There are limited data on chiropractic care for older adults, specifically from medically underserved communities. This study describes the characteristics, clinical management, and patient-reported outcomes of older adults with spinal pain who present for chiropractic care at a publicly funded community health centre serving marginalized populations. This retrospective analysis utilized quality assurance data from chiropractic encounters at Mount Carmel Clinic between January 2011 and June 2020 of adults aged 45 and older. Descriptive statistics summarized the study population and their self-reported pain severity scores. Student’s t-tests and repeated-measures ANOVA explored relationships between pain outcomes, age, and clinical characteristics. The sample included 240 middle-aged (45–59 years) and older adults (≥60 years) who recorded baseline and discharge pain scores following chiropractic treatment. Over half of middle-aged participants self-identified as Indigenous or as people with disabilities. Statistically and clinically important improvements in pain were noted across spinal regions and extremities for both cohorts.

Ventilated cavities in the wake of a two-dimensional bluff body are studied experimentally via time-resolved X-ray densitometry. With a systematic variation of flow velocity and gas injection rate, expressed as Froude number ($\textit{Fr}$) and ventilation coefficient ($C_{qs}$), four cavities with different closure types are identified. A regime map governed by $\textit{Fr}$ and $C_{qs}$ is constructed to estimate flow conditions associated with each cavity closure type. Each closure exhibits a different gas ejection mechanism, which in turn dictates the cavity geometry and the pressure in the cavity. Three-dimensional cavity closure is seen to exist for the supercavities at low $\textit{Fr}$. However, closure is nominally two-dimensional for supercavities at higher $\textit{Fr}$. At low $C_{qs}$, cavity closure is seen to be wake-dominated, while supercavities are seen to have interfacial perturbation near the closure at higher $C_{qs}$, irrespective of $\textit{Fr}$. With the measured gas fraction, a gas balance analysis is performed to quantify the gas ejection rate at the transitional cavity closure during its formation. For a range of $\textit{Fr}$, the transitional cavity closure is seen to be characterised by re-entrant flow, whose intensity depends on the flow inertia, dictating the gas ejection rates. Two different ventilation strategies were employed to systematically investigate the formation and maintenance gas fluxes. The interaction of wake and gas injection is suspected to dominate the cavity formation process and not the maintenance, resulting in ventilation hysteresis. Consequently, the ventilation gas flux required to maintain the supercavity is significantly less than the gas flux required to form the supercavity.

Adverse childhood experiences (ACE) significantly impact physical, mental and social well-being, making them a critical area of research. This study analyzed the emerging trends and intellectual structure of ACE research and identified key contributors, including the most productive nations, journals and authors. Using bibliometric tools and VOSviewer software (version 1.6.20), 1,957 articles from the Scopus database (2004 to March 2024) were systematically analyzed. A notable finding was the surge in ACE-related publications during the COVID-19 pandemic, potentially reflecting increased global attention on childhood adversity amid heightened social and economic challenges. The analysis also revealed a striking dearth of studies from the Global South, with the field predominantly shaped by Western nations, like the United States, the United Kingdom, Australia and Canada. Leading journals, such as the Journal of Interpersonal Violence, and prolific authors, like Kevin T. Wolff, played a central role in advancing the field. Co-citation analysis uncovered four thematic clusters: (1) conceptualization and assessment of ACE, (2) health implications, (3) mental health impacts and (4) juvenile delinquency. These clusters, though distinct, showed significant thematic overlaps, reflecting the interconnected nature of ACE research and its intellectual structure. These findings underscore the need for more regionally diverse and interdisciplinary approaches to understanding global childhood adversity.

The human gut microbiome represents an extended “second genome” harbouring about 1015 microbes containing >100 times the number of genes as the host. States of health and disease are largely mediated by host–microbial metabolic interplay, and the microbiome composition also underlies the differential responses to chemotherapeutic agents between people. Chemical information will be the key to tackle this complexity and discover specific gut microbiome metabolism for creating more personalised interventions. Additionally, rising antibiotic resistance and growing awareness of gut microbiome effects are creating a need for non-microbicidal therapeutic interventions. We classify chemical interventions for the gut microbiome into categories like molecular decoys, bacterial conjugation inhibitors, colonisation resistance-stimulating molecules, “prebiotics” to promote the growth of beneficial microbes, and inhibitors of specific gut microbial enzymes. Moreover, small molecule probes, including click chemistry probes, artificial substrates for assaying gut bacterial enzymes and receptor agonists/antagonists, which engage host receptors interacting with the microbiome, are some other promising developments in the expanding chemical toolkit for probing and modulating the gut microbiome. This review explicitly excludes “biologics” such as probiotics, bacteriophages, and CRISPR to concentrate on chemistry and chemical tools like chemoproteomics in the gut-microbiome context.

A purely elastic linear instability was recently reported for viscoelastic plane Poiseuille flow in the limit of ultra-dilute (solvent to solution viscosity ratio $\beta \gt 0.99$), highly elastic (Weissenberg number $W \sim 1000$) polymer solutions, within the framework of the Oldroyd-B model (Khalid et al., Phys. Rev. Lett., vol. 127, 2021, pp. 134–502). This is the first instance of a purely elastic instability in a strictly rectilinear shearing flow, with the phase speed of the unstable ‘centre mode’ being close to the base-state maximum velocity at the channel centreline. Subsequently, Buza, Page and Kerswell (J. Fluid Mech., vol. 940, 2022, A11) have shown, using the FENE-P model, that the centre-mode instability persists down to moderate elasticities ($W \sim O (100)$), the reduction in threshold evidently due to the finite extensibility of the polymer molecules. In this work, we augment this latter finding and provide a comprehensive account of the effect of finite extensibility on the centre-mode instability in viscoelastic channel flow, using the FENE-P and FENE-CR models, in both the absence and presence of fluid inertia. In both these models, finite extensibility causes a decrease in the polymer relaxation time at high shear rates, and the resulting weakening of elastic stresses would seem to indicate a stabilising effect. The latter trend has been demonstrated by earlier analyses of hoop-stress-driven instabilities in curvilinear flows, and is indeed borne out for the FENE-CR case, where finite extensibility has a largely stabilising influence on the centre-mode instability. In stark contrast, for the FENE-P model, finite extensibility plays a dual role – a stabilising one at lower values of the elasticity number $E$, but, surprisingly, a destabilising one at higher $E$ values. Further, the centre-mode instability is predicted over a significantly larger domain of the $Re$–$E$–$\beta$ parameter space, compared to the Oldroyd-B model, making it more amenable to experimental observations.

Planar linear flows are a one-parameter family, with the parameter $\hat {\alpha }\in [-1,1]$ being a measure of the relative magnitudes of extension and vorticity; $\hat {\alpha } = -1$, $0$ and $1$ correspond to solid-body rotation, simple shear flow and planar extension, respectively. For a neutrally buoyant spherical drop in a hyperbolic planar linear flow with $\hat {\alpha }\in (0,1]$, the near-field streamlines are closed for $\lambda \gt \lambda _c = 2 \hat {\alpha } / (1 - \hat {\alpha })$, $\lambda$ being the drop-to-medium viscosity ratio; all streamlines are closed for an ambient elliptic linear flow with $\hat {\alpha }\in [-1,0)$. We use both analytical and numerical tools to show that drop deformation, as characterized by a non-zero capillary number ($Ca$), destroys the aforementioned closed-streamline topology. While inertia has previously been shown to transform closed Stokesian streamlines into open spiralling ones that run from upstream to downstream infinity, the streamline topology around a deformed drop, for small but finite $Ca$, is more complicated. Only a subset of the original closed streamlines transforms to open spiralling ones, while the remaining ones densely wind around a configuration of nested invariant tori. Our results contradict previous efforts pointing to the persistence of the closed streamline topology exterior to a deformed drop, and have important implications for transport and mixing.

The diogenid hermit crab, Calcinus morgani Rahayu & Forest, 1999, is reported from the Andaman Islands in the eastern Indian Ocean. It was previously recorded as Calcinus gaimardii (H. Milne Edwards, 1848) from the Nicobar Islands, south of the Andaman Islands, in 1865 about 160 years ago, but there were no additional records of the species in the Andaman and Nicobar Islands. The diagnosis of C. morgani is provided on the basis of the present specimens for helping the identification. A key to species of the genus Calcinus known from the Andaman and Nicobar Islands is also provided.

Vaccines have revolutionised the field of medicine, eradicating and controlling many diseases. Recent pandemic vaccine successes have highlighted the accelerated pace of vaccine development and deployment. Leveraging this momentum, attention has shifted to cancer vaccines and personalised cancer vaccines, aimed at targeting individual tumour-specific abnormalities. The UK, now regarded for its vaccine capabilities, is an ideal nation for pioneering cancer vaccine trials. This article convened experts to share insights and approaches to navigate the challenges of cancer vaccine development with personalised or precision cancer vaccines, as well as fixed vaccines. Emphasising partnership and proactive strategies, this article outlines the ambition to harness national and local system capabilities in the UK; to work in collaboration with potential pharmaceutic partners; and to seize the opportunity to deliver the pace for rapid advances in cancer vaccine technology.

In this paper, we study the disturbance velocity and density fields induced by a sphere translating vertically in a viscous density-stratified ambient. Specifically, we consider the limit of a vanishingly small Reynolds number $(Re = \rho U a/\mu \ll 1)$, a small but finite viscous Richardson number $(Ri_v = \gamma a^3g/\mu U\ll 1)$ and large Péclet number $(Pe = Ua/D\gg 1)$. Here, $a$ is the sphere's radius, $U$ its translational velocity, $\rho$ an appropriate reference density within the framework of the Boussinesq approximation, $\mu$ the ambient viscosity, $\gamma$ the absolute value of the background density gradient, g is acceleration due to gravity and $D$ the diffusivity of the stratifying agent. For the scenario where buoyancy forces first become comparable to viscous forces at large distances, corresponding to the Stokes-stratification regime defined by $Re \ll Ri_v^{1/3} \ll 1$ for $Pe \gg 1$, important flow features have been identified by Varanasi & Subramanian (J. Fluid Mech., vol. 949, 2022, A29) – these include a vertically oriented reverse jet, and a horizontal axisymmetric wake, on scales larger than the primary (stratification) screening length of ${O}(aRi_v^{-1/3})$. Here, we study the reverse-jet region in more detail, and show that it is only the central portion of a columnar structure with multiple annular cells concentric about the rear stagnation streamline. In the absence of diffusion, corresponding to $Pe = \infty$ $( \beta _\infty = Ri_v^{1/3}Pe^{-1} = 0)$, this columnar structure extends to downstream infinity with the number of annular cells diverging in this limit. We provide expressions for the boundary of the structure, and the number of cells within, as a function of the downstream distance. For small but finite $\beta _\infty$, two length scales emerge in addition to the primary screening length – a secondary screening length of ${O}(aRi_v^{-1/2}Pe^{1/2})$ where diffusion starts to smear out density variations across cells, leading to exponentially decaying density and velocity fields; and a tertiary screening length, $l_t \sim {O}(aRi_v^{-1/2}Pe^{1/2}[\zeta + \frac {13}{4}\ln {\zeta } + ({13^2}/{4^2})({\ln \zeta }/{\zeta })])$ with $\zeta = \frac {1}{2}\ln ({\sqrt {{\rm \pi} }Ri_v^{-1}Pe^3}/{2160})$, beyond which the columnar structure ceases to exist. The latter causes a transition from a vertical to a predominantly horizontal flow, with the downstream disturbance fields reverting from an exponential to an eventual algebraic decay, analogous to that prevalent at large distances upstream.

Buildings employ an ensemble of technical systems like those for heating and ventilation. Ontologies such as Brick, IFC, SSN/SOSA, and SAREF have been created to describe such technical systems in a machine-understandable manner. However, these focus on describing system topology, whereas several relevant use cases (e.g., automated fault detection and diagnostics (AFDD)) also need knowledge about the physical processes. While mathematical simulation can be used to model physical processes, these are practically expensive to run and are not integrated with mainstream technical systems ontologies today. We propose to describe the effect of component actuation on underlying physical mechanisms within component stereotypes. These stereotypes are linked to actual component instances in the technical system description, thereby accomplishing an integration of knowledge about system structure and physical processes. We contribute an ontology for such stereotypes and show that it covers 100% of Brick heating, ventilation, and air-conditioning (HVAC) components. We further show that the ontology enables automatically inferring relationships between components in a real-world building in most cases, except in two situations where component dependencies are underreported. This is due to missing component models for passive parts like splits and join in ducts, and hence points at concrete future extensions of the Brick ontology. Finally, we demonstrate how AFDD applications can utilize the resulting knowledge graph to find expected consequences of an action, or conversely, to identify components that may be responsible for an observed state of the process.

We analyse the effect of drop-deformation-induced change in streamline topology on the scalar transport rate (the Nusselt number $Nu$) in an ambient planar linear flow. The drop-phase resistance is assumed dominant, and the drop deformation is characterised by the capillary number ($Ca$). For a spherical drop ($Ca = 0$) in an ambient planar extension, closed streamlines lead to $Nu$ increasing with the Péclet number ($Pe$), from $Nu_0$, corresponding to purely diffusive transport, to $4.1Nu_0$, corresponding to a large-$Pe$ diffusion-limited plateau. For non-zero $Ca$, we show that the flow field consists of spiralling streamlines densely wound around nested tori foliating the deformed drop interior. Now $Nu$ increases beyond the aforementioned primary plateau, saturating in a secondary one that approaches $22.3Nu_0$ for $Ca \rightarrow 0$, $Pe\,Ca \rightarrow \infty$. The enhancement appears independent of the drop-to-medium viscosity ratio. We further show that this singular dependence, of the transport rate on drop deformation, is generic across planar linear flows; chaotically wandering streamlines in some of these cases may even lead to a tertiary enhancement regime.

Background: Congenital cardiac care involves multiple stakeholders including patients and their families, surgeons, cardiologists, anaesthetists, the wider multidisciplinary team, healthcare providers, and manufacturers, all of whom are involved in the decision-making process to some degree. Game theory utilises human behaviour to address the dynamics involved in a decision and what the best payoff is depending on the decision of other players. Aim: By presenting these interactions as a strategic game, this paper aims to provide a descriptive analysis on the utility and effectiveness of game theory in optimising decision-making in congenital cardiac care. Methodology: The comprehensive literature was searched to identify papers on game theory, and its application within surgery. Results: The analysis demonstrated that by utilising game theories, decision-making can be more aligned with patient-centric approaches, potentially improving clinical outcomes. Conclusion: Game theory is a useful tool for improving decision-making and may pave the way for more efficient and improved patient-centric approaches.