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Empirical research using the Empathic Accuracy Task (EAT) has suggested that schizophrenia patients and people with schizotypal personality disorder exhibit lower empathic accuracy than healthy people. However, empathic accuracy in a subclinical sample with high levels of schizotypy has seldom been studied. Our study aimed to investigate empathy in a subclinical sample using the Chinese version of the EAT and a self‐report empathy measure. Forty participants with high levels of schizotypy (HS participants) and 40 with low levels of schizotypy (LS participants), as measured by the Schizotypal Personality Questionnaire (SPQ), were recruited. All participants completed the Chinese version of the EAT and the self‐report Questionnaire of Cognitive and Affective Empathy. Empathic accuracy (EA) scores and the intra‐individual variability of EA scores were calculated. Independent samples ttests and Pearson correlation analyses were performed to examine group differences in empathy and the relationship between empathy and schizotypy respectively. HS participants exhibited reduced EA for both positive and negative videos, and larger intra‐individual variability of EA for negative videos than LS participants. However, HS and LS participants did not differ in self‐report cognitive empathy. Moreover, the interpersonal dimension of the SPQ was negatively correlated with EAT performance and self‐report cognitive empathy in LS participants. Individuals with HS show poorer performance‐based EA but relatively intact self‐report cognitive empathy. This study provides empirical evidence for the ontogeny of empathy deficits in subclinical populations at risk of developing schizophrenia, supporting early interventions for social cognitive deficits.

We report a minimalist gaseous sulfonyl-chloride-derived reagent for multicomponent bioconjugation with amine, phenol, or aniline reagents to afford urea or carbamate products. With the utilization of a gas-phase reagent for a reaction mediated by metal ions, a variety of biologically relevant molecules, such as saccharide, poly(ethylene glycol), fluorophore, and affinity tag, can be efficiently cross-linked to the N terminus or lysine side-chain amines on natural polypeptides or proteins.

Interoception refers to the sensation and perception of internal bodily sensations, and may be related to depressive symptoms. Schemata concerning the body vary across different cultures and may influence interoception and symptom presentations of depression. This study explored the relationship between interoception, depressive symptoms, and schema of somatic focus in Chinese people with subsyndromal depression. Thirty‐nine individuals with subsyndromal depression (SD) and 40 healthy controls (HCs) were assessed at baseline and after 3 months. Participants completed the self‐report questionnaires for assessing interoceptive sensibility, somatic and psychological symptoms of depression, and somatization tendency. They also completed the heartbeat perception behavioral task for estimating interoceptive accuracy. The results showed that both the SD and the HC groups showed similar interoceptive accuracy, although the SD group showed heightened interoceptive sensibility. The discrepancy between interoceptive sensibility and interoceptive accuracy is termed the interoceptive trait prediction error (ITPE). The ITPE was positive in SD participants but was negative in HCs. In the entire sample, interoceptive sensibility and the ITPE were correlated with somatic symptoms rather than with psychological symptoms of depression. Interoceptive sensibility partially mediated the relationship between somatization tendency and somatic symptoms, after controlling for psychological symptoms of depression. These results remained stable after 3 months. The shortcomings of the present study were a lack of clinical interview to ascertain diagnosis and a short follow‐up duration. In conclusion, our study suggests that altered interoception occurs in subsyndromal depression. Interoception is related to somatic symptoms of depression. The schema of body was related to depressive symptoms, partially through interoception, in Chinese people with subsyndromal depression.

IMPORTANCE: The role of stereotactic ablative radiotherapy (SABR) for gynecologic malignant tumors has yet to be clearly defined despite recent clinical uptake. OBJECTIVE: To evaluate the outcomes of SABR in patients with oligometastatic and oligoprogressive gynecologic cancers. DESIGN, SETTING, AND PARTICIPANTS: In this retrospective pooled analysis, patients with oligometastatic and oligoprogressive gynecologic cancers receiving SABR at 5 institutions from Canada and the US were studied. Data were collected from January 2011 to December 2020, and data were analyzed from January to December 2023. EXPOSURE: Stereotactic ablative radiotherapy. MAIN OUTCOMES AND MEASURES: Cumulative incidence of local and distant recurrence, chemotherapy-free survival (CFS), and overall survival (OS) probabilities after SABR were calculated using Kaplan-Meier methods. Univariable and multivariable analysis was conducted using Cox regression methods. RESULTS: A total of 215 patients with 320 lesions meeting criteria were included in the analysis; the median (range) age at primary diagnosis was 59 (23-86) years. The median (range) follow-up from SABR was 18.5 (0.1-124.5) months. The primary site included the endometrium (n = 107), ovary (n = 64), cervix (n = 30), and vulva or vagina (n = 14). Local cumulative incidence of recurrence was 13.7% (95% CI, 9.4-18.9) and 18.5% (95% CI, 13.2-24.5) at 1 and 5 years, respectively. Distant cumulative incidence of recurrence was 48.5% (95% CI, 41.4-55.1) and 73.1% (95% CI, 66.0-79.0) at 1 and 5 years, respectively. OS was 75.7% (95% CI, 69.2-81.1) and 33.1% (95% CI, 25.3-41.1) at 1 and 5 years, respectively. The median CFS was 21.7 months (95% CI, 15.4-29.9). On multivariable analysis, local recurrence was significantly associated with nodal metastasis, lesion size, biologically effective dose, treatment indication, institution, and primary disease type. Distant progression-free survival was associated with nodal targets and lesion size. OS and CFS were significantly associated with lesion size. CONCLUSIONS AND RELEVANCE: In this study, SABR appeared to have excellent local control with minimal toxic effects in this large patient group, and certain patients may achieve durable distant control and OS as well. It may be possible to delay time to chemotherapy in select patient subtypes and therefore reduce associated toxic effects. Prospective multicenter trials will be critical to establish which characteristics procure the greatest benefit from SABR use and to define the ideal time to implement SABR with other oncologic treatments.

Theory of mind (ToM) and empathy are considered key components of social cognition that are often impaired in individuals with autism spectrum disorders (ASD). However, it remains unclear whether individuals with high levels of autistic traits exhibit similar impairments in these two functions. This study examined the affective and cognitive domains of ToM and empathy in individuals with high levels of autistic traits. We recruited 84 participants with high levels and 78 participants with low levels of autistic traits to complete a set of self‐reported checklists and performance‐based tasks capturing affective and cognitive components of ToM and empathy. The results showed that participants with high levels of autistic traits exhibited significant impairments in cognitive but not in affective ToM and empathy compared with their counterparts with low levels of autistic traits. We also found that empathy impairments in people with high levels of autistic traits were confounded by alexithymia and depressive traits.

Anhedonia is a transdiagnostic symptom found in patients with schizophrenia and depression. Current pharmacological interventions for anhedonia are unsatisfactory in a considerable proportion of patients. There has been growing interest in applying noninvasive brain stimulation (NIBS) to patients with anhedonia. However, evidence for the efficacy of NIBS for anhedonia remain inconsistent. This study systematically identified all studies that measured anhedonia and applied NIBS in patients with schizophrenia or depression. We conducted a search using the various databases in English (PubMed, EBSCOHost (PsycInfo/PsycArticles), Web of Science) and Chinese (China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform) languages, and reviewed original research articles on NIBS published from January 1989 to July 2023. Our search had identified 15 articles for quantitative synthesis, with three concerning schizophrenia samples, 11 concerning samples with depression, and one concerning both clinical samples. We conducted a meta‐analysis based on the 15 included studies, and the results suggested that NIBS could improve anhedonia symptoms in schizophrenia patients and patients with depression, with a medium‐to‐large effect size. Our findings are preliminary, given the limited number of included studies. Future NIBS research should measure anhedonia as a primary outcome and should recruit transdiagnostic samples.

Type 2 diabetes (T2D) is a heterogeneous disease that develops through diverse pathophysiological processes1,2and molecular mechanisms that are often specific to cell type3,4. Here, to characterize the genetic contribution to these processes across ancestry groups, we aggregate genome-wide association study data from 2,535,601 individuals (39.7% not of European ancestry), including 428,452 cases of T2D. We identify 1,289 independent association signals at genome-wide significance (P< 5 × 10−8) that map to 611 loci, of which 145 loci are, to our knowledge, previously unreported. We define eight non-overlapping clusters of T2D signals that are characterized by distinct profiles of cardiometabolic trait associations. These clusters are differentially enriched for cell-type-specific regions of open chromatin, including pancreatic islets, adipocytes, endothelial cells and enteroendocrine cells. We build cluster-specific partitioned polygenic scores5in a further 279,552 individuals of diverse ancestry, including 30,288 cases of T2D, and test their association with T2D-related vascular outcomes. Cluster-specific partitioned polygenic scores are associated with coronary artery disease, peripheral artery disease and end-stage diabetic nephropathy across ancestry groups, highlighting the importance of obesity-related processes in the development of vascular outcomes. Our findings show the value of integrating multi-ancestry genome-wide association study data with single-cell epigenomics to disentangle the aetiological heterogeneity that drives the development and progression of T2D. This might offer a route to optimize global access to genetically informed diabetes care.

This article has supplementary material on the web site: www.jdbp.org.

This study applied two incentive delay tasks involving social and non‐social incentive types to 76 pairs of participants with high and low depressive symptoms. The results suggest that higher levels of depressive symptoms are correlated with abnormalities in social and non‐social reward processing even in the healthy populations.

Deep learning methods have gained increasing attention in various applications due to their outstanding performance. For exploring how this high performance relates to the proper use of data artifacts and the accurate problem formulation of a given task, interpretation models have become a crucial component in developing deep learning-based systems. Interpretation models enable the understanding of the inner workings of deep learning models and offer a sense of security in detecting the misuse of artifacts in the input data. Similar to prediction models, interpretation models are also susceptible to adversarial inputs. This work introduces two attacks, AdvEdge and AdvEdge$^{+}$+, which deceive both the target deep learning model and the coupled interpretation model. We assess the effectiveness of proposed attacks against four deep learning model architectures coupled with four interpretation models that represent different categories of interpretation models. Our experiments include the implementation of attacks using various attack frameworks. We also explore the attack resilience against three general defense mechanisms and potential countermeasures. Our analysis shows the effectiveness of our attacks in terms of deceiving the deep learning models and their interpreters, and highlights insights to improve and circumvent the attacks.

Background: Patients with end-stage ankle osteoarthritis suffer from reduced mobility and quality of life and the main surgical treatments are total ankle replacement (TAR) and ankle fusion (AF). Objectives: Our aim was to calculate the mean incremental cost per quality-adjusted life-year (QALY) of TAR compared with AF in patients with end-stage ankle osteoarthritis, over 52 weeks and over the patients’ lifetime. Method: We conducted a cost-utility analysis of 282 participants from 17 UK centres recruited to a randomised controlled trial (TARVA). QALYs were calculated using index values from EQ-5D-5L. Resource use information was collected from case report forms and self-completed questionnaires. Primary analysis was within-trial analysis from the National Health Service (NHS) and Personal Social Services (PSS) perspective, while secondary analyses were within-trial analysis from wider perspective and long-term economic modelling. Adjustments were made for baseline resource use and index values. Results: Total cost at 52 weeks was higher in the TAR group compared with the AF group, from the NHS and PSS perspective (mean adjusted difference £2539, 95% confidence interval [CI] £1142, £3897). The difference became very small from the wider perspective (£155, 95% CI −  £1947, £2331). There was no significant difference between TAR and AF in terms of QALYs (mean adjusted difference 0.02, 95% CI −  0.015, 0.05) at 52 weeks post-operation. The incremental cost-effectiveness ratio (ICER) was £131,999 per QALY gained 52 weeks post-operation. Long-term economic modelling resulted in an ICER of £4200 per QALY gained, and there is a 69% probability of TAR being cost effective at a cost-effectiveness threshold of £20,000 per QALY gained. Conclusion: TAR does not appear to be cost effective over AF 52 weeks post-operation. A decision model suggests that TAR can be cost effective over the patients’ lifetime but there is a need for longer-term prospectively collected data.

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Purpose: Several controversies in the optimal treatment of femoral neck fractures persist, together with large variations in clinical practice.Methods: A narrative literature review covering 4 current controversies in the surgical management of femoral neck fractures (total hip arthroplasty (THA) versus hemiarthroplasty (HA), cemented versus uncemented HA, internal fixation versus arthroplasty, operative versus non-operative) was performed. Available literature was balanced against annual trends in the management of femoral neck fractures from the public domain of several national registries (Sweden, Norway, The Netherlands, Australia and New Zealand).Results: For most controversies, the literature provides stronger evidence than is reflected by variations encountered in daily practice. Implementation of clinical evidence tends to lag behind and important differences exist between countries.Conclusions: Trends of clinical practice from national registries indicate that implementation of available clinical evidence needs to be improved.

BackgroundUltra-short coeliac disease (USCD) is defined as villous atrophy only present in the duodenal bulb (D1) with concurrent positive coeliac serology. We present the first, multicentre, international study of patients with USCD.MethodsPatients with USCD were identified from 10 tertiary hospitals (6 from Europe, 2 from Asia, 1 from North America and 1 from Australasia) and compared with age-matched and sex-matched patients with conventional coeliac disease.FindingsPatients with USCD (n=137, median age 27 years, IQR 21–43 years; 73% female) were younger than those with conventional coeliac disease (27 vs 38 years, respectively, p<0.001). Immunoglobulin A-tissue transglutaminase (IgA-tTG) titres at index gastroscopy were lower in patients with USCD versus conventional coeliac disease (1.8×upper limit of normal (ULN) (IQR 1.1–5.9) vs 12.6×ULN (IQR 3.3–18.3), p<0.001).Patients with USCD had the same number of symptoms overall (median 3 (IQR 2–4) vs 3 (IQR 1–4), p=0.875). Patients with USCD experienced less iron deficiency (41.8% vs 22.4%, p=0.006).Both USCD and conventional coeliac disease had the same intraepithelial lymphocytes immunophenotype staining pattern; positive for CD3 and CD8, but not CD4.At follow-up having commenced a gluten-free diet (GFD) (median of 1181 days IQR: 440–2160 days) both USCD and the age-matched and sex-matched controls experienced a similar reduction in IgA-tTG titres (0.5 ULN (IQR 0.2–1.4) vs 0.7 ULN (IQR 0.2–2.6), p=0.312). 95.7% of patients with USCD reported a clinical improvement in their symptoms.InterpretationPatients with USCD are younger, have a similar symptomatic burden and benefit from a GFD. This study endorses the recommendation of D1 sampling as part of the endoscopic coeliac disease diagnostic workup.

To analyze the ability to evaluate changes over time of individual lesions of incomplete or complete retinal pigment epithelium (RPE) and outer retinal atrophy (iRORA and cRORA, respectively) in patients with intermediate age-related macular degeneration (iAMD).

Decentralized Identity (DID) is emerging as a new digital identity management scheme that promises users complete control of their personal data and identification without central authority involvement. The World Wide Web Consortium (W3C) has drafted the DID standard and provided reference implementations. We conduct a security analysis of the W3C DID standard and the reference universal resolver implementation, focusing on user privacy in the DID resolving process. The universal resolver is the key component in the architecture that processes DID requests and DID document retrievals. Our analysis demonstrates that privacy issues can arise due to the imprudent design of the universal resolver. Furthermore, we found that side-channels in the DID document caching schemes of real-world DID services can entail privacy concerns. Motivated by our security analysis, we present a novel DID resolving design, called Oblivira, to enable obliviously DID resolving. Oblivira is a secure resolving agent with a small footprint that enforces the universal resolver to resolve requests without knowing their content. We also propose a privacy-preserving DID document caching scheme that eliminates side-channels. Our evaluation results show that Oblivira only incurs approximately 2.6% of overhead on average with different resolver settings (3, 6, and 12 threads).

Background: One of the core aims of the European Union of Medical Specialists is to harmonize training across Europe by creating European Training Requirements for all medical specialties including Ophthalmology. The theoretical part is already defined by the EBO, however as ophthalmology also includes surgical skills, we herein propose a surgical minimum curriculum for ophthalmology residents in Europe. Methods: National and international ophthalmic training curricula which are publicly available in English were reviewed and compared. The final proposal was created from 5 criteria: 1. Disease prevalence; 2. Patient safety; 3. Case-trainee ratio; 4. Skill transfer; and 5. Technical difficulty. Results: In total 7 different training curricula from across the world were compared. Among the surgical procedures, cataract surgery has the highest median number of procedures required to be completed during residency: 86 procedures (50–350). Followed by oculoplastics: 28 procedures (10–40) and panretinal photocoagulation: 27.5 procedures (10–49) Full procedural competence is proposed in 9 surgical skills, including YAG laser posterior capsulotomy, retinal argon laser, intravitreal injection, corneal foreign body removal, removal of corneal sutures, facial and periocular laceration repair, eyelid laceration repair, minor eyelid procedures, and punctal occlusion. These procedures are deemed essential and feasible for all ophthalmology residents in Europe to perform independently upon completion of their training. Conclusion: This proposal should be regarded as a recommendation based on comparable surgical curricula in use worldwide to establish standards across European countries and may serve as valuable insight to those responsible for compiling ETRs for ophthalmology, or their national curriculums.

Purpose: The radiologists’ workload is increasing, and computational imaging techniques may have the potential to identify visually unequivocal lesions, so that the radiologist can focus on equivocal and critical cases. The purpose of this study was to assess radiomics versus dual-energy CT (DECT) material decomposition to objectively distinguish visually unequivocal abdominal lymphoma and benign lymph nodes. Methods: Retrospectively, 72 patients [m, 47; age, 63.5 (27–87) years] with nodal lymphoma (n= 27) or benign abdominal lymph nodes (n= 45) who had contrast-enhanced abdominal DECT between 06/2015 and 07/2019 were included. Three lymph nodes per patient were manually segmented to extract radiomics features and DECT material decomposition values. We used intra-class correlation analysis, Pearson correlation and LASSO to stratify a robust and non-redundant feature subset. Independent train and test data were applied on a pool of four machine learning models. Performance and permutation-based feature importance was assessed to increase the interpretability and allow for comparison of the models. Top performing models were compared by the DeLong test. Results: About 38% (19/50) and 36% (8/22) of the train and test set patients had abdominal lymphoma. Clearer entity clusters were seen in t-SNE plots using a combination of DECT and radiomics features compared to DECT features only. Top model performances of AUC = 0.763 (CI = 0.435–0.923) were achieved for the DECT cohort and AUC = 1.000 (CI = 1.000–1.000) for the radiomics feature cohort to stratify visually unequivocal lymphomatous lymph nodes. The performance of the radiomics model was significantly (p= 0.011, DeLong) superior to the DECT model. Conclusions: Radiomics may have the potential to objectively stratify visually unequivocal nodal lymphoma versus benign lymph nodes. Radiomics seems superior to spectral DECT material decomposition in this use case. Therefore, artificial intelligence methodologies may not be restricted to centers with DECT equipment.

Direct laser assisted machining (DLAM) is an effective way to improve the machinability of superalloys. It makes important progress compared to conventional laser assisted machining that enable the heating and cutting simultaneously during machining process. In the present work, improved DLAM based on the cubic zirconia tool is developed. By utilizing the Cubic Zirconia tool, improved DLAM has higher applicability and less cost. For the first time, DLAM cutting tests on Al 7075-T6 and Ti-6Al-4V are performed varying the cutting speeds and laser output powers. Cutting forces, surface roughness, and chip morphology are observed and compared. Finite element simulation is performed to estimate the cutting temperature for all cutting conditions. The study's results suggest that the DLAM with cubic zirconia tool could improve the cutting of alloys by less cutting forces and smoother surface finish. The work provides significant insight into the cutting mechanism of DLAM.

The anterior insula (AI) has the central role in coordinating attention and integrating information from multiple sensory modalities. AI dysfunction may contribute to both sensory and social impairments in autism spectrum disorder (ASD). Little is known regarding the brain mechanisms that guide multisensory integration, and how such neural activity might be affected by autistic‐like symptoms in the general population. In this study, 72 healthy young adults performed an audiovisual speech synchrony judgment (SJ) task during fMRI scanning. We aimed to investigate the SJ‐related brain activations and connectivity, with a focus on the AI. Compared with synchronous speech, asynchrony perception triggered stronger activations in the bilateral AI, and other frontal‐cingulate‐parietal regions. In contrast, synchronous perception resulted in greater involvement of the primary auditory and visual areas, indicating multisensory validation and fusion. Moreover, the AI demonstrated a stronger connection with the anterior cingulate gyrus (ACC) in the audiovisual asynchronous (vs. synchronous) condition. To facilitate asynchrony detection, the AI may integrate auditory and visual speech stimuli, and generate a control signal to the ACC that further supports conflict‐resolving and response selection. Correlation analysis, however, suggested that audiovisual synchrony perception and its related AI activation and connectivity did not significantly vary with different levels of autistic traits. These findings provide novel evidence for the neural mechanisms underlying multisensory temporal processing in healthy people. Future research should examine whether such findings would be extended to ASD patients.

Mental time travel (MTT) refers to the ability to mentally re‐experience the past and pre‐experience the future. Here we briefly review impairments in MTT, its underlying cognitive and neural mechanisms, and ways to improve MTT in psychiatric patients. Future research directions on MTT are discussed.

Mental time travel (MTT) is the ability to project oneself to the past or future through mental simulation. Moreover, MTT can involve self‐related or other‐related information. This study aimed to compare MTT in individuals with high levels of schizotypy and that in their counterparts with low levels of schizotypy. Participants with high (n= 37) and low (n= 37) levels of schizotypy completed an MTT task with four conditions [2 (Condition: self vs. other) × 2 (Time orientation: past vs. future)]. They were required to recall past events that had happened to themselves or to a non‐intimate person, and to imagine possible future events that might happen to themselves or to a non‐intimate person, related to cue words. Outcome measures included specificity, vividness, sense of experience, emotional valence, emotional intensity, proportion of first‐person visual perspective in events, and difficulty in event generation. A 2 (Group: high vs. low levels of schizotypy) × 2 (Condition) × 2 (Time orientation) mixed analysis of variance was conducted on each index. Results showed that self‐related MTT was more specific than other‐related MTT in low levels of schizotypy participants but not in high levels of schizotypy participants. Participants with a high level of schizotypy reported fewer specific events, and reported events with lower vividness and positive emotion than did those with a low level of schizotypy. Self‐related MTT showed higher levels of phenomenological characteristics than did other‐related MTT. In conclusion, individuals with a high level of schizotypy have altered MTT, and cannot benefit from the self‐advantage effect on the specificity of MTT.

TORT (Tapes on Round Tube) cables, which implement high-temperature superconducting (HTS) tapes, offer additional benefit over other HTS cables, which is the internal cooling in the former itself. Up to now, the superconducting tapes of existing TORT cables have been wound on a copper tube of various diameters. However, in the alternating current (AC) mode, the high conductivity of the former causes undesirable eddy currents. Therefore, it is necessary to replace the copper with a less electrically conductive material. We designed a former from polyethylene terephthalate glycol-modified and reinforced with carbon fibers (PETG CF), polycarbonate (PC) and polycarbonate reinforced with carbon fibers (PC CF) materials in order to reduce the AC losses in TORT cables, using 3D printing technology. Because of the low thermal conductivity of polymers, the former must be specially designed to improve the cooling of the HTS tapes inside the former. Moreover, thermal deformation of the former during cooling from room temperature to liquid nitrogen temperature and resilience against low-diameter bending is another important issue that was taken into account. Detailed structural finite-element (FE) analysis was carried out using the FE modeling software ANSYS, in prototyping of the former. Based on the numerical models, formers differing in the materials used were fabricated, and subsequently a short TORT cable with wound HTS tape was electromagnetically characterized.

SUMMARYWe tracked departures of European Robins Erithacus rubeculastopping over during spring migration at Skagen, Denmark, and facing a sea crossing of more than 50 km. The Robins stopped over on average for 3.8 days (range 1–14 days, n = 15) with departure days being slightly warmer than stopover days (1.5°C warmer, P = 0.003). Departures were concentrated in the evening, on average during astronomical twilight, and toward the northeast (µ = 33.3°, r = 0.499, P = 0.021). The mean northeasterly departure direction is close to the standard migration direction. Most birds probably crossed the sea to Sweden and we observed no obvious reversed departure directions.

The increasing demand for higher energy density in energy storage systems has instituted the need for electrodes with higher specific capacity and long-term cyclability. However, conventional Li-ion batteries using liquid electrolytes are incapable of reaching the high energy density requirements due to their incompatibility with these high-capacity electrodes. Moreover, these conventional Li-ion batteries are prone to catch fire due to dendrite growth, interfacial instabilities, liquid leakage, and thermal runaway. In contrast, solid-state batteries (SS-LIBs) are a promising technology which can utilize high theoretical specific capacity anodes such as Li metal and Si-based anodes. SS-LIBs experiences internal stresses in between the layers (of electrodes and electrolyte). During lithiation cycling in a SS-LIB, the electrode layers undergo volumetric, phase, and/or lattice dimensional changes, which induces the structural constraints at the interfaces. These constraints raise internal stresses in different stress concentrated regions, leading to poor interfacial contacts, capacity fading, and possible battery failure. In addition, the practicability of SS-LIBs relies on overcoming the scalability challenges, notably, in handling multilayered structures, homogeneity of the interfacial contact, and a suitable stacking process without damaging the multilayered SS-LIB structure. Herein, we evaluate and discuss the cause and impact of these stress management and manufacturability challenges and provide a review of the studies conducted in tackling these challenges. We aim to guide the readers towards tackling these problems and provide possible shortcomings in these solutions.

Major depressive disorder (MDD) is associated with deficits in emotion experience, expression and regulation. Whilst emotion regulation deficits prolong MDD, emotion expression influences symptomatic presentations, and anticipatory pleasure deficits predict recurrence risk. Profiling MDD patients from an emotion componential perspective can characterize subtypes with different clinical and functional outcomes. This study aimed to investigate emotional subtypes of MDD. A two‐stage cluster analysis applied to 150 MDD patients. Clustering variables included emotion experience measured by Temporal Experience of Pleasure Scale, emotion expression measured by Toronto Alexithymia Scale, and emotion regulation measured by Emotion Regulation Questionnaire. We validated the resultant clusters by comparing their symptoms and functioning with that of 50 controls. Cluster 1 (n= 50) exhibited intact emotion experience and expression yet adopted reappraisal rather than suppression strategy, whereas Cluster 2 (n= 66) exhibited generalized emotional deficits. Cluster 3 (n= 34) exhibited emotion expression deficits and adopted both reappraisal and suppression strategies. On validation, Cluster 2 exhibited the worst, but Cluster 1 exhibited the least symptoms and social functioning impairments. Cluster 3 was intermediate among the two other subtypes. Our findings support the existence of different emotional subtypes in MDD patients, and have clinical and theoretical implications for developing future specific treatments for MDD.

Emotion processing and beliefs about pleasure can influence the development and severity of depressive symptoms. This cluster analysis study aimed to profile a large sample of college students using pleasure experience, emotion expression and regulation as well as beliefs about pleasure. We also aimed to validate the resultant clusters in terms of depressive symptoms. A set of checklists capturing beliefs about pleasure and the three facets of emotion processing was administered to 1028 college students. A two‐stage cluster analysis was used to analyze the profile of these emotional aspects in these college students. Our results showed that a three‐cluster solution best fit the data. Cluster 1 (n= 536) was characterized by moderate levels of beliefs about pleasure, pleasure experience, emotion expression, and regulation; Cluster 2 (n= 402) was characterized by generally high levels of beliefs about pleasure, pleasure experience, emotion expression, and regulation; Cluster 3 (n= 90) was characterized by relatively low levels of beliefs about pleasure, pleasure experience, emotion expression, and regulation. The three clusters differed significantly in the severity of depressive symptoms. Our findings suggest the existence of three emotional subtypes, which may be useful in early detection of youth at risk of developing depression.

Background/objectives: This study aims to benchmark the training programs of European ophthalmology residents. Subjects/Methods: An online survey, aimed at European ophthalmology residents in training and those within two years of completion, was sent through the national representatives of the European Society of Ophthalmology, Young Ophthalmologists section (SOE-YO). The study involved 214 subjects representing 36 of the 44 European countries offering ophthalmology training programs. Results: Among the surveyed, 74.8% of participants had an official national curriculum; 55.8% had a national specialty examination to accredit their training as ophthalmologists. 45.8% were satisfied or very satisfied with the clinical skills acquired, while 42.1% were completely dissatisfied with the surgical skills achieved. Considering the 4th year residents (mean duration of the residency), many of them did not perform phacoemulsification surgery (34%), pterygium excision (46.9%), or repair of eyelid laceration (31.3%). Conclusions: There is great heterogeneity in the competencies achieved by residents in training according to their country of origin, especially in terms of surgical competences.

Grid-connected plug-in electric vehicle charging stations having integrated renewable energy sources like photovoltaic (PV) systems with battery energy storage help manage the variability of electric vehicle charging load and reduce the stress on the grid. Such charging stations will benefit from short to medium term forecasting of load demand, as it allows them to optimize the operation through better utilization of the PV and battery stored energy rather than relying on the grid. The load forecasting accuracy has a direct correlation with the degree of optimization achievable. Deep learning network is a form of artificial neural network which can be effectively used for time series forecasting. In this paper, some of the widely researched deep learning models such as long short-term memory (LSTM), gated recurrent units (GRU), hybrid of convolution neural network (CNN) and LSTM, hybrid of CNN and GRU, multivariate LSTM and multivariate GRU are analyzed for fitment for the charging load forecasting problem. The datasets available from multiple charging stations in a region are used for training the models. The predictions made using these models and their performances are analyzed using standard metrics and are presented.

This sequential mediation analysis study examined how the baseline effort–reward imbalance (ERI) would predict reward motivation 1 year later in 435 college students. We found that negative/disorganized schizotypal traits and anticipatory pleasure experience together mediate the prediction of ERI for reward motivation.

Wax crystallization in cold environments constitutes one of the main causes for flow assurance problems during oil production. Several techniques, such as differential scanning calorimetry (DSC) or gas chromatography/mass spectroscopy (GC/MS), are currently the established methods for the quantification of wax precipitation. Low-field nuclear magnetic resonance (NMR) techniques have seldom been used for the investigation of wax precipitation, despite early studies showing their ability to identify the rate of precipitation. This paper highlights three NMR methods, adapted for the purpose of wax crystallization quantification in crude oil systems. The proposed methods are based on free induction decay (FID) and Carr–Purcell–Meiboom–Gill (CPMG) sequences. Both allow for the quantification of a signal that is proportional to the non-crystalline wax content, while FID data can also be used for the computation of the crystalline wax component in systems with a sufficiently high wax content. DSC is also used as a reference method for wax content quantification. Model system analysis demonstrates consistency between the three methods in toluene-based wax solutions and also highlights a thorough comparison between macro- and microcrystalline waxes. Similar results are obtained with the four methods for crude oils with a high wax content, and a relevant comparison between different systems can be achieved for oils with wax concentrations as low as 2% at 0 °C. Overall, the determination of the solid content with FID represents an improved, more reliable method, which can be utilized during the creation of more robust flow assurance methods.

Robotic machining has attracted great interest in the fields of aerospace and automotive manufacturing because of its advantages over conventional computer numerical controlled (CNC) machine tools; robotic machining is flexible and can fabricate components with complex (sculpted) geometries and of large dimensions. The principal challenge, however, is the poor structural rigidity of robots, leading to high-level vibration and chatter during machining. The cutting force must be monitored to detect and suppress chatter as well as optimize machining. A practical method is required to measure the cutting force during machining without impeding robot movement. This study presents an indirect method that accurately measures the milling force using an accelerometer located on the spindle and a flange-mounted capacitive force sensor. A Kalman filter was used to compensate for the dynamics between the robot tool center point (TCP) and the location of the accelerometer. In the context of pose-dependent modeling of the dynamics of the robot, a novel machine-learning (ML)-based identifier is presented that rapidly identifies the relevant dynamics (i.e., the modal parameters) without any initial human guesswork. Data from dynamic simulations and experiments were used to train and validate the ML-based identifier. The validation results showed that the identifier rapidly predicted the behaviour of physical systems with an average accuracy of 98.49 % compared to the modal analysis method. Next, the cutting forces were indirectly measured using the acceleration signals and a Kalman filter, developed based on the modal parameters. The forces measured by the proposed method were in good agreement with the reference forces, measured using a table dynamometer; the average peak-to-peak accuracy was 90.17 % for the AC component of the cutting force, and the average time-domain accuracy was 95.27 % when the DC component was also considered.

ObjectivesNo randomised controlled trials have been conducted for breakthrough pain in paediatric palliative care and there are currently no standardised outcome measures. The DIPPER study aims to establish the feasibility of conducting a prospective randomised controlled trial comparing oral and transmucosal administration of opioids for breakthrough pain. The aim of the current study was to achieve consensus on design aspects for a small-scale prospective study to inform a future randomised controlled trial of oral morphine, the current first-line treatment, versus transmucosal diamorphine.MethodsThe nominal group technique was used to achieve consensus on best practice for mode of administration, dose regimen and a range of suitable pain intensity outcome measures for transmucosal diamorphine in children and young people with breakthrough pain. An expert panel of ten clinicians in paediatric palliative care and three parent representatives participated. Consensus was achieved when agreement was reached and no further comments from participants were forthcoming.ResultsThe panel favoured the buccal route of administration, with dosing according to the recommendations in the Association for Paediatric Palliative Medicine formulary (fifth Edition, 2020). The verbal Numerical Rating Scale was selected to measure pain in children 8 years old and older, the Faces Pain Scale-Revised for children between 4 and 8 years old, and Face, Legs, Activity, Cry and Consolability (FLACC)/FLACC-Revised as the observational tools.ConclusionsThe nominal group technique allowed consensus to be reached for a small-scale, prospective, cohort study and provided information to inform the design of a randomised controlled trial.

We evaluate the racial bias in face recognition application programming interfaces (APIs) using real and deepfake celebrity images. We use deepfake generation methods to introduce small, imperceptible changes to the real images to shift the racial class of predictions, showing how deepfake images exacerbated racial bias in web-based face recognition APIs.

BackgroundPolygenic risk score (PRS), calculated based on genome-wide association studies (GWASs), can improve breast cancer (BC) risk assessment. To date, most BC GWASs have been performed in individuals of European (EUR) ancestry, and the generalisation of EUR-based PRS to other populations is a major challenge. In this study, we examined the performance of EUR-based BC PRS models in Ashkenazi Jewish (AJ) women.MethodsWe generated PRSs based on data on EUR women from the Breast Cancer Association Consortium (BCAC). We tested the performance of the PRSs in a cohort of 2161 AJ women from Israel (1437 cases and 724 controls) from BCAC (BCAC cohort from Israel (BCAC-IL)). In addition, we tested the performance of these EUR-based BC PRSs, as well as the established 313-SNP EUR BC PRS, in an independent cohort of 181 AJ women from Hadassah Medical Center (HMC) in Israel.ResultsIn the BCAC-IL cohort, the highest OR per 1 SD was 1.56 (±0.09). The OR for AJ women at the top 10% of the PRS distribution compared with the middle quintile was 2.10 (±0.24). In the HMC cohort, the OR per 1 SD of the EUR-based PRS that performed best in the BCAC-IL cohort was 1.58±0.27. The OR per 1 SD of the commonly used 313-SNP BC PRS was 1.64 (±0.28).ConclusionsExtant EUR GWAS data can be used for generating PRSs that identify AJ women with markedly elevated risk of BC and therefore hold promise for improving BC risk assessment in AJ women.

ObjectiveTo estimate the proportion of cases of Crohn’s disease (CD) and ulcerative colitis (UC) that could be prevented by modifiable lifestyle factors.DesignIn a prospective cohort study of US adults from the Nurses’ Health Study (NHS; n=72 290), NHSII (n=93 909) and Health Professionals Follow-up Study (HPFS; n=41 871), we created modifiable risk scores (MRS; 0–6) for CD and UC based on established lifestyle risk factors, and healthy lifestyle scores (HLS; 0–9) derived from American healthy lifestyle recommendations. We calculated the population attributable risk by comparing the incidence of CD and UC between low-risk (CD-MRS≤1, UC-MRS≤2, HLS≥7) and high-risk groups. We externally validated our findings in three European cohorts: the Swedish Mammography Cohort (n=37 275), Cohort of Swedish Men (n=40 810) and European Prospective Investigation into Cancer and Nutrition (n=404 144).ResultsOver 5 117 021 person-years of follow-up (NHS, HPFS: 1986–2016; NHSII: 1991–2017), we documented 346 CD and 456 UC cases. Adherence to a low MRS could have prevented 42.9% (95% CI 12.2% to 66.1%) of CD and 44.4% (95% CI 9.0% to 69.8%) of UC cases. Similarly, adherence to a healthy lifestyle could have prevented 61.1% (95% CI 16.8% to 84.9%) of CD and 42.2% (95% CI 1.7% to 70.9%) of UC cases. In our validation cohorts, adherence to a low MRS and healthy lifestyle could have, respectively, prevented 43.9%–51.2% and 48.8%–60.4% of CD cases and 20.6%–27.8% and 46.8%–56.3% of UC cases.ConclusionsAcross six US and European cohorts, a substantial burden of inflammatory bowel diseases risk may be preventable through lifestyle modification.

Background A health inequalities gap exists between wealthy and deprived areas. Community-level occupation-focused interventions may support citizens and address inequities within their environments. Since the global financial crash of 2008 and fiscal policy changes within the United Kingdom, there has been a rise in food insecurity. Community volunteer initiatives have responded by providing for their residents. The aim of this study was to explore how occupational therapists may be agents for social change through exploring perspectives of members and volunteers from a community food cooperative in an area of social deprivation.Methods Eight semi-structured interviews were conducted with cooperative members and volunteers within a food cooperative established to address food insecurity in a local community. Data were analysed using thematic analysis.Results We found three main themes: It’s Not a Foodbank, Shared Hardshipand a cross-cutting theme of Community. The results suggest occupation-focused responses can support the development of community and collective occupations thereby contributing solutions to shared problems.Conclusion A community-centred, rights-based approach has supported local community need where socio-economic disadvantage and health inequalities were identified. Scope exists for occupational therapists to work genuinely with (not for) communities to address occupational injustice through collective occupation.

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