and liquid immiscibility of a carbonated tholeiitic magma, possibly derived from partial melting of an enriched subcontinental lithospheric mantle previously modified by slab-released fluids and sediment input in a continental rift setting. The coupled enriched Sr–Nd isotopic signatures, in combination with previous research, suggest that the enriched subcontinental lithospheric mantle could have been metasomatized by asthenospheric mantle melts to different degrees. The Qieganbulake carbonatite-related phosphate ores were the products of normal fractional crystallization/cumulation of P–Fe3+ complex enriched carbonatite magma in high oxygen fugacity conditions, which was generated by liquid immiscibility of CO2–Fe–Ti–P-rich residual magma undergoing high differentiation.
Obsessive-compulsive personality disorder (OCPD) is a high-prevalence personality disorder characterized by subtle but stable interpersonal dysfunction. There have been only limited studies addressing the behavioral patterns and cognitive features of OCPD in interpersonal contexts. The purpose of this study was to investigate how behaviors differ between OCPD individuals and healthy controls (HCs) in the context of guilt-related interpersonal responses.
Method
A total of 113 participants were recruited, including 46 who were identified as having OCPD and 67 HCs. Guilt-related interpersonal responses were manipulated and measured with two social interactive tasks: the Guilt Aversion Task, to assess how anticipatory guilt motivates cooperation; and the Guilt Compensation Task, to assess how experienced guilt induces compensation behaviors. The guilt aversion model and Fehr–Schmidt inequity aversion model were adopted to analyze decision-making in the Guilt Aversion Task and the Guilt Compensation Task, respectively.
Results
Computational model-based results demonstrated that, compared with HCs, the OCPD group exhibited less guilt aversion when making cooperative decisions as well as less guilt-induced compensation after harming others.
Conclusion
Our findings indicate that individuals with OCPD tend to be less affected by guilt than HCs. These impairments in guilt-related responses may prevent adjustments in behaviors toward compliance with social norms and thus result in interpersonal dysfunctions.
The average maturity of newly issued corporate bonds has declined substantially over the past 40 years, and the traditional determinants of debt maturity fail to explain this decline fully. We show that the changing composition of investors in the corporate bond market influences bond maturities. The results of a Granger causality test, an instrumental variable approach, and a natural experiment suggest that a decline in the insurance companies’ – which prefer long-term bonds – ownership share in the corporate bond market explains a significant part of the unexplained maturity decline. These findings illustrate how investor preferences can have real effects on corporations.
It has been unclear whether Holocene lake evolution in the Badain Jaran Desert of northwestern China, an area in which lakes are mainly recharged by groundwater, responded to climate change. In this study, we analyzed the Mg/Ca ratio and phytolith assemblages from 10 Holocene calcareous root tube samples from the desert to reconstruct changes in effective moisture and mean annual precipitation (MAP) at the millennial scale during the Holocene and to explore the factors affecting lake evolution. Our results revealed that the effective moisture at 7000–5000 cal yr BP was higher than that of 5000–2000 cal yr BP. Similarly, the MAP was higher at 7000–5000 cal yr BP (175 ± 37 to 205 ± 37 mm) than at 5000–2000 cal yr BP (145 ± 37 to 165 ± 39 mm). The expansion of the lakes during the Early Holocene would have resulted from the input of groundwater from the meltwater in the recharge area. High lake levels in the Middle Holocene corresponded to increased monsoonal precipitation and groundwater recharge. The gradual decline of lake levels in the Late Holocene indicated a relatively arid climate with decreased monsoonal precipitation and groundwater recharge.
Emerging evidence has suggested that mushrooms, which are a rich source of the potent antioxidants ergothioneine and glutathione as well as vitamin D, may have neuroprotective properties. This study investigated the association between mushroom consumption and cognitive performance in a nationally representative sample of US older adults. We analysed data from older adults aged ≥ 60 years from the 2011–2014 National Health and Nutrition Examination Survey. Mushroom intake was measured using up to two 24-h dietary recalls and was categorised into three groups (lowest, middle and highest). Cognitive function tests included the Animal Fluency (AF) Test; Consortium to Establish a Registry for Alzheimer’s Disease Delayed Recall (CERAD-DR) and Word Learning (CERAD-WL); and Digit Symbol Substitution Test (DSST). Multivariable linear regression models were developed, adjusting for socio-demographics, major lifestyle factors, self-reported chronic diseases and dietary factors, including the Healthy Eating Index-2015 score and total energy. The study included 2840 participants. Compared with the lowest category of mushroom intake, participants in the highest category (median intake = 13·4 g /4184 KJ (1000 kcal)/d) had higher scores for DSST (β = 3·87; 95 % CI 0·30, 7·45; P for trend = 0·03) and CERAD-WL (β = 1·05; 95 % CI 0·0003, 2·10; P for trend = 0·04). Similar non-significant trends were observed for AF (β = 0·24; 95 % CI −2·26, 2·73; P for trend = 0·92) but not for the CERAD-DR. Greater mushroom intake was associated with certain cognitive performance tests, suggesting regular mushroom consumption may reduce the risk of cognitive decline.
This study examined the change in dementia literacy and dementia worry over a 5-year span among older Chinese Americans living in Arizona.
Design, setting, participants, and measurement:
This study used survey data collected among a purposive sample of 703 community-dwelling Chinese Americans aged 55 years or older living in the metropolitan areas of Phoenix, Arizona, from 2013 to 2017. The average age of participants was 73.1 (SD = 8.7) and 64.2% were female. Dementia literacy was measured by dementia knowledge (knowledge about Alzheimer’s disease and related dementia) and dementia beliefs (biased attitude toward dementia). Dementia worry was measured by assessing participants’ fear toward and concerns of developing dementia.
Results:
Regression analyses found dementia knowledge decreased (p < 0.05) and dementia beliefs remained unchanged (p > 0.05) from 2013 to 2017 among participants. Dementia worry only increased among those who lived alone. Significant correlates of dementia worry included low formal education level, depressive symptoms, and family conflict.
Conclusions:
Public health education targeting older Chinese Americans should aim to enhance dementia knowledge and to rectify their biased attitudes toward dementia. Psychosocial education or counseling should be available to older Chinese Americans who present dementia worry, particularly for those who live alone. More studies using diverse study designs, such as a longitudinal design, are needed to examine change in dementia literacy and worry among this population.
This study aimed to determine the risk factors for chronic diseases and to identify the potential influencing mechanisms from the perspectives of lifestyle and dietary factors. The findings could provide updated and innovative evidence for the prevention and control of chronic diseases.
Design:
A cross-sectional study.
Setting:
Shanghai, China.
Participants:
1005 adults from Yangpu district of Shanghai participated in the study, and responded to questions on dietary habits, lifestyle and health status.
Results:
Residents suffering from chronic diseases accounted for about 34·99 % of the respondents. Logistic regression analysis showed that age, diet quality, amount of exercise and tea drinking were related to chronic diseases. Age > 60 and overeating (Diet Balance Index total score > 0) had negative additive interaction on the occurrence of chronic disease, while overexercise (Physical Activity Index > 17·1) and tea drinking had negative multiplicative interaction and negative additive interaction on the occurrence of chronic disease. Diet quality, physical activity and tea drinking were incomplete mediators of the relationship between types of medical insurance residents participating in and chronic diseases.
Conclusions:
The residents in Yangpu District of Shanghai have a high prevalence of chronic diseases. Strengthening access of residents to health education and interventions to prevent chronic diseases and cultivating healthy eating and exercise habits of residents are crucial. The nutritional environment of the elderly population should be considered, and the reimbursement level of different types of medical insurance should be designed reasonably to improve the accessibility of medical and health services and reduce the risk of chronic diseases.