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Large-amplitude gust encounters exhibit a range of separated flow phenomena, making them difficult to characterize using the traditional tools of aerodynamics. In this work, we propose a dynamical systems approach to gust encounters, viewing the flow as a cycle (or a closed trajectory) in state space. We posit that the topology of this cycle, or its shape and structure, provides a compact description of the flow, and can be used to identify coordinates in which the dynamics evolve in a simple, intuitive way. To demonstrate this idea, we consider flowfield measurements of a transverse gust encounter. For each case in the dataset, we characterize the full-state dynamics of the flow using persistent homology, a tool that identifies holes in point cloud data, and transform the dynamics to a reduced-order space using a nonlinear autoencoder. Critically, we constrain the autoencoder such that it preserves topologically relevant features of the original dynamics, or those features identified by persistent homology. Using this approach, we are able to transform six separate gust encounters to a three-dimensional latent space, in which each gust encounter reduces to a simple circle, and from which the original flow can be reconstructed. This result shows that topology can guide the creation of low-dimensional state representations for strong transverse gust encounters, a crucial step towards the modelling and control of aerofoil–gust interactions.
Studying phenotypic and genetic characteristics of age at onset (AAO) and polarity at onset (PAO) in bipolar disorder can provide new insights into disease pathology and facilitate the development of screening tools.
Aims
To examine the genetic architecture of AAO and PAO and their association with bipolar disorder disease characteristics.
Method
Genome-wide association studies (GWASs) and polygenic score (PGS) analyses of AAO (n = 12 977) and PAO (n = 6773) were conducted in patients with bipolar disorder from 34 cohorts and a replication sample (n = 2237). The association of onset with disease characteristics was investigated in two of these cohorts.
Results
Earlier AAO was associated with a higher probability of psychotic symptoms, suicidality, lower educational attainment, not living together and fewer episodes. Depressive onset correlated with suicidality and manic onset correlated with delusions and manic episodes. Systematic differences in AAO between cohorts and continents of origin were observed. This was also reflected in single-nucleotide variant-based heritability estimates, with higher heritabilities for stricter onset definitions. Increased PGS for autism spectrum disorder (β = −0.34 years, s.e. = 0.08), major depression (β = −0.34 years, s.e. = 0.08), schizophrenia (β = −0.39 years, s.e. = 0.08), and educational attainment (β = −0.31 years, s.e. = 0.08) were associated with an earlier AAO. The AAO GWAS identified one significant locus, but this finding did not replicate. Neither GWAS nor PGS analyses yielded significant associations with PAO.
Conclusions
AAO and PAO are associated with indicators of bipolar disorder severity. Individuals with an earlier onset show an increased polygenic liability for a broad spectrum of psychiatric traits. Systematic differences in AAO across cohorts, continents and phenotype definitions introduce significant heterogeneity, affecting analyses.
Recent advances in marine acoustic survey and land-based topographic monitoring technologies have resulted in increasingly cost-effective data acquisition in coastal areas. The DEFRA-funded National Network of Regional Coastal Monitoring Programmes of England are, for example, utilising swath bathymetry and airborne light detection and ranging (LiDAR) technology more routinely to survey the coastal zone around the coastline of England. The demand for data processing, visualisation and interpretation techniques to keep pace with such advances in data acquisition is clear. This study discusses collection and processing techniques for such data on the south coast of Dorset, England, which have enabled the production of a seamless, high spatial resolution digital elevation model across the coastal zone. Case studies demonstrate how this elevation model can be viewed and analysed using state-of-the-art digital techniques to allow geological mapping to be extended from onshore to offshore in unprecedented detail, effectively eliminating what is known as the ‘White Ribbon’ for coastal geological mapping. The potential for rolling out such techniques for wider surveying programmes across many environmental disciplines is significant, which could contribute towards improving the multi-disciplinary scientific evidence base in the complex coastal zone.
The aim of the present study was to describe the energy, nutrient and crude v. disaggregated food intake measured using 7 d diet diaries (7dDD) for the full baseline Norfolk cohort recruited for the European Prospective Investigation into Cancer (EPIC-Norfolk) study, with emphasis on methodological issues. The first data collection took place between 1993 and 1998 in Norfolk, East Anglia (UK). Of the 30 445 men and women, aged 40–79 years, registered with a general practitioner invited to participate in the study, 25 639 came for a health examination and were asked to complete a 7dDD. Data from diaries with data recorded for at least 1 d were obtained for 99 % members of the cohort; 10 354 (89·8 %) of the men and 12 779 (91·5 %) of the women completed the diet diaries for all 7 d. Mean energy intake (EI) was 9·44 (sd 2·22) MJ/d and 7·15 (sd 1·66) MJ/d, respectively. EI remained approximately stable across the days, but there was apparent under-reporting among the participants, especially among those with BMI >25 kg/m2. Micronutrient density was higher among women than among men. In conclusion, under-reporting is an issue, but not more so than that found in national surveys. How foods were grouped (crude or disaggregated) made a difference to the estimates obtained, and comparison of intakes showed wide limits of agreement. The choice of variables influences estimates obtained from the food group data; while this may not alter the ranking of individuals within studies, this issue may be relevant when comparing absolute food intakes between studies.
Objective: To describe initiatives undertaken by a network of community pediatricians to increase a city's surge capacity for patients presenting with influenza-like illnesses during the 2009 H1N1 influenza A pandemic.
Methods: This was a descriptive quality improvement project detailing the measures employed by a network of private practice community pediatricians in Houston, Texas, caring for both insured and uninsured children.
Results: Four categories of interventions were used: enhanced communication, increasing community pediatrician presence, vaccine distribution, and targeted viral diagnosis and antiviral utilization. Promoting communication between clinicians, families, and an affiliated local tertiary care children's hospital allowed for the efficient coordination of resources as well as a unified and consistent message. Increasing access of families to their primary medical home by employing additional clinicians, extending office hours, and locating additional space served to decrease the number of children with low-acuity illness seen in the local emergency centers. Vaccine distribution was enhanced by effective communication between clinicians and families. Finally, targeted antiviral testing and adherence to national recommendations on antiviral utilization enabled judicious utilization of a limited supply of antiviral medications.
Conclusions: Effective communication and improved access to health care enabled children within the network with influenza-like illnesses to continue to be cared for in their medical home. The measures used in response to novel influenza virus outbreaks can be adapted for other situations requiring increased community surge capacity.
(Disaster Med Public Health Preparedness 2012;6:113-116)
The need to improve the response of primary care in terms of identification of people with undiagnosed dementia has long been recognised. The role of Primary Care Liaison was identified as a possible solution. An in-depth consultation was undertaken to identify professional competencies required in executing such a role.
Methods
Comprehensive literature and policy reviews were conducted to establish draft competencies or different options/combinations of competencies and competency levels. Consultations with a wide range of professional stakeholders (n = 23) and over 70 users and carers were conducted through focus groups, electronic document circulation and telephone interviews. An Equality Impact Assessment was conducted concurrent to the consultation.
Results
The literature demonstrated a clear need both to improve the rate of diagnosis for people with dementia and to improve the way in which the diagnosis is made. The stakeholder consultation repeatedly affirmed that without a diagnosis the person with dementia and their caregivers did not get access to the appropriate services, and validated the need for a role that would be able to improve a system that would deliver an early and ‘timely’ diagnosis. Competencies, based on the literature and policy documents, were developed and debated through the consultation processes.
Conclusions
Three main areas of competency were identified: counselling; screening; and health education and promotion. The competencies identified require a skilled experienced professional approach. A useful team model would be that the role is placed within a ‘GP cluster’ as accessibility to GP records and collaborative working with GPs is essential within the role. Personal continuing professional development has a high profile in maintaining these competencies.
To determine healthcare-associated infection (HAI) prevalence in 9 hospitals in Jacksonville, Florida; to evaluate the performance of proxy indicators for HAIs; and to refine methodology in preparation for a multistate survey.
Design.
Point prevalence survey.
Patients.
Acute care inpatients of any age.
Methods.
HAIs were defined using National Healthcare Safety Network criteria. In each facility a trained primary team (PT) of infection prevention (IP) staff performed the survey on 1 day, reviewing records and collecting data on a random sample of inpatients. PTs assessed patients with one or more proxy indicators (abnormal white blood cell count, abnormal temperature, or antimicrobial therapy) for the presence of HAIs. An external IP expert team collected data from a subset of patient records reviewed by PTs to assess proxy indicator performance and PT data collection.
Results.
Of 851 patients surveyed by PTs, 51 had one or more HAIs (6.0%; 95% confidence interval, 4.5%–7.7%). Surgical site infections (n = 18), urinary tract infections (n = 9), pneumonia (n = 9), and bloodstream infections (n = 8) accounted for 75.8% of 58 HAIs detected by PTs. Staphylococcus aureus was the most common pathogen, causing 9 HAIs (15.5%). Antimicrobial therapy was the most sensitive proxy indicator, identifying 95.5% of patients with HAIs.
Conclusions.
HAI prevalence in this pilot was similar to that reported in the 1970s by the Centers for Disease Control and Prevention's Study on the Efficacy of Nosocomial Infection Control. Antimicrobial therapy was a sensitive screening variable with which to identify those patients at higher risk for infection and reduce data collection burden. Additional work is needed on validation and feasibility to extend this methodology to a national scale.
Amultidisciplinary collaborative study examining cognition in a large sample of twins is outlined. A common experimental protocol and design is used in The Netherlands, Australia and Japan to measure cognitive ability using traditional IQ measures (i.e., psychometric IQ), processing speed (e.g., reaction time [RT] and inspection time [IT]), and working memory (e.g., spatial span, delayed response [DR] performance). The main aim is to investigate the genetic covariation among these cognitive phenotypes in order to use the correlated biological markers in future linkage and association analyses to detect quantitativetrait loci (QTLs). We outline the study and methodology, and report results from our preliminary analyses that examines the heritability of processing speed and working memory indices, and their phenotypic correlation with IQ. Heritability of Full Scale IQ was 87% in the Netherlands, 83% in Australia, and 71% in Japan. Heritability estimates for processing speed and working memory indices ranged from 33–64%. Associations of IQ with RT and IT (−0.28 to −0.36) replicated previous findings with those of higher cognitive ability showing faster speed of processing. Similarly, significant correlations were indicated between IQ and the spatial span working memory task (storage [0.31], executive processing [0.37]) and the DR working memory task (0.25), with those of higher cognitive ability showing better memory performance. These analyses establish the heritability of the processing speed and working memory measures to be used in our collaborative twin study of cognition, and support the findings that individual differences in processing speed and working memory may underlie individual differences in psychometric IQ.
To achieve higher renewable energy (RE) shares than the low levels typically found in present energy supply systems will require additional integration efforts starting now and continuing over the longer term. These include improved understanding of the RE resource characteristics and availability, investments in enabling infrastructure and research, development and demonstrations (RD&D), modifications to institutional and governance frameworks, innovative thinking, attention to social aspects, markets and planning, and capacity building in anticipation of RE growth.
In many countries, sufficient RE resources are available for system integration to meet a major share of energy demands, either by direct input to end-use sectors or indirectly through present and future energy supply systems and energy carriers, whether for large or small communities in Organisation for Economic Co-operation and Development (OECD) or non-OECD countries. At the same time, the characteristics of many RE resources that distinguish them from fossil fuels and nuclear systems include their natural unpredictability and variability over time scales ranging from seconds to years. These can constrain the ease of integration and result in additional system costs, particularly when reaching higher RE shares of electricity, heat or gaseous and liquid fuels.
Existing energy infrastructure, markets and other institutional arrangements may need adapting, but there are few, if any, technical limits to the planned system integration of RE technologies across the very broad range of present energy supply systems worldwide, though other barriers (e.g., economic barriers) may exist. Improved overall system efficiency and higher RE shares can be achieved by the increased integration of a portfolio of RE resources and technologies.
A coming ‘Age of Interdependent Forms’ seems destined to mark the success of what could be called ‘despecialized/interspecific fitness’ among neotenic strains (perpetuating juvenile traits) of species such as humans and domestic animals. Humans as well as the first domesticants underwent a neotenic evolution in the wild during the repeated interglacial periods which, acting on a number of mammalian forms, selected against adult species-specific ancestral adaptations to a stable environment. Neotenic species continue to look and behave more like ancestral youths than adults—even after sexual maturity and throughout their life-history. As they retain lifelong youthful dependency motivations, they can easily, under suitable conditions, become interdependent forms. By the time of melting of the last Pleistocene glacier, all the domestic partners had already become more dependency-prone than formerly, and were behaviourally despecialized enough to form the alliance that is now changing the order of Nature.