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High-fidelity simulations are conducted to investigate the turbulent boundary layers around a finite-span NACA0012 wing with a rounded wing-tip geometry at a chord-based Reynolds number of $Re_c=200\,000$ and at various angles of attack up to $10^\circ$. The study aims to discern the differences between the boundary layers on the finite-span wing and those on infinite-span wings at equivalent angles of attack. The finite-span boundary layers exhibit: (i) an altered streamwise and a non-zero spanwise pressure gradient as a result of the variable downwash induced by the wing-tip vortices (an inviscid effect typical of finite-span wings); (ii) differences in the flow history at different wall-normal distances, caused by the variable flow angle in the wall-normal direction (due to constant pressure gradients and variable momentum normal to the wall); (iii) laminar flow entrainment into the turbulent boundary layers near the wing tip (due to a laminar–turbulent interface); and (iv) variations in boundary layer thickness across the span, attributed to the variable wall-normal velocity in that direction (a primarily inviscid effect). These physical effects are then used to explain the differences in the Reynolds stress profiles and other boundary layer quantities, including the reduced near-wall peak of the streamwise Reynolds stress and the elevated Reynolds stress levels near the boundary layer edge, both observed in the finite-span wings. Other aspects of the flow, such as the downstream development of wing-tip vortices and their interactions with the surrounding flow, are reserved for future investigations.
In this study, the presence of dizziness in the late period was investigated in patients working in the Armed Forces who were exposed to blast trauma with a test battery consisting of cervical and ocular vestibular-evoked myogenic potentials and the Dizziness Handicap Inventory.
Methods
Twenty-two healthy adult volunteers (44 healthy ears) and 25 military personnel (43 patient ears) who had blast trauma were included in the study. The cervical and ocular vestibular-evoked myogenic potential tests were applied to the control and patient groups. The patient group also filled in the Dizziness Handicap Inventory.
Results
The mean score of the Dizziness Handicap Inventory of the patient group was 14.80 ± 23.38. In cervical and ocular vestibular-evoked myogenic potential tests there was no significant difference in the comparison of P1 latency, N1 latency and P1N1 amplitude between control and patient groups.
Conclusıon
It was observed that the functions of otolith organs were not affected in the late period after blast trauma.
A 2300 year old bark shield found in Enderby, Leicestershire, in 2015 is the only known example of its type. Made from the bark of a willow tree, it has a woven basket boss, a roundwood handle, and a rim of split roundwood edging and lime bast bindings. Pre-Roman shields made from organic materials rarely survive in Britain and Ireland and those without metal components are exceptionally rare. Contemporaneous wooden shields are known from anaerobic environments in Scandinavia but, unlike Enderby, none of these has a body of tree bark. The complexity of the design of the Enderby shield, the skill with which it was made, and the similarities between this and metal examples suggests it was a tried and tested design, rather than a one-off. With no other example against which to compare it, experiments in reproducing the shield have been used as a tool for interpretation and have proved vital to understanding the original design. As a result of this research, it is proposed that this single artefact represents a more commonly available form of shield in the 1st millennium bc than does any metal enhanced version.
Let $\zeta _K(s)$ denote the Dedekind zeta-function associated to a number field K. We give an effective upper bound for the height of the first nontrivial zero other than $1/2$ of $\zeta _K(s)$ under the generalised Riemann hypothesis. This is a refinement of the earlier bound obtained by Sami [‘Majoration du premier zéro de la fonction zêta de Dedekind’, Acta Arith.99(1) (2000), 61–65].
Guidelines recommend screening for psychiatric co-morbidities in patients with congenital heart defects alongside cardiac outpatient follow-ups. These recommendations are not implemented in Denmark. This study aimed to investigate the psychiatric co-morbidities in children and adolescents with Fontan circulation in Denmark and to evaluate the feasibility of an online screening measure for psychiatric disorders.
Methods:
Children, adolescents, and their families answered the Development and Well-Being Assessment questionnaire and a questionnaire about received help online. Development and Well-Being Assessment ratings present psychiatric diagnoses in accordance with ICD-10 and DSM-5. Parent-reported received psychiatric help is also presented. Feasibility data are reported as participation rate (completed Development and Well-Being Assessments) and parental/adolescent acceptability from the feasibility questionnaire.
Results:
The participation rate was 27%. Of the participating children and adolescents, 53% (ICD-10)/59% (DSM-5) met full diagnostic criteria for at least one psychiatric diagnosis. Of these, 50% had not received any psychiatric or psychological help. Only 12% of participants had an a priori psychiatric diagnosis.
Conclusions:
We found that a large proportion of children and adolescents with Fontan circulation are underdiagnosed and undertreated for psychiatric disorders. The results from our study emphasise the need for psychiatric screening in this patient group. Development and Well-Being Assessment may be too comprehensive for online electronic screening in children and adolescents with CHD.
This research proposes an inexpensive technique for wireless image transfer for security and surveillance applications. The technique uses a 5.8 GHz transmitter and receiver module, along with external antennas in the real-time image transfer within a radius of 100 m. The transferred images are stored in a laptop using a Python code-based graphical user interface application. Different antennas, dipole, circular split-ring resonators, hexagonal split-ring resonators, and metamaterial antennas are utilized for comparison. The Blind/Referenceless Image Spatial Quality Evaluator method is used to assess the picture quality of transferred images to quantify image transfer performance when no ground truth or reference photos are supplied. According to the presented results, images transferred using metamaterial antennas have higher quality than those transferred with other types of antennas. For security considerations, such a system can communicate and store the images in real time.
Preoperative pneumonia in children with CHD may lead to longer stays in the ICU after surgery. However, research on the associated risk factors is limited. This study aims to evaluate the pre-, intra-, and postoperative risk factors contributing to extended ICU stays in these children.
Methods:
This retrospective cohort study collected data from 496 children with CHD complicated by preoperative pneumonia who underwent cardiac surgery following medical treatment at a single centre from 2017 to 2022. We compared the clinical outcomes of patients with varying ICU stays and utilised multivariate logistic regression analysis and multiple linear regression analyses to evaluate the risk factors for prolonged ICU stays.
Results:
The median ICU stay for the 496 children was 7 days. Bacterial infection, severe pneumonia, and Risk Adjustment for Congenital Heart Surgery-1 were independent risk factors for prolonged ICU stays following cardiac surgery (P < 0.05).
Conclusion:
CHD complicated by pneumonia presents a significant treatment challenge. Better identification of the risk factors associated with long-term postoperative ICU stays in these children, along with timely diagnosis and treatment of respiratory infections in high-risk populations, can effectively reduce ICU stays and improve resource utilisation.
We aimed to evaluate imaging modalities utilized in patients with vocal cord palsy (VCP) of unknown aetiology, emphasizing the significance of timing and diagnostic yield.
Methods
We conducted a retrospective review of medical records of patients diagnosed with VCP of unknown aetiology after their initial clinical examination between 2005 and 2016.
Results
In our cohort, 46 out of 173 (27 per cent) patients were diagnosed with malignancies. All malignancies were identified during the initial imaging examination, except for one patient. Diagnostic imaging facilitated the diagnosis in 36 per cent of the patients. Computed tomography (CT) of the neck and chest and full-body positron emission tomography-CT (PET-CT) presented the highest overall diagnostic yield of 36 per cent and 35 per cent, respectively.
Conclusion
We recommend that patients with initial CT of the neck and upper chest or PET-CT combined with magnetic resonance imaging without pathological findings, are followed without additional imaging examinations, unless new relevant symptoms arise.
During the second half of the first millennium BC, hundreds of hillforts dotted the central Italian Apennines. Often interpreted as ‘proto-towns’, the authors present results of investigations at Monte Santa Croce-Cognolo that challenge this idea. Previous studies identified a small area (<1ha) of occupation and suggested that habitation extended across the whole 18ha site. Combining geophysical and pedestrian survey with remotely sensed data, and local ethnographic accounts, the authors detect little evidence for permanent habitation and instead argue for activities connected with animal husbandry. The results challenge urban-centric interpretations by demonstrating the coexistence of monumental but uninhabited hillforts and urban sites—usually seen across the Mediterranean and Europe.
This study aimed to examine the efficacy of the automated mechanical repositioning chairs compared to canalith repositioning manoeuvres for elderly patients with benign paroxysmal positional vertigo (BPPV).
Methods:
A retrospective study included 969 patients with BPPV who were first diagnosed at Beijing Chaoyang Hospital, Capital Medical University between 1 January 2020 and 31 December 2020. Patients were followed up for one year. Demographics, disease status, treatment and various outcomes were collected through medical record reviews and follow-up interviews.
Results:
Based on the criteria for evaluating treatment efficacy using objective and subjective indicators, BPPV patients treated with automated mechanical repositioning chair therapy showed a significantly better prognosis and lower recurrence rates.
Conclusion:
Automated mechanical repositioning chair therapy is an effective approach for BPPV treatment, with advantages over conventional manual canalith repositioning procedures.
Despite chronicles from the 16th century describing fertile alluvial plains and densely populated wetlands, archaeology in western Mexico has been little studied. The Directorate of Archaeological Salvage (DSA) of National Institute of Anthropology and History (INAH) has initiated a study of two sites in Costa Canuva, at the southern part of Nayarit state: Becerros and Naranjos. Thirty charcoal and shell samples were radiocarbon (14C) dated to determine occupation history. A Bayesian approach was used to build a chronological modeling from charcoal samples. Charcoal and shell samples found in the same context allowed us to calculate the ΔR values of marine offset for this period. In general, the archaeological sites of this area are divided into three major periods: Formative, Classic, and Postclassic. The 14C dating of Becerros recovered materials provided a chronological framework for the site’s occupation, from cal AD 169–1025, corroborating the ceramic studies in the sense that human settlement activities date from the Formative (300 BC–AD 600) to the Early Postclassic (AD 900–1200). Naranjos started in the Classic period and reached its occupancy peak in the Late Classic. The site’s occupation may have persisted for at least two centuries after the conquest of the Altiplano in 1521. The comparison of charcoal dates and associated shell samples from the Naranjos Unit gave a probability distribution for ΔR, that ranged from 118.5 to 199.5 with a mean value of 159 ± 4, slightly higher than other values obtained at nearby sites.
Despite advances in treatment and outcomes for paediatric heart failure, both physical and psychosocial comorbidities remain notable among this patient population. We aimed to qualitatively describe the psychosocial experiences of adolescent and young adults with heart failure and their caregivers’ perceptions, with specific focus on personal challenges, worries, coping skills, and resilience.
Methods:
Structured, in-depth interviews were performed with 16 adolescent and young adults with heart failure and 14 of their caregivers. Interviews were recorded and transcribed. Content analysis was performed, and themes were generated. Transcripts were coded by independent reviewers.
Results:
Ten (63%) adolescent and young adults with heart failure identified as male and six (37.5%) patients self-identified with a racial or ethnic minority group. Adolescent and young adults with heart failure generally perceived their overall illness experience more positively and less burdensome than their caregivers. Some adolescent and young adults noted specific worries related to surgeries, admissions, major complications, death, and prognostic/treatment uncertainty, while caregivers perceived their adolescent and young adult’s greatest worries to be around major complications and death. Adolescent and young adults and their caregivers were able to define and reflect on adolescent and young adult experiences of resilience, with many adolescent and young adults expressing a sense of optimism and gratitude as it relates to their medical journey.
Conclusions:
This study is the first of its kind to qualitatively describe the psychosocial experiences of a racially and socioeconomically diverse sample of adolescent and young adults with heart failure, as well as their caregivers’ perceptions of patient experiences. Findings underscore the importance of identifying distress and fostering resilient processes and outcomes in young people with advanced heart disease.
To determine the short- and medium-term cardiac outcomes in children admitted with multisystem inflammatory syndrome in children at a tertiary care centre in Pakistan.
Methods:
Children fulfilling the criteria for multisystem inflammatory syndrome and admitted to the hospital between April 2020 and March 2022 were enrolled in this prospective longitudinal cohort study. From admission to discharge, laboratory and cardiac parameters were recorded for all patients, who were subsequently followed up in clinics at various intervals. Data analysis was conducted using STATA version 15.0.
Results:
A total of 51 children were included, with viral myocarditis (41.2%) and toxic shock syndrome (33.3%) being the most common phenotypes. The cardiovascular system was most commonly affected in 27 children (53%) with laboratory evidence of inflammation and myocardial injury with median and interquartile levels of ferritin 1169 (534-1704), C-reactive protein 83 (24-175), lactate dehydrogenase 468 (365-1270), N-terminal pro-B-type natriuretic peptide 8,656 (2,538-31,166), and troponin 0.16 (0.02-2.0).
On admission, decreased left ventricular ejection fraction was observed in 58.8% of patients and impaired global longitudinal strain in 33.3%. At discharge, left ventricular ejection fraction had normalised in 83% of patients. Pericardial effusion resolved in all patients, and valvulitis resolved in 86% by 12 months. Paediatric ICU admission was required in 42 (82%) of patients with an overall mortality of 12% (n = 6).
Conclusion:
Our study finds high hospital mortality for multisystem inflammatory syndrome in children compared to 1-2% from previous studies. Yet, in Pakistan, surviving children with multisystem inflammatory syndrome show favourable short- to medium-term cardiac outcomes
Pollen analysis was carried out on the infilling succession of the Fossa San Vito sinkhole, at the NE foothills of the Sarno Plain (Italy). Four 14C dates and six tephra layers constrain the pollen sequence between ca. 6000 and 500 cal yr BP. A forested environment, with a few signs of human activities, characterizes the pre-protohistoric period (ca. 6000–2750 yr BP). Stability of the arboreal pollen grains to non-arboreal pollen grains (AP/NAP) curve is due to climate-related opposite oscillations of deciduous and evergreen forest. In this period, the pyroclastic products from Neapolitan volcanoes that reached the upper Sarno Plain seem to have affected neither vegetation nor human activities. In the archaic and classic periods (ca. 2750–1500 yr BP), intensive deforestation and increase in anthropogenic indicators indicate the occurrence of grazing and crop activities managed by the main urban centers located in the plain: Pompeii, Stabiae, and Nuceria. After the Pompeii eruption in CE 79, a rapid re-afforestation and decline in all anthropogenic indicators testify to the temporary abandonment of the area, linked to the disastrous demise of the main economic centers. The upper plain was repopulated and exploited in the Late Ancient and Middle Ages (ca. 1700–500 yr BP), as indicated by the increase in all crop and grazing indicators.
The purpose of this study was to examine the potential for sustained almond consumption to reduce HbA1c concentrations among individuals with elevated values. A 16-week randomised, parallel-arm, controlled trial was conducted. Eighty-one adults with elevated HbA1c concentrations (> 5·7 %) were randomly assigned to incorporate 2 oz of raw almonds (A: n 39) or energy-matched snacks (C: n 42) into their daily diets. Body weight, body composition, plasma lipids, HbA1c, plasma vitamin E, glycaemia (by meal tolerance test and continuous glucose monitoring), dietary intake and hedonic responses to test foods were measured at stipulated time points. Participants consuming almonds ingested 253 kcal/d more than participants in the control group (P = 0·02), but this did not result in a significant difference in body weight. No statistically significant differences were observed in HbA1c concentrations, blood chemistries, body composition or glycaemia over time or between groups. However, Healthy Eating Index scores improved within the almond group as compared with the control group (P < 0·001). Additionally, the hedonic rating of almonds within the almond group did not decline as markedly as the control group’s reduced liking of the pretzel snack. Alpha-tocopherol increased significantly, and gamma tocopherol tended to decrease in the almond group, indicating compliance with the dietary intervention. Overall, daily ingestion of 2 oz of raw almonds in a self-selected diet for 16 weeks did not alter short-term or longer-term glycaemia or HbA1c concentrations in adults with elevated HbA1c concentrations, but they were well-tolerated hedonically and improved diet quality without promoting weight gain.
Characterised by the extensive use of obsidian, a blade-based tool inventory and microblade technology, the late Upper Palaeolithic lithic assemblages of the Changbaishan Mountains are associated with the increasingly cold climatic conditions of Marine Isotope Stage 2, yet most remain poorly dated. Here, the authors present new radiocarbon dates associated with evolving blade and microblade toolkits at Helong Dadong, north-east China. At 27 300–24 100 BP, the lower cultural layers contain some of the earliest microblade technology in north-east Asia and highlight the importance of the Changbaishan Mountains in understanding changing hunter-gatherer lifeways in this region during MIS 2.