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T long-term effects of cognitive therapy and behavior therapy (CTBT) for menopausal symptoms are unknown, and whether the effects are different between natural menopause and treatment-induced menopause are currently unclear. Therefore, we sought to conduct an accurate estimate of the efficacy of CTBT for menopausal symptoms.
We conducted searches of Cochrane Library, EMBASE, PsycINFO, PubMed, and Web of Science databases for studies from 1 January 1977 to 1 November 2021. Randomized controlled trials (RCTs) comparing intervention groups to control groups for menopausal symptoms were included. Hedge's g was used as the standardized between-group effect size with a random-effects model.
We included 14 RCTs comprising 1618 patients with a mean sample size of 116. CTBT significantly outperformed control groups in terms of reducing hot flushes [g = 0.39, 95% confidence interval (CI) 0.23–0.55, I2 = 45], night sweats, depression (g = 0.50, 95% CI 0.34–0.66, I2 = 51), anxiety (g = 0.38, 95% CI 0.23–0.54, I2 = 49), fatigue, and quality of life. Egger's test indicated no publication bias.
CTBT is an effective psychological treatment for menopausal symptoms, with predominantly small to moderate effects. The efficacy is sustained long-term, although it declines somewhat over time. The efficacy was stronger for natural menopause symptoms, such as vasomotor symptoms, than for treatment-induced menopause symptoms. These findings provide support for treatment guidelines recommending CTBT as a treatment option for menopausal symptoms.
Based on hubs of neural circuits associated with addiction and their degree centrality (DC), this study aimed to construct the addiction-related brain networks for patients diagnosed with heroin dependence undertaking stable methadone maintenance treatment (MMT) and further prospectively identify the ones at high risk for relapse with cluster analysis.
Sixty-two male MMT patients and 30 matched healthy controls (HC) underwent brain resting-state functional MRI data acquisition. The patients received 26-month follow-up for the monthly illegal-drug-use information. Ten addiction-related hubs were chosen to construct a user-defined network for the patients. Then the networks were discriminated with K-means-clustering-algorithm into different groups and followed by comparative analysis to the groups and HC. Regression analysis was used to investigate the brain regions significantly contributed to relapse.
Sixty MMT patients were classified into two groups according to their brain-network patterns calculated by the best clustering-number-K. The two groups had no difference in the demographic, psychological indicators and clinical information except relapse rate and total heroin consumption. The group with high-relapse had a wider range of DC changes in the cortical−striatal−thalamic circuit relative to HC and a reduced DC in the mesocorticolimbic circuit relative to the low-relapse group. DC activity in NAc, vACC, hippocampus and amygdala were closely related with relapse.
MMT patients can be identified and classified into two subgroups with significantly different relapse rates by defining distinct brain-network patterns even if we are blind to their relapse outcomes in advance. This may provide a new strategy to optimize MMT.
With the characteristics of full autonomy and no accumulated errors, polarisation navigation shows tremendous prospects in underwater scenarios. In this paper, inspired by the polarisation vision of aquatic organisms, a novel point-source polarisation sensor with high spectral adaptability (400 nm–760 nm) is designed for underwater orientation. To enhance the environmental applicability of the underwater polarisation sensor, a novel sensor model based on the underwater light intensity attenuation coefficient and optical coupling coefficient is established. In addition, concerned with the influence of light intensity uncertainty on sensor performance underwater, an antagonistic polarisation algorithm is adopted for the first time, to improve the accuracy of angle of polarisation and degree of polarisation in the low signal-to-noise ratio environment underwater. Finally, indoor and outdoor experiments are carried out to evaluate the performance of the designed polarisation sensor. The results show that the designed point-source polarisation sensor can acquire polarised light and be used for heading determination underwater.
COVID-19 is causing a significant burden on medical and healthcare resources globally due to high numbers of hospitalisations and deaths recorded as the pandemic continues. This research aims to assess the effects of climate factors (i.e., daily average temperature and average relative humidity) on effective reproductive number of COVID-19 outbreak in Wuhan, China during the early stage of the outbreak. Our research showed that effective reproductive number of COVID-19 will increase by 7.6% (95% Confidence Interval: 5.4% ~ 9.8%) per 1°C drop in mean temperature at prior moving average of 0–8 days lag in Wuhan, China. Our results indicate temperature was negatively associated with COVID-19 transmissibility during early stages of the outbreak in Wuhan, suggesting temperature is likely to effect COVID-19 transmission. These results suggest increased precautions should be taken in the colder seasons to reduce COVID-19 transmission in the future, based on past success in controlling the pandemic in Wuhan, China.
Digital medication health service (DMHS) platforms are increasingly used by pharmaceutical companies to provide direct medication health services through digital methods like apps, hotlines, and web services, etcetera. However, the implications of such platforms in supporting health technology assessment (HTA) are rarely discussed in the literature. This presentation sets out the opportunities for using the DMHS platforms of pharmaceutical companies as real-world data sources for HTA.
A mixed-method qualitative study combining literature review and case study was conducted. Relevant literature was identified by searching the Web of Science and PubMed databases. A case study on current DMHS platforms in China was carried out using an inductive approach to identify the key elements emerging from these platforms.
DMHS platforms of pharmaceutical companies can identify multiple attributes of medication information needs regarding medical products, including effectiveness, safety, and economic factors. The platforms can respond to different stakeholders, including patients and their carers, doctors, nurses, pharmacists, etcetera. As one kind of interactive process, DMHS platforms can provide further services, including patient education, consultation, and evaluation, follow-up visits, chronic disease management, promotion of the rational use of drugs, therapeutic drug monitoring, and adverse drug reaction surveillance and reporting.
The DMHS platforms of pharmaceutical companies provide a unique and valuable real-world data source for HTA. These types of self-reported outcomes have not gained enough attention in HTA. Collective efforts by HTA agencies and pharmaceutical companies are needed to set strategies for integrating DMHS platforms into HTA.
Fullerene dimers have attracted extensive attention due to their unique structures and fascinating properties. Here, fullerene dimer derivatives with four to six carbon atoms in the esters are designed and synthesized. The property differences that caused by the carbon number in the esters of the fullerene dimers are investigated by performing their electrochemical, optical, and photoelectric measurements. As the carbon atom numbers in the esters increase from four to five and six, the absorption intensities increase to 1.6- and 4.4-folds. The intensities of the fluorescence spectra increase to 1.8- and 5.2-folds. Their photocurrent increases to 2- and 7-folds under the irradiation of a 405-nm laser. The LUMO energy levels move downward slightly from −3.89 to −3.90 and −3.92 eV, respectively. Our results indicate that as the carbon number increases, the carbon chain lengths in the ester structures increase, very slight effects produced on the energy levels of the fullerene dimers, but strongly contribute to their chemical activities and thus the photoelectronic efficiencies.
Aggressive behaviour is common in animals and typically has lifetime consequences. As younger males have higher residual reproductive value than older males and lose more from injuries than older males do, the propensity for fighting tends to increase with age in many empirical reports and species. However, fighting patterns in those empirical reports cannot confirm the hypothesis that individuals cannot readily inflict injuries on their opponents. To address this shortcoming, a parasitoid wasp species, Anastatus disparis (Hymenoptera: Eupelmidae), was used as an experimental model to explore the characteristics of aggression from a life-history perspective; this wasp exhibits extreme fighting, resulting in contestants experiencing injury and death. Results showed that the energetic costs of fighting to injury significantly shortened life and caused the loss of most mating ability. Inconsistent with general predictions, the frequency and intensity of fighting in A. disparis significantly decreased with male age. Further study results showed significantly more young males were received by and successfully mated with virgin females, and most genes related to energy metabolism were downregulated in aged males. Our study provided supporting evidence that young A. disparis males show more aggression likely because of their resource holding potential and sexual attractiveness decline with age.
This paper studies the parameter estimation for Ornstein–Uhlenbeck stochastic volatility models driven by Lévy processes. We propose computationally efficient estimators based on the method of moments that are robust to model misspecification. We develop an analytical framework that enables closed-form representation of model parameters in terms of the moments and autocorrelations of observed underlying processes. Under moderate assumptions, which are typically much weaker than those for likelihood methods, we prove large-sample behaviors for our proposed estimators, including strong consistency and asymptotic normality. Our estimators obtain the canonical square-root convergence rate and are shown through numerical experiments to outperform likelihood-based methods.
This paper presents geochemical and grain-size records since the early Holocene in core ECS0702 with a fine chronology frame obtained from the Yangtze River subaqueous delta front. Since ~9500 cal yr BP, the proxy records of chemical weathering from the Yangtze River basin generally exhibit a Holocene optimum in the early Holocene, a weak East Asian summer monsoon (EASM) period during the middle Holocene, and a relatively strong EASM period in the late Holocene. The ~8.2 and ~4.4 cal ka BP cooling events are recorded in core ECS0702. The flooding events reconstructed by the grain-size parameters since the early Holocene suggest that the floods mainly occurred during strong EASM periods and the Yangtze River mouth sandbar caused by the floods mainly formed in the early and late Holocene. The Yangtze River-mouth sandbars since the early Holocene shifted from north to south, affected by tidal currents and the Coriolis force, and more importantly, controlled by the EASM. Our results are of great significance for enriching both the record of Holocene climate change in the Yangtze River basin and knowledge about the formation and evolution progress of the deltas located in monsoon regions.
Information about seed dormancy cycling and germination in relation to temperature and moisture conditions in the natural environment is important for the conservation and restoration of rare species, including Begonia guishanensis and Paraisometrum mileense, two sympatric perennial limestone (karst) species. Dry afterripening (DAR) and wet and dry (WD) cycles at 15/5 and 25/15°C as well as moist chilling (MC) at 15/5°C were used to mimic the natural environment at different times of the year. A field experiment was conducted to monitor seasonal changes in germination responses of the seeds. About 40–65% of B. guishanensis and 5% of P. mileense seeds were dormant at maturity. DAR at 25/15 and 15/5°C as well as MC and WD cycles at 15/5°C alleviated dormancy for B. guishanensis but not P. mileense, and WD cycles at 25/15°C induced a deeper conditional dormancy for both species. Seeds of B. guishanensis exhibited dormancy cycling in the field, with increased dormancy under natural WD cycles at relatively high temperatures during the transition from the dry to the wet season in April to May and decreased dormancy during the wet season from June to October. KNO3 mitigated the dormancy-inducing effect of both artificial and natural WD cycles at relatively high temperatures for B. guishanensis. The field experiment indicated that seeds of B. guishanensis may be able to form a persistent soil seed bank, while almost all seeds of P. mileense germinate at the beginning of the wet season in the field.
In the laser plasma interaction of quantum electrodynamics (QED)-dominated regime, γ-rays are generated due to synchrotron radiation from high-energy electrons traveling in a strong background electromagnetic field. With the aid of 2D particle-in-cell code including QED physics, we investigate the preplasma effect on the γ-ray generation during the interaction between an ultraintense laser pulse and solid targets. We found that with the increasing preplasma scale length, the γ-ray emission is enhanced significantly and finally reaches a steady state. Meanwhile, the γ-ray beam becomes collimated. This shows that, in some cases, the preplasmas will be piled up acting as a plasma mirror in the underdense preplasma region, where the γ-rays are produced by the collision between the forward electrons and the reflected laser fields from the piled plasma. The piled plasma plays the same role as the usual reflection mirror made from a solid target. Thus, a single solid target with proper scale length preplasma can serve as a manufactural and robust γ-ray source.
Maternal supraphysiological estradiol (E2) environment during pregnancy leads to adverse perinatal outcomes. However, the influence of oocyte exposure to high E2 levels on perinatal outcomes remains unknown. Thus, a retrospective cohort study was conducted to explore the effect of high E2 level induced by controlled ovarian stimulation (COH) on further outcomes after frozen embryo transfer (FET). The study included all FET cycles (n = 10,581) between 2014 and 2017. All cycles were categorized into three groups according to the E2 level on the day of the human Chorionic Gonadotropin trigger. Odds ratios (ORs) and their confidence intervals (CIs) were calculated to evaluate the association between E2 level during COH and pregnancy outcomes and subsequent neonatal outcomes. From our findings, higher E2 level was associated with lower percentage of chemical pregnancy, clinical pregnancy, ongoing pregnancy, and live birth as well as increased frequency of early miscarriage. Preterm births were more common among singletons in women with higher E2 level during COH (aOR1 = 1.93, 95% CI: 1.22–3.06; aOR2 = 2.05, 95% CI: 1.33–3.06). Incidence of small for gestational age (SGA) was more common in both singletons (aOR1 = 2.01, 95% CI: 1.30–3.11; aOR2 = 2.51, 95% CI: 1.69–3.74) and multiples (aOR1 = 1.58, 95% CI: 1.03–2.45; aOR2 = 1.99, 95% CI: 1.05–3.84) among women with relatively higher E2 level. No association was found between high E2 level during COH and the percentage of macrosomia or large for gestational age. In summary, oocyte exposure to high E2 level during COH should be brought to our attention, since the pregnancy rate decreasing and the risk of preterm birth and SGA increasing following FET.
Active Galactic Nuclei (AGN) exhibit multi-wavelength properties that are representative of the underlying physical processes taking place in the vicinity of the accreting supermassive black hole. The black hole mass and the accretion rate are fundamental for understanding the growth of black holes, their evolution, and the impact on the host galaxies. Recent results on reverberation-mapped AGNs show that the highest accretion rate objects have systematic shorter time-lags. These super-Eddington accreting massive black holes (SEAMBHs) show BLR size 3-8 times smaller than predicted by the Radius-Luminosity (R-L) relationship. Hence, the single-epoch virial black hole mass estimates of highly accreting AGNs have an overestimation of a factor of 3-8 times. SEAMBHs likely have a slim accretion disk rather than a thin disk that is diagnostic in X-ray. I will present the extreme X-ray properties of a sample of dozen of SEAMBHs. They indeed have a steep hard X-ray photon index, Γ, and demonstrate a steeper power-law slope, ασx.
A robust adaptive nonlinear asymptotic regulating control law is designed for dynamically positioned vessels exposed to unknown time-varying external disturbances incorporating Fuzzy Logic Systems (FLSs), projection operators, and the “robustifying” term into the vectorial backstepping technique. The FLSs approximate the vessel unknown dynamics and the update laws based on the online projection operators update the fuzzy weight vectors. The robustifying term handles the external disturbances and the fuzzy approximation errors. The designed Dynamic Positioning (DP) control law achieves asymptotic regulation of the vessel's position and heading and makes the other signals in the DP closed-loop control system of vessels be uniformly ultimately bounded. Simulations based on the Marine System Simulator toolbox validate the designed DP control law.
Oxidative stress is closely related to metabolic disorders, which can lead to various diseases. Nuclear factor E2-related factor 2 (Nrf2) is a central regulator of oxidative stress. Sodium butyrate (NaB) has been shown to alleviate oxidative stress and insulin resistance, yet how Nrf2 is involved in the action of NaB remains unclear. In the present study, rats were rendered obese by feeding a high-fat diet for 9 weeks. NaB (300 mg/kg), which was gavaged every 2 d for 7 weeks, significantly alleviated high-fat diet-induced oxidative stress and insulin resistance. Additionally, the insulin signalling pathway in the liver was activated by NaB, associated with significant activation of Nrf2, superoxide dismutase and glutathione. Furthermore, hepatic up-regulation of Nrf2 in NaB-treated rats was associated with reduced protein content of histone deacetylase 1 and increased histone H3 acetyl K9 (H3K9Ac) modification on the Nrf2 promoter. The actions of NaB were completely abolished when Nrf2 was knocked down in vitro. Taken together, NaB acts as a histone deacetylase inhibitor to up-regulate Nrf2 expression with enhanced H3K9Ac modification on its promoter. NaB-induced Nrf2 activation stimulates transcription of downstream antioxidant enzymes, thus contributing to the amelioration of high-fat diet-induced oxidative stress and insulin resistance.
Paediatric Mycoplasma pneumoniae pneumonia (MPP) is a major cause of community-acquired pneumonia in China. Data on epidemiology of paediatric MPP from China are little known. This study retrospectively collected data from June 2006 to June 2016 in Beijing Children's Hospital, Capital Medical University of North China and aims to explore the epidemiological features of paediatric MPP and severe MPP (SMPP) in North China during the past 10 years. A total of 27 498 paediatric patients with pneumonia were enrolled. Among them, 37.5% of paediatric patients had MPP. In this area, an epidemic took place every 2–3 years at the peak, and the positive rate of MPP increased during these peak years over time. The peak age of MPP was between the ages of 6 and 10 years, accounting for 75.2%, significantly more compared with other age groups (χ2 = 1384.1, P < 0.0001). The epidemics peaked in September, October and November (χ2 = 904.9, P < 0.0001). Additionally, 13.0% of MPP paediatric patients were SMPP, but over time, the rate of SMPP increased, reaching 42.6% in 2016. The mean age of paediatric patients with SMPP (6.7 ± 3.0 years old) was younger than that of patients with non-SMPP (7.4 ± 3.2 years old) (t = 3.60, P = 0.0001). The prevalence of MPP and SMPP is common in China, especially in children from 6 to 10 years old. Paediatric patients with SMPP tend to be younger than those with non-SMPP. MPP outbreaks occur every 2–3 years in North China. September, October and November are the peak months, unlike in South China. Understanding the epidemiological characteristics of paediatric MPP can contribute to timely treatment and diagnosis, and may improve the prognosis of children with SMPP.
The Chinese government has acknowledged that in order to turn Chinese universities into world class institutions, it will have to grant them a greater degree of autonomy. However, the reforms that have been introduced to achieve this goal run counter to a long tradition of central government oversight. The question now presenting itself is how much actual control government has devolved to universities. The qualitative evidence presented in this paper, obtained through interviews with university presidents and Party secretaries, not only confirms that, as one might expect, Chinese universities continue to operate “in the shadow of hierarchy,” but also and more importantly that formal efforts to devolve authority are being rendered ineffective by informal pressures and control mechanisms. Discussion reflects on the state of play in Chinese public administration studies, and urges public policy researchers examining devolution in China to account for both formal reforms and everyday “lived experiences.”
The purpose of the present meta-analysis was to evaluate the association between the inflammatory potential of diet, determined by the dietary inflammatory index (DII®) score, and depression.
Systematic review and meta-analysis.
A comprehensive literature search was conducted in PubMed, Web of Science and EMBASE databases up to August 2018. All observational studies that examined the association of the DII score with depression/depressive symptoms were included.
Four prospective cohorts and two cross-sectional studies enrolling a total of 49 584 subjects.
Overall, individuals in the highest DII v. the lowest DII category had a 23 % higher risk of depression (risk ratio (RR)=1·23; 95 % CI 1·12, 1·35). When stratified by study design, the pooled RR was 1·25 (95 % CI 1·12, 1·40) for the prospective cohort studies and 1·16 (95 % CI 0·96, 1·41) for the cross-sectional studies. Gender-specific analysis showed that this association was observed in women (RR=1·25; 95 % CI 1·09, 1·42) but was not statistically significant in men (RR=1·15; 95 % CI 0·83, 1·59).
The meta-analysis suggests that pro-inflammatory diet estimated by a higher DII score is independently associated with an increased risk of depression, particularly in women. However, more well-designed studies are needed to evaluate whether an anti-inflammatory diet can reduce the risk of depression.