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Language comprehension requires integration of multiple cues, but the underlying mechanisms of how accentuation, as a significant prosodic feature, influences the processing of words with different levels of cloze probability remains unclear. This study exploits event-related potentials (ERPs) to examine the processing of accented and unaccented words with high-, medium-, and low-cloze probabilities embedded in the final position of highly constrained contexts during spoken sentence comprehension. Our results indicate that accentuation and cloze probability interact across the N400 and post-N400 positivity (PNP) time windows. Under the accented condition, N400 amplitudes gradually increased as cloze probability decreased. Conversely, under the unaccented condition, PNP amplitudes gradually increased as cloze probability decreased with a frontal distribution. These results suggest that the effect of predictability is influenced by accentuation, which is likely due to the processing speed and depth of the critical words, modulated by the amount of attentional resources allocated to them.
Sensory neuron membrane protein (SNMP) gene play a crucial role in insect chemosensory systems. However, the role of SNMP in the host searching behaviour of Rhopalosiphum padi (Hemiptera: Aphididae), a highly destructive pest of cereal crops, has not been clearly understood. Our previous research has shown that three wheat volatile organic compounds (VOCs) – (E)-2-hexenol, linalool, and octanal can attract R. padi, but the involvement of SNMP in the aphid’s olfactory response to these wheat VOCs has not to be elucidated. In this study, only one SNMP gene was cloned and characterised from R. padi. The results revealed that the SNMP belongs to the SNMP1 subfamily and was named RpadSNMP1. RpadSNMP11 was predominantly expressed in the antennae of the aphid, with significantly higher expression levels observed in winged forms, indicating that it is involved in olfactory responses of R. padi. RpadSNMP1 expression was significantly up-regulated following starvation, and the expression of this gene showed a decreasing trend after 24 h of aphid feeding. Functional analysis through RpadSNMP1 knockdown demonstrated a significant decrease in R. padi’s ability to search for host plants. The residence time of R. padi injected with dsRpadSNMP1 significantly shortened in response to (E)-2-hexenol, linalool and octanal according to the four-arm olfactometer, indicating the crucial role of RpadSNMP1 in mediating the aphid’s response to these wheat VOCs. Molecular docking suggested potential binding interactions between RpadSNMP1 and three wheat VOCs. Overall, these findings provided evidence for the involvement of RpadSNMP1 in host plant searching and lay a foundation for developing new methods to control this destructive pest.
In this article, we focus on the Cauchy problem of the three-dimensional generalized incompressible micropolar system in critical Fourier–Besov–Morrey spaces. By using the Fourier localization argument and the Littlewood–Paley theory, we get the local well-posedness results and global well-posedness results with small initial data belonging to the critical Fourier–Besov–Morrey spaces.
There are significant delays in the funded access to medicines. Studies indicate that in many countries it takes more than a year for patients to have funded access to medicines after market authorization. This study aimed to understand the disparities in timelines for funded access to medicines across different countries and to identify underlying reasons for this access gap.
Methods
We conducted a scoping review to examine the nature of health technology assessment (HTA) processes, current methods, and policies for medicines in ten jurisdictions. The jurisdictions included in this study are Australia, Canada, France, Germany, South Korea, the Netherlands, United Kingdom (divided into England, Scotland and Wales), and United States of America. The information was extracted from the websites of International Network of Agencies for Health Technology Assessment (INAHTA) member agencies in the selected jurisdictions, grey literature from governments’ websites, and peer-reviewed literature.
Results
Overall median time from submission of the evidence dossier to HTA recommendations for most jurisdictions is 22 weeks. Although there are similarities in the time taken to reach a funding decision, there are considerable variations in the time taken for patients to have funded access to medicines after HTA recommendations. Only a few countries mentioned a specific timeline within which medicines approved for funding should be listed. Time taken for price negotiations and other arrangements (i.e., risk-sharing agreements) may contribute to varying timelines for listing medicines for funding. Mostly, such negotiations are confidential and may not be time limited.
Conclusions
There was surprising consistency, globally, in the time it takes for funding decisions after medicines registration. The causes of delays in the medicines’ listing decisions are multifactorial and mostly occur after HTA recommendations. The parallel regulatory-assessment process and prioritization tend to reduce the time to a funding decision. However, transparency is needed in the listing process to improve overall timeliness.
A multifunctional optical diagnostic system, which includes an interferometer, a refractometer and a multi-frame shadowgraph, has been developed at the Shenguang-II upgrade laser facility to characterize underdense plasmas in experiments of the double-cone ignition scheme of inertial confinement fusion. The system employs a 266 nm laser as the probe to minimize the refraction effect and allows for flexible switching among three modes of the interferometer, refractometer and multi-frame shadowgraph. The multifunctional module comprises a pair of beam splitters that attenuate the laser, shield stray light and configure the multi-frame and interferometric modules. By adjusting the distance and angle between the beam splitters, the system can be easily adjusted and switched between the modes. Diagnostic results demonstrate that the interferometer can reconstruct electron density below 1019 cm–3, while the refractometer can diagnose density approximately up to 1020 cm–3. The multi-frame shadowgraph is used to qualitatively characterize the temporal evolution of plasmas in the cases in which the interferometer and refractometer become ineffective.
We report a numerical investigation of a previously noticed but less explored flow state transition in two-dimensional turbulent Rayleigh–Bénard convection. The simulations are performed in a square domain over a Rayleigh number range of $10^7 \leq Ra \leq 2 \times 10^{11}$ and a Prandtl number range of $0.25 \leq Pr \leq 20$. The transition is characterized by the emergence of multiple satellite eddies with increasing $Ra$, which orbit around and interact with the main vortex roll in the system. Consequently, the main roll is squeezed to a smaller size compared with the domain and wanders around in the bulk region irregularly and extensively. This is in sharp contrast to the flow state before the transition, which is featured by a domain-sized circulatory roll with its vortex centre ‘condensed’ near the domain's centre. Detailed velocity field analysis reveals that there exists an abrupt increase in the energy fluctuations of the Fourier modes during the transition. Based on this phase-transition-like signal, the critical condition for the transition is found to follow a scaling relation as $Ra_t \sim Pr^{1.41}$ where $Ra_t$ is the critical Rayleigh number for the transition. This scaling relation is quantitatively explained by a phenomenological model grounded on the bistability behaviour (i.e. spontaneous and stochastic switching between the two flow states) observed at the edge of the transition. The model can also account for the effects of aspect ratio on the transition reported in the literature (van der Poel et al., Phys. Fluids, vol. 24, 2012).
Inflammation is involved in the pathogenesis of stroke and depression. We aimed to investigate the association between the dietary inflammatory index (DII) and depression in American adults with stroke. Adults with stroke were enrolled in the National Health and Nutrition Examination Survey between 2005 and 2018 in the USA. The DII was obtained from a 24-h dietary recall interview for each individual. Multivariate regression and restricted cubic spline analyses were conducted to evaluate the association between DII and depression in adults with stroke. The mean age of the 1239 participants was 63·85 years (50·20 % women), and the prevalence of depression was 18·26 %. DII showed a linear and positive association with severe depression in adults with stroke (OR 1·359; 95 % CI 1·021, 1·810; P for non-linearity = 0·493). Compared with those in the lowest tertile of the DII, adults with stroke in the third tertile of the DII had a 3·222-fold higher risk of severe depression (OR 3·222; 95 % CI 1·150, 9·026). In the stratified analyses, the association between DII score and severe depression was more significant in older adults (P for interaction = 0·010) but NS with respect to sex (P for interaction = 0·184) or smoking status (P for interaction = 0·396). No significant association was found between DII and moderate-to-moderately severe depression in adults with stroke. In conclusion, an increase in DII score was associated with a higher likelihood of severe depression in older adults with stroke.
Malignant vasovagal syncope in children seriously affects their physical and mental health. Our study aimed to explore the efficacy of catheter ablation in ganglionated plexus with malignant vasovagal syncope children.
Conclusion:
Catheter ablation of ganglionated plexus was safe and effective in children with malignant vasovagal syncope and can be used as a treatment option for these children.
Methods:
A total of 20 children diagnosed with malignant vasovagal syncope were enrolled in Beijing Children’s Hospital, affiliated with Capital Medical University. All underwent catheter ablation treatment of ganglionated plexus. Ganglionated plexuses of the left atrium were identified by high-frequency stimulation and/or anatomic landmarks being targeted by radiofrequency catheter ablation. The efficacy of the treatment was evaluated by comparing the remission rate of post-operative syncopal symptoms and the rate of negative head-up tilt results. Safety and adverse events were evaluated.
Results:
After follow-up for 2.5 (0.6–5) years, the syncope symptom scores were decreased significantly compared with before treatment [3 (2–4) versus 5 (3–8) scores, P < 0.01]. Eighty-five per cent (17/20) children no longer experienced syncope, whilst 80% (16/20) children showed negative head-up tilt test after treatment. No adverse effects such as cardiac arrhythmia occurred in the children.
Hippocampal disruptions represent potential neuropathological biomarkers in depressed adolescents with cognitive dysfunctions. Given heterogeneous outcomes of whole-hippocampus analyses, we investigated subregional abnormalities in depressed adolescents and their associations with symptom severity and cognitive dysfunctions.
Methods
MethodsSeventy-nine first-episode depressive patients (ag = 15.54 ± 1.83) and 71 healthy controls (age = 16.18 ± 2.85) were included. All participants underwent T1 and T2 imaging, completed depressive severity assessments, and performed cognitive assessments on memory, emotional recognition, cognitive control, and attention. Freesurfer was used to segment each hippocampus into 12 subfields. Multivariable analyses of variance were performed to identify overall and disease severity-related abnormalities in patients. LASSO regression was also conducted to explore the associations between hippocampal subfields and patients’ cognitive abilities.
Results
Depressed adolescents showed decreases in dentate gyrus, CA1, CA2/3, CA4, fimbria, tail, and molecular layer. Analyses of overall symptom severity, duration, self-harm behavior, and suicidality suggested that severity-related decreases mainly manifested in CA regions and involved surrounding subfields with disease severity increases. LASSO regression indicated that hippocampal subfield abnormalities had the strongest associations with memory impairments, with CA regions and dentate gyrus showing the highest weights.
Conclusions
Hippocampal abnormalities are widespread in depressed adolescents and such abnormalities may spread from CA regions to surrounding areas as the disease progresses. Abnormalities in CA regions and dentate gyrus among these subfields primarily link with memory impairments in patients. These results demonstrate that hippocampal subsections may serve as useful biomarkers of depression progression in adolescents, offering new directions for early clinical intervention.
Sedimentary and diagenetic processes control the distribution of clay minerals in sedimentary basins, although these processes have seldom been studied continuously in continental sedimentary basins. The Songliao Basin, northeast China, is a large continental, petroleum-bearing basin, and provides a unique study site to understand the sedimentary and diagenetic processes that influence clay assemblages. In this paper, the clay mineralogy of a 2500 m-thick Late Cretaceous (late Turonian to Maastrichtian) terrestrial sedimentary succession (SK-1s and SK-1n cores), retrieved by the International Continental Scientific Drilling Program in the Songliao Basin, was examined. The objective was to determine the diagenetic and paleoenvironmental variations that controlled the formation of clay mineral assemblages, and to determine the thermal and paleoenvironmental evolution of the basin. The results from both cores show that illite is ubiquitous through the succession, smectite is frequently encountered in the upper strata, and ordered mixed-layer illite-smectite (I-S), chlorite, and kaolinite are abundant in the lower strata. Burial diagenesis is the primary control on the observed decrease of smectite and increasing illite, I-S, and chlorite with depth. Observations of clay-mineral diagenesis are used to reconstruct the paleotemperatures and maximum burial depths to which the sediments were subjected. The lowermost sediments could have reached a maximum burial of ~1000 m deeper than today and temperatures ~50°C higher than today in the latest Cretaceous. The transition of smectite to I-S in the SK-1 cores and the inferred paleotemperatures provide new constraints for basin modeling of oil maturation at elevated temperatures in the Songliao Basin. Authigenic kaolinite and smectite are enriched in sandstones with respect to the coeval mudstones from the SK-1n core, as a result of early diagenesis with the participation of primary aluminosilicates and pore fluids. In the upper part of both SK-1 cores, variations in smectite and illite were controlled primarily by paleoenvironmental changes. Increases in smectite and decreases in illite from the late Campanian to Maastrichtian are interpreted as resulting from increasing humidity, a conclusion consistent with previous paleoenvironmental interpretations.
Dyes are toxic and considered to be extremely hazardous to natural environments. Hence, adsorbents to remove dyes from contaminated water are needed. To develop adsorbents with a high adsorption capacity for different dyes, easy separation, and low cost, a novel dye adsorbent was prepared by activating fly ash with NaOH. The adsorbent morphology, structure, and specific surface area were characterized using scanning electron microscopy, X-ray powder diffraction, and surface area measurements using N2 adsorption-desorption. The adsorption abilities of the synthesized adsorbents were examined based on methylene blue and acid fuchsin adsorption from water. The capabilities of the adsorbents as a function of adsorbent use, dye type, dye concentration, time, and pH were investigated and compared. The results for methylene blue and acid fuchsin adsorption were modeled using pseudo-second order kinetics and the Langmuir adsorption isotherm, respectively. These modified adsorbents synthesized from fly ash may provide a promising solution to purify dye-contaminated waste water with the advantages of high efficiency and low cost.
In Australia, cancer codependent technologies (cCDTs) mostly comprise a biomarker targeting medicine and a companion diagnostic test (CDx). Health technology assessment (HTA) of cCDTs is carried out to inform funding deliberations on CDxs by the Medical Services Advisory Committee (MSAC) and on personalized medicine by the Pharmaceutical Benefits Advisory Committee (PBAC). To understand the strengths and weaknesses of this dual assessment mechanism, we studied the journey of cCDTs in getting funding support from the two committees since the introduction of the codependent technology evaluation framework.
Methods
Public summary documents summarizing deliberations by each committee were reviewed from 2012 to 2022. Information was retrieved on the patient indication, date, biomarkers related to the tests, and PBAC or MSAC funding outcomes. The alignment of HTA decisions, time taken until dual funding approval (if approved), and the reasons for discrepant and negative decision-making were determined.
Results
From 2012 to 2022, a total of 26 cCDT applications were submitted to PBAC and MSAC, corresponding with 43 paired PBAC/MSAC considerations and 11 single committee considerations. Non-small cell lung cancer and programmed cell death ligand 1 were the most frequently nominated cancer and biomarker test, respectively. When a cCDT was submitted in the same decision round to both committees, 60 percent of funding decisions were aligned, reaching 73 percent when the considerations were made separately (resubmissions). Only 9 percent of considerations received polarized, where one committee supported and the other committee rejected funding. After multiple resubmissions, 73 percent of cCDTs obtained dual funding support after an average of 34.8 weeks, with considerations by PBAC and MSAC occurring an average of 2.3 and 1.9 times, respectively.
Conclusions
Most cCDTs obtain funding support, but only after multiple resubmissions to PBAC and MSAC. Polarized decisions are rare. Reasons for rejection primarily relate to uncertain clinical benefit and an unacceptably high incremental cost-effectiveness ratio.
In the Spring of 2020, the onset of the global pandemic intensified existing inequalities, but also accelerated organizing within some of the most precarious economic sectors. The neoliberal university was no exception to this general trend, and from 2020 until 2022, student workers organized for union contracts, just pandemic responses, independent arbitration for harassment and improved conditions at their workplaces. In those years, while neoliberal universities issued empty calls for “community,” and a prompt return to normalcy, student workers mobilized themselves and won unprecedented gains from their institutions, rejecting administrative pleas for the defense of the status quo. The following “Report from the Field,” details the struggle of student workers organizing from 2020 to 2022 at the University of New Mexico, the University of Michigan, New York University, and Columbia University, and offers a collectively authored reflection on the challenges, victories and future concerns of its respective movements.
This study aimed to assess whether there have been changes in the quality of clinical evidence submitted for government subsidy decisions on cancer medicines over the past 15 years.
Methods
We reviewed public summary documents (PSDs) reporting on subsidy decisions made by the Pharmaceutical Benefits Advisory Committee (PBAC) from July 2005 to July 2020. Information was extracted on the study design, directness of comparison, sample size, and risk of bias (RoB). Changes in the quality of evidence were assessed using regression analysis.
Results
Overall, 214 PSDs were included in the analysis. Thirty-seven percent lacked direct comparative evidence. Thirteen percent presented observational or single-arm studies as the basis for decisions. Among PSDs presenting indirect comparisons, 78 percent reported transitivity issues. Nearly half (41 percent) of PSDs reporting on medicines supported by head-to-head studies noted there was a moderate/high/unclear RoB. PSDs reporting concerns with RoB increased by a third over the past 7 years, even after adjusting for disease rarity and trial data maturity (OR 1.30, 95% CI: 0.99, 1.70). No time trends were observed regarding the directness of clinical evidence, study design, transitivity issues, or sample size during any of the analyzed periods.
Conclusion
Our findings indicate that the clinical evidence supplied to inform funding decisions for cancer medicines is often of poor quality and has been deteriorating over time. This is concerning as it introduces greater uncertainty in decision making. This is particularly important as the evidence supplied to the PBAC is often the same as that supplied to other global decision-making bodies.
The relationships between childhood weight self-misperception and obesity-related factors particularly health markers have not been extensively discussed. This study aims to examine the associations between weight self-misperception and obesity-related knowledge, attitudes, lifestyles and cardio-metabolic markers among Chinese paediatric population.
Design:
Cross-sectional study.
Setting:
Data sourced from a national survey in Chinese seven provinces in 2013.
Participants:
Children and adolescents aged 5–19 years.
Results:
Of the total 14 079 participants, there were 14·5 % and 2·2 % participants over-estimated and under-perceived their weight, respectively. Multi-variable logistic regression was applied to calculate OR and 95 % CI (95 % Cl) of obesity-related behaviours and cardio-metabolic markers by actual and perceived weight status. Individuals who perceived themselves as overweight/obese were more likely to have prolonged screen time, insufficient dairy intake and over sugar-sweetened beverages consumption (all P < 0·05), regardless of their weight. Furthermore, actual overweight/obese individuals had higher odds of abnormal cardio-metabolic markers, but a smaller magnitude of association was found among weight under-estimators. Among non-overweight/obese individuals, weight over-estimation was positively associated with abdominal obesity (OR: 10·49, 95 % CI: 7·45, 14·76), elevated blood pressure (OR: 1·30, 95 % CI: 1·12, 1·51) and dyslipidemia (OR: 1·43, 95 % CI: 1·29, 1·58).
Conclusions:
Weight over-perception was more prevalent than under-estimation, particularly in girls. Weight over-estimators tended to master better knowledge but behave more unhealthily; both weight over-perception and actual overweight/obesity status were associated with poorer cardio-metabolic markers. Future obesity intervention programmes should additionally pay attention to the population with inaccurate estimation of weight who were easily overlooked.
Dynamic interpersonal therapy (DIT) is a brief, structured psychodynamic psychotherapy with demonstrated efficacy in treating major depressive disorder (MDD). The aim of the study was to determine whether DIT is an acceptable and efficacious treatment for MDD patients in China.
Method
Patients were randomized to 16-week treatments with either DIT plus antidepressant medication (DIT + ADM; n = 66), general supportive therapy plus antidepressant medication (GST + ADM; n = 75) or antidepressant medication alone (ADM; n = 70). The Hamilton Depression Rating Scale (HAMD) administered by blind raters was the primary efficacy measure. Assessments were completed during the acute 16-week treatment and up to 12-month posttreatment.
Results
The group × time interaction was significant for the primary outcome HAMD (F = 2.900, df1 = 10, df2 = 774.72, p = 0.001) in the acute treatment phase. Pairwise comparisons showed a benefit of DIT + ADM over ADM at weeks 12 [least-squares (LS) mean difference = −3.161, p = 0.007] and 16 (LS mean difference = −3.237, p = 0.004). Because of the unexpected high attrition during the posttreatment follow-up phase, analyses of follow-up data were considered exploratory. Differences between DIT + ADM and ADM remained significant at the 1-, 6-, and 12-month follow-up (ps range from 0.001 to 0.027). DIT + ADM had no advantage over GST + ADM during the acute treatment phase. However, at the 12-month follow-up, patients who received DIT remained less depressed.
Conclusions
Acute treatment with DIT or GST in combination with ADM was similarly efficacious in reducing depressive symptoms and yielded a better outcome than ADM alone. DIT may provide MDD patients with long-term benefits in symptom improvement but results must be viewed with caution.
Suppose you need to complete a task of 5 steps, each of which has equal difficulty and pass rate. You somehow have a privilege that can ensure you pass one of the steps, but you need to decide which step to be privileged before you start the task. Which step do you want to privilege? Mathematically speaking, the effect of each step on the final outcome is identical, and so there seems to be no prima facie reason for a preference. Five studies were conducted to explore this issue. In Study 1, participants could place the privilege on any of steps 1–5. Participants were most inclined to privilege step 5. In Study 2, participants needed to pay some money to purchase the privilege for steps 1–5, respectively. Participants would pay most money for step 5. Study 3 directly reminded participants that the probability of success of the whole task is mathematically the same, no matter on which step the privilege is placed, but most of the participants still prefer to privilege the final step. Study 4 supposed that the outcomes of all steps were not announced until all steps were finished, and asked how painful participants would feel if they passed all steps but one. People thought they would feel most painful when they failed at the final step. In Study 5, an implicit association test showed that people associated the first step with easy and the final step with hard. These results demonstrated the phenomenon of the final step effect and suggested that both anticipated painfulness and stereotype may play a role in this phenomenon.
The Qieganbulake deposit associated with a mafic–ultramafic–carbonatite complex in the Kuluketage block is not only the world’s second-largest vermiculite deposit, but also a medium-size carbonatite-related phosphate deposit. Field observations, radiometric dating results and Sr–Nd–Hf isotopes reveal that the parental magmas of the carbonatite and mafic–ultramafic rocks are cogenetic and formed synchronously at c. 810 Ma. Geochemical characteristics and Sr–Nd–Hf–S isotopes ((87Sr/86Sr)i = 0.70581–0.70710; ϵNd(t) = −0.20 to −11.80; ϵHf(t) = −7.5 to −10.3; δ34S = +0.7 ‰ to +3.0 ‰ (some sulfides with high δ34S values (+3.2 to +6.6) were formed by late hydrothermal sulfur)), in combination with mineral compositions and previous research, strongly indicate that the Qieganbulake mafic–ultramafic–carbonatite complex formed via extensive crystal fractionation/cumulation and liquid immiscibility of a carbonated tholeiitic magma, possibly derived from partial melting of an enriched subcontinental lithospheric mantle previously modified by slab-released fluids and sediment input in a continental rift setting. The coupled enriched Sr–Nd isotopic signatures, in combination with previous research, suggest that the enriched subcontinental lithospheric mantle could have been metasomatized by asthenospheric mantle melts to different degrees. The Qieganbulake carbonatite-related phosphate ores were the products of normal fractional crystallization/cumulation of P–Fe3+ complex enriched carbonatite magma in high oxygen fugacity conditions, which was generated by liquid immiscibility of CO2–Fe–Ti–P-rich residual magma undergoing high differentiation.
Recently, there have been concerns regarding a trend toward poorer quality evidence being accepted by regulatory institutions and the consequent impact on health technology assessment (HTA) decision-making. This study aimed to determine whether there has been a change in the quality of evidence provided on cancer drugs proposed for listing on the Pharmaceutical Benefits Scheme, using data solely extracted from public summary documents (PSD) published by the Australian government.
Methods
PSDs published from July 2005–2020 were reviewed. Metrics associated with quality of evidence were extracted, including the directness of comparison, study design, sample size, and risk of bias (RoB). Additional data were extracted to provide greater context to any observed trends in quality of evidence. Analyses were performed across different time periods. Associations between the quality of evidence and time periods were explored using logistic regression analysis.
Results
In total, 214 PSDs were included in the analysis. Only 13 percent of submissions provided a single arm study or observational study as the key evidence; however, 37 percent of submissions did not contain a direct (‘head-to-head’) comparison relevant to Pharmaceutical Benefits Advisory Committee (PBAC) decision-making. Among all submissions containing direct evidence, about half had findings of a moderate/high/unclear RoB. Among all submissions containing indirect comparisons, over half had transitivity issues. In submissions containing direct comparisons, there was an increase in the RoB over time even after adjusting for trial data maturity and the rareness of the drug indication (odds ratio [OR] 1.30; 95% confidence interval [CI] 0.99, 1.70). There were no clear time trends observed in sample size, directness, study design, or transitivity issues during any of the observed time periods.
Conclusions
In the last 7 years, a high proportion of cancer drug submissions presented findings with a high RoB and transitivity issues. As the evidence dossiers provided to the PBAC are often congruent with submissions made elsewhere, this poor evidence quality is of concern and can only lead to higher levels of decision-maker uncertainty.
To achieve autonomous all-day flight by high-altitude long-endurance unmanned aerial vehicle (HALE UAV), a new navigation method with deep integration of strapdown inertial measurement unit (SIMU) and triple star sensors based on atmospheric refraction correction is proposed. By analysing the atmospheric refraction model, the stellar azimuth coordinate system is introduced and the coupling relationship between attitude and position is established. Based on the geometric relationship whereby all the stellar azimuth planes intersect on the common zenith direction, the sole celestial navigation system (CNS) method by stellar refraction with triple narrow fields of view (FOVs) is studied and a loss function is built to evaluate the navigation accuracy. Finally, the new SIMU/triple star sensors deep integrated navigation method with refraction correction upgraded from the traditional inertial navigation system (INS)/CNS integrated method can be established. The results of simulations show that the proposed method can effectively restrain navigation error of a HALE UAV in 24 h steady-state cruising in the stratosphere.