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In this experimental study, we explore the dynamics of the thermal boundary layer in liquid metal Rayleigh–Bénard convection, covering the parameter ranges of $0.026 \leq$ Prandtl numbers $(Pr) \leq 0.033$ and Rayleigh numbers ($Ra$) up to $2.9\times 10^9$. Our research focuses on characterising the thermal boundary layer near the top plate of a cylindrical convection cell with an aspect ratio of 0.5, distinguishing between two distinct regions: the shear-dominated region around the centre of the top plate and a location near the side wall where the boundary layer is expected to be affected by the impact or ejection of thermal plumes. The dependencies of the boundary layer thickness on $Ra$ at these positions reveal deviating scaling exponents with the difference diminishing as $Ra$ increases. We find stronger fluctuations in the boundary layer and increasing deviation from the Prandtl–Blasius–Pohlhausen profile with increasing $Ra$, as well as in the measurements outside the centre region. Our data illustrate the complex interplay between flow dynamics and thermal transport in low-$Pr$ convection.
Studies documenting insect succession throughout the decomposition of vertebrate remains have been performed in more than half of the provinces and one territory in Canada. However, some areas are not represented in the current published literature. Ontario is one province that does not have published records of local necrophagous insect succession. Therefore, three studies were performed in Oshawa, Ontario, to document the insect community and primary colonisers observed during the decomposition of domestic pig, Sus scrofa domestica (Artiodactyla: Suidae), remains. Adult and immature specimens located on the remains were collected, reared, and identified. Pitfall traps were installed to monitor insects present outside of visits. Pigs that decomposed in higher temperatures yielded fewer colonising dipteran species than those that decomposed in cooler temperatures. The most common primary colonisers were Phormia regina (Diptera: Calliphoridae), Lucilia illustris (Diptera: Calliphoridae), and Lucilia sericata (Diptera: Calliphoridae). In total, 11 Diptera families, six Coleoptera families, and families from the Hymenoptera and Hemiptera orders were observed. When comparing these results to published results from Québec, Ontario’s neighbour, major differences in primary colonisers can be noted. It is therefore important for researchers to study the succession, development, and colonisation patterns of the local fauna during vertebrate decomposition and to publish their findings.
To achieve resilience in the response of a major incident, it is essential to coordinate major processes and resources with the aim to manage expected and unexpected changes. The coordination is partly done through timely, adequate, and resilience-oriented decisions. Accordingly, the aim of the present paper is to describe factors that affected decision-making in a medical command and control team during the early COVID-19 pandemic.
Methods
This study used a qualitative method in which 13 individuals from a regional public healthcare system involved in COVID-19 related command and control were interviewed. Data was collected through semi-structured interviews and analyzed using qualitative content analysis.
Results
The factors affecting decision-making in medical command and control during early COVID-19 pandemic were grouped into 5 themes: organization, adaptation, making decisions, and analysis, as well as common operational picture.
Conclusions
The present study indicated that decision-making in medical command and control faces many challenges in the response to pandemics. The results may provide knowledge about disaster resilience and can be utilized in educational and training settings for medical command and control.
There has been a significant growth of social media as a means to inform oneself about politics. This article explores the consequences of this trend on the credibility audiences attribute to news exposing corrupt politicians and on their willingness to penalize the exposed politicians in elections. The study focuses on ten Latin American cities and employs a randomized control trial using experimental data embedded in a survey. Through this method, credibility and penalization levels are compared between state communications, newspapers, named journalists on social media, and anonymous journalists on social media. The article’s key findings demonstrate that corruption reports published on social media are deemed less credible than those published by state auditors and newspapers. This effect is exacerbated when the source of the report is anonymous. In addition, reports on corruption published on social media by anonymous sources have a negative effect on voter penalization of corrupt politicians.
In this article, I examine how the fear of miscegenation developed as a raison d’être for the construction and maintenance of apartheid. I argue that despite its efficacy at reproducing racial-caste formations, miscegenation taboo ultimately undermined its own hegemonic mythology by constructing contradictory erotic desires and subjectivities which could neither be governed nor contained. I consider how miscegenation fears and fantasies were debated in public discourse, enacted into law, institutionalized through draconian policing and punishment practices, culturally entrenched, yet negotiated and resisted through everyday intimacies. While crime statistics show that most incidences of interracial sex involved White men and women of color, the perceived threat to “White purity” was generally represented through images of White women—volks-mothers and daughters—in the Afrikaner nationalist iconography. White women’s wombs symbolized the future of “Whiteness.” This article offers a critique of the prevailing South African “exceptionalism” paradigm in apartheid studies. Detailed analyses of government commission reports (1939, 1984, 1985) and parliamentary debate records (1949) reveal considerable American influence on South Africa’s “petty apartheid” laws, and especially the Prohibition of Mixed Marriages Act (1949) and Immorality Amendment Act (1950). While these “cornerstone” policies of apartheid developed from local socio-political conflicts and economic tensions, they were always entangled in global racial formations, rooted in trans-oceanic histories of slavery, dispossession, and segregation. This historical anthropological study of race/sex taboo builds on interdisciplinary literatures in colonial history, sociology, postcolonial studies, literary theory, art history, cultural studies, feminist theory, queer studies, and critical race theory.
Effective field theory (EFT) is a computationally powerful theoretical framework, finding application in many areas of physics. The framework, applied to the Standard Model of particle physics, is even more empirically successful than our theoretical understanding would lead us to expect. I argue that this is a problem for our understanding of how the Standard Model relates to some successor theory. The problem manifests as two theoretical anomalies involving relevant parameters: the cosmological constant and the Higgs mass. The persistent failure to fix these anomalies from within suggests that the way forward is to go beyond the EFT framework.
We examine how media reports influenced trading volumes and order imbalances on the Sydney Stock Exchange (SSX) from 1901 to 1950, focusing on wool market reports as a substitute for broader financial advice in the absence of a specialised investment press. Given wool's status as Australia's primary export and its integration with various sectors, we construct a weekly media sentiment index based on news about wool sales and auctions from the Sydney Morning Herald. Our findings reveal that positive news about the wool market correlates with increased trading volumes and reduced order imbalances on the SSX. This relationship persisted during significant events such as the UK government's wool purchase plans, the 1929 Wall Street Crash, World War II-related trading restrictions, and the short selling ban.
A growing body of literature is challenging techno-fetishistic perspectives on digital capitalism, as well as claims of the start of a new era characterized by total automation. This article contributes to the ongoing debate on the implications of digital technology for the future of labour by reading Moritz Altenried's The Digital Factory (2022) through the lens of labour history. The use of digital factory and digital Taylorism as integrative tools significantly improves empirical evaluations of different digital labour environments. However, because of their high degree of abstraction, there are a number of limitations when applying these concepts to describe wildly disparate work environments. To illustrate these limits, I use examples from twentieth-century debates on technology and work autonomy, and (1) argue that a labour history perspective warns us against overgeneralizing the effects of technology on labour control and worker autonomy, and (2) broaden the discussion to larger issues of labour control before and during digitalization, incorporating new theoretical questions such as our understanding of classical Taylorism and, by extension, capitalism.
Population studies show the stigma of depression to diminish, while the stigma of schizophrenia increases. To find out whether this widening gap is reflected in the media portrayal of both disorders, this study compares the portrayal of depression and schizophrenia in German print media in 2010 vs. 2020.
Methods
We conducted a qualitative content analysis using a mixed deductive-inductive approach to establish a category system. In total, we analyzed 854 articles with the summative approach by Mayring.
Results
The study found a widening gap in the portrayal of schizophrenia and depression in German media between 2010 and 2020. Schizophrenia was depicted increasingly negative between 2010 and 2020, covering more negative stereotypes and focusing on its biological causes. Depression received increased attention and more neutral and professional coverage, with a greater emphasis on psychosocial causes and discussion of treatment options.
Conclusions
By showing a widening gap the study highlights how media may shape public views on mental illnesses and reflects public attitudes at the same time. Media analyses from other nations have shown similar trends. This emphasizes the need for responsible reporting to combat stigma and promote understanding worldwide. Therefore, the authors recommend a balanced coverage that includes accurate professional information about all mental illnesses.
Abrupt changes in aircraft attitude due to encountering terrain turbulence or wind shear at low altitudes can directly lead to serious accidents. Therefore, a highly responsive and reliable active attitude stabiliser on board is necessary to counteract low-level severe atmospheric disturbances. However, gust environments caused by local terrain and structures are difficult to represent with typical models, such as the Dryden continuous gust model in free space. As a result, an optimal model-based control design cannot be applied. To address this problem, this paper introduces an adaptive mechanism for updating motion equations based on atmospheric conditions using in-flight surface pressure-field sensing. Additionally, a dynamic wind tunnel experiment system, which can be constructed at universities at a low cost, is developed and described in detail. The effectiveness of the proposed scheme is evaluated through wind tunnel experiments and numerical simulations using a large number of gust samples.
The specific and multifaceted service needs of young people have driven the development of youth-specific integrated primary mental healthcare models, such as the internationally pioneering headspace services in Australia. Although these services were designed for early intervention, they often need to cater for young people with severe conditions and complex needs, creating challenges in service planning and resource allocation. There is, however, a lack of understanding and consensus on the definition of complexity in such clinical settings.
Methods
This retrospective study involved analysis of headspace’s clinical minimum data set from young people accessing services in Australia between 1 July 2018 and 30 June 2019. Based on consultations with experts, complexity factors were mapped from a range of demographic information, symptom severity, diagnoses, illness stage, primary presenting issues and service engagement patterns. Consensus clustering was used to identify complexity subgroups based on identified factors. Multinomial logistic regression was then used to evaluate whether these complexity subgroups were associated with other risk factors.
Results
A total of 81,622 episodes of care from 76,021 young people across 113 services were analysed. Around 20% of young people clustered into a ‘high complexity’ group, presenting with a variety of complexity factors, including severe disorders, a trauma history and psychosocial impairments. Two moderate complexity groups were identified representing ‘distress complexity’ and ‘psychosocial complexity’ (about 20% each). Compared with the ‘distress complexity’ group, young people in the ‘psychosocial complexity’ group presented with a higher proportion of education, employment and housing issues in addition to psychological distress, and had lower levels of service engagement. The distribution of complexity profiles also varied across different headspace services.
Conclusions
The proposed data-driven complexity model offers valuable insights for clinical planning and resource allocation. The identified groups highlight the importance of adopting a holistic and multidisciplinary approach to address the diverse factors contributing to clinical complexity. The large number of young people presenting with moderate-to-high complexity to headspace early intervention services emphasises the need for systemic change in youth mental healthcare to ensure the availability of appropriate and timely support for all young people.
We consider an internally heated fluid between parallel plates with fixed thermal fluxes. For a large class of heat sources that vary in the direction of gravity, we prove that $\smash { \smash {{\langle {\delta T} \rangle _h}} } \geq \sigma R^{-1/3} - \mu$, where $\smash { \smash {{\langle {\delta T} \rangle _h}} }$ is the average temperature difference between the bottom and top plates, $R$ is a ‘flux’ Rayleigh number and the constants $\sigma,\mu >0$ depend on the geometric properties of the internal heating. This result implies that mean downward conduction (for which $\smash { \smash {{\langle {\delta T} \rangle _h}} }< 0$) is impossible for a range of Rayleigh numbers smaller than a critical value $R_0:=(\sigma /\mu )^{3}$. The bound demonstrates that $R_0$ depends on the heating distribution and can be made arbitrarily large by concentrating the heating near the bottom plate. However, for any given fixed heating profile of the class we consider, the corresponding value of $R_0$ is always finite. This points to a fundamental difference between internally heated convection and its limiting case of Rayleigh–Bénard convection with fixed-flux boundary conditions, for which $\smash {{\langle {\delta T} \rangle _h}}$ is known to be positive for all $R$.
In Amilcar Cabral: The Life of a Reluctant Nationalist, a translation and revision of his earlier Portuguese edition, Antonio Tomas addresses what he sees as a gap between the reality of the armed struggle in Guinea and the ways in which it has been discussed by all previous writers on the subject. He claims to base his critique on newly released archival information and recent publications on Cabral, Portuguese colonialism, and its anti-colonial movements in Africa.
Background: Methicillin-resistant S. aureus (MRSA) is known to cause frequent and severe infections in community living centers, potentially resulting in significant mortality for elderly patients. More research is needed to understand how to utilize genomic and epidemiological data to understand characteristics that may lead to increased transmission. We hypothesized that combining genomic and epidemiological information to sample patients and their environments during long-term stays, we will be able to capture a diverse set of MRSA strains. Method: This work included genome sequencing of patient and environmental samples from 11 patients within the VA Ann Arbor Healthcare System from May 4, 2021- November 16, 2022. All 11 patients tested positive for MRSA during their stay (mean days = 31). Patient and environmental samples were taken throughout their stays, screened for MRSA, and whole-genome sequenced. Single nucleotide variants (SNVs) were identified by mapping reads and calling variants against strain-specific reference genomes. We used ape v5.6-2 in R v4.2.2 to analyze and infer evolution, acquisition, and transmission events based on pairwise SNV distances. Genomic clusters were determined using stats v3.6.2, with a SNV distance threshold of 20. Result: Samples that were collected from patient bodily sites were able to reveal 20 distinct genomic clusters of MRSA (patient hands: n = 10, nares: n = 7, groin: n = 3). Environmental samples from patient environments also revealed distinct genomic MRSA clusters (tv remote: n = 9, toilet seat and bed rail: n = 6, table top, bed control, and call button: n = 5, bed curtain: n = 4, pulse ox = 2, cell phone, tray, pulse ox, mat, body hoist wrap, and bed: n = 1). Conclusion: The identification of various genomic clusters from patients and their environmental reservoirs suggests intrahost variation that can only be captured by using a more holistic approach of integrating epidemiology and genomic sequencing. Developing studies that incorporate genomic data, various environmental sources, and multiple isolates over time within community living centers can increase our understanding of strains that are more likely to transmit, survive on living and non-living surfaces and therefore lead to improved recommendation for infection prevention interventions and drivers of endemicity.
Background: Candida auris is an emerging multidrug resistant fungus that presents a serious global health threat and causes severe infections with a high mortality rate in hospitalized patients with significant underlying comorbidities. We describe the risk factors and clinical outcomes associated with C. auris in Southeast Michigan. Methods: This is a retrospective case series of culture-positive C. auris patients who had contact with our healthcare facility in Detroit from 2021 to 2023. We evaluated demographics, comorbidities, risk factors, and outcomes. A comparative analysis of colonized and infected patients was performed. Results: Forty-eight (81%) colonized and 11 (19%) infected patients were included (Table); 70% were male with median age of 66 years. All variables were comparable between the two groups except chronic kidney disease, which was significantly more prevalent among colonized patients (40% vs 0, p=0.011). All patients had prior exposure to acute care hospital (ACH), 37% to long-term acute care hospital, and 42% to skilled nursing facility within 1 year of diagnosis. Chronic wounds, prior broad-spectrum antibiotic use, and indwelling devices were prevalent in both groups; more than half required mechanical ventilation in the last month, and one third had tracheostomy at the time of C. auris detection. Almost 60% had a prior history of drug-resistant organisms, including multi-drug resistant gram negative (37%) and carbapenem-resistant (20%) organisms. Blood (82%) and wound (18%) were sources of invasive candidiasis. More than half (61%) of the testing was performed at ACH. Nine patients (82%) with invasive disease were treated with echinocandins (88%); among the colonized, two (4%) were treated with echinocandins but had persistent colonization. Thirty-day mortality was not significantly different among the two groups and was nearly 20%. Conclusions: In this large cohort study, a history of healthcare exposure, drug-resistant organisms, use of broad-spectrum antibiotics, indwelling devices, and chronic wounds were common risk factors among C. auris patients. Limiting the use of broad-spectrum antimicrobials and invasive devices, adherence to infection prevention and control practices, and interfacility transfer communication are important mitigating strategies to reduce the incidence and spread of C. auris.
Background: The role of the infection preventionist (IP) is complex and encompasses a range of responsibilities requiring extensive knowledge in infection control practices, data analysis, surveillance, performance improvement and collaboration with multidisciplinary teams. Infection prevention certification (CIC) by the certification Board of Infection Control (CBIC) is a standardized marker of knowledge and competencies required for practice in the field. In a 2020 survey of IPs, less than half were certified or planned to become certified. Of those that do take the certification exam, less than three quarters pass on their initial exam attempt. Methods: From 2017 to 2023, fifty-two new IPs were enrolled in a competency-based training program which combined didactic and applied learning on core IP job functions, and a structured mentoring program. The initial didactic phase consisted of evidence-based learning modules with validation of competency through post-training testing and practical demonstration. Education was provided by an advanced practice IP via remote webinars, which included discussion of questions, skills coaching, and review of post-tests. Novice IPs were partnered with at least two preceptors: one advanced practice lead preceptor guided the novice IPs through assigned education modules and oversaw program management and training benchmarks. A second, near-peer preceptor or mentor collaborated with the novice IP in the facility setting. Initial training focused on facility operations, surveillance, rounding and other facility specific activities. Facility mentors were responsible for combining education module topics with practical application of skills. Mentors guided novice IPs through National Healthcare Surveillance network (NHSN) surveillance training and validated surveillance and infection coding until the novice IP had an interrater reliability validation assessing surveillance competency. After the initial training phase, the novice IPs began preparation for certification. This phase included additional training modules aligned with the CBIC certification content outline and practice exams. Results: All 52 novice IPs completed the training program and attempted the CIC examination. The initial pass rate for the certification exam among IPs in the supervised training and mentorship program was 98.1% (n=51). This is 33% higher than the initial pass rate published by CBIC, which was 73.9% (Figure 1). Conclusions: Organizing evidence-based guidelines into topic-specific modules builds a foundation of infection prevention and control knowledge, which is enhanced through remote instruction and direct application of skills under a preceptor’s supervision. This method allows IPs to be introduced to concepts covered in the board certification exam upon hire and support certification with improved outcome
Educational opportunities for investigators and staff to promote inclusive research practices are a critical piece of the effort to increase diversity in study participation and promote health equity. However, few trainings to date have empirically been shown to result in behavior changes. We present preliminary evaluation findings for the Just Research workshop offered at the University of Wisconsin–Madison between October 2022 and August 2023. These sessions included 80 participants who made up 4 cohorts. Data was collected through a retrospective pre/post-test survey administered 0–7 days following the workshop (n = 70), and a follow-up survey administered 9–12 months following the workshop (n = 21). Participants demonstrate significant increases in knowledge and self-efficacy regarding implementing inclusive practices post-intervention (p < .001). 85.7% of participants who completed the follow-up survey reported implementing inclusive practices.
Background: The diagnosis of Clostridioides difficile infection (CDI) is challenging. Despite guideline-directed, multistep testing algorithms and diagnostic stewardship, the treatment of C. difficile colonization persists. The testing algorithm at our system utilizes an initial real-time PCR test (PCR) for Toxin B gene, which if positive, reflexes to an enzyme immunoassay (EIA) for detecting Toxins A and B. Discordant results (PCR +/EIA -) are suggestive of colonization, but the majority of patients with discordant results are treated for CDI. Correlation of C. difficile EIA B polymerase chain reaction (PCR) cycle thresholds (Ct) with the presence of free EIA and disease severity has been observed, but the ability to use Ct in the decision to treat patients with discordant results is unclear. Our study assesses if Ct values and other clinical characteristics favor treatment in select patients with discordant Methods: A retrospective chart review was performed of adult patients (≥ 18-year-old) with positive C. difficile PCR results that were admitted to our health system between June 01 and August 31, 2023. C. difficile PCR and Ct results were obtained by Cepheid GeneXpert and Toxin A and B EIA results were obtained by Meridian Bioscience Immunocard. Patients with discordant (PCR+/EIA) and true positive (PCR+/EIA+) results were compared. We assessed demographics, past medical history, clinical characteristics, severity of illness, PCR Ct values, treatment, and clinical outcomes including: 30-day all-cause mortality and re-admission, and 60-day CDI repeat testing and treatment. Results Of the 122 patients identified, 89 patients had discordant results and 43 had true positive Results: Severity of illness and other clinical and laboratory characteristics were similar between both groups. Mean Ct values were significantly lower for true positive results compared to discordant results, 24.28 vs 29.27, respectively (p26 (p=.08). Of the patients with discordant results, 73 completed treatment for CDI and no difference in clinical outcomes was observed compared to patients with discordant results that were not treated. Conclusion Ct values were lower among patients with true positive results compared to patients with discordant Conclusion: There were no statistically significant different rates of severe or fulminant CDI among patients with discordant results and Ct values < 26, although this finding may be limited by sample size and Ct may be helpful in deciding which discordant patients to treat.