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The formation of Kelvin–Helmholtz-like rollers (referred to as K–H rollers) over riblet surfaces has been linked to the drag-increasing behaviour seen in certain riblet geometries, such as sawtooth and blade riblets, when the riblet size reaches sufficiently large viscous scales (Endrikat et al. (2021a), J. Fluid Mech. 913, A37). In this study, we focus on the sawtooth geometry of fixed physical size, and experimentally examine the response of these K–H rollers to further increases in viscous scaled riblet sizes, by adopting the conventional approach of increasing freestream speeds (and consequently, the friction Reynolds number). Rather than continual strengthening, the present study shows a gradual weakening of these K–H rollers with increasing sawtooth riblet size. This is achieved by an analysis of the roller geometric characteristics using both direct numerical simulations and hot-wire anemometry databases at matched viscous scaled riblet spacings, with the former used to develop a novel methodology for detecting these rollers via streamwise velocity signatures (e.g. as acquired by hot wires). Spectral analysis of the streamwise velocity time series, acquired within riblet grooves, reveals that the frequencies (and the streamwise wavelengths) of the K–H rollers increase with increasing riblet size. Cross-correlation spectra, estimated from unique two-point hot-wire measurements in the cross-plane, show a weakening of the K–H rollers and a reduction in their wall-normal coherence with increasing riblet size. Besides contributing to our understanding of the riblet drag-increasing mechanisms, the present findings also have implications for the heat transfer enhancing capabilities of sawtooth riblets, which have been associated previously with the formation of K–H rollers. The present study also suggests conducting future investigations by decoupling the effects of viscous scaled riblet spacing and friction Reynolds numbers, to characterise their influence on the K–H rollers independently.
The methodology and impact of independent inquiries of homicides by people in care of mental health services have been questioned.
Aims
To analyse characteristics of patients who committed homicide, their victims and inquiries published in England between 2010 and 2023.
Method
Documentary and thematic analysis of 162 mental health homicide inquiries. We compared characteristics of perpetrators with those from the National Confidential Inquiry into Suicide and Safety (2018), and characteristics of victims with those in the general population of England and Wales. We examined methodology used by inquiries and thematically analysed root causes, contributory factors, recommendations, action plans, predictability and preventability.
Results
Fifty-two per cent of perpetrators had a diagnosis of schizophrenia and 52% had a history of non-adherence to medication and follow-up; 71% of victims in mental health homicides were family, friends or partners compared with 44% in the general population; 77% of inquiries used no clear methodology. The most frequent root causes and contributory factors related to deficits in assessment, treatment, follow-up or discharge, and risk assessment. There was no direct link between putative causes and resulting recommendations. The most frequent recommendations related to changing policy, improving clinical governance and training. Only 4% of inquiries deemed the homcide to be predictable and preventable.
Conclusions
There is considerable variation in the methodology of mental health homicide inquiries, with little use of human factors and systems theory. Inquiries repeatedly identify the same themes, and most mental health homicides are found to be neither predictable nor preventable. We make recommendations for improving consistency and usefulness.
Derive and externally validate a prediction model for pneumococcal urinary antigen test (pUAT) positivity.
Methods:
Retrospective cohort study of adults admitted with community-acquired pneumonia (CAP) to 177 U.S. hospitals in the Premier Database (derivation and internal validation samples) or 12 Cleveland Clinic hospitals (external validation sample). We utilized multivariable logistic regression to predict pUAT positivity in the derivation dataset, followed by model performance evaluation in both validation datasets. Potential predictors included demographics, comorbidities, clinical findings, and markers of disease severity.
Results:
Of 198,130 Premier patients admitted with CAP, 27,970 (14.1%) underwent pUAT; 1962 (7.0%) tested positive. The strongest predictors of pUAT positivity were history of pneumococcal infection in the previous year (OR 6.99, 95% CI 4.27–11.46), severe CAP on admission (OR 1.76, 95% CI 1.56–1.98), substance abuse (OR 1.57, 95% CI 1.27–1.93), smoking (OR 1.23, 95% CI 1.09–1.39), and hyponatremia (OR 1.35, 95% CI 1.17–1.55). Negative predictors included IV antibiotic use in past year (OR 0.65, 95% CI 0.52–0.82), congestive heart failure (OR 0.72, 95% CI 0.63–0.83), obesity (OR 0.71, 95% CI 0.60–0.85), and admission from skilled nursing facility (OR 0.60, 95% CI 0.45–0.78). Model c-statistics were 0.60 and 0.67 in the internal and external validation cohorts, respectively. Compared to guideline-recommended testing of severe CAP patients, our model would have detected 23% more cases with 5% fewer tests.
Conclusion:
Readily available data can identify patients most likely to have a positive pUAT. Our model could be incorporated into automated clinical decision support to improve test efficiency and antimicrobial stewardship.
Root cause analysis (RCA), imported from high-reliability industries into health two decades ago, is the mandated methodology to investigate adverse events in most health systems. In this analysis, we argue that the validity of RCA in health and in psychiatry must be established, given the impact of these investigations on mental health policy and practice.
Accurate prediction of the natural frequency for the lateral oscillation of a liquid drop pinned on a vertical planar surface is important to many drop applications. The natural oscillation frequency, normalized by the capillary frequency, is mainly a function of the equilibrium contact angle and the Bond number ($Bo$), when the contact lines remain pinned. Parametric numerical and experimental studies have been performed to establish a comprehensive understanding of the oscillation dynamics. An inviscid model has been developed to predict the oscillation frequency for wide ranges of $Bo$ and the contact angle. The model reveals the scaling relation between the normalized frequency and $Bo$, which is validated by the numerical simulation results. For a given equilibrium contact angle, the lateral oscillation frequency decreases with $Bo$, implying that resonance frequencies will be magnified if the drop oscillations occur in a reduced gravity environment.
Evidence from pandemics suggests that influenza is often associated with bacterial coinfection. Among patients hospitalized for influenza pneumonia, we report the rate of coinfection and distribution of pathogens, and we compare outcomes of patients with and without bacterial coinfection.
Methods:
We included adults admitted with community-acquired pneumonia (CAP) and tested for influenza from 2010 to 2015 at 179 US hospitals participating in the Premier database. Pneumonia was identified using an International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) algorithm. We used multiple logistic and gamma-generalized linear mixed models to assess the relationships between coinfection and inpatient mortality, intensive care unit (ICU) admission, length of stay, and cost.
Results:
Among 38,665 patients hospitalized with CAP and tested for influenza, 4,313 (11.2%) were positive. In the first 3 hospital days, patients with influenza were less likely than those without to have a positive culture (10.3% vs 16.2%; P < .001), and cultures were more likely to contain Staphylococcus aureus (34.2% vs 28.2%; P = .007) and less likely to contain Streptococcus pneumoniae (24.9% vs 31.0%; P = .008). Of S. aureus isolates, 42.8% were methicillin resistant among influenza patients versus 53.2% among those without influenza (P = .01). After hospital day 3, pathogens for both groups were similar. Bacterial coinfection was associated with increased odds of in-hospital mortality (aOR, 3.00; 95% CI, 2.17–4.16), late ICU transfer (aOR, 2.83; 95% CI, 1.98–4.04), and higher cost (risk-adjusted mean multiplier, 1.77; 95% CI, 1.59–1.96).
Conclusions:
In a large US inpatient sample hospitalized with influenza and CAP, S. aureus was the most frequent cause of bacterial coinfection. Coinfection was associated with worse outcomes and higher costs.
Clostridioides difficile infection (CDI) causes significant morbidity and mortality; however, the diagnosis of CDI remains controversial. The primary aim of our study was to evaluate the association of polymerase chain reaction (PCR) cycle threshold (Ct) values with CDI disease severity, recurrence, and mortality among adult patients with CDI.
Design:
Retrospective cohort study.
Setting:
Single tertiary-care hospital.
Patients:
Adult patients diagnosed with hospital-onset, healthcare facility–associated CDI from June 2014 to September 2015.
Methods:
We performed a retrospective chart review of included patients. Univariate and multivariable logistic regression methods were used to evaluate the association between Ct values and CDI severity, 8-week recurrence, and 30-day mortality.
Results:
Among 318 included patients, 51% were male and the mean age was 62 years; ~32% of the patients developed severe CDI and 11% developed severe–complicated CDI. The 30-day all-cause mortality rate was 11% and the 8-week recurrence rate was 9.5%. The overall mean Ct value was 32.9 (range, 23–40). Multivariable analyses showed that lower values of PCR Ct were associated with increased odds of 30-day morality (odds ratio [OR] 0.83; 95% confidence interval [CI], 0.72–0.96) but were not independently associated with CDI severity (OR, 0.99; 95% CI, 0.90–1.09) or recurrence (OR, 0.88; 95% CI, 0.77–1.00).
Conclusions:
Our findings suggest that PCR Ct values at the time of diagnosis may have a limited predictive value and utility in clinical decision making for inpatients with CDI. Larger, prospective studies across different patient populations are needed to confirm our findings.
Schizophrenia is a mental disorder characterized by social problems and disorders of thought, behaviour and cognitive functions. These impaired cognitive functions may be associated with alterations in resting state functional connectivity in schizophrenia. Therefore, the present study has been carried out to determine the resting state functional brain connectivity changes associated with schizophrenia in all the resting state networks (RSNs) using independent component analysis approach (ICA) and dual-regression based approach.
Objective
The objective of this study was to investigate the aberrant resting-state functional connectivity patterns in schizophrenia patients as compared to healthy controls.
Methods
35 schizophrenia patients and 31 healthy controls were recruited for the study and scanned by using resting state functional magnetic resonance (rsfMRI). Pre-processing and post-processing of the resting state functional data were performed using the FMRI Expert Analysis Tool (FEAT), which is a part of FSL (FMRIB's Software Library, www.fmrib. ox.ac.uk/fsl).
Results
Our results showed significantly decreased functional connectivity in the regions of left fronto-parietal network, lateral visual network, medial visual network, motor network and default mode network (DMN) in schizophrenia patients as compared with healthy controls.
Conclusion
The overall findings suggest that the alterations in these resting state network connectivity may, in part, contribute to the impairments in cognitive functions associated with schizophrenia. These findings also suggest that aberrant resting state network connectivity contributes to regional functional pathology in schizophrenia and bears significance for core symptoms.
Schizophrenia is one of the psychotic mental disorders, characterized by social problems and disorders of thought, behaviour, motor and cognitive functions such as long-term memory, verbal memory, executive functioning and vigilance etc. However, the relation between structural and functional alterations in schizophrenia remains unclear. Therefore, the present study sought to investigate whether functional alterations in schizophrenia are also associated with structural brain aberrations directly in related brain regions or in anatomically closely connected areas.
The current study was conducted to investigate the possible relationship between functional and structural changes for a simple motor task in schizophrenics.
16 controls and 16 schizophrenic patients were chosen for the study. The structural and functional MRI scans were acquired using 3 Tesla whole-body MRI system with a 16 channel head array coil. For fMRI, a block paradigm with alternating blocks of motor task (right finger tapping; 120 taps/min) and rest was carried out. Pre-processing and post-processing of MRI scans were performed using SPM8 software.
The fMRI study showed relatively less activation in the left precentral and postcentral gyrus and right cerebellum in schizophrenic patients as compared to controls during finger tapping task. Voxel-based morphometry (VBM) revealed grey matter decreases in the left precentral and postcentral gyrus and left middle frontal gyrus while white matter decreases in the right cerebellum and right inferior temporal gyrus of schizophrenics as compared to controls.
The present study provides strong evidence for an association between motor functional deficits and structural alterations in schizophrenic patients as compared to controls.
The integration of materials and architectural features at multiple length scales into structural mechanics has shifted the paradigm of structural design toward optimally engineered structures, which resulted in, for example, the Eiffel Tower. This structural revolution paved the way for the development of computational design approaches used in modern-day construction. Similar principles are now being applied to the design and manufacture of architected materials with a suite of properties determined a priori and attained through multiscale approaches. These new material classes potentially offer breakthrough advances in almost every branch of technology: from ultra-lightweight and damage-tolerant structural materials to safe and efficient energy storage, biomedical devices, biochemical, and micromechanical sensors and actuators, nanophotonic devices, and textiles. When reduced to the microscale, such materials embody the characteristics of both the constituent material, which brings the effects of its microstructure and ensuing properties at the relevant characteristic length scales, as well as the structure, which is driven by architected design. This issue gives an overview of the current state of the art of this new class of materials.
Sorghum (Sorghum bicolor (L.) Moench) is an important resource to the national economy and it is essential to assess the genetic diversity in existing sorghum germplasm for better conservation, utilization and crop improvement. The aim of this study was to evaluate the level of genetic diversity within and among sorghum germplasms collected from diverse institutes in Nigeria and Mali using Single Nucleotide Polymorphic markers. Genetic diversity among the germplasm was low with an average polymorphism information content value of 0.24. Analysis of Molecular Variation revealed 6% variation among germplasm and 94% within germplasms. Dendrogram revealed three groups of clustering which indicate variations within the germplasms. Private alleles identified in the sorghum accessions from National Center for Genetic Resources and Biotechnology, Ibadan, Nigeria and International Crop Research Institute for the Semi-Arid Tropics, Kano, Nigeria shows their prospect for sorghum improvement and discovery of new agronomic traits. The presence of private alleles and genetic variation within the germplasms indicates that the accessions are valuable resources for future breeding programs.
The indentation response of a 3D noninterlaced composite comprising three sets of orthogonal carbon-fibre tows in an epoxy matrix is investigated. The 3D composites have a near isotropic and ductile indentation response. The deformation mode includes the formation of multiple kinks in the tows aligned with the indentation direction and shearing of the orthogonally oriented tows. Finite element (FE) calculations are also reported wherein tows in one direction are explicitly modeled with the other two sets of orthogonal tows and the matrix pockets treated as an effective homogenous medium. The calculations capture the indentation response in the direction of the explicitly modeled tows with excellent fidelity but under-predict the indentation strength in the other directions. In contrast to anisotropic and brittle laminated composites, 3D noninterlaced composites have a near isotropic and ductile indentation response making them strong candidates for application as materials to resist impact loading.
We have compiled a catalogue of H ii regions detected with the Murchison Widefield Array between 72 and 231 MHz. The multiple frequency bands provided by the Murchison Widefield Array allow us identify the characteristic spectrum generated by the thermal Bremsstrahlung process in H ii regions. We detect 306 H ii regions between 260° < l < 340° and report on the positions, sizes, peak, integrated flux density, and spectral indices of these H ii regions. By identifying the point at which H ii regions transition from the optically thin to thick regime, we derive the physical properties including the electron density, ionised gas mass, and ionising photon flux, towards 61 H ii regions. This catalogue of H ii regions represents the most extensive and uniform low frequency survey of H ii regions in the Galaxy to date.
We compare first-order (refractive) ionospheric effects seen by the MWA with the ionosphere as inferred from GPS data. The first-order ionosphere manifests itself as a bulk position shift of the observed sources across an MWA field of view. These effects can be computed from global ionosphere maps provided by GPS analysis centres, namely the CODE. However, for precision radio astronomy applications, data from local GPS networks needs to be incorporated into ionospheric modelling. For GPS observations, the ionospheric parameters are biased by GPS receiver instrument delays, among other effects, also known as receiver DCBs. The receiver DCBs need to be estimated for any non-CODE GPS station used for ionosphere modelling. In this work, single GPS station-based ionospheric modelling is performed at a time resolution of 10 min. Also the receiver DCBs are estimated for selected Geoscience Australia GPS receivers, located at Murchison Radio Observatory, Yarragadee, Mount Magnet and Wiluna. The ionospheric gradients estimated from GPS are compared with that inferred from MWA. The ionospheric gradients at all the GPS stations show a correlation with the gradients observed with the MWA. The ionosphere estimates obtained using GPS measurements show promise in terms of providing calibration information for the MWA.
GLEAM, the GaLactic and Extragalactic All-sky MWA survey, is a survey of the entire radio sky south of declination + 25° at frequencies between 72 and 231 MHz, made with the MWA using a drift scan method that makes efficient use of the MWA’s very large field-of-view. We present the observation details, imaging strategies, and theoretical sensitivity for GLEAM. The survey ran for two years, the first year using 40-kHz frequency resolution and 0.5-s time resolution; the second year using 10-kHz frequency resolution and 2 s time resolution. The resulting image resolution and sensitivity depends on observing frequency, sky pointing, and image weighting scheme. At 154 MHz, the image resolution is approximately 2.5 × 2.2/cos (δ + 26.7°) arcmin with sensitivity to structures up to ~ 10° in angular size. We provide tables to calculate the expected thermal noise for GLEAM mosaics depending on pointing and frequency and discuss limitations to achieving theoretical noise in Stokes I images. We discuss challenges, and their solutions, that arise for GLEAM including ionospheric effects on source positions and linearly polarised emission, and the instrumental polarisation effects inherent to the MWA’s primary beam.
The Murchison Widefield Array is a Square Kilometre Array Precursor. The telescope is located at the Murchison Radio–astronomy Observatory in Western Australia. The MWA consists of 4 096 dipoles arranged into 128 dual polarisation aperture arrays forming a connected element interferometer that cross-correlates signals from all 256 inputs. A hybrid approach to the correlation task is employed, with some processing stages being performed by bespoke hardware, based on Field Programmable Gate Arrays, and others by Graphics Processing Units housed in general purpose rack mounted servers. The correlation capability required is approximately 8 tera floating point operations per second. The MWA has commenced operations and the correlator is generating 8.3 TB day−1 of correlation products, that are subsequently transferred 700 km from the MRO to Perth (WA) in real-time for storage and offline processing. In this paper, we outline the correlator design, signal path, and processing elements and present the data format for the internal and external interfaces.
The Murchison Widefield Array is a new low-frequency interferometric radio telescope built in Western Australia at one of the locations of the future Square Kilometre Array. We describe the automated radio-frequency interference detection strategy implemented for the Murchison Widefield Array, which is based on the aoflagger platform, and present 72–231 MHz radio-frequency interference statistics from 10 observing nights. Radio-frequency interference detection removes 1.1% of the data. Radio-frequency interference from digital TV is observed 3% of the time due to occasional ionospheric or atmospheric propagation. After radio-frequency interference detection and excision, almost all data can be calibrated and imaged without further radio-frequency interference mitigation efforts, including observations within the FM and digital TV bands. The results are compared to a previously published Low-Frequency Array radio-frequency interference survey. The remote location of the Murchison Widefield Array results in a substantially cleaner radio-frequency interference environment compared to Low-Frequency Array’s radio environment, but adequate detection of radio-frequency interference is still required before data can be analysed. We include specific recommendations designed to make the Square Kilometre Array more robust to radio-frequency interference, including: the availability of sufficient computing power for radio-frequency interference detection; accounting for radio-frequency interference in the receiver design; a smooth band-pass response; and the capability of radio-frequency interference detection at high time and frequency resolution (second and kHz-scale respectively).
The science cases for incorporating high time resolution capabilities into modern radio telescopes are as numerous as they are compelling. Science targets range from exotic sources such as pulsars, to our Sun, to recently detected possible extragalactic bursts of radio emission, the so-called fast radio bursts (FRBs). Originally conceived purely as an imaging telescope, the initial design of the Murchison Widefield Array (MWA) did not include the ability to access high time and frequency resolution voltage data. However, the flexibility of the MWA’s software correlator allowed an off-the-shelf solution for adding this capability. This paper describes the system that records the 100 μs and 10 kHz resolution voltage data from the MWA. Example science applications, where this capability is critical, are presented, as well as accompanying commissioning results from this mode to demonstrate verification.
OxyCide Daily Disinfectant Cleaner, a novel peracetic acid/hydrogen peroxide–based sporicidal disinfectant, was as effective as sodium hypochlorite for in vitro killing of Clostridium difficile spores, methicillin-resistant Staphylococcus aureus, and vancomcyin-resistant enterococci. OxyCide was minimally affected by organic load and was effective in reducing pathogen contamination in isolation rooms
Infect Control Hosp Epidemiol 2014;35(11):1414–1416
Cryptosporidium parvum (C. parvum) is one of the most prevalent protozoan pathogens responsible for inducing human and animal disease worldwide. In this study, the glycoprotein-60 (gp60) subtyping tool was employed to assess the molecular diversity of C. parvum from human feces throughout Scotland during potential outbreaks. Over a 24-month period, microscopy analysis revealed 1139 positive feces containing Cryptosporidium species with 256 identified by molecular methods specifically as C. parvum. Cryptosporidium parvum was shown to be more prevalent in rural areas of Scotland and subtyping of 87 isolates demonstrated the predominant family as IIa, which occurred in 94% (n = 82) of isolates. The IIaA15G1R1 subtype was most common, being isolated from 47% (n = 41) of Scottish human cases. Non-IIa strains constituted a total of 5 isolates and included subtypes from the IIc, IId and IIg families. This information contributes significantly to existing knowledge and understanding of C. parvum subtypes in Scotland which is vital in assisting with the management of future local and national outbreaks.