For an integer $m>1$, we denote by $P(m)$ the largest prime divisor of m. We improve a result of Stewart [‘On the greatest and least prime factors of ${n!}+1$, II’, Publ. Math. Debrecen 65(3–4) (2004), 461–480] by showing that $\limsup _{n \rightarrow \infty } P({n!}+1)/n \geqslant 1+9\log 2$. More generally, for any nonzero polynomial $f(X)$ with integer coefficients, we show that $\limsup _{n \rightarrow \infty } P({n!}+f(n))/n \geqslant 1+9\log 2$. This improves a result of Luca and Shparlinski [‘Prime divisors of shifted factorials’, Bull. Lond. Math. Soc. 37(6) (2005), 809–817]. These improvements stem from an additional combinatorial idea that builds upon the works mentioned above.

Objectives: The recent experience of the COVID-19 pandemic emphasized the critical need for a surveillance system to alert healthcare facilities about the admission of patients with emerging infectious diseases (EID), thereby preventing nosocomial transmissions. Methods: Tan Tock Seng Hospital, an 1800-bed acute tertiary-care hospital in Singapore, transitioned to a new- generation electronic medical record system, Epic, in August 2022. Leveraging the system’s capabilities, we developed an algorithm to generate the line-list of suspected Middle East Respiratory Syndrome (MERS) patients, in alignment with the screening guidelines provided by Singapore’s Ministry of Health. The algorithm first identifies patients who presented within 14 days (maximum incubation period) of their travel to Arabic peninsular countries. This information is documented by the emergency department’s triage nurses. Additionally, patients with suspected MERS indicated in the problem list or diagnosis by attending clinicians, particularly emergency-medicine physicians or infectious-disease physicians, are included. Furthermore, patients who are ordered for a MERS- Coronavirus polymerase chain reaction test, are identified. The algorithm can also be further modified as and when the case definition of the EID changes. Results: The surveillance report constructed with Epic algorithm can be scheduled for daily generation or generated on demand within a few minutes. This newer approach is more time- and resource-efficient compared to the manual surveillance process, which necessitates at least three staff members to engage in a series of prolonged manual processes. The report, by extracting information directly from Epic in near real-time, also minimizes the likelihood of errors that may occur during the manual process. Subsequently, the team of epidemiologists identifies the suspected MERS patients form the generated report and efficiently follow up them until a diagnosis of MERS is excluded. Conclusions: Harnessing Epic’s capabilities, we constructed an algorithm to efficiently and swiftly identify suspected MERS patients, enabling the timely implementation of infection prevention strategies to prevent nosocomial transmission.

Objectives: The recent experience of the COVID-19 pandemic emphasized the critical need for a surveillance system to alert healthcare facilities about the admission of patients with emerging infectious diseases (EID), thereby preventing nosocomial transmissions. Methods: Tan Tock Seng Hospital, an 1800-bed acute tertiary-care hospital in Singapore, transitioned to a new- generation electronic medical record system, Epic, in August 2022. Leveraging the system’s capabilities, we developed an algorithm to generate the line-list of suspected Middle East Respiratory Syndrome (MERS) patients, in alignment with the screening guidelines provided by Singapore’s Ministry of Health. The algorithm first identifies patients who presented within 14 days (maximum incubation period) of their travel to Arabic peninsular countries. This information is documented by the emergency department’s triage nurses. Additionally, patients with suspected MERS indicated in the problem list or diagnosis by attending clinicians, particularly emergency-medicine physicians or infectious-disease physicians, are included. Furthermore, patients who are ordered for a MERS- Coronavirus polymerase chain reaction test, are identified. The algorithm can also be further modified as and when the case definition of the EID changes. Results: The surveillance report constructed with Epic algorithm can be scheduled for daily generation or generated on demand within a few minutes. This newer approach is more time- and resource-efficient compared to the manual surveillance process, which necessitates at least three staff members to engage in a series of prolonged manual processes. The report, by extracting information directly from Epic in near real-time, also minimizes the likelihood of errors that may occur during the manual process. Subsequently, the team of epidemiologists identifies the suspected MERS patients form the generated report and efficiently follow up them until a diagnosis of MERS is excluded. Conclusions: Harnessing Epic’s capabilities, we constructed an algorithm to efficiently and swiftly identify suspected MERS patients, enabling the timely implementation of infection prevention strategies to prevent nosocomial transmission.

Eclipta [Eclipta prostrata (L.) L.] is an important tropical weed that has recently emerged as a problematic weed in dry direct-seeded rice (Oryza sativa L.) (DSR) fields in China. Understanding its seed germination biology and ecology is crucial for developing integrated weed management strategies in the DSR system. Laboratory experiments were conducted to investigate seed germination of E. prostrata seeds under varying environmental conditions. Germination was greatest under alternating temperature regimes of 25/15 to 40/30 C, whereas it wa-s significantly reduced at 20/10 C and completely inhibited at 15/5 C. Germination was also fully suppressed under continuous darkness, indicating strong light dependency. Eclipta prostrata seeds tolerated a broad range of pH values (4 to 10) with germination rates consistently greater than 95%. However, germination declined sharply under osmotic potentials, falling below 2% at −0.6 MPa, and being completely inhibited at −0.7 MPa. Seeds also showed moderate salt tolerance, with 50% inhibition at 150 mM NaCl and no germination at 300 mM NaCl. Exposure to radiant heat (>90 C for 5 min) prevented germination, suggesting residue burning may be an effective control measure. Seedling emergence was highest (100%) on the soil surface but declined steeply with increasing burial depth, with no emergence observed beyond 0.5 cm. Similarly, surface application of wheat (Triticum aestivum L.) straw residue (2 to 6 Mg ha−1) significantly reduced seedling emergence and biomass. These findings provide essential insights into E. prostrata germination ecology and offer practical implications for its integrated management in DSR systems.

With the widespread use of high-fat diets (HFD) in aquaculture, the adverse effects of HFD on farmed fish are becoming increasingly apparent. Creatine has shown potential as a green feed additive in farmed fish; however, the potential of dietary creatine to attenuate adverse effects caused by high-fat diets remains poorly understood. To address such gaps, this study was conducted to investigate the mitigating effect of dietary creatine on HFD-induced disturbance on growth performance, hepatic lipid metabolism, intestinal health and muscle quality of juvenile largemouth bass. Three diets were formulated: a control diet (10·20 % lipid), a high-fat diet (HFD, 18·31 % lipid) and HFD with 2 % creatine (HFD + creatine). Juvenile largemouth bass (3·73 (sem 0·01) g) were randomly assigned to three diets for 10 weeks. The key findings were as follows: (1) the expression of muscle growth-related genes and proteins was stimulated by dietary creatine, which contributes to ameliorate the adverse effects of HFD on growth performance; (2) dietary creatine alleviates HFD-induced adverse effects on intestinal health by improving intestinal health, which also enhances feed utilisation efficiency; (3) dietary creatine causes excessive lipid deposition, mainly via lipolysis and β-oxidation. Notably, this study also reveals a previously undisclosed effect of creatine supplementation on improving muscle quality. Together, for the first time from a comprehensive multiorgan or tissue perspective, our study provides a feasible approach for developing appropriate nutritional strategies to alleviate the adverse effects of HFD on farmed fish, based on creatine supplementation.

This study explored the relationship between multifaceted multilingualism and cognitive shifting through a task-switching paradigm using fMRI. Multilingualism was modeled from both convergent (i.e., integrated multilingual index) and divergent (i.e., L2 proficiency, interpreting training, language entropy) perspectives. Participants identified letters or numbers based on task cues, with Repeat trials maintaining the same task and Switch trials requiring a different task. Switch cost (Switch–Repeat) was used to reflect shifting demands. Better task-switching performance was associated with a higher integrated multilingual index and interpreting training. Neuroimaging indicated that multilinguals predominantly engaged left-hemisphere regions for switching, with extensive multilingual experience requiring fewer neural resources for switch cost (i.e., more efficient processing for cognitive control). During task switching, brain connectivity was regulated locally by L2 proficiency, and globally by interpreting training. These findings underscore the importance of considering multifaceted multilingual experience to understand its impact on cognitive function and brain activity.

Cable-guiding mechanisms (CGMs) and the stiffness characteristics directly influence the dynamic features of the cable-driven upper limb rehabilitation robot (PCUR), which will affect PCUR’s performance. This paper introduces a novel CGM design. Given the precision and movement stability considerations of the mechanism, an analytical model is developed. Using this model, we analyze the error of the CGM and derive velocity and acceleration mappings from the moving platform to the cables. Continuity of cable trajectory and tension is rigorously demonstrated. Subsequently, a mathematical model for PCUR stiffness is formulated. Utilizing MATLAB/Simscape Multibody, simulation models for the CGM and stiffness characteristics are constructed. The feasibility of the proposed CGM design is validated through simulation and experimentation, while the influence of stiffness characteristics on PCUR motion stability is comprehensively analyzed.

The effects of the evolution of vortices on the aeroacoustics generated by a hovering wing are numerically investigated by using a hybrid method of an immersed boundary–finite difference method for the three-dimensional incompressible flows and a simplified model based on the Ffowcs Williams-Hawkings acoustic analogy. A low-aspect-ratio ($AR=1.5$) rectangular wing at low Reynolds ($Re=1000$) and Mach ($M=0.04$) numbers is investigated. Based on the simplified model, the far-field acoustics is shown to be dominated by the time derivative of the pressure on the wing surface. Results show that vortical structure evolution in the flow fields, which is described by the divergence of the convection term of the incompressible Navier–Stokes equations in a body-fixed reference frame, determines the time derivative of the surface pressure and effectively the far-field acoustics. It dominates over the centrifugal acceleration and Coriolis acceleration terms in determining the time derivative of the surface pressure. The position of the vortex is also found to affect the time derivative of the surface pressure. A scaling analysis reveals that the vortex acoustic source is scaled with the cube of the flapping frequency.

Flow control of a low-aspect-ratio flat-plate heaving wing at an average angle of attack of $10^{\circ }$ by a steady-blowing jet is numerically studied by using a feedback immersed boundary–lattice Boltzmann method. Blowing jets at the leading edge, mid-chord and trailing edge are considered. The wing enjoys the highest lift production with the trailing-edge downstream blowing jet, which improves the average lift by 50.0 % at $Re = 1000$ and 22.9 % at $Re = 5000$ through the enhancement of the tip vortex circulation caused by the increase in the mass flux of the shear layer at the wing tips. This increase in mass flux decreases as $Re$ increases from 1000 to 5000 due to its self-limiting mechanism. A mid-chord vertical blowing jet induces a middle vortex which enhances the lift production but the enhancement is smaller than that of trailing-edge downstream blowing jet. Other jet arrangements do not significantly increase the lift coefficient, but the mid-chord upstream blowing jet experiences a significant reduction in the drag coefficient, leading to an increase of 50.6 % in the average lift-to-drag ratio. The effectiveness of the flow control is not significantly affected by the aspect ratio.

Background: Subdural and subgaleal drains are equally effective after burrhole craniostomy for chronic subdural haematoma, however the optimal location of drains after minicraniotomy is not clear. As such we present the first study to assess this. Methods: Consecutive patients undergoing minicraniotomy for cSDH between 2019 and 2023 at a single institution were included. Subgaleal drains were placed exclusively by a single surgeon with the rest of the department utilising standard subdural drains. Cases were stratified by drain location. Primary outcomes included changes in functional status (Modified Rankin Score, mRS) at 3 months from preoperative baseline. Results: A total of 137 patients were included, of which 24.6% received subgaleal drains. Discharge home was higher in the subgaleal group compared to subdural group (79.4% vs 57.3%, p=0.02). Subgaleal drain location (p<0.0001) and better preoperative GCS (p=0.01) were predictors of improved 3 month mRS. Worse premorbid mRS (p=0.002), subdural drain (p=0.004), and decreased consciousness at presentation (p<0.002) were predictors of not being discharged home. Surgical recurrence was lower in the subgaleal group than the subdural group (2.9% vs 13.6%, p=0.12), but not statistically significant. Conclusions: Subgaleal drains are associated with shorter hospitalisation, greater chance of discharge home, and better functional outcomes than subdural drains.

We employed a Bayesian network meta-analysis for comparison of the efficacy and tolerability of US Food and Drug Administration (FDA)-approved atypical antipsychotics (AAPs) for the treatment of bipolar patients with depressive episodes. Sixteen randomized controlled trials with 7234 patients treated by one of the five AAPs (cariprazine, lumateperone, lurasidone, olanzapine, and quetiapine) were included. For the response rate (defined as an improvement of ≥50% from baseline on the Montgomery-Åsberg Depression Rating Scale [MADRS]), all AAPs were more efficacious than placebo. For the remission rate (defined as the endpoint of MADRS ≤12 or ≤ 10), cariprazine, lurasidone, olanzapine, and quetiapine had higher remission rates than placebo. In terms of tolerability, olanzapine was unexpectedly associated with lower odds of all-cause discontinuation in comparison with placebo, whereas quetiapine was associated with higher odds of discontinuation due to adverse events than placebo. Compared with placebo, lumateperone, olanzapine, and quetiapine showed higher odds of somnolence. Lumateperone had a lower rate of ≥ weight gain of 7% than placebo and other treatments. Olanzapine was associated with a significant increase from baseline in total cholesterol and triglycerides than placebo. These findings inform individualized prescriptions of AAPs for treating bipolar depression in clinical practice.

In preparation for an experiment with a laser-generated intense proton beam at the Laser Fusion Research Center at Mianyang to investigate the 11B(p,α)2α reaction, we performed a measurement at very low proton energy between 140 keV and 172 keV using the high-voltage platform at the Institute of Modern Physics, Lanzhou. The aim of the experiment was to test the ability to use CR-39 track detectors for cross-section measurements and to remeasure the cross-section of this reaction close to the first resonance using the thick target approach. We obtained the cross-section σ = 45.6 ± 12.5 mb near 156 keV. Our result confirms the feasibility of CR-39 type track detector for nuclear reaction measurement also in low-energy regions.