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Mental health problems commonly persist from childhood to adulthood. This study tested whether young adult life transitions can improve adult mental health symptoms after adjusting for childhood mental health symptoms.
Methods
The analysis uses data from the prospective, representative Great Smoky Mountains Study. Life transitions (e.g., high school completion, partnering, parenthood, and living independently) were assessed up to three times in young adulthood (ages 18 to 26; 3,241 observations). A cumulative variable counted the number of young adult transitions. Emotional, substance use, and antisocial personality symptoms were assessed at age 30 (1,154 participants or 81.2% of the original sample). Propensity models adjusted for early life adversities and psychiatric symptoms.
Results
Multiple young adult transitions were common (m = 4.62; SD = 1.57). After adjusting for childhood mental health problems and adversities, each additional transition was significantly associated with a reduction in subsequent adult emotional symptoms (β = −0.34, 95% CI: −0.59, −0.08, p = 0.01) and adult antisocial personality disorder symptoms (β = −0.08, 95% CI: −0.14, −0.02, p < 0.001. These associations were stronger in males than in females. Young adult transitions were not associated with reductions in subsequent substance use symptoms (β = −0.04; 95% CI: −0.11, 0.03, p = 0.30). Young adult transitions related to educational milestones and consistent employment were associated with the largest reductions in symptoms.
Conclusions
In this cohort study, life transitions during young adulthood were associated with reduced emotional and behavioral symptoms in adulthood. These transitions may constitute a potential mental health turning point and a specific, modifiable target for social policies.
This article highlights CSR disclosure as a strategic response of Chinese multinational enterprises (MNEs) to the social risk they face in host countries. Deviating from prior research that aims to directly measure social risk, we offer a new approach to isolate the effect of social risk by leveraging China's Belt & Road Initiative (BRI) as the research context, under which Chinese MNEs are largely protected from political risk in membership countries but are exposed to substantial social risk from local nongovernment stakeholders. Results from difference-in-differences analyses show that after the enactment of the BRI, Chinese MNEs investing in BRI countries significantly increases their likelihood of CSR disclosure than that of their counterparts investing in non-BRI countries. Further, such effects are more pronounced for state-owned MNEs and MNEs in natural resource industries. This research enriches the international business literature on the relationship between political risk and social risk, and that between corporate political actions and corporate social responsibility.
A need arose to divert patients with psychiatric complaints from the emergency department to alternative settings for psychiatric assessments to reduce footfall and to conduct consultations in a timely manner during COVID-19.
Objectives
We assessed the effectiveness of alternative referral pathway in reducing COVID-19 infection in our service, and its effect on service quality: response time and number of patients leaving before review. We evaluated the satisfaction of patients, General Practitioners (GPs) and mental health service (MHS) staff with the pathway.
Methods
All patients referred to the mental health service over a 2-month period following the introduction of the pathway were included. Findings were compared against the cohort referred for emergency assessment during the same period in 2019. Feedback surveys were distributed to patients, staff and GPs. χ ² and independent sample t-test were used to compare the variables.
Results
Over 2 months, 255 patients received an emergency assessment via the pathway, representing a 22.3% decrease in the volume of presentations from the same period in 2019. There were no COVID-19 cases among our patients or staff on the roster for assessing patients. In comparison to 2019, response times were improved (p<0.001), and the numbers of patients who left the hospital before the review were reduced by 3.2% during the study period (p<0.001). Patients and GPs were highly satisfied with the referral pathway and believed that the pathway should be retained post-COVID-19. Mental health service staff were divided in their opinions about its sustainability.
Conclusions
The pathway was successful in reducing the spread of infection, improving response times and reducing the numbers of patients who left without an assessment. Given the improved outcomes and acceptability, this is a preferable pathway for emergency referrals into the future.
One in six nursing home residents and staff with positive SARS-CoV-2 tests ≥90 days after initial infection had specimen cycle thresholds (Ct) <30. Individuals with specimen Ct<30 were more likely to report symptoms but were not different from individuals with high Ct value specimens by other clinical and testing data.
The recent development in the miniaturisation of small satellites and their subsystems has opened a new window of research for the universities around the globe. The low-cost, lightweight, small and flexible satellites have resulted in a broad range of multi-cube format small satellites, constructed from one-to-many adjoined cubes, having total mass between 1 and 10kg. The most challenging design part of the small satellites is to implant a large number of subsystems in a limited space. In order to resolve this issue, the designers are trying to shrink down the subsystem’s dimensions further. In this paper, a magnetorquer coil is designed and analysed for a 4U (4 units cube; 33 × 33 × 16.5)cm3 and 8U (8 units cube; 33 × 33 × 33)cm3 multi-cube small satellites, respectively. The coil is embedded in the six internal layers of an eight-layers printed circuit board (PCB). The designed magnetorquer system is fully reconfigurable and multiple coils configurations can be achieved by attaching them in series, parallel and hybrid arrangements. Due to embedded nature, the heat generated by the coil may damage the components mounted on the PCB outer surfaces. Therefore, thermal analysis is performed to ensure that the coil generated heat will not cross the PCB components temperature safety limits. All the possible combinations of the coils are analysed for current drawn, power consumption, heat dissipation, magnetic moment generation and resultant torque. A desired torque can be attained by using a particular coil configuration at the cost of specific amount of consumed power and PCB surface thermals.
The juvenile justice system in the USA adjudicates over seven hundred thousand youth in the USA annually with significant behavioral offenses. This study aimed to test the effect of juvenile justice involvement on adult criminal outcomes.
Methods
Analyses were based on a prospective, population-based study of 1420 children followed up to eight times during childhood (ages 9–16; 6674 observations) about juvenile justice involvement in the late 1990 and early 2000s. Participants were followed up years later to assess adult criminality, using self-report and official records. A propensity score (i.e. inverse probability) weighting approach was used that approximated an experimental design by balancing potentially confounding characteristics between children with v. without juvenile justice involvement.
Results
Between-groups differences on variables that elicit a juvenile justice referral (e.g. violence, property offenses, status offenses, and substance misuse) were attenuated after applying propensity-based inverse probability weights. Participants with a history of juvenile justice involvement were more likely to have later official and violent felony charges, and to self-report police contact and spending time in jail (ORs from 2.5 to 3.3). Residential juvenile justice involvement was associated with the highest risk of both, later official criminal records and self-reported criminality (ORs from 5.1 to 14.5). Sensitivity analyses suggest that our findings are likely robust to potential unobserved confounders.
Conclusions
Juvenile justice involvement was associated with increased risk of adult criminality, with residential services associated with highest risk. Juvenile justice involvement may catalyze rather than deter from adult offending.
Higher milk intake has been associated with a lower stroke risk, but not with risk of CHD. Residual confounding or reverse causation cannot be excluded. Therefore, we estimated the causal association of milk consumption with stroke and CHD risk through instrumental variable (IV) and gene-outcome analyses. IV analysis included 29 328 participants (4611 stroke; 9828 CHD) of the European Prospective Investigation into Cancer and Nutrition (EPIC)-CVD (eight European countries) and European Prospective Investigation into Cancer and Nutrition-Netherlands (EPIC-NL) case-cohort studies. rs4988235, a lactase persistence (LP) SNP which enables digestion of lactose in adulthood was used as genetic instrument. Intake of milk was first regressed on rs4988235 in a linear regression model. Next, associations of genetically predicted milk consumption with stroke and CHD were estimated using Prentice-weighted Cox regression. Gene-outcome analysis included 777 024 participants (50 804 cases) from MEGASTROKE (including EPIC-CVD), UK Biobank and EPIC-NL for stroke, and 483 966 participants (61 612 cases) from CARDIoGRAM, UK Biobank, EPIC-CVD and EPIC-NL for CHD. In IV analyses, each additional LP allele was associated with a higher intake of milk in EPIC-CVD (β = 13·7 g/d; 95 % CI 8·4, 19·1) and EPIC-NL (36·8 g/d; 95 % CI 20·0, 53·5). Genetically predicted milk intake was not associated with stroke (HR per 25 g/d 1·05; 95 % CI 0·94, 1·16) or CHD (1·02; 95 % CI 0·96, 1·08). In gene-outcome analyses, there was no association of rs4988235 with risk of stroke (OR 1·02; 95 % CI 0·99, 1·05) or CHD (OR 0·99; 95 % CI 0·95, 1·03). Current Mendelian randomisation analysis does not provide evidence for a causal inverse relationship between milk consumption and stroke or CHD risk.
Antarctica's ice shelves modulate the grounded ice flow, and weakening of ice shelves due to climate forcing will decrease their ‘buttressing’ effect, causing a response in the grounded ice. While the processes governing ice-shelf weakening are complex, uncertainties in the response of the grounded ice sheet are also difficult to assess. The Antarctic BUttressing Model Intercomparison Project (ABUMIP) compares ice-sheet model responses to decrease in buttressing by investigating the ‘end-member’ scenario of total and sustained loss of ice shelves. Although unrealistic, this scenario enables gauging the sensitivity of an ensemble of 15 ice-sheet models to a total loss of buttressing, hence exhibiting the full potential of marine ice-sheet instability. All models predict that this scenario leads to multi-metre (1–12 m) sea-level rise over 500 years from present day. West Antarctic ice sheet collapse alone leads to a 1.91–5.08 m sea-level rise due to the marine ice-sheet instability. Mass loss rates are a strong function of the sliding/friction law, with plastic laws cause a further destabilization of the Aurora and Wilkes Subglacial Basins, East Antarctica. Improvements to marine ice-sheet models have greatly reduced variability between modelled ice-sheet responses to extreme ice-shelf loss, e.g. compared to the SeaRISE assessments.
To investigate the plasma levels of IL-18, MIP-1α, MCP-1, SDF-1 and RANTES in major depression before and after treatment.
Method:
Twenty healthy volunteers and 40 patients with major depressive disorder (MDD) were involved in the current study. Depressed subjects had moderate or major depression according to the DSM-IV criteria. The HAMD scale was used to measure the efficacy after the 8-week treatment with fluoxetine hydrochloride. All subjects gave their written informed consents and were recruited from outpatients and inpatients of Sir Run Run Shaw Hospital between October 2004 and November 2005.The plasma levels of IL-18, MIP-1α, MCP-1, SDF-1 and RANTES in major depression were measured by ELISA before and after fluoxetine treatment.
Results:
HAMD score were significantly decreased after the treatment (P<0.001), there were seven cases score of after treatment <7,. At the time of admission, the plasma levels of IL-18, MCP-1, MIP-1α, SDF-1 and RANTES were significantly higher in the MDD than those in the healthy controls (P<0.001). In MDD, the cytokine values were significantly decreased after the treatment, including IL-18 (P=0.005), MCP-1 (P=0.001), MIP-1α (P<0.001, SDF-1 (P=0.004) and RANTES (P<0.001), but still significantly higher than those in the healthy controls (P<0.001).
Conclusions:
These findings suggest that major depression is accompanied by the immune activation, and the antidepressant treatments have anti-inflammatory effects. The remaining depression symptom after treatment may be related to the higher level of cytokines.
While assessing the environmental impact of nuclear power plants, researchers have focused their attention on radiocarbon (14C) owing to its high mobility in the environment and important radiological impact on human beings. The 10 MW high-temperature gas-cooled reactor (HTR-10) is the first pebble-bed gas-cooled test reactor in China that adopted helium as primary coolant and graphite spheres containing tristructural-isotropic (TRISO) coated particles as fuel elements. A series of experiments on the 14C source terms in HTR-10 was conducted: (1) measurement of the specific activity and distribution of typical nuclides in the irradiated graphite spheres from the core, (2) measurement of the activity concentration of 14C in the primary coolant, and (3) measurement of the amount of 14C discharged in the effluent from the stack. All experimental data on 14C available for HTR-10 were summarized and analyzed using theoretical calculations. A sensitivity study on the total porosity, open porosity, and percentage of closed pores that became open after irradiating the matrix graphite was performed to illustrate their effects on the activity concentration of 14C in the primary coolant and activity amount of 14C in various deduction routes.
The very high temperature reactor (VHTR) is a development of the high-temperature gas-cooled reactors (HTGRs) and one of the six proposed Generation IV reactor concept candidates. The 10 MW high temperature gas-cooled reactor (HTR-10) is the first pebble-bed gas-cooled test reactor in China. A sampling system for the measurement of carbon-14 (14C) was established in the helium purification system of the HTR-10 primary loop, which could sample 14C from the coolant at three locations. The results showed that activity concentration of 14C in the HTR-10 primary coolant was 1.2(1) × 102 Bq/m3 (STP). The production mechanisms, distribution characteristics, reduction routes, and release types of 14C in HTR-10 were analyzed and discussed. A theoretical model was built to calculate the amount of 14C in the core of HTR-10 and its concentration in the primary coolant. The activation reaction of 13C has been identified to be the dominant 14C source in the core, whereas in the primary coolant, it is the activation of 14N. These results can supplement important information for the source term analysis of 14C in HTR-10 and promote the study of 14C in HTGRs.
Complications of pregnancy remain key drivers of morbidity and mortality, affecting the health of both the mother and her offspring in the short and long term. There is lack of detailed understanding of the pathways involved in the pathology and pathogenesis of compromised pregnancy, as well as a shortfall of effective prognostic, diagnostic and treatment options. In many complications of pregnancy, such as in preeclampsia, there is an increase in uteroplacental vascular resistance. However, the cause and effect relationship between placental dysfunction and adverse outcomes in the mother and her offspring remains uncertain. In this review, we aim to highlight the value of gestational hypoxia-induced complications of pregnancy in elucidating underlying molecular pathways and in assessing candidate therapeutic options for these complex disorders. Chronic maternal hypoxia not only mimics the placental pathology associated with obstetric syndromes like gestational hypertension at morphological, molecular and functional levels, but also recapitulates key symptoms that occur as maternal and fetal clinical manifestations of these pregnancy disorders. We propose that gestational hypoxia provides a useful model to study the inter-relationship between placental dysfunction and adverse outcomes in the mother and her offspring in a wide array of examples of complicated pregnancy, such as in preeclampsia.
Prevalence of skin sores and scabies in remote Australian Aboriginal communities remains unacceptably high, with Group A Streptococcus (GAS) the dominant pathogen. We aim to better understand the drivers of GAS transmission using mathematical models. To estimate the force of infection, we quantified the age of first skin sores and scabies infection by pooling historical data from three studies conducted across five remote Aboriginal communities for children born between 2001 and 2005. We estimated the age of the first infection using the Kaplan–Meier estimator; parametric exponential mixture model; and Cox proportional hazards. For skin sores, the mean age of the first infection was approximately 10 months and the median was 7 months, with some heterogeneity in median observed by the community. For scabies, the mean age of the first infection was approximately 9 months and the median was 8 months, with significant heterogeneity by the community and an enhanced risk for children born between October and December. The young age of the first infection with skin sores and scabies reflects the high disease burden in these communities.
UK guidelines recommend routine HIV testing in high prevalence emergency departments (ED) and targeted testing for HBV and HCV. The ‘Going Viral’ campaign implemented opt-out blood-borne virus (BBV) testing in adults in a high prevalence ED, to assess seroprevalence, uptake, linkage to care (LTC) rates and staff time taken to achieve LTC. Diagnosis status (new/known/unknown), current engagement in care, and severity of disease was established. LTC was defined as patient informed plus ⩾1 clinic visit. A total of 6211/24 981 ED attendees were tested (uptake 25%); 257 (4.1%) were BBV positive (15 co-infected), 84 (33%) required LTC. 100/147 (68%) HCV positives were viraemic; 44 (30%) required LTC (13 new, 16 disengaged). 26/54 (48%) HBV required LTC (seven new, 11 disengaged). 16/71 (23%) HIV required LTC (10 new, five disengaged). 26/84 (31%) patients requiring LTC had advanced disease (CD4 <350, APRI (AST-to-Platelet Ratio Index) >1, Fibroscan F3/F4 or liver cancer), including five with AIDS-defining conditions and three hepatocellular carcinomas. There were five BBV-related deaths. BBV prevalence was high (4.1%); most were HCV (2.4%). HIV patients were more successfully and quickly LTC than HBV or HCV patients. ED testing was valuable as one-third of those requiring LTC (new, disengaged or unknown status patients) had advanced disease.
The relationship between Tartary buckwheat (Fagopyrum tataricum (L.) Gaertn. ♯ FAGTA) plant density (x) and percent yield loss (ŷ) was expressed by the following linear regression equations for barley (Hordeum vulgare L.) and wheat (Triticum aestivum L.), respectively; ŷ = 0.63 + 2.75 √x and ŷ = 5.04 + 3.05 √x. Tartary buckwheat causes serious yield reduction in barley and wheat. A Tartary buckwheat density at 30 plants/m2 at emergence reduced barley yield by 16% and wheat yield by 22%.
In a previous study we investigated three-scalar mixing in a turbulent coaxial jet (Cai et al.J. Fluid Mech., vol. 685, 2011, pp. 495–531). In this flow a centre jet and a co-flow are separated by an annular flow; therefore, the resulting mixing process approximates that in a turbulent non-premixed flame. In the present study, we investigate the effects of the velocity and length scale ratios of the annular flow to the centre jet, which determine the relative mean shear rates between the streams and the degree of separation between the centre jet and the co-flow, respectively. Simultaneous planar laser-induced fluorescence and Rayleigh scattering are employed to obtain the mass fractions of the centre jet scalar (acetone-doped air) and the annular flow scalar (ethylene). The results show that varying the velocity ratio and the annulus width modifies the scalar fields through mean-flow advection, turbulent transport and small-scale mixing. While the evolution of the mean scalar profiles is dominated by the mean-flow advection, the shape of the joint probability density function (JPDF) was found to be largely determined by the turbulent transport and molecular diffusion. Increasing the velocity ratio results in stronger turbulent transport, making the initial scalar evolution faster. However, further downstream the evolution is delayed due to slower small-scale mixing. The JPDF for the higher velocity ratio cases is bimodal at some locations while it is always unimodal for the lower velocity ratio cases. Increasing the annulus width delays the progression of mixing, and makes the effects of the velocity ratio more pronounced. For all cases the diffusion velocity streamlines in the scalar space representing the effects of molecular diffusion generally converge quickly to a curved manifold, whose curvature is reduced as mixing progresses. The curvature of the manifold increases significantly with the velocity and length scale ratios. Predicting the observed mixing path along the manifold as well as its dependence on the velocity and length scale ratios presents a challenge for mixing models. The results in the present study have implications for understanding and modelling multiscalar mixing in turbulent reactive flows.
Bacillary dysentery continues to be a major health issue in developing countries and ambient temperature is a possible environmental determinant. However, evidence about the risk of bacillary dysentery attributable to ambient temperature under climate change scenarios is scarce. We examined the attributable fraction (AF) of temperature-related bacillary dysentery in urban and rural Hefei, China during 2006–2012 and projected its shifting pattern under climate change scenarios using a distributed lag non-linear model. The risk of bacillary dysentery increased with the temperature rise above a threshold (18·4 °C), and the temperature effects appeared to be acute. The proportion of bacillary dysentery attributable to hot temperatures was 18·74% (95 empirical confidence interval (eCI): 8·36–27·44%). Apparent difference of AF was observed between urban and rural areas, with AF varying from 26·87% (95% eCI 16·21–36·68%) in urban area to −1·90% (95 eCI −25·03 to 16·05%) in rural area. Under the climate change scenarios alone (1–4 °C rise), the AF from extreme hot temperatures (>31·2 °C) would rise greatly accompanied by the relatively stable AF from moderate hot temperatures (18·4–31·2 °C). If climate change proceeds, urban area may be more likely to suffer from rapidly increasing burden of disease from extreme hot temperatures in the absence of effective mitigation and adaptation strategies.
Spinal epidural angiolipoma is a rare cause of spinal cord compression. We present a case and review the clinical presentation, radiological appearance, pathological aspects and treatment of this distinct clinico-pathological entity.
Methods:
A case of a 46-year-old woman with a five-month history of progressive myelopathy affecting her lower extremities is presented. CT and MRI revealed a large epidural fat-containing mass compressing the spinal cord dorsally at the T7-T8 level. A laminectomy was performed with gross total resection of the lesion.
Results:
The patient's neurologic symptoms improved postoperatively. A two-year follow-up period has revealed no signs of tumor recurrence and no neurological deficit.
Conclusion:
The diagnosis of spinal angiolipoma should be considered in the differential diagnosis of spinal cord compression. Magnetic resonance imaging is the investigation of choice. The surgical objective is complete excision but, for anterior lesions involving bone, an overly aggressive approach should be tempered by an awareness of the overall indolent natural history of so-called "infiltrating" spinal angiolipomas that are only partially excised.
A pilot study by 6 Clinical and Translational Science Awards (CTSAs) explored how bibliometrics can be used to assess research influence.
Methods
Evaluators from 6 institutions shared data on publications (4202 total) they supported, and conducted a combined analysis with state-of-the-art tools. This paper presents selected results based on the tools from 2 widely used vendors for bibliometrics: Thomson Reuters and Elsevier.
Results
Both vendors located a high percentage of publications within their proprietary databases (>90%) and provided similar but not equivalent bibliometrics for estimating productivity (number of publications) and influence (citation rates, percentage of papers in the top 10% of citations, observed citations relative to expected citations). A recently available bibliometric from the National Institutes of Health Office of Portfolio Analysis, examined after the initial analysis, showed tremendous potential for use in the CTSA context.
Conclusion
Despite challenges in making cross-CTSA comparisons, bibliometrics can enhance our understanding of the value of CTSA-supported clinical and translational research.