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For clinical trials with continuous outcomes, researchers may opt to report the whole or part of the five-number summary rather than the sample mean and standard deviation, especially when the outcome data are skewed. To include such studies in meta-analysis, several popular methods have been proposed in the literature that convert the five-number summary back to the sample mean and standard deviation. Nevertheless, most existing methods are based on the normality assumption, which may not hold for the clinical studies with the five-number summary being reported. Recently, Shi et al. (2023, Stat Methods Med Res, 32, 1338–1360) and Balakrishnan et al. (2023, Math Methods Stat, 32, 260–273) proposed methods for detecting the skewness of data that utilize the whole or part of the five-number summary, together with the sample size. In this article, we show that the max-type test of Shi et al. is not only structurally complex but also conservative in controlling the type I error rate, whereas the test of Balakrishnan et al. has difficulty controlling the type I error rate with small sample sizes. Inspired by these findings, we develop a novel test statistic that leverages the ratio of two tails, a measure known for its heightened sensitivity to data skewness. Simulation results demonstrate that our ratio-based test is both less conservative and more powerful compared to the existing methods, especially when the alternative distribution exhibits mild skewness. Additionally, simulated meta-analyses and real-world data examples are presented to demonstrate the utility of our new method in the context of meta-analysis.
Prior observational studies have reported conflicting results regarding whether antidepressant treatment reduces long-term dementia risk, likely due to confounding by indication and reverse causation. We aimed to investigate the association between baseline antidepressant use and incident dementia, incorporating cognitive and neuroimaging outcomes.
Methods
We conducted a prospective cohort study using UK Biobank participants free of dementia at baseline. Antidepressant use was self-reported at baseline (2006–2010). Incident dementia was identified through linked electronic health records until December 19, 2022. Cox proportional hazards models estimated hazard ratios (HRs) for all-cause dementia, Alzheimer’s disease (AD), and vascular dementia (VD), adjusting for sociodemographic, lifestyle, health-related, antidepressant indication factors, and co-medication of other anticholinergics. In subsamples, cognitive performance (n = 57,330) and structural brain imaging (n = 42,276) were examined as intermediate outcomes.
Results
Among 461,464 participants, 33,721 (7.3%) reported baseline antidepressant use. Over a mean follow-up of 13.4 years, 7,922 (1.7%) developed incident dementia. Baseline antidepressant use was associated with higher risks of all-cause dementia (adjusted HR: 1.47, 95% CI 1.36–1.60), AD (1.53, 1.36–1.73), and VD (1.44, 1.23–1.70). Users performed worse on fluid intelligence and prospective memory tasks and showed lower total and gray matter volume, regional reductions in the hippocampal gray matter and basal nucleus, and greater white matter hyperintensity volume.
Conclusions
Baseline antidepressant use was linked to a higher risk of dementia, poorer cognitive performance, and adverse brain structural changes. These findings underscore the importance of judicious prescribing, regular cognitive monitoring, and consideration of non-pharmacological approaches in clinical care.
This study aims to explore the significance of discrepancies in crown-rump length (CRL) and abnormal cord insertion in predicting selective fetal growth restriction (sFGR) in monochorionic (MC) twin pregnancies. Special attention was paid to determining the potential value of these factors in early pregnancy for predicting sFGR. A retrospective analysis included 131 pregnant women diagnosed with MC twin pregnancies. CRL was measured using a GE E8 color Doppler ultrasound instrument. Groups were compared based on the discrepancy in CRL (≥6 mm difference group, n = 26; <6 mm normal group, n = 105) and the presence of abnormal cord insertion (abnormal group, n = 27; normal group, n = 104). The study found no significant association between CRL discrepancy and postnatal birth-weight discordance suggestive of sFGR (p > .05). In contrast, abnormal cord insertion was significantly associated with an increased occurrence of sFGR-related outcome (p < .001). Specifically, sFGR-related outcome occurred in 12 of 27 cases (44.4%) in the abnormal cord insertion group, compared with 7 of 104 cases (6.7%) in the normal cord insertion group. In this retrospective MC twin cohort, abnormal cord insertion was associated with an increased risk of postnatal birth-weight discordance suggestive of sFGR, whereas CRL discrepancy showed limited discriminative ability. Because of the retrospective design, limited number of outcome events, and use of postnatal rather than standardized antenatal Doppler-based sFGR criteria, these findings should be interpreted as exploratory and require validation in larger prospective studies.
Replacing soiled bed linens is a common practice in intensive care units . We identified dust-driven transmission of carbapenem-resistant Acinetobacter baumannii correlated with changing bed linens by air sampling and genome-based analysis. This uncovers a hidden airborne route, which needs to be considered to design countermeasures against multidrug-resistant organisms.
The traditional design of laser drivers for inertial confinement fusion (ICF) is highly dependent on coherent laser light fields, which have significant advantages in achieving harmonic conversion and enhancing amplification efficiency. However, they also bring the core challenge of achieving uniform irradiation. This paper investigates the dynamic evolution process of uniform irradiation of multi-mode spatiotemporal light fields and analyzes the influence mechanism of spatiotemporal coherence on irradiation uniformity with different integration times. By balancing the relationship between the spatiotemporal coherence of the light field and uniform irradiation, we explore a possible scheme to alleviate the beam smoothing problem while satisfying the basic requirements of laser amplification and high-efficiency harmonic conversion. Based on this scheme, the overall architecture of the ICF laser driver is constructed.
Multi-plane light conversion (MPLC) is a versatile technique that enables arbitrary manipulation of optical fields, and is numerically investigated as a novel avenue for coherent beam combining (CBC) applications. The optical parameters have been investigated to guide the MPLC design, indicating that the number of phase planes and plane spacing serve as pivotal factors. The channel scalability is simulated, revealing that the plane spacing should be increased in a larger array to maintain high performance under a few-plane limit. CBC of up to 1027 lasers has been numerically demonstrated with near-diffraction-limited beam quality (M2 of 1.16 and combining efficiency close to 100%) with only seven phase plates. Beam steering is investigated, revealing that steering capability is related to both the number of multiplexed modes in MPLC and their mode fidelities, and the main-lobe power ratio of 87.1% at one divergence angle is achieved in a 10-mode MPLC with five phase plates.
Radio recombination line (RRL) maser is a useful tool to study massive star formation regions with ionised gas close to new born massive stars. Masers often show sharp line profiles and/or extreme narrow widths, and high brightness temperatures. However, RRL masers were rarely detected only in several sources. Here we report the detection of sharp line profiles of the RRL H29$\alpha$, which can be interpreted as maser candidates, in two sources within W49A, a mini-starburst region in our Galaxy. These observations, conducted with high resolution ($\sim0.03''$) using the Atacama Large Millimeter/sub-millimeter Array (ALMA), reveal high brightness temperatures up to $\sim$9 000 K for H29$\alpha$ emission in another two sources, which might also be regarded as maser candidates. Additionally, suggestions for efficiently identifying RRL maser candidates are also provided.
Power scaling of neodymium (Nd)-doped single-frequency fiber lasers (SFFLs) operating at approximately 900 nm has been fundamentally constrained by dominant emission of approximately 1060 nm, with previous demonstrations limited to below 3 W. Here, we demonstrate a 910 nm single-mode Nd-doped SFFL system that achieves a record output power of over 30 W employing homemade Nd-doped silica fiber (NDF), while preserving exceptional 49 dB suppression of competing emission of approximately 1060 nm. The laser system originates from a distributed Bragg reflector single-frequency (SF) oscillator with 11 mW output power, which is subsequently amplified to 31.1 W through three polarization-maintaining (PM) amplification stages utilizing PM 10/125 μm NDF. To the best of our knowledge, this represents the highest power achieved for Nd-doped SFFLs in this spectral region. The output exhibits excellent beam quality (Mx2 = 1.03, My2 = 1.05) and narrow linewidth (10.2 kHz). These results validate that the homemade PM 10/125 μm NDF can be employed in intermediate and main amplifiers in all-fiber SF master oscillator power amplifier systems at approximately 900 nm.
A dual-beam platform is developed for all-optical Thomson/Compton scattering, with versatile parameter tuning capabilities including electron energy, radiation energy, radiation polarization, etc. By integrating this platform with a 200 TW Ti:sapphire laser system, we demonstrate the generation of inverse Compton scattering X-/gamma-rays with tunable energies ranging from tens of keV to MeV. The polarization of X-/gamma-rays is manipulated by adjusting the polarization of the scattering laser. In the near future, by combining this platform with multi-PW laser facilities, our goal is to explore the transition from nonlinear Thomson scattering to nonlinear Compton scattering, ultimately verifying theories related to strong-field quantum electrodynamics effects induced by extreme scattering.
This paper provides an overview of the current status of ultrafast and ultra-intense lasers with peak powers exceeding 100 TW and examines the research activities in high-energy-density physics within China. Currently, 10 high-intensity lasers with powers over 100 TW are operational, and about 10 additional lasers are being constructed at various institutes and universities. These facilities operate either independently or are combined with one another, thereby offering substantial support for both Chinese and international research and development efforts in high-energy-density physics.
Machine learning has already shown promising potential in tiled-aperture coherent beam combining (CBC) to achieve versatile advanced applications. By sampling the spatially separated laser array before the combiner and detuning the optical path delays, deep learning techniques are incorporated into filled-aperture CBC to achieve single-step phase control. The neural network is trained with far-field diffractive patterns at the defocus plane to establish one-to-one phase-intensity mapping, and the phase prediction accuracy is significantly enhanced thanks to the strategies of sin-cos loss function and two-layer output of the phase vector that are adopted to resolve the phase discontinuity issue. The results indicate that the trained network can predict phases with improved accuracy, and phase-locking of nine-channel filled-aperture CBC has been numerically demonstrated in a single step with a residual phase of λ/70. To the best of our knowledge, this is the first time that machine learning has been made feasible in filled-aperture CBC laser systems.
Human activity recognition (HAR) is a vital component of human–robot collaboration. Recognizing the operational elements involved in an operator’s task is essential for realizing this vision, and HAR plays a key role in achieving this. However, recognizing human activity in an industrial setting differs from recognizing daily living activities. An operator’s activity must be divided into fine elements to ensure efficient task completion. Despite this, there is relatively little related research in the literature. This study aims to develop machine learning models to classify the sequential movement elements of a task. To illustrate this, three logistic operations in an integrated circuit (IC) design house were studied, with participants wearing 13 inertial measurement units manufactured by XSENS to mimic the tasks. The kinematics data were collected to develop the machine learning models. The time series data preprocessing involved applying two normalization methods and three different window lengths. Eleven features were extracted from the processed data to train the classification models. Model validation was carried out using the subject-independent method, with data from three participants excluded from the training dataset. The results indicate that the developed model can efficiently classify operational elements when the operator performs the activity accurately. However, incorrect classifications occurred when the operator missed an operation or awkwardly performed the task. RGB video clips helped identify these misclassifications, which can be used by supervisors for training purposes or by industrial engineers for work improvement.
The optimisation of inter-island transportation systems constitutes a critical determinant of regional economic development and the efficacy of mobility infrastructure. This study presents a comparative analysis of passenger mode selection between short-sea shipping (SSS) and road transport alternatives through stated preference surveys conducted via anonymised questionnaires. Employing advanced discrete choice modelling techniques – specifically the multinomial logit (MNL), random parameter logit (RPL) and latent class (LC) frameworks – we quantitatively disentangle the complex determinants influencing modal preferences. Our systematic sensitivity analysis reveals distinct behavioural patterns: passengers opting for SSS prioritise journey convenience, whereas road transport users exhibit stronger cost sensitivity. These findings provide actionable insights for formulating evidence-based policies to enhance intermodal transportation networks in the Zhoushan Archipelago of China. Beyond its immediate geographical focus, this research contributes methodological innovations by applying finite mixture models to capture unobserved heterogeneity in maritime transport decisions. The framework demonstrates significant transferability potential for island territories globally and urban freight corridor optimisation challenges, particularly in contexts requiring trade-off analyses between maritime efficiency and terrestrial logistics constraints.
One hundred and thirteen mid-lactation cows fed same diets and supplemented with 20 g/d rumen-protected methionine (RPM) for 8 weeks were used to investigate the individual responses of dairy cows to RPM in terms of lactation performance, amino acids (AA) metabolism, and milk metabolites. Among the cows, 10 cows exhibited positive responses (PR) and 10 cows showed limited responses (LR) in energy-corrected milk yield to RPM were used for further analysis. The lactation performance changed from gradual decline to steady increase in PR cows, while kept downward trend in LR cows following RPM supplementation. In PR cows, the AA metabolism was notably enhanced after RPM supplementation, evidenced by increased mammary blood flow (69.4%, P = 0.05), mammary uptake and clearance rate and uptake-to-output ratio (U:O) of essential AA. The improved AA metabolism could be attributed to the enrichment of pyrimidine (P = 0.06) and pyruvate (P = 0.07) metabolism pathways, which may have stimulated mammary cell proliferation and enhanced AA uptake. Additionally, the upregulation of milk biotin (fold change > 2, variable importance projection > 1), known to support milk yield, likely contributed to the PR observed in PR cows. Conversely, in LR cows, RPM supplementation did not improve AA metabolism, decrease was observed in mammary uptake, mammary clearance rate, and U:O of cysteine, potentially due to cysteine being irreversibly converted from methionine. Moreover, the enrichment of central carbon metabolism in cancer pathway (P = 0.06), which also utilize methionine, along with the lysine degradation pathway (P = 0.04), suggests that methionine in the mammary glands may have been diverted toward non-lactational metabolic processes, resulting in absence of PR in LR cows. Our results indicate that the responses to RPM in dairy cows are individualized, with variation in lactation performance likely driven by differential AA metabolism.
This study aimed to investigate the effects of esketamine (Esk) combined with dexmedetomidine (Dex) on postoperative delirium (POD) and quality of recovery (QoR) in elderly patients undergoing thoracoscopic radical lung cancer surgery.
Methods
In this prospective, randomized, and controlled study, 172 elderly patients undergoing thoracoscopic radical lung cancer surgery were divided into two groups: the Esk + Dex group (n = 86) and the Dex group a (n = 86). The primary outcome was the incidence of POD within 7 days after surgery and the overall Quality of Recovery−15 (QoR − 15) scores within 3 days after surgery. Secondary outcomes included postoperative adverse reactions, extubation time, PACU stay, and hospitalization time. Serum levels of IL-6, IL-10, S100β protein, NSE, CD3+, CD4+, and CD8+ were detected from T0 to T5.
Results
Compared with the Dex group, the incidence of POD in the Esk + Dex group was significantly lower at 7 days after surgery (14.6% vs 30.9%; P = 0.013). The QoR − 15 score was significantly increased 3 days after surgery (P < 0.01). Levels of IL-6 and CD8+ were significantly decreased, and IL − 10 levels were significantly increased at T1-T2 (P < 0.05). At T1-T4, NSE levels were significantly decreased, while CD3+ and CD4+/CD8+ values were significantly increased (P < 0.01). At T1-T5, serum S100β protein concentration decreased significantly, and CD4+ value increased significantly (P < 0.01). The incidence of nausea/vomiting and hyperalgesia decreased significantly 48 hours after surgery (P < 0.01). The duration of extubation, PACU stay, and postoperative hospitalization were significantly shortened.
Conclusions
Esketamine combined with dexmedetomidine can significantly reduce the POD incidence and improve the QoR in patients undergoing thoracoscopic radical lung cancer surgery, which may be related to the improvement of cellular immune function.
Certain rhythmic arterial pressure waves in humans and animals have been noticed for over one century. We found the novel and slowest arterial pressure waves in children following surgical repair for CHD, and examined their characteristics and clinical implications.
Methods:
We enrolled 212 children with 22 types of CHD within postoperative 48 h. We monitored haemodynamics (blood pressure, cardiac cycle efficiency, dP/dTmax), cerebral (ScO2), and renal (SrO2) oxygen saturation every 6 s. Electroencephalogram was continuously monitored. Mean blood flow velocity (Vm) of the middle cerebral artery was measured at 24 h.
Results:
We found the waves with a frequency of ∼ 90 s immediately following surgical repair in 46 patients in 12 types of CHD (21.7%), being most prevalent in patients with aortic arch abnormalities (Aorta Group, n = 24, 42.3%) or ventricular septal defect (Ventricular Septal Defect Group, n = 12, 23.5%). In Aorta and Ventricular Septal Defect Groups, the occurrence of the waves was associated with lower blood pressures, dP/dTmax, cardiac cycle efficiency, ScO2, SrO2, Vm, worse electroencephalogram background abnormalities, higher number of electroencephalogram sharp waves, and serum lactate (Ps <0.0001–0.07), and were accompanied with fluctuations of ScO2 and SrO2 in 80.6% and 69.6% of patients, respectively.
Conclusions:
The waves observed in children following cardiovascular surgery are the slowest ever reported, occurring most frequently in patients with aortic arch abnormalities or ventricular septal defect. While the occurrence of the waves was associated with statistically worse and fluctuated ScO2 and SrO2, worse systemic haemodynamics, and electroencephalogram abnormalities, at present these waves have no known clinical relevance.
Whether material deprivation-related childhood socio-economic disadvantages (CSD) and care-related adverse childhood experiences (ACE) have different impacts on depressive symptoms in middle-aged and older people is unclear.
Methods
In the Guangzhou Biobank Cohort Study, CSD and ACE were assessed by 7 and 5 culturally sensitive questions, respectively, on 8,716 participants aged 50+. Depressive symptoms were measured by 15-item Geriatric Depression Scale (GDS). Multivariable linear regression, stratification analyses, and mediation analyses were done.
Results
Higher CSD and ACE scores were associated with higher GDS score in dose-response manner (P for trend <0.001). Participants with one point increment in CSD and ACE had higher GDS score by 0.11 (95% confidence interval [CI], 0.09–0.14) and 0.41 (95% CI, 0.35–0.47), respectively. The association of CSD with GDS score was significant in women only (P for sex interaction <0.001; women: β (95% CI)=0.14 (0.11–0.17), men: 0.04 (−0.01 to 0.08)). The association between ACE and GDS score was stronger in participants with high social deprivation index (SDI) (P for interaction = 0.01; low SDI: β (95% CI)=0.36 (0.29–0.43), high SDI: 0.64 (0.48–0.80)). The proportion of association of CSD and ACE scores with GDS score mediated via education was 20.11% and 2.28%.
Conclusions
CSD and ACE were associated with late-life depressive symptoms with dose-response patterns, especially in women and those with low adulthood socio-economic status. Education was a major mediator for CSD but not ACE. Eliminating ACE should be a top priority.
Tree-ring cellulose is a commonly used material for radiocarbon analysis. Extracting cellulose is labor-consuming and several devices that enable batchwise extraction have been developed. However, these devices bear the risk of sample contamination. The present study describes a new device which improves upon two aspects of currently available devices. First, to prevent cross-sample-contamination, we redesigned the drainage module to enable independent removal of chemical waste from each individual sample funnel. Second, we added covers to the sample funnels to reduce the risk of external contamination. Cellulose purity (i.e., holocellulose) was confirmed by Fourier Transform Infrared (FTIR) Spectroscopy. Furthermore, accuracy of the radiocarbon analysis was confirmed by results of 14C-blank samples and samples of known age. In conclusion, while maintaining labor-saving, our modified device significantly reduces the risk of sample contamination during extraction of tree-ring cellulose.