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The incorporation of trace metals into land snail shells may record the ambient environmental conditions, yet this potential remains largely unexplored. In this study, we analyzed modern snail shells (Cathaica sp.) collected from 16 sites across the Chinese Loess Plateau to investigate their trace metal compositions. Our results show that both the Sr/Ca and Ba/Ca ratios exhibit minimal intra-shell variability and small inter-shell variability at individual sites. A significant positive correlation is observed between the shell Sr/Ca and Ba/Ca ratios across the plateau, with higher values being recorded in the northwestern sites where less monsoonal rainfall is received. We propose that shell Sr/Ca and Ba/Ca ratios, which record the composition of soil solution, may be controlled by the Rayleigh distillation in response to prior calcite precipitation. Higher rainfall amounts may lead to a lower degree of Rayleigh distillation and thus lower shell Sr/Ca and Ba/Ca ratios. This is supported by the distinct negative correlation between summer precipitation and shell Sr/Ca and Ba/Ca ratios, enabling us to reconstruct summer precipitation amounts using the Sr/Ca and Ba/Ca ratios of Cathaica sp. shells. The potential application of these novel proxies may also be promising for other terrestrial mollusks living in the loess deposits globally.
Persistent malnutrition is associated with poor clinical outcomes in cancer. However, assessing its reversibility can be challenging. The present study aimed to utilise machine learning (ML) to predict reversible malnutrition (RM) in patients with cancer. A multicentre cohort study including hospitalised oncology patients. Malnutrition was diagnosed using an international consensus. RM was defined as a positive diagnosis of malnutrition upon patient admission which turned negative one month later. Time-series data on body weight and skeletal muscle were modelled using a long short-term memory architecture to predict RM. The model was named as WAL-net, and its performance, explainability, clinical relevance and generalisability were evaluated. We investigated 4254 patients with cancer-associated malnutrition (discovery set = 2977, test set = 1277). There were 2783 men and 1471 women (median age = 61 years). RM was identified in 754 (17·7 %) patients. RM/non-RM groups showed distinct patterns of weight and muscle dynamics, and RM was negatively correlated to the progressive stages of cancer cachexia (r = –0·340, P < 0·001). WAL-net was the state-of-the-art model among all ML algorithms evaluated, demonstrating favourable performance to predict RM in the test set (AUC = 0·924, 95 % CI = 0·904, 0·944) and an external validation set (n 798, AUC = 0·909, 95 % CI = 0·876, 0·943). Model-predicted RM using baseline information was associated with lower future risks of underweight, sarcopenia, performance status decline and progression of malnutrition (all P < 0·05). This study presents an explainable deep learning model, the WAL-net, for early identification of RM in patients with cancer. These findings might help the management of cancer-associated malnutrition to optimise patient outcomes in multidisciplinary cancer care.
This study introduces a low-profile, broadband antenna with filtering features and tunable radiation nulls. The antenna consists of an arc-shaped slot, a sawtooth square slot, a Y-shaped filtering branch, two rectangular metal cavities, and curved current loops. High-frequency current balancing technology is used in this research, two rectangular metal cavities are added above the slot to balance the current strength and reduce cross-polarization. By introducing a Y-shaped filtering branch based on the reverse diversion technique, the filtering capability of the antenna can be significantly enhanced. The electric and magnetic field intensity in the specific area is enhanced through arc-shaped slot tuning technology, and the bandwidth is effectively broadened. The radius adjustment of the sector-shaped feeding network controls the position of the high-frequency radiation null, and the curved current loops control the low-frequency radiation null, the two modulate to regulate the roll-off rate of the radiation characteristic. Experimental tests demonstrate an impedance matching bandwidth greater than 55%, a peak gain of 4.5 dBi, and out-of-band suppression of 25 and 21 dB in the low and high-frequency bands, respectively. Moreover, the cross-polarization level obtained in the xoz plane is lower than –35 dB. The designed antenna demonstrates considerable potential for broadband filtering applications.
Exploring the minimum wage policy discontinuities at county borders, we find that minimum wage hikes induce industrial firms to pollute more and reduce their abatement efforts. State ownership mitigates these negative effects, suggesting its role in addressing externality. The adverse environmental impacts are attenuated by the staggered increase in pollution discharge fees across provinces. These effects are stronger for firms with higher minimum wage sensitivity, lower market power, and greater financial constraints, and for firms that are the subsidiaries of nonlisted companies. Overall, our findings highlight the unintended environmental consequences of labor market policies.
Clinical high risk for psychosis (CHR) is often managed with antipsychotic medications, but their effects on neurocognitive performance and clinical outcomes remain insufficiently explored. This study investigates the association between aripiprazole and olanzapine use and cognitive and clinical outcomes in CHR individuals, compared to those receiving no antipsychotic treatment.
Methods
A retrospective analysis was conducted on 127 participants from the Shanghai At Risk for Psychosis (SHARP) cohort, categorized into three groups: aripiprazole, olanzapine, and no antipsychotic treatment. Neurocognitive performance was evaluated using the MATRICS Consensus Cognitive Battery (MCCB), while clinical symptoms were assessed through the Structured Interview for Prodromal Syndromes (SIPS) at baseline, 8 weeks, and one year.
Results
The non-medicated group demonstrated greater improvements in cognitive performance, clinical symptoms, and functional outcomes compared to the medicated groups. Among the antipsychotic groups, aripiprazole was associated with better visual learning outcomes than olanzapine. Improvements in neurocognition correlated significantly with clinical symptom relief and overall functional gains at follow-up assessments.
Conclusions
These findings suggest potential associations between antipsychotic use and cognitive outcomes in CHR populations while recognizing that observed differences may reflect baseline illness severity rather than medication effects alone. Aripiprazole may offer specific advantages over olanzapine, underscoring the importance of individualized risk-benefit evaluations in treatment planning. Randomized controlled trials are needed to establish causality.
We investigate the statistical properties of kinetic and thermal dissipation rates in two-dimensional/three-dimensional vertical convection of liquid metal ($Pr = 0.032$) within a square cavity. Two situations are specifically discussed: (i) classical vertical convection with no external forces and (ii) vertical magnetoconvection with a horizontal magnetic field. Through an analysis of dissipation fields and a reasonable approximation of buoyancy potential energy sourced from vertical heat flux, the issue of the ‘non-closure of the dissipation balance relation’, which has hindered the application of the GL theory in vertical convection, is partially resolved. The resulting asymptotic power laws are consistent with existing laminar scaling theories and even show certain advantages in validating simulations with large Prandtl number ($Pr$). Additionally, a full-parameter model and prefactors applicable to low-$Pr$ fluids are provided. The extension to magnetoconvection naturally introduces the approximate expression for total buoyancy potential energy and necessitates adjustments to the contributions of kinetic dissipation in both the bulk and boundary layer. The flow dimensionality and boundary layer thickness are key considerations in this analysis. The comprehension of Joule dissipation has been updated: the Lorentz force generates positive dissipation in the bulk by suppressing convection, while in the Hartmann layer, shaping the exponential boundary layer requires the fluid to perform positive work to accelerate, leading to negative dissipation. Finally, the proposed transport equations for magnetoconvection are supported by current direct numerical simulation (DNS) and literature data, and the applicability of the model is discussed.
This paper presents an investigation of the secondary saturation characteristics of a HfTe2 saturable absorber. Pulse energies of 5.85 and 7.4 mJ were demonstrated with a high-order Hermite–Gaussian (HG) laser and a vortex laser, respectively, using alexandrite as the gain medium. To the best of our knowledge, these are the highest pulse energies directly generated with HG and vortex lasers. To broaden the applications of high-energy pulsed HG and vortex lasers, wavelength tuning in the region of 40 nm was achieved using an etalon.
We prove several results showing that every locally finite Borel graph whose large-scale geometry is ‘tree-like’ induces a treeable equivalence relation. In particular, our hypotheses hold if each component of the original graph either has bounded tree-width or is quasi-isometric to a tree, answering a question of Tucker-Drob. In the latter case, we moreover show that there exists a Borel quasi-isometry to a Borel forest, under the additional assumption of (componentwise) bounded degree. We also extend these results on quasi-treeings to Borel proper metric spaces. In fact, our most general result shows treeability of countable Borel equivalence relations equipped with an abstract wallspace structure on each class obeying some local finiteness conditions, which we call a proper walling. The proof is based on the Stone duality between proper wallings and median graphs (i.e., CAT(0) cube complexes). Finally, we strengthen the conclusion of treeability in these results to hyperfiniteness in the case where the original graph has one (selected) end per component, generalizing the same result for trees due to Dougherty–Jackson–Kechris.
Myocardial bridge contributes to chest pain, often accompanied by non-specific complaints.
Aims
Our study aims to determine somatic symptom disorder (SSD) prevalence in patients with myocardial bridge, investigating associated clinical and psychological features.
Method
In this prospective cross-sectional study, we enrolled 1357 participants (337 with and 1020 without myocardial bridge) from Shanghai Renji Hospital. The Somatic Symptom Scale-China questionnaire was used to assess SSD. Depressive and anxiety disorders were assessed by the Patient Health Questionnaire-9 (PHQ-9) and Generalised Anxiety Disorder-7 (GAD-7).
Results
The prevalence of SSD in the myocardial bridge group was 63.2%, higher than the group without myocardial bridge (53.8%). Patients with myocardial bridge were at an increased risk of SSD (odds ratio 1.362, 95% CI 1.026–1.809; P = 0.033). There were no differences in the mean PHQ-9 scores (3.2 ± 3.4 v. 3.2 ± 4.1; P = 0.751) or GAD-7 scores (2.5 ± 3.0 v. 2.3 ± 3.7; P = 0.143) between the two groups. Among patients with myocardial bridge, gender was the only independent risk factor for SSD. Women were 3.119 times more likely to experience SSD compared with men (95% CI 1.537–6.329; P = 0.002).
Conclusions
Our findings emphasise the high prevalence and severity of SSD among patients with myocardial bridge. The screening for SSD should be of particular concern, especially among female patients.
Accurate characterization of high-power laser parameters, especially the near-field and far-field distributions, is crucial for inertial confinement fusion experiments. In this paper, we propose a method for computationally reconstructing the complex amplitude of high-power laser beams using modified coherent modulation imaging. This method has the advantage of being able to simultaneously calculate both the near-field (intensity and wavefront/phase) and far-field (focal-spot) distributions using the reconstructed complex amplitude. More importantly, the focal-spot distributions at different focal planes can also be calculated. To verify the feasibility, the complex amplitude optical field of the high-power pulsed laser was measured after static aberrations calibration. Experimental results also indicate that the near-field wavefront resolution of this method is higher than that of the Hartmann measurement. In addition, the far-field focal spot exhibits a higher dynamic range (176 dB) than that of traditional direct imaging (62 dB).
Post-traumatic stress disorder (PTSD) is a mental health condition caused by the dysregulation or overgeneralization of memories related to traumatic events. Investigating the interplay between explicit narrative and implicit emotional memory contributes to a better understanding of the mechanisms underlying PTSD.
Methods
This case–control study focused on two groups: unmedicated patients with PTSD and a trauma-exposed control (TEC) group who did not develop PTSD. Experiments included real-time measurements of blood oxygenation changes using functional near-infrared spectroscopy during trauma narration and processing of emotional and linguistic data through natural language processing (NLP).
Results
Real-time fNIRS monitoring showed that PTSD patients (mean [SD] Oxy-Hb activation, 0.153 [0.084], 95% CI 0.124 to 0.182) had significantly higher brain activity in the left anterior medial prefrontal cortex (L-amPFC) within 10 s after expressing negative emotional words compared with the control group (0.047 [0.026], 95% CI 0.038 to 0.056; p < 0.001). In the control group, there was a significant time-series correlation between the use of negative emotional memory words and activation of the L-amPFC (latency 3.82 s, slope = 0.0067, peak value = 0.184, difference = 0.273; Spearman’s r = 0.727, p < 0.001). In contrast, the left anterior cingulate prefrontal cortex of PTSD patients remained in a state of high activation (peak value = 0.153, difference = 0.084) with no apparent latency period.
Conclusions
PTSD patients display overactivity in pathways associated with rapid emotional responses and diminished regulation in cognitive processing areas. Interventions targeting these pathways may alleviate symptoms of PTSD.
The emotion regulation network (ERN) in the brain provides a framework for understanding the neuropathology of affective disorders. Although previous neuroimaging studies have investigated the neurobiological correlates of the ERN in major depressive disorder (MDD), whether patients with MDD exhibit abnormal functional connectivity (FC) patterns in the ERN and whether the abnormal FC in the ERN can serve as a therapeutic response signature remain unclear.
Methods
A large functional magnetic resonance imaging dataset comprising 709 patients with MDD and 725 healthy controls (HCs) recruited across five sites was analyzed. Using a seed-based FC approach, we first investigated the group differences in whole-brain resting-state FC of the 14 ERN seeds between participants with and without MDD. Furthermore, an independent sample (45 MDD patients) was used to evaluate the relationship between the aforementioned abnormal FC in the ERN and symptom improvement after 8 weeks of antidepressant monotherapy.
Results
Compared to the HCs, patients with MDD exhibited aberrant FC between 7 ERN seeds and several cortical and subcortical areas, including the bilateral middle temporal gyrus, bilateral occipital gyrus, right thalamus, calcarine cortex, middle frontal gyrus, and the bilateral superior temporal gyrus. In an independent sample, these aberrant FCs in the ERN were negatively correlated with the reduction rate of the HAMD17 score among MDD patients.
Conclusions
These results might extend our understanding of the neurobiological underpinnings underlying unadaptable or inflexible emotional processing in MDD patients and help to elucidate the mechanisms of therapeutic response.
Depression is associated with serious disease burden. Despite the multitude of antidepressant options available, the adherence rate is often low. Accounting for patient preferences can potentially boost adherence to antidepressant medication and elevate patient satisfaction. However, limited evidence exists regarding patient preferences for antidepressant selection. This study aims to elicit patient preferences regarding the benefits, risks, and cost attributes of antidepressants in China.
Methods
A best-worst scaling profile case experiment was conducted using a face-to-face survey administered to patients diagnosed with depression. Patients were recruited from general and psychiatric hospitals. We utilized a multiphase approach that integrated literature review, expert consultation, and best-worst scaling to develop attributes within choice sets. The attributes with each varying across two or three levels encompassed remission rate, sleep disorders, risk of headache or dizziness, risk of gastrointestinal adverse events, risk of liver or kidney injury, and monthly out-of-pocket costs. Each respondent answered seven choice tasks, including a dominant task. Data were analyzed using conditional logit, mixed logit, and generalized multinomial logit models. Subgroup analyses were conducted to explore preference heterogeneity.
Results
A total of 331 participants completed the survey and met the inclusion criteria. Almost all attribute levels were statistically significant. Overall, the most desirable characteristics of antidepressant medications were higher remission rates (80% and 55% rates; p<0.05), lower risk of liver or kidney injury (1% rate; p<0.05), and fewer monthly out-of-pocket costs (CNY100 [USD13.93, EUR12.75]; p<0.05). Risks of gastrointestinal adverse events (60% and 35% rates) and insomnia were the least preferred features. Regarding attributes, efficacy, the risk of gastrointestinal adverse events, and sleep disorders were relatively important factors influencing patient choice. Preferences differed slightly by age, degree of education, personal annual income, and treatments currently received.
Conclusions
Our study suggests that efficacy, gastrointestinal adverse effects, sleep disorders, and treatment costs are critical drivers behind medication choices among patients with depression. Preference heterogeneity also exists regarding individual and therapeutic characteristics, which need more samples and further analyses to identify. These discoveries hold the potential to enrich the shared decision-making process between physicians and patients within healthcare settings.
Ultrasonic scalpels are widely used in urological surgery. Although portable ultrasonic scalpels are convenient to use and install, the existing evidence on their safety and effectiveness is scarce. This study aimed to compare the safety and effectiveness of portable ultrasonic scalpels in urological surgery with traditional ultrasonic scalpels to aid clinical decision-making.
Methods
A multicenter, prospective, non-randomized controlled trial was conducted from February to August 2023 in three tertiary hospitals in China. The intervention group included 90 prospectively enrolled patients undergoing urological surgery during the same period of hospitalization: 45 with portable ultrasonic scalpels and 45 with traditional scalpels. Demographic and clinical data of patients in the study were collected. Data on quality of life were obtained using the EuroQol EQ-5D-5L scale preoperatively, at discharge, and one month and three months after surgery. Descriptive analysis and a generalized linear model were used in the data analysis.
Results
A total of 82 patients were included in the study: 39 in the intervention group and 43 in the control group. The average hospital stay and intraoperative and postoperative blood loss in the intervention group were lower than in the control group (p>0.05). From baseline to discharge, the decrease in quality-adjusted life-years (QALYs) in the intervention group was smaller (–0.134 versus –0.287; p<0.05) than in the control group. During the follow-up period, there were no significant differences in the changes in QALYs between the two groups. The decline in QALYs was significantly influenced by variables such as intraoperative blood loss and surgical site.
Conclusions
There were no significant differences in baseline characteristics or changes in QALYs between the intervention and control groups. Portable ultrasonic scalpels in urological surgery may be as equally effective as traditional scalpels with respect to clinical outcomes, with additional benefits in reducing QALY decline at discharge. Further research with large samples and long-term follow-up should be conducted.
We develop a latent variable selection method for multidimensional item response theory models. The proposed method identifies latent traits probed by items of a multidimensional test. Its basic strategy is to impose an \documentclass[12pt]{minimal}\usepackage{amsmath}\usepackage{wasysym}\usepackage{amsfonts}\usepackage{amssymb}\usepackage{amsbsy}\usepackage{mathrsfs}\usepackage{upgreek}\setlength{\oddsidemargin}{-69pt}\begin{document}$$L_{1}$$\end{document} penalty term to the log-likelihood. The computation is carried out by the expectation–maximization algorithm combined with the coordinate descent algorithm. Simulation studies show that the resulting estimator provides an effective way in correctly identifying the latent structures. The method is applied to a real dataset involving the Eysenck Personality Questionnaire.
Item replenishing is essential for item bank maintenance in cognitive diagnostic computerized adaptive testing (CD-CAT). In regular CAT, online calibration is commonly used to calibrate the new items continuously. However, until now no reference has publicly become available about online calibration for CD-CAT. Thus, this study investigates the possibility to extend some current strategies used in CAT to CD-CAT. Three representative online calibration methods were investigated: Method A (Stocking in Scale drift in on-line calibration. Research Rep. 88-28, 1988), marginal maximum likelihood estimate with one EM cycle (OEM) (Wainer & Mislevy In H. Wainer (ed.) Computerized adaptive testing: A primer, pp. 65–102, 1990) and marginal maximum likelihood estimate with multiple EM cycles (MEM) (Ban, Hanson, Wang, Yi, & Harris in J. Educ. Meas. 38:191–212, 2001). The objective of the current paper is to generalize these methods to the CD-CAT context under certain theoretical justifications, and the new methods are denoted as CD-Method A, CD-OEM and CD-MEM, respectively. Simulation studies are conducted to compare the performance of the three methods in terms of item-parameter recovery, and the results show that all three methods are able to recover item parameters accurately and CD-Method A performs best when the items have smaller slipping and guessing parameters. This research is a starting point of introducing online calibration in CD-CAT, and further studies are proposed for investigations such as different sample sizes, cognitive diagnostic models, and attribute-hierarchical structures.
This study aims to investigate the effects of the vine of Lonicera japonica Thunb (VLT) and marine-derived Bacillus amyloliquefaciens-9 (BA-9) supplementation on the growth performance, antioxidant capacity, and gut microbiota of goat kids. A total of 32 4-week-old kids were randomly assigned into four groups: a control group (CON), a group supplemented with 0.3% BA-9 (BA-9), a group supplemented with 2% VLT (VLT), and a group supplemented with both 0.3% BA-9 and 2% VLT (MIX). The results indicated that VLT supplementation significantly increased both average daily (P < 0.001) and total weight gain (TWG) (P < 0.001), while BA-9 alone had no significant effect (P > 0.05) on the average daily and TWG. Biomarker analysis of oxidative stress revealed that supplementation of VLT or BA-9 alone enhanced antioxidant capacity. The MIX group showing a higher total antioxidant capacity (T-AOC) compared with the CON, VLT, and BA-9 groups (P < 0.05). Plasma albumin (ALB) levels were significantly increased in the both VLT and BA-9 groups. Microbiota analysis revealed significant differences in α-diversity and β-diversity between the MIX and CON groups, with specific genera such as Prevotellaceae_UCG.004 and Rikenellaceae_RC9_gut_group negatively correlated with average daily gain (ADG), while Alistipes was positively correlated with T-AOC. These findings suggest that the combined supplementation of VLT and BA-9 can significantly enhance growth performance and antioxidant capacity in goat kids by modulating the composition of gut microbiota and reducing oxidative stress.
Pro-environmental behavior, including waste sorting and recycling, involves a combination of future-oriented (futureness) and other-oriented (otherness) attributes. Inspired by the perspective of intergenerational choice, this work explores whether eliciting concerns for future others could increase public support for recycling policy and recycling behavior. Study 1 consisted of an online random controlled trial and a laboratory experiment. In Study 1A (N = 400), future other-concern was primed using a static text manipulation, whereas in Study 1B (N = 192), a dynamic virtual manipulation was employed. The results showed that people in the conditions that elicited future other-concern reported greater household recycling intentions and more actual recycling behavior than those in the control conditions. Study 2A (N = 467) and Study 2B (N = 600) generalized this effect on the acceptance of the ‘Certain Time Certain Place’ waste sorting policy in China. Consistent with the intergenerational choice model, envisioning the future of subsequent generations is more impactful in gaining policy approval than merely envisioning a future time. These findings provide a new method for promoting public policy approval and recycling behavior, suggesting that people could become environmentally friendly when they are guided to consider future others.
Our study aimed to develop and validate a nomogram to assess talaromycosis risk in hospitalized HIV-positive patients. Prediction models were built using data from a multicentre retrospective cohort study in China. On the basis of the inclusion and exclusion criteria, we collected data from 1564 hospitalized HIV-positive patients in four hospitals from 2010 to 2019. Inpatients were randomly assigned to the training or validation group at a 7:3 ratio. To identify the potential risk factors for talaromycosis in HIV-infected patients, univariate and multivariate logistic regression analyses were conducted. Through multivariate logistic regression, we determined ten variables that were independent risk factors for talaromycosis in HIV-infected individuals. A nomogram was developed following the findings of the multivariate logistic regression analysis. For user convenience, a web-based nomogram calculator was also created. The nomogram demonstrated excellent discrimination in both the training and validation groups [area under the ROC curve (AUC) = 0.883 vs. 0.889] and good calibration. The results of the clinical impact curve (CIC) analysis and decision curve analysis (DCA) confirmed the clinical utility of the model. Clinicians will benefit from this simple, practical, and quantitative strategy to predict talaromycosis risk in HIV-infected patients and can implement appropriate interventions accordingly.
Precise pose estimation is crucial to various robots. In this paper, we present a localization method using correlative scan matching (CSM) technique for indoor mobile robots equipped with 2D-LiDAR to provide precise and fast pose estimation based on the common occupancy map. A pose tracking module and a global localization module are included in our method. On the one hand, the pose tracking module corrects accumulated odometry errors by CSM in the classical Bayesian filtering framework. A low-pass filter associating the predictive pose from odometer with the corrected pose by CSM is applied to improve precision and smoothness of the pose tracking module. On the other hand, our localization method can autonomously detect localization failures with several designed trigger criteria. Once a localization failure occurs, the global localization module can recover correct robot pose quickly by leveraging branch-and-bound method that can minimize the volume of CSM-evaluated candidates. Our localization method has been validated extensively in simulated, public dataset-based, and real environments. The experimental results reveal that the proposed method achieves high-precision, real-time pose estimation, and quick pose retrieve and outperforms other compared methods.