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Do US Circuit Courts' decisions on criminal appeals influence sentence lengths imposed by US District Courts? This Element explores the use of high-dimensional instrumental variables to estimate this causal relationship. Using judge characteristics as instruments, this Element implements two-stage models on court sentencing data for the years 1991 through 2013. This Element finds that Democratic, Jewish judges tend to favor criminal defendants, while Catholic judges tend to rule against them. This Element also finds from experiments that prosecutors backlash to Circuit Court rulings while District Court judges comply. Methodologically, this Element demonstrates the applicability of deep instrumental variables to legal data.
The linguistic study of Chinese, with its rich morphological, syntactic and prosodic/tonal structures, its complex writing system, and its diverse socio-historical background, is already a long-established and vast research area. With contributions from internationally renowned experts in the field, this Handbook provides a state-of-the-art survey of the central issues in Chinese linguistics. Chapters are divided into four thematic areas: writing systems and the neuro-cognitive processing of Chinese, morpho-lexical structures, phonetic and phonological characteristics, and issues in syntax, semantics, pragmatics, and discourse. By following a context-driven approach, it shows how theoretical issues in Chinese linguistics can be resolved with empirical evidence and argumentation, and provides a range of different perspectives. Its dialectical design sets a state-of-the-art benchmark for research in a wide range of interdisciplinary and cross-lingual studies involving the Chinese language. It is an essential resource for students and researchers wishing to explore the fascinating field of Chinese linguistics.
Neither war nor preparations for war were the cause or effect of state formation in East Asia. Instead, emulation of China—the hegemon with a civilizational influence—drove the rapid formation of centralized, bureaucratically administered, territorial governments in Korea, Japan, and Vietnam. Furthermore, these countries engaged in state-building not to engage in conflict or to suppress revolt. In fact, war was relatively rare and there was no balance of power system with regular existential threats—the longevity of the East Asian dynasties is evidence of both the peacefulness of their neighborhood and their internal stability. We challenge the assumption that the European experience with war and state-making was universal. More importantly, we broaden the scope of state formation in East Asia beyond the study of China itself and show how countries in the region interacted and learned from each other and China to develop strong capacities and stable borders.
Glutamatergic dysfunction has been implicated in sensory integration deficits in schizophrenia, yet how glutamatergic function contributes to behavioural impairments and neural activities of sensory integration remains unknown.
Methods
Fifty schizophrenia patients and 43 healthy controls completed behavioural assessments for sensory integration and underwent magnetic resonance spectroscopy (MRS) for measuring the anterior cingulate cortex (ACC) glutamate levels. The correlation between glutamate levels and behavioural sensory integration deficits was examined in each group. A subsample of 20 pairs of patients and controls further completed an audiovisual sensory integration functional magnetic resonance imaging (fMRI) task. Blood Oxygenation Level Dependent (BOLD) activation and task-dependent functional connectivity (FC) were assessed based on fMRI data. Full factorial analyses were performed to examine the Group-by-Glutamate Level interaction effects on fMRI measurements (group differences in correlation between glutamate levels and fMRI measurements) and the correlation between glutamate levels and fMRI measurements within each group.
Results
We found that schizophrenia patients exhibited impaired sensory integration which was positively correlated with ACC glutamate levels. Multimodal analyses showed significantly Group-by-Glutamate Level interaction effects on BOLD activation as well as task-dependent FC in a ‘cortico-subcortical-cortical’ network (including medial frontal gyrus, precuneus, ACC, middle cingulate gyrus, thalamus and caudate) with positive correlations in patients and negative in controls.
Conclusions
Our findings indicate that ACC glutamate influences neural activities in a large-scale network during sensory integration, but the effects have opposite directionality between schizophrenia patients and healthy people. This implicates the crucial role of glutamatergic system in sensory integration processing in schizophrenia.
Patients with terminal cancer often experience physical and mental distress. Signing a do-not-resuscitate order (DNR) is crucial to protect against invalid treatment. This study aims to explore the effect of hospice shared care intervention by medical staff on the completion of a DNR-S (DNR order signed by surrogates) for patients with terminal cancer.
Method
The cross-sectional study in this research involved secondary analysis of data from the 2011–2015 clinical cancer case management database of a medical center in central Taiwan. Those with a DNR order signed by patients (DNR-P) or DNR-S before the hospice shared care consultation were excluded from this study; a total of 1,306 patients with terminal cancer were selected.
Results
This study demonstrated that the percentage of DNR-S after consultation involving both nurse and physician was 75.4%. With other variables controlled, the number of DNR-Ss after consultation with a nurse was significantly lower [odds ratio (OR) = 0.57, 95% confidence interval (CI) = 0.42–0.75] and that of DNR-Ss after consultation involving both nurse and physician was significantly higher (OR = 1.35, 95% CI = 1.01–1.79), than that of DNR-Ss after consultation with only the physician.
Significance of results
Joint involvement of the nurse and physician in hospice care provides sufficient information to patients and family with terminal cancer about their condition and enhances doctor–patient communication. This effectively assists patients with terminal cancer and their family members in making the major decision of signing a DNR, alleviates the concerns of patients and family members about signing a DNR, and reduces terminal cancer patients’ pain at the end of life to ensure that they die in peace and dignity.
The selection of high-quality sperms is critical to intracytoplasmic sperm injection, which accounts for 70–80% of in vitro fertilization (IVF) treatments. So far, sperm screening is usually performed manually by clinicians. However, the performance of manual screening is limited in its objectivity, consistency, and efficiency. To overcome these limitations, we have developed a fast and noninvasive three-stage method to characterize morphology of freely swimming human sperms in bright-field microscopy images using deep learning models. Specifically, we use an object detection model to identify sperm heads, a classification model to select in-focus images, and a segmentation model to extract geometry of sperm heads and vacuoles. The models achieve an F1-score of 0.951 in sperm head detection, a z-position estimation error within ±1.5 μm in in-focus image selection, and a Dice score of 0.948 in sperm head segmentation, respectively. Customized lightweight architectures are used for the models to achieve real-time analysis of 200 frames per second. Comprehensive morphological parameters are calculated from sperm head geometry extracted by image segmentation. Overall, our method provides a reliable and efficient tool to assist clinicians in selecting high-quality sperms for successful IVF. It also demonstrates the effectiveness of deep learning in real-time analysis of live bright-field microscopy images.
Ahsan, Sinha, and Srinivasan (2020) studied the motives of knowledge-intensive Indian firms’ international expansion based on resource-based considerations and the locational advantages offered by host countries. They identified firm characteristics associated with strategic asset-seeking, opportunity-seeking, and market-seeking motives. In this replication study, we examine Ahsan et al.'s (2020) model in the Chinese context. Based on our improved empirical model, our findings reveal some similarities but more importantly some key differences in the antecedents of internationalization motives between Indian and Chinese firms. Drawing on insights from prior studies, we propose that these differences can be attributed to differences in absorptive capacity, international expansion scales and patterns, ownership type, and the home institutional contexts in which Indian and Chinese firms operate. Overall, this replication study demonstrates the importance of contextualizing international business research.
The horse played a crucial role in China through the first millennium BC, used both for military advantage and, through incorporation into elite burials, to express social status. Details of how horses were integrated into mortuary contexts during the Qin Empire, however, are poorly understood. Here, the authors present new zooarchaeological data for 24 horses from an accessory pit in Qin Shihuang's mausoleum, indicating that the horses chosen were tall, adult males. These findings provide insights into the selection criteria for animals to be included in the emperor's tomb and invite consideration of questions concerning horse breeds, husbandry practices, and the military and symbolic importance of horses in early imperial China.
The RCPsych Standards for Early Intervention in Psychosis Services documents Gold Standard treatment, including: every service-user with psychosis is offered antipsychotic medication; if their illness does not respond to therapeutic dose of 2 different antipsychotics, they are offered clozapine. The Southwark Team for Early Psychosis (‘STEP’) in the South London and Maudsley Trust (SLaM) treats adults in their first 3 years of psychosis diagnoses. We aimed to compare prescribing practice in STEP to RCPsych Standards.
Methods
STEP's caseload of 296 individuals was reviewed on 7th June 2021. Those excluded: inpatients/under Home Treatment Team; not yet assessed. Final number of outpatients assessed = 269. Data gathered: 1) Taking an AP? If taking an AP, the name and dose of AP. If not taking, trial discontinuation with medical advice or unsupervised refusal? 2) Remission status 3) Total number of AP trials. Uncertainties in categorisation were reviewed by the 2 other contributors.
Results
In 269 outpatients on 7/6/21, 186(69%) were taking an antipsychotic (167:19 oral:depot), with a further 62(23%) recommended but declining. 21(8%) were not recommended, following change in diagnosis or resolution of psychotic symptoms.
7 service-users had down-titrated off AP with medical collaboration. All but 1 remained in remission. 35/47(74%) who discontinued AP independently had relapsed.
172 patients were reliably taking antipsychotic medication as prescribed. 56(32.5%) had ongoing psychotic symptoms (ranging from non-preoccupying residual delusions to distressing delusions/hallucinations). 4 symptomatic service-users were prescribed lower than BNF minimum effective doses.
Of those symptomatic and on hypothetically therapeutic doses (n = 52; median% of BNF Maximum Dose 50%; mean 54%), 26 were on their 1st AP, 26 on or beyond their 2nd AP. 8 service-users had ever trialled clozapine.
Conclusion
Even in an experienced EI team for a highly psychiatrically morbid population, there remain gaps between best practice and actual prescribing.
Close to 1/3 of patients taking their prescription weren't in remission, almost all of whom had room to increase doses or trial an alternative medication. Clozapine is under-utilised in the treatment resistant group. For those who stopped AP, supervised tapering is a reasonable treatment option.
The next steps will be run as a quality improvement project addressing MDT and service-user barriers to assertive medication management:
– Encourage efficient up-titration and frequent MDT review of AP efficacy (empowering service-users self-management, care-coordinator opportunistic mental state assessments to trigger dose increase, medical review frequency)
– Identify and refer service-users suitable for clozapine
To describe the genomic analysis and epidemiologic response related to a slow and prolonged methicillin-resistant Staphylococcus aureus (MRSA) outbreak.
Design:
Prospective observational study.
Setting:
Neonatal intensive care unit (NICU).
Methods:
We conducted an epidemiologic investigation of a NICU MRSA outbreak involving serial baby and staff screening to identify opportunities for decolonization. Whole-genome sequencing was performed on MRSA isolates.
Results:
A NICU with excellent hand hygiene compliance and longstanding minimal healthcare-associated infections experienced an MRSA outbreak involving 15 babies and 6 healthcare personnel (HCP). In total, 12 cases occurred slowly over a 1-year period (mean, 30.7 days apart) followed by 3 additional cases 7 months later. Multiple progressive infection prevention interventions were implemented, including contact precautions and cohorting of MRSA-positive babies, hand hygiene observers, enhanced environmental cleaning, screening of babies and staff, and decolonization of carriers. Only decolonization of HCP found to be persistent carriers of MRSA was successful in stopping transmission and ending the outbreak. Genomic analyses identified bidirectional transmission between babies and HCP during the outbreak.
Conclusions:
In comparison to fast outbreaks, outbreaks that are “slow and sustained” may be more common to units with strong existing infection prevention practices such that a series of breaches have to align to result in a case. We identified a slow outbreak that persisted among staff and babies and was only stopped by identifying and decolonizing persistent MRSA carriage among staff. A repeated decolonization regimen was successful in allowing previously persistent carriers to safely continue work duties.
This study details the results of an experimental intervention designed to address the issue of price anchoring in the choice experiment framework. The intervention, which informs respondents of the tendency to anchor choices on potentially arbitrary pieces of information, is applied to a choice experiment used to examine consumers’ willingness to pay for local and/or organic tomatoes in Northern New England and develops three primary contributions. First, evidence from this study shows that anchoring effects are present. Second, providing information to consumers plays a mitigating role on these effects; price anchoring changes willing to pay estimates between 44% and 51% and exposure to anchoring-specific cheap talk is associated with a reduction in these anchoring effects between 60% and 80%. These results are explained through decreases in price sensitivity induced by increasing the mean price vector and subsequent increases in price sensitivity due to the information intervention. Finally, this study reveals that consumers are willing to pay a substantial price premium for locally grown tomatoes, from $0.96 to $1.12 per pound, offering some guidance for policy regarding growing practice and farm land use as regional coalitions support local agriculture expansion in the Northeast.
Se is an indispensable trace element for the human body, and telomere length is considered a marker of biological ageing. Previous studies have shown that dietary Se intake is associated with telomere length. However, the relationship between Se intake and telomere length in patients with diabetes has not been well studied. Therefore, this study aimed to investigate the relationship between dietary Se intake and telomere length in patients with diabetes. We extracted 878 participants with diabetes from the National Health and Nutrition Examination Survey database for 1990–2002. Dietary Se intake was assessed using the 24 h dietary recall method, and telomere length was measured using quantitative PCR. Generalised linear models were constructed to assess the relationship between dietary Se intake and telomere length. After controlling for the confounders, 1 μg increase in dietary Se intake in female patients with diabetes, and telomere length increased by 1·84 base pairs (β = 1·84 (95 % CI: 0·15, 3·53)), there was a line relationship between dietary Se intake and telomere length in female patients with diabetes and telomere length increased with increasing dietary Se intake within the range of 0–250 μg. The study demonstrates that dietary Se intake is significantly associated with telomere length only in the female population with diabetes in the USA. However, further prospective studies are required to confirm this finding.
Let n and k be positive integers with
$n\ge k+1$
and let
$\{a_i\}_{i=1}^n$
be a strictly increasing sequence of positive integers. Let
$S_{n, k}:=\sum _{i=1}^{n-k} {1}/{\mathrm {lcm}(a_{i},a_{i+k})}$
. In 1978, Borwein [‘A sum of reciprocals of least common multiples’, Canad. Math. Bull.20 (1978), 117–118] confirmed a conjecture of Erdős by showing that
$S_{n,1}\le 1-{1}/{2^{n-1}}$
. Hong [‘A sharp upper bound for the sum of reciprocals of least common multiples’, Acta Math. Hungar.160 (2020), 360–375] improved Borwein’s upper bound to
$S_{n,1}\le {a_{1}}^{-1}(1-{1}/{2^{n-1}})$
and derived optimal upper bounds for
$S_{n,2}$
and
$S_{n,3}$
. In this paper, we present a sharp upper bound for
$S_{n,4}$
and characterise the sequences
$\{a_i\}_{i=1}^n$
for which the upper bound is attained.
This 62-d research aimed to evaluate the effects of dietary lysine levels (DLL) and salinity on growth performance and nutrition metabolism of genetically improved farmed tilapia (GIFT) juveniles (Oreochromis niloticus). Six diets with lysine supplementation (1·34, 1·70, 2·03, 2·41, 2·72 and 3·04 % of DM) were formulated under different cultured salinities in a two-factorial design. The results indicated that supplemental lysine improved the specific growth rate (SGR) and weight gain (WG) and decreased the feed conversion ratio (FCR). Meanwhile, the fish had higher SGR and WG and lower FCR at 8 ‰ salinity. Except for moisture, the whole-body protein, lipid and ash content of GIFT were increased by 8 ‰ salinity, which showed that DLL (1·34 %) increased the whole-body fat content and DLL (2·41 %) increased whole-body protein content. Appropriate DLL up-regulated mRNA levels of protein metabolism-related genes such as target of rapamycin, 4EBP-1 and S6 kinase 1. However, 0 ‰ salinity reduced these protein metabolism-related genes mRNA levels, while proper DLL could improve glycolysis and gluconeogenesis mRNA levels but decrease lipogenesis-related genes mRNA levels in liver. 0 ‰ salinity improved GLUT2, glucokinase and G6 Pase mRNA levels; however, sterol regulatory element-binding protein 1 and fatty acid synthase mRNA levels were higher at 8 ‰ salinity. Moreover, 8 ‰ salinity also increased plasma total protein and cholesterol levels and decreased glucose levels. These results indicated that the recommended range of lysine requirement under different salinity was 2·03–2·20 % (0 ‰) and 2·20–2·41 % (8 ‰) and 8 ‰ salinity resulted in higher lysine requirements due to changes in the related nutrient metabolism, which might provide useful information for designing more effective feed formulations for GIFT cultured in different salinity environment.
We report direct numerical simulations (DNS) of the Nusselt number $Nu$, the vertical profiles of mean temperature $\varTheta (z)$ and temperature variance $\varOmega (z)$ across the thermal boundary layer (BL) in closed turbulent Rayleigh–Bénard convection (RBC) with slippery conducting surfaces ($z$ is the vertical distance from the bottom surface). The DNS study was conducted in three RBC samples: a three-dimensional cuboid with length $L = H$ and width $W = H/4$ ($H$ is the sample height), and two-dimensional rectangles with aspect ratios $\varGamma \equiv L/H = 1$ and $10$. The slip length $b$ for top and bottom plates varied from $0$ to $\infty$. The Rayleigh numbers $Ra$ were in the range $10^{6} \leqslant Ra \leqslant 10^{10}$ and the Prandtl number $Pr$ was fixed at $4.3$. As $b$ increases, the normalised $Nu/Nu_0$ ($Nu_0$ is the global heat transport for $b = 0$) from the three samples for different $Ra$ and $\varGamma$ can be well described by the same function $Nu/Nu_0 = N_0 \tanh (b/\lambda _0) + 1$, with $N_0 = 0.8 \pm 0.03$. Here $\lambda _0 \equiv L/(2Nu_0)$ is the thermal boundary layer thickness for $b = 0$. Considering the BL fluctuations for $Pr>1$, one can derive solutions of temperature profiles $\varTheta (z)$ and $\varOmega (z)$ near the thermal BL for $b \geqslant 0$. When $b=0$, the solutions are equivalent to those reported by Shishkina et al. (Phys. Rev. Lett., vol. 114, 2015, 114302) and Wang et al. (Phys. Rev. Fluids, vol. 1, 2016, 082301(R)), respectively, for no-slip plates. For $b > 0$, the derived solutions are in excellent agreement with our DNS data for slippery plates.