We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save 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 saving content to .
To save content items to your Kindle, first ensure coreplatform@cambridge.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 saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved 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.
This study aimed to examine the same-sex matching effect of posttraumatic stress disorder (PTSD) symptoms from parents to children and the mediating role of children’ sense of security and catastrophization. Longitudinal data from 447 parent–child dyads were acquired using self-report scales. Parents (77.0% mothers; Mage = 40.15 years old) reported their PTSD symptoms 3 months after Super Typhoon Lekima, and children (55.9% girls; Mage = 13.40 years old) reported their PTSD symptoms, sense of security, and catastrophization 3 months and 15 months after the typhoon. Results showed that intrusion in mothers predicated intrusion, avoidance, and hyperarousal symptoms in daughters, while avoidance and hyperarousal in mothers predicted the same symptoms in daughters. This was not observed in any other parent–child dyads. Moreover, mothers’ intrusion positively predicted daughters’ PTSD symptoms via daughters’ sense of security and then catastrophization, while mothers’ hyperarousal showed the opposite prediction. These findings suggest that a same-sex matching effect occurs from mothers to daughters in terms of intrusion, avoidance, and hyperarousal symptoms of PTSD. Thus, clinical interventions that target daughters’ PTSD symptoms should also consider mothers’ intrusion and avoidance symptoms. Moreover, it may be possible to develop interventions to improve daughters’ sense of security.
This paper explores the effect of fiscal policy on the welfare of heterogeneous agents with different income sources over the business cycle. Policy experiments allow the government to choose the cyclical properties of fiscal policy instruments conditional on long-run levels to separately maximize the welfare of entrepreneurs and workers. This policy choice creates welfare conflicts between the two groups, which is confirmed by empirical evidence. The government maximizes workers’ welfare by choosing procyclical capital income tax rates and countercyclical labor income tax rates while it optimizes entrepreneurs’ welfare with countercyclical capital income tax rates and strongly countercyclical labor income tax rates. The socially optimal policy is a tradeoff between the welfare of entrepreneurs and workers. The welfare conflict holds when the government modifies the cyclical behavior of policy in a crisis, or it adjusts the long-run level and cyclical behavior at the same time.
Evidence on the long-term comparative effectiveness of posttraumatic stress disorder (PTSD) psychotherapies in adults remains unknown. Therefore, we performed an extensive network meta-analysis of randomised controlled trials (RCTs) to determine the comparative effectiveness of psychotherapies for people diagnosed with PTSD.
Methods
A comprehensive search was conducted in Cochrane library, Embase, Medline-OVID, PubMed, Scopus, and Psych-Info until March 2021. Studies on the effectiveness of cognitive processing therapy (CPT), cognitive therapy (CT), eye movement desensitisation reprocessing (EMDR), narrative exposure therapy (NET), prolonged exposure (PE), cognitive behavioural therapy (CBT), present-centred therapy (PCT), brief eclectic psychotherapies (BEP), psychodynamic therapy (PDT) or combination therapies compared to no treatment (NT) or treatment as usual (TAU) in adults with PTSD were included. Frequentist and Bayesian approaches were used for analysis in R-software.
Results
We included 98 RCTs with 5567 participants from 18 897 studies. CPT, EMDR, CT, NET, PE, CBT, and PCT were significant to reduce PTSD symptoms (SMD range: −1.53 to −0.75; Certainty: very low to high) at immediate post-treatment and ranked accordingly. Longitudinal analysis found EMDR (1.02) and CPT (0.85) as the significant therapies with large effect size in short-term and long-term follow-up, respectively. NET and CPT showed higher proportion of loss of PTSD diagnosis (RR range: 5.51–3.45) while there were no significant psychotherapies for retention rate compared to NT.
Conclusions:
Our findings provide evidence for improving current guidelines and informing clinical decision-making for PTSD management. However, the best PTSD treatment plan should be tailored to patients' needs, characteristics, and clinician expertise.
Homeostasis of gut microbiota is a critical contributor to growth and health in weaned piglets. Fish oil is widely reported to benefit health of mammals including preventing intestinal dysfunction, yet its protective effect during suckling-to-weaning transition in piglets remains undetermined. Low (30 g/d) and high (60 g/d) doses of n-3-rich fish oil were supplemented in sows from late gestation to lactation. Serum indicators and gut microbiota were determined to evaluate the effects of maternal fish oil on growth performance, immunity and diarrhea of piglets. DHA and EPA in the colostrum as well as serum of suckling and 1-week post-wean piglets were significantly and linearly increased by maternal supplementation of fish oil (P < 0.05). IGF1 and T3 in nursing and weaned piglets were significantly elevated by maternal fish oil (P < 0.05), and the increase of IGF1 was concerning the dosage of fish oil. Colostrum IgG, plasma IgG, IgM in suckling piglets, IgG, IgM and IgA in weaned piglets were significantly increase as maternal replenishment of fish oil increased (P < 0.05). Additionally, cortisol was significantly reduced in weaned pigs (P < 0.05), regardless of dosage. 16S rRNA sequencing revealed that α-diversity of fecal microbiota in nursery piglets, and fecal Lactobacillus genus, positively correlated with post-weaning IgA, was significantly increased by high dosage. Collectively, maternal fish oil during late pregnancy and lactation significantly promoted growth, enhanced immunity, and reduced post-weaning diarrhea in piglets, therefore facilitated suckling-to-weaning transition in piglets, which may be partially due to the altered gut microbial community.
Instrument delivery is critical part in vascular intervention surgery. Due to the soft-body structure of instruments, the relationship between manipulation commands and instrument motion is non-linear, making instrument delivery challenging and time-consuming. Reinforcement learning has the potential to learn manipulation skills and automate instrument delivery with enhanced success rates and reduced workload of physicians. However, due to the sample inefficiency when using high-dimensional images, existing reinforcement learning algorithms are limited on realistic vascular robotic systems. To alleviate this problem, this paper proposes discrete soft actor-critic with auto-encoder (DSAC-AE) that augments SAC-discrete with an auxiliary reconstruction task. The algorithm is applied with distributed sample collection and parameter update in a robot-assisted preclinical environment. Experimental results indicate that guidewire delivery can be automatically implemented after 50k sampling steps in less than 15 h, demonstrating the proposed algorithm has the great potential to learn manipulation skill for vascular robotic systems.
In this work, a confined-doped fiber with the core/inner-cladding diameter of 40/250 μm and a relative doping ratio of 0.75 is fabricated through a modified chemical vapor deposition method combined with the chelate gas deposition technique, and subsequently applied in a tandem-pumped fiber amplifier for high-power operation and transverse mode instability (TMI) mitigation. Notably, the impacts of the seed laser power and mode purity are preliminarily investigated through comparative experiments. It is found that the TMI threshold could be significantly affected by the seed laser mode purity. The possible mechanism behind this phenomenon is proposed and revealed through comprehensive comparative experiments and theoretical analysis. Finally, a maximum output power of 7.49 kW is obtained with the beam quality factor of approximately 1.83, which is the highest output power ever reported in a forward tandem-pumped confined-doped fiber amplifier. This work could provide a good reference and practical solution to improve the TMI threshold and realize high-power high-brightness fiber lasers.
This study is design to explore the association between dietary betaine intake and risk of all-cause and cardiovascular death in patients with CAD. In this cohort study, 1292 patients with CAD were followed-up for a median of 9.2 years. Baseline dietary betaine intake was collected using a paper-based semi-quantitative food frequency questionnaire (FFQ) and assessed according to the US Department of Agriculture (USDA) Database and the data of betaine in common foods. Cox proportional hazards regression models were used to analyze the association between dietary betaine intake and risks of all-cause and cardiovascular mortality. During the follow-up periods, 259 deaths recorded in 1292 participants, of which 167 died of cardiovascular diseases. Patients in the highest tertile of dietary betaine intake had a lower risk of all-cause (P=0.007) and cardiovascular death (P<0.001) than those in the lowest tertile after adjusting for age and sex, traditional cardiovascular risk factors and other potential confounders. After further adjusting for plasma methionine metabolites and vitamins, HRs across tertiles of dietary betaine intake were 1.00, 0.84 and 0.72 for all-cause mortality (P for trend=0.124), and 1.00, 0.77 and 0.55 for cardiovascular mortality (P for trend=0.021). Higher dietary betaine intake was associated with a decreased risk of cardiovascular death after fully adjustment for cardiovascular risk factors, other potential confounders and plasma methionine metabolites and vitamins. However, the association between dietary betaine intake and risk of all-cause mortality was not statistically significant after further adjusting for plasma methionine metabolites and vitamins.
Exploring reliable hydrogenation catalysts to remove trace olefins in aromatic hydrocarbons through hydrogenation is an important topic. In this paper, a bimetallic Cu–Ru/montmorillonite (Cu–Ru/M) catalyst was prepared using a step-by-step impregnation method, and the effects of bimetallic catalysts on removing olefins were assessed. The catalysts were characterized using X-ray diffraction, Brunauer–Emmett–Teller specific surface area, inductively coupled plasma atomic emission spectrometry, high-resolution transmission electron microscopy and temperature-programmed reduction of H2. The results show that there is a strong interaction between Cu and Ru on the Cu–Ru/M catalyst, which improves the dispersion of the metals on the surface of the support M. The hydrogen spillover phenomenon of Cu–Ru/M enhances its activity and adsorption capacity for hydrogen species. The catalytic performance test confirmed that the bimetallic catalyst has significantly greater activity and stability. The optimal loadings are 5% copper and 1% ruthenium, and the performance of this catalyst is comparable to those of noble-metal Pt/M catalysts.
Caregiver-mediated intervention (CMI), based on parent skills training, is a family-mediated intervention model for children with neurodevelopmental disorders, in particular autism spectrum disorder. This study aimed to evaluate the effectiveness of CMI.
Methods:
Thirty-three children (aged 22–69 months from our department) and their caregivers participated in a two-week training course of ten 90-minute lessons. Caregivers were encouraged to try their best to apply intervention skills in both home routines and play routines to encourage the development of cognition, motion, social adaptability, and behavior of children. Demographic information, video-recorded data, and diagnostic scales were collected at two key time points: baseline and post-training (PT – within six months).
Results:
Three aspects were assessed – primary variables, secondary variables, and correlation analyses. Results showed an improvement in PT in (1) Adult/Child Interaction Fidelity Rating (P < 0.01) and (2) adaptability of Gesell Developmental Scale and stereotyped behaviors and limited interests of Autism Diagnostic Observation Schedule (P < 0.05, P < 0.01). Moreover, a negative correlation occurred between caregiver skill improvement and parent education (P < 0.05), but without correlations with other demographics.
Conclusions:
As an efficacious family intervention for both children and their caregivers, CMI is worth being generalized widely.
Despite increasing knowledge on the neuroimaging patterns of eating disorder (ED) symptoms in non-clinical populations, studies using whole-brain machine learning to identify connectome-based neuromarkers of ED symptomatology are absent. This study examined the association of connectivity within and between large-scale functional networks with specific symptomatic behaviors and cognitions using connectome-based predictive modeling (CPM).
Methods
CPM with ten-fold cross-validation was carried out to probe functional networks that were predictive of ED-associated symptomatology, including body image concerns, binge eating, and compensatory behaviors, within the discovery sample of 660 participants. The predictive ability of the identified networks was validated using an independent sample of 821 participants.
Results
The connectivity predictive of body image concerns was identified within and between networks implicated in cognitive control (frontoparietal and medial frontal), reward sensitivity (subcortical), and visual perception (visual). Crucially, the set of connections in the positive network related to body image concerns identified in one sample was generalized to predict body image concerns in an independent sample, suggesting the replicability of this effect.
Conclusions
These findings point to the feasibility of using the functional connectome to predict ED symptomatology in the general population and provide the first evidence that functional interplay among distributed networks predicts body shape/weight concerns.
The relationship of a diet low in fibre with mortality has not been evaluated. This study aims to assess the burden of non-communicable chronic diseases (NCD) attributable to a diet low in fibre globally from 1990 to 2019.
Design:
All data were from the Global Burden of Disease (GBD) Study 2019, in which the mortality, disability-adjusted life-years (DALY) and years lived with disability (YLD) were estimated with Bayesian geospatial regression using data at global, regional and country level acquired from an extensively systematic review.
Setting:
All data sourced from the GBD Study 2019.
Participants:
All age groups for both sexes.
Results:
The age-standardised mortality rates (ASMR) declined in most GBD regions; however, in Southern sub-Saharan Africa, the ASMR increased from 4·07 (95 % uncertainty interval (UI) (2·08, 6·34)) to 4·60 (95 % UI (2·59, 6·90)), and in Central sub-Saharan Africa, the ASMR increased from 7·46 (95 % UI (3·64, 11·90)) to 9·34 (95 % UI (4·69, 15·25)). Uptrends were observed in the age-standardised YLD rates attributable to a diet low in fibre in a number of GBD regions. The burden caused by diabetes mellitus increased in Central Asia, Southern sub-Saharan Africa and Eastern Europe.
Conclusions:
The burdens of disease attributable to a diet low in fibre in Southern sub-Saharan Africa and Central sub-Saharan Africa and the age-standardised YLD rates in a number of GBD regions increased from 1990 to 2019. Therefore, greater efforts are needed to reduce the disease burden caused by a diet low in fibre.
Our research question was to evaluate the chromosome concordance of trophectoderm (TE) biopsy with noninvasive chromosome screening (NICS) using embryo culture medium renewed twice on Day 3 (D3) and Day 4 (D4). In this study, we evaluated 64 cycles with 223 biopsied blastocysts. These were categorized into two groups based on replacing embryo culture medium on D3 (control group) or on D3 and D4 (experimental group). The fundamental characteristics and main outcomes were compared. The concordance rates of NICS results with TE biopsy were determined according to next generation sequencing results. In total, 103 experimental and 120 control embryo cultures were collected, and the euploid status was analyzed using NICS technology. The overall concordance rates with TE biopsy of the experimental and control groups were 0.86 and 0.75, respectively. Statistically significant difference was found between the two groups. An additional medium renewal of the D4 embryo culture can improve the concordance of NICS with TE biopsy.
To investigate the association between folate levels and the risk of gestational diabetes mellitus (GDM) risk during the whole pregnancy.
Design:
In this retrospective cohort study of pregnant women, serum folate levels were measured before 24 gestational weeks (GW). GDM was diagnosed between 24th and 28th GW based on the criteria of the International Association of Diabetes and Pregnancy Study Groups. General linear models were performed to examine the association of serum folate with plasma glucose (i.e. linear regressions) and risk of GDM (i.e. log-binomial regressions) after controlling for confounders. Restricted cubic spline regression was conducted to test the dosage–response relationship between serum folate and the risk of GDM.
Setting:
A sigle, urban hospital in Shanghai, China.
Participants:
A total of 42 478 women who received antenatal care from April 2013 to March 2017 were included.
Results:
Consistent positive associations were observed between serum folate and plasma glucose levels (fasting, 1-h, 2-h). The adjusted relative risks (RR) and 95 % CI of GDM across serum folate quartiles were 1·00 (reference), 1·15 (95 % CI (1·04, 1·26)), 1·40 (95 % CI (1·27, 1·54)) and 1·54 (95 % CI (1·40, 1·69)), respectively (P-for-trend < 0·001). The positive association between serum folate and GDM remained when stratified by vitamin B12 (adequate v. deficient groups) and the GW of serum folate measurement (≤13 GW v. >13 GWs)
Conclusions:
The findings of this study may provide important evidence for the public health and clinical guidelines of pregnancy folate supplementation in terms of GDM prevention.
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.
Some parasitic plants are major pests in agriculture, but how this might be affected by climate change remains largely unknown. In this study, we assessed this question for five generalist holoparasitic Cuscuta species (smoothseed alfalfa dodder [Cuscuta approximata Bab.], alfalfa dodder [Cuscuta europaea L.], soybean dodder [Cuscuta chinensis C. Wright], Peruvian dodder [Cuscuta australis R. Br.], and Japanese dodder [Cuscuta japonica Choisy]) and two of their main Leguminosae host crop species (soybean [Glycine max (L.) Merr.] and alfalfa [Medicago sativa L.]. For each of the five Cuscuta species and the two crop species, we ran MaxEnt models, using climatic and soil variables to predict their potential current distributions and potential future distributions for 2070. We ran species distribution models for all seven species for multiple climate change scenarios, and tested for changes in the overlap of suitable ranges of each crop with the five parasites. We found that annual mean temperature and isothermality are the main bioclimatic factors determining the suitable habitats of the Cuscuta species and their hosts. For both host species, the marginally to optimally suitable area will increase by 2070 for all four representative concentration pathway scenarios. For most of the Cuscuta species, the marginally to optimally suitable area will also increase. While the suitable areas for both the hosts and the parasites will increase overall, Schoener’s D, indicating the relative overlap in suitable area, will change only marginally. However, the absolute area of potential niche overlap may increase up to 6-fold by 2070. Overall, our results indicate that larger parts of the globe will become suitable for both host species, but that they could also suffer from Cuscuta parasitism in larger parts of their suitable ranges.
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.
Pharmacological treatment of major depressive disorder is often inefficient, and multiple strategies are used for inadequate response to antidepressants. Second-generation antipsychotics are used as augmentation measures in clinical practice; evidence of their efficacy and acceptability is insufficient, and it remains confusing as to which drug should be selected first. In this systematic review and network meta-analysis, we included randomised controlled trials of second-generation antipsychotics used as adjunctive treatment in patients with suboptimal responses. Outcome measures were efficacy (response and remission) and acceptability (dropout due to any reason and adverse events). Thirty-three trials comprising 10 602 participants were included. Regarding efficacy, response rates indicated that all antipsychotics except for ziprasidone were more efficacious than the placebo, with the odds ratios (ORs) ranging from 1.34 for olanzapine and cariprazine [95% credible interval (CrI) 1.04–1.73 and 1.07–1.67, respectively] to 2.17 for risperidone (95% CrI 1.38–3.42). When considering remission, cariprazine was not effective (OR 1.21, 95% CrI 0.96–1.54). For acceptability, quetiapine (OR 0.68, 95% CrI 0.50–0.91), brexpiprazole (OR 0.69, 95% CrI 0.55–0.86), and cariprazine (OR 0.61, 95% CrI 0.46–0.82) were worse than the placebo. With regards to tolerability, only olanzapine (OR 0.51, 95% CrI 0.25–1.07) and risperidone (OR 0.48, 95% CrI 0.10–2.21) showed no significant differences compared with placebo. The administration of adjunctive antipsychotics is associated with high effectiveness and low acceptability. Risperidone and aripiprazole are more efficacious and accepted than other atypical antipsychotics.
To investigate the correlation between ventricular pre-excitation-related dyssynchrony, on cardiac dysfunction, and recovery.
Methods and Results:
This study included 76 children (39 boys and 37 girls) with a median age of 5.25 (2.67–10.75) years. The patients with pre-excitation-related cardiac dysfunction (cardiac dysfunction group, n = 34) had a longer standard deviation of the time-to-peak systolic strain of the left ventricle and larger difference between the maximum and minimum times-to-peak systolic strain than those with a normal cardiac function (normal function group, n = 42) (51.77 ± 24.70 ms versus 33.29 ± 9.48 ms, p < 0.05; 185.82 ± 92.51 ms versus 111.93 ± 34.27 ms, p < 0.05, respectively). The cardiac dysfunction group had a maximum time-to-peak systolic strain at the basal segments of the anterior and posterior septa and the normal function group at the basal segments of anterolateral and posterolateral walls. The prevalence of ventricular septal dyssynchrony in the cardiac dysfunction group was significantly higher than that in the normal function group (94.1% (32/34) versus 7.7% (3/42), p < 0.05). The patients with ventricular septal dyssynchrony (n = 35) had a significantly higher prevalence of intra-left ventricular systolic dyssynchrony than those with ventricular septal synchrony (n = 41) (57.1% (20/35) versus 14.6% (6/41), p < 0.05). During follow-up after pathway ablation, the patients who recovered from intra-left ventricular dyssynchrony (n = 29) had a shorter left ventricular ejection fraction recovery time than those who did not (n = 5) (χ2 = 5.94, p < 0.05). Among the patients who recovered, 93.1% (27/29) had a normalised standard deviation of the time-to-peak systolic strain and difference between the maximum and minimum times-to-peak systolic strain within 1 month after ablation.
Conclusion:
Ventricular pre-excitation may cause ventricular septal dyssynchrony; thus, attention must be paid to intra-left ventricular dyssynchrony and cardiac dysfunction. Whether intra-left ventricular systolic dyssynchrony can resolve within 1 month may be a new early predictor of patient prognosis.
The fish-eye star sensor with a field of view (FOV) of 180° is an important piece of equipment for attitude determination, which improves the visibility of stars significantly. However, it also brings the star identification (star-ID) difficulties because of imprecise calibrations. Thus, a fish-eye star-ID algorithm supported by the integration of the precise point positioning/inertial navigation system (PPP/INS) is proposed. At first, a reference star map is generated in combination with the distortion model of the fish-eye camera based on the position and attitude information from the PPP/INS. Then the star points are extracted in a specific neighbourhood of the reference star points. Subsequently, the extracted star points are individually tested and identified according to angular distance error. Finally, the real-time precise attitude is determined based on the star-ID results. Experimental results show that, 270–310 stars can be identified in a fish-eye star map with an average time of 0.03 s if the initial attitude error is smaller than 1.5° and an attitude determination accuracy better than 10″ can be achieved by support from PPP/INS.