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The $n$th-order velocity structure function $S_n$ in homogeneous isotropic turbulence is usually represented by $S_n \sim r^{\zeta _n}$, where the spatial separation $r$ lies within the inertial range. The first prediction for $\zeta _n$ (i.e. $\zeta _3=n/3$) was proposed by Kolmogorov (Dokl. Akad. Nauk SSSR, vol. 30, 1941) using a dimensional argument. Subsequently, starting with Kolmogorov (J. Fluid Mech., vol. 13, 1962, pp. 82–85), models for the intermittency of the turbulent energy dissipation have predicted values of $\zeta _n$ that, except for $n=3$, differ from $n/3$. In order to assess differences between predictions of $\zeta _n$, we use the Hölder inequality to derive exact relations, denoted plausibility constraints. We first derive the constraint $(p_3-p_1)\zeta _{2p_2} = (p_3 -p_2)\zeta _{2p_1} +(p_2-p_1)\zeta _{2p_3}$ between the exponents $\zeta _{2p}$, where $p_1 \leq p_2 \leq p_3$ are any three positive numbers. It is further shown that this relation leads to $\zeta _{2p} = p \zeta _2$. It is also shown that the relation $\zeta _n=n/3$, which complies with $\zeta _{2p} = p \zeta _2$, can be derived from constraints imposed on $\zeta _n$ using the Cauchy–Schwarz inequality, a special case of the Hölder inequality. These results show that while the intermittency of $\epsilon$, which is not ignored in the present analysis, is not incompatible with the plausible relation $\zeta _n=n/3$, the prediction $\zeta _n=n/3 +\alpha _n$ is not plausible, unless $\alpha _n =0$.
We evaluated the performance of an early-warning algorithm, based on ward-specific incidence cutoffs for detecting Clostridioides difficile transmission in hospitals. We also sought to determine the frequency of intrahospital Clostridioides difficile transmission in our setting.
Design:
Diagnostic performance of the algorithm was tested with confirmed transmission events as the comparison criterion. Transmission events were identified by a combination of high-molecular-weight typing, ward history, ribotyping, and whole-genome sequencing (WGS).
Setting:
The study was conducted in 2 major and 2 minor secondary-care hospitals with adjacent catchment areas in western Sweden, comprising a total population of ∼480,000 and ∼1,000 hospital beds.
Patients:
All patients with a positive PCR test for Clostridioides difficile toxin B during 2020 and 2021.
Methods:
We conducted culturing and high-molecular-weight typing of all positive clinical samples. Ward history was determined for each patient to find possible epidemiological links between patients with the same type. Transmission events were determined by PCR ribotyping followed by WGS.
Results:
We identified 4 clusters comprising a total of 10 patients (1.5%) among 673 positive samples that were able to be cultured and then typed by high-molecular-weight typing. The early-warning algorithm performed no better than chance; patient diagnoses were made at wards other than those where the transmission events likely occurred.
Conclusions:
In surveillance of potential transmission, it is insufficient to consider only the ward where diagnosis is made, especially in settings with high strain diversity. Transmission within wards occurs sporadically in our setting.
To outline the clinical picture of bilateral posterior canal benign paroxysmal positional vertigo.
Methods
A total of 573 patients with posterior canal benign paroxysmal positional vertigo were classified as having unilateral, or true or pseudo bilateral, posterior canal benign paroxysmal positional vertigo, and were treated with the Epley manoeuvre. Statistical significance was set at p < 0.05.
Results
Of the patients, 483 had unilateral and 90 (15.7 per cent) had bilateral presentation. Of the latter, 72 patients had pseudo bilateral posterior canal benign paroxysmal positional vertigo. Comparisons of site of involvement, male to female ratio and the incidence of associated problems in unilateral, and true and pseudo bilateral posterior canal benign paroxysmal positional vertigo did not reveal any statistically significant differences (p = 0.828, p = 0.200, p = 0.142). Comparisons of the number of manoeuvres required to provide symptom relief and the rate of recurrence were significant (p < 0.05).
Conclusion
Identification of true and pseudo bilateral posterior canal benign paroxysmal positional vertigo is important given the differences in aetiology and treatment outcome. Treatment of patients with true bilateral posterior canal benign paroxysmal positional vertigo requires several therapeutic manoeuvre attempts, and patients should be warned about recurrence.
We derive conditions for recurrence and transience for time-inhomogeneous birth-and-death processes considered as random walks with positively biased drifts. We establish a general result, from which the earlier known particular results by Menshikov and Volkov [‘Urn-related random walk with drift $\rho x^\alpha /t^\beta $’, Electron. J. Probab.13 (2008), 944–960] follow.
The symbiotic relationship between people and the genus Agave spans millennia and a vast geographical area encompassing Mexico, the southwestern United States, and the Texas borderlands. In the early 1950s, Richard MacNeish's investigations in Tamaulipas yielded evidence of past agave use in the mountains of northeastern Mexico. Excavations in the Ocampo Caves revealed 9,000 years of sporadic occupations by hunter-gatherers, mixed forager-farmers, and finally, periodic visits by residents of nearby agricultural villages. Although these discoveries are incompletely published—and existing publications largely underemphasize the range of utilized wild resources in favor of domesticated maize, beans, and squash—agave is among the wild plant taxa most often mentioned in use throughout the Holocene. Unpublished field notes, curated plant assemblages recovered during MacNeish's excavations, and data from recent archaeological survey complement the published literature to explore the role of this prominent plant in this important archaeological region.
In this paper, we investigate the thermal evolution in a one-dimensional bagasse stockpile. The mathematical model involves four unknowns: the temperature, oxygen content, liquid water content and water vapour content. We first nondimensionalize the model to identify dominant terms and so simplify the system. We then calculate solutions for the approximate and full system. It is shown that under certain conditions spontaneous combustion will occur. Most importantly, we show that spontaneous combustion can be avoided by sequential building. To be specific, in a situation where, say, a $4.7\,$m stockpile can spontaneously combust, we could construct a $3\,$m pile and then some days later add another $1.7\,$m to produce a stable $4.7\,$m pile.
As it is presently employed, grounding permits grounding many things from one ground. In this paper, I show why this is a mistake by pushing for a uniqueness principle on grounding. After arguing in favor of this principle, I say something about it and kinds of grounding, discuss a similar principle, and consider its import on a formal feature of grounding, ontology, and ontological simplicity.
Cardiac tumours are extremely rare. Most of the cases are diagnosed post-mortem.
In this case, a tumour was found in a neonate during routine ultrasound screening in the first trimester of pregnancy. After birth, resection of the formation was performed and histologically confirmed as a cavernous haemangioma. Additionally, propranolol was prescribed in order to prevent relapse.
Among the forms of anthropogenic disturbance, agricultural land use is one of the main threats to biodiversity. Understanding how interactions between parasites and hosts are affected by agricultural land use allows predictions of how these anthropogenic impacts affect parasites. Although parasitism patterns are affected by agricultural land use, it is noteworthy that different groups of parasites can respond differently to these environmental alterations. While heteroxenous species need more than one host to complete their life cycle and tend to be more harmed by anthropization, monoxenous species, which need only one host to complete their life cycle, tend to be less harmed. In this work, we evaluate how agricultural land use affects the abundance and prevalence of parasitism for monoxenous and heteroxenous helminths in the generalist lizard Tropidurus hispidus in Caatinga Domain, Brazil. We recorded differences in abundance and prevalence of heteroxeneous (higher in conserved areas) and monoxenous helminths (higher in agricultural areas). Heteroxenous helminths that have lizards as definitive hosts are mainly obtained through diet. Tropidurus hispidus predominantly consumes insects, so it is possible that the lower abundance and prevalence of heteroxenous parasites in agricultural areas, beyond habitat simplification, is related to the decrease in the insect population. As monoxenous species do not need an intermediate host, it is possible that this aspect has influenced their greater success in anthropogenic environments than heteroxenous species. This contrasting result reinforces the need for a separate assessment between these groups when evaluating effects of land use.
Let p be a prime and let r, s be positive integers. In this paper, we prove that the Goormaghtigh equation $(x^m-1)/(x-1)=(y^n-1)/(y-1)$, $x,y,m,n \in {\mathbb {N}}$, $\min \{x,y\}>1$, $\min \{m,n\}>2$ with $(x,y)=(p^r,p^s+1)$ has only one solution $(x,y,m,n)=(2,5,5,3)$. This result is related to the existence of some partial difference sets in combinatorics.
We extend the group-theoretic notion of conditional flatness for a localization functor to any pointed category, and investigate it in the context of homological categories and of semi-abelian categories. In the presence of functorial fiberwise localization, analogous results to those obtained in the category of groups hold, and we provide existence theorems for certain localization functors in specific semi-abelian categories. We prove that a Birkhoff subcategory of an ideal determined category yields a conditionally flat localization, and explain how conditional flatness corresponds to the property of admissibility of an adjunction from the point of view of categorical Galois theory. Under the assumption of fiberwise localization, we give a simple criterion to determine when a (normal epi)-reflection is a torsion-free reflection. This is shown to apply, in particular, to nullification functors in any semi-abelian variety of universal algebras. We also relate semi-left-exactness for a localization functor L with what is called right properness for the L-local model structure.
To assess the accuracy of provider estimates of ventilator-associated pneumonia (VAP) diagnostic probability in various clinical scenarios.
Design:
We conducted a clinical vignette-based survey of intensive care unit (ICU) physicians to evaluate provider estimates of VAP diagnostic probability before and after isolated cardinal VAP clinical changes and VAP diagnostic test results. Responses were used to calculate imputed diagnostic likelihood ratios (LRs), which were compared to evidence-based LRs.
Setting:
Michigan Medicine University Hospital, a tertiary-care center.
Participants:
This study included 133 ICU clinical faculty and house staff.
Results:
Provider estimates of VAP diagnostic probability were consistently higher than evidence-based diagnostic probabilities. Similarly, imputed LRs from provider-estimated diagnostic probabilities were consistently higher than evidence-based LRs. These differences were most notable for positive bronchoalveolar lavage culture (provider-estimated LR 5.7 vs evidence-based LR 1.4; P < .01), chest radiograph with air bronchogram (provider-estimated LR 6.0 vs evidence-based LR 3.6; P < .01), and isolated purulent endotracheal secretions (provider-estimated LR 1.6 vs evidence-based LR 0.8; P < .01). Attending physicians and infectious disease physicians were more accurate in their LR estimates than trainees (P = .04) and non-ID physicians (P = .03).
Conclusions:
Physicians routinely overestimated the diagnostic probability of VAP as well as the positive LRs of isolated cardinal VAP clinical changes and VAP diagnostic test results. Diagnostic stewardship initiatives, including educational outreach and clinical decision support systems, may be useful adjuncts in minimizing VAP overdiagnosis and ICU antibiotic overuse.
Hospital-acquired Aspergillus rates among coronavirus disease 2019 (COVID-19) patients were initially higher at a hospital with high negative-pressure room utilization compared to a similar hospital with low utilization but with otherwise identical infection control policies. After the index hospital decreased negative-pressure utilization, hospital-acquired Aspergillus case rates at the 2 hospitals converged.
Light has a substantial effect on the behaviour and physiology of nocturnal moths. Ectropis grisescens is a major nocturnal tea pest in China, and light traps are commonly used to control geometrid moths because of their positive phototaxis. However, some moths gather around light traps and enter the light adaptation state, which decreases the efficacy of light traps in controlling this pest. We identified opsin genes and the spectral sensitivities of the photoreceptors of E. grisescens moths. We also determined the effects of several monochromatic lights on opsin gene expression and light adaptation. We detected three types of opsin genes and six spectral sensitive peaks (at 370, 390, 480, 530, 550, and 580 nm). We also observed significant changes in the diurnal rhythm of opsin gene expression under different light conditions. When active males were suddenly exposed to different monochromatic lights, they quickly entered the light adaptation state, and the adaptation time was negatively correlated with the light intensity. Males were most sensitive to 390 nm wavelengths, followed by 544 nm, 457 nm, and 593 nm. Red light (627 nm) did not affect the activity of E. grisescens males but had detectable physiological effects.
We consider the simple random walk on the d-dimensional lattice $\mathbb{Z}^d$ ($d \geq 1$), traveling in potentials which are Bernoulli-distributed. The so-called Lyapunov exponent describes the cost of traveling for the simple random walk in the potential, and it is known that the Lyapunov exponent is strictly monotone in the parameter of the Bernoulli distribution. Hence the aim of this paper is to investigate the effect of the potential on the Lyapunov exponent more precisely, and we derive some Lipschitz-type estimates for the difference between the Lyapunov exponents.