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Previous studies investigating the effectiveness of augmentation therapy have been limited.
Aims
To evaluate the effectiveness of antipsychotic augmentation therapies among patients with treatment-resistant depression.
Method
We included patients diagnosed with depression receiving two antidepressant courses within 1 year between 2009 and 2020 and used the clone-censor-weight approach to address time-lag bias. Participants were assigned to either an antipsychotic or a third-line antidepressant. Primary outcomes were suicide attempt and suicide death. Cardiovascular death and all-cause mortality were considered as safety outcomes. Weighted pooled logistic regression and non-parametric bootstrapping were used to estimate approximate hazard ratios and 95% confidence intervals.
Results
The cohort included 39 949 patients receiving antipsychotics and the same number of matched antidepressant patients. The mean age was 51.2 (standard deviation 16.0) years, and 37.3% of participants were male. Compared with patients who received third-line antidepressants, those receiving antipsychotics had reduced risk of suicide attempt (sub-distribution hazard ratio 0.77; 95% CI 0.72–0.83) but not suicide death (adjusted hazard ratio 1.08; 95% CI 0.93–1.27). After applying the clone-censor-weight approach, there was no association between antipsychotic augmentation and reduced risk of suicide attempt (hazard ratio 1.06; 95% CI 0.89–1.29) or suicide death (hazard ratio 1.22; 95% CI 0.91–1.71). However, antipsychotic users had increased risk of all-cause mortality (hazard ratio 1.21; 95% CI 1.07–1.33).
Conclusions
Antipsychotic augmentation was not associated with reduced risk of suicide-related outcomes when time-lag bias was addressed; however, it was associated with increased all-cause mortality. These findings do not support the use of antipsychotic augmentation in patients with treatment-resistant depression.
In this article, motivated by the regularity theory of the solutions of doubly nonlinear parabolic partial differential equations, the authors introduce the off-diagonal two-weight version of the parabolic Muckenhoupt class with time lag. Then the authors introduce the uncentered parabolic fractional maximal operator with time lag and characterize its two-weighted boundedness (including the endpoint case) in terms of these weights under an additional mild assumption (which is not necessary for one-weight case). The most novelty of this article exists in that the authors further introduce a new parabolic shaped domain and its corresponding parabolic fractional integral with time lag and, moreover, applying the aforementioned (two-)weighted boundedness of the parabolic fractional maximal operator with time lag, the authors characterize the (two-)weighted boundedness (including the endpoint case) of these parabolic fractional integrals in terms of the off-diagonal (two-weight) parabolic Muckenhoupt class with time lag; as applications, the authors further establish a parabolic weighted Sobolev embedding and a priori estimate for the solution of the heat equation. The key tools to achieve these include the parabolic Calderón–Zygmund-type decomposition, the chaining argument, and the parabolic Welland inequality, which is obtained by making the utmost of the geometrical relation between the parabolic shaped domain and the parabolic rectangle.
The study aimed to determine the patterns of the vestibular and ocular motor findings in cerebellar infarction (CI).
Methods:
We retrospectively analyzed vestibular and ocular motor test results in 23 CI patients and 32 acute unilateral vestibulopathy (AUVP) patients.
Results:
Among CI cases, the posterior inferior cerebellar artery (PICA) was the most commonly affected territory. Vertigo is predominantly observed in patients with infarctions affecting PICA or anterior inferior cerebellar artery (AICA). Lesions involving the superior cerebellar artery (SCA) mainly result in dizziness. Saccadic intrusion and oscillation, abnormal bilateral smooth pursuit (SP) and abnormal saccades were more prevalent in the CI group than in the AUVP group (all p < 0.05). Horizontal saccades were abnormal in 11 patients (47.8%) with CI. All AUVP patients had normal horizontal saccades. Horizontal SP was impaired in 13 patients (56.5%) with CI, with decreased gain toward both sides in 10 and toward 1 side in 3. Impaired horizontal SP was noted in nine patients (28.1%) with AUVP, with decreased gain toward the contralesional side in all cases. A total of 26.3% (5/19) of patients with CI exhibited subjective visual vertical (SVV) deviation toward the affected side and 31.6% (6/19) toward the unaffected side. In patients with AUVP, 70.0% (21/30) showed SVV deviation toward the affected side.
Conclusions:
Vertigo is mainly seen in PICA or AICA infarctions. SCA lesions mostly cause dizziness. Saccadic intrusion and oscillation, abnormal bilateral SP and abnormal saccades contribute to the diagnosis of CI. Moreover, SVV deviation varies depending on the cerebellar structures involved.
The school–vacation cycle may have impacts on the psychological states of adolescents. However, little evidence illustrates how transition from school to vacation impacts students’ psychological states (e.g. depression and anxiety).
Aims
To explore the changing patterns of depression and anxiety symptoms among adolescent students within a school–vacation transition and to provide insights for prevention or intervention targets.
Method
Social demographic data and depression and anxiety symptoms were measured from 1380 adolescent students during the school year (age: 13.8 ± 0.88) and 1100 students during the summer vacation (age: 14.2 ± 0.93) in China. Multilevel mixed-effect models were used to examine the changes in depression and anxiety levels and the associated influencing factors. Network analysis was used to explore the symptom network structures of depression and anxiety during school and vacation.
Results
Depression and anxiety symptoms significantly decreased during the vacation compared to the school period. Being female, higher age and with lower mother's educational level were identified as longitudinal risk factors. Interaction effects were found between group (school versus vacation) and the father's educational level as well as grade. Network analyses demonstrated that the anxiety symptoms, including ‘Nervous’, ‘Control worry’ and ‘Relax’ were the most central symptoms at both times. Psychomotor disturbance, including ‘Restless’, ‘Nervous’ and ‘Motor’, bridged depression and anxiety symptoms. The central and bridge symptoms showed variation across the school vacation.
Conclusions
The school–vacation transition had an impact on students’ depression and anxiety symptoms. Prevention and intervention strategies for adolescents’ depression and anxiety during school and vacation periods should be differentially developed.
This paper studies the heterogeneity of households’ present bias in a heterogeneous-agent model. Our model jointly matches the average marginal propensities to consume and the wealth distribution in the USA, even when all wealth is liquid. A fiscal stimulus targeting households in the bottom half of the wealth distribution improves the consumption response. A financial literacy campaign removing present bias gets naive households out of the debt trap but harms sophisticated households’ wealth accumulation due to a lower equilibrium interest rate. Finally, we show that a borrowing cost penalty and illiquidity both discipline excessive borrowing and are therefore potential remedies for present bias and naivete.
Cognitive impairment, a major determinant of poor functioning in schizophrenia, had limited responses to existing antipsychotic drugs. The limited efficacy could be due to regional differences in the dysregulation of the dopamine system. This study investigated striatal and peripheral dopaminergic makers in schizophrenia and their relationship with cognitive impairment.
Methods
Thirty-three patients with schizophrenia and 36 age- and sex-matched healthy controls (HC) participated. We evaluated their cognitive performance, examined the availability of striatal dopamine transporter (DAT) using single-photon emission computed tomography with 99mTc-TRODAT, and measured plasma levels of dopaminergic precursors (phenylalanine and tyrosine) and three branched-chain amino acids (BCAA) that compete with precursors for brain uptake via ultra-performance liquid chromatography.
Results
Schizophrenia patients exhibited lower cognitive performance, decreased striatal DAT availability, and reduced levels of phenylalanine, tyrosine, leucine, and isoleucine, and the ratio of phenylalanine plus tyrosine to BCAA. Within the patient group, lower DAT availability in the left caudate nucleus (CN) or putamen was positively associated with attention deficits. Meanwhile, lower tyrosine levels and the ratio of phenylalanine plus tyrosine to BCAA were positively related to executive dysfunction. Among all participants, DAT availability in the right CN or putamen was positively related to memory function, and plasma phenylalanine level was positively associated with executive function.
Conclusions
This study supports the role of dopamine system abnormalities in cognitive impairment in schizophrenia. The distinct associations between different dopaminergic alterations and specific cognitive domain impairments suggest the potential need for multifaceted treatment approaches to target these impairments.
We report an experimental study of Rayleigh–Bénard convection of liquid metal GaInSn in a cuboid cell with an aspect ratio of 0.5 under the effect of a horizontal magnetic field. The Rayleigh number spans a range of $3.8\times 10^5 \leqslant Ra \leqslant 1.1\times 10^7$, while the magnetic field strength reaches up to 0.5 T, corresponding to a maximum Hartmann number to 2041. By combining temperature and velocity measurements, we identify several flow morphologies, including a novel cellular pattern characterized by four stacked vortices that periodically squeeze and induce velocity reversals. Based on the identified flow morphologies, we partition the entire ($Ra, Ha$) parameter space into five distinct flow regimes and systematically investigate the flow characteristics within each regime. The temperature gradient and oscillation frequency exhibit scaling relationships with the combined parameters $Ra$ and $Ha$. Notably, we observe a coupling between flow regime and global transport efficiencies, particularly in a regime dominated by the double-roll structure, which experiences a maximum 36 % decrease in heat transfer efficiency compared with the single-roll structure. The dependencies of heat and momentum transport on $Ra$ and $Ha$ follow scaling laws as $Nu \sim (Ha^{-2/3}RaPr^{-1})^{3/5}$ and $Re \sim (Ha^{-1}RaPr^{-1})^{4/3}$, respectively.
Growing evidence indicates a link between diet and depression risk. We aimed to examine the association between an inflammatory diet index and depression utilising extensive data from UK biobank cohort. The energy-adjusted dietary inflammation index (E-DII) was calculated to quantify the potential of daily diet, with twenty-seven food parameters utilised. The E-DII scores were classified into two categories (low v. high) based on median value. To mitigate bias and ensure comparability of participant characteristics, propensity score matching was employed. To ascertain the robustness of these associations, sensitivity analyses were conducted. Subgroup analyses were performed to evaluate the consistency of these associations within different subpopulations. Totally, 152 853 participants entered the primary analyses with a mean age of 56·11 (sd 7·98) years. Employing both univariate and multivariate logistic regression models, adjustments were made for varying degrees of confounding factors (socio-demographics, lifestyle factors, common chronic medical conditions including type 2 diabetes and hypertension). Results consistently revealed a noteworthy positive correlation between E-DII and depression. In the context of propensity score matching, participants displaying higher E-DII scores exhibited an increased likelihood of experiencing incident depression (OR = 1·12, 95 % CI: 1·05, 1·19; P = 0·000316). Subgroup analysis results demonstrated variations in these associations across diverse subpopulations. The E-value for the point-estimate OR calculated from the propensity score matching dataset was 1·48. Excluding individuals diagnosed with type 2 diabetes or hypertension, the findings consistently aligned with the positive association in the primary analysis. These findings suggested that consumption of a diet with higher pro-inflammatory potential might associated with an increase of future depression risk.
To investigate the associations between dietary patterns and biological ageing, identify the most recommended dietary pattern for ageing and explore the potential mediating role of gut microbiota in less-developed ethnic minority regions (LEMRs). This prospective cohort study included 8288 participants aged 30–79 years from the China Multi-Ethnic Cohort study. Anthropometric measurements and clinical biomarkers were utilised to construct biological age based on Klemera and Doubal’s method (KDM-BA) and KDM-BA acceleration (KDM-AA). Dietary information was obtained through the baseline FFQ. Six dietary patterns were constructed: plant-based diet index, healthful plant-based diet index, unhealthful plant-based diet index, healthy diet score, Dietary Approaches to Stop Hypertension (DASH), and alternative Mediterranean diets. Follow-up adjusted for baseline analysis assessed the associations between dietary patterns and KDM-AA. Additionally, quantile G-computation identified significant beneficial and harmful food groups. In the subsample of 764 participants, we used causal mediation model to explore the mediating role of gut microbiota in these associations. The results showed that all dietary patterns were associated with KDM-AA, with DASH exhibiting the strongest negative association (β = −0·91, 95 % CI (–1·19, −0·63)). The component analyses revealed that beneficial food groups primarily included tea and soy products, whereas harmful groups mainly comprised salt and processed vegetables. In mediation analysis, the Synergistetes and Pyramidobacter possibly mediated the negative associations between plant-based diets and KDM-AA (5·61–9·19 %). Overall, healthy dietary patterns, especially DASH, are negatively associated with biological ageing in LEMRs, indicating that Synergistetes and Pyramidobacter may be potential mediators. Developing appropriate strategies may promote healthy ageing in LEMRs.
This study presents observations of coherent modes (CMs) in a spherical tokamak using a microwave interferometer near the midplane. The CMs within the 30–60 kHz frequency range were observed during electron cyclotron resonance heating only, and the frequency of the CMs increased proportionally with the square root of the electron temperature near $R = 0.7m$. Generally, these modes displayed bursting and chirping signatures with strong density rise and fall. Their appearance indicated an increase in the intensity of hard x rays, suggesting a deterioration in energetic electron confinement. Furthermore, the effect of CMs on the intensity of energetic electron-driven whistler waves was observed. They decreased when CMs were present and gradually increased with the decrease in CM intensity. The CMs may influence the intensity of whistler waves by affecting the energetic electron confinement.
Varicella is a vaccine-preventable infectious disease. Since 1 December 2018, the varicella vaccine has been included in the local Expanded Programme on Immunization (EPI) in Wuxi, China, and children born after 1 December 2014 are eligible for free vaccination. To evaluate the effect of varicella vaccination in Wuxi city, we selected 382 397 children born from 2012 to 2016 as subjects. Their disease data were obtained from the Chinese Disease Prevention and Control Information System, and their vaccination data were obtained from the Jiangsu Province Vaccination Integrated Service Management Information System. The incidence of breakthrough varicella cases increased in the first 4 years and reached the peak in the fifth year. With the increase of vaccination rate, the incidence of varicella decreased significantly. The vaccine effectiveness (VE) was found to be 88.17%–95.78% for one dose and 98.65%–99.93% for two doses. Although the VE per dose decreased from 99.57% in the first year to 93.04% in the eighth year, it remained high. These findings confirmed the effectiveness of varicella vaccination in children, supported the use of a two-dose varicella vaccination strategy to achieve better protection, and provided important insights into the optimal vaccination strategy for varicella prevention in children.
Thanks to its real-time computation efficiency, deep reinforcement learning (DRL) has been widely applied in motion planning for mobile robots. In DRL-based methods, a DRL model computes an action for a robot based on the states of its surrounding obstacles, including other robots that may communicate with it. These methods always assume that the environment is attack-free and the obtained obstacles’ states are reliable. However, in the real world, a robot may suffer from obstacle localization attacks (OLAs), such as sensor attacks, communication attacks, and remote-control attacks, which cause the robot to retrieve inaccurate positions of the surrounding obstacles. In this paper, we propose a robust motion planning method ObsGAN-DRL, integrating a generative adversarial network (GAN) into DRL models to mitigate OLAs in the environment. First, ObsGAN-DRL learns a generator based on the GAN model to compute the approximation of obstacles’ accurate positions in benign and attack scenarios. Therefore, no detectors are required for ObsGAN-DRL. Second, by using the approximation positions of the surrounding obstacles, ObsGAN-DRL can leverage the state-of-the-art DRL methods to compute collision-free motion commands (e.g., velocity) efficiently. Comprehensive experiments show that ObsGAN-DRL can mitigate OLAs effectively and guarantee safety. We also demonstrate the generalization of ObsGAN-DRL.
Double-cone ignition [Zhang et al., Phil. Trans. R. Soc. A 378, 20200015 (2020)] was proposed recently as a novel path for direct-drive inertial confinement fusion using high-power lasers. In this scheme, plasma jets with both high density and high velocity are required for collisions. Here we report preliminary experimental results obtained at the Shenguang-II upgrade laser facility, employing a CHCl shell in a gold cone irradiated with a two-ramp laser pulse. The CHCl shell was pre-compressed by the first laser ramp to a density of 3.75 g/cm3 along the isentropic path. Subsequently, the target was further compressed and accelerated by the second laser ramp in the cone. According to the simulations, the plasma jet reached a density of up to 15 g/cm3, while measurements indicated a velocity of 126.8 ± 17.1 km/s. The good agreements between experimental data and simulations are documented.
In large-scale galaxy surveys, particularly deep ground-based photometric studies, galaxy blending was inevitable. Such blending posed a potential primary systematic uncertainty for upcoming surveys. Current deblenders predominantly depended on analytical modelling of galaxy profiles, facing limitations due to inflexible and imprecise models. We presented a novel approach, using a U-net structured transformer-based network for deblending astronomical images, which we term the CAT-deblender. It was trained using both RGB and the grz-band images, spanning two distinct data formats present in the Dark Energy Camera Legacy Survey (DECaLS) database, including galaxies with diverse morphologies in the training dataset. Our method necessitated only the approximate central coordinates of each target galaxy, sourced from galaxy detection, bypassing assumptions on neighbouring source counts. Post-deblending, our RGB images retained a high signal-to-noise peak, consistently showing superior structural similarity against ground truth. For multi-band images, the ellipticity of central galaxies and median reconstruction error for r-band consistently lie within $\pm$0.025 to $\pm$0.25, revealing minimal pixel residuals. In our comparison of deblending capabilities focused on flux recovery, our model showed a mere 1% error in magnitude recovery for quadruply blended galaxies, significantly outperforming SExtractor’s higher error rate of 4.8%. Furthermore, by cross-matching with the publicly accessible overlapping galaxy catalogs from the DECaLS database, we successfully deblended 433 overlapping galaxies. Moreover, we have demonstrated effective deblending of 63 733 blended galaxy images, randomly chosen from the DECaLS database.
Many professional managers are driven to achieve the bottom line to secure income, honor, and standing in the workplace. Drawing on social information processing theory, we propose that supervisor bottom-line mentality in the workplace has a dysfunctional effect on organizations. Specifically, supervisor bottom-line mentality will hinder subordinates’ perception of the meaning of work, which eventuates high employee withdrawal (turnover intention and work withdrawal behavior). We also verified that amoral management weakens the negative relationship between supervisor bottom-line mentality and meaning of work in the first-stage moderated mediation model. Additionally, the strength of the indirect effects of supervisor bottom-line mentality on turnover intention and work withdrawal behavior is weaker (stronger) when supervisors’ amoral management is high (low). Our hypothesized moderated mediation model is supported by 301 data points generated by a three-stage full-time staff member. Furthermore, we put forward important theoretical and practical implications according to the research.
Nacrite and dickite are found in two localities in northern Taiwan. One, containing nacrite and dickite, is associated with a gold-enargite deposit as a vug-filling clay in the Chinkushih (CKS) mine district near the northern coast. The other is the occurrence of dickite in the interstices of a Miocene coarse-grained quartzose sandstone in the Nanshihchiao (NSC) area, near Taipei city. X-ray diffraction (XRD), differential thermal analysis (DTA), scanning electron microscope (SEM), and petrographic examinations were used to characterize the mineralogical features. Nacrite most often takes the unusual form of rhombic platelets, and dickite is commonly elongated in habit with the shapes possibly related to their origin. Based on geological evidence, we believe that both nacrite and dickite are of hydrothermal origin. In the CKS area, the formation of nacrite and dickite is related to the hypogene gold-enargite mineralization. In contrast, the transformation of dickite in the NSC area is due to the influence of the raised temperatures of sandstone formation, resulting from volcanic activity during the Kungkuan stage after the deposition of the sandstone.
Hippocampal disruptions represent potential neuropathological biomarkers in depressed adolescents with cognitive dysfunctions. Given heterogeneous outcomes of whole-hippocampus analyses, we investigated subregional abnormalities in depressed adolescents and their associations with symptom severity and cognitive dysfunctions.
Methods
MethodsSeventy-nine first-episode depressive patients (ag = 15.54 ± 1.83) and 71 healthy controls (age = 16.18 ± 2.85) were included. All participants underwent T1 and T2 imaging, completed depressive severity assessments, and performed cognitive assessments on memory, emotional recognition, cognitive control, and attention. Freesurfer was used to segment each hippocampus into 12 subfields. Multivariable analyses of variance were performed to identify overall and disease severity-related abnormalities in patients. LASSO regression was also conducted to explore the associations between hippocampal subfields and patients’ cognitive abilities.
Results
Depressed adolescents showed decreases in dentate gyrus, CA1, CA2/3, CA4, fimbria, tail, and molecular layer. Analyses of overall symptom severity, duration, self-harm behavior, and suicidality suggested that severity-related decreases mainly manifested in CA regions and involved surrounding subfields with disease severity increases. LASSO regression indicated that hippocampal subfield abnormalities had the strongest associations with memory impairments, with CA regions and dentate gyrus showing the highest weights.
Conclusions
Hippocampal abnormalities are widespread in depressed adolescents and such abnormalities may spread from CA regions to surrounding areas as the disease progresses. Abnormalities in CA regions and dentate gyrus among these subfields primarily link with memory impairments in patients. These results demonstrate that hippocampal subsections may serve as useful biomarkers of depression progression in adolescents, offering new directions for early clinical intervention.
Motivated by practical applications of inspection and maintenance, we have developed a wall-climbing robot with passive compliant mechanisms that can autonomously adapt to curved surfaces. At first, this paper presents two failure modes of the traditional wall-climbing robot on the variable curvature wall surface and further introduces the designed passive compliant wall-climbing robot in detail. Then, the motion mechanism of the passive compliant wall-climbing robot on the curved surface is analyzed from stable adsorption conditions, parameter design process, and force analysis. At last, a series of experiments have been carried out on load capability and curved surface adaptability based on a developed principle prototype. The experimental results indicated that the wall-climbing robot with passive compliant mechanisms can effectively promote both adsorption stability and adaptability to variable curvatures.
The traffic issues have been attracting global attention due to increased occurrence and higher mortality rate in the older population. Many countries have employed different kinds of regulations on the elder drivers depending either on their age or whether being demented. These policy differences left a research gap to identify the temporal relationship between serious traffic accidents (STA) and dementias, which can inform the most appropriate time for policymaking. In the present study, we linked two national databases and performed analyses to explore this problem.
Methods:
With the grant and supports from the government, the research team combined the databases of STA registries and the whole population dataset of National Health Insurance Research Database to form a 10-year retrospective cohort for analyses. We performed both retrospective and prospective directions to explore the time length between STAs and the diagnoses of dementia depending on the selection of the STA occurrences and dementia diagnoses as outcomes. In addition to descriptive statistical analyses, we also performed inferential statistics to analyse the variables between different types of STAs. A p-value less than 0.05 was set as statistically significant.
Results:
437516 persons involved in STAs were enrolled for analyses and the mean age was 61.47 years (SD=8.90) with sex ratio (F/M) of 0.62. We divided the samples into three groups: (1) STAs without dementias (95.17%) (2) dementias after STAs (3.40%), and (3) dementias before STAs (1.43%). The mean age of the 3rd group (73.80 years, SD=8.79) was significantly older than the rest two. When comparing these three groups, a preceded dementia diagnosis was a significant risk factor for repeated STAs. (OR: 1.205, 95% CI: 1.100-1.320, p<0.001) Finally, an average length of 2.35 years (SD: 1.60) was found for those who was diagnosed of dementias before the first STA while 2.57 years (SD: 1.69) was noted for the diagnosis of dementia after first STA.
Conclusion:
In our study, dementia was identified as a significant risk factor for STAs. We further asserted that 2.5 years would be an appropriate time length for the authorities to examine the traffic risks of those who were diagnosed of dementias.
Introduction of African swine fever (ASF) to China in mid-2018 and the subsequent transboundary spread across Asia devastated regional swine production, affecting live pig and pork product-related markets worldwide. To explore the spatiotemporal spread of ASF in China, we reconstructed possible ASF transmission networks using nearest neighbour, exponential function, equal probability, and spatiotemporal case-distribution algorithms. From these networks, we estimated the reproduction numbers, serial intervals, and transmission distances of the outbreak. The mean serial interval between paired units was around 29 days for all algorithms, while the mean transmission distance ranged 332 –456 km. The reproduction numbers for each algorithm peaked during the first two weeks and steadily declined through the end of 2018 before hovering around the epidemic threshold value of 1 with sporadic increases during 2019. These results suggest that 1) swine husbandry practices and production systems that lend themselves to long-range transmission drove ASF spread; 2) outbreaks went undetected by the surveillance system. Efforts by China and other affected countries to control ASF within their jurisdictions may be aided by the reconstructed spatiotemporal model. Continued support for strict implementation of biosecurity standards and improvements to ASF surveillance is essential for halting transmission in China and spread across Asia.