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While 24-hour dietary recalls (24HDRs) are increasingly used to assess polyphenol-disease associations, their performance for measuring total dietary polyphenols and their subclasses remains unknown. In the Anhui Lifestyle Validation Study, 432 community-dwelling adults completed 12-day dietary recalls, structured as 4 seasonal sets of 3 consecutive 24HDRs (2 weekdays and 1 weekend day each) between July 2021 and July 2022. Reproducibility of dietary total polyphenols, flavonoids, lignans and phenolic acids assessed by different number of non-consecutive 24HDRs was evaluated by intraclass correlation coefficient (ICC). Relative validity was evaluated by comparing estimates from different numbers of 24HDRs with the internal reference using deattenuated Spearman correlation coefficients (rc). The reproducibility from 2 24HDRs was weak for these 4 polyphenol categories (ICC: 0.10–0.39), while 3 24HDRs yielded a reasonable reproducibility for total polyphenols (ICC: 0.40, 95% CI: 0.31-0.50), flavonoids (ICC: 0.42, 95% CI: 0.33-0.51), and phenolic acids (ICC: 0.45, 95% CI: 0.16-0.66), but not for lignans (ICC: 0.11, 95% CI: 0.01-0.26). Increasing recall days up to 4–6 seemed not to appreciably improve the reproducibility (ICC range: 0.13-0.17 for lignans, 0.41-0.56 for other polyphenols). The relative validity against the internal reference of these 4 polyphenol categories was moderate for 2 24HDRs (rc: 0.50-0.74) and improved for ≥ 3 24HDRs (rc: 0.76-1.00). Older age, female sex, and weekend administration were associated with lower reproducibility of 3 24HDR-based assessments of phenolic acids or flavonoids. Overall, our results suggest that 3 non-consecutive 24HDRs may have acceptable performance in measuring most dietary polyphenol intake except for lignans.
Childhood adversity impairs well-being, yet psychological resilience may buffer its impact. Using resting-state fMRI in 94 rural Chinese children (ages 10–14), we examined whether psychological resilience protects brain network connectivity from adversity and its relevance to psychological well-being. Psychological resilience significantly moderated the impact of abuse, but not neglect, on limbic connectivity. Low-resilience children exposed to abuse showed heightened limbic-somatomotor and limbic-ventral attention connectivity, which predicted greater somatization and depression at baseline and more severe levels of anxiety six months later. These associations were absent in high-resilience children. Our findings reveal that psychological resilience specifically shields against the neurotoxic effects of abuse by modulating networks involved in emotion regulation, salience, and sensorimotor processing. Targeted interventions should consider adversity dimensions and psychological resilience capacity to mitigate long-term mental health risks.
This study examined how newly learned emotional meanings influence word processing in first-language (L1) and second-language (L2) speakers. Participants learned Chinese pseudowords paired with disgusted, sad or neutral faces. Generalization and refreshing tests assessed whether the learned meanings extended beyond specific pairings, and event-related potentials (ERPs) were recorded during a modified lexical decision task to probe neural processing. Both groups successfully learned and generalized the emotional associations, although L2 speakers showed reduced cross-modal generalization for sadness. ERP analyses revealed that unlearned pseudowords elicited stronger early posterior negativity (EPN) while emotional pseudowords elicited larger late positive complex (LPC). Also, L2 participants exhibited greater LPC amplitudes and broader cortical recruitment than L1 counterparts. Moreover, disgust and sadness diverged in early neural responses, with disgust eliciting enhanced EPNs. These findings indicate rapid affective binding to novel words and greater neural effort for L2 processing, suggesting similar temporal dynamics but increased resource demands in L2.
The term ‘schizo-obsessive comorbidity (SOC)’ is used to describe the presence of obsessive-compulsive symptoms or obsessive-compulsive disorder (OCD) in patients with schizophrenia (SOC). Recent studies have found overlapped executive dysfunctions in SCZ and OCD implicating shared pathophysiology. However, specific deficits in the components of executive function (EF) in patients with SOC remains unclear.
Methods
We recruited 37 patients with SOC, 68 patients with SCZ, 70 patients with OCD, and 59 healthy controls (HCs). All participants completed a battery of measures for EF components, namely initiation, sustained attention, online updating, switching, disinhibition, and planning. Apart from traditional group-mean analysis, we applied machine learning approaches to identify the unique patterns of EF among different clinical groups.
Results
The results showed that the three clinical groups could be distinguished from HCs. The feature importance analysis showed that, to classify clinical groups from HC, online updating was the core feature of SCZ patients, whereas disinhibition and online updating jointly determine classification between OCD patients and HC. In differentiating SOC from HC, online updating, planning, and disinhibition collectively served as key features. Machine learning algorithms classified SOC and OCD with acceptable performance but classified SOC and SCZ with lower performance.
Conclusions
Deficits of EF are shared features among patients with SOC, SCZ, and OCD. However, the specific components of executive dysfunction in these clinical groups appeared distinct.
Extending the concept of economic interdependence to the subnational level, this paper explores how the foreign commercial ties of non-state actors can introduce geopolitical risks to advanced democracies. We examine this phenomenon through the lens of US–China higher education partnerships. Facing budget constraints, public universities in the United States often rely on revenue from international tuition and fees. Due to trade barriers in China, American universities frequently recruit fee-paying Chinese students through joint degree programs (JDPs) established with Chinese partner institutions. These transnational partnerships create asymmetric market dependencies that the Chinese government can exploit. Using newly compiled panel data from the United States, we find that the extensive pre-existing JDP network is significantly correlated with the proliferation of Confucius Institutes (CIs) – a flagship soft power initiative of the Chinese government – on American college campuses. Preliminary evidence from other countries aligns with the patterns observed in the USA. Our findings highlight how China employs a decentralized approach to advance its soft power strategy through higher education ties.
We present an experimental study on electron and X-ray generation from the interaction of a hundreds of TW femtosecond laser with microchannels. Leveraging the guiding effect of the channel structure on both the laser and electrons, a well-collimated electron beam is achieved, with a beam charge of 1.5 nC (>10 MeV), a slope temperature of 9.1 MeV and a nearly constant divergence angle (~14°) over a broad energy range (10–50 MeV). Meanwhile, we demonstrate a ring-shaped X-ray source generated through bremsstrahlung radiation mechanism from electrons collision with channel walls, exhibiting a characteristic energy of 90 keV and emittance of 0.8 mm mrad. Three-dimensional simulations elucidate the underlying acceleration dynamics. It is found that elongated channels facilitate the formation of well-collimated electron beams. These results establish the foundation for applications of channel guided electrons and secondary radiation sources and represent a key step toward the controlled manipulation of particle sources in laser-driven plasmas.
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.
Bioelectrical impedance analysis (BIA)-derived water composition ratios are non-invasive and cost-effective indices that reflect body fluid distribution. This study aimed to investigate the associations between these BIA-derived ratios and overall survival (OS) in patients with gastric cancer. A retrospective multicentre study included 385 gastric cancer patients. Optimal cut-offs were determined via receiver operating characteristic curves. Kaplan–Meier survival analysis, Cox regression analysis and restricted cubic spline (RCS) evaluated associations with OS. The optimal cut-off values were 0.389 for extracellular water (ECW)/total body water (TBW), 0·611 for intracellular water (ICW]/TBW and 0·638 for ECW/ICW. Kaplan–Meier survival analysis revealed that elevated ECW/TBW (72·6% vs. 58·7%; P < 0·001) and ECW/ICW (59·1% vs. 72·4%; P < 0·001) were associated with poorer OS, while a higher ICW/TBW (73·4% vs. 57·3%; P < 0·001) indicated better prognosis. In RCS models, ECW/TBW (hazard ratio (HR) = 1·552, 1·202–2·005, P = 0·001) and ECW/ICW (HR = 1·735, 1·320–2·280, P < 0·001) independently predicted worse OS, whereas ICW/TBW inversely correlated with mortality (HR = 0·620, 0·486–0·790, P < 0·001). Multivariable Cox regression analysis further confirmed that higher ECW/TBW (HR =1·552, 95% CI 1·272–2·688, P < 0·001) and ECW/ICW (HR = 1·735, 1·320–2·280, P < 0·001) ratios independently predicted worse OS. Conversely, a higher ICW/TBW ratio was inversely correlated with mortality (HR = 0·567, 95% CI 0·390–0·824, P = 0·003). The ECW/ICW ratio demonstrated the highest C-index (0·596), outperforming other ratios in predicting survival. These associations were consistent across subgroups, including advanced-stage patients. BIA-derived water composition ratios, particularly ECW/ICW, are robust and independent predictors of survival in gastric cancer patients, reflecting underlying metabolic and inflammatory disturbances. These non-invasive and cost-effective markers could enhance prognostic accuracy and guide personalised treatment strategies.
Secondary intracranial infections are common and severe complications in patients with viral encephalitis, contributing to higher mortality, prolonged hospitalization and increased healthcare burden. Evidence on risk factors, pathogen spectrum and resistance patterns remains limited, and predictive models tailored to this population are lacking.
Methods:
We conducted a single-center retrospective cohort study, including 160 consecutive patients diagnosed with viral encephalitis. Clinical, therapeutic, laboratory and microbiological data were extracted from hospital records. Independent risk factors were identified using multivariate logistic and Cox regression. Predictive performance was assessed by receiver operating characteristic analysis. Pathogen distribution and antimicrobial resistance profiles were analyzed descriptively.
Results:
During a median follow-up of 16 days, 50 patients (31.3%) developed secondary intracranial infections, corresponding to an incidence of 2.9 events per 1000 patient-days. Independent predictors included older age (adjusted OR 1.39 per 10 years, P = 0.021), comorbidities (OR 2.18, P = 0.048), corticosteroid use ≥7 days (OR 2.45, P = 0.025), ≥2 invasive procedures (OR 2.92, P = 0.007) and elevated CSF protein (OR 2.36, P = 0.037). The multivariable risk score achieved an area under the curve of 0.86 (95% CI 0.80–0.92). Pathogen analysis revealed methicillin-resistant Staphylococcus aureus (MRSA) (24.0%) and Acinetobacter baumannii (20.0%) as predominant isolates, both showing high multidrug resistance, including carbapenem resistance rates of 70% in A. baumannii.
Conclusion:
Secondary intracranial infections occur frequently in viral encephalitis and are strongly associated with host vulnerability. The predominance of MRSA and carbapenem-resistant A. baumannii underscores the urgent need for tailored infection control and antimicrobial strategies in neurocritical care.
To explore molecular targets for regulating glucose metabolism in carnivorous fish, the glucose tolerance test was carried out on the Paralichthys olivaceus. The concentration of glucose and insulin in serum was measured at 0, 1, 3, 5, 7, 9, 12, 24 and 48 h after intraperitoneal (IP) injection. The concentration of insulin was the lowest after 3 h of glucose injection, and that of glucose reached the highest after 5 h. Therefore, 0 h (IP0) was chosen as control group, and 3 h (IP3) and 5 h (IP5) were selected as experimental groups, for which the liver samples at three time points were used for high-throughput sequencing. Although there were no significant Kyoto Encyclopedia of Genes and Genomes and Gene Ontology functional enrichment, the differential genes, including mitogen-activated protein kinase binding protein 1, glycosyltransferase, suppressor of cytokine signalling 3 (SOCS3) and CCAAT/enhancer-binding protein α, were closely related to glucose metabolism. The open reading frame of SOCS3 encoded 225 amino acids, including conserved domains SH2 and SOCS3-box. The SOCS3 was knocked down by specific siRNA in the primary hepatocyte of P. olivaceus. Results showed that the gene expression of insulin receptor substrate 1, protease B1, GLUT2, pyruvate kinase and glucokinase increased significantly after knocking down SOCS3. Meanwhile, the phosphatidylinositol-3-hydroxykinase and glucose-6-phosphatase decreased significantly. The results of this study indicated that siSOSC3 enhanced the sensitivity of the insulin signalling pathway to promote glucose transport, thereby affecting gluconeogenesis and glycolysis to maintain glucose homeostasis.
Clinical pharmacists are increasingly recognized as essential members of multidisciplinary palliative care teams, yet their specific roles and impact have not been comprehensively summarized. This scoping review aimed to systematically map and synthesize published evidence on the clinical roles, interventions, and professional contributions of pharmacists within multidisciplinary palliative care services for patients with non-communicable diseases.
Methods
A scoping review was conducted by searching PubMed, Embase, Web of Science, and Scopus from January 2000 to May 2024. Eligible studies reported clinical pharmacist interventions in palliative care. Data were extracted on study characteristics, pharmacist activities, and clinical outcomes.
Results
Twelve studies were included, predominantly from the United States. Pharmacist-led interventions encompassed medication reconciliation (91.7%), symptom management (83.3%), adverse drug event prevention (75.0%), patient and caregiver education (58.3%), and policy-level contributions (33.3%). High physician acceptance rates (≥90%) were consistently reported. Outcomes included improved symptom control, reduced drug-related problems, and enhanced patient-reported quality of life.
Significance of results
This scoping review synthesizes current evidence on the roles of clinical pharmacists in palliative care teams. The findings highlight their essential contributions to medication safety, symptom management, deprescribing, and opioid stewardship, reinforcing the need for pharmacist integration into multidisciplinary palliative care models to improve patient-centered outcomes. Future research should focus on implementation models, cost-effectiveness analyses, and service expansion in community-based settings.
Late-onset depression (LOD) is featured by disrupted cognitive performance, which is refractory to conventional treatments and increases the risk of dementia. Aberrant functional connectivity among various brain regions has been reported in LOD, but their abnormal patterns of functional network connectivity remain unclear in LOD.
Methods
A total of 82 LOD and 101 healthy older adults (HOA) accepted functional magnetic resonance imaging scanning and a battery of neuropsychological tests. Static functional network connectivity (sFNC) and dynamic functional network connectivity (dFNC) were analyzed using independent component analysis, with dFNC assessed via a sliding window approach. Both sFNC and dFNC contributions were classified using a support vector machine.
Results
LOD exhibited decreased sFNC among the default mode network (DMN), salience network (SN), sensorimotor network (SMN), and language network (LAN), along with reduced dFNC of DMN-SN and SN-SMN. The sFNC of SMN-LAN and dFNC of DMN-SN contributed the most in differentiating LOD and HOA by support vector machine. Additionally, abnormal sFNC of DMN-SN and DMN-SMN both correlated with working memory, with DMN-SMN mediating the relationship between depression and working memory. The dFNC of SN-SMN was associated with depressive severity and multiple domains of cognition, and mediated the impact of depression on memory and semantic function.
Conclusions
This study displayed the abnormal connectivity among DMN, SN, and SMN that involved the relationship between depression and cognition in LOD, which might reveal mutual biomarkers between depression and cognitive decline in LOD.
There is a growing attention towards personalised digital health interventions such as health apps. These often depend on the collection of sensitive personal data, which users generally have limited control over. This work explores perspectives on data sharing and health apps in two different policy contexts, London and Hong Kong. Through this study, our goal is to generate insight about what digital health futures should look like and what needs to be done to achieve them. Using a survey based on a hypothetical health app, we considered a range of behavioural influences on personal health data sharing with the Capability, Opportunity, Motivation model of Behaviour (COM-B) to explore some of the key factors affecting the acceptability of data sharing. Results indicate that willingness to use health apps is influenced by users’ data literacy and control, comfort with sharing health and location data, existing health concerns, access to personalised health advice from a trusted source, and willingness to provide data access to specific parties. Gender is a statistically significant factor, as men are more willing to use health apps. Survey respondents in London are statistically more willing to use health apps than respondents in Hong Kong. Finally, we propose several policy approaches to address these factors, which include the co-creation of standards for using artificial intelligence (AI) to generate health advice, innovating app design and governance models that allow users to carefully control their data, and addressing concerns of gender-specific privacy risks and public trust in institutions dealing with data.
This article proposes a dielectric waveguide bandpass filter (BPF) with good stopband suppression based on different kinds of dielectric waveguide resonators (DWRs). Three distinct types of DWRs are modified from the traditional rectangular DWR, i.e., one with a metallized blind hole, one with a metallized U-shaped slot and another one with a pair of parallel ridges. These resonators are designed that their fundamental mode frequencies are basically the same and their higher-order modes are staggered. As a result, the higher-order modes can be suppressed to a certain extent when conducting BPF designs. For verification, a sixth-order BPF with an operating frequency band ranging from 3.4 to 3.5 GHz is designed, fabricated and measured. It is composed of the above three distinct types of DWRs, with a deliberate arrangement that prevents the DWRs of the same type from being adjacent to each other, guaranteeing that the harmonics are well suppressed. In measurement, the in-band return loss is better than 12 dB, the minimum in-band insertion loss is about 1.0 dB. Besides, the 20 dB out-of-band suppression reaches 6.9 GHz, which is almost twice the center frequency.
Transoral robotic surgery has gained much recognition in the surgical management of obstructive sleep apnoea, allowing for improved surgical access and precise dissection around the narrow surgical field. However, it is associated with a steeper learning curve and may give rise to significant morbidity especially amongst less experienced surgeons.
Methods
Through a comprehensive literature search, this review summarises patient selection for transoral robotic surgery as well as peri-operative considerations and management.
Results
Apart from technical mastery, successful transoral robotic surgery require for the surgeon to be proficient with navigating the entire care continuum beginning with patient selection to management of post-operative complications.
Conclusion
Transoral robotic surgery remains a promising tool for surgical treatment of patients with obstructive sleep apnoea. This review provides an overview of the surgical application of transoral robotic surgery in obstructive sleep apnoea, together with practical guidance for the sleep surgeon.
The current study aims to assess associations between trimethylamine N-oxide (TMAO) levels and mortality and to investigate modification effects of genetics. A total of 500 participants from a family-based cohort study were enrolled from 2005 to 2017 and followed up until 2020 in Fangshan District, Beijing, China. Serum TMAO levels were measured using the ELISA kit. The primary outcomes were all-cause mortality and deaths from CVD and stroke. During a median follow-up time of 7·38 years, thirty-eight deaths were recorded, including twenty deaths due to CVD and nineteen deaths due to stroke. Compared with the lowest TMAO quartile group, the HR for all-cause mortality was 1·35 (95 % CI: 0·44, 4·15), 1·65 (95 % CI: 0·58, 4·64) and 2·45 (95 % CI: 0·91, 6·57), respectively, in higher groups. No association was observed between TMAO and CVD mortality. However, compared with the lowest TMAO concentration group, the HR for stroke mortality was 1·93 (95 % CI: 0·40, 9·39), 1·91 (95 % CI: 0·41, 8·96) and 4·16 (95 % CI: 0·94, 18·52), respectively, in higher groups (Pfor trend = 0·046). Furthermore, polygenic risk score (PRS) for longevity modified the association of TMAO with all-cause mortality (Pfor interaction = 0·008). The risk of mortality (HR = 2·20, 95 % CI: 1·06, 4·57) was higher among participants with lower PRS compared with higher PRS (HR = 1·00, 95 % CI: 0·71, 1·40). The study indicates that elevated serum TMAO levels are potentially associated with long-term mortality risk in rural areas of northern China, especially for stroke deaths. Additionally, it provides novel evidence that genetic variations might modify the association.
We will give a precise and explicit asymptotic estimate for the characteristic of the Riemann zeta function $\zeta $ with an error term of order $O(\frac {\log r}{r})$ and a corresponding asymptotic estimate for the number of fixed points of $\zeta $.
The heating effect of electromagnetic waves in ion cyclotron range of frequencies (ICRFs) in magnetic confinement fusion device is different in different plasma conditions. In order to evaluate the ICRF heating effect in different plasma conditions, we conducted a series of experiments and corresponding TRANSP simulations on the EAST tokamak. Both simulation and experimental results show that the effect of ICRF heating is poor at low core electron density. The decrease in electron density changes the left-handed electric field near the resonant layer, resulting in a significant decrease in the power absorbed by the hydrogen fundamental resonance. However, quite a few experiments must be performed in plasma conditions with low electron density. It is necessary to study how to make ICRF heating best in low electron density plasma. Through a series of simulation scans of the parallel refractive index (n//) of the ICRF antenna, it is concluded that the change of the ICRF antenna n// will lead to the change of the left-handed electric field, which will change the fundamental absorption of ICRF power by the hydrogen minority ions. Fully considering the coupling of ion cyclotron wave at the tokamak boundary and the absorption in the plasma core, optimizing the ICRF antenna structure and selecting appropriate parameters such as parallel refractive index, minority ion concentration, resonance layer position, plasma current and core electron temperature can ensure better heating effect in the ICRF heating experiments in the future EAST upgrade. These results have important implications for the enhancement of the auxiliary heating effect of EAST and other tokamaks.
Using three waves (2011–15) of CHARLS data, we analyze the short-term effects of widowhood on cognitive function among older Chinese. Fixed-effect models show that widowhood has significant adverse effects on cognition for rural elders but not for urban ones. Furthermore, compared to rural men, rural women exhibit greater declines in cognition, especially in fluid cognition. We explore the possible mechanism from the neighborhood perspective. The results show that community sports and entertainment facilities and public services can effectively mitigate the negative impact of widowhood on cognitive function for rural widows. Sports and entertainment facilities can mainly enhance word recall ability, especially delayed word recall. Public services such as elderly health centers focusing on the healthcare function for the elderly can also improve the word recall ability of rural widows. On the other hand, family-based elderly care centers mainly increase the cognition ability of mental intactness.
The attached-eddy model (AEM) predicts that the mean streamwise velocity and streamwise velocity variance profiles follow a logarithmic shape, while the vertical velocity variance remains invariant with height in the overlap region of high Reynolds number wall-bounded turbulent flows. Moreover, the AEM coefficients are presumed to attain asymptotically constant values at very high Reynolds numbers. Here, the AEM predictions are examined using sonic anemometer measurements in the near-neutral atmospheric surface layer, with a focus on the logarithmic behaviour of the streamwise velocity variance. Utilizing an extensive 210-day dataset collected from a 62 m meteorological tower located in the Eastern Snake River Plain, Idaho, USA, the inertial sublayer is first identified by analysing the measured momentum flux and mean velocity profiles. The logarithmic behaviour of the streamwise velocity variance and the associated ‘$-1$’ scaling of the streamwise velocity energy spectra are then investigated. The findings indicate that the Townsend–Perry coefficient ($A_1$) is influenced by mild non-stationarity that manifests itself as a Reynolds number dependence. After excluding non-stationary runs, and requiring the bulk Reynolds number defined using the atmospheric boundary layer height to be larger than $4 \times 10^{7}$, the inferred $A_1$ converges to values ranging between 1 and 1.25, consistent with laboratory experiments. Furthermore, nine benchmark cases selected through a restrictive quality control reveal a close relation between the ‘$-1$’ scaling in the streamwise velocity energy spectrum and the logarithmic behaviour of streamwise velocity variance. However, additional data are required to determine whether the plateau value of the pre-multiplied streamwise velocity energy spectrum is identical to $A_1$.