Psychogenic pseudosyncope is one of the primary causes of transient loss of consciousness in children and adolescents, essentially classified as a conversion disorder that significantly impacts patients’ quality of life. Clinically, psychogenic pseudosyncope shares certain similarities with vasovagal syncope in terms of pre-syncope symptoms and triggers, making it sometimes difficult to differentiate and easily misdiagnosed. Therefore, placing emphasis upon the characteristics of psychogenic pseudosyncope is crucial for early identification and treatment, which holds significant importance for the mental and psychological health of children and adolescents. In the present review, we aimed to address psychogenic pseudosyncope with clinical features, diagnosis, and treatment.

An important question in literacy education is whether reading instruction should focus on whole words or subword constituents. We tested whether this question captures something general across writing systems by examining the functionalities of words and characters in learning Chinese. We introduce a character-word dual-focus instructional approach based on the Character-Word Dual Function model and test its predictions with American undergraduate students enrolled in a beginner-level Chinese course. One group learned new words through dual-focus instruction: characters for pronunciation and words for meaning. A second group followed typical word-focus instruction prevalent in classrooms, learning word-level pronunciation and meaning. Results indicated that while both approaches produced comparable levels of word pronunciation and meaning learning, the dual-focus instruction significantly enhanced character pronunciation and transfer to new word learning. The advantages of dual-focus instruction highlight the importance of learning the subword components through acquiring the systematic structure of the writing system in learning to read.

The presence of dispersed-phase droplets can result in a notable increase in a system's drag. However, our understanding of the mechanism underlying this phenomenon remains limited. In this study, we use three-dimensional direct numerical simulations with a modified multi-marker volume-of-fluid method to investigate liquid–liquid two-phase turbulence in a Taylor–Couette geometry. The dispersed phase has the same density and viscosity as the continuous phase. The Reynolds number $Re\equiv r_i\omega _i d/\nu$ is fixed at 5200, the volume fraction of the dispersed phase is up to $40\,\%$, and the Weber number $We\equiv \rho u^2_\tau d/\sigma$ is approximately 8. It is found that the increase in the system's drag originates from the contribution of interfacial tension. Specifically, droplets experience significant deformation and stretching in the streamwise direction due to shear near the inner cylinder. Consequently, the rear end of the droplets lags behind the fore head. This causes opposing interfacial tension effects on the fore head and rear end of the droplets. For the fore head of the droplets, the effect of interfacial tension appears to act against the flow direction. For the rear end, the effect appears to act in the flow direction. The increase in the system's drag is attributed primarily to the effect of interfacial tension on the fore head of the droplets which leads to the hindering effect of the droplets on the surrounding continuous phase. This hindering effect disrupts the formation of high-speed streaks, favouring the formation of low-speed ones, which are generally associated with higher viscous stress and drag of the system. This study provides new insights into the mechanism of drag enhancement reported in our previous experiments.

Prior to the No Surprises Act (NSA), numerous states passed laws protecting patients from surprise medical bills from out-of-network (OON) hospital-based physicians supporting elective treatment in in-network hospitals. Even in non-emergency situations, patients have little ability to choose physicians such as anaesthesiologists, pathologists or radiologists. Using a comprehensive, multi-payer claims database, we estimated the effect of these laws on hospital-based physician reimbursement, charges, network participation and potential surprise billing episodes. Overall, the state laws were associated with a reduction in anaesthesiology prices and charges, but an increase in pathology and radiology prices. The price effects for each state exhibit substantial heterogeneity. California and New Jersey experienced increases in network participation by anaesthesiologists and pathologists and reductions in potential surprise billing episodes, but, overall, we find little evidence of changes in network participation across all of the states implementing surprise billing laws. Our results suggest that the effects of the NSA may vary across states.

We investigate the coupling effects of the two-phase interface, viscosity ratio and density ratio of the dispersed phase to the continuous phase on the flow statistics in two-phase Taylor–Couette turbulence at a system Reynolds number of $6\times 10^3$ and a system Weber number of 10 using interface-resolved three-dimensional direct numerical simulations with the volume-of-fluid method. Our study focuses on four different scenarios: neutral droplets, low-viscosity droplets, light droplets and low-viscosity light droplets. We find that neutral droplets and low-viscosity droplets primarily contribute to drag enhancement through the two-phase interface, whereas light droplets reduce the system's drag by explicitly reducing Reynolds stress due to the density dependence of Reynolds stress. In addition, low-viscosity light droplets contribute to greater drag reduction by further reducing momentum transport near the inner cylinder and implicitly reducing Reynolds stress. While interfacial tension enhances turbulent kinetic energy (TKE) transport, drag enhancement is not strongly correlated with TKE transport for both neutral droplets and low-viscosity droplets. Light droplets primarily reduce the production term by diminishing Reynolds stress, whereas the density contrast between the phases boosts TKE transport near the inner wall. Therefore, the reduction in the dissipation rate is predominantly attributed to decreased turbulence production, causing drag reduction. For low-viscosity light droplets, the production term diminishes further, primarily due to their greater reduction in Reynolds stress, while reduced viscosity weakens the density difference's contribution to TKE transport near the inner cylinder, resulting in a more pronounced reduction in the dissipation rate and consequently stronger drag reduction. Our findings provide new insights into the physics of turbulence modulation by the dispersed phase in two-phase turbulence systems.

Linear instability analysis of a viscous swirling liquid jet surrounded by ambient gas is carried out by considering the significant influence of axial shear effect. The jet azimuthal flow is assumed as a Rankine vortex, and the non-uniform velocity distribution in the jet axial direction is approximated by parabolic and error functions. The enhancement of jet rotation is found to promote the predominant mode with larger azimuthal wavenumbers, and the mode transition is decided by the competition between centrifugal force and axial shear stress. Subsequently, the influence of the axial shear effect is examined through changing the degree of shear stress and the thickness of the gas velocity boundary layer. It is found that an increase of jet average velocity or surface velocity in the axial direction leads to the predominant mode transition to smaller azimuthal wavenumbers, due to the combined effects of shear stress and gas pressure perturbation. A larger velocity difference between ambient gas and liquid jet also promotes the predominant modes with smaller azimuthal wavenumbers, and the physical mechanism is attributed to gas pressure perturbation. Phase diagrams of different azimuthal modes are given and compared with the study of Kubitschek & Weidman (J. Fluid Mech., vol. 572, 2007, pp. 261–286), where a static swirling column without axial shear stress was considered. The strengthened axial shear effect is found to delay the transition of predominant modes with the increase of angular velocity. Experimental studies considering the swirling jets with different axial velocities are further carried out, which validate the theoretical findings. Different instability mechanisms and their transition rules are also identified through energy budget analysis. This study is expected to give scientific guidance on understanding the instability mechanisms of the swirling jets that widely exist in natural phenomena and engineering applications.

Timing of food intake is an emerging aspect of nutrition; however, there is a lack of research accurately assessing food timing in the context of the circadian system. The study aimed to investigate the relation between food timing relative to clock time and endogenous circadian timing with adiposity and further explore sex differences in these associations among 151 young adults aged 18–25 years. Participants wore wrist actigraphy and documented sleep and food schedules in real time for 7 consecutive days. Circadian timing was determined by dim-light melatonin onset (DLMO). The duration between last eating occasion and DLMO (last EO-DLMO) was used to calculate the circadian timing of food intake. Adiposity was assessed using bioelectrical impedance analysis. Of the 151 participants, 133 were included in the statistical analysis finally. The results demonstrated that associations of adiposity with food timing relative to circadian timing rather than clock time among young adults living in real-world settings. Sex-stratified analyses revealed that associations between last EO-DLMO and adiposity were significant in females but not males. For females, each hour increase in last EO-DLMO was associated with higher BMI by 0·51 kg/m2 (P = 0·01), higher percent body fat by 1·05 % (P = 0·007), higher fat mass by 0·99 kg (P = 0·01) and higher visceral fat area by 4·75 cm2 (P = 0·02), whereas non-significant associations were present among males. The findings highlight the importance of considering the timing of food intake relative to endogenous circadian timing instead of only as clock time.

The delay-shift of the pre-pulse may mislead the determination of its origination and cause problems for the temporal contrast improvement of high-peak-power lasers, especially when the corresponding post-pulse is beyond the time window of the measurement device. In this work, an empirical formula is proposed to predict the delay-shift of pre-pulses for the first time. The empirical formula shows that the delay-shift is proportional to the square of the post-pulse’s initial delay, and also the ratio of the third-order dispersion to the group delay dispersion’s square, which intuitively reveals the main cause for the delay-shift and may provide a convenient routing for identifying the real sources of pre-pulses in both chirped-pulse amplification (CPA) and optical parametric chirped-pulse amplification (OPCPA) systems. The empirical formula agrees well with the experimental results both in the CPA and the OPCPA systems. Besides, a numerical simulation is also carried out to further verify the empirical formula.

Purple nutsedge (Cyperus rotundus L.) is one of the world’s resilient upland weeds, primarily spreading through its tubers. Its emergence in rice (Oryza sativa L.) fields has been increasing, likely due to changing paddy-farming practices. This study aimed to investigate how C. rotundus, an upland weed, can withstand soil flooding and become a problematic weed in rice fields. The first comparative analysis focused on the survival and recovery characteristics of growing and mature tubers of C. rotundus exposed to soil-flooding conditions. Notably, mature tubers exhibited significant survival and recovery abilities in these environments. Based on this observation, further investigation was carried out to explore the morphological structure, nonstructural carbohydrates, and respiratory mechanisms of mature tubers in response to prolonged soil flooding. Over time, the mature tubers did not form aerenchyma but instead gradually accumulated lignified sclerenchymal fibers, with lignin content also increasing. After 90 d, the lignified sclerenchymal fibers and lignin contents were 4.0 and 1.1 times higher than those in the no soil-flooding treatment. Concurrently, soluble sugar content decreased while starch content increased, providing energy storage, and alcohol dehydrogenase activity rose to support anaerobic respiration via alcohol fermentation. These results indicated that mature tubers survived in soil-flooding conditions by adopting a low-oxygen quiescence strategy, which involves morphological adaptations through the development of lignified sclerenchymal fibers, increased starch reserves for energy storage, and enhanced anaerobic respiration. This mechanism likely underpins the flooding tolerance of mature C. rotundus tubers, allowing them to endure unfavorable conditions and subsequently germinate and grow once flooding subsides. This study provides a preliminary explanation of the mechanism by which mature tubers of C. rotundus from the upland areas confer flooding tolerance, shedding light on the reasons behind this weed’s increasing presence in rice fields.

Perinatal malnutrition is a critical cause of diseases in offspring. Based on the different rates of organ development, we hypothesised that malnutrition at varying early life stages would have a differential impact on cardiovascular disease in middle-aged and older adults. This study sought to assess the long-term impact of exposure to the 1959–1961 Great Chinese Famine (GCF) during early developmental periods on risks of cardiovascular diseases in the late middle-aged offspring. A total 6, 662 individuals, born between 1958 and 1964, were divided into six groups according to the birth date. The generalised line model was used to control age and estimate differences with 95% confidence interval (CI) in blood pressure. Binary logistic regression was applied to evaluate the association between famine exposure and cardiovascular diseases. Compared to the unexposed late middle-aged persons, blood pressure was elevated in the entire gestation exposure group, regardless of postnatal exposure to GCF. Increased blood pressure was also found in the female offspring exposed to GCF during early and middle gestation. The early-childhood exposure was associated with the risk of bradycardia in the offspring. The risks of vertebral artery atherosclerosis were elevated in GCF famine-exposed groups except first trimester exposed group. The chronic influence of GCF in early life periods was specific to the developmental timing window, sexesand organs, suggesting an essential role of interactions among multiple factors and prenatal malnutrition in developmentally “programming” cardiovascular diseases.

Characterised by the extensive use of obsidian, a blade-based tool inventory and microblade technology, the late Upper Palaeolithic lithic assemblages of the Changbaishan Mountains are associated with the increasingly cold climatic conditions of Marine Isotope Stage 2, yet most remain poorly dated. Here, the authors present new radiocarbon dates associated with evolving blade and microblade toolkits at Helong Dadong, north-east China. At 27 300–24 100 BP, the lower cultural layers contain some of the earliest microblade technology in north-east Asia and highlight the importance of the Changbaishan Mountains in understanding changing hunter-gatherer lifeways in this region during MIS 2.

A novel method, combining an asymmetric four-grating compressor (AFGC) with pulse post-compression, is numerically demonstrated to improve the spatial uniformity of laser beams and hence to suppress small-scale self-focusing (SSSF) during the beam propagation in nonlinear materials of high peak power lasers. The spatial uniformity of laser beams is an important factor in performing post-compression, due to the spatial intensity modulation, or hot spots will be aggravated during the nonlinear propagation and then seriously damage the subsequent optical components. Three-dimensional numerical simulations of post-compression are implemented based on a femtosecond laser with a standard compressor and an AFGC, respectively. The simulated results indicate that post-compression with the AFGC can efficiently suppress the SSSF and also shorten the laser pulses from 30 fs to sub-10 fs. This work can provide a promising route to overcome the challenge of SSSF and will be meaningful to promote the practical application of the post-compression technique in high peak power lasers.

Pi-d2, which encodes a potential serine-threonine receptor-like kinase (RLK) membrane-spanning protein consisting of 825 amino acids, confers resistance to Magnaporthe oryzae strain ZB15 via an unidentified recognition mechanism. In this study, the Pid2 alleles of 303 rice (O. sativa) varieties from China's Yunnan region were amplified and sequenced in order to produce 24 haplotypes and 16 translation variants. Six of twenty-four alleles possessing the resistant site at the 441st amino acid were chosen for evaluating blast resistance by transforming into the blast-vulnerable rice variety Nipponbare. After being infected with 11 strains of M. oryzae, all transgenic lines exhibited resistance to ZB-15, whereas resistance to other strains varied. Notably, Pi-d2_H23 and Pi-d2_H24 exhibited resistance to all M. oryzae strains tested, indicating that these two alleles may have a broader resistance spectrum to M. oryzae. Alignment of these alleles’ amino acid sequences revealed that the differences in blast resistance spectra were primarily related to the amino acids present in the PAN domain at position 363 (valine/alanine). These findings suggested that the two extracellular signal recognition domains of PI-D2, B-lectin and PAN, may play a role in the identification of M. oryzae effectors. The present results provide insight into the mechanism of interaction between RLKs and M. oryzae.

The presence of a dispersed phase can significantly modulate the drag in turbulent systems. We derived a conserved quantity that characterizes the radial transport of azimuthal momentum in the fluid–fluid two-phase Taylor–Couette turbulence. This quantity consists of contributions from advection, diffusion and two-phase interface, which are closely related to density, viscosity and interfacial tension, respectively. We found from interface-resolved direct numerical simulations that the presence of the two-phase interface consistently produces a positive contribution to the momentum transport and leads to drag enhancement, while decreasing the density and viscosity ratios of the dispersed phase to the continuous phase reduces the contribution of local advection and diffusion terms to the momentum transport, respectively, resulting in drag reduction. Therefore, we concluded that the decreased density ratio and the decreased viscosity ratio work together to compete with the presence of a two-phase interface for achieving drag modulation in fluid–fluid two-phase turbulence.