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To investigate the spiritual care needs and associated influencing factors among elderly inpatients with stroke, and to examine the correlations among spiritual care needs, spiritual well-being, self-perceived burden, self-transcendence, and social support.
Methods
A cross-sectional quantitative design was implemented, and the STROBE Checklist was used as the foundation of the study. A convenience sample of 458 elderly inpatients with stroke was selected from three hospitals in China. The sociodemographic characteristics questionnaire, the Nurse Spiritual Therapeutics Scale, the Functional Assessment of Chronic Illness Therapy—Spiritual Well-being, the Self-Perceived Burden Scale, the Chinese Self-Transcendence Scale, and the Perceived Social Support Scale were used. Descriptive statistics, correlation, Student's t-test, ANOVA, non-parametric, and multiple linear regression analyses were used to analyze the data.
Results
The total score of spiritual care needs was 29.82 ± 7.65. Spiritual care needs were positively correlated with spiritual well-being (r = 0.709, p < 0.01), self-transcendence (r = 0.710, p < 0.01), and social support (r = 0.691, p < 0.01), whereas being negatively correlated with self-perceived burden (r = −0.587, p < 0.01). Religious beliefs, educational level, residence place, disease course, spiritual well-being, self-perceived burden, self-transcendence, and social support were found to be the main influencing factors.
Significance of results
The spiritual care needs were prevalent and moderate. It is suggested that nurses should enhance spiritual care knowledge and competence, take targeted spiritual care measures according to inpatients’ individual personality traits or characteristics and differences of patients, reduce their self-perceived burden and improve their spiritual well-being, self-transcendence and social support in multiple ways and levels, so as to meet their spiritual care needs to the greatest extent and enhance their spiritual comfort.
Interactions between the boundary layer and two successive incident shock waves (ISWs) often occur in the supersonic mixed-compression inlets. However, the flow mechanism involved in such interactions has been studied rarely. In this study, we investigate experimentally and analytically the turbulent boundary layer separation flow induced by the single ISW and dual ISWs at the identical total deflection angles in a Mach 2.73 flow. Schlieren photography, wall pressure measurement and surface oil-flow visualisation are employed to diagnose the flow field. Experiments with the impingement points of the two ISWs intersecting on the bottom wall exhibit a separated flow with a triangle-like separation bubble, namely the first kind of dual-ISW/turbulent boundary layer interaction (ISWTBLI). Comparative studies show that various flow features of this kind of dual-ISWTBLI, including the extent of the separation region, pressure distribution and surface-flow topological structures, are nearly identical to those of the single-ISWTBLI with an identical total deflection angle. As the distance between the two ISWs increases, the shape of the separation region in the dual-ISWTBLI changes from triangle-like to quadrilateral-like, and the height of the separation region decreases accordingly, forming the second kind of dual-ISWTBLI. Furthermore, an inviscid model is developed for the dual-ISWTBLI to describe the complex shock wave system and elucidate the cause of a quadrilateral-like separation bubble in the second kind of dual-ISWTBLI. Moreover, based on a previous work by Souverein et al. (J. Fluid Mech., vol. 714, 2013, pp. 505–535) on the single-ISWTBLI, a modified scaling method is established for the first kind of dual-ISWTBLI.
The paper deals with the workspace-based optimization of a novel humanoid robotic arm. The eight-degree-of-freedom hybrid manipulator that conforms to the kinematics characteristics of the human arm is briefly introduced. According to the structural features of this mechanism and the requirements of tasks in the complex environment, the workspace is divided into three parts, the orientation space of the humanoid shoulder joint, the position space of the humanoid elbow joint, and the active orientation space of the end-moving platform. Moreover, a multi-parameter planar model is proposed for the optimization problem with multidimensional parameters and highly nonlinear constraints. Based on the visualized optimization result, the coupling effect of each parameter on the corresponding workspace is clearly presented. Considering the compactness and the processing and assembling technology of this mechanism, a set of structural parameters satisfying the workspace-based optimization objective is obtained. Simulation results show that the corresponding workspace of the three parts has increased significantly by the factor of 1.45, 1.68, and 1.3, respectively.
We perform a theoretical investigation of the instability of a helical vortex filament beneath a free surface in a semi-infinite ideal fluid. The focus is on the leading-order free-surface boundary effect upon the equilibrium form and instability of the vortex. This effect is characterised by the Froude number $F_r = U(gh^*)^{-{1}/{2}}$ where $g$ is gravity, and $U = \varGamma /(2{\rm \pi} b^*)$ with $\varGamma$ being the strength, $2{\rm \pi} b^*$ the pitch and $h^*$ the centre submergence of the helical vortex. In the case of $F_r \rightarrow 0$ corresponding to the presence of a rigid boundary, a new approximate equilibrium form is found if the vortex possesses a non-zero rotational velocity. Compared with the infinite fluid case (Widnall, J. Fluid Mech., vol. 54, no. 4, 1972, pp. 641–663), the vortex is destabilised (or stabilised) to relatively short- (or long-)wavelength sub-harmonic perturbations, but remains stable to super-harmonic perturbations. The wall-boundary effect becomes stronger for smaller helix angle and could dominate over the self-induced flow effect depending on the submergence. In the case of $F_r > 0$, we obtain the surface wave solution induced by the vortex in the context of linearised potential-flow theory. The wave elevation is unbounded when the $m$th wave mode becomes resonant as $F_r$ approaches the critical Froude numbers ${\mathcal {F}} (m) = (C_0^*/U)^{-1} (mh^*/b^*)^{-{1}/{2}}$, $m=1, 2, \ldots,$ where $C_0^*$ is the induced wave speed. We find that the new approximate equilibrium of the vortex exists if and only if $F_r < {\mathcal {F}}(1)$. Compared with the infinite fluid and $F_r \rightarrow 0$ cases, the wave effect causes the vortex to be destabilised to super-harmonic and long-wavelength sub-harmonic perturbations with generally faster growth rate for greater $F_r$ and smaller helix angle.
Residents of long-term care facilities face significantly greater risk of contracting or dying from coronavirus disease 2019 (COVID-19). However, little is known about COVID-19 in assisted living communities (ALCs) and the potential determinants of its spread. We examined the association between COVID-19 cases in ALCs and the proportion of Medicare-Medicaid (dual) eligible minority residents, neighborhood area deprivation, and state COVID-19 policy stringency.
Methods:
We conducted longitudinal analyses employing data on confirmed COVID-19 cases in ALCs in 5 states. We sought to determine the weekly cumulative number of COVID-19 cases in ALCs. Covariates were ALC characteristics, area deprivation index, and state COVID-19 policy stringency. Multivariate 2-part models were used to determine the associations between independent variables and the likelihood of an outbreak and the overall count of cases.
Results:
In our study sample, 201 ALCs (7.04%) reported 1 or more COVID-19 cases as of August 17, 2020. A higher percentage of minority residents was associated with an increased likelihood of an ALC reporting at least 1 COVID-19 case (odds ratio [OR], 1.06; P = .032). Conditional on having at least 1 case, ALCs in states with stricter social distancing policies had lower case counts (incidence rate ratio [IRR], 0.98; P < .001). Greater neighborhood deprivation was associated with higher case count (IRR, 1.36; P = .049).
Conclusions:
ALCs with higher proportions of dual-eligible minority residents were more likely to have COVID-19 outbreaks within their communities. ALCs located in more socioeconomically deprived neighborhoods, and in states with less stringent state social distancing policies, tended to have more COVID-19 cases.
Archaeological fieldwork at the fortified site of Kuiyukexiehai'er (Koyuk Shahri) in the Xinjiang Uygur Autonomous Region of north-western China yields the earliest known evidence for urban occupation in the Tarim Basin, providing new insights into early urbanism and agro-pastoral subsistence practices in the region during the first millennium BC.
Previous analyses of grey and white matter volumes have reported that schizophrenia is associated with structural changes. Deep learning is a data-driven approach that can capture highly compact hierarchical non-linear relationships among high-dimensional features, and therefore can facilitate the development of clinical tools for making a more accurate and earlier diagnosis of schizophrenia.
Aims
To identify consistent grey matter abnormalities in patients with schizophrenia, 662 people with schizophrenia and 613 healthy controls were recruited from eight centres across China, and the data from these independent sites were used to validate deep-learning classifiers.
Method
We used a prospective image-based meta-analysis of whole-brain voxel-based morphometry. We also automatically differentiated patients with schizophrenia from healthy controls using combined grey matter, white matter and cerebrospinal fluid volumetric features, incorporated a deep neural network approach on an individual basis, and tested the generalisability of the classification models using independent validation sites.
Results
We found that statistically reliable schizophrenia-related grey matter abnormalities primarily occurred in regions that included the superior temporal gyrus extending to the temporal pole, insular cortex, orbital and middle frontal cortices, middle cingulum and thalamus. Evaluated using leave-one-site-out cross-validation, the performance of the classification of schizophrenia achieved by our findings from eight independent research sites were: accuracy, 77.19–85.74%; sensitivity, 75.31–89.29% and area under the receiver operating characteristic curve, 0.797–0.909.
Conclusions
These results suggest that, by using deep-learning techniques, multidimensional neuroanatomical changes in schizophrenia are capable of robustly discriminating patients with schizophrenia from healthy controls, findings which could facilitate clinical diagnosis and treatment in schizophrenia.
The significance of spiritual care competence among nurses has been emphasized across countries and cultures in many studies. However, there were few studies on correlations among spiritual care competence, spiritual care perceptions, and spiritual health of nurses in China.
Objective
To investigate spiritual care competence, spiritual care perceptions, and spiritual health, and examine the correlations among spiritual care competence, spiritual care perceptions and spiritual health, and the mediating role of spiritual health between other two variables of Chinese nurses.
Methods
A cross-sectional and correlational design was implemented, and the STROBE Checklist was used to report the study. A convenience sample of 2,181 nurses were selected from 17 hospitals in 3 provinces, China. Participants provided data on sociodemographic by completing the Chinese Version of the Spiritual Care Competence Scale, the Chinese Version of the Spiritual Care-Giving Scale, and the Spiritual Health Scale Short Form. Descriptive statistics, univariate, multiple linear regression, and Pearson correlation analysis were used to analyze data.
Results
The total scores of spiritual care competence, spiritual care perceptions, and spiritual health were 58.25 ± 16.21, 144.49 ± 16.87, and 84.88 ± 10.57, respectively, which both were moderate. Spiritual care competence was positively correlated with spiritual care perceptions (r = 0.653, p < 0.01) and spiritual health (r = 0.587, p < 0.01). And spiritual health played a mediating role between the other two variables (accounting for 35.6%).
Significance of results
The spiritual care competence, spiritual care perceptions, and spiritual health of Chinese nurses need to be improved. It is recommended that nursing managers should pay attention to spiritual care education of nurses, and improve spiritual care perceptions and spiritual health in multiple ways, so as to improve their spiritual care competence and to maximize the satisfy spiritual care needs of patients in China.
This Element introduces the exotic wave phenomena arising from the extremely small optical refractive index, and sheds light on the underlying mechanisms, with a primary focus on the basic concepts and fundamental wave physics. The authors reveal the exciting applications of ENZ metamaterials, which have profound impacts over a wide range of fields of science and technology. The sections are organized as follows: in Section 2, the authors demonstrate the extraordinary wave properties in ENZ metamaterials, analyzing the unique wave dynamics and the resulting effects. Section 3 is dedicated to introducing various realization methods of the ENZ metamaterials with periodic and non-periodic styles. The applications of ENZ metamaterials are discussed in Sections 4 and 5, from the perspectives of microwave engineering, optics, and quantum physics. The authors close in Section 6 by presenting an outlook on the development of ENZ metamaterials and discussing the key challenges addressed in future works.
The aim of this study was to evaluate the association between prenatal and neonatal period exposures and the risk of childhood and adolescent nasopharyngeal carcinoma (NPC). From January 2009 to January 2016, a total of 46 patients with childhood and adolescent NPC (i.e., less than 18 years of age) who were treated at Sun Yat-sen University Cancer Center were screened as cases, and a total of 45 cancer-free patients who were treated at Sun Yat-sen University Zhongshan Ophthalmic Center were selected as controls. The association between maternal exposures during pregnancy and obstetric variables and the risk of childhood and adolescent NPC was evaluated using logistic regression analysis. Univariate analysis revealed that compared to children and adolescents without a family history of cancer, those with a family history of cancer had a significantly higher risk of childhood and adolescent NPC [odds ratios (OR) = 3.15, 95% confidence interval (CI) = 1.02–9.75, P = 0.046], and the maternal use of folic acid and/or multivitamins during pregnancy was associated with a reduced risk of childhood and adolescent NPC in the offspring (OR = 0.07, 95% CI = 0.02–0.25, P < 0.001). After multivariate analysis, only the maternal use of folic acid and/or multivitamins during pregnancy remained statistically significant. These findings suggest that maternal consumption of folic acid and/or multivitamins during pregnancy is associated with a decreased risk of childhood and adolescent NPC in the offspring.
With differentiated tissues and organs, a high-level eukaryotic macroalga Lanceaphyton xiaojiangensis n. gen. n. sp. lived on the middle–late Ediacaran (ca. 560–551 Ma) seafloor in South China. Its body had a pith (perhaps mechanical tissue) and outer tissue (perhaps epidermis and/or cortex). The lance-like macroalga consists of an unbranching thallus that grew over the sediment surface for sunlight and a holdfast grown into sediments to keep the thallus fixed on the seafloor. The pithy stipe (lower thallus) might have served to support the upper pithless thallus for photosynthesis. The holdfast is composed of a tapering pithy rhizome growing down into the sediments, with many filamentous pithless rhizoids dispersedly growing within the sediments. With the differentiated tissues and organs, especially the pith accounting for about half of the width of the rhizome and stipe, Lanceaphyton n. gen. was a high-level eukaryotic macroalga, similar to phaeophytes in morphological features, but further research is needed on its microstructural details. The pithy macroalga shows that the macroalgal pith had emerged in the Ediacaran.
Based on hubs of neural circuits associated with addiction and their degree centrality (DC), this study aimed to construct the addiction-related brain networks for patients diagnosed with heroin dependence undertaking stable methadone maintenance treatment (MMT) and further prospectively identify the ones at high risk for relapse with cluster analysis.
Methods
Sixty-two male MMT patients and 30 matched healthy controls (HC) underwent brain resting-state functional MRI data acquisition. The patients received 26-month follow-up for the monthly illegal-drug-use information. Ten addiction-related hubs were chosen to construct a user-defined network for the patients. Then the networks were discriminated with K-means-clustering-algorithm into different groups and followed by comparative analysis to the groups and HC. Regression analysis was used to investigate the brain regions significantly contributed to relapse.
Results
Sixty MMT patients were classified into two groups according to their brain-network patterns calculated by the best clustering-number-K. The two groups had no difference in the demographic, psychological indicators and clinical information except relapse rate and total heroin consumption. The group with high-relapse had a wider range of DC changes in the cortical−striatal−thalamic circuit relative to HC and a reduced DC in the mesocorticolimbic circuit relative to the low-relapse group. DC activity in NAc, vACC, hippocampus and amygdala were closely related with relapse.
Conclusion
MMT patients can be identified and classified into two subgroups with significantly different relapse rates by defining distinct brain-network patterns even if we are blind to their relapse outcomes in advance. This may provide a new strategy to optimize MMT.
Atom probe tomography (APT) is often introduced as providing “atomic-scale” mapping of the composition of materials and as such is often exploited to analyze atomic neighborhoods within a material. Yet quantifying the actual spatial performance of the technique in a general case remains challenging, as it depends on the material system being investigated as well as on the specimen's geometry. Here, by using comparisons with field-ion microscopy experiments, field-ion imaging and field evaporation simulations, we provide the basis for a critical reflection on the spatial performance of APT in the analysis of pure metals, low alloyed systems and concentrated solid solutions (i.e., akin to high-entropy alloys). The spatial resolution imposes strong limitations on the possible interpretation of measured atomic neighborhoods, and directional neighborhood analyses restricted to the depth are expected to be more robust. We hope this work gets the community to reflect on its practices, in the same way, it got us to reflect on our work.
Across Eurasia, horse transport transformed ancient societies. Although evidence for chariotry is well dated, the origins of horse riding are less clear. Techniques to distinguish chariotry from riding in archaeological samples rely on elements not typically recovered from many steppe contexts. Here, the authors examine horse remains of Mongolia's Deer Stone-Khirigsuur (DSK) Complex, comparing them with ancient and modern East Asian horses used for both types of transport. DSK horses demonstrate unique dentition damage that could result from steppe chariotry, but may also indicate riding with a shallow rein angle at a fast gait. A key role for chariots in Late Bronze Age Mongolia helps explain the trajectory of horse use in early East Asia.
Self-efficacy is a pivotal factor in the etiology and prognosis of major depression. However, longitudinal studies on the relationship between self-efficacy and major depressive disorder (MDD) are scarce. The objectives were to investigate: (1) the associations between self-efficacy and the 1-year and 2-year risks of first onset of MDD and (2) the associations between self-efficacy and the 1-year and 2-year risks of the persistence/recurrence of MDD, in a sample of first-year university students.
Methods
We followed 8079 first-year university students for 2 years from April 2018 to October 2020. MDD was ascertained by the Chinese version of the Composite International Diagnostic Interview (CIDI-3.0) based on self-report. Self-efficacy was measured by the 10-item General Self-efficacy (GSE) scale. Random effect logistic regression modeling was used to estimate the associations.
Results
Among participants without a lifetime MDD, the data showed that participants with high baseline GSE scores were associated with a higher risk of first onset of MDD over 2 years [odds ratio (OR) 1.04, 95% confidence interval (CI) 1.01–1.08]. Among those with a lifetime MDD, participants with high baseline GSE scores were less likely to have had a MDD over 2 years (OR 0.93, 95% CI 0.88–0.99) compared to others.
Conclusions
A high level of GSE may be protective of the risk of persistent or recurrent MDD. More longitudinal studies in university students are needed to further investigate the impact of GSE on the first onset of MDD.
The significance of spiritual care needs among chronic diseases patients has been emphasized across countries and cultures in many studies. However, there were few studies on spiritual care needs among elderly patients with moderate-to-severe chronic heart failure (CHF) in China.
Objective
To investigate spiritual care needs and associated influencing factors among elderly patients with moderate-to-severe CHF, and to examine the relationships among spiritual care needs, self-perceived burden, symptom management self-efficacy, and perceived social support.
Methods
A cross-sectional design was implemented, and the STROBE Checklist was used to report the study. A convenience sample of 474 elderly patients with moderate-to-severe CHF were selected from seven hospitals in Tianjin, China. The sociodemographic characteristics questionnaire, the Spiritual Needs Questionnaire Scale, the Self-Perceived Burden Scale, the Self-efficacy for Symptom Management Scale, and the Perceived Social Support Scale were used. Descriptive statistics, univariate, multiple linear regression, and Pearson's correlation analysis were used to analyze data.
Results
The total score of spiritual care needs among 474 elderly patients with moderate-to-severe CHF was 37.95 ± 14.71, which was moderate. Religious belief, educational background, self-perceived burden, symptom management self-efficacy, and perceived social support were the main factors affecting spiritual care needs, and spiritual care needs were negatively correlated with self-perceived burden (r = −0.637, p < 0.01) and positively correlated with symptom management self-efficacy (r = 0.802, p < 0.01) and social support (r = 0.717, p < 0.01).
Significance of results
The spiritual care needs of elderly patients with moderate-to-severe CHF were moderate, which were influenced by five factors. It is suggested that clinical nurses, families, and society should take targeted spiritual care measures to improve patients’ symptom management self-efficacy and perceived social support from many aspects, and reduce self-perceived burden to meet their spiritual care needs and improve the quality and satisfaction of spiritual care in nursing practice.