To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Needles of Juniperus rigida are used in Chinese traditional medicine for the treatment of brucellosis, dropsy, skin disease, and rheumatoid arthritis. This is the first study that reports anatomical structures of the J. rigida needles collected at different altitudes. The most common anatomical, phytochemical, and histochemical techniques and methods are used. The results show that anatomical structures and chemical composition change significantly at different altitudes. The main anatomical characters are significant xeromorphic structures (thick epidermis, hypodermis, and cuticle), a stomatal band, a developed vascular bundle, and a marginal resin duct. The xeromorphic structures become more pronounced with increasing altitude. The phytochemical and histochemical results demonstrate that the content of the main chemical compounds (phenols and terpenoids) basically increases at a higher elevation. Histochemical analysis localizes the phenols in epidermal cells, sponge tissue, endothelial layer cells, and stomatal bands, and the terpenoids in palisade tissue, sponge tissue, and the edge of the resin duct. This work reveals the relation between anatomy and chemistry in J. rigida needles, contributes to the quality control of its ethno-medicine, and provides the evidence to develop the commercial cultivation.
The search for life in the Universe is a fundamental problem of astrobiology and modern science. The current progress in the detection of terrestrial-type exoplanets has opened a new avenue in the characterization of exoplanetary atmospheres and in the search for biosignatures of life with the upcoming ground-based and space missions. To specify the conditions favourable for the origin, development and sustainment of life as we know it in other worlds, we need to understand the nature of global (astrospheric), and local (atmospheric and surface) environments of exoplanets in the habitable zones (HZs) around G-K-M dwarf stars including our young Sun. Global environment is formed by propagated disturbances from the planet-hosting stars in the form of stellar flares, coronal mass ejections, energetic particles and winds collectively known as astrospheric space weather. Its characterization will help in understanding how an exoplanetary ecosystem interacts with its host star, as well as in the specification of the physical, chemical and biochemical conditions that can create favourable and/or detrimental conditions for planetary climate and habitability along with evolution of planetary internal dynamics over geological timescales. A key linkage of (astro)physical, chemical and geological processes can only be understood in the framework of interdisciplinary studies with the incorporation of progress in heliophysics, astrophysics, planetary and Earth sciences. The assessment of the impacts of host stars on the climate and habitability of terrestrial (exo)planets will significantly expand the current definition of the HZ to the biogenic zone and provide new observational strategies for searching for signatures of life. The major goal of this paper is to describe and discuss the current status and recent progress in this interdisciplinary field in light of presentations and discussions during the NASA Nexus for Exoplanetary System Science funded workshop ‘Exoplanetary Space Weather, Climate and Habitability’ and to provide a new roadmap for the future development of the emerging field of exoplanetary science and astrobiology.
This study investigates the acoustic and articulatory properties of phonation contrast in Shanghainese, the most thoroughly studied Chinese Wu dialect. Although previous studies generally suggest that the non-modal phonation associated with the lower register in Shanghainese is relatively breathier, it is unclear whether it is ‘breathy voice’, ‘slack voice’ or ‘whispery voice’. This study aims to provide a better understanding of the phonetic realization of the non-modal phonation in Shanghainese. Simultaneous audio and electroglottographic recordings were made from 52 speakers born before 1980. Both acoustic and articulatory data confirmed that the non-modal phonation in Shanghainese is produced with relatively less glottal constriction and more aperiodic noise than the modal phonation. The novel finding of this study is that aperiodic noise plays a much more important role than spectral measures (i.e. indicators of glottal constriction) in the phonetic realization of the non-modal phonation. This property is distinct from the breathier voices in Gujarati, White Hmong and Southern Yi. These results suggest that the non-modal phonation in Shanghainese should be characterized as ‘whispery voice’, which is phonetically distinct from both ‘breathy voice’ and ‘slack voice’.
To compare and validate neurocognitive tests in the Harmonized Cognitive Assessment Protocol (HCAP) for the China Health and Retirement Longitudinal Study (CHARLS), and to identify appropriate tests to be administered in future waves of CHARLS.
We recruited 825 individuals from the CHARLS sample and 766 subjects from hospitals in six provinces and cities in China. All participants were administered the HCAP-neurocognitive tests, and their informants were interviewed regarding the respondents’ functional status. Trained clinicians administered the Clinical Dementia Rating scale (CDR) to assess the respondents’ cognitive status independently.
The testing protocol took an average of 58 minutes to complete. Refusal rates for tests of general cognition, episodic memory, and language were less than 10%. All neurocognitive test scores significantly correlated with the CDR global score (correlation coefficients ranged from 0.139 to 0.641). The Mini-Mental State Examination (MMSE), the Health and Retirement Study (HRS) - telephone interview for cognitive status (TICS), community screening instrument for dementia (CSI-D) for respondent, episodic memory and language tests each accounted for more than 20% of the variance in global CDR score (p < 0.001) in bivariate tests. In the CHARLS subsample, age and education were associated with neuropsychological performance across most cognitive domains, and with functional status.
A brief set of the CHARLS-HCAP neurocognitive tests are feasible and valid to be used in the CHARLS sample and hospital samples. It could be applied in the future waves of the CHARLS study, and it allows estimating the prevalence of dementia in China through the population-based CHARLS.
On February 6, 2018, a 6.0 magnitude earthquake struck Hualien, a county of East Taiwan. Hualien Tzu Chi Hospital, the only tertiary hospital in East Taiwan, activated the mass casualty incident (MCI) call and received 144 patients that night. Our operation did not perform satisfactorily despite regular MCI drills. Thus, a new strategy to cope with the increasing frequency of disaster-related MCIs was developed.
To facilitate the management of disaster-related MCIs, we developed a novel Disaster Response System which includes a triage system combining Simple Triage and Rapid Treatment (START) and Five-Level Taiwan Triage and Acuity Scale (TTAS), a novel registration system for MCIs, and anonymous patient identification and reporting system.
We begin the triage with the START method and then shift to the TTAS. The new registration system only needs the patient’s gender, age, and triage category. Patients are then assigned to different treatment areas accordingly. Further dispositions are applied after initial stabilization management. To identify the anonymous disaster victims, we take photographs of victims after clean-up and display them on an electronic bulletin with the patient list to the families in our emergency department. Real-time casualty statistics are collected automatically and synchronized to the governmental administrative system.
This novel Disaster Response System reduces the time from patient arrival to definite treatment and disposition in a simulated mass casualty incident exercise. The victim identification bulletin provides clear information to those who are seeking their family, and thus, avoids the chaos of the scene.
From the experience of the earthquake-related MCI, we found that inadequate training causes time mis-triage and treatment delays. Our Disaster Response System facilitates the workflow with an easily practiced algorithm, reveals on-time and easily accessible information to the public, and altogether improves our MCI management.
After a 6.0 magnitude earthquake struck Hualien on February 6, 2018, over one hundred and fifty patients crammed into the emergency department of a nearby tertiary hospital within two hours. The mass casualty incident (MCI) call was activated, and over 300 related personnel responded to the call and engaged with the MCI management.
This research aimed to analyze the practice of an MCI call and to form the strategies to improve its efficiency and effectiveness.
The research was conducted in a tertiary hospital in Hualien, Taiwan. Questionnaires regarding the practice of the MCI call were sent out to the healthcare providers in the emergency department who responded to that MCI operation.
Thirty-seven responders in the emergency department were involved in this study. 78% had participated in training courses for hospital incident command system (HICS) or MCI management before this event. On arrival at the emergency department, 69.4% of the responders were aware of the check-in station and received a clear task assignment and briefing. During the operation, 25.7% reported the lack of confidence carrying out the assigned tasks and 54.1% of the participants experienced great stress (stress score over 7 out of 10).
MCI is an uncommon event for hospital management. It is universally challenging owing to its unpredictable and time-sensitive nature. Furthermore, the administration could be further complicated by the associated disasters. Despite regular exercises and drills, there are still a significant number of participants experiencing stress and confusion during the operation. The chaotic situation may further compromise the performance of the participants. This study showed that optimizing task briefing and on-site directions may improve the performance of the MCI participants.
On February 6, 2018, a magnitude 6.2 earthquake struck Hualien, Taiwan. Over 150 patients crammed into the emergency department of nearby hospitals within two hours. Mass casualty incident (MCI) management was activated. During the recovery phase, little attention was paid to the mental health of hospital staff.
To analyze the prevalence of post-traumatic stress disorder (PTSD) among healthcare providers (HCPs) and explore the possible risk factors.
63 HCPs in the emergency department of the single tertiary hospital near the epicenter were included. The Chinese version of the Davidson Trauma Scale (DTS-C) was used to evaluate the prevalence of PTSD. Questionnaires were sent to explore the possible contributing factors.
The average age of the HCPs was 32.7 years (30.3 years for nurses; 40.4 years for physicians). The prevalence of PTSD was 3.2% eight months after the incident. The mean DTS-C score was 8.9/136. Nurses had a higher score than physicians (10.8 and 4.7). HCPs with 6-10 years working experience had the highest score (14.2), while those with less than 3 years experience had the lowest (4.8).
We found HCPs had a lower prevalence of PTSD compared with earthquake survivors (Chou 2007), and physicians had longer working years and lower DTS-C scores. The professional training may help HCPs going through psychological impacts during the disaster. HCPs with 6-10 years of experience in the emergency department were found to have a higher risk of developing PTSD. Most of them were taking the responsibility of a team leader during the MCI, which may cause significant stress to these staff. Adequate training regarding MCI management could help to relieve tension and frustration, hoping to prevent the development of PTSD. Based on our study, PTSD among HCPs is an ignored issue, and we should follow-up HCPs’ psychological condition in the future.
Heteroatom-doped carbon plays a vital role in the field of energy storage and conversion, and the synthesis of them has intimate relation with doping pathways. In this work, a facile two-step doping pathway, i.e., hydrothermal method followed by thermal annealing process, was employed to prepare annealed three-dimensional N,S-codoped graphene framework (3D A-NSG). The morphology, structure, composition, and related electrochemical performance were all studied. The results showed that A-NSG possessed typical 3D thin nanosheets, much increased specific surface area and structural defects, strengthened conductivity, and optimized N and S configurations (especially for dominated pyridinic N as well as graphitic N and –C–S–C–). As a result, A-NSG presented much better capacitance and oxygen reduction reaction performance than the counterparts. Apparently, our work offers a good guidance on the synthesis of advanced heteroatom-doped carbon materials by adjusting the doping strategy.
The 16-item Filial Piety Scale (FPS) has been used in different cultural groups to measure individuals’ loyalty to their family and traditions. Nevertheless, the language could be a barrier for Malay-speaking populations to fully comprehend the items. Thus, the present study translated the FPS into the Malay language (FPS-M) and examined psychometric qualities of the scale in a sample of 621 secondary school students in Malaysia, which was randomly split into an exploration sample and a validation sample. Traditional confirmatory factor analysis and exploratory structural equation modeling were applied to the exploration sample to identify the best-fit model. Results indicated that the hypothetical two-correlated-factor model was superior to the single-factor model. The model was then verified using the validation sample. The FPS-M reported good internal consistency and positive correlation with self-reported life satisfaction. However, the measurement invariance test revealed that the factor structure of the FPS-M was not equivalent across gender groups. In contrast, the factor loadings, but not intercepts, were found equivalent across the Chinese and Indian students. Overall, the results support that the FPS-M is a useful tool for measuring filial piety attitude in Malaysian adolescents. More studies are needed to identify cultural differences and modify the items to ensure that the FPS-M is applicable for all ethnicity groups.
Foreign direct investment (FDI) from China has recently met with increasing public opposition in many host nations. Why does the public respond less favourably to Chinese FDI than to FDI from other countries? We explore this question by conducting a series of survey experiments in Canada, where the majority of the public holds a negative opinion of Chinese investment. We find that the bias can be attributed to innumeracy about the relative size of China's FDI and misinformation about investment rules that govern FDI projects in Canada. Correcting both misperceptions substantially reduces the bias of respondents against FDI projects from China. These results suggest that corrective information can lead to positive change in public attitudes, a finding that has important policy implications for Canadian leaders hoping to expand the country's business ties with China.
The seasonality of individual influenza subtypes/lineages and the association of influenza epidemics with meteorological factors in the tropics/subtropics have not been well understood. The impact of the 2009 H1N1 pandemic on the prevalence of seasonal influenza virus remains to be explored. Using wavelet analysis, the periodicities of A/H3N2, seasonal A/H1N1, A/H1N1pdm09, Victoria and Yamagata were identified, respectively, in Panzhihua during 2006–2015. As a subtropical city in southwestern China, Panzhihua is the first industrial city in the upper reaches of the Yangtze River. The relationship between influenza epidemics and local climatic variables was examined based on regression models. The temporal distribution of influenza subtypes/lineages during the pre-pandemic (2006–2009), pandemic (2009) and post-pandemic (2010–2015) years was described and compared. A total of 6892 respiratory specimens were collected and 737 influenza viruses were isolated. A/H3N2 showed an annual cycle with a peak in summer–autumn, while A/H1N1pdm09, Victoria and Yamagata exhibited an annual cycle with a peak in winter–spring. Regression analyses demonstrated that relative humidity was positively associated with A/H3N2 activity while negatively associated with Victoria activity. Higher prevalence of A/H1N1pdm09 and Yamagata was driven by lower absolute humidity. The role of weather conditions in regulating influenza epidemics could be complicated since the diverse viral transmission modes and mechanism. Differences in seasonality and different associations with meteorological factors by influenza subtypes/lineages should be considered in epidemiological studies in the tropics/subtropics. The development of subtype- and lineage-specific prevention and control measures is of significant importance.
In this paper, we make the case that an argument for price-level targeting over inflation targeting need not to be based on some overly restrictive assumptions. We adopt a theoretical framework that deviates from the assumption of rational expectation, and that takes into account the cognitive limitations and a “trial and error” learning mechanism of the agents. The (im)perfect credibility of various monetary policies (e.g., a Taylor-type rule, strict domestic inflation targeting, strict consumer price index (CPI) inflation targeting, exchange rate peg, and domestic price-level and CPI-level targeting) may lead agents to react according to their expectation rules, and then create various degrees of booms and busts in output and inflation. Therefore, relaxing the rational expectation hypothesis has potential consequences for policy planning. We find that price-level targeting prevails over inflation targeting even under different expectation formation and even when the announced inflation target is not fully credible. The counterfactual analysis and sensitivity test confirm that CPI-level targeting is the most effective for improving social welfare and stability in an open economy. The business cycles induced by animal spirits are enhanced by strict inflation targeting.
Wave energy converters have been developed and commercialized in past decades; they have now faced numerous challenges of large volume sizes, environmental hazards, and high costs of deployment, components and maintenance. To address these challenges and make a wave energy converter practically available for various applications at a reasonable cost, we have developed a soft wave energy harvester that integrated low-cost soft material structures and piezoelectric-based Macro Fiber Composite (MFC). This integrated soft wave energy converter has a straightforward fabrication process and structure that can harvest energy from a broad working frequency of waves. The innovative design combined low-cost and commercially available materials and formed a harvester that addressed the aforementioned problems of commercially available harvesters. Additionally, the low cost and simple design are scalable for large energy conversion in the future. The energy conversion performance of the proposed platform has been investigated in a wave flume with low-frequency incoming waves (<2Hz). The soft energy conversion platform is hung like a curtain and produces a maximum 487nW. Also, the low cost and durable encapsulation can protect the electrical properties of MFCs and circuits, and a single harvester can last through all experiment steps without any degradation, which was more than 170 hours.
The microstructure and oxidation behavior at high temperatures ranging from 900 °C to 1100 °C of equiatomic CrMoNbTaV high-entropy alloy produced by vacuum arc melting were investigated. The phase component, microstructure, and microhardness of the alloy were examined by using X-ray diffraction, scanning electron microscopy equipped with an energy-dispersive X-ray spectroscope, and Vickers hardness tests, respectively. The as-cast alloy consists of a single body-centered cubic (BCC) refractory metal solid solution due to the high mixing entropy effect and exhibits a dendritic microstructure. The alloy has a very high microhardness value of 923 HV due to the strong solid solution strengthening effect. The average microhardness in interdendrites (950 HV) was higher than that in dendrites (896 HV) because of composition segregation. The oxidation kinetic curves of the alloy after exposure to air at 900 and 1000 °C follow the pseudo-parabolic rate law, while the mass gain increases first and then decreases at 1100 °C. The thickness of the oxide layer increases with the increasing of oxidation time. The long rod-shaped oxidation products are composed of Nb2O5, NbO2, CrTaO4, CrNbO4, Ta9VO25, Nb9VO25, and TaO after oxidation at 900 and 1000 °C for 25 h. The oxides of CrTaO4 and CrNbO4 disappear as the oxidation temperature elevated to 1100 °C.
There is increasing evidence for shared genetic susceptibility between schizophrenia and bipolar disorder. Although genetic variants only convey subtle increases in risk individually, their combination into a polygenic risk score constitutes a strong disease predictor.
To investigate whether schizophrenia and bipolar disorder polygenic risk scores can distinguish people with broadly defined psychosis and their unaffected relatives from controls.
Using the latest Psychiatric Genomics Consortium data, we calculated schizophrenia and bipolar disorder polygenic risk scores for 1168 people with psychosis, 552 unaffected relatives and 1472 controls.
Patients with broadly defined psychosis had dramatic increases in schizophrenia and bipolar polygenic risk scores, as did their relatives, albeit to a lesser degree. However, the accuracy of predictive models was modest.
Although polygenic risk scores are not ready for clinical use, it is hoped that as they are refined they could help towards risk reduction advice and early interventions for psychosis.
Declaration of interest
R.M.M. has received honoraria for lectures from Janssen, Lundbeck, Lilly, Otsuka and Sunovian.
A lack of standardized clinical research coordinator (CRC) training programs requires determining appropriate approaches for content delivery. The purpose of this study was to assess CRCs preferred training delivery methods related to the 8 designated Joint Task Force Clinical Trial Competency domains.
Repeated measures analysis of variance and split-plot analysis of variance were adopted to compare the group means among 5 training delivery methods by 8 competency content domains and to examine whether demographic variables caused different preference patterns on the training delivery methods.
Participants reported a preference for online video; mentoring/coaching was the least preferred. Significant training delivery method preferences were reported for 3 content domains: participant safety considerations, medicines development and regulation, and clinical trials operations.
Observed statistical differences in the training delivery methods by the content domains provides guidance for program development. Ensuring that standardized educational training is aligned with the needs of adult learners may help ensure that CRCs are appropriately prepared for the workforce.
Seeking a latent-crosslinkable, mechanically flexible, fully thermoplastic shape memory polymer, we have developed a simple but effective macromolecular design that includes pendent crosslinking sites via the chain extender of a polyurethane architecture bearing semicrystalline poly(ε-caprolactone) (PCL) soft segments. This new composition was used to prepare fibrous mats by electrospinning and films by solvent casting, each containing thermal initiators for chemical crosslinking. The one-step synthesis strategy proved successful, and the crosslinking sites within PCL segments resulted in two-way (reversible) shape memory: repeatable elongation (cooling) and contraction (heating) under constant tensile stress. Being fully characterized, the crosslinked fiber mats revealed promising one-way and two-way (reversible) shape memory phenomena, with lower storage moduli though, compared to uncrosslinked films. We observed for both fibrous mats and films that increasing the applied tensile stress led to greater crystallization-induced elongation upon cooling as well as smaller strain hysteresis, particularly for covalently crosslinked samples. Relevant to medical applications, the materials were observed to feature unique, two-stage enzymatic degradation that was sensitive to differences in crystallinity and microstructure among samples.