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This study aimed to determine the ideal pacing site in children by comparing the postoperative ventricular synchrony in children with left bundle branch area pacing and those with right ventricular septal pacing.
Methods:
This retrospective study included children with complete atrioventricular block who underwent permanent pacemaker implantation from March 2019 to August 2021. Patients were grouped according to their ventricular pacing site, the left bundle branch area pacing group and the right ventricular septal pacing group. Two-dimensional speckle tracking echocardiography was used to evaluate the ventricular synchrony.
Results:
Forty-eight children (median age, 2.7 years; interquartile range, 1.7–4.6 years) were included. The paced QRS duration in the left bundle branch area pacing group was significantly narrower than that in the right ventricular septal pacing group (100.2 ± 9.3 versus 115.4 ± 15.1 ms, p = 0.001). The median follow-up duration was 1.5 years (interquartile range, 1–2 years). At the last follow-up, the average capture threshold of the ventricular electrode in the left bundle branch area pacing group was lower than that in the right ventricular septal pacing group (0.79 ± 0.18 versus 1.20 ± 0.56 V, p = 0.008). The left ventricular intraventricular synchrony parameters in the left bundle branch area pacing group were better than those in the right ventricular septal pacing group (e.g. standard deviation of the time to peak longitudinal strain, 37.4 ± 4.3 versus 46.6 ± 8.2 ms, p = 0.000). The average interventricular mechanical delay time in the left bundle branch area pacing group was significantly shorter than that in the right ventricular septal pacing group (36.4 ± 14.2 versus 52.5 ± 22.7 ms, p = 0.016).
Conclusion:
Compared with right ventricular septal pacing, left bundle branch area pacing in children produces a narrower QRS duration and better pacing and ventricular synchrony parameters postoperatively.
For the omnivorous Cherax quadricarinatus crayfish, plant raw materials can be good alternatives to dietary fish meal (FM). A 56-d feeding trial was conducted in C. quadricarinatus (11·70 (se 0·13) g). Diet with 100 % FM as the protein source was the control. Seven experimental diets were formulated by replacing 75 or 100 % of FM with soyabean meal (SM75, SM100) or cottonseed meal (CM75 and CM100), and a mixture of SM and CM (protein content is 1:1) replacing 50, 75 or 100 % of FM (SC50, SC75 and SC100). Crayfish fed the CM100 and SC100 showed significantly lower weight gain (WG), specific growth rate, trypsin and pepsin activities compared with the control diet. Crayfish in CM100 group showed significantly higher GPx, alanine aminotransferase, aspartate aminotransferase activities and malondialdehyde content than the control. SM100 and CM100 diets can cause slight separation of the peritrophic membrane from the intestinal folds. The pepsin activity of crayfish in SC50 was significantly higher than those in other experimental diets. The highest WG and muscle arginine content were also found in crayfish fed SC50. The relative abundance of Proteobacteria, Unclassified Enterobacteriaceae and Candidatus Bacilloplasma was significantly higher, but Actinobacteriota was significantly lower in SM100, CM100 and SC100 than in control. Microbiota functional prediction indicated that the relative abundance of ‘cell motility’ pathway in crayfish fed CM100 was significantly decreased compared with the control. In conclusion, only half of the FM can be effectively substituted with a mixture of SM and CM (protein content is 1:1) for C. quadricarinatus.
Understanding the statistics of bedload particle motions is of great importance. To model the hop events which are defined as trajectories of particles moving successively from the start to the end of their motions, recently, Wu et al. (Water Resour. Res., vol. 56, 2020, p. e2019WR025116) have successfully performed individual-based simulations according to the Fokker–Planck equation for particle velocities. However, analytical solutions are still not available due to (i) difficulties in treating the velocity-dependent diffusivity, and (ii) a knowledge gap in incorporating the termination of particle motions for the equation. To tackle the above-mentioned challenges, we first specify a Robin boundary condition representing the deposition of particles. Second, for analytical solutions of hop statistics, a variable transformation is devised to deal with the velocity-dependent diffusivity. The original bedload transport problem is thus found to be governed by the classic equation for the solute transport in tube flows with a constant diffusivity after the transformation. Finally, through solving the spatial and temporal moments of the governing equation, we investigate the influence of the deposition rate on three key characteristics of particle hops. Importantly, we have related the deposition rate to the mean travel times and hop distances, enabling a direct determination of this physical parameter based on measured particle motion statistics. The analytical solutions are validated by experimental observations with different bedload particle diameters and transport conditions. Based on the limited experimental datasets, the deposition frequency is shown to decrease as the shear stress increases when the flow rate is not small.
Everyone faces uncertainty on a daily basis. Two kinds of probability expressions, verbal and numerical, have been used to characterize the uncertainty that we face. Because our cognitive concept of living things differs from that of non-living things, and distinguishing cognitive concepts might have linguistic markers, we designed four studies to test whether people use different probability expressions when faced with animate or inanimate uncertainty. We found that verbal probability is the preferred way to express animate uncertainty, whereas numerical probability is the preferred way to express inanimate uncertainty. The “verbal-animate” and “numerical-inanimate” associations were robust enough to persist when tested with forced-choice response patterns regardless of the information (e.g., equally likely outcomes, frequencies, or personal beliefs) used to construct probabilities of events. When the response pattern was changed to free-responses, the associations were evident unless the subjects were asked to write their own probability predictions for vague uncertainty. Given that the world around us consists of both animate (i.e., living) and inanimate (i.e., non-living) things, “verbal-animate” and “numerical-inanimate” associations may play a major role in risk communication and may otherwise be useful for practitioners and consultants.
According to the positive time-discounting assumption of intertemporal decision-making, people prefer to undergo negative events in the future rather than in the present. However, negative discounting has been identified in the intertemporal choice and loss domains, which refers to people’s preference to experience negative events earlier rather than later. Studies have validated and supported the "anticipated dread" as an explanation for negative discounting. This study again explored the effect of anticipated dread on intertemporal choice using content analysis; that is, having participants identify anticipated dread among reasons for negative discounting. This study also validated the effect of anticipated dread on negative discounting by manipulating anticipated dread. This study adds empirical and direct evidence for the role of anticipated dread in negative discounting.
Intertemporal choices involve tradeoffs between outcomes that occur at different times. Most of the research has used pure gains tasks and the discount rates yielding from those tasks to explain and predict real-world behaviors and consequences. However, real decisions are often more complex and involve mixed outcomes (e.g., sooner-gain and later-loss or sooner-loss and later-gain). No study has used mixed gain-loss intertemporal tradeoff tasks to explain and predict real-world behaviors and consequences, and studies involving such tasks are also scarce. Considering that tasks involving a combination of gains and losses may yield different discount rates and that existing pure gains tasks do not explain or predict real-world outcomes well, this study conducted two experiments to compare the discount rates of mixed gain-loss intertemporal tradeoffs with those of pure gains or pure losses (Experiment 1) and to examine whether these tasks predicted different real-world behaviors and consequences (Experiment 2). Experiment 1 suggests that the discount rate ordering of the four tasks was, from highest to lowest, pure gains, sooner-loss and later-gain, pure losses, and sooner-gain and later-loss. Experiment 2 indicates that the evidence supporting the claim that the discount rates of the four tasks were related to different real-world behaviors and consequences was insufficient.
In “The value of nothing: asymmetric attention to opportunity costs drives intertemporal decision making” Read, Olivola and Hardisty (2017) proposed an asymmetric subjective opportunity cost (ASOC) effect to explain and predict why impatience can be detected in intertemporal choice. This work deserves to be replicated and extended for its novel and potentially important findings. The present study aimed to examine the reliability and robustness of the evidence presented by Read et al. by conducting precise replications of their key findings in Study 1. The ASOC effect (Read, et al., 2017) was important for expanding its application and reported to be typically stronger when baseline larger-but-later option (LL) and smaller-but-sooner option (SS) preferences were closer to 50% in the authors’ original condition. Therefore, the present study also aimed to replicate and test the ASOC effect when baseline LL preferences were higher or lower than those in the original condition. We intended to set two additional conditions wherein either LL or SS is more obviously favored (i.e., baseline LL preferences were higher or lower than those in the original condition) by respectively applying the common difference effect (Kirby & Herrnstein, 1995) and the unit effect (Burson, Larrick & Lynch Jr., 2009; Pandelaere, Briers & Lembregts, 2011). Having successfully generated two more obviously favored conditions, the ASOC effect was replicated and confirmed under the original condition and one additional condition wherein SS was more obviously favored. However, the ASOC effect was not detected under the other additional condition wherein LL was more obviously favored. The implications of these findings were discussed.
According to the Healthy China 2030 Plan, children under 5 years is the main focus group to achieve universal health and sustainable development of China. To identify the major threats to children’s health, we analyzed and compared the burden of disease and risk factors among children under 5 years in China and other regions.
Methods
Indicators were gathered from the Global Burden of Disease 2019, which included the standardized rates and risk factors of mortality and DALYs of children under 5 years in China, Western Europe, North America and the world from 1990 to 2019. Paired t-test or Wilcoxon test were used to compare the rates based on gender. A joinpoint regression model was used to analyze the trend, and the Annual Percent of Change (APC) was calculated and statistically tested.
Results
From 1990 to 2019, the all-cause mortality and DALYs of children under 5 years in China decreased from 1 153.81/100 000 to 160.39/100 000 and 104 426.40/100 000 to 16 479.01/100 000, respectively. The top 3 causes of both death and DALYs were neonatal preterm birth, congenital heart anomalies, lower respiratory infections. The top 3 risk factors of both death and DALYs were low birth weight, short gestation, child wasting. Unintentional injuries, behavioral and environmental risks posed greater threats to children compared with other regions. The rates of mortality and DALYs of the top 15 diseases and injuries in boys and girls showed a downward trend (p<0.05), and most of them were higher in boys than girls (p<0.05).
Conclusions
The burden of diseases among children under 5 years in China has decreased significantly from 1990 to 2019. Compared to other regions, it remains to strengthen the prevention and control of preterm birth, birth defects and unintentional injuries, and to adopt targeted gender-specific interventions. Promoting the parenting behavior and multiple social security may also affects children’s health status.
In this work, theoretical modelling, quasi-three-dimensional (quasi-3D) simulations and micromodel experiments are conducted to study spontaneous imbibition with gravity in porous media micromodels. By establishing the force balance governing the spontaneous imbibition process, we develop a theoretical model for predicting the imbibition length against time in a rectangular capillary. The theoretical model is then extended to the prediction of a compact displacement process in a micromodel by using an equivalent width, which is derived by analogising the micromodel to a rectangular capillary. By simulating spontaneous imbibition in a rectangular capillary with various aspect ratios ($\varepsilon$), we show that the application condition of the quasi-3D method is $\varepsilon \leqslant 1/3$. Next, we simulate spontaneous imbibition in micromodels with various geometries and flow conditions. Fingering and compact displacement are identified for varying viscosity ratios and gravitational accelerations. At low (high) viscosity ratio of wetting to non-wetting fluids, an upward (downward) gravity can promote the stability of the wetting front, favouring the transition from fingering to compact displacement. In addition, we find that the depth-oriented interface curvature dominates the capillary effect during the imbibition, and such a mechanism is considered by introducing an equivalent contact angle into the theoretical model. With the help of equivalent width and contact angle, the theoretical model is shown to provide satisfactory prediction of the compact displacement process. Finally, a micromodel experiment is presented to further verify the developed theoretical model and the quasi-3D simulation.
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.
Multilayer dielectric gratings typically remove multiple-grating pillars after picosecond laser irradiation; however, the dynamic formation process of the removal is still unclear. In this study, the damage morphologies of multilayer dielectric gratings induced by an 8.6-ps laser pulse were closely examined. The damage included the removal of a single grating pillar and consecutive adjacent grating pillars and did not involve the destruction of the internal high-reflection mirror structure. Comparative analysis of the two damage morphological characteristics indicated the removal of adjacent pillars was related to an impact process caused by the eruption of localized materials from the left-hand pillar, exerting impact pressure on its adjacent pillars and eventually resulting in multiple pillar removal. A finite-element strain model was used to calculate the stress distribution of the grating after impact. According to the electric field distribution, the eruptive pressure of the dielectric materials after ionization was also simulated. The results suggest that the eruptive pressure resulted in a stress concentration at the root of the adjacent pillar that was sufficient to cause damage, corresponding to the experimental removal of the adjacent pillar from the root. This study provides further understanding of the laser-induced damage behavior of grating pillars and some insights into reducing the undesirable damage process for practical applications.
High-molecular-weight glutenin subunits (HMW-GS) contribute to dough elasticity and bread baking quality in wheat. In this study, wheat varieties were classified based on their HMW-GS composition into three groups: 1Dx5 (5 + 10, Gaoyou 8901, Xinmai 28, Xinmai 19, Xinmai 26 and Jinbaoyin), 1Dx2 (2 + 12, Zhoumai 24, Xinmai 9 and Yumai) and 1Dx4 (4 + 12, Aikang 58). Sequence analysis showed that 1Dx-GY8901, 1Dx-XM28, 1Dx-XM19 and 1Dx-XM26 were similar to the 1Dx5 gene and clustered on the same branch, while 1Dx-AK58, 1Dx-ZM24, 1Dx-JBY, 1Dx-YM, 1Dx-XM9 and 1Dx-JBY were more similar to the 1Dx2 gene and clustered on the same branch with 1Dx.2.2. There was a mutation of Ser to Cys at position S2, for an extra Cys in the repeat regions of 1Dx-XM19, 1Dx-XM26, 1Dx-XM28 and 1Dx-GY8901. The wheat HMW-GS genes exhibited similar percentages of α-helix, extended strand, β-turn and random coil structure, with ranges of 13.33–13.59, 4.77–5.78, 7.08–9.18 and 72.3–73.94%, respectively. Sequence conservation and the composition of HMW-GS subunits were also analysed for a series of strong gluten wheat varieties, Xinmai 9 (1, 7 + 8, 2 + 12), Xinmai 19 (1, 7 + 9, 5 + 10), Xinmai 26 (1, 7 + 8, 5 + 10) and Xinmai 28 (1, 7 + 9, 5 + 10). The results of this work should facilitate future breeding efforts and provide the theoretical basis for wheat quality improvement.
Benzodiazepine receptor agonists (BZRAs) are commonly used clinically and data on their hazardous use from large populations of psychiatric patients is limited.
Aims
To assess the current status of hazardous BZRA use and related factors in Chinese out-patient psychiatric settings.
Method
The study included out-patients with at least one BZRA prescription from five psychiatric settings in east, central and west China in 2018. Demographic and prescription information were extracted from the electronic prescription database. We defined the co-occurrence of overdose and long-term use as hazardous use, and patients whose recorded diagnoses did not meet any indications approved by the Chinese Food and Drug Administration as over-indication users. Additionally, 200 hazardous users were randomly selected for follow-up interview to confirm the actual situation.
Results
Among 720 054 out-patients, 164 450 (22.8%) had at least one BZRA prescription; 55.9% of patients were prescribed over-indication and 3% were defined as hazardous users. Multilevel multivariate regression analysis with hospital as a random effect showed that factors associated with hazardous use were older age (18–64 years: β = 0.018; 95% CI 0.013–0.023; >65 years: β = 0.015; 95% CI 0.010–0.021), male (β = 0.005, 95% CI 0.003–0.007), over-indication (β = 0.013, 95% CI 0.012–0.015), more out-patient visits (β = 0.006, 95% CI 0.006–0.006) and more visits to different doctors (β = 0.007, 95% CI 0.007–0.008); 98.5% of hazardous users (197/200) could not be contacted.
Conclusions
BZRAs are commonly used and there is a relatively large proportion of over-indication users among Chinese psychiatric out-patients. However, only a small proportion of hazardous users were detected. The study highlights how to use prescription data to support improvements in clinical practice.
COVID-19 has spread worldwide due to high infectivity. The social sexual environment in rural areas of China and the weak basic medical facilities, may affect the treatment and transmission of the disease. The aim of this study was to understand the knowledge, attitude and practice (KAP) related to COVID-19 among residents in rural areas experiencing the epidemic and the factors, to provide a basis for further epidemic prevention and control.
Methods:
The COVID-19 KAP of rural residents in Hebei Province was collected by the snowball sampling method. The COVID-19 KAP questionnaire was distributed on social platforms such as WeChat and QQ through a network questionnaire.
Results:
The overall level of COVID-19 KAP in rural residents was good, but in terms of knowledge, the correct rate of isolation was 73.2%, the correct rate of two disinfection items were 72.3% and 77.4%, and the correct rate about hand washing was 70.7%. 54.5% residents feel panic. 81.0% disinfected household items, and 84.9% washed hands correctly. Residents still needed to strengthen these aspects. Binary logistic analysis showed that age, education and whether to participated in training were factors affecting the level of COVID-19 KAP.
Conclusions:
This study found that rural residents had good levels of COVID-19 KAP, but there were gaps in specific issues that warrant attention. We advocate training on COVID-19 for rural residents.
In the treatment of infertile patients with non-obstructive azoospermia (NOA) caused by the deletion of the azoospermia factor c region (AZFc) on the Y chromosome, synchronous and asynchronous surgical strategies are discussed. Clinical data from NOA patients with the AZFc deletion who underwent micro-TESE were analyzed retrospectively. The sperm retrieval rate (SRR) and sperm utilization rate of synchronous and asynchronous operation groups were followed up and compared. The fertilization rate, high-quality embryo rate, clinical pregnancy rate, abortion rate, and cumulative live birth rate of ICSI in patients with successful sperm retrieval were compared between the two groups. The two groups had sperm utilization rates of 98.9% (93/94) and 50.0% (14/28), respectively. The asynchronous group’s sperm consumption rates were much lower than those of the synchronous operation group. Fertilization rate, high-quality embryo rate, clinical pregnancy rate of fresh transfer cycle, abortion rate, and cumulative live birth rate of patients in the synchronous operation group with fresh sperm, and the asynchronous operation group with thawed sperm, respectively, were 30.6% vs 33.8%, 33.8% vs 40.7%, 40.0% vs 12.5%, 30.4% vs 7.1%. Between the two groups, there was no significant difference. This suggests that individuals with NOA caused by the AZFc deletion have a high possibility of successfully acquiring sperm using micro-TESE and ICSI to conceive their own offspring. Synchronous micro-TESE is recommended to improve sperm utilization rate and the cumulative live birth rate.
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.
Typical headed relatives in English include a relative pronoun which takes the head as its antecedent. However, some modifying when-clauses in this language are peculiar relatives in that their heads are not the antecedent of when and they do not even have temporal referents. In view of the peculiarity of this type of relative clause, a novel account of the syntactic generation and interpretation of temporal when-clauses is pro- posed. Under this account four lexical entries of when, which have different semantic and syntactic properties, are recognized. The semantics of various whens are analyzed based on existing work, while the syntactic properties of different whens in non-interrogative sentences are characterized in the form of lexical information, which is implemented in the framework of Dynamic Syntax. The work in this article enriches the description of the diversity of relatives and suggests that the analysis of relatives can be unified semantically but not syntactically.
Surface reactions such as the adsorption and desorption at boundaries are very common for solute dispersion in many applications of chemistry, biology, hydraulics, etc. To study how reversible adsorption affects the transient dispersion, Zhang, Hesse & Wang (J. Fluid Mech., vol. 828, 2017, pp. 733–752) have investigated the temporal evolution of moments using the Laplace transform method. Owing to difficulties introduced by the adsorption–desorption boundary condition, great challenges arise from the inverse Laplace transform: dealing with the singularities by the residue theorem can tremendously increase complexities. This work provides a much simpler analytical method to derive solutions in a more compact form that is valid for the entire range of the reactive transport process. Such a progress demonstrates that the classic framework of separation of variables can be extended and applied to this more general adsorption–desorption condition, based on which higher-order statistics including skewness and kurtosis can be explicitly explored in practice. Also extended is Gill's generalised dispersion model for solute concentration distributions, which can now address the entire transient dispersion characteristics, instead of just applied for the long-time asymptotic reactive process as done previously. Regarding the most classic Taylor dispersion problem, we investigate the influence of the reversible adsorption–desorption on the solute cloud in a tube flow. Not only the transient dispersion characteristics of transverse-average concentration distribution but also those of the bulk, surface and total-average distributions are discussed. We further investigate the influence of initial conditions on the non-uniformity of the transient dispersion over the cross-section.