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This study aimed to investigate the optimal frozen embryo transfer (FET) strategy for recurrent implantation failure (RIF) patients with three consecutive failed cleaved embryo implantations and no blastocyst preservation. This retrospective analysis was divided into three groups based on the FET strategy: thawed day 3 embryo transfer (D3 FET group); and extended culture of frozen–thawed day 3 embryos to day 5 blastocysts transfer (D3–D5 FET group); thawed blastocyst transfer (D5 FET group). Transplant cycle data were compared between the three groups. In total, 43.8% of vitrified–thawed cleavage embryos developed into blastocysts. Analysis of the three transplantation strategies showed that, compared with the D3 FET group, D3–D5 had a significantly better hCG-positivity rate and live-birth rate (P < 0.05). Pregnancy outcomes in the D3–D5 FET group and D5 FET group were similar regarding hCG-positivity rate, implantation rate, clinical pregnancy rate, and live-birth rate. Our findings propose two potentially valuable transfer strategies for patients experiencing repeated implantation failures. The D3–D5 FET approach presents a greater potential for selecting promising embryos in cases without blastocyst preservation; however, this strategy does entail the risk of cycle cancellation. Conversely, in instances where blastocyst preservation is an option, prioritizing consideration of the D5 FET strategy is recommended.
Service design has been an emerging transdisciplinary field that includes product, system, and social science, since the term was first introduced to academic research in the early 1990s. With socioeconomical shifts and emerging technologies, people have faced more complex and systemic challenges, which enable researchers to consider how to reapply service design not only as problem-solving tools but also as ways for communication and alignment to adapt to the change. The study focuses on the paradigm shifts of service from its definitions to applications by interviewing nine design experts from academia and industry, and utilizing survey results to help us explore applying service design to solve complicated social-technological challenges. We present four takeaways: 1) a new understanding of service design, 2) the purpose of using service design tools, 3) the evaluation of service quality through time, and 4) the applications of service design in the public sector. We proposed a macro-trend model with service systems: product, service, and experience to conclude 1) constructing service systems in the macro-trend context and 2) gaining holistic views and building service implementation capability in the era of transformations.
The purpose of the study is to understand the design considerations for creating a provocative financial planning toolkit with services to help facilitate more constructive and meaningful conversations to build trust and empathy between financial advisors and senior people. We conducted four rounds of 60-minute co-creation workshops with eight invited participants from various design disciplines to work in pairs to generate four preliminary concepts suggesting design considerations. We used ATLAS.ti to do qualitative research analysis under an NCT (notice, collecting, thinking) model to identify 22 codes synthesized from verbal and behavioral data. The study concluded with three design principles: 1) the concept of financial planning is about people's expectation management, 2) a financial planning toolkit is designed under service systems, and 3) the tailor-made and modular design features can give financial advisors more flexibility to engage with senior people and enable them to share more about their life stories and needs to recommend financial planning packages precisely according to personal preference, health conditions, and financial status.
Large gatherings of people on cruise ships and warships are often at high risk of COVID-19 infections. To assess the transmissibility of SARS-CoV-2 on warships and cruise ships and to quantify the effectiveness of the containment measures, the transmission coefficient (β), basic reproductive number (R0), and time to deploy containment measures were estimated by the Bayesian Susceptible-Exposed-Infected-Recovered model. A meta-analysis was conducted to predict vaccine protection with or without non-pharmaceutical interventions (NPIs). The analysis showed that implementing NPIs during voyages could reduce the transmission coefficients of SARS-CoV-2 by 50%. Two weeks into the voyage of a cruise that begins with 1 infected passenger out of a total of 3,711 passengers, we estimate there would be 45 (95% CI:25-71), 33 (95% CI:20-52), 18 (95% CI:11-26), 9 (95% CI:6-12), 4 (95% CI:3-5), and 2 (95% CI:2-2) final cases under 0%, 10%, 30%, 50%, 70%, and 90% vaccine protection, respectively, without NPIs. The timeliness of strict NPIs along with implementing strict quarantine and isolation measures is imperative to contain COVID-19 cases in cruise ships. The spread of COVID-19 on ships was predicted to be limited in scenarios corresponding to at least 70% protection from prior vaccination, across all passengers and crew.
The transport phenomena of dust particles have been widely observed in fusion plasmas. In this article, we report the observations of dust fragmentations in the Experimental Advanced Superconducting Tokamak (EAST). A dust particle splits into two daughter particles and their motions are recorded before and after the breakup with a fast video camera. The trajectories of the daughter particles in the experiment are consistent with equation-of-motion simulations. The stability of a rotating charged particle in the plasma is briefly discussed.
Excavations at Tiaotou reveal evidence for cultural continuity through the late third to the mid first millennia BC. This research explores shifts in subsistence, production and ritual at Tiaotou, and the emergence of the Pishan-Tiaotou Culture (1200–1000 BC). Tiaotou/Pishan-Tiaotou represents a missing link among Taihu Lake archaeological cultures and contributes to our knowledge of complex political formations and cultural change in Bronze Age southern China.
As optical parametric chirped pulse amplification has been widely adopted for the generation of extreme intensity laser sources, nonlinear crystals of large aperture are demanded for high-energy amplifiers. Yttrium calcium oxyborate (YCa4O(BO3)3, YCOB) is capable of being grown with apertures exceeding 100 mm, which makes it possible for application in systems of petawatt scale. In this paper, we experimentally demonstrated for the first time to our knowledge, an ultra-broadband non-collinear optical parametric amplifier with YCOB for petawatt-scale compressed pulse generation at 800 nm. Based on the SG-II 5 PW facility, amplified signal energy of approximately 40 J was achieved and pump-to-signal conversion efficiency was up to 42.3%. A gain bandwidth of 87 nm was realized and supported a compressed pulse duration of 22.3 fs. The near-field and wavefront aberration represented excellent characteristics, which were comparable with those achieved in lithium triborate-based amplifiers. These results verified the great potential for YCOB utilization in the future.
It is unclear whether the enhancing contact model (ECM) intervention is effective in reducing family caregiving burden and improving hope and quality of life (QOL) among family caregivers of persons with schizophrenia (FCPWS).
We conducted a cluster randomized controlled trial in FCPWS in eight rural townships in Xinjin, Chengdu, China. In total, 253 FCPWS were randomly allocated to the ECM, psychoeducational family intervention (PFI), or treatment as usual (TAU) group. FCPWS in three groups were assessed caregiving burden, QOL and state of hope at baseline (T0), post-intervention (T1), 3-month (T2), and 9-month (T3) follow-up, respectively.
Compared with participants in the TAU group, participants in the ECM group had statistically significantly lower caregiving burden scores both at T1 and T2 (p = 0.0059 and 0.0257, respectively). Compared with participants in the TAU group, participants in the PFI group had statistically significantly higher QOL scores in T1 (p = 0.0406), while participants in the ECM group had statistically significantly higher QOL scores in T3 (p = 0.0240). Participants in both ECM and PFI groups had statistically significantly higher hope scores than those in the TAU group at T1 (p = 0.0160 and 0.0486, respectively).
This is the first study to explore the effectiveness of ECM on reducing family caregiving burden and improving hope and QOL in rural China. The results indicate the ECM intervention, a comprehensive and multifaceted intervention, is more effective than the PFI in various aspects of mental wellbeing among FCPWS. Future research needs to confirm ECM's effectiveness in various population.
The aging population is now a global challenge, and impaired walking ability is a common feature in the elderly. In addition, some occupations such as military and relief workers require extra physical help to perform tasks efficiently. Robotic hip exoskeletons can support ambulatory functions in the elderly and augment human performance in healthy people during normal walking and loaded walking by providing assistive torque. In this review, the current development of robotic hip exoskeletons is presented. In addition, the framework of actuation joints and the high-level control strategy (including the sensors and data collection, the way to recognize gait phase, the algorithms to generate the assist torque) are described. The exoskeleton prototypes proposed by researchers in recent years are organized to benefit the related fields realizing the limitations of the available robotic hip exoskeletons, therefore, this work tends to be an influential factor with a better understanding of the development and state-of-the-art technology.
Little is known about how sociodemographic and clinical factors affect the caregiving burden of persons with schizophrenia (PwSs) with transition in primary caregivers.
This study aimed to examine the predictive effects of sociodemographic and clinical factors on the caregiving burden of PwSs with and without caregiver transition from 1994 to 2015 in rural China.
Using panel data, 206 dyads of PwSs and their primary caregivers were investigated in both 1994 and 2015. The generalised linear model approach was used to examine the predictive effects of sociodemographic factors, severity of symptoms and changes in social functioning on the caregiving burden with and without caregiver transition.
The percentages of families with and without caregiver transition were 38.8% and 61.2%, respectively. Among families without caregiver transition, a heavier burden was significantly related to a larger family size and more severe symptoms in PwSs. Deteriorated functioning of ‘social activities outside the household’ and improved functioning of ‘activity in the household’ were protective factors against a heavy caregiving burden. Among families with caregiver transition, younger age, improved marital functioning, deteriorated self-care functioning, and better functioning of ‘social interest or concern’ were significant risk factors for caregiving burden.
The effects of sociodemographic and clinical correlates on the caregiving burden were different among families with and without caregiver transition. It is crucial to explore the caregiver arrangement of PwSs and the risk factors for burden over time, which will facilitate culture-specific family interventions, community-based mental health services and recovery.
Hibernation is a biological status during which hibernating animals acclimatize themselves to reduced energy consumption through extreme but governed decline in self-metabolism. The role of mitochondria (Mt) in metabolic suppression during hibernation has already been elaborated in different organs and species. Nonetheless, the concretely changing process of mitochondrial architecture and the mechanism underlying this transformation during hibernation remains unclear. Herein, the present study was aimed at clarifying the detailed alteration of mitochondrial morphology and its potential role in the Chinese soft-shelled turtle (Pelodiscus sinensis) during different stages of hibernation. Compared with the nonhibernation period, the mitochondrial architecture was changing from round to crescent, and lipid droplet (LD)/Mt interaction was enhanced during hibernation, as observed by transmission electron microscopy (TEM). Further ultrastructural analysis uncovered that mitochondrial fusion was promptly accelerated in the early stage of hibernation, followed by mitochondrial fission in the middle stage, and mitophagy was boosted in the late stage. Moreover, gene and protein expression related to mitochondrial fusion, fission, and mitophagy accorded closely with the mitochondrial ultrastructural changes in different stages of hibernation. Taken together, our results clarified that the transformation of mitochondrial architecture and mitochondrial dynamics are of vital importance in maintaining internal environment homeostasis of Pelodiscus sinensis.
The blood-brain barrier (BBB) is an important internal barrier. Herein, the electron microscope examination of duck BBB was performed during the brain development. Meanwhile, the genes/proteins of tight junctions (TJs) including zonula occludens-1, occludin, and claudin-5 in the duck brain were detected by Q-PCR and immunohistochemistry. The results showed the density of capillaries in the brain gradually increased during the embryonic period. The generation of the BBB and the specialization of its components occurred mainly in the embryonic stage. During this period, the endothelial cells (ECs) became thinner and pinocytic vesicles decreased; the TJs between EC membranes became longer and more electron-dense; the basement membrane surrounding ECs and pericytes gradually thickened; and the astrocyte foot processes appeared to wrap around the vessels. By the day of hatching (P1), the whole set of duck BBB structures was completely assembled and gradually improved in the subsequent growth process. Interestingly, compared with the cerebrum and cerebellum, the maturity level of the midbrain BBB was earlier seen during the embryonic stage. The expression of TJs increased during the embryonic period and remained stable by post-hatching. The study systematically investigated the histochemical and ultrastructural features of duck BBB during development and explored the corresponding relationship between structure and function.
Neuronal intranuclear inclusion disease (NIID) is a rare slowly progressive neurodegenerative disorder that is characterized pathologically by the presence of eosinophilic intranuclear inclusions. NIID is a heterogeneous disease with diverse clinical manifestations, making diagnosis difficult. Here, we analyzed the clinical, pathological, and radiological features of Chinese NIID patients to improve our understanding of NIID.
A total of 17 patients with sporadic NIID were recruited from the Ruijin Hospital Database between 2014 and 2021. Clinical patient information and brain MRI data were collected. All of the patients underwent standard skin biopsy procedures.
The average age of onset for symptoms was 60.18 years, and the average duration of illness was 4.06 years. All patients were diagnosed with NIID due to the presence of intranuclear inclusions confirmed by skin biopsy. Tremor was the most common initial symptom. The average ages at onset and at diagnosis were both lower in patients with tremor than in patients without tremor. NIID may be a systemic disease that affects multiple organs, for one patient had a history of chronic renal insufficiency for more than 10 years. In addition to high-intensity U-fibers signals on diffusion-weighted imaging, there were several other MRI findings, such as focal leukoencephalopathy and cortical swelling. Encephalitic episodes followed by reversible leukoencephalopathy was another important imaging feature of NIID.
The clinical manifestations of NIID are highly variable. Tremor may be the most common initial symptom in certain cohorts. Encephalitic episodes followed by reversible asymmetric leukoencephalopathy may also indicate this disease.
We describe an extraordinarily preserved non-trilobite artiopod Bailongia longicaudata gen. et sp. nov. from the Cambrian Stage 4 Guanshan Biota in Yiliang, Kunming of the Yunnan Province in China. Its exoskeleton consists of a large semi-elliptical cephalon with paired lateral posterior eyes, nine tapering homonomous tergites and a long slender tailspine. Appendages include paired small antennae, at least three pairs of post-antennal cephalic limbs, and trunk biramous limbs consisting of an endopod and an exopod with lamellae. B. longicaudata does not conform to any taxon within Artiopoda, although the eyes invite comparisons with Xandarella spectaculum, Sinoburius lunaris and Phytophilaspis. Parsimony analyses indicate Bailongia is a member of Artiopoda and cannot be readily accommodated within any of the major artiopod clades.
This study examined the pattern of medical utilization and the distribution of comorbidities shortly before death among adolescents who died from suicide and compared these data with those of living controls.
From Taiwan's National Health Insurance Research Database, this study identified adolescents aged 10–19 years who died from suicide (n = 935) between 1 January 2000, and 31 December 2016, by linking each patient with the national mortality database. The researchers conducted a nested case–control study through risk set sampling, and for each case, 20 age- and sex-matched controls (n = 18 700) were selected from the general population. The researchers applied conditional logistic regression to investigate differences in medical utilization and physical and psychiatric comorbidities between cases and controls.
Cases had a higher proportion of contact with the psychiatric department but a similar proportion of contact with any non-psychiatric medical department within 1 year before suicide compared with controls. There were 18.6% of adolescent suicide victims who only had contacted with a psychiatric department 3 months before suicide. Moreover, cases had a higher proportion of contact with non-psychiatric services within 3 months before suicide, particularly with emergency, surgery, and internal medicine departments. Cases had higher risks of several psychiatric disorders and physical illnesses, including heart diseases, pneumonia, and ulcer disease, than did controls.
The findings of increased medical utilization and higher risks of physical and psychiatric comorbidities in adolescent suicide victims are crucial for developing specific interventions to prevent suicide in this population.
Climbing robots have broad application prospects in aerospace equipment inspection, forest farm monitoring, and pipeline maintenance. Different types of climbing robots in existing research have different advantages. However, the self-adaptability and stability have not been achieved at the same time. In order to realize the self-adaptability of holding and climbing stability, this work proposes a new type of climbing robot under the premise of minimizing the driving source. The robot realizes stable multifinger holding and wheeled movement through two motors. At the same time, the robot has two different working modes, namely pole climbing and ground crawling. The holding adaptability and climbing stability are realized by underactuated holding mechanism and model reference adaptive controller (MRAC). On the basis of model design and parameter analysis, a prototype of the climbing robot is built. Experiments prove that the proposed climbing robot has the ability to stably climb poles of different shapes. The holding and climbing stability, self-adaptability, and climbing and crawling speed of the proposed climbing robot are verified by experiments.
Cognitive impairment is common in late-life depression, which may increase Alzheimer disease (AD) risk. Therefore, we aimed to investigate whether late-life major depressive disorder (MDD) has worse cognition and increases the characteristic AD neuropathology. Furthermore, we carried out a comparison between treatment-resistant depression (TRD) and non-TRD. We hypothesized that patients with late-life depression and TRD may have increased β-amyloid (Aβ) deposits in brain regions responsible for global cognition.
We recruited 81 subjects, including 54 MDD patients (27 TRD and 27 non-TRD) and 27 matched healthy controls (HCs). Neurocognitive tasks were examined, including Mini-Mental State Examination and Montreal Cognitive Assessment to detect global cognitive functions. PET with Pittsburgh compound-B and fluorodeoxyglucose were used to capture brain Aβ pathology and glucose use, respectively, in some patients.
MDD patients performed worse in Montreal Cognitive Assessment (p = 0.003) and had more Aβ deposits than HCs across the brain (family-wise error-corrected p < 0.001), with the most significant finding in the left middle frontal gyrus. Significant negative correlations between global cognition and prefrontal Aβ deposits existed in MDD patients, whereas positive correlations were noted in HCs. TRD patients had significantly more deposits in the left-sided brain regions (corrected p < 0.001). The findings were not explained by APOE genotypes. No between-group fluorodeoxyglucose difference was detected.
Late-life depression, particularly TRD, had increased brain Aβ deposits and showed vulnerability to Aβ deposits. A detrimental role of Aβ deposits in global cognition in patients with late-onset or non-late-onset MDD supported the theory that late-life MDD could be a risk factor for AD.
Deep nets have done well with early adopters, but the future will soon depend on crossing the chasm. The goal of this paper is to make deep nets more accessible to a broader audience including people with little or no programming skills, and people with little interest in training new models. A github is provided with simple implementations of image classification, optical character recognition, sentiment analysis, named entity recognition, question answering (QA/SQuAD), machine translation, speech to text (SST), and speech recognition (STT). The emphasis is on instant gratification. Non-programmers should be able to install these programs and use them in 15 minutes or less (per program). Programs are short (10–100 lines each) and readable by users with modest programming skills. Much of the complexity is hidden behind abstractions such as pipelines and auto classes, and pretrained models and datasets provided by hubs: PaddleHub, PaddleNLP, HuggingFaceHub, and Fairseq. Hubs have different priorities than research. Research is training models from corpora and fine-tuning them for tasks. Users are already overwhelmed with an embarrassment of riches (13k models and 1k datasets). Do they want more? We believe the broader market is more interested in inference (how to run pretrained models on novel inputs) and less interested in training (how to create even more models).
Nutritional Risk Screening index is a standard tool to assess nutritional risk, but epidemiological data are scarce on controlling nutritional status (CONUT) as a prognostic marker in acute haemorrhagic stroke (AHS). We aimed to explore whether the CONUT may predict a 3-month functional outcome in AHS. In total, 349 Chinese patients with incident AHS were consecutively recruited, and their malnutrition risks were determined using a high CONUT score of ≥ 2. The cohort patients were divided into high-CONUT (≥ 2) and low-CONUT (< 2) groups, and primary outcomes were a poor functional prognosis defined as the modified Rankin Scale (mRS) score of ≥ 3 at post-discharge for 3 months. Odds ratios (OR) with 95 % confidence intervals (CI) for the poor functional prognosis at post-discharge were estimated by using a logistic analysis with additional adjustments for unbalanced variables between the high-CONUT and low-CONUT groups. A total of 328 patients (60·38 ± 12·83 years; 66·77 % male) completed the mRS assessment at post-discharge for 3 months, with 172 patients at malnutrition risk at admission and 104 patients with a poor prognosis. The levels of total cholesterol and total lymphocyte counts were significantly lower in high-CONUT patients than low-CONUT patients (P = 0·012 and < 0·001, respectively). At 3-month post discharge, there was a greater risk for the poor outcome in the high-CONUT compared with the low-CONUT patients at admission (OR: 2·32, 95 % CI: 1·28, 4·17). High-CONUT scores independently predict a 3-month poor prognosis in AHS, which helps to identify those who need additional nutritional managements.