To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Health anxiety, characterised by excessive worry about having or acquiring a serious illness, significantly impacts mental health and well-being. Determining which psychological interventions and components should be considered as first-line treatments requires robust evidence.
Aims
This study aimed to evaluate the efficacy of various psychological interventions and their essential components in managing health anxiety.
Method
A comprehensive search was conducted across multiple academic databases, including PubMed, Embase, PsyINFO, Web of Science, Scopus and the Cochrane Central Register of Controlled Trials, with updates until 16 January 2025. Randomised clinical trials investigating the efficacy of psychological interventions among adults with substantial levels of health anxiety were included. We employed random-effects network meta-analysis for treatment comparison, and component network meta-analysis to assess the impacts of key therapeutic elements.
Results
A total of 35 trials involving 3263 participants (67% female; mean age 37 years, s.d. = 6) were analysed. The results revealed significant effects for several therapies, including cognitive–behavioural therapy (CBT), exposure therapy, acceptance and commitment therapy, metacognitive therapy, and mindfulness-based cognitive therapy, as well as behavioural stress management, compared with a waiting list control. However, cognitive bias modification, imagery therapy and short-term psychodynamic psychotherapy did not show significant effects. Component analysis indicated that exposure and response prevention, cognitive restructuring and mindfulness were linked to improved treatment outcomes.
Conclusions
Both CBT and third-wave CBT are reasonable first-line choices for managing health anxiety. Effective CBT packages for health anxiety should integrate key components such as exposure and response prevention, cognitive restructuring and mindfulness.
In flight safety monitoring, risk prediction demands high accuracy for rare but critical events such as engine failures and weather-related hazards. However, the limited sample size of such extreme cases within a single dataset poses a significant challenge to achieving precise predictions. Aggregating data across sources is a potential solution, but datasets are often not independently and identically distributed. Transfer learning can improve target performance by leveraging related sources, yet classical methods struggle with heavy-tailed data due to the lack of robust loss functions. This paper proposes a transfer learning algorithm based on composite quantile regression (CQR). It identifies and transfers information from similar sources and constructs pseudo response variables to linearise the CQR loss, enabling robust computation under heavy-tailed noise. Extensive simulation studies demonstrate the superior performance of the proposed method. The practical utility of the algorithm is further illustrated through its application to quick access recorder (QAR) flight data for hard landing risk prediction. This work aims to identify and quantify key controllable factors influencing landing safety through a data-driven approach. Our research provides quantitative analytical tools for multiple core safety aspects, including flight operation standardisation, aircraft condition monitoring, operational environment assessment and support resource allocation, thereby enabling more precise and proactive risk mitigation strategies.
Radiocarbon dating is essential for establishing robust chronologies in archaeological and paleoenvironmental contexts spanning the last 55,000 years. Pottery, pervasive in the archaeological record, offers a crucial framework for dating human activity during the Holocene. Traditionally, radiocarbon dating of pottery has relied on targeting carbonaceous inclusions such as organic temper or measuring stratigraphically associated materials like bone and charcoal. Inaccuracies can arise, however, if the targeted fraction does not reflect the timing of vessel use or if stratigraphic associations are uncertain. An alternative involves radiocarbon dating of lipid residues, particularly fatty acids absorbed into the ceramic matrix during the processing and storage of plant and animal-derived resources. This approach holds promise for delivering highly accurate measurements directly correlating to vessel use. At the Oxford Radiocarbon Accelerator Unit, efforts have been made to develop this methodology through compound-specific radiocarbon dating of pottery, employing a gas chromatography (GC)-preparative fraction collector (PFC) approach. Here, we describe the protocol and present preliminary findings, including analyses conducted on pottery samples sourced from an archaeological site with an established chronology.
In this paper, a two-component discrete Boltzmann method is used to investigate the influence of the relaxation time on the two-dimensional compressible Kelvin–Helmholtz instability under dual-mode perturbations. The evolution characteristics of density gradient, vorticity, mixing entropy, Knudsen number (Kn), and thermodynamic non-equilibrium (TNE) effects are analysed. The results reveal that increasing relaxation time enhances diffusive and dissipative effects, leading to smoother interfaces, weaker vortex structures and suppressed instability growth. The global density gradient and vorticity intensity decrease accordingly. Mixing entropy analysis shows that larger relaxation times promote early mixing through diffusion, while smaller ones enhance late-stage mixing via vortex-induced convection. The Kn and TNE counters exhibit similar spatial and temporal variations, both effectively capturing the interface dynamics and deviations from local equilibrium. Both their magnitudes and the area over which they are spatially distributed increase with relaxation time, reflecting enhanced non-equilibrium effects. Besides, the global Kn and average TNE intensity initially rise, then decline, increase again and finally decrease, increasing with the relaxation time. These are jointly driven by the competitive physical mechanisms of the interface stretching, vortex merging and diffusion mechanisms. The findings provide a theoretical foundation for further exploration of non-equilibrium processes in complex fluid systems.
The Union began gaining competence in external relations in 1993 after the implementation of the Maastricht Treaty. Since then the EU has struggled to increase its international presence, and public diplomacy has been one option in the toolbox. In terms of traditional diplomacy, the role and weight of the EU in Asia have been less prominent compared to unitary actors such as the US and Russia; the Union’s public visibility and awareness among the Asian public have also lagged behind. This chapter is devoted to examining the public diplomacy programme of the EU in Asia, to determine how it has (or has not) contributed to the EU’s rapprochement with Asia. It focuses on the EU’s public diplomacy in countries of the ASEAN+3 group. These are subdivided into Northeast Asia (China, Japan and South Korea, which are three of the EU’s ten strategic partners) and Southeast Asia (the ten member states of ASEAN). This study excludes public diplomacy of the individual member states of the EU. The timeframe monitored is between 1994 and the present, as in 1994 the EU published the New Asia Strategy, which marked the beginning of the EU’s redisiy of Asia.
Individuals with first-episode psychosis (FEP) face markedly increased excess mortality, yet the long-term trends and key contributing factors remain insufficiently characterized. This study aimed to examine long-term mortality patterns, standardized mortality ratios (SMRs), and associated factors in a FEP cohort.
Methods
This population-based cohort study included 1,389 individuals diagnosed with FEP, followed for up to 25 years. Mortality outcomes were obtained from Hong Kong’s centralized hospital database (CMS) and coroner’s court reports, with SMRs calculated. Baseline sociodemographic and clinical, as well as long-term treatment-related factors of all-cause, natural, and unnatural mortality were analyzed.
Results
Among 1,389 participants, 137 deaths (9.86%) occurred during the follow-up period with the overall SMR of 6.56 (95% CI, 5.50–7.71). The cumulative incidence rate of unnatural mortality increased sharply over the first 10 years and that of the natural cause of death started to increase after the first decade of the illness. Male gender and poorer social functioning were associated with increased all-cause mortality risk, while male gender, lower education, and baseline hospitalization raised unnatural mortality risk. Greater monthly antipsychotic variability during the first 10 years increased all-cause mortality risk in the period after the initial 10 years.
Conclusions
This 25-year follow-up study of FEP highlighted the changes in the long-term mortality pattern of FEP and thus the phase-specific needs of individuals with FEP. Therefore, it is important to integrate physical care into mental health services, as well as stage-specific and individualized care for patients with psychotic disorders to reduce long-term excess mortality.
For an integer $m>1$, we denote by $P(m)$ the largest prime divisor of m. We improve a result of Stewart [‘On the greatest and least prime factors of ${n!}+1$, II’, Publ. Math. Debrecen65(3–4) (2004), 461–480] by showing that $\limsup _{n \rightarrow \infty } P({n!}+1)/n \geqslant 1+9\log 2$. More generally, for any nonzero polynomial $f(X)$ with integer coefficients, we show that $\limsup _{n \rightarrow \infty } P({n!}+f(n))/n \geqslant 1+9\log 2$. This improves a result of Luca and Shparlinski [‘Prime divisors of shifted factorials’, Bull. Lond. Math. Soc.37(6) (2005), 809–817]. These improvements stem from an additional combinatorial idea that builds upon the works mentioned above.
Objectives: The recent experience of the COVID-19 pandemic emphasized the critical need for a surveillance system to alert healthcare facilities about the admission of patients with emerging infectious diseases (EID), thereby preventing nosocomial transmissions. Methods: Tan Tock Seng Hospital, an 1800-bed acute tertiary-care hospital in Singapore, transitioned to a new- generation electronic medical record system, Epic, in August 2022. Leveraging the system’s capabilities, we developed an algorithm to generate the line-list of suspected Middle East Respiratory Syndrome (MERS) patients, in alignment with the screening guidelines provided by Singapore’s Ministry of Health. The algorithm first identifies patients who presented within 14 days (maximum incubation period) of their travel to Arabic peninsular countries. This information is documented by the emergency department’s triage nurses. Additionally, patients with suspected MERS indicated in the problem list or diagnosis by attending clinicians, particularly emergency-medicine physicians or infectious-disease physicians, are included. Furthermore, patients who are ordered for a MERS- Coronavirus polymerase chain reaction test, are identified. The algorithm can also be further modified as and when the case definition of the EID changes. Results: The surveillance report constructed with Epic algorithm can be scheduled for daily generation or generated on demand within a few minutes. This newer approach is more time- and resource-efficient compared to the manual surveillance process, which necessitates at least three staff members to engage in a series of prolonged manual processes. The report, by extracting information directly from Epic in near real-time, also minimizes the likelihood of errors that may occur during the manual process. Subsequently, the team of epidemiologists identifies the suspected MERS patients form the generated report and efficiently follow up them until a diagnosis of MERS is excluded. Conclusions: Harnessing Epic’s capabilities, we constructed an algorithm to efficiently and swiftly identify suspected MERS patients, enabling the timely implementation of infection prevention strategies to prevent nosocomial transmission.
Objectives: The recent experience of the COVID-19 pandemic emphasized the critical need for a surveillance system to alert healthcare facilities about the admission of patients with emerging infectious diseases (EID), thereby preventing nosocomial transmissions. Methods: Tan Tock Seng Hospital, an 1800-bed acute tertiary-care hospital in Singapore, transitioned to a new- generation electronic medical record system, Epic, in August 2022. Leveraging the system’s capabilities, we developed an algorithm to generate the line-list of suspected Middle East Respiratory Syndrome (MERS) patients, in alignment with the screening guidelines provided by Singapore’s Ministry of Health. The algorithm first identifies patients who presented within 14 days (maximum incubation period) of their travel to Arabic peninsular countries. This information is documented by the emergency department’s triage nurses. Additionally, patients with suspected MERS indicated in the problem list or diagnosis by attending clinicians, particularly emergency-medicine physicians or infectious-disease physicians, are included. Furthermore, patients who are ordered for a MERS- Coronavirus polymerase chain reaction test, are identified. The algorithm can also be further modified as and when the case definition of the EID changes. Results: The surveillance report constructed with Epic algorithm can be scheduled for daily generation or generated on demand within a few minutes. This newer approach is more time- and resource-efficient compared to the manual surveillance process, which necessitates at least three staff members to engage in a series of prolonged manual processes. The report, by extracting information directly from Epic in near real-time, also minimizes the likelihood of errors that may occur during the manual process. Subsequently, the team of epidemiologists identifies the suspected MERS patients form the generated report and efficiently follow up them until a diagnosis of MERS is excluded. Conclusions: Harnessing Epic’s capabilities, we constructed an algorithm to efficiently and swiftly identify suspected MERS patients, enabling the timely implementation of infection prevention strategies to prevent nosocomial transmission.
Eclipta [Eclipta prostrata (L.) L.] is an important tropical weed that has recently emerged as a problematic weed in dry direct-seeded rice (Oryza sativa L.) (DSR) fields in China. Understanding its seed germination biology and ecology is crucial for developing integrated weed management strategies in the DSR system. Laboratory experiments were conducted to investigate seed germination of E. prostrata seeds under varying environmental conditions. Germination was greatest under alternating temperature regimes of 25/15 to 40/30 C, whereas it wa-s significantly reduced at 20/10 C and completely inhibited at 15/5 C. Germination was also fully suppressed under continuous darkness, indicating strong light dependency. Eclipta prostrata seeds tolerated a broad range of pH values (4 to 10) with germination rates consistently greater than 95%. However, germination declined sharply under osmotic potentials, falling below 2% at −0.6 MPa, and being completely inhibited at −0.7 MPa. Seeds also showed moderate salt tolerance, with 50% inhibition at 150 mM NaCl and no germination at 300 mM NaCl. Exposure to radiant heat (>90 C for 5 min) prevented germination, suggesting residue burning may be an effective control measure. Seedling emergence was highest (100%) on the soil surface but declined steeply with increasing burial depth, with no emergence observed beyond 0.5 cm. Similarly, surface application of wheat (Triticum aestivum L.) straw residue (2 to 6 Mg ha−1) significantly reduced seedling emergence and biomass. These findings provide essential insights into E. prostrata germination ecology and offer practical implications for its integrated management in DSR systems.
The heterogeneity of chronic post-COVID neuropsychiatric symptoms (PCNPS), especially after infection by the Omicron strain, has not been adequately explored.
Aims
To explore the clustering pattern of chronic PCNPS in a cohort of patients having their first COVID infection during the ‘Omicron wave’ and discover phenotypes of patients based on their symptoms’ patterns using a pre-registered protocol.
Method
We assessed 1205 eligible subjects in Hong Kong using app-based questionnaires and cognitive tasks.
Results
Partial network analysis of chronic PCNPS in this cohort produced two major symptom clusters (cognitive complaint–fatigue and anxiety–depression) and a minor headache–dizziness cluster, like our pre-Omicron cohort. Participants with high numbers of symptoms could be further grouped into two distinct phenotypes: a cognitive complaint–fatigue predominant phenotype and another with symptoms across multiple clusters. Multiple logistic regression showed that both phenotypes were predicted by the level of pre-infection deprivation (adjusted P-values of 0.025 and 0.0054, respectively). The severity of acute COVID (adjusted P = 0.023) and the number of pre-existing medical conditions predicted only the cognitive complaint–fatigue predominant phenotype (adjusted P = 0.003), and past suicidal ideas predicted only the symptoms across multiple clusters phenotype (adjusted P < 0.001). Pre-infection vaccination status did not predict either phenotype.
Conclusions
Our findings suggest that we should pursue a phenotype-driven approach with holistic biopsychosocial perspectives in disentangling the heterogeneity under the umbrella of chronic PCNPS. Management of patients complaining of chronic PCNPS should be stratified according to their phenotypes. Clinicians should recognise that depression and anxiety cannot explain all chronic post-COVID cognitive symptoms.
Methamphetamine (METH) dependence is a globally significant public health concern with no efficacious treatment. Trait impulsivity is associated with the initiation, maintenance, and recurrence of substance abuse. However, the presence of these associations in METH addiction, as well as the underlying neurobiological mechanisms, remains incompletely understood.
Methods
We scanned 110 individuals with METH use disorder (MUDs) and 55 matched healthy controls (HCs) using T1-weighted imaging and assessed their drug use characteristics and trait impulsivity. Surface-based morphometry and graph theoretical analysis were used to investigate group differences in brain morphometry and network attributes. Partial correlations were conducted to investigate the relationships between brain morphometric changes, drug use parameters, and trait impulsivity. Mediation analyses examined how trait impulsivity and drug craving influenced the link between brain morphometric change and MUD severity in patients.
Results
MUDs exhibited thinner thickness in the left fusiform gyrus and right pars opercularis, as well as diminished small-world properties in their structural covariance networks (SCNs) compared to HCs. Furthermore, reduced cortical thickness in the right pars opercularis was linked to motor impulsivity (MI) and MUD severity, and the association between the right pars opercularis thickness and MUD severity was significantly mediated by both MI and cue-induced craving.
Conclusions
These findings suggest that MUDs exhibit distinct brain structural abnormalities in both the cortical thickness and SCNs and highlight the critical role of impulse control in METH addiction. This insight may offer a potential neurobiological target for developing therapeutic interventions to treat addiction and prevent relapse.
Existing evidence on the association between combined lifestyle and depressive symptoms is limited to the general population and is lacking in individuals with subthreshold depression, a high-risk group for depressive disorders. Furthermore, it remains unclear whether an overall healthy lifestyle can mitigate the association between childhood trauma (CT) and depressive symptoms, even in the general population. We aimed to explore the associations of combined lifestyle, and its interaction with CT, with depressive symptoms and their subtypes (i.e. cognitive-affective and somatic symptoms) among adults with subthreshold depression.
Methods
This dynamic cohort was initiated in Shenzhen, China in 2019, including adults aged 18–65 years with the Patient Health Questionnaire-9 (PHQ-9) score of ≥ 5 but not diagnosed with depressive disorders at baseline. CT (present or absent) was assessed with the Childhood Trauma Questionnaire-Short Form. Combined lifestyle, including no current drinking, no current smoking, regular physical exercise, optimal sleep duration and no obesity, was categorized into 0–2, 3 and 4–5 healthy lifestyles. Depressive symptoms were assessed using the PHQ-9 during follow-up. This cohort was followed every 6 months, and as of March 2023, had been followed for 3.5 years.
Findings
This study included 2298 participants (mean [SD] age, 40.3 [11.1] years; 37.7% male). After fully adjusting for confounders, compared with 0–2 healthy lifestyles, 3 (β coefficient, −0.619 [95% CI, −0.943, −0.294]) and 4–5 (β coefficient, −0.986 [95% CI, −1.302, −0.671]) healthy lifestyles were associated with milder depressive symptoms during follow-up. There exists a significant synergistic interaction between a healthy lifestyle and the absence of CT. The CT-stratified analysis showed that compared with 0–2 healthy lifestyles, 3 healthy lifestyles were associated with milder depressive symptoms in participants with CT, but not in those without CT, and 4–5 healthy lifestyles were associated with milder depressive symptoms in both participants with and without CT, with a stronger association in those with CT. The lifestyle-stratified analysis showed that CT was associated with more severe depressive symptoms in participants with 0–2 healthy lifestyles, but not in those with 3 or 4–5 healthy lifestyles. Cognitive-affective and somatic symptoms showed similar results.
Conclusions
In this 3.5-year longitudinal study of adults with subthreshold depression, an overall healthy lifestyle was associated with subsequent milder depressive symptoms and their subtypes, with a stronger association in adults with CT than those without CT. Moreover, an overall healthy lifestyle mitigated the association of CT with depressive symptoms and their subtypes.
With the widespread use of high-fat diets (HFD) in aquaculture, the adverse effects of HFD on farmed fish are becoming increasingly apparent. Creatine has shown potential as a green feed additive in farmed fish; however, the potential of dietary creatine to attenuate adverse effects caused by high-fat diets remains poorly understood. To address such gaps, this study was conducted to investigate the mitigating effect of dietary creatine on HFD-induced disturbance on growth performance, hepatic lipid metabolism, intestinal health and muscle quality of juvenile largemouth bass. Three diets were formulated: a control diet (10·20 % lipid), a high-fat diet (HFD, 18·31 % lipid) and HFD with 2 % creatine (HFD + creatine). Juvenile largemouth bass (3·73 (sem 0·01) g) were randomly assigned to three diets for 10 weeks. The key findings were as follows: (1) the expression of muscle growth-related genes and proteins was stimulated by dietary creatine, which contributes to ameliorate the adverse effects of HFD on growth performance; (2) dietary creatine alleviates HFD-induced adverse effects on intestinal health by improving intestinal health, which also enhances feed utilisation efficiency; (3) dietary creatine causes excessive lipid deposition, mainly via lipolysis and β-oxidation. Notably, this study also reveals a previously undisclosed effect of creatine supplementation on improving muscle quality. Together, for the first time from a comprehensive multiorgan or tissue perspective, our study provides a feasible approach for developing appropriate nutritional strategies to alleviate the adverse effects of HFD on farmed fish, based on creatine supplementation.
This study explored the relationship between multifaceted multilingualism and cognitive shifting through a task-switching paradigm using fMRI. Multilingualism was modeled from both convergent (i.e., integrated multilingual index) and divergent (i.e., L2 proficiency, interpreting training, language entropy) perspectives. Participants identified letters or numbers based on task cues, with Repeat trials maintaining the same task and Switch trials requiring a different task. Switch cost (Switch–Repeat) was used to reflect shifting demands. Better task-switching performance was associated with a higher integrated multilingual index and interpreting training. Neuroimaging indicated that multilinguals predominantly engaged left-hemisphere regions for switching, with extensive multilingual experience requiring fewer neural resources for switch cost (i.e., more efficient processing for cognitive control). During task switching, brain connectivity was regulated locally by L2 proficiency, and globally by interpreting training. These findings underscore the importance of considering multifaceted multilingual experience to understand its impact on cognitive function and brain activity.
Supporting family caregivers (FCs) is a critical core function of palliative care. Brief, reliable tools suitable for busy clinical work in Taiwan are needed to assess bereavement risk factors accurately. The aim is to develop and evaluate a brief bereavement scale completed by FCs and applicable to medical staff.
Methods
This study adopted convenience sampling. Participants were approached through an intentional sampling of patients’ FCs at 1 palliative care center in Taiwan. This cross-sectional study referred to 4 theories to generate the initial version of the Hospice Foundation of Taiwan Bereavement Assessment Scale (HFT-BAS). A 9-item questionnaire was initially developed by 12 palliative care experts through Delphi and verified by content validity. A combination of exploratory factor analysis (EFA), reliability measures including items analysis, Cronbach’s alpha and inter-subscale correlations, and confirmatory factor analysis (CFA) was employed to test its psychometric properties.
Results
Two hundred seventy-eight participants conducted the questionnaire. Three dimensions were subsequently extracted by EFA: “Intimate relationship,” “Existential meaning,” and “Disorganization.” The Cronbach’s alpha of the HFT-BAS scale was 0.70, while the 3 dimensions were all significantly correlated with total scores. CFA was the measurement model: chi-squared/degrees of freedom ratio = 1.9, Goodness of Fit Index = 0.93, Comparative Fit Index = 0.92, root mean square error of approximation = 0.08. CFA confirmed the scale’s construct validity with a good model fit.
Significance of results
This study developed an HFT-BAS and assessed its psychometric properties. The scale can evaluate the bereavement risk factors of FCs in clinical palliative care.
Cable-guiding mechanisms (CGMs) and the stiffness characteristics directly influence the dynamic features of the cable-driven upper limb rehabilitation robot (PCUR), which will affect PCUR’s performance. This paper introduces a novel CGM design. Given the precision and movement stability considerations of the mechanism, an analytical model is developed. Using this model, we analyze the error of the CGM and derive velocity and acceleration mappings from the moving platform to the cables. Continuity of cable trajectory and tension is rigorously demonstrated. Subsequently, a mathematical model for PCUR stiffness is formulated. Utilizing MATLAB/Simscape Multibody, simulation models for the CGM and stiffness characteristics are constructed. The feasibility of the proposed CGM design is validated through simulation and experimentation, while the influence of stiffness characteristics on PCUR motion stability is comprehensively analyzed.
The effects of the evolution of vortices on the aeroacoustics generated by a hovering wing are numerically investigated by using a hybrid method of an immersed boundary–finite difference method for the three-dimensional incompressible flows and a simplified model based on the Ffowcs Williams-Hawkings acoustic analogy. A low-aspect-ratio ($AR=1.5$) rectangular wing at low Reynolds ($Re=1000$) and Mach ($M=0.04$) numbers is investigated. Based on the simplified model, the far-field acoustics is shown to be dominated by the time derivative of the pressure on the wing surface. Results show that vortical structure evolution in the flow fields, which is described by the divergence of the convection term of the incompressible Navier–Stokes equations in a body-fixed reference frame, determines the time derivative of the surface pressure and effectively the far-field acoustics. It dominates over the centrifugal acceleration and Coriolis acceleration terms in determining the time derivative of the surface pressure. The position of the vortex is also found to affect the time derivative of the surface pressure. A scaling analysis reveals that the vortex acoustic source is scaled with the cube of the flapping frequency.
Flow control of a low-aspect-ratio flat-plate heaving wing at an average angle of attack of $10^{\circ }$ by a steady-blowing jet is numerically studied by using a feedback immersed boundary–lattice Boltzmann method. Blowing jets at the leading edge, mid-chord and trailing edge are considered. The wing enjoys the highest lift production with the trailing-edge downstream blowing jet, which improves the average lift by 50.0 % at $Re = 1000$ and 22.9 % at $Re = 5000$ through the enhancement of the tip vortex circulation caused by the increase in the mass flux of the shear layer at the wing tips. This increase in mass flux decreases as $Re$ increases from 1000 to 5000 due to its self-limiting mechanism. A mid-chord vertical blowing jet induces a middle vortex which enhances the lift production but the enhancement is smaller than that of trailing-edge downstream blowing jet. Other jet arrangements do not significantly increase the lift coefficient, but the mid-chord upstream blowing jet experiences a significant reduction in the drag coefficient, leading to an increase of 50.6 % in the average lift-to-drag ratio. The effectiveness of the flow control is not significantly affected by the aspect ratio.
Background: Subdural and subgaleal drains are equally effective after burrhole craniostomy for chronic subdural haematoma, however the optimal location of drains after minicraniotomy is not clear. As such we present the first study to assess this. Methods: Consecutive patients undergoing minicraniotomy for cSDH between 2019 and 2023 at a single institution were included. Subgaleal drains were placed exclusively by a single surgeon with the rest of the department utilising standard subdural drains. Cases were stratified by drain location. Primary outcomes included changes in functional status (Modified Rankin Score, mRS) at 3 months from preoperative baseline. Results: A total of 137 patients were included, of which 24.6% received subgaleal drains. Discharge home was higher in the subgaleal group compared to subdural group (79.4% vs 57.3%, p=0.02). Subgaleal drain location (p<0.0001) and better preoperative GCS (p=0.01) were predictors of improved 3 month mRS. Worse premorbid mRS (p=0.002), subdural drain (p=0.004), and decreased consciousness at presentation (p<0.002) were predictors of not being discharged home. Surgical recurrence was lower in the subgaleal group than the subdural group (2.9% vs 13.6%, p=0.12), but not statistically significant. Conclusions: Subgaleal drains are associated with shorter hospitalisation, greater chance of discharge home, and better functional outcomes than subdural drains.