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Stochastic resonance (SR) is universal phenomenon, where noise amplifies a weak periodic signal in bistable nonlinear systems, with wide applications in biology, climate science, engineering etc., although in fluid dynamics it remains underexplored. Recently, we unexpectedly found SR above non-modal elastic instability onset in an inertialess viscoelastic channel flow, where it emerges on the top of a chaotic streamwise velocity power spectrum $E_u$ due to its interaction with white-noise spanwise velocity power spectrum $E_w$ and weak elastic waves. These three conditions necessary for SR emergence differ from those required for the classical SR emergence mentioned above. Here, we consider SR in an inertialess viscoelastic channel flow with a smoothed inlet causing order of magnitude lower noise intensity than in our former studies. Our observations reveal that SR appears at the same conditions mentioned above, where SR is found just upon the instability onset in a lower subrange of a transition regime, in contrast, here, SR persists across all flow regimes – transition, elastic turbulence and drag reduction. Furthermore, we provide experimental evidence that SR, presented by a sharp peak in $E_u$, manifests as either a standing or propagating wave in the $x$-direction, with a rather uniform amplitude of streamwise velocity fluctuations and zero propagation velocity in the $z$-direction. These findings reveal a new mechanism underpinning the transition to a chaotic channel flow of viscoelastic fluids and establish SR as a robust framework for understanding complex flow dynamics. This work opens new avenues for exploring SR in other nonlinear systems and practical applications such as mixing enhancement and flow control in industrial and biological contexts.
Broad-spectrum antibiotic use in febrile neutropenia is often driven by concerns for severe and drug-resistant infections. In select patients who do not have an active infection and improve, their prolonged and unnecessary use contributes to antimicrobial resistance, drug toxicity, and increased healthcare costs. We describe the implementation of an antibiotic de-escalation protocol to reduce inappropriate antibiotic use in febrile neutropenia among hematology patients.
Methods:
We conducted baseline analysis (January–June 2024) of antibiotic use in febrile neutropenia cases admitted under hematology. Interventions included the (i) development of an antibiotic de-escalation protocol to guide clinical management, (ii) a roadshow to educate and improve uptake of this protocol, and (iii) regular feedback via “report cards” for hematology teams. The primary outcome was the proportion of febrile neutropenia cases with inappropriate antibiotic use, with secondary measures including adverse outcomes (in-hospital mortality, Clostridioides difficile infection, need for intensive care).
Results:
Baseline data indicated inappropriate antibiotic use rates of 45.5–66.7% per month from January to June 2024, with 13–28 days of inappropriate therapy. The protocol was developed in July 2024, with a subsequent roadshow to promote its uptake. Regular feedback was provided in the form of “report cards” every 2-monthly thereafter. Post-intervention, inappropriate antibiotic use decreased to a median of 23.35% from July to December 2024, with no observed increase in adverse outcomes.
Conclusions:
The implementation of a structured de-escalation protocol, combined with frequent education and feedback, effectively reduced inappropriate antibiotic use in febrile neutropenia without compromising patient safety.
Recent studies utilizing AI-driven speech-based Alzheimer’s disease (AD) detection have achieved remarkable success in detecting AD dementia through the analysis of audio and text data. However, detecting AD at an early stage of mild cognitive impairment (MCI), remains a challenging task, due to the lack of sufficient training data and imbalanced diagnostic labels. Motivated by recent advanced developments in Generative AI (GAI) and Large Language Models (LLMs), we propose an LLM-based data generation framework, leveraging prior knowledge encoded in LLMs to generate new data samples. Our novel LLM generation framework introduces two novel data generation strategies, namely, the cross-lingual and the counterfactual data generation, facilitating out-of-distribution learning over new data samples to reduce biases in MCI label prediction due to the systematic underrepresentation of MCI subjects in the AD speech dataset. The results have demonstrated that our proposed framework significantly improves MCI Detection Sensitivity and F1-score on average by a maximum of 38% and 31%, respectively. Furthermore, key speech markers in predicting MCI before and after LLM-based data generation have been identified to enhance our understanding of how the novel data generation approach contributes to the reduction of MCI label prediction biases, shedding new light on speech-based MCI detection under low data resource constraint. Our proposed methodology offers a generalized data generation framework for improving downstream prediction tasks in cases where limited and/or imbalanced data have presented significant challenges to AI-driven health decision-making. Future study can focus on incorporating more datasets and exploiting more acoustic features for speech-based MCI detection.
Opioid use disorder (OUD) is a devastating condition with frequent suicidality, contributing to overdose deaths. Theta burst stimulation (TBS) to the dorsolateral prefrontal cortex (DLPFC) is used to treat major depressive disorder (MDD) and is effective in treating suicidal ideation. We piloted a randomized, double-blind, sham-controlled trial of bilateral rTMS for patients with OUD and MDD experiencing suicidality.
Methods
Sequential bilateral TBS was delivered guided by structural neuroimaging: continuous TBS to the right then intermittent TBS to the left DLPFC, daily (20 treatments). The primary objective was to determine the feasibility of this population. The primary clinical outcome was the scale for suicidal ideation (SSI), secondary outcomes included depressive symptoms and opioid cue-induced craving. ClinicalTrials.gov: NCT04785456.
Results
Eighty-seven individuals were pre-screened. The most common reasons for ineligibility included being unreachable by the study team, difficulty with scheduling/travel requirements, and medical/psychiatric instability. Six participants (5:1 M:F) were enrolled (3/arm), four had a fentanyl use history; two completed per protocol (1/arm). Of the participants with follow-up data, SSI scores decreased in 2/3 in the sham arm and 2/2 in the active arm; depression and opioid craving scores decreased in all participants.
Conclusion
We present the first data piloting a structural neuroimaging-guided, multi-session rTMS treatment course in outpatients with suicidality and OUD in the current North American context. Recruitment and retention were the main challenges given the highly unstable medical and psychosocial context of this patient population. Future trials should consider a suitable environment to improve the feasibility of delivering this treatment.
Zuranolone is an investigational positive allosteric modulator of synaptic and extrasynaptic GABAA receptors and a neuroactive steroid in clinical development as a once-daily, oral, 14-day treatment course for adults with major depressive disorder or postpartum depression (PPD). The randomized, double-blind, placebo-controlled SKYLARK Study (NCT04442503) demonstrated that zuranolone 50 mg significantly improved depressive symptoms (as assessed by 17-item Hamilton Rating Scale for Depression total score) at Day 15 (primary endpoint; p<0.001) and was generally well tolerated in adults with PPD.
Methods
In the SKYLARK Study, patients were randomized 1:1 to receive zuranolone 50 mg or placebo for 14 days. Safety and tolerability were assessed by the incidence and severity of treatment-emergent adverse events (TEAEs), rates of dose reduction and treatment discontinuation, as well as weight gain and sexual dysfunction.
Results
The SKYLARK Study assessed safety data from 98 patients treated with zuranolone 50 mg and 98 patients treated with placebo. TEAEs were reported in 66.3% of zuranolone-treated patients and 53.1% of placebo-treated patients. In patients that experienced TEAEs, most reported mild (zuranolone, 50.8%; placebo, 75%) or moderate (zuranolone, 44.6%; placebo, 23.1%) events. The most common (≥5%) TEAEs were somnolence (26.5%), dizziness (13.3%), sedation (11.2%), headache (9.2%), diarrhea (6.1%), nausea (5.1%), urinary tract infection (5.1%), and COVID-19 (5.1%) with zuranolone, and headache (13.3%), dizziness (10.2%), nausea (6.1%), and somnolence (5.1%) with placebo. Dose reduction due to TEAEs was 16.3% in patients receiving zuranolone vs 1.0% in patients receiving placebo; the most common TEAEs (>1 patient) leading to zuranolone dose reduction were somnolence (7.1%), dizziness (6.1%), and sedation (3.1%). Treatment discontinuation due to TEAEs was 4.1% in patients receiving zuranolone vs 2.0% in patients receiving placebo; TEAEs leading to zuranolone discontinuation in >1 patient included somnolence (2.0%). Serious TEAEs were reported in 2.0% of zuranolone-treated and 0% of placebo-treated patients; these included upper abdominal pain (1.0%, [1/98]), peripheral edema (1.0%, [1/98]), perinatal depression (1.0%, [1/98]), and hypertension (1.0%, [1/98]). Per investigators, serious TEAEs were not related to zuranolone. No signals for weight gain or sexual dysfunction were identified.
Conclusions
In adults with PPD, zuranolone 50 mg was generally well tolerated. Most TEAEs were mild or moderate in severity. Dose reduction due to TEAEs mainly resulted from somnolence, dizziness, and sedation, while treatment discontinuation due to TEAEs was low. No signals for weight gain or sexual dysfunction were identified.
Glowacki offers many new directions for understanding and even eliminating the problem of war, especially creating positive interdependencies with out-group members. We develop Glowacki's intriguing proposition that in-group dynamics provide a route to peace by describing a prosocial motivational system, the caregiving system, that aligns individual interests and eliminates the need to use coercion to achieve mutually beneficial outcomes.
Telecommunications data are being explored by many countries as a new source of data that can be incorporated into their national statistical systems. In particular, “mobile positioning data” are increasingly being used to study population movements and population distributions. However, the legal, ethical, and technical complexities of working with this type of data often pose many barriers, which can prevent the data from being used at the times when it is most urgently needed. We demonstrate how having a robust public–private partnership framework, a privacy-preserving technical setup, and a communications strategy already in place, prior to an emergency, can enable governments to harness the advantages of telecommunications data at the times when it is most valuable. However, even once these foundations are in place, the challenges of competing priorities, managing expectations, and maintaining communication with data consumers during a pandemic mean that the potential of the data is not automatically translated into direct impact. This highlights the importance of sensitisation exercises, targeted at potential data users, to make clear the potential and limitations of the data, as well as the importance of being able to maintain direct communication with data users. The views expressed in this work belong solely to the authors and should not be interpreted as the views of their institutions.
In China, one percent of the richest population holds more than one-third of the wealth, while the poorest 25% shares no more than two percent of the total. The country’s rapid economic development has resulted in increasing socio-economic disparities, and a rapidly deteriorating environment. This puts the Chinese citizens, especially the most vulnerable and deprived socio-economic status (SES) groups, at high risks of environmental inequality (EI). In most SES-based EI studies conducted in China, household wealth has often been overlooked, though it potentially serves a good economic indicator to capture the socio-economic effect of environmental change in China. Nevertheless, existing SES databases in China are of low spatial resolution and are insufficient to support fine-grained EI studies at the intra-city level in China. The core research challenge is to develop a representative household wealth proxy in high-spatial resolution for China. This study highlights the research gaps and proposes a new household wealth proxy, which integrates both fine-grained data/features such as daytime satellite imagery and easily accessible wealth indicators such as house prices. We also capitalize on everyday economic activity data retrieved from personal mobile phones and online transaction/social platforms in the composition of our wealth proxy to achieve a higher accuracy in estimating household wealth at fine-grained resolution via machine learning. Finally, we summarize the challenges in improving both the quality and the availability of Chinese socio-economic datasets, while protecting personal privacy and information security during the data collection process for household wealth proxy development in China.
In this chapter, the air pollution trends in historical London (1950 – 66) and contemporary Beijing (2000 – 16) are compared. In both cases, coal is the main source of air pollution, due to coal-fired electricity generation and coal-burning activities that provide heating. In London, the Clean Air Act of 1956 marked a successful milestone in the history of air pollution abatement in the UK. In Beijing, various policies have been introduced but air qualities in China have not been improved substantially. By examining the effectiveness of respective pollution control regulations/policies in a broader socioeconomic context, policy implications on respective jurisdictions are drawn. For effective implementation of air pollution control policies at the local level, it would be good for China to move beyond simply introducing stringent policies and regulations at the central or the provincial level. More resources can be re-directed to resolving the competing interests of stakeholders across different levels of jurisdictions.
The Tibetan Plateau (TP) lakes are sensitive to climate change due to ice-albedo feedback, but almost no study has paid attention to the ice albedo of TP lakes and its potential impacts. Here we present a recent field experiment for observing the lake ice albedo in the TP, and evaluate the applicability of the Moderate Resolution Imaging Spectroradiometer (MODIS) products as well as ice-albedo parameterizations. Most of the observed lake ice albedos on TP are <0.12, and the clear blue ice albedo is only 0.075, much lower than reported in the previous studies. Even that of ice covered with snow patches is only 0.212. MOD10A1 albedo product has the best agreement with observations, followed by those of MYD10A1. MCD43A3 product is consistently higher than the observations. Due to an error of snow flag and inconsistent time windows in MCD43A2 and MCD43A3, at certain times, the albedo of the ice without snow is even higher than that covered with snow. When the solar zenith angle is not considered, there is no significant correlation between the albedo and the ice surface temperature. None of the existing ice-albedo parameterizations can reproduce well the observed relationship of the albedo and surface temperature.
Observations show that glaciers around the world are in retreat and losing mass. Internationally coordinated for over a century, glacier monitoring activities provide an unprecedented dataset of glacier observations from ground, air and space. Glacier studies generally select specific parts of these datasets to obtain optimal assessments of the mass-balance data relating to the impact that glaciers exercise on global sea-level fluctuations or on regional runoff. In this study we provide an overview and analysis of the main observational datasets compiled by the World Glacier Monitoring Service (WGMS). The dataset on glacier front variations (∼42 000 since 1600) delivers clear evidence that centennial glacier retreat is a global phenomenon. Intermittent readvance periods at regional and decadal scale are normally restricted to a subsample of glaciers and have not come close to achieving the maximum positions of the Little Ice Age (or Holocene). Glaciological and geodetic observations (∼5200 since 1850) show that the rates of early 21st-century mass loss are without precedent on a global scale, at least for the time period observed and probably also for recorded history, as indicated also in reconstructions from written and illustrated documents. This strong imbalance implies that glaciers in many regions will very likely suffer further ice loss, even if climate remains stable.
In his Afterword to The Singapore Grip, J. G. Farrell thanks Giorgio and Ginevra Agamben for suggesting the phrase that became the title of his novel. What can we make of this surprising and unexpected connection between an Anglo-Irish author’s novel about colonial Singapore on the eve of its fall to the Japanese army during World War II and Agamben’s writings on biopolitics? Despite the serendipitous nature of the encounter between the two writers and the lack of any causal relation between their works, my paper argues that there is an unacknowledged affinity that allows us to open them up to what Agamben calls their Entwicklungsfähigkeit, “the locus and the moment wherein they are susceptible to development,” thereby bringing out the biopolitical elements in Farrell’s novel and turning Agamben’s insights into dispositifs or biopolitical apparatuses in the direction of the analysis of colonial rule.
Dielectric thin films of high- and low-refractive index are the essential components for optical coatings. To achieve high sputtering rates and superior film quality, the authors have developed novel conductive SiO2:Si and ZnO:Zn composites that become conductive once the doped silicon and metal Zn reach a critical ratio. The sputtering characteristics of the composite targets in direct current and radio-frequency (RF) plasma discharge are quite different from the corresponding element targets. The optical properties of the RF sputtered SiO2 and ZnO films from the composite targets is comparable with the films obtained from RF sputtering of pure oxide targets.
Concerns with global warming prompted many governments to mandate increased proportion of electricity generation from renewable sources. This, together with the desire to have more efficient and secure power generation and distribution, has driven research in the next-generation power grid, namely, the smart grid. Through integrating advanced information and communication technologies with power electronic and electric power technologies, smart grid will be highly reliable, efficient, and environmental-friendly. A key component of smart grid is the communication system. This paper explores the design goals and functions of the smart grid communication system, followed by an in-depth investigation on the communication requirements. Discussions on some of the recent developments related to smart grid communication systems are also introduced.
In Markov Chain Monte Carlo (MCMC) simulations, thermal equilibria quantities are estimated by ensemble average over a sample set containing a large number of correlated samples. These samples are selected in accordance with the probability distribution function, known from the partition function of equilibrium state. As the stochastic error of the simulation results is significant, it is desirable to understand the variance of the estimation by ensemble average, which depends on the sample size (i.e., the total number of samples in the set) and the sampling interval (i.e., cycle number between two consecutive samples). Although large sample sizes reduce the variance, they increase the computational cost of the simulation. For a given CPU time, the sample size can be reduced greatly by increasing the sampling interval, while having the corresponding increase in variance be negligible if the original sampling interval is very small. In this work, we report a few general rules that relate the variance with the sample size and the sampling interval. These results are observed and confirmed numerically. These variance rules are derived for the MCMC method but are also valid for the correlated samples obtained using other Monte Carlo methods. The main contribution of this work includes the theoretical proof of these numerical observations and the set of assumptions that lead to them.
In the past few years, smart grid (SG) has attracted much interest from governments, power companies, and research institutes [1–3]. Compared to the traditional power grid, by employing advanced information technologies (IT), SG can achieve better reliability and stability, higher energy efficiency, higher penetration of renewable energy (RE), and lower greenhouse gas emission [3, 4]. Sensor and actuator networks (SANETs) play a key role in realizing these advantages. Compared to sensor networks, SANETs can not only sense the environment, but also react to it. This characteristic makes SANETs an essential enabling technology for various monitoring and control applications. However, to properly design an effective SANETs for SG, we must overcome many challenges.
ASANET is a network of nodes which sense and react to their environment. Compared to traditional sensor networks, which focus on sensing, SANETs can be used for both monitoring and control purposes. With a SANET, closed-loop control can be achieved to support more powerful applications.
Major actors in a SANET include sensors, actuators, controllers, and communication networks. Sensors are components or devices to measure and convert physical properties into electrical signals and/or data. Controllers perform calculations on the sensed data and make control decisions. Actuators execute the control decisions, convert electrical signals into physical phenomena (e.g., displays) or actions (e.g., switches). Different actors in a SANET may be physically separated or located in a single device. Actors in a SANET communicate with each other through communication networks, operating diverse kinds of protocols and media, to enable collaboration among nodes and interaction between nodes and the surrounding environment. SANET actors and the closed-loop control are shown in Figure 13.1.
The one who made too much of an effort to understand, the one who underwent the agonies of a conversion, the one whose idea was that of renunciation when he embraced the customs of those who forged their destinies in this primeval slime in a hand-to-hand struggle with the mountains and the trees, was vulnerable because certain forces of the world he had left behind continued to operate in him.
Titles are never simple or innocent especially when they appear to be so. This holds true for the seemingly innocuous title of this chapter. For what should give us pause in the title is the innocent, commonplace conjunction. Why is ‘primitivism’ – a term that summons up colonial projects and projections and enables the West to assert its modernity and maturity – linked through the conjunction ‘and’ to ‘postcolonial literature’ which, one can justifiably assume, would reject the scandalous problems associated with the term ‘primitivism’? If, as literary and art historians have informed us repeatedly, modernist art and literature relied heavily on the resources provided by so-called primitive cultures, then surely postcolonial writers and artists would be critical of any form of primitivism that energized Western modernism? What, then, is the status of the conjunction in our title? Does it imply some kind of relation between primitivism and postcolonial literature? What sort of relation do we have here? Is it an antagonistic relation in which postcolonialism is opposed to primitivism? Or a complementary relation in which postcolonial literature finds primitivism useful as a strategic partner?
The emergence of fiat money is studied in a multiple-matching environment in which exchange is organized around trading posts and prices are determined with a dynamic monopolistically competitive framework. Each household consumes a bundle of commodities and has a preference for consumption variety. We determine the endogenous organization of exchange between firms and shoppers, the means of factor payment (remuneration), and the prices at which these trades occur. We verify that the endogenous linkage of factor payments with the medium of exchange can lead to a monetary equilibrium outcome where only fiat money trades for goods, an ex ante feature of cash-in-advance models. We also examine the long-run effects of money growth on equilibrium exchange patterns. A key finding, consistent with documented hyperinflationary episodes, is that a sufficiently rapid expansion of the money supply leads to the gradual emergence of barter, where sellers accept both goods and cash payments and workers receive part of their remuneration in goods.
Thromboembolic events are a serious complication occurring in critically ill children admitted to the cardiac intensive care unit. Although enoxaparin is one of the current anticoagulants of choice, dosages in children are extrapolated from adult guidelines. Recent data suggest that this population may need a higher dose than what is currently recommended to achieve target anti-factor Xa levels. The purpose of this study was to evaluate whether children less than 2 years old admitted to the cardiac intensive care unit require a higher enoxaparin dose than that currently recommended to achieve target anti-factor Xa levels.
Methods
Retrospective chart review including patients who received enoxaparin for the treatment or prophylaxis of venous thrombosis between January, 2005 and October, 2007. Patients were classified as younger and older as well as prophylactic and therapeutic on the basis of age and enoxaparin dose, respectively. Younger patients were those 2 month old or less and older patients were those older than 2 months of age.
Results
A total of 31 patients were identified; 13 (42%) were 2 months or younger and 25 (81%) were postoperative patients. Ten (32%) received prophylactic and 21 (68%) received therapeutic enoxaparin doses. To achieve optimal anti-factor Xa levels, enoxaparin dose was increased in all groups and reached statistical significance in all patients except those older than 2 months who received prophylactic enoxaparin. An average of 2.8 dosage adjustments was needed. No bleeding complications were reported.
Conclusions
Young children, infants, and neonates admitted to the cardiac intensive care unit required a significantly higher enoxaparin dose than that currently recommended to achieve target anti-factor Xa levels.