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Random effects meta-analysis model is an important tool for integrating results from multiple independent studies. However, the standard model is based on the assumption of normal distributions for both random effects and within-study errors, making it susceptible to outlying studies. Although robust modeling using the t distribution is an appealing idea, the existing work, that explores the use of the t distribution only for random effects, involves complicated numerical integration and numerical optimization. In this article, a novel robust meta-analysis model using the t distribution is proposed (tMeta). The novelty is that the marginal distribution of the effect size in tMeta follows the t distribution, enabling that tMeta can simultaneously accommodate and detect outlying studies in a simple and adaptive manner. A simple and fast EM-type algorithm is developed for maximum likelihood estimation. Due to the mathematical tractability of the t distribution, tMeta frees from numerical integration and allows for efficient optimization. Experiments on real data demonstrate that tMeta is compared favorably with related competitors in situations involving mild outliers. Moreover, in the presence of gross outliers, while related competitors may fail, tMeta continues to perform consistently and robustly.
This study aimed to explore the potential causal association between PUFA and the risk of intrahepatic cholestasis of pregnancy (ICP) using Mendelian randomisation (MR) analysis. A two-sample MR analysis was conducted utilising large-scale European-based genome-wide association studies summary databases. The primary MR analysis was carried out using the inverse variance-weighted (IVW) method, complemented by other methods such as MR-egger, weighted-median and weighted mode. Sensitivity analysis was also performed to validate the robustness of the findings. Results indicated a 31 % reduced risk of ICP for every 1 standard deviation (sd) increase in n-3 fatty acids levels (OR = 0·69, 95 % CI: 0·54, 0·89, P = 0·004) and in the ratio of n-3 fatty acids to total fatty acids (OR = 0·69, 95 % CI: 0·53, 0·91, P = 0·008). Conversely, there was a 51 % increased risk of ICP for every 1 sd increase in the ratio of n-6 fatty acids to n-3 fatty acids (OR = 1·51, 95 % CI: 1·20, 1·91, P < 0·001) and a 138 % increased risk for every 1 sd increase in the ratio of linoleic fatty acids to total fatty acids (OR = 2·38, 95 % CI: 1·55, 3·66, P < 0·001). The findings suggest that n-3 fatty acids may have a protective effect against the risk of ICP, while n-6 fatty acids and linoleic fatty acids could be potential risk factors for ICP. The supplementation of n-3 fatty acids, as opposed to n-6 fatty acids, could be a promising strategy for the prevention and management of ICP.
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.
The long- and finite-wavelength instabilities of weakly viscoelastic film on an oscillating inclined plane are investigated. By using the Chebyshev series solution with the Floquet theory, the combined effects of viscoelasticity and forcing amplitude on instability are described when the inclined plane oscillates in streamwise and wall-normal directions. For long-wavelength instability, the solution to the eigenvalue problem is obtained analytically by the asymptotic expansion method. Results show that the Floquet exponent is independent of the wall-normal oscillation amplitude. The effects of inclined angle, gravity and surface tension on the stability of viscoelastic liquid film are also discussed. For finite-wavelength instability, numerical results corresponding to the wall-normal oscillation disclose that with the increase of viscoelasticity, the unstable gravitational boundary moves to a higher wavenumber, and the critical amplitudes of subharmonic and harmonic instabilities are reduced. The neutral curve of gravity instability for streamwise oscillatory flow is divided into two parts, and a stable bandwidth is formed for a large value of the viscoelastic parameter. Besides, a new oscillatory mode is identified at small angles of inclination, which will be enhanced if the effect of viscoelasticity is incorporated.
This paper retrospectively analysed the prevalence of macrolide-resistant Mycoplasma pneumoniae (MRMP) in some parts of China. Between January 2013 and December 2019, we collected 4,145 respiratory samples, including pharyngeal swabs and alveolar lavage fluid. The highest PCR-positive rate of M. pneumoniae was 74.5% in Beijing, the highest resistance rate was 100% in Shanghai, and Gansu was the lowest with 20%. The highest PCR-positive rate of M. pneumoniae was 74.5% in 2013, and the highest MRMP was 97.4% in 2019; the PCR-positive rate of M. pneumoniae for adults in Beijing was 17.9% and the MRMP was 10.48%. Among the children diagnosed with community-acquired pneumonia (CAP), the PCR-positive and macrolide-resistant rates of M. pneumoniae were both higher in the severe ones. A2063G in domain V of 23S rRNA was the major macrolide-resistant mutation, accounting for more than 90%. The MIC values of all MRMP to erythromycin and azithromycin were ≥ 64 μg/ml, and the MICs of tetracycline and levofloxacin were ≤ 0.5 μg/ml and ≤ 1 μg/ml, respectively. The macrolide resistance varied in different regions and years. Among inpatients, the macrolide-resistant rate was higher in severe pneumonia. A2063G was the common mutation, and we found no resistance to tetracycline and levofloxacin.
This paper presents a broadband circularly polarized (CP) antenna array for millimeter-wave applications, and the antenna array has the advantages of wide impedance bandwidth (IBW), novel CP design, and low profile. The antenna unit consists of a two-layer substrate and two pairs of magnetoelectric dipoles. Stepped microstrip lines coupled by rectangular slits form a feeder network for easy integration. The axial ratio bandwidth (ARBW) is extended because a pair of parasitic patches is loaded and an elliptical perturbation is added. The simulation results show that the antenna has an ARBW of 18.6% (26.4–31.9 GHz) and an IBW of 45.5% (20.6–32.7 GHz), with a gain greater than 7.11 dBic in the IBW. To improve the gain of the antenna, a 2 × 2 antenna array is designed, fabricated, and measured. The measured results show that the array has an ARBW of 16.6% (26.42–31.21 GHz), an IBW of 41.6% (22.28–33.97 GHz), a peak gain of 13.89 dBic in the IBW, the cross-polarization levels in the xoz-plane and yoz-plane are above 20 dB, and a radiation efficiency greater than 89%.
In preparation for an experiment with a laser-generated intense proton beam at the Laser Fusion Research Center at Mianyang to investigate the 11B(p,α)2α reaction, we performed a measurement at very low proton energy between 140 keV and 172 keV using the high-voltage platform at the Institute of Modern Physics, Lanzhou. The aim of the experiment was to test the ability to use CR-39 track detectors for cross-section measurements and to remeasure the cross-section of this reaction close to the first resonance using the thick target approach. We obtained the cross-section σ = 45.6 ± 12.5 mb near 156 keV. Our result confirms the feasibility of CR-39 type track detector for nuclear reaction measurement also in low-energy regions.
In order to establish a compact all-optical Thomson scattering source, experimental studies were conducted on the 45 TW Ti: sapphire laser facility. By including a steel wafer, mixed gas, and plasma mirror into a double-exit jet, several mechanisms, such as shock-assisted ionization injection, ionization injection, and driving laser reflection, were integrated into one source. So, the source of complexity was remarkably reduced. Electron bunches with central energy fluctuating from 90 to 160 MeV can be produced. Plasma mirrors were used to reflect the driving laser. The scattering of the reflected laser on the electron bunches led to the generation of X-ray photons. Through comparing the X-ray spots under different experimental conditions, it is confirmed that the X-ray photons are generated by Thomson scattering. For further application, the energy spectra and source size of the Thomson scattering source were measured. The unfolded spectrum contains a large amount of low-energy photons besides a peak near 67 keV. Through importing the electron energy spectrum into the Monte Carlo simulation code, the different contributions of the photons with small and large emitting angles can be used to explain the origin of the unfolded spectrum. The maximum photon energy extended to about 500 keV. The total photon production was 107/pulse. The FWHM source size was about 12 μm.
The linear instability of viscoelastic film with insoluble surfactants on an oscillating plane for disturbances with arbitrary wavenumbers is investigated. The combined effects of viscoelastic and insoluble surfactants on the instability are described using Floquet theory. For long-wavelength instability, the solution in the limit of long wave perturbations is obtained by the asymptotic expansion method. The results show that the presence of viscoelastic film shifts the stability boundaries to the low-frequency region in the absence of gravity when the imposed frequency is less than 6. The U-shaped neutral curves with separation bandwidth appear in the presence of gravity. The finite-wavelength instability is solved numerically based on the Chebyshev spectral collocation method. Different from the previous results, a new branch point with special structure of a neutral curve is detected for clean-surface film. Results show that the presence of the surfactants will decrease the unstable frequency bandwidth and increase the critical Reynolds number. Both the travelling-wave mode and standing-wave mode are found due to the existence of surface surfactants. For high-frequency oscillation, the viscoelastic parameter may significantly destabilize the flow and the instability is determined by the finite-wavelength mode over a relatively large frequency range.
This paper is concerned with the increasing stability of the inverse source problem for the elastic wave equation with attenuation in three dimensions. The stability estimate consists of the Lipschitz type data discrepancy and the high frequency tail of the source function, where the latter decreases as the upper bound of the frequency increases. The stability also shows exponential dependence on the attenuation coefficient. The ingredients of the analysis include Carleman estimates and time decay estimates for the elastic wave equation to obtain an exact observability bound, and the study of the resonance-free region and an upper bound of the resolvent in this region for the elliptic operator with respect to the complex frequency. The advantage of the method developed in this work is that it can be used to study the case of variable attenuation coefficient.
Recently, Scholten and Read (2014) found new violations of dominance in intertemporal choice. Although adding a small receipt before a delayed payment or adding a small delayed receipt after an immediate receipt makes the prospect objectively better, it decreases the preference for that prospect (better is worse). Conversely, although adding a small payment before a delayed receipt or adding a small delayed payment after an immediate payment makes the prospect objectively worse, it increases the preference for that prospect (worse is better). Scholten and Read explained these violations in terms of a preference for improvement. However, to produce violations such as these, we find that the temporal sequences need not be constructed as Scholten and Read suggested. In this study, adding a small receipt before a dated receipt (thus constructed as improving) or adding a receipt after a dated payment (thus constructed as improving) decreases preferences for those prospects. Conversely, adding a small payment after a dated receipt (thus constructed as deteriorating) or adding a small payment before a delayed payment (thus constructed as deteriorating) increases preferences for those prospects.
The influence of second-order dispersion (SOD) on stimulated Raman scattering (SRS) in the interaction of an ultrashort intense laser with plasma was investigated. More significant backward SRS was observed with the increase of the absolute value of SOD ($\mid \kern-1pt\!{\psi}_2\!\kern-1pt\mid$). The integrated intensity of the scattered light is positively correlated to the driver laser pulse duration. Accompanied by the side SRS, filaments with different angles along the laser propagation direction were observed in the transverse shadowgraph. A model incorporating Landau damping and above-threshold ionization was developed to explain the SOD-dependent angular distribution of the filaments.
To investigate the spiritual care needs and their attributes among Chinese elders hospitalized for severe chronic heart failure (CHF) based on the Kano model, in order to provide a reference for improving the quality and satisfaction of spiritual care.
Methods
An observational design was implemented, and the STROBE Checklist was used to ensure quality reporting of the study. The demographic characteristics questionnaire, the Nurse Spiritual Therapeutics Scale, and the Kano model–based Nurse Spiritual Therapeutics Attributes Scale were used. A convenience sample of 451 patients were selected from 2 hospitals. Descriptive statistics, and Kano model were used to analyze the data.
Results
The total score of spiritual care needs was 29.95 ± 7.51. Among the 12 items, 3 items were attractive attributes, all of which were located in Reserving Zone IV; 5 items were one-dimensional attributes, of which 3 were located in Predominance Zone I and 2 were located in Improving Zone II; 2 items were must-be attributes, all of which were located in Improving Zone II; and 2 items were indifference attributes, all of which were located in Secondary Improving Zone III.
Significance of results
The spiritual care needs among Chinese elders hospitalized for severe CHF were moderate. The must-be and one-dimensional attributes mainly focus on “creating a good atmosphere” and “sharing self-perception” dimensions, while attractive attributes mainly focus on “sharing self-perception” and “helping thinking” dimensions. It is suggested that hospital authority should develop and innovate attractive attributes on the basis of maintaining and perfecting must-be and one-dimensional attributes, and objectively analyze and optimize indifference attributes.
The finite-amplitude instability of the buoyancy-driven boundary layer is considered on a vertical plate immersed in a thermally stratified ambient medium, where the wall and surrounding fluid have different temperature gradients. Although the linear stability in this configuration has been investigated, the finite-amplitude solution arising from the critical instability has been studied only for specific parameter values. We extend this by using the amplitude expansion method. The primary bifurcations to the two-dimensional least unstable mode for different temperature gradient ratios ($0 \leqslant \lambda \leqslant 10$) and Prandtl numbers ($10^{-1} \leqslant Pr \leqslant 10^{4}$) are investigated. Only supercritical bifurcations are found to occur when $0 \leqslant \lambda < 2$ and $Pr \leqslant 2800$, while subcritical bifurcations are also found for larger values of temperature gradient ratio and Prandtl number. Analysis of the contribution of the nonlinear terms in the Landau coefficient reveals that the interaction of the modification of the mean flow and second harmonic for velocity with the fundamental mode for temperature plays an important role in subcritical bifurcation. Based on the Landau equation, the threshold amplitude of the nonlinear equilibrium solution is discussed as well. These encouraging results should be helpful for understanding such a buoyancy-driven flow system.
To investigate spiritual care perceptions, spiritual well-being, and empathy, examine the correlations among spiritual care perceptions, spiritual well-being, and empathy, and explore the mediating role of spiritual well-being between other two variables of Chinese nursing students.
Methods
A cross-sectional design was implemented, and the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Checklist was used to ensure quality reporting of the study. A cluster sample of 2,718 nursing students was selected from 7 universities and colleges in China. The demographic characteristics questionnaire, the Chinese Version of the Spiritual Care-Giving Scale (C-SCGS), the Spiritual Health Scale Short Form (SHS-SF), and the Jefferson Scale of Physician Empathy-Nursing Student (JSPE-NS) were used. Descriptive statistics, correlation, and process plug-in mediation effect analyses were used to analyze the data.
Results
The total score of spiritual care perceptions, spiritual well-being, and empathy were 173.83 ± 25.62, 98.74 ± 12.87, and 105.04 ± 21.34, respectively. Spiritual care perceptions were positively correlated with spiritual well-being (r = 0.617, p < 0.01) and empathy (r = 0.528, p < 0.01). And spiritual well-being played a partial mediating role between the other two variables (accounting for 28.1%).
Significance of results
Spiritual care perceptions, spiritual well-being, and empathy were quite moderate, which need in improving. It is suggested that nursing educators pay attention to the spiritual care education of nursing students, perfect the spiritual care education system, and take targeted measures according to nursing students’ individual personality traits and differences, improve their spiritual well-being and empathy in multiple ways, so as to improve their spiritual care perceptions and competence.
The southern Great Xing’an Range (SGXR), located in the eastern segment of the Central Asian Orogenic Belt (CAOB), is one of the most economically important Cu–Mo–Fe–Sn–Pb–Zn–Ag metallogenic provinces in China. The newly discovered Panjiaduan Cu–Pb–Zn deposit (9.3 Mt; at 1.36% Cu, 2.90% Pb, 3.80% Zn and 38.12 g/t Ag), located in the SE segment of the SGXR, is primarily hosted in fracture zones in volcanic rocks and granodiorite of the Manitu Formation. Four paragenetic stages of metallic mineralization are identified: (I) quartz-pyrite-arsenopyrite; (II) quartz-polymetallic sulphide; (III) quartz-galena-sphalerite-argentite; and (IV) quartz-calcite-minor sulphide. The hydrothermal quartz contains three types of primary fluid inclusion (FIs): vapour-rich two-phase liquid-vapour (LV-type), liquid-rich two-phase liquid-vapour (VL-type) and three-phase liquid-vapour-solid FIs (SL-type). Stages I and II contain all types with homogenization temperatures (Th) of 324–386 °C and 276–334 °C as well as salinities of 0.7–38.0 wt% and 0.9–34.7 wt%, respectively, whereas stage III is composed of VL- and LV-type FIs with Th of 210–269 °C and salinities of 0.5–7.2 wt%. Only VL-type FIs occur in stage IV, with Th of 139–185 °C and salinities of 1.6–4.2 wt%. The δ18OH2O and δD values vary from −15.7 to 2.6‰ and −132.7 to −110.2‰, respectively, indicating predominant meteoric water with an initial magmatic source. The He–Ar isotopic compositions of the pyrite inclusions from the Panjiaduan Cu–Pb–Zn veins suggest that fluids were derived from the crust.
To investigate the spiritual care needs and associated influencing factors among elderly inpatients with stroke, and to examine the correlations among spiritual care needs, spiritual well-being, self-perceived burden, self-transcendence, and social support.
Methods
A cross-sectional quantitative design was implemented, and the STROBE Checklist was used as the foundation of the study. A convenience sample of 458 elderly inpatients with stroke was selected from three hospitals in China. The sociodemographic characteristics questionnaire, the Nurse Spiritual Therapeutics Scale, the Functional Assessment of Chronic Illness Therapy—Spiritual Well-being, the Self-Perceived Burden Scale, the Chinese Self-Transcendence Scale, and the Perceived Social Support Scale were used. Descriptive statistics, correlation, Student's t-test, ANOVA, non-parametric, and multiple linear regression analyses were used to analyze the data.
Results
The total score of spiritual care needs was 29.82 ± 7.65. Spiritual care needs were positively correlated with spiritual well-being (r = 0.709, p < 0.01), self-transcendence (r = 0.710, p < 0.01), and social support (r = 0.691, p < 0.01), whereas being negatively correlated with self-perceived burden (r = −0.587, p < 0.01). Religious beliefs, educational level, residence place, disease course, spiritual well-being, self-perceived burden, self-transcendence, and social support were found to be the main influencing factors.
Significance of results
The spiritual care needs were prevalent and moderate. It is suggested that nurses should enhance spiritual care knowledge and competence, take targeted spiritual care measures according to inpatients’ individual personality traits or characteristics and differences of patients, reduce their self-perceived burden and improve their spiritual well-being, self-transcendence and social support in multiple ways and levels, so as to meet their spiritual care needs to the greatest extent and enhance their spiritual comfort.
The significance of spiritual care competence among nurses has been emphasized across countries and cultures in many studies. However, there were few studies on correlations among spiritual care competence, spiritual care perceptions, and spiritual health of nurses in China.
Objective
To investigate spiritual care competence, spiritual care perceptions, and spiritual health, and examine the correlations among spiritual care competence, spiritual care perceptions and spiritual health, and the mediating role of spiritual health between other two variables of Chinese nurses.
Methods
A cross-sectional and correlational design was implemented, and the STROBE Checklist was used to report the study. A convenience sample of 2,181 nurses were selected from 17 hospitals in 3 provinces, China. Participants provided data on sociodemographic by completing the Chinese Version of the Spiritual Care Competence Scale, the Chinese Version of the Spiritual Care-Giving Scale, and the Spiritual Health Scale Short Form. Descriptive statistics, univariate, multiple linear regression, and Pearson correlation analysis were used to analyze data.
Results
The total scores of spiritual care competence, spiritual care perceptions, and spiritual health were 58.25 ± 16.21, 144.49 ± 16.87, and 84.88 ± 10.57, respectively, which both were moderate. Spiritual care competence was positively correlated with spiritual care perceptions (r = 0.653, p < 0.01) and spiritual health (r = 0.587, p < 0.01). And spiritual health played a mediating role between the other two variables (accounting for 35.6%).
Significance of results
The spiritual care competence, spiritual care perceptions, and spiritual health of Chinese nurses need to be improved. It is recommended that nursing managers should pay attention to spiritual care education of nurses, and improve spiritual care perceptions and spiritual health in multiple ways, so as to improve their spiritual care competence and to maximize the satisfy spiritual care needs of patients in China.
With differentiated tissues and organs, a high-level eukaryotic macroalga Lanceaphyton xiaojiangensis n. gen. n. sp. lived on the middle–late Ediacaran (ca. 560–551 Ma) seafloor in South China. Its body had a pith (perhaps mechanical tissue) and outer tissue (perhaps epidermis and/or cortex). The lance-like macroalga consists of an unbranching thallus that grew over the sediment surface for sunlight and a holdfast grown into sediments to keep the thallus fixed on the seafloor. The pithy stipe (lower thallus) might have served to support the upper pithless thallus for photosynthesis. The holdfast is composed of a tapering pithy rhizome growing down into the sediments, with many filamentous pithless rhizoids dispersedly growing within the sediments. With the differentiated tissues and organs, especially the pith accounting for about half of the width of the rhizome and stipe, Lanceaphyton n. gen. was a high-level eukaryotic macroalga, similar to phaeophytes in morphological features, but further research is needed on its microstructural details. The pithy macroalga shows that the macroalgal pith had emerged in the Ediacaran.