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We undertake a comprehensive investigation into the distribution of in situ stars within Milky Way-like galaxies, leveraging TNG50 simulations and comparing their predictions with data from the H3 survey. Our analysis reveals that 28% of galaxies demonstrate reasonable agreement with H3, while only 12% exhibit excellent alignment in their profiles, regardless of the specific spatial cut employed to define in situ stars. To uncover the underlying factors contributing to deviations between TNG50 and H3 distributions, we scrutinise correlation coefficients among internal drivers (e.g. virial radius, star formation rate [SFR]) and merger-related parameters (such as the effective mass-ratio, mean distance, average redshift, total number of mergers, average spin-ratio, and maximum spin alignment between merging galaxies). Notably, we identify significant correlations between deviations from observational data and key parameters such as the median slope of virial radius, mean SFR values, and the rate of SFR change across different redshift scans. Furthermore, positive correlations emerge between deviations from observational data and parameters related to galaxy mergers. We validate these correlations using the Random Forest Regression method. Our findings underscore the invaluable insights provided by the H3 survey in unravelling the cosmic history of galaxies akin to the Milky Way, thereby advancing our understanding of galactic evolution and shedding light on the formation and evolution of Milky Way-like galaxies in cosmological simulations.
On several key issues we agree with the commentators. Perhaps most importantly, everyone seems to agree that psychology has an important role to play in building better models of human vision, and (most) everyone agrees (including us) that deep neural networks (DNNs) will play an important role in modelling human vision going forward. But there are also disagreements about what models are for, how DNN–human correspondences should be evaluated, the value of alternative modelling approaches, and impact of marketing hype in the literature. In our view, these latter issues are contributing to many unjustified claims regarding DNN–human correspondences in vision and other domains of cognition. We explore all these issues in this response.
We present the first geochemical data of archaeological obsidian for Isla Victoria, Nahuel Huapi National Park in Patagonia. XRF analyses were performed on 15 samples of obsidian-like rocks from the Puerto Tranquilo 1 site. Only five of the artifacts—all of which come from upper levels of the site—correspond to obsidian as a raw material. The provenance analysis indicates the use of obsidian sources located in the Andean Forest area of southern Neuquen Province. Based on these preliminary results, we propose a north–south circulation axis for this raw material. These geographic results are discussed in relation to the information available regionally.
For primary care clinics at a Veterans’ Affairs (VA) medical center, the shift from in-person to telehealth visits during the coronavirus disease 2019 (COVID-19) pandemic was associated with low rates of antibiotic prescription. Understanding contextual factors associated with antibiotic prescription practices during telehealth visits may help promote antibiotic stewardship in primary care settings.
Simulation is an “educational method that can be applied to the training of processes, technical, and non-technical skills.” Literature underlines how simulating with the maximum realism possible improves the quality of training.
Objectives:
To describe the methodology used by CRIMEDIM to create a high-quality database of clinical cases to improve the realism of the EU MODEX exercises.
Method/Description:
In 2021, CRIMEDIM created a new database of clinical cases with disaster and non-disaster-related injuries and diseases to be used for the EU MODEX exercises. Each clinical case has four temporal stages: prehospital, T0, T1, and T2, and each of them has two possible variations: Type A (improvement) and Type B (deterioration). Timing and treatments received (or not received) determine the evolution between one step and the following one. Each clinical case consists of past medical history, disaster-related history, drugs, and allergies. There are also various exams (eg, blood tests [blood count, ABG, biochemical test, coagulation], imaging [ultrasound, XR, CT], and EKG) and other clinical information. The database allows printing casualty cards, each containing instructions for role players and make-up artists.
Results/Outcomes:
At this moment, the database consists of 1,174 clinical cases, with the possibility to create new cases according to different disaster scenarios, training needs, and learning objectives.
Conclusion:
According to participants’ feedback, the introduction of such an innovative and comprehensive database seemed to have improved the quality and the realism of the Medical EU MODEX.
We report on theoretical and experimental studies describing the buoyancy-driven ascent of a Taylor long drop in a circular vertical pipe where the descending fluid is Newtonian, and the ascending fluid is non-Newtonian yield shear thinning and described by the three-parameter Herschel–Bulkley model, including the Ostwald–de Waele model as a special case for zero yield. Results for the Ellis model are included to provide a more realistic description of purely shear-thinning behaviour. In all cases, lubrication theory allows us to obtain the velocity profiles and the corresponding integral variables in closed form, for lock-exchange flow with a zero net flow rate. The energy balance allows us to derive the asymptotic radius of the inner current, corresponding to a stable node of the differential equation describing the time evolution of the core radius. We carried out a series of experiments measuring the rheological properties of the fluids, the speed and the radius of the ascending long drop. For some tests, we measured the velocity profile with the ultrasound velocimetry technique. The measured radius of the ascending current compares fairly well with the asymptotic radius as derived through the energy balance, and the measured ascent speed shows a good agreement with the theoretical model. The measured velocity profiles also agree with their theoretical counterparts. We have also developed dynamic similarity conditions to establish whether laboratory physical models, limited by the availability of real fluids with defined rheological characteristics, can be representative of real phenomena on a large scale, such as exchanges in volcanic conduits. Appendix B contains scaling rules for the approximated dynamic similarity of the physical process analysed; these rules serve as a guide for the design of experiments reproducing real phenomena.
In this large, retrospective cohort study, we used administrative data to evaluate nonpregnant adults with group B Streptococcus (GBS) bacteriuria. We found greater all-cause mortality in those with urinary tract infections compared to asymptomatic bacteriuria. Differences in patients’ baseline characteristics and the 1-year mortality rate raise the possibility that provider practices contribute to differences observed.
Parasites can significantly influence the ecology, behaviour and physiology of their hosts sometimes with remarkable effects on their survivorship. However, endemic parasites or those not associated with obvious clinical disease have been partly neglected in the past decades comparatively to the most pathogenic ones. Apicomplexa are an important example of blood parasites that have been broadly investigated, although it can be difficult to determine the effects of infections at the population level, especially in widespread species. Such is the case of the common wall lizard (Podarcis muralis). We investigated 61 populations across Italy between 2008 and 2017 and recorded snout–vent length, latitude, date of collection and took blood samples for parasite count. We modelled parasite prevalence and load in a Bayesian framework. Parasites were present in all populations but 1 and in 13 of them all individuals were parasitized. We recorded almost identical responses for probability of infection and parasite load in both sexes, directly proportional to body size and inversely proportional to latitude, with a peak in cooler months. Therefore, haemosporidians can be very common in P. muralis, although their presence can vary significantly. Moreover, such a high prevalence makes it necessary to investigate to what extent haemosporidians affect hosts' survivorship, taking into consideration abiotic and biotic factors such as temperature, hormone levels and immune response.
To assess the prevalence of antibiotic-resistant gram-negative bacteria (R-GNB) among patients without recent hospitalization and to examine the influence of outpatient antibiotic exposure on the risk of acquiring R-GNB in this population.
Design:
2-year retrospective cohort study.
Setting:
Regional Veterans Affairs healthcare system.
Patients:
Outpatients at 13 community-based clinics.
Methods:
We examined the rate of acquisition of R-GNB within 90 days following an outpatient visit from 2018 to 2019. We used clinical and administrative databases to determine and summarize prescriptions for systemic antibiotics, associated infectious diagnoses, and subsequent R-GNB acquisition among patients without recent hospitalizations. We also calculated the odds ratio of R-GNB acquisition following antibiotic exposure.
Results:
During the 2-year study period, 7,215 patients had outpatient visits with microbiological cultures obtained within 90 days. Of these patients, 206 (2.9%) acquired an R-GNB. Among patients receiving antibiotics at the visit, 4.6% acquired a R-GNB compared to 2.7% among patients who did not receive antibiotics, yielding an unadjusted odds ratio of 1.75 (95% confidence interval, 1.18–2.52) for a R-GNB following an outpatient visit with versus without an antibiotic exposure. Regardless of R-GNB occurrence, >50% of antibiotic prescriptions were issued at visits without an infectious disease diagnosis or issued without documentation of an in-person or telehealth clinical encounter.
Conclusions:
Although the rate of R-GNBs was low (2.9%), the 1.75-fold increased odds of acquiring a R-GNB following an outpatient antibiotic highlights the importance of antimicrobial stewardship efforts in outpatient settings. Specific opportunities include reducing antibiotics prescribed without an infectious diagnosis or a clinical visit.
We examined the impact of microbiological results from respiratory samples on choice of antibiotic therapy in patients treated for hospital-acquired pneumonia (HAP) or ventilator-associated pneumonia (VAP).
Design:
Four-year retrospective study.
Setting:
Veterans’ Health Administration (VHA).
Patients:
VHA patients hospitalized with HAP or VAP and with respiratory cultures between October 1, 2014, and September 30, 2018.
Interventions:
We compared patients with positive and negative respiratory culture results, assessing changes in antibiotic class and Antibiotic Spectrum Index (ASI) from the day of sample collection (day 0) through day 7.
Results:
Between October 1, 2014, and September 30, 2018, we identified 5,086 patients with HAP/VAP: 2,952 with positive culture results and 2,134 with negative culture results. All-cause 30-day mortality was 21% for both groups. The mean time from respiratory sample receipt in the laboratory to final respiratory culture result was longer for those with positive (2.9 ± 1.3 days) compared to negative results (2.5 ± 1.3 days; P < .001). The most common pathogens were Staphylococcus aureus and Pseudomonas aeruginosa. Vancomycin and β-lactam/β-lactamase inhibitors were the most commonly prescribed agents. The decrease in the median ASI from 13 to 8 between days 0 and 6 was similar among patients with positive and negative respiratory cultures. Patients with negative cultures were more likely to be off antibiotics from day 3 onward.
Conclusions:
The results of respiratory cultures had only a small influence on antibiotics used during the treatment of HAP/VAP. The decrease in ASI for both groups suggests the integration of antibiotic stewardship principles, including de-escalation, into the care of patients with HAP/VAP.
We study non-Newtonian effects associated with power-law rheology of behaviour index $n$ on the propagation of horizontal gravity currents. Two different set-ups are examined: (i) converging flow toward the origin in a channel of gap thickness $b(x) \propto x^k$ and $k<1$ and (ii) converging flow along $r$ toward the centre in a cylinder. The front of the current propagates in the negative $x$ or $r$ direction reaching the origin in a finite touch-down time $t_c$ during the pre-closure phase; in the post-closure phase, the current flows back in the positive direction and progressively levels out. Under the classical viscous-buoyancy balance, the current propagation is described by a differential problem amenable to a self-similar solution of the second-kind coupling space and reduced time $t_r=t_c-t$. The problem formulation in the phase plane leads to an autonomous system of differential equations which requires numerical integration and yields the shape of the current and its front as $\xi _f\propto t_r^{\delta _c}$, $\xi _f$ being the self-similar variable value at the front and $\delta _c$ being the critical eigenvalue. The latter is a function of fluid rheology $n$ and of channel geometry $k$ for the first set-up; it is a function only of $n$ for the second set-up. The dependency on $n$ is modest. The theoretical formulation is validated through experiments conducted during both pre- and post-closure phases and aimed at measuring the front position and the profile of the current. Experimental results are in fairly good agreement with theory and allow quantitative determination of the time interval of validity of the intermediate asymptotics regime, when self-similarity is achieved and when it is lost.
Models are developed to grasp the combined effect of rheology and spatial layering on buoyancy-driven dispersion in geologic media. We consider a power-law (PL) or Herschel–Bulkley (HB) constitutive equation for the fluid, and an array of $N$ independent layers in a vertical fracture or porous medium subject to the same upstream overpressure. Under these assumptions, analytical solutions are derived in self-similar form (PL) or based on an expansion (HB) for the nose of single-phase gravity currents advancing into the layers ahead of a pressurized body. The position and size of the body and nose and the shape of the latter are significantly influenced by the interplay of model parameters: flow behaviour index $n$, dimensionless yield stress $\kappa$ for HB fluids, number of layers $N$ and upstream overpressure. It is seen that layering produces (i) a relatively modest increase of the total flow rate with respect to the single layer of equal thickness, and (ii) macro-dispersion at the system scale in addition to local dispersion. The second longitudinal spatial moment of the solute cloud scales with time as $t^{2n/(n+1)}$ for power-law fluids. The macro-dispersion induced by the layering prevails upon local dispersion beyond a threshold time. Theoretical results for the fracture are validated against a set of experiments conducted within a Hele-Shaw cell consisting of six layers. Comparison with experimental results shows that the proposed model is able to capture the propagation of the current and the macro-dispersion due to the velocity difference between layers, typically over-predicting the former and under-predicting the latter.
Sexual response in obsessive–compulsive disorder (OCD) research and practice is overlooked. According to the Dual Control Model, satisfactory sexual response is based upon a balance of sexual excitation and inhibition. The assessment of sexual response in OCD may have clinical implications, such as the integration of sex therapy in psychotherapeutic intervention. The present study was aimed at comparing sexual excitation and inhibition levels between OCD patients and matched control subjects, and investigating whether obsessive beliefs might predict sexual excitation/inhibition.
Methods
Seventy-two OCD patients (mean age ± standard deviation [SD]: 34.50 ± 10.39 years) and 72 matched control subjects (mean age ± SD: 34.25 ± 10.18) were included (62.50% men and 37.50% women in both groups). The Obsessive Compulsive Inventory-Revised (OCI-R), the Obsessive Beliefs Questionnaire-46 (OBQ-46), and the Sexual Inhibition/Sexual Excitation Scales (SIS/SES) were administered.
Results
Patients with OCD showed significantly higher levels of sexual excitation, inhibition due to threat of performance failure, and inhibition due to threat of performance consequences than the controls. In addition, the patients with more severe symptoms showed lower excitation than those with less severe symptoms, and those with higher perfectionism had stronger inhibition due to threat of performance failure than those with lower perfectionism.
Conclusions
This is the first study exploring sexual response in OCD according to the Dual Control Model. Sexual response is an impaired quality of life outcome in OCD that should be assessed in routine clinical practice. These findings support the importance of addressing specific obsessive beliefs to improve sexuality in OCD patients.
We present an investigation on the onset of Darcy–Bénard instability in a two-dimensional porous medium saturated with a non-Newtonian fluid and heated from below in the presence of a uniform horizontal pressure gradient. The fluid is taken to be of power-law nature with constant rheological index $n$ and temperature-dependent consistency index $\unicode[STIX]{x1D707}^{\ast }$. A two-dimensional linear stability analysis in the vertical plane yields the critical wavenumber and the generalised critical Rayleigh number as functions of dimensionless problem parameters, with a non-monotonic dependence from $n$ and with maxima/minima at given values of $\unicode[STIX]{x1D6FE}$, a parameter representing the effects of consistency index variations due to temperature. A series of experiments are conducted in a Hele-Shaw cell of aspect ratio $H/b=13.3{-}20$ to provide a verification of the theory. Xanthan Gum mixtures (nominal concentration from 0.10 % to 0.20 %) are employed as working fluids with a parameter range $n=0.55{-}0.72$ and $\unicode[STIX]{x1D707}_{0}^{\ast }=0.02{-}0.10~\text{Pa}~\text{s}^{n}$. The experimental critical wavenumber corresponding to incipient instability of the convective cells is derived via image analysis for different values of the imposed horizontal velocity. Theoretical results for critical wavenumber favourably compare with experiments, systematically underestimating their experimental counterparts by 10 % at most. The discrepancy between experiments and theory is more relevant for the critical Rayleigh number, with theory overestimating the experiments by a maximum factor less than two. Discrepancies are attributable to a combination of factors: nonlinear phenomena, possible subcritical bifurcations, and unaccounted-for disturbing effects such as approximations in the rheological model, wall slip, ageing and degradation of the fluid properties.
In Canada, recreational use of cannabis was legalized in October 2018. This policy change along with recent publications evaluating the efficacy of cannabis for the medical treatment of epilepsy and media awareness about its use have increased the public interest about this agent. The Canadian League Against Epilepsy Medical Therapeutics Committee, along with a multidisciplinary group of experts and Canadian Epilepsy Alliance representatives, has developed a position statement about the use of medical cannabis for epilepsy. This article addresses the current Canadian legal framework, recent publications about its efficacy and safety profile, and our understanding of the clinical issues that should be considered when contemplating cannabis use for medical purposes.
We present a combined theoretical and experimental study of lock-release inertial gravity currents (GCs) propagating in a horizontal channel of circular cross-section with open-top surface in the non-Boussinesq regime. A two-layer shallow-water (SW) model is developed for a generic shape of the cross-section with open top, and then implemented in a finite difference numerical code for the solution in a circular-cross-section channel of the type used in the experiments. The model predicts propagation with (almost) constant speed for a fairly long distance, accompanied by a depression of the ambient free open-top surface behind the front of the current. Sixteen experiments were conducted with a density ratio $r=0.587{-}0.939$ in full-depth and part-depth release conditions, measuring the front speed and the free-surface time series at four cross-sections. The channel was a circular tube 409 cm long, with a radius of 9.5 cm; the lengths of the locks were 52 and 103.5 cm. Density contrast was obtained by adding sodium chloride and dipotassium phosphate to fresh water. The theoretical values of the front speed and of the depression overestimate the experimental values, but they predict correctly their trend for varying parameters and provide reliable insights into the underlying mechanisms. In particular, we demonstrate that the circular cross-section increases the speed of propagation as compared to the standard rectangular cross-section case (for the same initial height and density ratio). The discrepancies between the SW predictions and the present experiments are of the same order of magnitude as those of previously published results for simpler systems (Boussinesq, rectangular). In addition to the depression, which is a wave bound to, and following the front of, the GC, the system also displays two kinds of free-surface waves, namely the initial bump (its amplitude is of the same order as the depression) and some short-length and low-amplitude waves in the tail of the bump. These free waves propagate with a celerity well predicted by the ‘fast’ eigenvalues of the mathematical model. Comparison is provided with the celerity of a solitary wave. It is expected that discrepancies between theory and experiments can be partly attributed to the presence of these waves. The reported insights and SW prediction method can be applied to a variety of cross-sections of practical interest (triangles, trapezoids, etc.).
To compare the epidemiology, clinical characteristics, and mortality of patients with bloodstream infections (BSI) caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (ESBL-EC) versus ESBL-producing Klebsiella pneumoniae (ESBL-KP) and to examine the differences in clinical characteristics and outcome between BSIs caused by isolates with CTX-M versus other ESBL genotypes
METHODS
As part of the INCREMENT project, 33 tertiary hospitals in 12 countries retrospectively collected data on adult patients diagnosed with ESBL-EC BSI or ESBL-KP BSI between 2004 and 2013. Risk factors for ESBL-EC versus ESBL-KP BSI and for 30-day mortality were examined by bivariate analysis followed by multivariable logistic regression.
RESULTS
The study included 909 patients: 687 with ESBL-EC BSI and 222 with ESBL-KP BSI. ESBL genotype by polymerase chain reaction amplification of 286 isolates was available. ESBL-KP BSI was associated with intensive care unit admission, cardiovascular and neurological comorbidities, length of stay to bacteremia >14 days from admission, and a nonurinary source. Overall, 30-day mortality was significantly higher in patients with ESBL-KP BSI than ESBL-EC BSI (33.7% vs 17.4%; odds ratio, 1.64; P=.016). CTX-M was the most prevalent ESBL subtype identified (218 of 286 polymerase chain reaction-tested isolates, 76%). No differences in clinical characteristics or in mortality between CTX-M and non–CTX-M ESBLs were detected.
CONCLUSIONS
Clinical characteristics and risk of mortality differ significantly between ESBL-EC and ESBL-KP BSI. Therefore, all ESBL-producing Enterobacteriaceae should not be considered a homogeneous group. No differences in outcomes between genotypes were detected.
We present theoretical and experimental analyses of the critical condition where the inertial–buoyancy or viscous–buoyancy regime is preserved in a uniform-density gravity current (which propagates over a horizontal plane) of time-variable volume ${\mathcal{V}}=qt^{\unicode[STIX]{x1D6FF}}$ in a power-law cross-section (with width described by $f(z)=bz^{\unicode[STIX]{x1D6FC}}$, where $z$ is the vertical coordinate, $b$ and $q$ are positive real numbers, and $\unicode[STIX]{x1D6FC}$ and $\unicode[STIX]{x1D6FF}$ are non-negative real numbers) occupied by homogeneous or linearly stratified ambient fluid. The magnitude of the ambient stratification is represented by the parameter $S$, with $S=0$ and $S=1$ describing the homogeneous and maximum stratification cases respectively. Earlier theoretical and experimental results valid for a rectangular cross-section ($\unicode[STIX]{x1D6FC}=0$) and uniform ambient fluid are generalized here to a power-law cross-section and stratified ambient. Novel time scalings, obtained for inertial and viscous regimes, allow a derivation of the critical flow parameter $\unicode[STIX]{x1D6FF}_{c}$ and the corresponding propagation rate as $Kt^{\unicode[STIX]{x1D6FD}_{c}}$ as a function of the problem parameters. Estimates of the transition length between the inertial and viscous regimes are also derived. A series of experiments conducted in a semicircular cross-section ($\unicode[STIX]{x1D6FC}=1/2$) validate the critical values $\unicode[STIX]{x1D6FF}_{c}=2$ and $\unicode[STIX]{x1D6FF}_{c}=9/4$ for the two cases $S=0$ and $1$. The ratio between the inertial and viscous forces is determined by an effective Reynolds number proportional to $q$ at some power. The threshold value of this number, which enables a determination of the regime of the current (inertial–buoyancy or viscous–buoyancy) in critical conditions, is determined experimentally for both $S=0$ and $S=1$. We conclude that a very significant generalization of the insights and results from two-dimensional (rectangular cross-section channel) gravity currents to power-law cross-sections is available.
Background: Resting state functional connectivity (RSFC) in the fronto-parietal network (FPN) has been associated with cognitive ability. For this reason, it was hypothesized that RSFC connectivity of the FPN would be related to cognition in patients with diffuse glioma. To assess this relationship, pre-operative cognitive status was correlated to patient specific connectivity within the FPN. Further, we assessed whether RSFC could predict neuropsychological outcome following surgery Methods: Sixteen patients with diffuse glioma underwent neuropsychological assessment and pre-operative task and resting state fMRI. Thirteen had post-operative cognitive assessment at one-month post-surgery. RSFC in a subject-specific FPN was correlated with pre- and post-operative cognitive scores. Results: Higher connectivity within the FPN was associated with lower composite cognitive scores, while higher connectivity of the parietal node of the tumor-affected hemisphere was associated with lower fluid cognition but not crystallized cognition. Higher connectivity values between the parietal node of the healthy hemisphere and the rest of the FPN was associated with better neuropsychological outcome one month after surgery. Conclusions: RSFC between key nodes of the FPN is associated with cognitive performance in patients with diffuse glioma and is a promising biomarker for cognitive outcome following surgery.
New analytical models are introduced to describe the motion of a Herschel–Bulkley fluid slumping under gravity in a narrow fracture and in a porous medium. A useful self-similar solution can be derived for a fluid injection rate that scales as time $t$; an expansion technique is adopted for a generic injection rate that is power law in time. Experiments in a Hele-Shaw cell and in a narrow channel filled with glass ballotini confirm the theoretical model within the experimental uncertainty.