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Children with coeliac disease (CD) on a gluten-free diet (GFD) often have poor dietary quality (DQ). A Gluten-Free Food Guide (GFFG) was developed to address this. This pilot randomised controlled trial evaluated the impact of GFFG dietary counselling on DQ and ultra-processed food (UPF) intake in newly diagnosed CD children. Child–parent pairs were randomised to the standard of care only (CON: n 20) or the intervention (INT: standard of care + GFFG; n 20). Primary outcomes included DQ (Healthy Eating Index-Canadian) and UPF intake (NOVA classification), assessed at baseline (BL), 3 and 6 months. In INT, dietary variety scores, a subcomponent of DQ, increased between BL and 3 months (BL: 6·7 (3·3–6·7) v. 3 months: 10 (10–10); P = 0·01) and in higher variety scores than CON at 3 months (P < 0·01). Total DQ and UPF intake remained unchanged. Increased dietary variety in INT was associated with increases in dairy products (BL: 7·5 (sd 3·6) % v. 3 months: 12·4 (sd 6·7) %; P = 0·01) and unsweetened milk (BL: 2·5 (sd 2·2) % v. 3 months: 4·7 (sd 3·0) %; P = 0·01) servings, consumed as a percentage of the total food group servings. These improvements were not observed at 6 months. A greater number of INT children met the GFFG protein recommendation at 3 months (BL: 0/19 v. 3 months: 5/19; P = 0·01), with no change in CON. A single GFFG session improved short-term dietary variety and unsweetened milk intake. Ongoing work addressing the GF food environment, dietitian access and policies to improve DQ are needed.
Generative artificial intelligence (GenAI) applications in job scheduling are expected to help schedulers embed their requirements into scheduling models in a more user-friendly way to generate customized scheduling results. However, there are still very few such applications, while using existing general-purpose GenAI services is inconvenient and prone to data leakage risks. To solve these problems, this study established a GenAI job scheduling system. By hosting the GenAI job scheduling system locally, schedulers can avoid the leakage of order- or recipe-related information that may occur when uploading to the cloud-based GenAI service. In the GenAI job scheduling system, a user interface is designed for users to enter queries in natural language. The user’s query is then analyzed to extract his/her requirements related to the scheduling task, thereby building an extended three-field notation (ETFN) of the scheduling problem. A customized genetic algorithm (GA) is generated to help solve the mathematical programming (MP) model corresponding to the ETFN, thereby updating invalid code or adding new code to the basic GA application. The effectiveness of the GenAI job scheduling system has been tested in a flexible job shop case.
Schizophrenia is a severe psychiatric disorder characterised by positive symptoms, such as hallucinations and delusions, which are linked to dysregulated striatal connectivity. Although traditional models highlight the limbic striatum’s role in salience processing, emerging evidence suggests that the associative striatum, critical for cognitive control and habit formation, also plays a significant role. However, the structural connectivity underlying striatal subregions and its relationship to symptom severity and treatment response remains poorly understood.
Aims
This study aimed to investigate the structural connectivity of striatal subregions in first-episode schizophrenia (FE-SCZ) patients and to evaluate its association with positive symptoms and changes following antipsychotic treatment.
Method
We recruited 80 FE-SCZ patients and 80 healthy controls who underwent diffusion tensor imaging probabilistic tractography to assess white matter tract strength between the striatum and ten cortical targets. Longitudinal analysis was conducted in patients at baseline (within 2 weeks of initial antipsychotic exposure) and after ongoing treatment to evaluate changes in connectivity and their relationship to symptom improvement.
Results
FE-SCZ patients exhibited reduced connectivity between the dorsolateral prefrontal cortex (dlPFC) and associative striatum and increased connectivity between the anterior cingulate cortex (ACC) and associative striatum compared to controls. Longitudinal analysis revealed that antipsychotic treatment increased dlPFC–associative striatum connectivity and decreased ACC–associative striatum connectivity, which correlated with reductions in positive symptom severity.
Conclusions
These findings highlight the critical role of striatal subregions in the pathophysiology of schizophrenia, emphasising the associative striatum’s involvement in cognitive control and salience attribution. Changes in striatal connectivity after continued antipsychotic therapy may serve as a biomarker for symptom improvement, advancing our understanding of schizophrenia and guiding future therapeutic strategies.
Little is known regarding the shared genetic architecture underlying the phenotypic associations between depression and preterm birth (PTB). We aim to investigate the genetic overlap and causality of depression with PTB.
Methods
Leveraging summary statistics from the largest genome-wide association studies for broad depression (Ntotal = 807,533), major depression (Ntotal = 173,005), bipolar disorder (Ntotal = 414,466), and PTB (Ntotal = 226,330), we conducted a large-scale genome-wide cross-trait analysis to assess global and local genetic correlations, identify pleiotropic loci, and infer potential causal relationships
Results
Positive genetic correlations were observed between PTB and broad depression (rg = 0.242), major depression (rg = 0.236), and bipolar disorder (rg = 0.133) using the linkage disequilibrium score regression, which were further verified by the genetic covariance analyzer. Local genetic correlation was identified at chromosome 11q22.3 (harbors NCAM1-TTC12-ANKK1-DRD2) for PTB with depression. Cross-trait meta-analysis identified two loci shared between PTB and broad depression, two loci shared with major depression, and five loci shared with bipolar disorder, among which three were novel (rs7813444, rs3132948 and rs9273363). Mendelian randomization demonstrated a significantly increased risk of PTB for genetic liability to broad depression (odds ratio [OR]=1.30; 95% confidence interval [CI]: 1.11-1.52) and major depression (OR=1.27; 95%CI: 1.08-1.49), and the estimates remained significant across the sensitivity analyses.
Conclusions
Our findings demonstrate an intrinsic link underlying depression and PTB and shed novel light on the biological mechanisms, highlighting an important role of early screening and effective intervention of depression in PTB prevention, and may provide novel treatment strategies for both diseases.
Previous studies highlighted the health benefits of coffee and tea, but they only focused on the comparisons between different consumptions. Consequently, the association estimate lacked a clear interpretation, as the substitution of beverages and distribution of doses were not explicitly prescribed. We focused on the ‘relative association’ to ascertain the optimal consumption strategy (including total intake and optimal allocation strategy) for coffee, tea and plain water associated with decreased mortality. Self-reported coffee, tea and plain water intake were used from the UK Biobank. Within a compositional data analysis framework, a multivariate Cox model was used to assess the relative associations after adjusting for a range of potential confounders. The lower mortality risk was observed with at least approximately 7–8 drinks/d of total consumption. When the total intake > 4 drinks/d, substituting plain water with coffee or tea was linked to reduced mortality; nevertheless, the benefit was not seen for ≤ 4 drinks/d. Besides, a balanced consumption of coffee and tea (roughly a ratio of 2:3) associated with the lowest hazard ratios of 0·55 (95 % CI 0·47, 0·64) for all-cause mortality, 0·59 (95 % CI 0·48, 0·72) for cancer mortality, 0·69 (95 % CI 0·49, 0·99) for CVD mortality, 0·28 (95 % CI 0·15, 0·52) for respiratory disease mortality and 0·35 (95 % CI 0·15, 0·82) for digestive disease mortality than other combinations. These results highlight the importance of the rational combination of coffee, tea and plain water, with particular emphasis on ensuring adequate total intake, offering more comprehensive and explicit guidance for individuals.
In patients with remitted psychosis, the dosage of antipsychotics can be lowered without increased risk of relapse. Whether dose tapering can lead to improved cognition is unclear. We compared changes in cognitive performance between patients undergoing dose tapering and those receiving a fixed maintenance dose.
Methods
A 2-year prospective trial of patients with stable schizophrenia-related psychotic disorders was conducted: one group received guided dose reduction (GDR) and one group received maintenance treatment. Cognitive function was assessed using the Wechsler Adult Intelligence Scale-Third Edition, Mandarin Chinese version, at baseline, 1, and 2 years. The relations between the ratio of reduced dose and the extent of cognitive improvement were examined by Spearman’s correlation coefficient. We also examined cognitive performance between aripiprazole (ARI) users and non-ARI users.
Results
GDR patients exhibited significantly greater improvements in total intellectual quotient (IQ), particularly working memory, and information and arithmetic subtest scores, with no significant difference in relapse rates between groups. Statistically significant dose–response correlations were found between the degree of dose reduction and improvements in total IQ (n = 72, r = 0.242, p = 0.041), Working Memory Index (n = 72, r = 0.284, p = 0.016), and Arithmetic subtest (n = 72, r = 0.295, p = 0.012). There were no differences in cognitive changes between ARI users and non-users.
Conclusions
Lowering antipsychotic dosage may ameliorate patient performance in several cognitive domains. This finding is worthy of consideration while evaluating the risk-to-benefit ratio of tapering antipsychotics in patients with remitted psychosis.
Electronic Health Record (EHR) data are critical for advancing translational research and AI technologies. The ENACT network offers access to structured EHR data across 57 CTSA hubs. However, substantial information is contained in clinical narratives, requiring natural language processing (NLP) for research. The ENACT NLP Working Group was formed to make NLP-derived clinical information accessible and queryable across the network.
Methods:
We established the ENACT NLP Working Group with 13 sites selected based on criteria including clinical notes access, IT infrastructure, NLP expertise, and institutional support. We divided sites into five focus groups targeting clinical tasks within disease contexts. Each focus group consisted of two development sites and two validation sites. We extended the ENACT ontology to standardize NLP-derived data and conducted multisite evaluations using the Open Health Natural Language Processing (OHNLP) Toolkit.
Results:
The working group achieved 100% site retention and deployed NLP infrastructure across all sites. We developed and validated NLP algorithms for rare disease phenotyping, social determinants of health, opioid use disorder, sleep phenotyping, and delirium phenotyping. Performance varied across sites (F1 scores 0.53–0.96), highlighting data heterogeneity impacts. We extended the ENACT common data model and ontology to incorporate NLP-derived data while maintaining Shared Health Research Informatics NEtwork (SHRINE) compatibility.
Conclusion:
This demonstrates feasibility of deploying NLP infrastructure across large, federated networks. The focus group approach proved more practical than general-purpose approaches. Key lessons include the challenge of data heterogeneity and importance of collaborative governance. This work also provides a foundation that other networks can build on to implement NLP capabilities for translational research.
DNA methylation plays a crucial role in gene regulation and has been implicated in various neuropsychiatric disorders, including alcohol use disorder (AUD). The rs27072 polymorphism within the SLC6A3 gene has been studied in addictive disorders; however, its role in epigenetic modifications remains unclear. This study investigates the methylation levels of CpG sites near rs27072 and their potential associations with AUD, personality traits, and environmental stressors.
Materials and methods
One hundred twenty-four male participants (66 patients with AUD and 58 controls) were analyzed for DNA methylation at CpG islands proximal to the rs27072 locus. The personality traits and life stress events were assessed in all participants.
Results
AUD patients had a lower methylation level than healthy controls (p = 0.003 for total average). However, the results changed to borderline significance after adjusting for clinical covariates in the analysis (p = 0.042), and the genotype at rs27072 did not modulate the methylation levels. There is high novelty seeking (p < 0.001), and more bad life events in patients with AUD than healthy controls (p < 0.001). Additionally, no significant correlations were found between methylation levels and personality traits or life stress scores (p > 0.05).
Conclusions
The methylation of the SLC6A3 gene may be marginally associated with AUD; however, the rs27072 genotype, personality, and life stress may not be directly linked to epigenetic modifications. Cross-sectional epigenetic studies may not establish causality; future studies with larger, more diverse cohorts and longitudinal designs are warranted to elucidate the complex interplay in AUD pathophysiology.
This manuscript presents a novel three-series-only topology P-insulator-N (PIN) diode single-pole-double-through (SPDT) switch designed to address the challenges of high power handling and low insertion loss in Q-band and V-band communication systems. The manuscript provides a detailed theoretical analysis of series-connected PIN diodes, offering insights into their behavior under both small- and large-signal conditions. Based on GaAs PIN diode technology, the switch operates across a frequency range of 37.7 to 61 GHz, achieving a low insertion loss of 0.707 dB and providing an isolation of 24.6 dB. The proposed SPDT switch demonstrates a high $\text{IP}_{\text{0.1~dB}}$ of 37.6 dBm at 38 GHz. With a compact chip size of $0.905\times 0.885 \text{mm}^2$, including all pads, this work offers excellent power handling capability, making it highly suitable for advanced communication systems in Q-band and V-band applications.
Aims: Antenatal depression significantly impacts maternal and foetal health outcomes, yet it remains underdiagnosed and undertreated. The Psychological Resilience in Antenatal Management (PRAM) programme at KK Women’s and Children’s Hospital in Singapore was established in December 2022 as a strategy to identify antenatal depression early among pregnant patients. Under the PRAM programme, universal antenatal depression screening is integrated into the routine care programme for pregnant patients, using a modified version of the Edinburgh Postnatal Depression Scale (EPDS) questionnaire during their routine obstetric check-up in the second trimester, for early intervention by the perinatal mental health team.
This qualitative study explores the lived experiences of pregnant women who have undergone screening and intervention under the PRAM programme. It seeks to understand their perceptions of the screening and intervention process, identify barriers and facilitators to help-seeking, and examine effective components of the therapeutic process.
Methods: Using an Interpretative Phenomenological Analysis (IPA) approach, semi-structured interviews were conducted with 10 women who have participated in the PRAM programme between November 2023 to January 2025. Interviews were completed either virtually over Zoom (N=8) or in person (N=2). The interviews explored participants’ experiences with antenatal depression screening, subsequent interventions, and their overall pregnancy journey while managing mental health concerns.
Results: Preliminary analysis reveals several key themes in participants’ experiences. For half of the participants (N=5), the screening process served as an opportunity for self-evaluation and mental health awareness. Obstetricians have also been identified to be crucial facilitators, serving as the initial point of psychiatric referral and influencing women’s decisions to seek support. A significant barrier identified by four participants was the stigma associated with psychiatric diagnoses and receiving psychiatric help. Additionally, participants emphasised the importance of spousal involvement in the therapeutic process, with several women expressing a desire for greater partner participation in their mental health journey.
Conclusion: Understanding women’s experiences with the PRAM programme contributes to improving screening protocols and developing more effective, patient-centred approaches to managing antenatal depression. The findings highlight the need for integrated care pathways that address stigma, enhance partner involvement, and strengthen the role of obstetricians in perinatal mental health care. These insights can inform the development of more comprehensive and accessible mental health support services within perinatal care settings.
A dual-beam platform is developed for all-optical Thomson/Compton scattering, with versatile parameter tuning capabilities including electron energy, radiation energy, radiation polarization, etc. By integrating this platform with a 200 TW Ti:sapphire laser system, we demonstrate the generation of inverse Compton scattering X-/gamma-rays with tunable energies ranging from tens of keV to MeV. The polarization of X-/gamma-rays is manipulated by adjusting the polarization of the scattering laser. In the near future, by combining this platform with multi-PW laser facilities, our goal is to explore the transition from nonlinear Thomson scattering to nonlinear Compton scattering, ultimately verifying theories related to strong-field quantum electrodynamics effects induced by extreme scattering.
This paper presents an investigation of the secondary saturation characteristics of a HfTe2 saturable absorber. Pulse energies of 5.85 and 7.4 mJ were demonstrated with a high-order Hermite–Gaussian (HG) laser and a vortex laser, respectively, using alexandrite as the gain medium. To the best of our knowledge, these are the highest pulse energies directly generated with HG and vortex lasers. To broaden the applications of high-energy pulsed HG and vortex lasers, wavelength tuning in the region of 40 nm was achieved using an etalon.
This paper provides an overview of the current status of ultrafast and ultra-intense lasers with peak powers exceeding 100 TW and examines the research activities in high-energy-density physics within China. Currently, 10 high-intensity lasers with powers over 100 TW are operational, and about 10 additional lasers are being constructed at various institutes and universities. These facilities operate either independently or are combined with one another, thereby offering substantial support for both Chinese and international research and development efforts in high-energy-density physics.
Knowledge of the critical periods of crop–weed competition is crucial for designing weed management strategies in cropping systems. In the Lower Yangtze Valley, China, field experiments were conducted in 2011 and 2012 to study the effect of interference from mixed natural weed populations on cotton growth and yield and to determine the critical period for weed control (CPWC) in direct-seeded cotton. Two treatments were applied: allowing weeds to infest the crop or keeping plots weed-free for increasing periods (0, 1, 2, 4, 6, 8, 10, 12, 14, and 20 wk) after crop emergence. The results show that mixed natural weed infestations led to 35- to 55-cm shorter cotton plants with stem diameters 10 to 13 mm smaller throughout the season, fitting well with modified Gompertz and logistic models, respectively. Season-long competition with weeds reduced the number of fruit branches per plant by 65% to 82%, decreasing boll number per plant by 86% to 96% and single boll weight by approximately 24%. Weed-free seed cotton yields ranged from 2,900 to 3,130 kg ha−1, while yield loss increased with the duration of weed infestation, reaching up to 83% to 96% compared with permanent weed-free plots. Modified Gompertz and logistic models were used to analyze the impact of increasing weed control duration and weed interference on relative seed cotton yield (percentage of season-long weed-free cotton), respectively. Based on a 5% yield loss threshold, the CPWC was found to be from 145 to 994 growing degree days (GDD), corresponding to 14 to 85 d after emergence (DAE). These findings emphasize the importance of implementing effective weed control measures from 14 to 85 DAE in the Lower Yangtze Valley to prevent crop losses exceeding a 5% yield loss threshold.
The Early-Middle Jurassic impression/compression macroflora and the palynoflora from the Qaidam Basin in the northeastern Qinghai-Xizang (Tibetan) Plateau have been well studied; however, fossil wood from this region has not been previously documented systematically. Here, we describe an anatomically well-preserved fossil wood specimen from the Lower Jurassic Huoshaoshan Formation at the Dameigou section in northern Qinghai Province, northwestern China. This fossil exhibits typical Metapodocarpoxylon Dupéron-Laudoueneix et Pons anatomy with usually araucarian radial tracheid pits and variable cross-field pits, representing a new record for Metapodocarpoxylon in the Qaidam Basin. This discovery indicates that trees with this type of wood anatomy were not confined to northern Gondwana but also grew in more northerly regions in Laurasia. The wood displays distinct growth rings, with abundant, well-formed earlywood and narrow latewood. This observation, along with previous interpretations based on macroflora, palynoflora and sedimentological data, suggests that a warm and humid climate with mild seasonality prevailed in the region during the Early Jurassic.
Green water loads on prismatic obstacles (representing topside structures) mounted on the raised deck of a simplified vessel are investigated using computational fluid dynamics simulations and physical model testing with emphasis on examining different structure shapes, orientation angles and relative structure size. For each scenario investigated, several flow features are identified that characterize the green water interaction with the structure and influence loads, namely delayed flow diversion, formation of a vertical jet, scattered wave formation and the development of complex wake patterns. Comparing across structures, these interactions are more pronounced for blunt objects, and the associated force impulse is larger. For example, a cube with flow at normal incidence is found to experience approximately twice the force impulse of a circular cylinder of the same projected area. Equally, rotation of the cube leads to reduced run-up height and streamwise force on the structure. To explain these trends, a theoretical model based on Newtonian flow theory is adopted. This model provides an estimate of the streamwise force exerted on obstacles in high-Froude-number flows and shows good agreement with the numerical results when the flow is supercritical, shallow (small water depth relative to structure width) and the structure is tall (large structure height relative to water depth). Despite some limitations, the model should provide an efficient force prediction tool for practical use in design.
Drawing upon research on the visual complexity effect and Dual Coding Theory, this research examined the influence of character properties and the role of individual learner differences in Chinese character acquisition. The participants included 248 Chinese-speaking children in grades 1 through 3 in Taiwan. The study extended the scope of previous research by concurrently examining two types of cognitive processing: activation of verbal codes with nonverbal codes (activation of word form) and activation of nonverbal codes with verbal codes (activation of meaning). Results revealed the asymmetry in the two types of cognitive processing. Regarding the influence of character properties, while characters with less visual complexity and with radical presence are generally more acquirable, the interaction between these two properties was only present in the activation of meaning but not the activation of word form. Individual differences contributing to character acquisition did not mirror each other in the two directions of cognitive processing either. The contribution of radical awareness and visual skills remained the same across grade levels in the activation of meaning but varied with grades and the properties of the characters in the activation of word form. The methodological and theoretical contributions of the study were discussed.
To speed up the construction of grassroots medical and health teams in China, free training of rural order-oriented medical students was launched in June 2010. Based on the theory of policy tools, a quantitative analysis of policy texts at the national level was conducted to explore the use of policy tools and to put forward corresponding suggestions for adjustments.
Methods
From January to February 2023, the research team searched the Peking University Treasure Database and the official websites of the State Council, the National Health Commission, the Ministry of Education, and other ministries for national policy documents related to free training of order-oriented medical students published from June 2010 to May 2023. A policy tool and policy target analysis framework were used to quantitatively analyze the policy documents.
Results
A total of 16 policy documents were included and 213 policy provisions were extracted. From the perspective of policy tools, the proportion of policy provisions using imperative policy tools was the highest (63.4%), followed by advisory policy tools (18.8%). and reward-based policy tools (13.6%). Functional expansion tools (2.8%) and authoritative restructuring tools (1.4%) accounted for a relatively low proportion. The institutional education stage is the main policy target, with provisions accounting for 75 percent (162 articles), followed by the continuing education stage (17.6%; 38 articles), and the postgraduate education stage (7.4%; 16 articles).
Conclusions
The distribution of policy tools for the free training policy of rural order-oriented medical students in China needs to be balanced, and the internal combination of the same policy tools needs to be optimized. The policy targets were mainly concentrated in the education stage of universities.
With the aging population, chronic diseases have become a serious threat to public health in China. Adhering to the doctor’s advice is an effective strategy for controlling chronic diseases, and the preferences of patients with chronic disease has an important impact on compliance with medication. However, there is insufficient research exploring this aspect.
Methods
In this study patients with chronic disease were selected by stratified random sampling to participate in a survey carried out in three cities of a province in eastern China. The discrete choice experiment used a questionnaire of D-efficiency experimental design to measure the medication choices of patients with chronic disease. The main attributes included drug price, onset of action, adverse reactions, traditional Chinese or Western medicine, domestic drug, and reimbursed by medical insurance. The data were analyzed using a mixed logit model.
Results
A total of 1,062 valid questionnaires were received. The 1,045 questionnaires that passed the consistency test covered three prefecture-level cities, nine counties, and 216 villages. All drug attributes were statistically significant for selection preferences. The preference of patients in rural areas with chronic disease was “quick onset of action” (β=2.491), “Western medicine” (β=0. 826), “medical insurance” (β=0.556), “domestic drugs” (β=0.286), and “very few adverse reactions” (β=0.170). “Drug price” also had an impact on medication preferences among patients in rural areas with chronic disease (β=−0.013).
Conclusions
Onset of action is the attribute of medications that is of most concern for patients in rural areas with chronic disease. Subgroup analysis showed that these patients were predominantly female, had a primary school education or lower, were younger than 69 years, were unemployed, and had an annual income between CNY10,000 (USD1,396.78) and CNY50,000 (USD6,983.92). They were willing to pay more for drugs with a quick onset of action, Western medicines, and drugs with reimbursed by medical insurance.
Fiber Bragg grating-based Raman oscillators are capable of achieving targeted frequency conversion and brightness enhancement through the provision of gain via stimulated Raman scattering across a broad gain spectrum. This capability renders them an exemplary solution for the acquisition of high-brightness, specialized-wavelength lasers. Nonetheless, the output power of all-fiber Raman oscillators is typically limited to several hundred watts, primarily due to limitations in injectable pump power and the influence of higher-order Raman effects, which is inadequate for certain application demands. In this study, we introduce an innovative approach by employing a graded-index fiber with a core diameter of up to 150 μm as the Raman gain medium. This strategy not only enhances the injectable pump power but also mitigates higher-order Raman effects. Consequently, we have successfully attained an output power of 1780 W for the all-fiber Raman laser at 1130 nm, representing the highest output power in Raman fiber oscillators with any configuration reported to date.