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We propose a two-sided market entry game and present experiments studying coordination behavior in the game. The two-sided market in the game is operated by an intermediary monopoly platform, serving two sides (i.e., customers and service providers) and featuring asymmetric agents, cross-side network effects, and endogenous market capacity. The game has multiple pure-strategy Nash equilibria if at least one side has a high willingness to enter the market and the other side’s willingness is not very low. We conduct a laboratory experiment involving three treatments corresponding to different combinations of willingness to enter the market among customers and service providers. The experimental results indicate that willingness to enter the market and cross-side network effects significantly influence coordination behavior in two-sided markets. When the multiple pure-strategy Nash equilibria are Pareto ranked on both sides, customers and service providers can coordinate their behavior to the payoff-dominant equilibrium via tacit coordination under strategic uncertainty. However, when the multiple pure-strategy Nash equilibria are Pareto ranked on one side but Pareto equivalent on the other side, coordination failure and disequilibrium occurred, and the equilibria cannot predict the aggregate behavior well. Our experimental results indicate that a thriving two-sided market should coordinate both sides on board.
Parkinson’s disease (PD) is a severe neurodegenerative disorder characterized by prominent motor and non-motor (e.g., cognitive) abnormalities. Notwithstanding Food and Drug Administration (FDA)-approved treatments (e.g., L-dopa), most persons with PD do not adequately benefit from the FDA-approved treatments and treatment emergent adverse events are often reasons for discontinuation. To date, no current therapy for PD is disease modifying or curative. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are central nervous system (CNS) penetrant and have shown to be neuroprotective against oxidative stress, neuroinflammation, and insulin resistance, as well as promoting neuroplasticity. Preclinical evidence suggests that GLP-1RAs also attenuate the accumulation of α-synuclein. The cellular and molecular effects of GLP-1RAs provide a basis to hypothesize putative therapeutic benefit in individuals with PD. Extant preclinical and clinical trial evidence in PD provide preliminary evidence of clinically meaningful benefit in the cardinal features of PD. Herein, we synthesize extant preclinical and early-phase clinical evidence, suggesting that GLP-1RAs may be beneficial as a treatment and/or illness progression modification therapeutic in PD.
Noise source identification has been a long-standing challenge for decades. Although it is known that sound sources are closely related to flow structures, the underlying physical mechanisms remain controversial. This study develops a sound source identification method based on longitudinal and transverse process decomposition (LTD). Large-eddy simulations were performed on the flow around a cylinder at a Reynolds number of 3900. Using the new LTD method, sound sources in the cylinder flow were identified, and the mechanisms linking flow structures with noise generation were discussed in detail. Identifying the physical sound sources from two levels, low-order theory and high-order theory, the physical mechanism of wall sound sources was also analysed. Results indicate that the sound sources in the flow field mainly come from the leading edge, shear layer and wake region of the cylinder. The high-order theory reveals that sound sources are correlated with the spatio-temporal evolution of enstrophy, vortex stretching and surface deformation processes, this reflecting the coupling between transversal and longitudinal flow fields. The boundary thermodynamic flux and boundary dilatation flux distribution of the cylinder were analysed. Results indicate that the wall sound sources mainly come from the separation point and have a disorderly distribution on the leeward side of the cylinder, which is the main region where longitudinal variables enter the fluid from the wall surface, and the wall sound source is related to the boundary enstrophy flux.
The evolutionary process of mixing induced by Rayleigh–Taylor (RT) and Richtmyer–Meshkov (RM) instabilities typically progresses through three stages: initial instability growth, subsequent mixing transition and ultimate turbulent mixing. Accurate prediction of this entire process is crucial for both scientific research and engineering applications. For engineering applications, Reynolds-averaged Navier–Stokes (RANS) simulation stands as the most viable method currently. However, it is noteworthy that existing RANS mixing models are primarily tailored for the fully developed turbulent mixing stage, rendering them ineffective in predicting the crucial mixing transition. To address that, the present study proposes a RANS mixing transition model. Specifically, we extend the idea of the intermittent factor, which has been widely employed to integrate with turbulence models for predicting boundary layer transition, to mixing problems. Based on a high-fidelity simulation of a RT case, the intermittent factor defined based on enstrophy is extracted and then applied to RANS calculations, showing that it is possible to accurately predict mixing transition by introducing the intermittent factor to the turbulence production from the baseline K-L turbulence mixing model. Furthermore, to facilitate practical predictions, a transport equation has been established to model the spatio-temporal evolution of the intermittent factor. Coupled with the K-L model, the intermittent factor provided by the transport equation is applied to modify the Reynolds stress in RANS calculations. Thereafter, the present transition model has been validated in a series of tests, demonstrating its accuracy and robustness in the capturing mixing process in different types and stages of interfacial mixing flows.
Turbulent mixing is a pivotal phenomenon in fusion research with profound implications for energy gain. A Reynolds-averaged Navier–Stokes model capable of predicting realistic mixing transition processes is of significant importance for fusion applications, yet such a model remains elusive. This work addresses the limitations of prevalent global transition criteria, proposing a new idea to quantify local transition characteristics based on the mixing state, recognizing its direct relevance to fusion reaction rates. We delve into the description and analysis of the spatiotemporal evolution of the mixing state and its interplay with the transition process. Then, a local transition indicator is developed and compared with conventional global criteria using the large-eddy simulation (LES) of Rayleigh–Taylor turbulent mixing. Building upon this foundation, we introduce a novel eddy viscosity model based on the local transition indicator. A posterior assessment using LES data validates that it significantly outperforms standard gradient transport models during the transition stage. Consequently, we integrate this new eddy viscosity model with the Besnard–Harlow–Rauenzahn model to construct a comprehensive transition model, which demonstrates reasonably good performance in comparison with LES results. This work paves the way for future research in developing advanced modelling strategies that can effectively address the complexities of transitional flows in fusion engineering applications.
We present a theory that quantifies the interplay between intrapore and interpore flow variabilities and their impact on hydrodynamic dispersion. The theory reveals that porous media with varying levels of structural disorder exhibit notable differences in interpore flow variability, characterised by the flux-weighted probability density function (PDF), $\hat {\psi }_\tau (\tau ) \sim \tau ^{-\theta -2}$, for advection times $\tau$ through conduits. These differences result in varying relative strengths of interpore and intrapore flow variabilities, leading to distinct scaling behaviours of the hydrodynamic dispersion coefficient $D_L$, normalised by the molecular diffusion coefficient $D_m$, with respect to the Péclet number $Pe$. Specifically, when $\hat {\psi }_\tau (\tau )$ exhibits a broad distribution of $\tau$ with $\theta$ in the range of $(0, 1)$, the dispersion undergoes a transition from power-law scaling, $D_L/D_m \sim Pe^{2-\theta }$, to linear scaling, $D_L/D_m \sim Pe$, and eventually to logarithmic scaling, $D_L/D_m \sim Pe\ln (Pe)$, as $Pe$ increases. Conversely, when $\tau$ is narrowly distributed or when $\theta$ exceeds 1, dispersion consistently follows a logarithmic scaling, $D_L/D_m \sim Pe\ln (Pe)$. The power-law and linear scaling occur when interpore variability predominates over intrapore variability, while logarithmic scaling arises under the opposite condition. These theoretical predictions are supported by experimental data and network simulations across a broad spectrum of porous media.
This study aimed to investigate the effects of esketamine (Esk) combined with dexmedetomidine (Dex) on postoperative delirium (POD) and quality of recovery (QoR) in elderly patients undergoing thoracoscopic radical lung cancer surgery.
Methods
In this prospective, randomized, and controlled study, 172 elderly patients undergoing thoracoscopic radical lung cancer surgery were divided into two groups: the Esk + Dex group (n = 86) and the Dex group a (n = 86). The primary outcome was the incidence of POD within 7 days after surgery and the overall Quality of Recovery−15 (QoR − 15) scores within 3 days after surgery. Secondary outcomes included postoperative adverse reactions, extubation time, PACU stay, and hospitalization time. Serum levels of IL-6, IL-10, S100β protein, NSE, CD3+, CD4+, and CD8+ were detected from T0 to T5.
Results
Compared with the Dex group, the incidence of POD in the Esk + Dex group was significantly lower at 7 days after surgery (14.6% vs 30.9%; P = 0.013). The QoR − 15 score was significantly increased 3 days after surgery (P < 0.01). Levels of IL-6 and CD8+ were significantly decreased, and IL − 10 levels were significantly increased at T1-T2 (P < 0.05). At T1-T4, NSE levels were significantly decreased, while CD3+ and CD4+/CD8+ values were significantly increased (P < 0.01). At T1-T5, serum S100β protein concentration decreased significantly, and CD4+ value increased significantly (P < 0.01). The incidence of nausea/vomiting and hyperalgesia decreased significantly 48 hours after surgery (P < 0.01). The duration of extubation, PACU stay, and postoperative hospitalization were significantly shortened.
Conclusions
Esketamine combined with dexmedetomidine can significantly reduce the POD incidence and improve the QoR in patients undergoing thoracoscopic radical lung cancer surgery, which may be related to the improvement of cellular immune function.
To investigate the associations between dietary patterns and biological ageing, identify the most recommended dietary pattern for ageing and explore the potential mediating role of gut microbiota in less-developed ethnic minority regions (LEMRs). This prospective cohort study included 8288 participants aged 30–79 years from the China Multi-Ethnic Cohort study. Anthropometric measurements and clinical biomarkers were utilised to construct biological age based on Klemera and Doubal’s method (KDM-BA) and KDM-BA acceleration (KDM-AA). Dietary information was obtained through the baseline FFQ. Six dietary patterns were constructed: plant-based diet index, healthful plant-based diet index, unhealthful plant-based diet index, healthy diet score, Dietary Approaches to Stop Hypertension (DASH), and alternative Mediterranean diets. Follow-up adjusted for baseline analysis assessed the associations between dietary patterns and KDM-AA. Additionally, quantile G-computation identified significant beneficial and harmful food groups. In the subsample of 764 participants, we used causal mediation model to explore the mediating role of gut microbiota in these associations. The results showed that all dietary patterns were associated with KDM-AA, with DASH exhibiting the strongest negative association (β = −0·91, 95 % CI (–1·19, −0·63)). The component analyses revealed that beneficial food groups primarily included tea and soy products, whereas harmful groups mainly comprised salt and processed vegetables. In mediation analysis, the Synergistetes and Pyramidobacter possibly mediated the negative associations between plant-based diets and KDM-AA (5·61–9·19 %). Overall, healthy dietary patterns, especially DASH, are negatively associated with biological ageing in LEMRs, indicating that Synergistetes and Pyramidobacter may be potential mediators. Developing appropriate strategies may promote healthy ageing in LEMRs.
The practical implementation of machine learning in flow control is limited due to its significant training expenses. In the present study the convolutional neural network (CNN) trained with the data of the restricted nonlinear (RNL) model is used to predict the normal velocity on a detection plane at $y^+=10$ in a turbulent channel flow, and the predicted velocity is used as wall blowing and suction for drag reduction. An active control test is carried out by using the well-trained CNN in direct numerical simulation (DNS). Substantial drag reduction rates up to 19 % and 16 % are obtained based on the spanwise and streamwise wall shear stresses, respectively. Furthermore, we explore the online control of wall turbulence by combining the RNL model with reinforcement learning (RL). The RL is constructed to determine the optimal wall blowing and suction based on its observation of the wall shear stresses without using the label data on the detection plane for training. The controlling and training processes are conducted synchronously in a RNL flow field. The control strategy discovered by RL has similar drag reduction rates with those obtained previously by the established method. Also, the training cost decreases by over thirty times at $Re_{\tau }=950$ compared with the DNS-RL model. The present results provide a perspective that combining the RNL model with machine learning control for drag reduction in wall turbulence can be effective and computationally economical. Also, this approach can be easily extended to flows at higher Reynolds numbers.
Utilizing the discrete element method and the pore network model, we numerically investigate the impact of compaction on the longitudinal dispersion coefficient of porous media. Notably, the dispersion coefficient exhibits a non-monotonic dependence on the degree of compaction, which is distinguished by the presence of three distinct regimes in the variation of dispersion coefficient. The non-monotonic variation of dispersion coefficient is attributed to the disparate effect of compaction on dispersion mechanisms. Specifically, the porous medium tightens with an increasing pressure load, reducing the effect of molecular diffusion that primarily governs at small Péclet numbers. On the other hand, heightened pressure loads enhance the heterogeneity of pore structures, resulting in increased disorder and a higher proportion of stagnant zones within porous media flow. These enhancements further strengthen mechanical dispersion and hold-up dispersion, respectively, both acting at higher Péclet numbers. It is crucial to highlight that hold-up dispersion is induced by the low-velocity regions in porous media flow, which differ fundamentally from zero-velocity regions (such as dead-ends or the interior of permeable grains) as described by the classical theory of dispersion. The competition between weakened molecular diffusion and enhanced hold-up dispersion and mechanical dispersion, together with the shift in the dominance of dispersion mechanisms across various Péclet numbers, results in multiple regimes in the variation of dispersion coefficients. Our study provides unique insights into structural design and modulation of the dispersion coefficient of porous materials.
Dengue fever is a viral disease caused by one of four dengue stereotypes (Flavivirus: Flaviviridae) that are primarily transmitted by Aedes albopictus (Skuse) and Aedes aegypti (L.). To safeguard public health, it is crucial to conduct surveys that examine the factors favouring the presence of these species. Our study surveyed 42 councils across four towns within the Bhakkar district of Punjab Province, by inspecting man-made or natural habitats containing standing water. First, door-to-door surveillance teams from the district health department were assigned to each council to surveillance Aedes species and dengue cases. Second, data collection through surveillance efforts, and validation procedures were implemented, and the verified data was uploaded onto the Dengue Tracking System by Third Party Validation teams. Third, data were analysed to identify factors influencing dengue fever cases. The findings demonstrated the following: (1) Predominantly, instances were discerned among individuals who had a documented history of having travelled beyond the confines of the province. (2) Containers associated with evaporative air coolers and tyre shops were responsible for approximately 30% of the Aedes developmental sites. (4) Variability in temperature was responsible for approximately 45% of the observed differences in the quantity of recorded Aedes mosquito developmental sites. (5) Implementation of dengue prevention initiatives precipitated a 50% reduction in Aedes-positive containers, alongside a notable 70% decline in reported cases of dengue fever during the period spanning 2019 to 2020, while the majority of reported cases were of external origin. Aedes control measures substantially curtailed mosquito populations and lowered vector-virus interactions. Notably, local dengue transmission was eliminated through advanced and effective Aedes control efforts, emphasising the need for persistent surveillance and eradication of larval habitats in affected regions.
Previous studies have revealed an association between dietary factors and atopic dermatitis (AD). To explore whether there was a causal relationship between diet and AD, we performed Mendelian randomisation (MR) analysis. The dataset of twenty-one dietary factors was obtained from UK Biobank. The dataset for AD was obtained from the publicly available FinnGen consortium. The main research method was the inverse-variance weighting method, which was supplemented by MR‒Egger, weighted median and weighted mode. In addition, sensitivity analysis was performed to ensure the accuracy of the results. The study revealed that beef intake (OR = 0·351; 95 % CI 0·145, 0·847; P = 0·020) and white bread intake (OR = 0·141; 95 % CI 0·030, 0·656; P = 0·012) may be protective factors against AD. There were no causal relationships between AD and any other dietary intake factors. Sensitivity analysis showed that our results were reliable, and no heterogeneity or pleiotropy was found. Therefore, we believe that beef intake may be associated with a reduced risk of AD. Although white bread was significant in the IVW analysis, there was large uncertainty in the results given the wide 95 % CI. Other factors were not associated with AD in this study.
With the advantages of short duration and extreme brightness, laser proton accelerators (LPAs) show great potential in many fields for industrial, medical, and research applications. However, the quality of current laser-driven proton beams, such as the broad energy spread and large divergence angle, is still a challenge. We use numerical simulations to study the propagation of such proton bunches in the plasma. Results show the bunch will excite the wakefield and modulate itself. Although a small number of particles at the head of the bunch cannot be manipulated by the wakefield, the total energy spread is reduced. Moreover, while reducing the longitudinal energy spread, the wakefield will also pinch the beam in the transverse direction. The space charge effect of the bunch is completely offset by the wakefield, and the transverse momentum of the bunch decreases as the bunch transports in the plasma. For laser-driven ion beams, our study provides a novel idea about the optimization of these beams.
This paper is concerned with the problem of collision-free path planning for manipulators in multi-obstacle scenarios. Aiming at overcoming the deficiencies of existing algorithms in excessive time consumption and poor expansion quality, a path planning algorithm named Fast Bi-directional Rapidly-exploring Random Tree (FBi-RRT) with novel heuristic node expansion is proposed, which includes a selective-expansion strategy and a vertical-exploration strategy. The selective-expansion strategy is designed to guide the selection of the nearest-neighbor node to avoid the repeated expansion failure, thereby shortening the overall planning time. Also, the vertical-exploration strategy is developed to regulate the expansion direction of the collision nodes to escape from the obstacle space with less blindness, thus improving the expansion quality and further reducing time cost. Compared with previous planning algorithms, FBi-RRT can generate a feasible path for manipulators in a drastically shorter time. To validate the effectiveness of the proposed heuristic node expansion, FBi-RRT is conducted on a 6-DOF manipulator and tested in five scenarios. The experimental results demonstrate that FBi-RRT outperforms the existing methods in time consumption and expansion quality.
This study assesses the difference in professional attitudes among medical students, both before and after coronavirus disease 2019 (COVID-19), and identifies the determinants closely associated with it, while providing precise and scientific evidence for implementing precision education on such professional attitudes.
Methods:
A pre-post-like study was conducted among medical students in 31 provinces in mainland China, from March 23, to April 19, 2021.
Results:
The proportion of medical students whose professional attitudes were disturbed after the COVID-19 pandemic, was significantly lower than before the COVID-19 pandemic (χ2 = 15.6216; P < 0.0001). Compared with the “undisturbed -undisturbed” group, the “undisturbed-disturbed” group showed that there was a 1.664-fold risk of professional attitudes disturbed as grade increased, 3.269-fold risk when others suggested they choose a medical career rather than their own desire, and 7.557-fold risk for students with COVID-19 in their family, relatives, or friends; while the “disturbed-undisturbed” group showed that students with internship experience for professional attitudes strengthened was 2.933-fold than those without internship experience.
Conclusions:
The professional attitudes of medical students have been strengthened during the COVID-19 pandemic. The results provide evidence of the importance of education on professional attitudes among medical students during public health emergencies.
With the rapid development of society, the probability of criminal incidents among college students is gradually increasing, leading to an aggravation of social barriers among college students. Therefore, legalized management of universities has become an important method for building a harmonious campus.
Subjects and Methods
To provide effective psychological guidance for students’ social disorders caused by the increase in crime rates in universities, this study selected 150 students from a certain university to conduct a social disorder questionnaire survey targeting the crime rate in universities and filled out the Hamilton Depression and Anxiety Scale (HAMA). Then, a one-semester rule of law management was adopted for the university, and after the experiment, a social disorders questionnaire survey and HAMA scale were conducted again on the 150 students.
Results
The experimental results showed that before the start of the experiment, a total of 135 students developed anxiety due to the increase in crime rates in universities. Among them, 76 were mild, 51 were moderate, and 8 were severe, with a HAMA score of 52.4 ± 3.1. After the experiment, the number of people who developed anxiety due to the crime rate in universities decreased to 114, among which 81 were mild, 30 were moderate, and 1 was severe. The HAMA score decreased to 43.5 ± 2.6. The number of anxious individuals and HAMA scores have decreased to a certain extent after the experiment.
Conclusions
Legalizing the management of universities can alleviate students’ social disorders caused by university crimes and provide good psychological guidance for students.
The association between sarcopenia and kidney function remains poorly investigated. We aimed to evaluate the associations between sarcopenia status and kidney function (rapid kidney function decline and chronic kidney disease (CKD)) in middle-aged and older Chinese population. A total of 9375 participants from the China Health and Retirement Longitudinal Study 2011 were included in the cross-sectional analyses. A total of 5864 participants with eGFRcr-cys ≥ 60 ml/min per 1·73 m2 at baseline were included in the longitudinal analyses and were followed up in 2015. Sarcopenia status was defined according to the Asian Working Group for Sarcopenia 2019 criteria. In the cross-sectional analyses, possible sarcopenia and sarcopenia were significantly associated with an increased risk of CKD. During the 4 years of follow-up, 359 (6·12 %) participants experienced rapid decline in kidney function and 126 (2·15 %) participants developed CKD. After multivariable adjustment of baseline eGFRcr-cys level and other risk factors, possible sarcopenia (OR, 1·33; 95 % CI 1·01, 2·12) and sarcopenia (OR, 1·49; 95 % CI 1·05, 2·12) were associated with an increased risk of primary outcome (composite of rapid decline in kidney function (annualised decline in eGFRcr-cys ≥ 5 ml/min per 1·73 m2) and progression to CKD (eGFRcr-cys < 60 ml/min per 1·73 m2). Individuals with low muscle mass or low muscle strength alone also had an increased risk of rapid decline in kidney function and progression to CKD.
Continuous risky decisions refer to decisions that involve trade-offs among options with persistent risks. People can use the probability of occurrence per unit time (e.g., ‘the probability of occurrence is 1% per month’) or the average time of risk occurrence (e.g., ‘the average occurrence time is 100 months’) to represent continuous risky options. In this study, we examined the effect of the presentation format (i.e., the probability of occurrence per unit time vs. the average time of risk occurrence) on continuous risky decisions in the gain domain and further explored the underlying mechanism. In Study 1 (N = 122), we demonstrated the effect of presentation format on continuous risky decisions and the moderating effect of the magnitude of probabilities. Specifically, when the probabilities were relatively low, compared with the probability of occurrence per unit time, using the average time of risk occurrence to present the continuous risky options led to more risk-averse decisions. However, when the probabilities were relatively high, compared with the probability of occurrence per unit time, the presentation format of the average time occurrence led to more risk-seeking decisions. In Study 2 (N = 136), we found that the moderating effect of the option probabilities on continuous risky decisions was mediated by the subjective attribute-wise difference judgment. In Study 3 (N = 221), we replicated the effect of presentation format on continuous risky decisions in more natural scenarios. The study offered a deep understanding of the mechanism of continuous risky decision-making, and the results were conducive to further developing theories in relevant fields.
Ventilated cavitating flows are investigated via direct numerical simulations, using a coupled level set and volume of fluid method to capture the interface between the air and water phases. A ventilated disk cavitator is used to create the cavity and is modelled by a sharp-interface immersed boundary method. The simulation data provide a comprehensive description of the two-phase flow and the air leakage and vortex shedding processes in the cavitating flow. The mean velocity of the air phase suggests the existence of three characteristic flow structures, namely the shear layer (SL), recirculating area (RA) and jet layer (JL). The turbulent kinetic energy (TKE) is concentrated in the JL in the closure region, and streamwise turbulent fluctuations dominate transverse fluctuations in both SL and JL. Budget analyses of the TKE show that the production term causes the TKE to increase in the SL due to the high velocity gradients, and decrease in the JL due to streamwise stretching effects. Air leakage and vortex shedding occur periodically in the closure region, and the one-to-one correspondence between these two processes is confirmed by the velocity and volume fluid spectra results, and the autocorrelation function of the air volume fraction. Moreover, the coherent flow structures are analysed using the spectral proper orthogonal decomposition method. We identify several fine coherent structures, including $SL_{KH}$ induced by the Kelvin–Helmholtz instability, $SL_{out}$ associated with large-scale vortex shedding, $SL_{in}$ associated with small-scale vortex shedding, and $SL_{r}$ associated with upstream turbulent convection. The present study complements previous research by providing detailed descriptions of the turbulent motions associated with the violent mixing of air and water, and the complex interactions between different characteristic structures in cavitating flows.