We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
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.
The exact mechanisms underlying dysfunction of the basal ganglia that lead to Parkinson’s disease (PD) remain unclear. According to the standard model of PD, motor symptoms result from abnormal neuronal activity in dysfunctional basal ganglia, which can be recorded in human basal ganglia structures as functional neurosurgery for PD provides a unique opportunity to record from these regions. Microelectrode and local field potential recordings studies show alterations exist in basal ganglia nuclei as well as in the motor thalamus. Lesioning or stimulation of the basal ganglia results in significant improvement of PD symptoms, supporting the view that basal ganglia–thalamocortical circuits abnormality is important in parkinsonism generation. Different patterns of oscillatory neuronal activity plus changes in firing rate are associated with different parkinsonian motor subtypes. We present recordings of basal ganglia activity obtained with microelectrode recordings in parkinsonian patients, providing pathophysiology insight.
Rates of self-harm among children and young people (CYP) have been on the rise, presenting major public health concerns in Australia and worldwide. However, there is a scarcity of evidence relating to self-harm among CYP from culturally and linguistically diverse (CALD) backgrounds.
Aims
To analyse the relationship between self-harm-related mental health presentations of CYP to emergency departments and CALD status in South Western Sydney (SWS), Australia.
Method
We analysed electronic medical records of mental health-related emergency department presentations by CYP aged between 10 and up to 18 years in six public hospitals in the SWS region from January 2016 to March 2022. A multilevel logistic regression model was used on these data to assess the association between self-harm-related presentations and CALD status while adjusting for covariates and individual-level clustering.
Results
Self-harm accounted for 2457 (31.5%) of the 7789 mental health-related emergency department presentations by CYP; CYP from a CALD background accounted for only 8% (n = 198) of the self-harm-related presentations. CYP from the lowest two most socioeconomic disadvantaged areas made 63% (n = 1544) of the total self-harm-related presentations. Findings of the regression models showed that CYP from a CALD background (compared with those from non-CALD backgrounds) had 19% lower odds of self-harm (adjusted odds ratio 0.81, 95% CI 0.66–0.99).
Conclusions
Findings of this study provide insights into the self-harm-related mental health presentations and other critical clinical features related to CYP from CALD backgrounds that could better inform health service planning and policy to manage self-harm presentations and mental health problems among CYP.
Although numerous neuroimaging studies have depicted neural alterations in individuals with obsessive–compulsive disorder (OCD), a psychiatric disorder characterized by intrusive cognitions and repetitive behaviors, the molecular mechanisms connecting brain structural changes and gene expression remain poorly understood.
Methods
This study combined the Allen Human Brain Atlas dataset with neuroimaging data from the Meta-Analysis (ENIGMA) consortium and independent cohorts. Later, partial least squares regression and enrichment analysis were performed to probe the correlation between transcription and cortical thickness variation among adults with OCD.
Results
The cortical map of case-control differences in cortical thickness was spatially correlated with cortical expression of a weighted combination of genes enriched for neurobiologically relevant ontology terms preferentially expressed across different cell types and cortical layers. These genes were specifically expressed in brain tissue, spanning all cortical developmental stages. Protein–protein interaction analysis revealed that these genes coded a network of proteins encompassing various highly interactive hubs.
Conclusions
The study findings bridge the gap between neural structure and transcriptome data in OCD, fostering an integrative understanding of the potential biological mechanisms.
The Chinese Loess Plateau (CLP), recognized as the world's largest loess plateau, has been a subject of ongoing debate regarding the continuity of its sedimentary loess sequence due to its intricate depositional environment. In this study, we conducted dating on a 9.8-m-long Malan loess core obtained from the Sanmen Gorge in the southern CLP using optically stimulated luminescence (OSL). The OSL dates indicate loess deposition between 52.4 and 11.3 ka, with no apparent hiatus on a millennial scale, and a sedimentation rate (SR) exhibiting six distinct episodes. Additionally, a comprehensive review of 613 OSL ages from 18 sections at 14 sites across the CLP was conducted. The results reveal loess deposition at most sites shows no apparent hiatus on a millennial scale over the past 60 ka, except for two specific locations. High SR episodes during Marine Isotope Stage (MIS) 3 across the CLP were attributed to heightened dust emissions from the source region and an enhanced dust deposition efficiency, while MIS 2 deposits were influenced by an intensified East Asian winter monsoon. Low SR episodes during MIS 1 at most sites were likely associated with reduced atmospheric transportation and pedogenesis. Spatially heterogeneous SR variations across the CLP might be influenced by local depositional environments.
Caused by multiple risk factors, heavy burden of major depressive disorder (MDD) poses serious challenges to public health worldwide over the past 30 years. Yet the burden and attributable risk factors of MDD were not systematically known. We aimed to reveal the long-term spatio-temporal trends in the burden and attributable risk factors of MDD at global, regional and national levels during 1990–2019.
Methods
We obtained MDD and attributable risk factors data from Global Burden of Disease Study 2019. We used joinpoint regression model to assess the temporal trend in MDD burden, and age–period–cohort model to measure the effects of age, period and birth cohort on MDD incidence rate. We utilized population attributable fractions (PAFs) to estimate the specific proportions of MDD burden attributed to given risk factors.
Results
During 1990–2019, the global number of MDD incident cases, prevalent cases and disability-adjusted life years (DALYs) increased by 59.10%, 59.57% and 58.57%, respectively. Whereas the global age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR) and age-standardized DALYs rate (ASDR) of MDD decreased during 1990–2019. The ASIR, ASPR and ASDR in women were 1.62, 1.62 and 1.60 times as that in men in 2019, respectively. The highest age-specific incidence, prevalence and DALYs rate occurred at the age of 60–64 in women, and at the age of 75–84 in men, but the maximum increasing trends in these age-specific rates occurred at the age of 5–9. Population living during 2000–2004 had higher risk of MDD. MDD burden varied by socio-demographic index (SDI), regions and nations. In 2019, low-SDI region, Central sub-Saharan Africa and Uganda had the highest ASIR, ASPR and ASDR. The global PAFs of intimate partner violence (IPV), childhood sexual abuse (CSA) and bullying victimization (BV) were 8.43%, 5.46% and 4.86% in 2019, respectively.
Conclusions
Over the past 30 years, the global ASIR, ASPR and ASDR of MDD had decreased trends, while the burden of MDD was still serious, and multiple disparities in MDD burden remarkably existed. Women, elderly and populations living during 2000–2004 and in low-SDI regions, had more severe burden of MDD. Children were more susceptible to MDD. Up to 18.75% of global MDD burden would be eliminated through early preventing against IPV, CSA and BV. Tailored strategies-and-measures in different regions and demographic groups based on findings in this studywould be urgently needed to eliminate the impacts of modifiable risk factors on MDD, and then mitigate the burden of MDD.
We show that for any $\varepsilon \gt 0$ and $\Delta \in \mathbb{N}$, there exists $\alpha \gt 0$ such that for sufficiently large $n$, every $n$-vertex graph $G$ satisfying that $\delta (G)\geq \varepsilon n$ and $e(X, Y)\gt 0$ for every pair of disjoint vertex sets $X, Y\subseteq V(G)$ of size $\alpha n$ contains all spanning trees with maximum degree at most $\Delta$. This strengthens a result of Böttcher, Han, Kohayakawa, Montgomery, Parczyk, and Person.
The aim of this study was to investigate the prevalence of anemia in twin pregnancies and the influence of anemia on maternal and neonatal outcomes. This retrospective study included twin pregnant women who delivered in a tertiary hospital in China from January 2018 to December 2018. Patients were divided by WHO criteria (hemoglobin <11.0 g/dL): the anemic and nonanemic groups. Patients with anemia were further classified as recovered or unrecovered subgroup after oral iron therapy. Maternal and neonatal outcomes in women carrying twins were compared using Student’s t test and the chi-squared test or the Fisher exact test. Univariable and multivariable logistic regression models were used to determine the association of maternal and neonatal characteristics with anemia. Linear regression analysis was used to estimate mean birth weight and gestational week. The prevalence of anemia was 42.6% (182/427) in twin pregnancies. The anemic group had higher rates of low 1-minute Apgar score (4.4% vs. 1.8%, p = .028), perinatal death (1.9% vs. 0.2%, p = .012) and neonatal intensive care unit (NICU) admission (27.2% vs. 20.2%, p = .017; adjusted OR, 1.478; 95% CI [1.07, 2.044]). The recovered subgroup had lower NICU admission rate (13.5% vs. 30.3%, p = .006; OR, 0.388; 95% CI [0.186, 0.809]), higher gestational week and birth weight (β, 0.954 week; 95% CI [0.114, 1.794] and β, 171.01 g; 95% CI [9.894, 332.126] respectively). The prevalence of anemia in twin gestation is high. Anemia is associated with adverse neonatal outcomes, and correction of anemia significantly improved the pregnancy outcomes.
Given a graph
$G$
and an integer
$\ell \ge 2$
, we denote by
$\alpha _{\ell }(G)$
the maximum size of a
$K_{\ell }$
-free subset of vertices in
$V(G)$
. A recent question of Nenadov and Pehova asks for determining the best possible minimum degree conditions forcing clique-factors in
$n$
-vertex graphs
$G$
with
$\alpha _{\ell }(G) = o(n)$
, which can be seen as a Ramsey–Turán variant of the celebrated Hajnal–Szemerédi theorem. In this paper we find the asymptotical sharp minimum degree threshold for
$K_r$
-factors in
$n$
-vertex graphs
$G$
with
$\alpha _\ell (G)=n^{1-o(1)}$
for all
$r\ge \ell \ge 2$
.
Pregnancy is a complex biological process. The establishment and maintenance of foetal–maternal interface are pivotal events. Decidual immune cells and inflammatory cytokines play indispensable roles in the foetal–maternal interface. The disfunction of decidual immune cells leads to adverse pregnancy outcome. Tumour necrosis factor (TNF)-α, a common inflammatory cytokine, has critical roles in different stages of normal pregnancy process. However, the relationship between the disorder of TNF-α and adverse pregnancy outcomes, including preeclampsia (PE), intrauterine growth restriction (IUGR), spontaneous abortion (SA), preterm birth and so on, is still indefinite. In this review, we thoroughly reviewed the effect of TNF-α disorder on pathological conditions. Moreover, we summarized the reports about the adverse pregnancy outcomes (PE, IUGR, SA and preterm birth) of using anti-TNF-α drugs (infliximab, etanercept and adalimumab, certolizumab and golimumab) currently in the clinical studies. Overall, IUGR, SA and preterm birth are the most common adverse pregnancy outcomes of anti-TNF-α drugs. Our review may provide insight for the immunological treatment of pregnancy-related complication, and help practitioners make informed decisions based on the current evidences.
In this study, we focus on the significant upward trend of occupational accidental traffic injuries in commercial couriers during the coronavirus disease (COVID-19) pandemic. This review comments on the characteristics of occupational accidental injuries of commercial couriers in China and then discusses the reasons of the high incidence rate and associated risk factors. Various potential protective measures were also explored to prevent and control the occupational injuries in this vulnerable worker group.
Accumulating evidence suggests that supplementation of n-3 PUFA was associated with reduction in risk of major cardiovascular events. This meta-analysis was to systematically evaluate whether daily supplementation and accumulated intake of n-3 PUFA are associated with improved left ventricular (LV) remodelling in patients with chronic heart failure (CHF). Articles were obtained from Pubmed, Clinical key and Web of Science from inception to January 1 in 2021, and a total of twelve trials involving 2162 participants were eligible for inclusion. The sources of study heterogeneity were explained by I2 statistic and subgroup analysis. Compared with placebo groups, n-3 PUFA supplementation improved LV ejection fraction (LVEF) (eleven trials, 2112 participants, weighted mean difference (WMD) = 2·52, 95 % CI 1·25, 3·80, I2 = 87·8 %) and decreased LV end systolic volume (five studies, 905 participants, WMD = –3·22, 95 % CI 3·67, −2·77, I2 = 0·0 %) using the continuous variables analysis. Notably, the high accumulated n-3 PUFA dosage groups (≥ 600 g) presented a prominent improvement in LVEF, while the low and middle accumulated dosage (≤ 300 and 300–600 g) showed no effects on LVEF. In addition, n-3 PUFA supplementation decreased the levels of pro-inflammatory mediators including TNF-α, IL-6 (IL-6) and hypersensitive c-reactive protein. Therefore, the present meta-analysis demonstrated that n-3 PUFA consumption was associated with a substantial improvement of LV function and remodelling in patients subjected to CHF. The accumulated dosage of n-3 PUFA intake is vital for its cardiac protective role.
Understanding factors associated with post-discharge sleep quality among COVID-19 survivors is important for intervention development.
Aims
This study investigated sleep quality and its correlates among COVID-19 patients 6 months after their most recent hospital discharge.
Method
Healthcare providers at hospitals located in five different Chinese cities contacted adult COVID-19 patients discharged between 1 February and 30 March 2020. A total of 199 eligible patients provided verbal informed consent and completed the interview. Using score on the single-item Sleep Quality Scale as the dependent variable, multiple linear regression models were fitted.
Results
Among all participants, 10.1% reported terrible or poor sleep quality, and 26.6% reported fair sleep quality, 26.1% reported worse sleep quality when comparing their current status with the time before COVID-19, and 33.7% were bothered by a sleeping disorder in the past 2 weeks. After adjusting for significant background characteristics, factors associated with sleep quality included witnessing the suffering (adjusted B = −1.15, 95% CI = −1.70, −0.33) or death (adjusted B = −1.55, 95% CI = −2.62, −0.49) of other COVID-19 patients during hospital stay, depressive symptoms (adjusted B = −0.26, 95% CI = −0.31, −0.20), anxiety symptoms (adjusted B = −0.25, 95% CI = −0.33, −0.17), post-traumatic stress disorders (adjusted B = −0.16, 95% CI = −0.22, −0.10) and social support (adjusted B = 0.07, 95% CI = 0.04, 0.10).
Conclusions
COVID-19 survivors reported poor sleep quality. Interventions and support services to improve sleep quality should be provided to COVID-19 survivors during their hospital stay and after hospital discharge.
The sudden outbreak of the COVID-19 pandemic has caused tremendous challenges to the medical system. The government and hospitals have taken robust measures to curb the spread of the deadly virus. Its impact on routine medical services is gradually being taken seriously.
Objective:
To identify the impact of the novel Coronavirus pandemic on emergency department (ED) patient flow and the performance of the routine ED service.
Methods:
This retrospective cohort study was undertaken in a tertiary public teaching hospital ED in Chengdu, China. ED data of patients were routinely collected to compare demographic, clinical characteristics and outcomes during an 8-week period from January 1, 2019 to February 25, 2020. Data were analyzed with the chi-square statistical test.
Results:
Over the study periods, there were 31855 and 25244 patients presented to the ED in 2019 and 2020 respectively. During the pandemic period in 2020, the daily number of average ED visits was lower than that in 2019 (430 ± 134.9 versus 572 ± 38.6, P = 0.00), with fewer triage 1&2 cases (145 ± 33.3 versus 178 ± 15.0, P = 0.00). Nevertheless, the mortality increased remarkably during the pandemic period in 2020 (0.2% versus 0.1%, P = 0.009), with higher APACHE II scores (28 versus 19, P = 0.022) and shorter ED elapsed time (0.2 versus 1.4 days, P = 0.016) among these death cases.
Conclusions:
The COVID-19 pandemic had an evident impact on the patient’s behavioral patterns and routine emergency services, which caused higher ED mortality.
The very high frequency data exchange system (VDES) is promising in promoting electronic navigation (E-navigation) and improving navigation safety. The multiple access control (MAC) protocol is crucial to the transmission performance of VDES. The self-organising time division multiple access (SOTDMA) protocol, as the only access mode given by current recommendations, leads to a high rate of transmission collisions in the traditional automatic identification system (AIS), especially with heavy traffic loads. This paper proposes a novel feedback based time division multiple access (FBTDMA) protocol to address the problems caused by SOTDMA, such that collision of transmissions can be avoided in information transmission among vessels. Simulation results demonstrate that the proposed FBTDMA outperforms the traditional SOTDMA in terms of channel utilisation and throughput, and significantly reduces the transmission collision rate. The study is expected to provide insights into VDES standardisation and E-navigation modernisation.
A multicenter study of sharps injuries (SIs) and other blood or body fluid (OBBF) exposures was conducted among 33,156 healthcare workers (HCWs) from 175 hospitals in Anhui, China. In total, 12,178 HCWs (36.7%) had experienced at least 1 SI in the previous 12 months and 8,116 HCWs (24.5%) had experienced at least 1 OBBF exposure during the previous 12 months.
This authoritative work on the Chinese Communist party's practices of reeducation and indoctrination, supersedes all previous works by bringing into account recent events. Hu Ping has provided a rich and rigorous study based not only in historical research and numerous compelling case studies of Chinese intellectuals, but also in a first person account of his own experience of Maoist thought remolding. 'The Thought Remolding Campaign of the Chinese Communist Party-State' is an important history not only of the reeducation programs, but of the interrogation processes of the Party, and the strategies of either evasion or rebellion that released prisoners adopted.