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Real-world outcomes of repetitive transcranial magnetic stimulation (rTMS) for depressive disorders vary, and generalizable predictors of response and remission remain unclear.
Objective
To identify demographic, clinical, and treatment-related predictors of rTMS outcomes using a multinational registry.
Methods
We pooled registry data from six countries between January 2017 and April 2026. Patients with depression treated with rTMS were included. Primary outcomes were response and remission. Predictors were evaluated using hierarchical logistic regression. Model 1 was the primary complete-case core model, with sensitivity analyses using multiple imputation and excluding clinical-trial-derived patients. Model 2 incorporated treatment-dose and medication variables, whereas Model 3 explored clinical and sociodemographic variables with substantial missingness and was considered hypothesis-generating. Clinician-rated and patient-reported outcomes were also analyzed separately.
Results
Among 2,015 cases, 1,691 were analyzed. Response and remission rates were 43.6% and 28.7%, respectively. More treatment sessions were associated with higher odds of response (adjusted odds ratio (aOR) = 1.02 per session, p = 0.002), whereas lower baseline depression severity was consistently associated with higher odds of remission (aOR = 0.33, p < 0.001). Intermittent theta-burst stimulation was associated with lower odds of remission than high-frequency rTMS (aOR = 0.39, p < 0.001), although this association varied by outcome rater and protocol effects for response were non-significant. Country-level differences were observed, whereas medication-related and sociodemographic associations were inconsistent.
Conclusions
Treatment exposure and baseline severity were the most stable predictors of rTMS outcomes. Protocol and regional variations warrant standardized prospective studies to define personalized rTMS strategies.
Late-life depression often extends to the marital partner, yet mechanisms of dyadic interdependence and their cross-cultural generalizability remain unclear.
Methods
We analyzed harmonized longitudinal data from couples in the China Health and Retirement Longitudinal Study (CHARLS; n = 3,532; 5 waves, 2011–2020), the Health and Retirement Study (HRS; n = 2,332; 8 waves, 2006–2020), and the English Longitudinal Study of Ageing (ELSA; n = 1,895; 9 waves, 2002–2018). Depressive symptoms (CES-D) and activities of daily living (ADL)/instrumental ADL (IADL) limitations were measured at every wave. Complementary actor–partner interdependence models (APIM) and random-intercept cross-lagged panel models (RI-CLPM) were applied, with multiplicity adjustment, full-information maximum likelihood (FIML), and 20-imputation triangulation.
Results
Within-couple correlations of depressive symptoms were positive in every cohort (r = 0.34–0.43 in CHARLS, 0.14–0.20 in HRS, 0.23–0.29 in ELSA). APIM partner effects were robust in CHARLS but sparse elsewhere. After partialling out stable between-couple similarity, RI-CLPM within-person cross-spouse associations were attenuated, reaching consistent significance under FIML and multiple imputation only in ELSA. Four-variable RI-CLPMs showed bidirectional depression–disability coupling, strongest in HRS and ELSA, with cross-spouse function-to-depression effects in Western cohorts but not in CHARLS. Sex distinguishability was not supported, and half-longitudinal mediation through ADL/IADL did not survive multiplicity correction.
Conclusions
Concordance in late-life depressive symptoms replicates across three major aging cohorts; in CHARLS, it primarily reflects stable between-couple similarity, whereas modest within-person prospective coupling persists in ELSA and in the multiple-imputation HRS estimates. Bidirectional depression–disability coupling in Western cohorts is the most replicable within-person signal, supporting combined depression management and functional rehabilitation for older couples.
Dispersion in turbulent flows is of broad interest in engineering and environmental processes, particularly for rivers, lakes and oceanic water bodies. Based on our streamwise dispersion model grounded in a Lagrangian perspective of convection–diffusion dynamics (Guan & Chen, 2024, J. Fluid Mech., vol. 980, A33), this work presents a comprehensive solution that consistently unifies dispersion across the Reynolds number spectrum, bridging laminar and turbulent regimes. The streamwise dispersion mechanism is general across time scales, yet its statistical behaviour cannot be fully described using conventional coarse-grained moments averaged over cross-sections. While classical drift–diffusion models that are effective for long-time asymptotics fail to capture the turbulent dynamics of the pre-asymptotic phase, our analytical model enables a complete spatio-temporal characterisation of concentration, and reveals how local statistics evolve towards their asymptotic, coarse-grained limits. Through asymptotic expansions and eigenfunction analysis, we quantify the time-dependent behaviour of phenomenological dispersion coefficients, and distinguish between local and mean statistics, which diverge significantly during the pre-asymptotic phase. The early regime exhibits robust features, including an overshoot in local dispersivity, asymmetric long tails in mean concentration, and island-shaped solute accumulation near the free surface. Three regimes are identified in the evolution of the local concentration: (i) an initially uniform line source, (ii) a transitional logarithmic profile shaped by vertical shear, and (iii) an emergent Gaussian dispersion regime approaching vertical uniformity. Comparisons of both local and mean concentration demonstrate quantitative agreement with finite difference and Monte Carlo simulations across all regimes. These findings clarify the interplay between shear and turbulent diffusion, laying a foundation for addressing more intricate and physically significant transport problems.
Extensive research has examined whether political satire promotes or suppresses political discussion, but far less attention has been paid to how it shapes discourse quality. This study investigates the impact of political satire on discourse quality by scrutinizing the substance of online discussions in a non-democratic context. Drawing on manual content analysis of discussions on a major Chinese social media platform surrounding China’s controversial policy to raise the age of retirement, we analysed original posts and subsequent replies (N = 3,400) to assess the impact of satire on online political talk. The results show that political satire significantly decreases topic relevance and rationality, while exerting no significant effect on civility, and virtually precludes argument reciprocity. These findings contribute theoretically by shifting the focus from whether satire stimulates political engagement to how it influences the substantive quality of deliberation. They also invite a reassessment of the often-overemphasized optimistic role of political satire, highlighting its potential to erode rational and constructive discourse.
Compared to land-terminating glaciers, lake-terminating glaciers generally experience a higher mass loss due to the feedback from processes such as calving, dynamic thinning and flow acceleration associated with proglacial lakes. These processes often result in substantial changes in glacier length. We analyzed the evolution of the Jiongpu Co lake-terminating glacier on the Tibetan Plateau between October 2014 and November 2015, during which the glacier retreated by approximately 800 m. This dramatic retreat of the Jiongpu Co Glacier was mainly caused by calving from March to May 2015, leading to a mean retreat rate of 7.6 m d−1 during this period. The total mass loss of the glacier during the study period was 0.15 ± 0.01 Gt, with frontal ablation accounting for 74 ± 9% of this loss. Our findings highlight that the rapid calving event of the Jiongpu Co Glacier during 2014–2015 was likely associated with both accelerated velocity and a reduction in ice thickness above the flotation height at the terminus, which together enhanced frontal ablation and contributed to the observed rapid retreat.
Low heart rate variability (HRV) levels may be a susceptibility factor for major depressive disorder (MDD). Sleep-state HRV may be more likely to reveal the pathological features of MDD compared with resting state HRV (RS-HRV). This study aimed to elucidate HRV alterations in the sleep states of patients with MDD.
Methods:
Physiological signal data from the resting state before sleep, first non-rapid eye movement (NREM) and rapid eye movement (REM) stages, and last NREM and REM stages were acquired using polysomnography.
Results:
The RS-HRV indices (the standard deviation [SD] of all normal-to-normal [NN] intervals [SDNN], the square root of the mean of the sum of the squares of the differences between adjacent NN intervals [RMSSD], the percentage difference between adjacent NN intervals >50 ms [pNN50], high-frequency [HF], low-frequency [LF], very low frequency [VLF], SD1, and sample entropy [SampEn]) were lower in patients with MDD than in healthy controls (HCs). Patients with MDD had lower SDNN, RMSSD, pNN50, HF, LF, VLF, SD1, SD2, and SampEn and higher SD2/SD1, α1, and α2 than HCs in the NREM stage. They also had lower SDNN, RMSSD, pNN50, HF, LF, VLF, SD1, SD2, and SampEn and higher LF/HF than HCs in the REM stage. Fewer indices changed significantly during different sleep stages in patients with MDD than in HCs.
Conclusions:
Patients with MDD had a generalised reduction in HRV in both RS and sleep state and decreased dynamic changes during sleep. Altered autonomic nervous system activity has been implicated in MDD pathology.
Dispersion of microswimmers is widespread in environmental and biomedical applications. In the category of continuum modelling, the present study investigates the dispersion of microswimmers in a confined unidirectional flow under a diffuse reflection boundary condition, instead of the specular reflection and the Robin boundary conditions prevailing in existing studies. By the moment analysis based on the Smoluchowski equation, the asymptotic and transient solutions are directly obtained, as validated against random walk simulations, to illustrate the effects of mean flow velocity, swimming velocity and gyrotaxis on the migration and distribution patterns of elongated microswimmers. Under the diffuse reflection boundary condition, microswimmers are found more likely to exhibit M-shaped low-shear trapping and even pronounced centreline aggregation, and elongated shape affects depletion at the centreline. Along the flow direction, they readily form unimodal distributions oriented downstream, resulting in prominent downstream migration. Near the centreline, the migration is almost entirely downstream, while upstream and vertical migrations are confined near the boundaries. When the mean flow velocity and swimming velocity are comparable, the system undergoes a temporal transition from M-shaped low-shear trapping to M-shaped high-shear trapping and ultimately to centreline aggregation. The downstream migration continuously strengthens over time, while the upstream first strengthens and then weakens. Moreover, the coupling between swimming-induced diffusion and convective dispersion leads to non-monotonic, fluctuating trends in both drift velocity and dispersivity over time. These results contribute to a deeper understanding of the underlying mechanisms governing the locomotion and control of natural and synthetic microswimmers.
This manuscript presents a novel three-series-only topology P-insulator-N (PIN) diode single-pole-double-through (SPDT) switch designed to address the challenges of high power handling and low insertion loss in Q-band and V-band communication systems. The manuscript provides a detailed theoretical analysis of series-connected PIN diodes, offering insights into their behavior under both small- and large-signal conditions. Based on GaAs PIN diode technology, the switch operates across a frequency range of 37.7 to 61 GHz, achieving a low insertion loss of 0.707 dB and providing an isolation of 24.6 dB. The proposed SPDT switch demonstrates a high $\text{IP}_{\text{0.1~dB}}$ of 37.6 dBm at 38 GHz. With a compact chip size of $0.905\times 0.885 \text{mm}^2$, including all pads, this work offers excellent power handling capability, making it highly suitable for advanced communication systems in Q-band and V-band applications.
Bactrocera dorsalis (Diptera: Tephritidae) is a highly invasive and destructive quarantine pests worldwide. To improved biological control efficiency, reduce chemical pesticides use, and optimise the application of Metarhizium anisopliae (Hypocreales: Clavicipitaceae) against B. dorsalis. This study evaluated the combined toxicity of M. anisopliae with deltamethrin and chlorpyrifos. The biocompatibility of M. anisopliae CQMa421 with these pesticides was assessed based on spore germination, mycelial growth, and sporulation. Additionally, the effects of combined treatments on detoxification enzyme and related gene expression in B. dorsalis were investigated. The results indicated that the virulence effect of M. anisopliae CQMa421 against B. dorsalis adults was time-dependent and dose-dependent. Deltamethrin showed good compatibility with M. anisopliae CQMa421, achieving 100% mortality at 1 × 10⁸ CFU/mL by 84 hours. Different concentrations of deltamethrin can promote the mycelial growth and sporulation of M. anisopliae CQMa421. The toxicity effect of deltamethrin and chlorpyrifos combined with M. anisopliae CQMa421 on B. dorsalis adults was better than that of single-agent treatment, and the co-toxicity factor of 5 mg/L deltamethrin and 1 × 108 CFU/mL M. anisopliae CQMa421 was 24.81, which synergistically affected on B. dorsalis control. Enzyme activity assays and qRT-PCR results revealed that the combination treatment differentially activated and enhanced the activities of AChE, CarE, GST, CAT, and SOD. Meanwhile, BdCarE was significantly inhibited and upregulating BdGSTD7, BdGSTS1, BdCYP4ae1, BdPOD, BdPOD1, and BdCAT genes. In conclusion, the combination of deltamethrin and M. anisopliae CQMa421 enhanced the insecticidal efficacy against B. dorsalis, significantly affected the activity of related detoxification enzymes. Provided a robust basis for integrating biological and chemical control strategies to manage B. dorsalis more effectively.
As a novel type of catalytic Janus micromotor (JM), a double-bubble-powered Janus micromotor has a distinct propulsion mechanism that is closely associated with the bubble coalescence in viscous liquids and corresponding flow physics. Based on high-speed camera and microscopic observation, we provide the first experimental results of the coalescence of two microbubbles near a JM. By performing experiments with a wide range of Ohnesorge numbers, we identify a universal scaling law of bubble coalescence, which shows a cross-over at dimensionless time $\tilde{t}$ = 1 from an inertially limited viscous regime with linear scaling to an inertial regime with 1/2 scaling. Due to the confinement from the nearby solid JM, we observe asymmetric neck growth and find the combined effect of the surface tension and viscosity. The bubble coalescence and detachment can result in a high propulsion speed of ∼0.25 m s−1 for the JM. We further characterise two contributions to the JM’s displacement propelled by the coalescing bubble: the counteraction from the liquid due to bubble deformation and the momentum transfer during bubble detachment. Our findings provide a better understanding of the flow dynamics and transport mechanism in micro- and nano-scale devices like the swimming microrobot and bubble-powered microrocket.
Radiocarbon (14C) measurements play important roles in dating and tracing applications where the isotopic concentration can differ from 0.1 to 106 pMC (percent modern carbon). A liquid scintillation counter cannot provide enough sensitivity when dealing with low-concentration samples of limited amounts over a reasonable time period. Accelerator mass spectroscopy (AMS) measures low-concentrations well but must first do dilution for high-concentration samples, and suffers from high instrument and maintenance costs. Saturated absorption CAvity Ring-down spectroscopy (SCAR) has now been developed into a practical technique with performances close to AMS but at much lower costs. The dynamic range covers 1–105 pMC, and the measurement uncertainties in the range of 0.4–1 pMC can be achieved within 0.5–2.5 hr of operation time. SCAR measures CO2 gases directly without graphitization in sample preparation. The typical sample consumption is ∼1 mg of carbon mass and the time for sample preparation can be as short as 15 min. Applications of SCAR to Suess-effect evaluation, biogenic-component analysis, ancient- and modern-sample dating, food-fraud detection and medicine-metabolism study have all been demonstrated by employing a close-to-automatic sample preparation system.
Biped wall-climbing robots (BWCRs) serve as viable alternatives to human workers for inspection and maintenance tasks within three-dimensional (3D) curtain wall environments. However, autonomous climbing in such environments presents significant challenges, particularly related to localization and navigation. This paper presents a pioneering navigation framework tailored for BWCRs to navigate through 3D curtain wall environments. The framework comprises three essential stages: Building Information Model (BIM)-based map extraction, 3D climbing path planning (based on our previous work), and path tracking. An algorithm is developed to extract a detailed 3D map from the BIM, including structural elements such as walls, frames, and ArUco markers. This generated map is input into a proposed path planner to compute a viable climbing motion. For path tracking during actual climbing, an ArUco marker-based global localization method is introduced to estimate the pose of the robot, enabling adjustments to the target foothold by comparing desired and actual poses. The conducted experiments validate the feasibility and efficacy of the proposed navigation framework and associated algorithms, aiming to enhance the autonomous climbing capability of BWCRs.
Shear-induced migration of elongated micro-swimmers exhibiting anisotropic Brownian diffusion at a population scale is investigated analytically in this work. We analyse the steady motion of confined ellipsoidal micro-swimmers subject to coupled diffusion in a general setting within a continuum homogenisation framework, as an extension of existing studies on macro-transport processes, by allowing for the direct coupling of convection and diffusion in local and global spaces. The analytical solutions are validated successfully by comparison with numerical results from Monte Carlo simulations. Subsequently, we demonstrate from the probability perspective that symmetric actuation does not yield net vertical polarisation in a horizontal flow, unless non-spherical shapes, external fields or direct coupling effects are harnessed to generate steady locomotion. Coupled diffusivities modify remarkably the drift velocity and vertical migration of motile micro-swimmers exposed to fluid shear. The interplay between stochastic swimming and preferential alignment could explain the diverse concentration and orientation distributions, including rheological formations of depletion layers, centreline focusing and surface accumulation. Results of the analytical study shed light on unravelling peculiar self-propulsion strategies and dispersion dynamics in active-matter systems, with implications for various transport problems arising from the fluctuating shape, size and other external or inter-particle interactions of swimmers in confined environments.
Initial microbial colonization plays an important role in neonatal gut health. However, studies on gut microbial composition at birth are challenging, due to the limited access to accurate sampling. Here, we characterized the jejunal and ileal bacterial composition (epimural and luminal) of neonatal calves within 30 minutes after birth, and compared it with maternal (birth canal and rectum) and birth environments. RNA-based quantification along with amplicon sequencing revealed the colonization of active, dense (1.1–9.4 × 108 16S rRNA copy/g of sample), and diverse bacteria in the calf small intestine at birth. Pseudomonadaceae and Propionibacteriaceae dominated epimural communities, while Propionibacteriaceae, Prevotellaceae, Ruminococcaceae, and Lachnospiraceae dominated luminal communities. The composition of calf gut bacteria at birth was significantly different from maternal bacteria, especially for beneficial bifidobacteria. The bacterial communities of calf body habitats were similar to those of the birth environment, which was again divergent from gut microbiota. This study suggests an establishment of small intestinal-specific microbiota from birth, which is considerably deviated from maternal microbiota. In corollary, we further propose that small intestinal microbiota colonization could be mainly modulated by host selection.
For the dispersion of soluble matter in solvent flowing through a tube as investigated originally by G.I. Taylor, a streamwise dispersion theory is developed from a Lagrangian perspective for the whole process with multi-scale effects. By means of a convected coordinate system to decouple convection from diffusion, a diffusion-type governing equation is presented to reflect superposable diffusion processes with a multi-scale time-dependent anisotropic diffusivity tensor. A short-time benchmark, complementing the existing Taylor–Aris solution, is obtained to reveal novel statistical and physical features of mean concentration for an initial phase with isotropic molecular diffusion. For long times, effective streamwise diffusion prevails asymptotically corresponding to the overall enhanced diffusion in Taylor's classical theory. By inverse integral expansions of local concentration moments, a general streamwise dispersion model is devised to match the short- and long-time asymptotic solutions. Analytical solutions are provided for most typical cases of point and area sources in a Poiseuille tube flow, predicting persistent long tails and skewed platforms. The theoretical findings are substantiated through Monte Carlo simulations, from the initial release to the Taylor dispersion regime. Asymmetries of concentration distribution in a circular tube are certified as originated from (a) initial non-uniformity, (b) unidirectional flow convection, and (c) non-penetration boundary effect. Peculiar peaks in the concentration cloud, enhanced streamwise dispersivity and asymmetric collective phenomena of concentration distributions are illustrated heuristically and characterised to depict the non-equilibrium dispersion. The streamwise perspective could advance our understanding of macro-transport processes of both passive solutes and active suspensions.
When motile algal cells are exposed to gyrotactic torques, their swimming directions are guided to form radial accumulation, well known as hydrodynamic focusing. The origin of hydrodynamic focusing from the effects of active swimming, ambient flow and particle anisotropy is elucidated in the present study on the pre-asymptotic dispersion of active particles through a vertical pipe. With an extension of the Galerkin method to pipe flows, time-dependent solutions directly from the Smoluchowski equation in the position and orientation space are derived by series expansions of spherical harmonics and Bessel functions. Ballistic and diffusive scaling laws are examined with the predominance of self-propelled swimming, and computation is validated against an explicit benchmark solution and Lagrangian particle simulation. In the limit of extreme shear, the competitive roles of shear dispersion and Brownian rotation are reflected concretely in the pre-asymptotic phase of hydrodynamic focusing. For flows with various shear strengths, a concentration peak in near-wall regions with a smooth transition to hydrodynamic focusing is illustrated with richer phenomena in upwelling and downwelling flows. A newly observed regime through a vertical pipe, named transient effective trapping, is revealed as a transitional mode towards hydrodynamic focusing. The pre-asymptotic approach to hydrodynamic focusing is elaborated intensively through extensive solutions of concentration moments and macroscopic transport coefficients characterised by swimming and flow Péclet numbers. The unique findings for the origin of hydrodynamic focusing could provide insight into related micro-algae reactor technology and contribute to flow control and biomass transfer in confined environments.
Visual place recognition (VPR) in condition-varying environments is still an open problem. Popular solutions are convolutional neural network (CNN)-based image descriptors, which have been shown to outperform traditional image descriptors based on hand-crafted visual features. However, there are two drawbacks of current CNN-based descriptors: (a) their high dimension and (b) lack of generalization, leading to low efficiency and poor performance in real robotic applications. In this paper, we propose to use a convolutional autoencoder (CAE) to tackle this problem. We employ a high-level layer of a pre-trained CNN to generate features and train a CAE to map the features to a low-dimensional space to improve the condition invariance property of the descriptor and reduce its dimension at the same time. We verify our method in four challenging real-world datasets involving significant illumination changes, and our method is shown to be superior to the state-of-the-art. The code of our work is publicly available at https://github.com/MedlarTea/CAE-VPR.
Coastal eutrophication and hypoxia remain a persistent environmental crisis despite the great efforts to reduce nutrient loading and mitigate associated environmental damages. Symptoms of this crisis have appeared to spread rapidly, reaching developing countries in Asia with emergences in Southern America and Africa. The pace of changes and the underlying drivers remain not so clear. To address the gap, we review the up-to-date status and mechanisms of eutrophication and hypoxia in global coastal oceans, upon which we examine the trajectories of changes over the 40 years or longer in six model coastal systems with varying socio-economic development statuses and different levels and histories of eutrophication. Although these coastal systems share common features of eutrophication, site-specific characteristics are also substantial, depending on the regional environmental setting and level of social-economic development along with policy implementation and management. Nevertheless, ecosystem recovery generally needs greater reduction in pressures compared to that initiated degradation and becomes less feasible to achieve past norms with a longer time anthropogenic pressures on the ecosystems. While the qualitative causality between drivers and consequences is well established, quantitative attribution of these drivers to eutrophication and hypoxia remains difficult especially when we consider the social economic drivers because the changes in coastal ecosystems are subject to multiple influences and the cause–effect relationship is often non-linear. Such relationships are further complicated by climate changes that have been accelerating over the past few decades. The knowledge gaps that limit our quantitative and mechanistic understanding of the human-coastal ocean nexus are identified, which is essential for science-based policy making. Recognizing lessons from past management practices, we advocate for a better, more efficient indexing system of coastal eutrophication and an advanced regional earth system modeling framework with optimal modules of human dimensions to facilitate the development and evaluation of effective policy and restoration actions.
We reported a case of ischaemic stroke with moyamoya disease with simultaneous occurrence of patent foramen ovale. The patient underwent percutaneous closure of patent foramen ovale and was scheduled for follow-up.