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Departing from simplistic portrayals of Chinese environmental governance as authoritarian, this study identifies a hybrid policy style that combines authoritarian environmentalism with policy experimentation, as evidenced in national park policy. A detailed examination of the North-East China Tiger and Leopard National Park shows that this hybrid increasingly tilts towards authoritarianism during implementation. To explain this dynamic, the study moves beyond the prevailing central–local lens and employs the tiao–kuai model, which captures the power relations among top leaders, central departments (tiao), and local governments (kuai). The analysis reveals that organizational interests centred on conservation have led central departments to expand their authority, marginalize local governments and narrow the space for experimentation, thereby suppressing community development demands. Even when top leaders intervene from above, the entrenched power structure of tiao and kuai still limits the effectiveness of corrective measures. The study contends that a hybrid policy style, supported by balanced power relations between tiao and kuai, is essential for reconciling conservation with development through environmental policy experimentation.
This paper presents an experimental and analytical investigation into the use of trailing edge slits for the reduction of aerofoil trailing edge noise. The noise reduction mechanism is shown to be fundamentally different from conventional trailing edge serrations, relying on destructive interference from highly compact and coherent sources generated at either ends of the slit. This novel approach is the first to exploit the coherence intrinsic to the boundary layer turbulence. Furthermore, the study demonstrates that trailing edge slits not only achieve superior noise reductions compared with sawtooth serrations of the same amplitude at certain conditions, but also offer frequency-tuning capability for noise reduction. Noise reduction is driven by the destructive interference between acoustic sources at the root and tip of the slit, which radiate with a phase difference determined by the difference in times taken for the boundary layer flow to convect between the root and tip. Maximum noise reductions occur at frequencies where the phase difference between these sources is $180^\circ$. The paper also presents a detailed parametric study into the variation in noise reductions due to the slit length, slit wavelength and slit root width. Additionally, a simple two-source analytic model is proposed to explain the observed results. Wind tunnel measurements of the unsteady flow field around the trailing edge slits are also presented, providing insights into the underlying flow physics.
Femoral neck bone mineral density (FNBMD) is a high risk factor for femoral head fractures, and coffee intake affects bone mineral density, but the effect on FNBMD remains to be explored. First, we conducted an observational study in the National Health and Nutrition Examination Survey and collected data on coffee intake, FNBMD, and sixteen covariates. Weight linear regression was used to explore the association of coffee intake with FNBMD. Then, Mendelian randomisation (MR) was used to explore the causal relationship between coffee intake and FNBMD, the exposure factor was coffee intake, and the outcome factor was FNBMD. The inverse variance weighting (IVW) method was used for the analysis, while heterogeneity tests, sensitivity, and pleiotropy analysis were performed. A total of 5 915 people were included in the cross-sectional study, including 3 178 men and 2 737 women. In the completely adjusted model, no coffee was used as a reference. The ORs for the overall population at ‘< 1’, ‘1–<2’, ‘2–<4’, and ‘4+’ (95% CI) were 0.02 (–0.01, 0.04), 0.00 (–0.01, 0.02), –0.01 (–0.02, 0.00), and 0.00 (–0.01, 0.02), respectively. The male and female population showed no statistically significant differences in both univariate and multivariate linear regressions. In the MR study, the IVW results showed an OR (95% CI) of 1.06 (0.88–1.27), a P-value of 0.55, and an overall F-value of 80.31. The heterogeneity, sensitivity analyses, and pleiotropy had no statistical significance. Our study used cross-sectional studies and MR to demonstrate that there is no correlation or causal relationship between coffee intake and FNBMD.
As cities like Beijing expand rapidly, green and blue spaces (GBS)—essential for ecosystem services (ESs) such as clean air, flood control, and recreation—are increasingly threatened. This 20-year study examines how urban expansion and policy interventions have shaped Beijing’s GBS. While green initiatives have increased natural areas, unchecked urban sprawl has fragmented these spaces, reducing their environmental benefits. Satellite data and urban planning analyses underscore a key lesson: maintaining well-connected natural zones is critical for urban resilience. These findings are broadly applicable for rapidly growing cities globally, urging urban planners to integrate ecological conservation with development, and to safeguard healthy environments and vibrant communities.
Technical Summary
This study quantifies the spatiotemporal dynamics of urban GBS in Beijing, evaluating their essential role in delivering ESs and strengthening urban resilience. Although China has achieved substantial progress in urban greening, the ecological impacts of rapid urbanization on GBS configuration and connectivity have not been comprehensively quantified. Using an integrated analytical framework combining principal component analysis and multiple linear regression, we reveal how urban development strategies have shaped GBS dynamics over two decades. A spatially explicit analysis, utilizing geographically weighted regression, further elucidates the heterogeneous relationships among the normalized difference vegetation index, human footprint index, and ESs delivery capacity. Notably, socioeconomic incentives and green infrastructure governance—especially objective indicators such as forest, garden, and greenspace area—have effectively driven GBS expansion. However, urban expansion has led to pronounced fragmentation of peri-urban GBS, suggesting potential degradation of their ecosystem service support functions. These findings emphasize the need for adaptive GBS management strategies that balance ecological conservation with sustainable urban growth in rapidly developing cities.
Social Media Summary
Urban growth fragments green and blue spaces, reducing vital ecosystem services. Balancing conservation with development is essential for sustainable cities.
Aims: Progressive supranuclear palsy (PSP) typically presents with a constellation of motor symptoms, most commonly with frequent falls and gait disturbances. As the disease progresses, cognitive dysfunction and behavioural abnormalities may develop, however hypersexuality in the absence of the usage of dopaminergic agonists is rarely described. We report a case of a 70-year-old male referred to Consultation Liaison Psychiatry for inappropriate sexual behaviour on a background of Progressive Supranuclear Palsy with Predominant Cerebellar Ataxia.
Methods: He was admitted to hospital due to inappropriate sexual behaviours resulting in significant caregiver distress. There were increased sexual demands over the past year with other frontal lobe symptoms of hyperorality, apathy, distractibility and motor perseveration. His clinical history, previous investigations and treatments received were reviewed. He was subsequently diagnosed with Major Neurocognitive Disorder due to multiple aetiologies (PSP, Alzheimer’s disease and Frontotemporal lobar degeneration). He was started on trazodone and memantine with improvement and subsequently discharged home.
Results: PSP is known to cause frontal lobe deficits affecting executive function, with apathy, impulsivity and disinhibition, but rarely hypersexuality. Hypersexuality is more commonly associated with use of dopaminergic agonists that may be given to address motor symptoms in PSP. It is known that the use of dopaminergic agonists is associated with impulse control disorders such as pathological gambling, hypersexuality and compulsive eating. Further research into how progressive neurodegeneration from PSP affects brain function may shed more light on the emergence of behavioural changes such as hypersexuality.
In the management of hypersexuality, other contributing factors such as boredom, feelings of insecurity and lack of a sexual partner may need to be considered. Non-pharmacological options include behavioural interventions and education of caregivers. Medications may have potential side effects which need to be considered during prescribing. Serotonergic medications such as Selective Serotonin Reuptake Inhibitors are often used due to lower risks and have shown some benefit in reducing problematic behaviour. Other options include antipsychotics, cholinesterase inhibitors and hormonal treatments. It is also important to consider the wellbeing of family and staff looking after the patient as they may be victims of the patient’s sexual behaviour, and provide the necessary support.
Conclusion: Hypersexuality is rare in PSP and a thorough review of all possible causes is required. Management may involve both behavioural interventions and pharmacological treatment to aim to reduce inappropriate behaviours.
Noise source identification has been a long-standing challenge for decades. Although it is known that sound sources are closely related to flow structures, the underlying physical mechanisms remain controversial. This study develops a sound source identification method based on longitudinal and transverse process decomposition (LTD). Large-eddy simulations were performed on the flow around a cylinder at a Reynolds number of 3900. Using the new LTD method, sound sources in the cylinder flow were identified, and the mechanisms linking flow structures with noise generation were discussed in detail. Identifying the physical sound sources from two levels, low-order theory and high-order theory, the physical mechanism of wall sound sources was also analysed. Results indicate that the sound sources in the flow field mainly come from the leading edge, shear layer and wake region of the cylinder. The high-order theory reveals that sound sources are correlated with the spatio-temporal evolution of enstrophy, vortex stretching and surface deformation processes, this reflecting the coupling between transversal and longitudinal flow fields. The boundary thermodynamic flux and boundary dilatation flux distribution of the cylinder were analysed. Results indicate that the wall sound sources mainly come from the separation point and have a disorderly distribution on the leeward side of the cylinder, which is the main region where longitudinal variables enter the fluid from the wall surface, and the wall sound source is related to the boundary enstrophy flux.
Few empirical studies have examined the collective impact of and interplay between individual factors on collaborative outcomes during major infectious disease outbreaks and the direct and interactive effects of these factors and their underlying mechanisms. Therefore, this study investigates the effects and underlying mechanisms of emergency preparedness, support and assurance, task difficulty, organizational command, medical treatment, and epidemic prevention and protection on collaborative outcomes during major infectious disease outbreaks.
Methods
A structured questionnaire was distributed to medical personnel with experience in responding to major infectious disease outbreaks. SPSS software was used to perform the statistical analysis. Structural equation modeling was conducted using AMOS 24.0 to analyze the complex relationships among the study variables.
Results
Organizational command, medical treatment, and epidemic prevention and protection had significant and positive impacts on collaborative outcomes. Emergency preparedness and supportive measures positively impacted collaborative outcomes during health crises and were mediated through organizational command, medical treatment, and epidemic prevention and protection.
Conclusions
The results underscore the critical roles of organizational command, medical treatment, and epidemic prevention and protection in achieving positive collaborative outcomes during health crises, with emergency preparedness and supportive measures enhancing these outcomes through the same key factors.
Glyphodes pyloalis Walker (Lepidoptera: Pyralidae) is a destructive monophagous pest of mulberry, Morus Linnaeus (Moraceae), trees. In order to identify mulberry cultivars resistant to G. pyloalis, 12 cultivars were examined using field and in vitro testing. Field observations indicated that cultivars AlbapC, BombyL, LaeviT, and CathaB had less than 10.0% damage, with no observed damage on the CathaB cultivar. The life table parameters showed that CathaB cultivar had the longest larval and pupal duration (23.2 days in total), the shortest adult period (5.3 days), the lowest rates of both pupation (55.0%) and adult emergence (69.7%), the highest adult mortality (61.7%), the lowest average weight of pupae (30.4 mg), and the lowest daily oviposition (5.0 eggs/female/day). The larval performance of G. pyloalis in the field revealed that CathaB had the lowest larval density. Correlation analyses confirmed that significant correlations exist between all the performance parameters of G. pyloalis for both the observed damage and larval performance. Leaf characterisation of selected cultivars indicated CathaB had significantly higher values of leaf wax, trichome density, soluble glucose, and protein contents compared to MultiQ. This study would be a valuable reference for evaluating pest-resistant cultivars and establishing a theoretical foundation for managing G. pyloalis.
Evidence suggests the crucial role of dysfunctional default mode (DMN), salience and frontoparietal (FPN) networks, collectively termed the triple network model, in the pathophysiology of treatment-resistant depression (TRD).
Aims
Using the graph theory- and seed-based functional connectivity analyses, we attempted to elucidate the role of low-dose ketamine in the triple networks, namely the DMN, salience and FPN.
Method
Resting-state functional connectivity magnetic resonance imaging (rs–fcMRI) data derived from two previous clinical trials of a single, low-dose ketamine infusion were analysed. In clinical trial 1 (Trial 1), patients with TRD were randomised to either a ketamine or normal saline group, while in clinical trial 2 (Trial 2) those patients with TRD and pronounced suicidal symptoms received a single infusion of either 0.05 mg/kg ketamine or 0.045 mg/kg midazolam. All participants underwent rs–fcMRI pre and post infusion at Day 3. Both graph theory- and seed-based functional connectivity analyses were performed independently.
Results
Trial 1 demonstrated significant group-by-time effects on the degree centrality and cluster coefficient in the right posterior cingulate cortex (PCC) cortex ventral 23a and b (DMN) and the cluster coefficient in the right supramarginal gyrus perisylvian language (salience). Trial 2 found a significant group-by-time effect on the characteristic path length in the left PCC 7Am (DMN). In addition, both ketamine and normal saline infusions exerted a time effect on the cluster coefficient in the right dorsolateral prefrontal cortex a9-46v (FPN) in Trial 1.
Conclusions
These findings may support the utility of the triple-network model in elucidating ketamine’s antidepressant effect. Alterations in DMN, salience and FPN function may underlie this effect.
Optical fibers offer convenient access to a variety of nonlinear phenomena. However, due to their inversion symmetry, second-order nonlinear effects, such as second-harmonic generation (SHG), are challenging to achieve. Here, all-fiber in-core SHG with high beam quality is achieved in a random fiber laser (RFL). The fundamental wave (FW) is generated in the same RFL. The phase-matching condition is mainly achieved through an induced periodic electric field and the gain is enhanced through the passive spatiotemporal gain modulation and the extended fiber. The conversion needs no pretreatment and the average second-harmonic (SH) power reaches up to 10.06 mW, with a corresponding conversion efficiency greater than 0.04%. Moreover, a theoretical model is constructed to explain the mechanism and simulate the evolution of the SH and FW. Our work offers a simple method to generate higher brightness for in-fiber SHs, and may further provide new directions for research on all-fiber χ(2)-based nonlinear fiber optics and RFLs.
Cardiovascular disease (CVD) poses a substantial global health burden, necessitating effective and scalable interventions for primary prevention. Despite the increasing recognition of peer-based interventions in managing chronic diseases, their application in CVD prevention still needs to be explored.
Aims:
We describe the protocol of a quasi-experiment to evaluate the effectiveness of a peer-led digital health lifestyle intervention, MYCardio-PEER, for a low-income community at risk for CVD. This study aims to assess the effectiveness of MYCardio-PEER in improving the participants’ knowledge, lifestyle behaviours and biomarkers related to CVD. Secondarily, we aim to assess the adherence and satisfaction of participants towards MYCardio-PEER.
Methods:
A minimum total sample of 68 low-income community members at risk for CVD will be recruited and allocated either to the control group or the intervention group. Participants in the control group will receive standard lifestyle advice and printed materials for CVD prevention, while the intervention group will participate in the 8-week MYCardio-PEER intervention program. The participants will be assessed at Week 0 (baseline), Week 8 (post-intervention) and Week 20 (post-follow-up).
Discussion:
We anticipate a net improvement in CVD risk score, besides investigating the effectiveness of the intervention program on CVD-related knowledge, biomarkers, and diet and lifestyle behaviours. The successful outcome of this study is essential for various healthcare professionals and stakeholders to implement population-based, cost-effective, and accessible interventions in reducing CVD prevalence in the country.
Bronze mou vessels appear in Shu tombs in south-west China during the Eastern Zhou period (c. 771–256 BC). Examination of these vessels reveals major changes in the supply of metal and alloying technology in the Shu State, throwing new light on the social impact of the Qin conquest and later unification of China.
Supporting family caregivers (FCs) is a critical core function of palliative care. Brief, reliable tools suitable for busy clinical work in Taiwan are needed to assess bereavement risk factors accurately. The aim is to develop and evaluate a brief bereavement scale completed by FCs and applicable to medical staff.
Methods
This study adopted convenience sampling. Participants were approached through an intentional sampling of patients’ FCs at 1 palliative care center in Taiwan. This cross-sectional study referred to 4 theories to generate the initial version of the Hospice Foundation of Taiwan Bereavement Assessment Scale (HFT-BAS). A 9-item questionnaire was initially developed by 12 palliative care experts through Delphi and verified by content validity. A combination of exploratory factor analysis (EFA), reliability measures including items analysis, Cronbach’s alpha and inter-subscale correlations, and confirmatory factor analysis (CFA) was employed to test its psychometric properties.
Results
Two hundred seventy-eight participants conducted the questionnaire. Three dimensions were subsequently extracted by EFA: “Intimate relationship,” “Existential meaning,” and “Disorganization.” The Cronbach’s alpha of the HFT-BAS scale was 0.70, while the 3 dimensions were all significantly correlated with total scores. CFA was the measurement model: chi-squared/degrees of freedom ratio = 1.9, Goodness of Fit Index = 0.93, Comparative Fit Index = 0.92, root mean square error of approximation = 0.08. CFA confirmed the scale’s construct validity with a good model fit.
Significance of results
This study developed an HFT-BAS and assessed its psychometric properties. The scale can evaluate the bereavement risk factors of FCs in clinical palliative care.
In laser systems requiring a flat-top distribution of beam intensity, beam smoothing is a critical technology for enhancing laser energy deposition onto the focal spot. The continuous phase modulator (CPM) is a key component in beam smoothing, as it introduces high-frequency continuous phase modulation across the laser beam profile. However, the presence of the CPM makes it challenging to measure and correct the wavefront aberration of the input laser beam effectively, leading to unwanted beam intensity distribution and bringing difficulty to the design of the CPM. To address this issue, we propose a deep learning enabled robust wavefront sensing (DLWS) method to achieve effective wavefront measurement and active aberration correction, thereby facilitating active beam smoothing using the CPM. The experimental results show that the average wavefront reconstruction error of the DLWS method is 0.04 μm in the root mean square, while the Shack–Hartmann wavefront sensor reconstruction error is 0.17 μm.
The diverse implant landscape, the rising and disparate costs of implants in public healthcare institutions (PHIs), and the limited application of health technology assessment (HTA) impede fair and sustainable implant subsidies in Singapore. This study described the Agency for Care Effectiveness (ACE) Implant Subsidy List (ISL) methodology and the key enablers for supporting government subsidy of clinically effective and cost-effective implants in Singapore.
Methods
A multi-tiered implant grouping scheme on the ISL was established by adapting overseas implant classifications, consulting clinicians, and conducting HTA evaluations, with subsidy extensions at the product group tier. Implants within a product group share similar biomechanical actions and patient outcomes and are subject to the same clinical criteria and pricing requirement. Implants on the ISL must be approved by the regulatory authority. Patients who meet the clinical criteria for ISL implants are eligible for subsidy. ACE conducted value-based pricing (VBP) and partnered with the public healthcare supply chain agency to harmonize PHI implant prices. The ISL is updated three times per year.
Results
Implants listed on the ISL were deemed clinically and cost effective. Underpinned by HTA principles, the implant grouping scheme promoted parsimonious classification, while allowing the creation of new product groups for implants offering superior benefits for patients. Reasonable prices set for the product groups aided affordability and cost sustainability. The ISL clinical criteria and standardized implant identifiers encouraged the appropriate use of subsidized implants and facilitated implementation. By ISL implementation in December 2023, ACE assessed 42,165 implants and listed 22,689 ISL implants spanning 143 product groups. Industry can apply for ISL listing three times per year, which keeps the ISL updated and relevant.
Conclusions
The ISL adopts a fit-for-purpose methodology to standardize implant classifications, enable scalable application of HTA, drive appropriate use of subsidized implants, and bring cost sustainability to the government subsidy of implants in Singapore. A strategic partnership with the public healthcare supply chain agency to concurrently establish national procurement contracts reduced disparate implant prices in PHIs and provided greater leverage for better implant prices.
Low iron (Fe) stores at birth may adversely influence child cognitive and motor development. The aims of this study were to assess cord blood Fe levels and explore maternal and neonatal factors associated with Fe status. Cord blood specimens (n 46) were obtained from the BC Children’s Hospital BioBank in Vancouver, Canada. The primary outcome was cord plasma ferritin, measured using sandwich-ELISA. Predictors of interest included maternal age, gestational age, gravidity, infant sex, birth weight and delivery method. Median (interquartile range (IQR)) maternal age and gestational age at delivery was 33·5 (29·3–35·8) years and 36·5 (30·0–39·0) weeks, respectively, and 44 % of infants were female. Median (IQR) cord ferritin was 100·4 (75·7–128·9) µg/l, and 26 % had low Fe status (ferritin <76 µg/l). Among preterm deliveries, a 1-week increase in gestational age was associated with a 6·22 (95 % CI (1·10, 9·52)) µg/l increase in median cord ferritin. However, among term deliveries, a negative trend was observed (–2·38 µg/l per week of gestation (95 % CI (–34·8, 0·78))), indicating a potential non-linear relationship between gestational age and cord ferritin. Female term infants had higher cord ferritin compared with males (β (95 % CI): 30·3 (18·4, 57·9) µg/l), suggesting sex-specific differences in Fe transfer, acquisition and utilisation. Cord ferritin was higher with vaginal deliveries compared with caesarean sections (β (95 % CI): 39·1 (29·0, 51·5) µg/l). Low Fe status may be a concern among infants in Canada; however, further research is needed to inform appropriate thresholds to define optimal Fe status in cord blood.
Computerized adaptive testing (CAT) is characterized by its high estimation efficiency and accuracy, in contrast to the traditional paper-and-pencil format. CAT specifically for cognitive diagnosis (CD-CAT) carries the same advantages and has been seen as a tool for advancing the use of cognitive diagnosis (CD) assessment for educational practice. A powerful item selection method is the key to the success of a CD-CAT program, and to date, various parametric item selection methods have been proposed and well-researched. However, these parametric methods all require large samples, to secure high-precision calibration of the items in the item bank. Thus, at present, implementation of parametric methods in small-scale educational settings, such as classroom, remains challenging. In response to this issue, Chang, Chiu, and Tsai (Appl Psychol Meas 43:543–561, 2019) proposed the nonparametric item selection (NPS) method that does not require parameter calibration and outperforms the parametric methods for settings with only small or no calibration samples. Nevertheless, the NPS method is not without limitations; extra assumptions are required to guarantee a consistent estimator of the attribute profiles when data conform to complex models. To remedy this shortcoming, the general nonparametric item selection (GNPS) method that incorporates the newly developed general NPC (GNPC) method (Chiu et al. in Psychometrika 83:355–375, 2018) as the classification vehicle is proposed in this study. The inclusion of the GNPC method in the GNPS method relaxes the assumptions imposed on the NPS method. As a result, the GNPS method can be used with any model or multiple models without abandoning the advantage of being a small-sample technique. The legitimacy of using the GNPS method in the CD-CAT system is supported by Theorem 1 proposed in the study. The efficiency and effectiveness of the GNPS method are confirmed by the simulation study that shows the outperformance of the GNPS method over the compared parametric methods when the calibration samples are small.
By harnessing optical memories based on electromagnetically induced transparency in warm vapors of gaseous alkali metals and cold atomic clouds, this article presents new methods for motion sensing. The proposed scheme for velocimetry can substantially increase the sensitivity of some recent works based on the light-dragging effect in a moving medium, and on the other hand, our proposal, when realized using cold atoms, opens new research questions with regard to limits of light storage in cold atomic clouds. Ultimately, a detailed experimental setup is presented for the realization of the velocimetry scheme using stopped light, which includes considerations for the choice of the medium, laser configuration and control. By investigating the limits of optical memories in motion sensing applications, this research opens up new avenues for employing optical memories beyond applications in quantum information science.
This paper explores whether attitudes toward ethnic nationalism among Black and Asian Americans influence attitudes toward the Black Lives Matter Movement. Acceptance of a nationalist ideology typically makes an individual animus towards outgroups. Moreover, ethnic/Black nationalism is known to flare in times of perceived intense oppression. Given current racial tensions in the United States, we are interested in examining factors that may help facilitate alliance-building between Black and Asian Americans—two nonwhite groups that exist on different planks of the U.S. racial hierarchy. We begin by recounting historical and contemporary instances of Afro-Asian solidarity and conflict. This is followed by a review of past theoretical articulation and empirical research on nationalist ideology within each community. We develop a set of group-specific indicators of ethnic nationalism for Black and Asian Americans from the 2020 Collaborative Multiracial Post-Election Survey. Our results show clear evidence that being sympathetic to ethnic nationalism can unite rather than divide the two racialized communities in their attitudes toward present-day projects such as the Black Lives Matter Movement.