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Periodic gravity-capillary waves on a fluid of finite depth with constant vorticity are studied theoretically and numerically. The classical Stokes expansion method is applied to obtain the wave profile and the interior flow up to the fourth order of approximation, which thereby extends the works of Barakat & Houston (1968) J. Geophys. Res.73 (20), 6545–6554 and Hsu et al. (2016) Proc. R. Soc. Lond. A472, 20160363. The classical perturbation scheme possesses singularities for certain wavenumbers, whose variations with depth are shown to be affected by the vorticity. This analysis also reveals that for any given value of the physical depth, there exists a threshold value of the vorticity above which there are no singularities in the theoretical solution. The validity of the third- and fourth-order solutions is examined by comparison with exact numerical results, which are obtained with a method based on conformal mapping and Fourier series expansions of the wave surface. The outcomes of this comparison are surprising as they report important differences in the internal flow structure, when compared with the third-order predictions, even though both approximations predict almost perfectly the phase velocity and the surface profiles. Usually, this occurs when the wavenumber is far enough from a critical value and the steepness is not too large. In these non-resonant cases, it is found that the fourth-order theory is more consistent with the exact numerical results. With negative vorticity the improvement is noticeable both beneath the crest and the trough, whereas with positive vorticity the fourth-order theory does a better job either beneath the crest or beneath the trough, depending of the type of the wave.
The avoidance of asthma triggers, like tobacco smoke, facilitates asthma management. Reliance upon caregiver report of their child’s environmental tobacco smoke (ETS) exposure may result in information bias and impaired asthma management. This analysis aimed to characterize the chronicity of ETS exposure, assess the validity of caregiver report of ETS exposure, and investigate the relationship between ETS exposure and asthma attack.
Methods:
A secondary data analysis was performed on data from a longitudinal study of 162 children aged 7–12 years with asthma living in federally subsidized housing in three US cities (Boston, Cincinnati, and New Orleans). Data were collected at three time points over 1 year.
Results:
Over 90% of children were exposed to ETS (≥0.25 ng/ml of urine cotinine (UC)). Exposure was consistent over 1 year. Questionnaire data had a sensitivity of 28–34% using UC ≥0.25 ng/ml as the gold standard. High ETS exposure (UC ≥ 30 ng/ml) was significantly associated with asthma attack (aOR 2.97, 0.93–9.52, p = 0.07). Lower levels (UC 0.25–30 ng/ml) were not statistically significant (aOR 1.76, 0.71– 4.38, p = 0.22). No association was found using caregiver-reported ETS exposure.
Conclusion:
Relying on questionnaire data to assess children’s exposure to tobacco smoke may lead to substantial information bias. For children with asthma, incorrect characterization may substantially impact asthma morbidity.
In submerged sandy slopes, soil is frequently eroded as a combination of two main mechanisms: breaching, which refers to the retrogressive failure of a steep slope forming a turbidity current, and instantaneous sliding wedges, known as shear failure, that also contribute to shape the morphology of the soil deposit. Although there are several modes of failures, in this paper we investigate breaching and shear failures of granular columns using the two-fluid approach. The numerical model is first applied to simulate small-scale granular column collapses (Rondon et al., Phys. Fluids, vol. 23, 2011, 073301) with different initial volume fractions to study the role of the initial conditions in the main flow dynamics. For loosely packed granular columns, the porous medium initially contracts and the resulting positive pore pressure leads to a rapid collapse. Whereas in initially dense-packing columns, the porous medium dilates and negative pore pressure is generated stabilizing the granular column, which results in a slow collapse. The proposed numerical approach shows good agreement with the experimental data in terms of morphology and excess of pore pressure. Numerical results are extended to a large-scale application (Weij, doctoral dissertation, 2020, Delft University of Technology; Alhaddad et al., J. Mar. Sci. Eng., vol. 11, 2023, 560) known as the breaching process. This phenomenon may occur naturally at coasts or on dykes and levees in rivers but it can also be triggered by humans during dredging operations. The results indicate that the two-phase flow model correctly predicts the dilative behaviour and the subsequent turbidity currents associated with the breaching process.
The optimal timing of blood culture (BCx) sets collection has not been evaluated with continuous BCx detection systems. The yield of BCx was similar between short intervals (median, 3 minutes) and longer intervals (median, 16 or 43 minutes) among 5,856 BCx, except for improved polymicrobial bacteremia detection with long-interval BCx.
In, essentially, all species where meiotic crossovers (COs) have been studied, they occur preferentially in open chromatin, typically near gene promoters and to a lesser extent, at the end of genes. Here, in the case of Arabidopsis thaliana, we unveil further trends arising when one considers contextual information, namely summarised epigenetic status, gene or intergenic region size, and degree of divergence between homologs. For instance, we find that intergenic recombination rate is reduced if those regions are less than 1.5 kb in size. Furthermore, we propose that the presence of single nucleotide polymorphisms enhances the rate of CO formation compared to when homologous sequences are identical, in agreement with previous works comparing rates in adjacent homozygous and heterozygous blocks. Lastly, by integrating these different effects, we produce a quantitative and predictive model of the recombination landscape that reproduces much of the experimental variation.
Healthcare workers (HCWs) not adhering to physical distancing recommendations is a risk factor for acquisition of severe acute respiratory coronavirus virus 2 (SARS-CoV-2). The study objective was to assess the impact of interventions to improve HCW physical distancing on actual distance between HCWs in a real-life setting.
Methods:
HCWs voluntarily wore proximity beacons to measure the number and intensity of physical distancing interactions between each other in a pediatric intensive care unit. We compared interactions before and after implementing a bundle of interventions including changes to the layout of workstations, cognitive aids, and individual feedback from wearable proximity beacons.
Results:
Overall, we recorded 10,788 interactions within 6 feet (∼2 m) and lasting >5 seconds. The number of HCWs wearing beacons fluctuated daily and increased over the study period. On average, 13 beacons were worn daily (32% of possible staff; range, 2–32 per day). We recorded 3,218 interactions before the interventions and 7,570 interactions after the interventions began. Using regression analysis accounting for the maximum number of potential interactions if all staff had worn beacons on a given day, there was a 1% decline in the number of interactions per possible interactions in the postintervention period (incident rate ratio, 0.99; 95% confidence interval, 0.98–1.00; P = .02) with fewer interactions occurring at nursing stations, in workrooms and during morning rounds.
Conclusions:
Using quantitative data from wearable proximity beacons, we found an overall small decline in interactions within 6 feet between HCWs in a busy intensive care unit after a multifaceted bundle of interventions was implemented to improve physical distancing.
Falls and fall-related injuries among older adults represent a substantial health burden. Approximately 30% of older adults experience at least one fall each year, and half of these individuals fall recurrently [1, 2]. Fall-related non-fatal injuries are associated with increased morbidity, decreased functioning, and increased health care resource utilization [3, 4]. Fall-related injuries such as fracture account for 10-15% of emergency department presentations of those aged 65 years and older [5, 6]. With the number of adults aged 65 and older expected to increase to 1 in 5 by 2050, the economic burden imposed by falls is expected to increase proportionally [7].
When a deposited layer of granular material fully immersed in a liquid is suddenly inclined above a certain critical angle, it starts to flow down the slope. The initial dynamics of these underwater avalanches strongly depends on the initial volume fraction. If the granular bed is initially loose, i.e. looser than the critical state, the avalanche is triggered almost instantaneously and exhibits a strong acceleration, whereas for an initially dense granular bed, i.e. denser than the critical state, the avalanche's mobility remains low for some time before it starts flowing normally. This behaviour can be explained by a combination of geometrical granular dilatancy and pore pressure feedback on the granular media. In this contribution, a continuum formulation is presented and implemented in a three-dimensional continuum numerical model. The originality of the present model is to incorporate dilatancy as an elasto-plastic normal stress or pressure and not as a modification of the friction coefficient. This allows an explanation of the two different behaviours of initially loose and dense underwater avalanches. It also highlights the contribution from each depth-resolved variable in the strongly coupled transition to a flowing avalanche. The model compares favourably with existing experiments for the initiation of underwater granular avalanches. Results reveal the interplay between shear-induced changes of the granular stress and fluid pressure in the dynamics of avalanches. The characteristic time of the triggering phase is nearly independent of the local rheological parameters, whereas the initial drop in pore pressure and the surface velocity at steady state still strongly depend on them. Finally, the multidimensional capabilities of the model are illustrated for the two-dimensional Hele-Shaw configuration and some of the observed differences between one-dimensional simulations and experiments are clarified.
We present experimental data providing evidence for the formation of transient (${\sim }20\ \mathrm {\mu }\textrm {s}$) plasmas that are simultaneously weakly magnetized (i.e. Hall magnetization parameter $\omega \tau > 1$) and dominated by thermal pressure (i.e. ratio of thermal-to-magnetic pressure $\beta > 1$). Particle collisional mean free paths are an appreciable fraction of the overall system size. These plasmas are formed via the head-on merging of two plasmas launched by magnetized coaxial guns. The ratio $\lambda _{\textrm {gun}}=\mu _0 I_{\textrm {gun}}/\psi _{\textrm {gun}}$ of gun current $I_{\textrm {gun}}$ to applied magnetic flux $\psi _{\textrm {gun}}$ is an experimental knob for exploring the parameter space of $\beta$ and $\omega \tau$. These experiments were conducted on the Big Red Ball at the Wisconsin Plasma Physics Laboratory. The transient formation of such plasmas can potentially open up new regimes for the laboratory study of weakly collisional, magnetized, high-$\beta$ plasma physics; processes relevant to astrophysical objects and phenomena; and novel magnetized plasma targets for magneto-inertial fusion.
Although testing is widely regarded as critical to fighting the COVID-19 pandemic, what measure and level of testing best reflects successful infection control remains unresolved. Our aim was to compare the sensitivity of two testing metrics – population testing number and testing coverage – to population mortality outcomes and identify a benchmark for testing adequacy. We aggregated publicly available data through 12 April on testing and outcomes related to COVID-19 across 36 OECD (Organization for Economic Development) countries and Taiwan. Spearman correlation coefficients were calculated between the aforementioned metrics and following outcome measures: deaths per 1 million people, case fatality rate and case proportion of critical illness. Fractional polynomials were used to generate scatter plots to model the relationship between the testing metrics and outcomes. We found that testing coverage, but not population testing number, was highly correlated with population mortality (rs = −0.79, P = 5.975 × 10−9vs. rs = −0.3, P = 0.05) and case fatality rate (rs = −0.67, P = 9.067 × 10−6vs. rs = −0.21, P = 0.20). A testing coverage threshold of 15–45 signified adequate testing: below 15, testing coverage was associated with exponentially increasing population mortality; above 45, increased testing did not yield significant incremental mortality benefit. Taken together, testing coverage was better than population testing number in explaining country performance and can serve as an early and sensitive indicator of testing adequacy and disease burden.
Lurasidone has demonstrated efficacy in the treatment of schizophrenia in a series of short-term placebo-controlled trials.
Objectives:
To evaluate the safety, tolerability and effectiveness of lurasidone in the long-term treatment of patients with a DSM-IV-TR diagnosis of schizophrenia.
Methods:
Patients who completed a 6 week, double-blind, placebo-controlled trial received once-daily, flexible-doses of lurasidone, 40–120 mg in a 22 month open-label extension study. An observed case analysis was performed on change from pre-treatment baseline in safety and efficacy parameters.
Results:
250 subjects entered the study; 39.8% completed 12 months and 26.8% completed 22 months of treatment. Lurasidone treatment was associated with a mean endpoint change in weight of +0.7 kg. Median endpoint change at Month 12 and Month 24, respectively, was -1.0 and −9.0 mg/dL for total cholesterol; 0.0 and −1.0 mg/dL for LDL; +1.0 and −11.0 mg/dL for triglycerides; +4.0 and +2.0 mg/dL for glucose; 0.0 and +0.1% for HbA1c; and −1.3 and −1.1 ng/mL for prolactin. The mean PANSS total score was 69.5 at extension baseline. The mean (95% CI) endpoint change from extension baseline in PANSS total score was −0.5 (95%-CI: −0.7, −0.3). Overall, 14.7% of patients discontinued due to an adverse event. Adverse events occurring with an incidence ≥10% were schizophrenia (12.4%), akathisia (10.8%) and somnolence (10.8%).
Conclusions:
In this 22 month extension study, treatment with lurasidone was associated with minimal effects on weight, glucose, and lipids. Subjects demonstrated sustained improvement in the PANSS total score for up to 24 months of lurasidone treatment.
Several studies suggested that depression might worsen the clinical outcome of diabetes mellitus; however, such association was confounded by duration of illness and baseline complications. This study aimed to assess whether depression increases the risk of diabetes complications and mortality among incident patients with diabetes.
Methods
This was a population-based matched cohort study using Taiwan's National Health Insurance Research Database. A total of 38 537 incident patients with diabetes who had depressive disorders and 154 148 incident diabetes patients without depression who were matched by age, sex and cohort entry year were randomly selected. The study endpoint was the development of macrovascular and microvascular complications, all-cause mortality and cause-specific mortality.
Results
Among participants, the mean (±SD) age was 52.61 (±12.45) years, and 39.63% were male. The average duration of follow-up for mortality was 5.5 years, ranging from 0 to 14 years. The adjusted hazard ratios were 1.35 (95% confidence interval [CI], 1.32–1.37) for macrovascular complications and 1.08 (95% CI, 1.04–1.12) for all-cause mortality. However, there was no association of depression with microvascular complications, mortality due to cardiovascular diseases or mortality due to diabetes mellitus. The effect of depression on diabetes complications and mortality was more prominent among young adults than among middle-aged and older adults.
Conclusions
Depression was associated with macrovascular complications and all-cause mortality in our patient cohort. However, the magnitude of association was less than that in previous studies. Further research should focus on the benefits and risks of treatment for depression on diabetes outcome.
While echocardiographic parameters are used to quantify ventricular function in infants with single ventricle physiology, there are few data comparing these to invasive measurements. This study correlates echocardiographic measures of diastolic function with ventricular end-diastolic pressure in infants with single ventricle physiology prior to superior cavopulmonary anastomosis.
Methods:
Data from 173 patients enrolled in the Pediatric Heart Network Infant Single Ventricle enalapril trial were analysed. Those with mixed ventricular types (n = 17) and one outlier (end-diastolic pressure = 32 mmHg) were excluded from the analysis, leaving a total sample size of 155 patients. Echocardiographic measurements were correlated to end-diastolic pressure using Spearman’s test.
Results:
Median age at echocardiogram was 4.6 (range 2.5–7.4) months. Median ventricular end-diastolic pressure was 7 (range 3–19) mmHg. Median time difference between the echocardiogram and catheterisation was 0 days (range −35 to 59 days). Examining the entire cohort of 155 patients, no echocardiographic diastolic function variable correlated with ventricular end-diastolic pressure. When the analysis was limited to the 86 patients who had similar sedation for both studies, the systolic:diastolic duration ratio had a significant but weak negative correlation with end-diastolic pressure (r = −0.3, p = 0.004). The remaining echocardiographic variables did not correlate with ventricular end-diastolic pressure.
Conclusion:
In this cohort of infants with single ventricle physiology prior to superior cavopulmonary anastomosis, most conventional echocardiographic measures of diastolic function did not correlate with ventricular end-diastolic pressure at cardiac catheterisation. These limitations should be factored into the interpretation of quantitative echo data in this patient population.
The bifurcation of two-dimensional gravity–capillary waves into solitary waves when the phase velocity and group velocity are nearly equal is investigated in the presence of constant vorticity. We found that gravity–capillary solitary waves with decaying oscillatory tails exist in deep water in the presence of vorticity. Furthermore we found that the presence of vorticity influences strongly (i) the solitary wave properties and (ii) the growth rate of unstable transverse perturbations. The growth rate and bandwidth instability are given numerically and analytically as a function of the vorticity.
Research suggests an association between metabolic disorders, such as type 2 diabetes mellitus (T2DM), and schizophrenia. However, the risk of metabolic disorders in the unaffected siblings of patients with schizophrenia remains unclear.
Methods
Using the Taiwan National Health Insurance Research Database, 3135 unaffected siblings of schizophrenia probands and 12,540 age-/sex-matched control subjects were included and followed up to the end of 2011. Individuals who developed metabolic disorders during the follow-up period were identified.
Results
The unaffected siblings of schizophrenia probands had a higher prevalence of T2DM (3.4% vs. 2.6%, p = 0.010) than the controls. Logistic regression analyses with the adjustment of demographic data revealed that the unaffected siblings of patients with schizophrenia were more likely to develop T2DM (odds ratio [OR]: 1.39, 95% confidence interval [CI]: 1.10–1.75) later in life compared with the control group. Moreover, only female siblings of schizophrenia probands had an increased risk of hypertension (OR: 1.47, 95% CI: 1.07–2.01) during the follow-up compared with the controls.
Discussion
The unaffected siblings, especially sisters, of schizophrenia probands had a higher prevalence of T2DM and hypertension compared with the controls. Our study revealed a familial link between schizophrenia and T2DM in a large sample. Additional studies are required to investigate the shared pathophysiology of schizophrenia and T2DM.
All organisms encounter pathogens, and birds are especially susceptible to infection by malaria parasites and other haemosporidians. It is important to understand how immune genes, primarily innate immune genes which are the first line of host defense, have evolved across birds, a highly diverse group of tetrapods. Here, we find that innate immune genes are highly conserved across the avian tree of life and that although most show evidence of positive or diversifying selection within specific lineages or clades, the number of sites is often proportionally low in this broader context of putative constraint. Rather, evidence shows a much higher level of negative or purifying selection in these innate immune genes – rather than adaptive immune genes – which is consistent with birds' long coevolutionary history with pathogens and the need to maintain a rapid response to infection. We further explored avian responses to haemosporidians by comparing differential gene expression in wild birds (1) uninfected with haemosporidians, (2) infected with Plasmodium and (3) infected with Haemoproteus (Parahaemoproteus). We found patterns of significant differential expression with some genes unique to infection with each genus and a few shared between ‘treatment’ groups, but none that overlapped with the genes included in the phylogenetic study.
In this systematic evaluation of fluorescent gel markers (FGM) applied to high-touch surfaces with a metered applicator (MA) made for the purpose versus a generic cotton swab (CS), removal rates were 60.5% (476 of 787) for the MA and 64.3% (506 of 787) for the CS. MA-FGM removal interpretation was more consistent, 83% versus 50% not removed, possibly due to less varied application and more adhesive gel.
A nonlinear Schrödinger equation for the envelope of two-dimensional gravity–capillary waves propagating at the free surface of a vertically sheared current of constant vorticity is derived. In this paper we extend to gravity–capillary wave trains the results of Thomas et al. (Phys. Fluids, 2012, 127102) and complete the stability analysis and stability diagram of Djordjevic & Redekopp (J. Fluid Mech., vol. 79, 1977, pp. 703–714) in the presence of vorticity. The vorticity effect on the modulational instability of weakly nonlinear gravity–capillary wave packets is investigated. It is shown that the vorticity modifies significantly the modulational instability of gravity–capillary wave trains, namely the growth rate and instability bandwidth. It is found that the rate of growth of modulational instability of short gravity waves influenced by surface tension behaves like pure gravity waves: (i) in infinite depth, the growth rate is reduced in the presence of positive vorticity and amplified in the presence of negative vorticity; (ii) in finite depth, it is reduced when the vorticity is positive and amplified and finally reduced when the vorticity is negative. The combined effect of vorticity and surface tension is to increase the rate of growth of modulational instability of short gravity waves influenced by surface tension, namely when the vorticity is negative. The rate of growth of modulational instability of capillary waves is amplified by negative vorticity and attenuated by positive vorticity. Stability diagrams are plotted and it is shown that they are significantly modified by the introduction of the vorticity.