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Classification and Regression Trees (CART), and their successors—bagging and random forests, are statistical learning tools that are receiving increasing attention. However, due to characteristics of censored data collection, standard CART algorithms are not immediately transferable to the context of survival analysis. Questions about the occurrence and timing of events arise throughout psychological and behavioral sciences, especially in longitudinal studies. The prediction power and other key features of tree-based methods are promising in studies where an event occurrence is the outcome of interest. This article reviews existing tree algorithms designed specifically for censored responses as well as recently developed survival ensemble methods, and introduces available computer software. Through simulations and a practical example, merits and limitations of these methods are discussed. Suggestions are provided for practical use.
Humans depend heavily on nature. Drylands are home to 2.5 billion people, but the extent to which nature contributes to people (NCP) in drylands has been little explored. We examined the global contribution of nature to people, aiming to compare drylands and non-drylands. We predicted a lower contribution in drylands than non-drylands, largely because of the sparser population densities (peoples’ needs) and more degraded status of natural resources (lower potential contribution). Consistent with expectation, nature’s contribution was about 30% lower in drylands, with significantly lower values for drylands in Asia, Oceania, Africa and South America, but no difference for Europe and North America. Differences were due mainly to lower contributions from material and regulating contributions, i.e., the regulation of air quality, climate, water quantity and flow, soil protection and the supply of woody material, and potentially, lower use by people in drylands. Predicted declines in rainfall and increasing temperature are likely to place increasing pressure on nature to contribute to human well-being in drylands. A better understanding of nature’s contributions to people would improve our ability to allocate limited resources and achieve sustainable development in drylands.
Applying a variational analysis, a minimum-enstrophy vortex in three-dimensional (3-D) fluids with continuous stratification is found, under the quasi-geostrophic hypothesis. The buoyancy frequency is held constant. This vortex is an ideal limiting state in a flow with an enstrophy decay while energy and generalized angular momentum remain fixed. The variational method used to obtain two-dimensional (2-D) minimum-enstrophy vortices is applied here to 3-D integral quantities. The solution from the first-order variation is expanded on a basis of orthogonal spherical Bessel functions. By computing second-order variations, the solution is found to be a true minimum in enstrophy. This solution is weakly unstable when inserted in a numerical code of the quasi-geostrophic equations. After a stage of linear instability, nonlinear wave interaction leads to the reorganization of this vortex into a tripolar vortex. Further work will relate our solution with maximal entropy 3-D vortices.
Genes involved in melanin production directly impact insect pigmentation and can affect diverse physiology and behaviours. The role these genes have on sex behaviour, however, is unclear. In the present study, the crucial melanin pigment gene black was functionally characterised in an urban pest, the German cockroach, Blattella germanica. RNAi knockdown of B. germanica black (Bgblack) had no effect on survival, but did result in black pigmentation of the thoraxes, abdomens, heads, wings, legs, antennae, and cerci due to cuticular accumulation of melanin. Sex-specific variation in the pigmentation pattern was apparent, with females exhibiting darker coloration on the abdomen and thorax than males. Bgblack knockdown also resulted in wing deformation and negatively impacted the contact sex pheromone-based courtship behaviour of males. This study provides evidence for black function in multiple aspects of B. germanica biology and opens new avenues of exploration for novel pest control strategies.
As an important component of prehistoric subsistence, an understanding of bone-working is essential for interpreting the evolution of early complex societies, yet worked bones are rarely systematically collected in China. Here, the authors apply multiple analytical methods to worked bones from the Longshan site of Pingliangtai, in central China, showing that Neolithic bone-working in this area, with cervid as the main raw material, was mature but localised, household-based and self-sufficient. The introduction of cattle in the Late Neolithic precipitated a shift in bone-working traditions but it was only later, in the Bronze Age, that cattle bones were utilised in a specialised fashion and dedicated bone-working industries emerged in urban centres.
Tight focusing with very small f-numbers is necessary to achieve the highest at-focus irradiances. However, tight focusing imposes strong demands on precise target positioning in-focus to achieve the highest on-target irradiance. We describe several near-infrared, visible, ultraviolet and soft and hard X-ray diagnostics employed in a ∼1022 W/cm2 laser–plasma experiment. We used nearly 10 J total energy femtosecond laser pulses focused into an approximately 1.3-μm focal spot on 5–20 μm thick stainless-steel targets. We discuss the applicability of these diagnostics to determine the best in-focus target position with approximately 5 μm accuracy (i.e., around half of the short Rayleigh length) and show that several diagnostics (in particular, 3$\omega$ reflection and on-axis hard X-rays) can ensure this accuracy. We demonstrated target positioning within several micrometers from the focus, ensuring over 80% of the ideal peak laser intensity on-target. Our approach is relatively fast (it requires 10–20 laser shots) and does not rely on the coincidence of low-power and high-power focal planes.
Dicarbonyl compounds are highly reactive precursors of advanced glycation end products (AGE), produced endogenously, present in certain foods and formed during food processing. AGE contribute to the development of adverse metabolic outcomes, but health effects of dietary dicarbonyls are largely unexplored. We investigated associations between three dietary dicarbonyl compounds, methylglyoxal (MGO), glyoxal (GO) and 3-deoxyglucosone (3-DG), and body weight changes in European adults. Dicarbonyl intakes were estimated using food composition database from 263 095 European Prospective Investigation into Cancer and Nutrition–Physical Activity, Nutrition, Alcohol, Cessation of Smoking, Eating Out of Home in Relation to Anthropometry participants with two body weight assessments (median follow-up time = 5·4 years). Associations between dicarbonyls and 5-year body-weight changes were estimated using mixed linear regression models. Stratified analyses by sex, age and baseline BMI were performed. Risk of becoming overweight/obese was assessed using multivariable-adjusted logistic regression. MGO intake was associated with 5-year body-weight gain of 0·089 kg (per 1-sd increase, 95 % CI 0·072, 0·107). 3-DG was inversely associated with body-weight change (–0·076 kg, −0·094, −0·058). No significant association was observed for GO (0·018 kg, −0·002, 0·037). In stratified analyses, GO was associated with body-weight gain among women and older participants (above median of 52·4 years). MGO was associated with higher body-weight gain among older participants. 3-DG was inversely associated with body-weight gain among younger and normal-weight participants. MGO was associated with a higher risk of becoming overweight/obese, while inverse associations were observed for 3-DG. No associations were observed for GO with overweight/obesity. Dietary dicarbonyls are inconsistently associated with body weight change among European adults. Further research is needed to clarify the role of these food components in overweight and obesity, their underlying mechanisms and potential public health implications.
Screen time in infancy is linked to changes in social-emotional development but the pathway underlying this association remains unknown. We aim to provide mechanistic insights into this association using brain network topology and to examine the potential role of parent–child reading in mitigating the effects of screen time.
Methods
We examined the association of screen time on brain network topology using linear regression analysis and tested if the network topology mediated the association between screen time and later socio-emotional competence. Lastly, we tested if parent–child reading time was a moderator of the link between screen time and brain network topology.
Results
Infant screen time was significantly associated with the emotion processing-cognitive control network integration (p = 0.005). This network integration also significantly mediated the association between screen time and both measures of socio-emotional competence (BRIEF-2 Emotion Regulation Index, p = 0.04; SEARS total score, p = 0.04). Parent–child reading time significantly moderated the association between screen time and emotion processing-cognitive control network integration (β = −0.640, p = 0.005).
Conclusion
Our study identified emotion processing-cognitive control network integration as a plausible biological pathway linking screen time in infancy and later socio-emotional competence. We also provided novel evidence for the role of parent–child reading in moderating the association between screen time and topological brain restructuring in early childhood.
Studies have shown a relationship between oestrogen and Alzheimer's disease. However, there is neither clear nor strong evidence on the use of oestrogen-only therapy in reducing the risk of Alzheimer's disease.
Aims
To assess the effects of oestrogen-only therapy on reducing the risk of Alzheimer's disease.
Method
Inclusion criteria was determined with the PICO framework. Outcome was cognitive function measured by neuropsychological tests and strict protocols. Exclusion criteria included non-Alzheimer's dementia, progesterone-only therapy and pre-menopausal women. Searches were conducted in nine electronic healthcare databases, last searched in July 2022. Quality assessments conducted on randomised controlled trials (RCTs) were performed with the GRADE assessment, and cohort studies and case–control studies were assessed with the Newcastle–Ottawa Scale. Extracted data were used to analyse participants, interventions and outcomes.
Results
Twenty-four studies satisfied the search criteria (four RCTs, nine cohort studies, 11 case–control studies). Fifteen studies showed positive associations for oestrogen-only therapy reducing the risk of Alzheimer's disease, and the remaining nine found no evidence of association.
Conclusions
Fifteen studies showed that oestrogen-only therapy effectively reduced the risk of Alzheimer's disease, whereas nine showed no correlation. Studies also investigated oestrogen-related variables such as length of oestrogen exposure, being an apolipoprotein E ε4 carrier and concomitant use of non-steroidal anti-inflammatory drugs, and their role in neuroprotection. This review was limited by the limited ranges of duration of oestrogen treatment and type of oestrogen-only therapy used. In conclusion, oestrogen-only therapy has potential for use in preventing Alzheimer's disease, although current evidence is inconclusive and requires further study.
Rapid urbanization and development in Southeast Asia have impacted its high biodiversity and unique ecosystems, directly through the use of forest lands for infrastructure building, and indirectly through increasing ecological footprints. In Greater Bandung, Indonesia and Greater Kuala Lumpur, Malaysia, rapid urbanization over the last thirty years has resulted in an increase in built infrastructure of approximately two and three times respectively. A Nature-Based Solutions approach can potentially underpin urban design and planning strategies in Greater Bandung and Greater Kuala Lumpur, as well as other cities in Southeast Asia, to address biodiversity conservation and also global environmental challenges such as climate change adaption and mitigation, while supporting well-being. Mainstreaming Nature-Based Solutions in Southeast Asia will require knowledge gaps to be addressed, greater awareness, increasing the evidence base, metrics for measuring success, support from institutions and stakeholders, and new and innovative financing. The urgency of global socio-ecological challenges, in particular the biodiversity and climate crisis, means transformational change is needed in Southeast Asia, for urban, ecological, technical, economic, and social systems, while still supporting sustainable development.
More people are living in cities than ever before with around 55 per cent of the world’s population in cities as of 2018, and this is expected to grow to 68 per cent by 2050 (UN DESA 2018). Much of this rapid urbanization is concentrated in the Global South, such as in low- and middle-income countries, which have all experienced significant increases in population and rural to urban migration (Hajer et al. 2020; UN DESA 2018). By 2050, there is expected to be another 2.5 billion people living in urban areas with approximately 90 per cent of this increase taking place in Asia and Africa (UN DESA 2018). Of the urban infrastructure required in 2050, around 40 per cent has yet to be built (Hajer et al. 2020). In the coming decades, Southeast Asia is expected to experience one of the greatest increases in population and urbanization in the world.
Countries in Southeast Asia are rapidly urbanizing from their historically rural population base, with each country at different points in their urbanization development pathway, from Singapore with 100 per cent urbanization to Cambodia with 24.7 per cent urbanization in 2021 (UN DESA 2018). Around 66 per cent of the population of Southeast Asia is expected to reside in urban areas in 2050, compared to an estimated 51 per cent in 2021 and 16 per cent in 1950 (Figure 1a). Of the Southeast Asian nations, Malaysia is one of the most urbanized of the low- and middle-income countries (Lechner et al. 2020a), with an estimated 78 per cent of its population in cities (Figure 1a). Meanwhile, Indonesia, which is a lower-middle-income country (World Bank 2021), has the largest population in Southeast Asia at 271 million (BPS 2021), with an estimated 57 per cent of its population in cities (Figure 1a). Indonesia is also home to the megacity (i.e., city with over 10 million) of Jakarta with a population in Daerah Khusus Ibukota (Capital Special Region) of 11 million (BPS 2021) and upwards of 30 million in the Jakarta metropolitan area (Jabodetabekjur) (BPS 2021). The growth of megacities such as Bangkok and Manila, and major cities approaching megacity size, such as Greater Kuala Lumpur and Ho Chi Minh, is triggering a ripple effect, promoting growth in nearby cities and thereby concentrating urbanization in selected regions (Suzuki 2019).
The economic, political, strategic and cultural dynamism in Southeast Asia has gained added relevance in recent years with the spectacular rise of giant economies in East and South Asia. This has drawn greater attention to the region and to the enhanced role it now plays in international relations and global economics.
The sustained effort made by Southeast Asian nations since 1967 towards a peaceful and gradual integration of their economies has had indubitable success, and perhaps as a consequence of this, most of these countries are undergoing deep political and social changes domestically and are constructing innovative solutions to meet new international challenges. Big Power tensions continue to be played out in the neighbourhood despite the tradition of neutrality exercised by the Association of Southeast Asian Nations (ASEAN).
The Trends in Southeast Asia series acts as a platform for serious analyses by selected authors who are experts in their fields. It is aimed at encouraging policymakers and scholars to contemplate the diversity and dynamism of this exciting region.
• Rapid urbanization and development in Southeast Asia have impacted its high biodiversity and unique ecosystems, directly through the use of forest lands for infrastructure building, and indirectly through increasing ecological footprints.
• In Greater Bandung, Indonesia and Greater Kuala Lumpur, Malaysia, rapid urbanization over the last thirty years has resulted in an increase in built infrastructure of approximately two and three times respectively.
• A Nature-Based Solutions approach can potentially underpin urban design and planning strategies in Greater Bandung and Greater Kuala Lumpur, as well as other cities in Southeast Asia, to address biodiversity conservation and also global environmental challenges such as climate change adaption and mitigation, while supporting well-being.
• Mainstreaming Nature-Based Solutions in Southeast Asia will require knowledge gaps to be addressed, greater awareness, increasing the evidence base, metrics for measuring success, support from institutions and stakeholders, and new and innovative financing.
• The urgency of global socio-ecological challenges, in particular the biodiversity and climate crisis, means transformational change is needed in Southeast Asia, for urban, ecological, technical, economic, and social systems, while still supporting sustainable development.
Dentists prescribe 10% of all outpatient antibiotics in the United States and are the top specialty prescriber. Data on current antibiotic prescribing trends are scarce. Therefore, we evaluated trends in antibiotic prescribing rates by dentists, and we further assessed whether these trends differed by agent, specialty, and by patient characteristics.
Design:
Retrospective study of dental antibiotic prescribing included data from the IQVIA Longitudinal Prescription Data set from January 1, 2012 to December 31, 2019.
Methods:
The change in the dentist prescribing rate and mean days’ supply were evaluated using linear regression models.
Results:
Dentists wrote >216 million antibiotic prescriptions between 2012 and 2019. The annual dental antibiotic prescribing rate remained steady over time (P = .5915). However, the dental prescribing rate (antibiotic prescriptions per 1,000 dentists) increased in the Northeast (by 1,313 antibiotics per 1,000 dentists per year), among oral and maxillofacial surgeons (n = 13,054), prosthodontists (n = 2,381), endodontists (n = 2,255), periodontists (n = 1,961), and for amoxicillin (n = 2,562; P < .04 for all). The mean days’ supply significantly decreased over the study period by 0.023 days per 1,000 dentists per year (P < .001).
Conclusions:
From 2012 to 2019, dental prescribing rates for antibiotics remained unchanged, despite decreases in antibiotic prescribing nationally and changes in guidelines during the study period. However, mean days’ supply decreased over time. Dental specialties, such as oral and maxillofacial surgeons, had the highest prescribing rate with increases over time. Antibiotic stewardship efforts to improve unnecessary prescribing by dentists and targeting dental specialists may decrease overall antibiotic prescribing rates by dentists.
This research uses signaling theory to combine the perspective of investment results with existing venture capital (VC) standards and reexamines the factors that influence the attractiveness of innovative internet tech startups to VC from the perspective of equal opportunity startups. Taking the financing status of 310 startups in China's sharing economy as an example and using regression analysis, we empirically test the influence of entrepreneur and firm characteristics on attracting VC. Our results show that among founder characteristics, the entrepreneur's entrepreneurial experience alone is insufficient to attract VC. Industrial experience and political background have a positive influence on attracting VC. Among firm characteristics, market-entry order and business group (BG) affiliation positively influence attracting VC. This is a new and relevant discovery. In the Chinese market, investors are more inclined to provide financial support to entrepreneurs or startups that have already gained legitimacy from the government or business groups.
We examined the effect of an antimicrobial stewardship program (ASP), procalcitonin testing and rapid blood-culture identification on hospital mortality in a prospective quality improvement project in critically ill septic adults. Secondarily, we have reported antimicrobial guideline concordance, acceptance of ASP interventions, and antimicrobial and health-resource utilization.
Parents of medically complex children juggle unique demands associated with caring for chronically ill children, many of which negatively impact their mental wellbeing. Despite this, parents of medically complex children often forgo mental health support due to concerns with costs, time, stigma, and accessibility. There is limited research on evidence-based interventions addressing such barriers for these caregivers. We piloted an adapted version of Mood Lifters, a peer-led wellness program, to equip parents of medically complex children with evidence-based strategies to manage their mental health while also reducing barriers to support. We hypothesized parents would find Mood Lifters to be feasible and acceptable. Further, parents would experience improvements in mental wellbeing upon program completion.
Methods
We conducted a single-arm prospective pilot study to assess Mood Lifters for parents of medically complex children. Participants included 51 parents in the U.S. recruited from a local pediatric hospital providing care for their children. Caregiver mental wellbeing was assessed through validated questionnaires pre-intervention (T1) and post-intervention (T2). Repeated-measures analysis of variance was conducted to evaluate change between T1 and T2.
Results
Analyses from T1 and T2 (n = 18) revealed improvements in parents’ depression (F(1,17) = 7.691, p = 0.013) and anxiety (F(1,17) = 6.431, p = 0.021) after program completion. Improvements in perceived stress and positive and negative emotion were significant at p < 0.0083.
Significance of results
Parents of medically complex children experienced improved mental health upon participating in Mood Lifters. Results offer preliminary support for the feasibility and acceptability of Mood Lifters as an evidence-based care option that may also alleviate common barriers to care.
Collaborative planning for multiple hypersonic vehicles can effectively improve operational effectiveness. Time coordination is one of the main forms of cooperation among multi-hypersonic glide vehicles, and time cooperation trajectory optimisation is a key technology that can significantly increase the success rate of flight missions. However, it is difficult to obtain satisfactory time as a constraint condition during trajectory optimisation. To solve this problem, a multilayer Perceptrona is trained and adopted in a time-decision module, whose input is a four-dimensional vector selected according to the trajectory characteristics. Additionally, the MLP will be capable of determining the optimal initial heading angle of each aircraft to reduce unnecessary manoeuvering performance consumption in the flight mission. Subsequently, to improve the cooperative flight performance of hypersonic glide vehicles, the speed-dependent angle-of-attack and bank command were designed and optimised using the Artificial Bee Colony algorithm. The final simulation results show that the novel strategy proposed in this study can satisfy terminal space constraints and collaborative time constraints simultaneously. Meanwhile, each aircraft saves an average of 13.08% flight range, and the terminal speed is increased by 315.6m/s compared to the optimisation results of general purpose optimal control software (GPOPS) tools.