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Multimorbidity, especially physical–mental multimorbidity, is an emerging global health challenge. However, the characteristics and patterns of physical–mental multimorbidity based on the diagnosis of mental disorders in Chinese adults remain unclear.
Methods
A cross-sectional study was conducted from November 2004 to April 2005 among 13,358 adults (ages 18–65years) residing in Liaoning Province, China, to evaluate the occurrence of physical–mental multimorbidity. Mental disorders were assessed using the Composite International Diagnostic Interview (version 1.0) with reference to the Diagnostic and Statistical Manual of Mental Disorders (3rd Edition Revised), while physical diseases were self-reported. Physical–mental multimorbidity was assessed based on a list of 16 physical and mental morbidities with prevalence ≥1% and was defined as the presence of one mental disorder and one physical disease. The chi-square test was used to calculate differences in the prevalence and comorbidity of different diseases between the sexes. A matrix heat map was generated of the absolute number of comorbidities for each disease. To identify complex associations and potential disease clustering patterns, a network analysis was performed, constructing a network to explore the relationships within and between various mental disorders and physical diseases.
Results
Physical–mental multimorbidity was confirmed in 3.7% (498) of the participants, with a higher prevalence among women (4.2%, 282) than men (3.3%, 216). The top three diseases with the highest comorbidity rate and average number of comorbidities were dysphoric mood (86.3%; 2.86), social anxiety disorder (77.8%; 2.78) and major depressive disorder (77.1%; 2.53). A physical–mental multimorbidity network was visually divided into mental and physical domains. Additionally, four distinct multimorbidity patterns were identified: ‘Affective-addiction’, ‘Anxiety’, ‘Cardiometabolic’ and ‘Gastro-musculoskeletal-respiratory’, with the digestive-respiratory-musculoskeletal pattern being the most common among the total sample. The affective-addiction pattern was more prevalent in men and rural populations. The cardiometabolic pattern was more common in urban populations.
Conclusions
The physical–mental multimorbidity network structure and the four patterns identified in this study align with previous research, though we observed notable differences in the proportion of these patterns. These variations highlight the importance of tailored interventions that address specific multimorbidity patterns while maintaining broader applicability to diverse populations.
The outbreak of major epidemics, such as COVID-19, has had a significant impact on supply chains. This study aimed to explore knowledge innovation in the field of emergency supply chain during pandemics with a systematic quantitative analysis.
Methods
Based on the Web of Science (WOS) Core Collection, proposing a 3-stage systematic analysis framework, and utilizing bibliometrics, Dynamic Topic Models (DTM), and regression analysis to comprehensively examine supply chain innovations triggered by pandemics.
Results
A total of 888 literature were obtained from the WOS database. There was a surge in the number of publications in recent years, indicating a new field of research on Pandemic Triggered Emergency Supply Chain (PTESC) is gradually forming. Through a 3-stage analysis, this study identifies the literature knowledge base and distribution of research hotspots in this field and predicts future research hotspots and trends mainly boil down to 3 aspects: pandemic-triggered emergency supply chain innovations in key industries, management, and technologies.
Conclusions
COVID-19 strengthened academic exchange and cooperation and promoted knowledge output in this field. This study provides an in-depth perspective on emergency supply chain research and helps researchers understand the overall landscape of the field, identifying future research directions.
Brown dwarfs are failed stars with very low mass (13 to 75 Jupiter mass), and an effective temperature lower than 2500 K. Their mass range is between Jupiter and red dwarfs. Thus, they play a key role in understanding the gap in the mass function between stars and planets. However, due to their faint nature, previous searches are inevitably limited to the solar neighbourhood (20 pc). To improve our knowledge of the low mass part of the initial stellar mass function and the star formation history of the MilkyWay, it is crucial to find more distant brown dwarfs. Using JamesWebb Space Telescope (JWST) COSMOS-Web data, this study seeks to enhance our comprehension of the physical characteristics of brown dwarfs situated at a distance of kpc scale. The exceptional sensitivity of the JWST enables the detection of brown dwarfs that are up to 100 times more distant than those discovered in the earlier all-sky infrared surveys. The large area coverage of the JWST COSMOS-Web survey allows us to find more distant brown dwarfs than earlier JWST studies with smaller area coverages. To capture prominent water absorption features around 2.7 μm, we apply two colour criteria, F115W – F277W + 1 < F277W – F444W and F277W – F444W > 0.9. We then select point sources by CLASS_STAR, FLUX_RADIUS, and SPREAD_MODEL criteria. Faint sources are visually checked to exclude possibly extended sources. We conduct SED fitting and MCMC simulations to determine their physical properties and associated uncertainties. Our search reveals 25 T-dwarf candidates and 2 Y-dwarf candidates, more than any previous JWST brown dwarf searches. They are located from 0.3 kpc to 4 kpc away from the Earth. The spatial number density of 900-1050 K dwarf is (2.0 ± 0.9) × 10–6 pc–3, 1050–1200 K dwarf is (1.2 ± 0.7) × 10–6 pc–3, and 1200–1350 K dwarf is (4.4 ± 1.3) × 10–6 pc–3. The cumulative number count of our brown dwarf candidates is consistent with the prediction from a standard double exponential model. Three of our brown dwarf candidates were detected by HST, with transverse velocities 12 ± 5 km s–1, 12 ± 4 km s–1, and 17 ± 6 km s–1. Along with earlier studies, the JWST has opened a new window of brown dwarf research in the MilkyWay thick disk and halo.
Dietary intervention is a key strategy for preventing and managing chronic kidney disease (CKD). However, evidence on specific foods’ effects on CKD is limited. This study aims to clarify the impact of various foods on CKD risk. We used two-sample Mendelian randomization (TSMR) to analyze the causal relationships between the intake of 18 foods (e.g., cheese, processed meat, poultry, beef, non-oily fish) and CKD risk, as well as eGFRcr and eGFRcys levels. The inverse variance weighting (IVW) method, weighted median method, MR-Egger regression, simple mode and weighted mode were employed. Sensitivity analysis included Cochran’s Q test and the Egger intercept test. Frequent alcohol intake was linked to higher CKD risk (P=0.007, 0.048). Protective factors included cheese (OR=0.71, [95%CI: 0.53, 0.94], P=0.017), tea (OR=0.66, [95%CI: 0.43, 1.00], P=0.048) and dried fruit (OR=0.78, [95%CI: 0.63, 0.98], P=0.033). Oily fish (β=0.051, [95%CI: 0.001, 0.102], p=0.046) and dried fruit (β=0.082, [95%CI: 0.016, 0.149], p=0.014) were associated with elevated eGFRcys. Salad/raw vegetables (β=0.024, [95%CI: 0.003, 0.045], p=0.028) and dried fruit (β=0.013, [95%CI: 0.001, 0.031], p=0.014) were linked to higher eGFRcr, while cereal intake (β=-0.021, [95%CI: -0.033, -0.010], p<0.001) was associated with lower eGFRcr. These findings provide insights for optimizing dietary strategies for CKD patients.
Patients with chronic insomnia are characterized by alterations in default mode network and alpha oscillations, for which the medial parietal cortex (MPC) is a key node and thus a potential target for interventions.
Methods
Fifty-six adults with chronic insomnia were randomly assigned to 2 mA, alpha-frequency (10 Hz), 30 min active or sham transcranial alternating current stimulation (tACS) applied over the MPC for 10 sessions completed within two weeks, followed by 4- and 6-week visits. The connectivity of the dorsal and ventral posterior cingulate cortex (vPCC) was calculated based on resting functional MRI.
Results
For the primary outcome, the active group showed a higher response rate (≥ 50% reduction in Pittsburgh Sleep Quality Index (PSQI)) at week 6 than that of the sham group (71.4% versus 3.6%) (risk ratio 20.0, 95% confidence interval 2.9 to 139.0, p = 0.0025). For the secondary outcomes, the active therapy induced greater and sustained improvements (versus sham) in the PSQI, depression (17-item Hamilton Depression Rating Scale), anxiety (Hamilton Anxiety Rating Scale), and cognitive deficits (Perceived Deficits Questionnaire-Depression) scores. The response rates in the active group decreased at weeks 8–14 (42.9%–57.1%). Improvement in sleep was associated with connectivity between the vPCC and the superior frontal gyrus and the inferior parietal lobe, whereas vPCC-to-middle frontal gyrus connectivity was associated with cognitive benefits and vPCC-to-ventromedial prefrontal cortex connectivity was associated with alleviation in rumination.
Conclusions
Targeting the MPC with alpha-tACS appears to be an effective treatment for chronic insomnia, and vPCC connectivity represents a prognostic marker of treatment outcome.
Bilinguals use languages strategically and make decisions differently depending on the language context. Here, we explored whether verbal feedback modulates language use and risk-taking in bilinguals engaged in a coin-drawing game that incentivises lying. In the game, participants announced bets in Chinese or English, and feedback on the outcome of the current bet was given in the same language. They selected Chinese over English after receiving positive feedback in Chinese, and no language difference was found when feedback was provided in English. They also tended to take more risks after receiving positive than negative feedback. Furthermore, participants were more likely to switch from one language to the other following negative feedback as compared to positive feedback, and when telling the truth, they were faster after negative than positive feedback. Thus, the language in which bilinguals receive feedback constrains language use, which may have implications for understanding interactions in multilingual communities.
To summarise the characteristics and postoperative outcomes in paediatric patients with coronary sinus septal defect.
Method:
This retrospective study recruited paediatric patients diagnosed with coronary sinus septal defect from the Guangdong Cardiovascular Institute between 2011 and 2023. Clinical characteristics, echocardiographic parameters, surgical procedures, and postoperative outcomes were collected from electronic health records.
Results:
Among the 68 patients, 50% were male, with a median age of 1.0 years. Four cases (5.9%) were diagnosed during the prenatal period. The proportions of patients with type I, II, III, and IV coronary sinus septal defect were 51.5%, 5.9%, 16.1%, and 26.5%, respectively. The most common coexisting cardiac anomalies were persistent left superior caval vein. Twenty-seven cases were either missed or misdiagnosed by echocardiogram, accounting for 39.7% of the overall cases, with type I being the most frequently missed diagnosis. Fifty-four patients underwent surgery, two patients received transcutaneous intervention, while the remaining patients did not undergo any surgery or intervention. At follow-up, two patients with type I coronary sinus septal defect died from multiorgan dysfunction, and one patient underwent reoperation due to narrowing of the extracardiac tunnel. The remaining patients did not experience any major events and recovered well.
Conclusion:
Paediatric patients with coronary sinus septal defect often do not exhibit specific clinical manifestations. Enhancing our understanding of the anatomic and haemodynamic characteristics of coronary sinus septal defect can improve the diagnostic accuracy of echocardiography. If diagnosis is suspected, confirmation can be obtained by cardiac CT and cardiac magnetic resonance. Accurate preoperative and intraoperative diagnosis of coronary sinus septal defect contributes to high surgical success rates and favourable treatment outcomes.
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.
Systematically monitoring the baseline sensitivity of troublesome weeds to herbicides is a crucial step in the early detection of their market lifespan. Florpyrauxifen-benzyl is one of the most important herbicides used in rice production throughout the world, and has been used for 5 yr in China. Barnyardgrass is one of the main targeted weed species of florpyrauxifen-benzyl. In total, 114 barnyardgrass populations were collected from rice fields in Jiangsu Province, China, and using whole-plant bioassays they were screened for susceptibility to florpyrauxifen-benzyl. The GR50 values (representing the dose that causes a 50% reduction in fresh weight of aboveground parts) of florpyrauxifen-benzyl for all populations ranged from 1.0 to 34.5 g ai ha−1, with an average of 6.8 g ai ha−1, a baseline sensitivity dose of 3.3 g ai ha−1, and a baseline sensitivity index of 34.5. Twenty-one days after treatment with florpyrauxifen-benzyl at the labeled dose (36 g ai ha−1), 90% of the barnyardgrass populations exhibited >95% reductions in fresh weight of aboveground parts. Compared with the baseline sensitivity dose, 63, 44, and 7 populations had, respectively, no resistance (55%), low resistance (39%), and moderate resistance (6%) to florpyrauxifen-benzyl. Furthermore, the GR50 distribution of barnyardgrass populations did not show a significant correlation with collection location, planting method (direct-seeding or transplanting), or rice species (Oryza sativa L. ssp. indica or ssp. japonica) at any of rice fields where seeds had been collected (P > 0.05). In conclusion, florpyrauxifen-benzyl remains effective for barnyardgrass control in rice fields despite serious resistance challenges.
Previous research has shown abnormal functional network gradients in Alzheimer’s disease (AD). Structural network gradient is capable of capturing continuous changes in brain morphology and has the ability to elucidate the underlying processes of neurodevelopment. However, it remains unclear whether structural network gradients are altered in AD and what associations exist between these changes and cognitive function, and gene expression profiles.
Methods
By constructing an individualized structural network gradient decomposition framework, we calculated the morphological similarity network (MSN) gradients for 404 subjects (186 AD patients and 218 normal controls). We investigated AD-related alterations in MSN gradients, along with the associations between MSN gradients and cognitive function, MSN topological properties, and gene expression profiles.
Results
Our findings indicated that the principal MSN gradient alterations in AD were primarily characterized by an increase in the primary and secondary sensory cortices and a decrease in the association cortex 1. The primary and higher-order cortices exhibited opposite associations with cognition, including executive function, language skills, and memory processes. Moreover, the principal MSN gradients were found to significantly predict cognitive function in AD. The altered gradient pattern was 14.8% attributable to gene expression profiles, and the genes demonstrating the highest correlation are involved in metabolic activity and synaptic signaling.
Conclusions
Our results offered novel insights into the underlying mechanisms of structural brain network impairment in AD patients, enhancing our understanding of the neurobiological processes responsible for impaired cognition in patients with AD, and offering a new dimensional structural biomarker for AD.
Suicidal ideation (SI) is very common in patients with major depressive disorder (MDD). However, its neural mechanisms remain unclear. The anterior cingulate cortex (ACC) region may be associated with SI in MDD patients. This study aimed to elucidate the neural mechanisms of SI in MDD patients by analyzing changes in gray matter volume (GMV) in brain structures in the ACC region, which has not been adequately studied to date.
Methods
According to the REST-meta-MDD project, this study subjects consisted of 235 healthy controls and 246 MDD patients, including 123 MDD patients with and 123 without SI, and their structural magnetic resonance imaging data were analyzed. The 17-item Hamilton Depression Rating Scale (HAMD) was used to assess depressive symptoms. Correlation analysis and logistic regression analysis were used to determine whether there was a correlation between GMV of ACC and SI in MDD patients.
Results
MDD patients with SI had higher HAMD scores and greater GMV in bilateral ACC compared to MDD patients without SI (all p < 0.001). GMV of bilateral ACC was positively correlated with SI in MDD patients and entered the regression equation in the subsequent logistic regression analysis.
Conclusions
Our findings suggest that GMV of ACC may be associated with SI in patients with MDD and is a sensitive biomarker of SI.
The emotion regulation network (ERN) in the brain provides a framework for understanding the neuropathology of affective disorders. Although previous neuroimaging studies have investigated the neurobiological correlates of the ERN in major depressive disorder (MDD), whether patients with MDD exhibit abnormal functional connectivity (FC) patterns in the ERN and whether the abnormal FC in the ERN can serve as a therapeutic response signature remain unclear.
Methods
A large functional magnetic resonance imaging dataset comprising 709 patients with MDD and 725 healthy controls (HCs) recruited across five sites was analyzed. Using a seed-based FC approach, we first investigated the group differences in whole-brain resting-state FC of the 14 ERN seeds between participants with and without MDD. Furthermore, an independent sample (45 MDD patients) was used to evaluate the relationship between the aforementioned abnormal FC in the ERN and symptom improvement after 8 weeks of antidepressant monotherapy.
Results
Compared to the HCs, patients with MDD exhibited aberrant FC between 7 ERN seeds and several cortical and subcortical areas, including the bilateral middle temporal gyrus, bilateral occipital gyrus, right thalamus, calcarine cortex, middle frontal gyrus, and the bilateral superior temporal gyrus. In an independent sample, these aberrant FCs in the ERN were negatively correlated with the reduction rate of the HAMD17 score among MDD patients.
Conclusions
These results might extend our understanding of the neurobiological underpinnings underlying unadaptable or inflexible emotional processing in MDD patients and help to elucidate the mechanisms of therapeutic response.
The ubiquitous marine radiocarbon reservoir effect (MRE) constrains the construction of reliable chronologies for marine sediments and the further comparison of paleoclimate records. Different reference values were suggested from various archives. However, it remains unclear how climate and MREs interact. Here we studied two pre-bomb corals from the Hainan Island and Xisha Island in the northern South China Sea (SCS), to examine the relationship between MRE and regional climate change. We find that the MRE from east of Hainan Island is mainly modulated by the Southern Asian Summer Monsoon-induced precipitation (with 11.4% contributed to seawater), rather than wind induced upwelling. In contrast, in the relatively open seawater of Xisha Island, the MRE is dominated by the East Asian Winter Monsoon, with relatively more negative (lower) ΔR values associated with high wind speeds, implying horizontal transport of seawater. The average SCS ΔR value relative to the Marine20 curve is –161±39 14C years. Our finding highlights the essential role of monsoon in regulating the MRE in the northern SCS, in particularly the tight bond between east Asian winter monsoon and regional MRE.
In this paper, we explore the optimal risk sharing problem in the context of peer-to-peer insurance. Using the criterion of minimizing total variance, we find that the optimal risk sharing strategy should take a linear form. Although linear risk sharing strategies have been examined in the literature, our study uncovers a significant finding: to minimize total variance, the linear strategy should be applied to the residual risks rather than the original risks, as commonly adopted in existing studies. By comparing with the existing models, we demonstrate the advantage of the linear residual risk sharing model in variance reduction and robustness. Furthermore, we develop and study a number of new models by incorporating some constraints, to reflect desirable properties required by the market. With those constraints, the optimal strategies turn out to favor market development, such as incentivize participation and guarantee fairness. A relevant model is considered at last, which establishes the connection among multiple optimization problems and provides insights on how to extend the models into a more general setup.
Congenital heart disease (CHD), the most common congenital malformation affecting fetuses and infants, poses a significant and rapidly emerging global challenge in children’s health. Prenatal and newborn screening are very important for preventing CHD. Therefore, this study aimed to analyze the status and corresponding foci of articles on CHD screening in the Chinese or English language using bibliometric methods.
Methods
Publications on prenatal or newborn screening for CHD were included. The Web of Science Core Collection (WoS) and China National Knowledge Infrastructure (CNKI) databases were searched to identify literature published from inception to 31 March 2023. CiteSpace was used to perform bibliometric analysis on the number of publications, institutions, authors, and keywords to generate corresponding knowledge maps.
Results
A total of 582 publications were retrieved from the WoS and 233 from the CNKI databases. There was an increasing trend in the number of English and Chinese articles published, with the trend beginning in 2010 for Chinese language articles and in 2007 for English language articles. In English language publications, GR Martin was the most influential author, and the top five institutions were from high-income countries. Among the Chinese language publications, Wenhong Ding was the most influential author and the Hunan Province Maternal and Child Health Care Hospital was the most commonly reported institution. Keyword analysis revealed that the most frequently occurring terms in both language publications were as follows: antenatal diagnosis, cardiac auscultation, and fetal echocardiography in English language articles and screening, prenatal screening, and fetal in Chinese language publications.
Conclusions
Increasingly, articles on CHD screening have been listed in the WoS and CNKI databases. This bibliometric study provides the status and trends in the research on screening for CHD and may help researchers identify hot topics and explore new research directions in this field.
This research seeks to ascertain the prevalence and determinants of mirror-image dextrocardia in fetuses
Study design:
With December 2022 as the reference point, we compiled colleted data on pregnant women who carried fetuses with mirror-image dextrocardia in Xi’an, Shaanxi Province: September–October 2022, November 2022, and December 2022–January 2023. An online questionnaire was distributed to 209 pregnant across China who had contracted COVID-19. The case group comprised women whose final menstrual cycle occurred in November 2022 and who had a fetus with mirror-image dextrocardia. Women with a November 2022 final menstrual period and a fetus without this condition made up the control group. To identify the risk factors associated with fetal mirror-image dextrocardia, both univariate and multivariate logistic regression analyses were employed.
Results:
A significant difference was noted in the gestational age at COVID-19 infection women with a September to October 2022 and December 2022 to January 2023 final menstrual period who did not bear a fetus with mirror-image dextrocardia, and those with a November 2022 final menstrual period whose fetus exhibited this condition. The univariate and multivariate analyses conducted on pregnant women with a final menstrual period in November 2022 who had contracted COVID-19 revealed significant differences in the presence and duration of fever between those bearing fetuses with mirror-image dextrocardia and those without (P = 0.000).
Conclusion:
The findings suggest two critical factors to the increased prevalence of fetal mirror-image dextrocardia: 1) the infection timing which occurs between the 4th and 6th week of pregnancy and 2) the presence of fever and its prolonged duration.
Developing large-eddy simulation (LES) wall models for separated flows is challenging. We propose to leverage the significance of separated flow data, for which existing theories are not applicable, and the existing knowledge of wall-bounded flows (such as the law of the wall) along with embedded learning to address this issue. The proposed so-called features-embedded-learning (FEL) wall model comprises two submodels: one for predicting the wall shear stress and another for calculating the eddy viscosity at the first off-wall grid nodes. We train the former using the wall-resolved LES (WRLES) data of the periodic hill flow and the law of the wall. For the latter, we propose a modified mixing length model, with the model coefficient trained using the ensemble Kalman method. The proposed FEL model is assessed using the separated flows with different flow configurations, grid resolutions and Reynolds numbers. Overall good a posteriori performance is observed for predicting the statistics of the recirculation bubble, wall stresses and turbulence characteristics. The statistics of the modelled subgrid-scale (SGS) stresses at the first off-wall grids are compared with those calculated using the WRLES data. The comparison shows that the amplitude and distribution of the SGS stresses and energy transfer obtained using the proposed model agree better with the reference data when compared with the conventional SGS model.
Despite growing awareness of the mental health damage caused by air pollution, the epidemiologic evidence on impact of air pollutants on major mental disorders (MDs) remains limited. We aim to explore the impact of various air pollutants on the risk of major MD.
Methods
This prospective study analyzed data from 170 369 participants without depression, anxiety, bipolar disorder, and schizophrenia at baseline. The concentrations of particulate matter with aerodynamic diameter ≤ 2.5 μm (PM2.5), particulate matter with aerodynamic diameter > 2.5 μm, and ≤ 10 μm (PM2.5–10), nitrogen dioxide (NO2), and nitric oxide (NO) were estimated using land-use regression models. The association between air pollutants and incident MD was investigated by Cox proportional hazard model.
Results
During a median follow-up of 10.6 years, 9 004 participants developed MD. Exposure to air pollution in the highest quartile significantly increased the risk of MD compared with the lowest quartile: PM2.5 (hazard ratio [HR]: 1.16, 95% CI: 1.09–1.23), NO2 (HR: 1.12, 95% CI: 1.05–1.19), and NO (HR: 1.10, 95% CI: 1.03–1.17). Subgroup analysis showed that participants with lower income were more likely to experience MD when exposed to air pollution. We also observed joint effects of socioeconomic status or genetic risk with air pollution on the MD risk. For instance, the HR of individuals with the highest genetic risk and highest quartiles of PM2.5 was 1.63 (95% CI: 1.46–1.81) compared to those with the lowest genetic risk and lowest quartiles of PM2.5.
Conclusions
Our findings highlight the importance of air pollution control in alleviating the burden of MD.