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Vascular rings cause highly variable clinical presentations. This study assesses the impact of prenatal versus postnatal diagnosis on clinical outcomes.
Methods:
We conducted a single centre retrospective review of isolated vascular ring patients (without significant CHD) from 2011 to 2022 and compared clinical and operative data between patients with prenatal and postnatal diagnoses.
Results:
Of 177 patients, 45% (N = 80) had prenatal diagnosis. Between 2018 and 2022, 78% had prenatal diagnosis compared to 41% from 2013 to 2018 and 4% before 2013 (p < 0.001). 76.3% (N = 135) had a right aortic arch with left ligamentum arteriosum, 22.6% (N = 40) had a double aortic arch, and 1.1% (N = 2) had a left aortic arch with right ligamentum arteriosum. Postnatal diagnosis patients were more likely to have preoperative respiratory symptoms (55.7%), medications (34.0%), or admissions (24.7%) (versus 32.5%, 10.0%, and 11.3% of the prenatal diagnosis patients, p < 0.05) and require surgical repair (68.0% versus 38.8% of prenatal diagnosis patients, p < 0.0001). 54.8% of patients had surgical repair; prenatal diagnosis patients were younger at surgery, 7.5 (3-11) months compared to 16.0 (5-18) months in the postnatal diagnosis patients (p = .0014). Double aortic arch patients were more likely to require surgical repair (90.0%, compared to 44.5% with right aortic arch, p < 1e−4). Postnatal diagnosis patients had more residual postoperative symptoms (40.9% versus 16.1% in prenatal diagnosis patients, p = 0.01).
Conclusion:
Prenatal diagnosis of vascular rings improves clinical surveillance, resulting in earlier surgical repair in symptomatic patients and diminished morbidity. Higher risk double aortic arch patients should have a tailored evaluation pathway.
As avionics systems become increasingly complex, traditional fault prediction methods are no longer sufficient to meet modern demands. This paper introduces four advanced fault prediction methods for avionics components, utilising a multi-step prediction strategy combined with a stacking regressor. By selecting various standard regression models as base regressors, these base regressors are first trained on the original data, and their predictions are subsequently used as input features for training a meta-regressor. Additionally, the Tree-structured Parzen Estimator (TPE) algorithm is employed for hyperparameter optimisation. The experimental results demonstrate that the proposed stacking regression methods exhibit superior accuracy in fault prediction compared to traditional single-model approaches.
Interlaminar delamination damage is a common and typical defect in the context of structural damage in carbon fiber-reinforced resin matrix composites. The technology to identify such damage is crucial for improving the safety and reliability of structures. In this paper, we fabricated carbon fiber-reinforced composite laminates with different degrees of delamination damage, conducted static load experiments on them and used femtosecond fiber Bragg grating sensors (fsFBG) to determine their structural state to investigate the effects of delamination damage on their performance. We constructed a model to identify damage based on the deep residual shrinkage network, and used experimental data to enable it to identify varying degrees of delamination damage to carbon fiber-reinforced composites with an accuracy of 97.98%.
The objective of this study was to investigate the effects of different cockpit primary flight display (PFD) interface designs on pilot cognitive efficiency and cognitive load. This study designed five optimised PFD interfaces and conducted interface cognition experiments to assess cognitive responses across six different PFD interface designs, including the original design. It compared various subjective and objective metrics across different interface designs and evaluated the impact of each design factor on cognitive task performance. The experimental results show that the PFD interface in the original interface design performs better under different flight symbol designs, and the interface with 50% increase in font size performs better among interface designs with different font sizes with relatively lower cognitive load. This study provides experimental support and optimization suggestions for the optimal design of cockpit PFD interface, which can help improve pilots’ perception and operational capabilities, and thus enhance task performance efficiency and flight safety. Future research can investigate the effects of various design factors on the cognitive effects of the interface to enhance the ongoing improvement and optimisation of interface design.
Leveraging the National COVID-19 Cohort Collaborative (N3C), a nationally sampled electronic health records repository, we explored associations between individual-level social determinants of health (SDoH) and COVID-19-related hospitalizations among racialized minority people with human immunodeficiency virus (HIV) (PWH), who have been historically adversely affected by SDoH.
Methods:
We retrospectively studied PWH and people without HIV (PWoH) using N3C data from January 2020 to November 2023. We evaluated SDoH variables across three domains in the Healthy People 2030 framework: (1) healthcare access, (2) economic stability, and (3) social cohesion with our primary outcome, COVID-19-related hospitalization. We conducted hierarchically nested additive and adjusted mixed-effects logistic regression models, stratifying by HIV status and race/ethnicity groups, accounting for age, sex, comorbidities, and data partners.
Results:
Our analytic sample included 280,441 individuals from 24 data partner sites, where 3,291 (1.17%) were PWH, with racialized minority PWH having higher proportions of adverse SDoH exposures than racialized minority PWoH. COVID-19-related hospitalizations occurred in 11.23% of all individuals (9.17% among PWH, 11.26% among PWoH). In our initial additive modeling, we observed that all three SDoH domains were significantly associated with hospitalizations, even with progressive adjustments (adjusted odds ratios [aOR] range 1.36–1.97). Subsequently, our HIV-stratified analyses indicated economic instability was associated with hospitalization in both PWH and PWoH (aOR range 1.35–1.48). Lastly, our fully adjusted, race/ethnicity-stratified analysis, indicated access to healthcare issues was associated with hospitalization across various racialized groups (aOR range 1.36–2.00).
Conclusion:
Our study underscores the importance of assessing individual-level SDoH variables to unravel the complex interplay of these factors for racialized minority groups.
Ultra-processed plant-based foods, such as plant-based burgers, have gained in popularity. Particularly in the out-of-home (OOH) environment, evidence regarding their nutritional profile and environmental sustainability is still evolving. Plant-based burgers available at selected OOH sites were randomly sampled in Amsterdam, Copenhagen, Lisbon and London. Plant-based burgers (patty, bread and condiment) (n 41) were lab analysed for their energy, macronutrients, amino acids and minerals content per 100 g and serving and were compared with reference values. For the plant-based burgers, the median values per 100 g were 234 kcal, 20·8 g carbohydrates, 3·5 g dietary fibre and 12·0 g fat, including 0·08 g TFS and 2·2 g SFA. Protein content was 8·9 g/100 g, with low protein quality according to amino acid composition. Median Na content was 389 mg/100 g, equivalent to 1 g salt. Compared with references, the median serving provided 31% of energy intake based on a 2000 kcal per day and contributed to carbohydrates (17–28%), dietary fibre (42%), protein (40%), total fat (48%), SFA (26%) and Na (54%). One serving provided 15–23% of the reference values for Ca, K and Mg, while higher contributions were found for Zn, Mn, P and Fe (30–67%). The ultra-processed plant-based burgers provide protein, dietary fibre and essential minerals and contain relatively high levels of energy, Na and total fats. The amino acid composition indicated low protein quality. The multifaceted nutritional profile of plant-based burgers highlights the need for manufacturers to implement improvements to better support healthy dietary habits, including reducing energy, Na and total fats.
This chapter focuses on literacy development in East Asia, the eastern region of the Asian continent. Students in most East Asian countries perform well in literacy. However, migrant communities still face struggles, leading to fewer opportunities in the labor market. East Asia has a very long history of literary practice. With China being the largest and oldest country in East Asia, its writing system has a profound impact in the region. The modern Chinese writing system is used not only by the 1.4 billion people in Mainland China but also in Chinese-speaking regions such as Hong Kong, Macau, and Taiwan. It is further used by Chinese-heritage speakers in Singapore, Malaysia, and countries around the world. However, most East Asian countries are biscriptal. This chapter starts out with an overview of the writing systems used in China, Japan, Korea, and Mongolia, followed by a description of the educational system in relation to literacy in each country. In the remaining part of the chapter the focus is on individual variation, neurological foundations and environmental factors related to literacy development in Chinese. Finally, the chapter presents a comparison of the factors related to literacy development in Chinese, Japanese, and Korean.
This study presents novel findings on stochastic electron heating via a random electron cyclotron wave (ECW) in a spherical tokamak. Hard x ray measurements demonstrate the time evolution of hard x ray counts at different energy bands, consistent with predictions from the stochastic heating model. The ECW heating rate shows a positive correlation with applied power, confirming the effectiveness of stochastic heating. Remarkably, the ECW-driven plasma current remains insensitive to ECW incidence angle, consistent with model predictions. The observed stochastic heating of electrons offers potential for exploring innovative non-inductive current drive modes in spherical tokamaks. This research contributes to the understanding of plasma behaviour and motivates the development of new models for non-inductive current drive in fusion devices.
In a recent survey of nematodes associated with tobacco in Shandong, China, the root-lesion nematode Pratylenchus coffeae was identified using a combination of morphology and molecular techniques. This nematode species is a serious parasite that damages a variety of plant species. The model plant benthi, Nicotiana benthamiana, is frequently used to study plant-disease interactions. However, it is not known whether this plant species is a host of P. coffeae. The objectives of this study were to evaluate the parasitism and pathogenicity of five populations of the root-lesion nematode P. coffeae on N. benthamiana.N. benthamiana seedlings with the same growth status were chosen and inoculated with 1,000 nematodes per pot. At 60 days after inoculation, the reproductive factors (Rf = final population densities (Pf)/initial population densities (Pi)) for P. coffeae in the rhizosphere of N. benthamiana were all more than 1, suggesting that N. benthamiana was a good host plant for P. coffeae.Nicotiana. benthamiana infected by P. coffeae showed weak growth, decreased tillering, high root reduction, and noticeable brown spots on the roots. Thus, we determined that the model plant N. benthamiana can be used to study plant-P. coffeae interactions.
While the role of benzodiazepines (BZDs) has been well established for anxiety and related disorders, there are significant concerns about BZD dependence, withdrawal, and tolerance. There is a lot of ambiguity regarding the potential long-term effects of BZDs on mental health. However, the risk of developing subsequent other substance use disorders is in question.
Objectives
In this electronic medical record (EMR) based retrospective cohort study, the study cohort was defined as patients between the ages of 18 and 65 with anxiety disorders (ICD-10-CM: F40-F48) prescribed with at least one BZD; the control cohort was defined as patients between the ages of 18 and 65 with anxiety disorders (ICD-10-CM: F40-F48) with no BZD prescription during the five-year timeframe examined. We excluded patients with pre-existing substance use disorders (ICD-10-CM: F10-F19), et al.
Methods
We collected data from TriNetX Research database, a real-time international EMR network, from September 2017 to September 2022. Patients in the two cohorts were matched by gender, age, race, ethnicity, and common medical conditions at a 1:1 ratio by propensity scoring and then underwent Kaplan–Meier analysis and association analysis.
Results
A total of 626,754 patients were identified and matched for analysis. Patients in the study cohort were more likely to be female (67.6% vs. 66.7%, p < 0.001), non-Hispanic (65.8% vs. 62.5%, p < 0.001) and white (72.8% vs. 69.1%, p < 0.001). Kaplan–Meier analysis showed the survival probability at the end of the time window was 94.1% for the control cohort and 89.5% for the study cohort (Hazard ratio, 2.20; 95% CI, 2.16-2.25; P < 0.001) in all type of substance use disorders. (Table 1)Table 1.
Hazard ratio of substance use disorders difference in BZD cohort versus the control cohort.
Substance use disorders was defined as Mental and behavioral disorders due to psychoactive substance use (ICD-10-CM: F10-F19).
Conclusions
Patients with an anxiety disorder who were prescribed BZDs are at higher risk of not only BZD dependence but all types of substance use disorders than a matched cohort not prescribed BZDs. Given this notable association, clinicians should be cautious while prescribing BZDs and inform the patient about the risks associated with their utilization.
The target backsheath field acceleration mechanism is one of the main mechanisms of laser-driven proton acceleration (LDPA) and strongly depends on the comprehensive performance of the ultrashort ultra-intense lasers used as the driving sources. The successful use of the SG-II Peta-watt (SG-II PW) laser facility for LDPA and its applications in radiographic diagnoses have been manifested by the good performance of the SG-II PW facility. Recently, the SG-II PW laser facility has undergone extensive maintenance and a comprehensive technical upgrade in terms of the seed source, laser contrast and terminal focus. LDPA experiments were performed using the maintained SG-II PW laser beam, and the highest cutoff energy of the proton beam was obviously increased. Accordingly, a double-film target structure was used, and the maximum cutoff energy of the proton beam was up to 70 MeV. These results demonstrate that the comprehensive performance of the SG-II PW laser facility was improved significantly.
This paper studied the use of eye movement data to form criteria for judging whether pilots perceive emergency information such as cockpit warnings. In the experiment, 12 subjects randomly encountered different warning information while flying a simulated helicopter, and their eye movement data were collected synchronously. Firstly, the importance of the eye movement features was calculated by ANOVA (analysis of variance). According to the sorting of the importance and the Euclidean distance of each eye movement feature, the warning information samples with different eye movement features were obtained. Secondly, the residual shrinkage network modules were added to CNN (convolutional neural network) to construct a DRSN (deep residual shrinkage networks) model. Finally, the processed warning information samples were used to train and test the DRSN model. In order to verify the superiority of this method, the DRSN model was compared with three machine learning models, namely SVM (support vector machine), RF (radom forest) and BPNN (backpropagation neural network). Among the four models, the DRSN model performed the best. When all eye movement features were selected, this model detected pilot perception of warning information with an average accuracy of 90.4%, of which the highest detection accuracy reached 96.4%. Experiments showed that the DRSN model had advantages in detecting pilot perception of warning information.
We report the experimental results of the commissioning phase in the 10 PW laser beamline of the Shanghai Superintense Ultrafast Laser Facility (SULF). The peak power reaches 2.4 PW on target without the last amplifying during the experiment. The laser energy of 72 ± 9 J is directed to a focal spot of approximately 6 μm diameter (full width at half maximum) in 30 fs pulse duration, yielding a focused peak intensity around 2.0 × 1021 W/cm2. The first laser-proton acceleration experiment is performed using plain copper and plastic targets. High-energy proton beams with maximum cut-off energy up to 62.5 MeV are achieved using copper foils at the optimum target thickness of 4 μm via target normal sheath acceleration. For plastic targets of tens of nanometers thick, the proton cut-off energy is approximately 20 MeV, showing ring-like or filamented density distributions. These experimental results reflect the capabilities of the SULF-10 PW beamline, for example, both ultrahigh intensity and relatively good beam contrast. Further optimization for these key parameters is underway, where peak laser intensities of 1022–1023 W/cm2 are anticipated to support various experiments on extreme field physics.
To summarise and describe the clinical presentations, diagnostic approaches and airway management techniques in children with laryngotracheal trauma.
Methods
The clinical data related to laryngotracheal trauma diagnosed and treated at the Beijing Children's Hospital, between January 2013 and July 2018, were retrospectively reviewed. Disease diagnosis, treatment, management and outcomes were analysed.
Results
A total of 13 cases were enrolled, including 7 cases of penetrating laryngotracheal trauma. The six cases of blunt laryngotracheal trauma were caused by collisions with hard objects. In all cases, voice, airway and swallowing outcomes were graded as ‘good’, except for one patient who had residual paralysis of the vocal folds.
Conclusion
Flexible fibre-optic laryngoscopy and computed tomography can play an important role in diagnosing laryngotracheal trauma. The airway should be secured and, if necessary, opened by tracheal intubation or tracheostomy.
The association between executive dysfunction, brain dysconnectivity, and inflammation is a prominent feature across major psychiatric disorders (MPDs), schizophrenia, bipolar disorder, and major depressive disorder. A dimensional approach is warranted to delineate their mechanistic interplay across MPDs.
Methods
This single site study included a total of 1543 participants (1058 patients and 485 controls). In total, 1169 participants underwent diffusion tensor and resting-state functional magnetic resonance imaging (745 patients and 379 controls completed the Wisconsin Card Sorting Test). Fractional anisotropy (FA) and regional homogeneity (ReHo) assessed structural and functional connectivity, respectively. Pro-inflammatory cytokine levels [interleukin (IL)-1β, IL-6, and tumor necrosis factor-α] were obtained in 325 participants using blood samples collected with 24 h of scanning. Group differences were determined for main measures, and correlation and mediation analyses and machine learning prediction modeling were performed.
Results
Executive deficits were associated with decreased FA, increased ReHo, and elevated IL-1β and IL-6 levels across MPDs, compared to controls. FA and ReHo alterations in fronto-limbic-striatal regions contributed to executive deficits. IL-1β mediated the association between FA and cognition, and IL-6 mediated the relationship between ReHo and cognition. Executive cognition was better predicted by both brain connectivity and cytokine measures than either one alone for FA-IL-1β and ReHo-IL-6.
Conclusions
Transdiagnostic associations among brain connectivity, inflammation, and executive cognition exist across MPDs, implicating common neurobiological substrates and mechanisms for executive deficits in MPDs. Further, inflammation-related brain dysconnectivity within fronto-limbic-striatal regions may represent a transdiagnostic dimension underlying executive dysfunction that could be leveraged to advance treatment.
Root-lesion nematodes (Pratylenchus spp.) are a group of economically important pathogens that have caused serious economic losses in many crops. In 2019, root-lesion nematodes were recovered from tomato (Solanum lycopersicum) root samples collected from Sichuan Province, People's Republic of China (PRC). Extracted nematodes were disinfected, and one individual female was cultured on a carrot disc for propagation at 25 °C by parthenogenesis and designated the SC isolate. Afterwards, the isolate was identified on the basis of morphometric and molecular markers. Both morphometric characters and molecular analysis of the internal transcribed spacer region gene (ITS) of ribosomal DNA, the D2-D3 expansion region of the 28S rDNA gene and the mitochondrial cytochrome oxidase I (mtDNA-COI) gene revealed that the species of root-lesion nematode was Pratylenchus scribneri. The Bayesian tree inferred from the ITS rDNA, 28S rDNA and mtDNA-COI gene sequences also showed that this isolate formed a highly supported clade with other P. scribneri isolates. The pathogenicity of the root-lesion nematode SC isolate on tomato was assessed, showing that tomato was a suitable host for P. scribneri. To the best of our knowledge, this is the first report of P. scribneri on tomato in Sichuan Province, PRC. These are also the first molecular data obtained from P. scribneri on tomato in the PRC, and the pathogenicity of P. scribneri to tomato was studied for the first time. This study provides scientific data for the detection, identification and control of tomato root-lesion nematode disease.
This study aimed to elucidate whether molecular signalling involved in upper airway remodelling is enhanced in patients with obstructive sleep apnoea.
Method
Twenty patients with mild obstructive sleep apnoea (control group) and 40 patients with moderate to severe obstructive sleep apnoea (obstructive sleep apnoea group) who desired uvulopalatopharyngoplasty were recruited for the study. After uvulopalatopharyngoplasty, surgical specimens of the uvula were subjected to haematoxylin and eosin, Masson's trichrome and immunohistochemical staining. Western blot and reverse transcriptase-polymerase chain reaction were used to evaluate the protein and messenger RNA expressions.
Results
The obstructive sleep apnoea group showed more severe inflammation, increased collagen deposition and higher immunohistochemical staining intensity for TGF-ß and MMP-9 as well as higher protein and messenger RNA expression of MMP-9, VEGF, TGF-ß, p38 MAPK, SMAD 2/3, AKT and JNK in the uvula than control group.
Conclusion
Patients with obstructive sleep apnoea demonstrated more severe inflammation, increased airway remodelling, and increased protein and messenger RNA expression of pro-inflammatory and pro-fibrotic cytokines in the uvula than control participants.
This study aimed to investigate the association of nasal nitric oxide and olfactory function.
Method
A cross-sectional study was performed in 117 adults, including 91 patients with chronic rhinosinusitis and 26 healthy controls. Scores on the 22-item Sino-Nasal Outcomes Test, Lund-Mackay scale and Lund-Kennedy scale were recorded to assess severity of disease. All participants were screened for common inhaled and food allergens. Nasal nitric oxide and fractional exhaled nitric oxide testing, acoustic rhinometry and anterior rhinomanometry testing were performed to measure nasal function. The validated Sniffin’ Sticks test battery was used to assess olfactory function.
Results
Higher nasal nitric oxide was an independent protective factor for odour discrimination and odour threshold in participants with chronic rhinosinusitis after adjusting for age, gender, drinking, smoking, 22-item Sino-Nasal Outcomes Test, Lund-Mackay score, Lund-Kennedy score, immunoglobulin E and the second minimal cross-sectional area by acoustic rhinometry. Nasal nitric oxide also showed high discrimination in predicting impaired odour discrimination. In addition, nasal nitric oxide was lower in older participants, those with higher Lund-Mackay or Lund-Kennedy scores and higher with elevated total serum immunoglobulin E concentrations above a threshold of 0.35 kU/l.
Conclusion
Higher nasal nitric oxide is associated with better odour discrimination in chronic rhinosinusitis and is modulated by age, degree of allergy and severity of chronic rhinosinusitis.