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To generate and employ scenarios of sentinel human and animal outbreak cases in local contexts that integrate human and animal health interests and practices and facilitate outbreak risk management readiness.
Methods
We conducted a scoping review of past outbreaks and the strengths and weaknesses of response efforts in USAID STOP Spillover program countries. This information and iterative query-and-response with country teams and local stakeholders led to curated outbreak scenarios emphasizing One Health human:animal interfaces at sub-national levels.
Results
Two core scenarios were generated adapted to each of 4 countries’ pathogen priorities and workflows in Africa and Asia, anchoring on sub-national outbreak response triggered by either an animal or human health event. Country teams subsequently used these scenarios in a variety of local preparedness discussions and simulations. The process of creating outbreak scenarios encourages discussion and review of current country practices and procedures. Guideline documents and lessons learned do not necessarily reflect how workflows occur in outbreak response in countries at highest risk for spillover events.
Conclusions
Discussion-based engagement across One Health stakeholders can improve sub-national coordination, clarify guidelines and responsibilities, and provide a space for interagency cooperation through use of scenarios in tabletop and other exercises.
Adolescence is a period marked by highest vulnerability to the onset of depression, with profound implications for adult health. Neuroimaging studies have revealed considerable atrophy in brain structure in these patients with depression. Of particular importance are regions responsible for cognitive control, reward, and self-referential processing. However, the causal structural networks underpinning brain region atrophies in adolescents with depression remain unclear.
Objectives
This study aimed to investigate the temporal course and causal relationships of gray matter atrophy within the brains of adolescents with depression.
Methods
We analyzed T1-weighted structural images using voxel-based morphometry in first-episode adolescent patients with depression (n=80, 22 males; age = 15.57±1.78) and age, gender matched healthy controls (n=82, 25 males; age = 16.11±2.76) to identify the disease stage-specific gray matter abnormalities. Then, with granger causality analysis, we arranged the patients’ illness duration chronologically to construct the causal structural covariance networks that investigated the causal relationships of those atypical structures.
Results
Compared to controls, smaller volumes in ventral medial prefrontal cortex (vmPFC), dorsal anterior cingulate cortex (dACC), middle cingulate cortex (MCC) and insula areas were identified in patients with less than 1 year illness duration, and further progressed to the subgenual ACC, regions of default, frontoparietal networks in longer duration. Causal network results revealed that dACC, vmPFC, MCC and insula were prominent nodes projecting exerted positive causal effects to regions of the default mode and frontoparietal networks. The dACC, vmPFC and insula also had positive projections to the reward network, which included mainly the thalamus, caudate and putamen, while MCC also exerted a positive causal effect on the insula and thalamus.
Conclusions
These findings revealed the progression of structural atrophy in adolescent patients with depression and demonstrated the causal relationships between regions involving cognitive control, reward and self-referential processes.
The aerodynamic performance of a wing model with a row of distributed engines are investigated at the vertical take-off condition. The engines are installed near the trailing edge of the wing. During vertical take-off, the jets exit from the engines and impinge perpendicularly to the ground, providing a thrust for the aircraft. Due to the ground effects, complex vortex structures are induced by the jets. The vortices are categorised into the spanwise vortices and the chordwise vortices. The underwing vortices can lead to low-pressure regions on the lower surface of the wing, resulting in an undesirable downward force. The underwing vortex structures are affected by the ratio of the engine distance to the engine diameter ($S/D$). At a small $S/D$ = 1.10, the flow field is dominated by the spanwise vortices; at a large $S/D$ = 2.78, the flow field is dominated by the chordwise vortices. The range and strength of the spanwise vortices are affected by the vortices interaction. Competition mechanism exists between the range and strength effects, which results in the non-linear variation of the wing lift coefficient with engine spacing. The details of the flow physics underneath the wing and its mechanism on the lift of the wing during take-off are investigated.
This article reinterprets the tension between sound and music in Pierre Schaeffer's 1966 Treatise on Musical Objects. Schaeffer famously insisted that the Treatise did not address music or composition; scholars have therefore engaged with it primarily as a theoretical text on sound and listening. In this article, however, I argue that the denial and deferral of music throughout the Treatise should be considered a discrete and key part of its theoretical contributions. By the early 1960s, Schaeffer's aesthetic frustration with the practice of musique concrète had blossomed into something of an ethical imperative and paradox. He saw it necessary to suspend all musical activity in the present, so as to salvage music's future. This dynamic is key to understanding Schaeffer's controversial and influential calls for the deferral of cultural responses to sound in the Treatise, as illustrated by the practices of ‘deconditioning’ and ‘reconditioning’.
We report the experimental results of the commissioning phase in the 10 PW laser beamline of the Shanghai Superintense Ultrafast Laser Facility (SULF). The peak power reaches 2.4 PW on target without the last amplifying during the experiment. The laser energy of 72 ± 9 J is directed to a focal spot of approximately 6 μm diameter (full width at half maximum) in 30 fs pulse duration, yielding a focused peak intensity around 2.0 × 1021 W/cm2. The first laser-proton acceleration experiment is performed using plain copper and plastic targets. High-energy proton beams with maximum cut-off energy up to 62.5 MeV are achieved using copper foils at the optimum target thickness of 4 μm via target normal sheath acceleration. For plastic targets of tens of nanometers thick, the proton cut-off energy is approximately 20 MeV, showing ring-like or filamented density distributions. These experimental results reflect the capabilities of the SULF-10 PW beamline, for example, both ultrahigh intensity and relatively good beam contrast. Further optimization for these key parameters is underway, where peak laser intensities of 1022–1023 W/cm2 are anticipated to support various experiments on extreme field physics.
This study aimed to investigate the association between hyperemesis gravidarum (HG) severity and early enteral tube feeding on cardiometabolic markers in offspring cord blood. We included women admitted for HG, who participated in the MOTHER randomised controlled trial (RCT) and observational cohort. The MOTHER RCT showed that early enteral tube feeding in addition to standard care did not affect symptoms/birth outcomes. Among RCT and cohort participants, we assessed how HG severity affected lipid, c-peptide, glucose and free thyroxine cord blood levels. HG severity measures were severity of vomiting at inclusion and 3 weeks after inclusion, pregnancy weight gain and 24-h energy intake at inclusion, readmissions and duration of hospital admissions. Cord blood measures were also compared between RCT participants allocated to enteral tube feeding and those receiving standard care. Between 2013-2016, 215 women were included: 115 RCT and 100 cohort participants. Eighty-one cord blood samples were available. Univariable not multivariable regression analysis showed that lower maternal weight gain was associated with higher cord blood glucose levels (β: –0·08, 95% CI –0·16, –0·00). Lower maternal weight gain was associated with higher Apo-B cord blood levels in multivariable regression analysis (β: –0·01, 95% CI –0·02, –0·01). No associations were found between other HG severity measures or allocation to enteral tube feeding and cord blood cardiometabolic markers. In conclusion, while lower maternal weight gain was associated with higher Apo-B cord blood levels, no other HG severity measures were linked with cord blood cardiometabolic markers, nor were these markers affected by enteral tube feeding.
Explore a thorough and up to date overview of the current knowledge, developments and outstanding challenges in turbulent combustion and application. The balance among various renewable and combustion technologies are surveyed, and numerical and experimental tools are discussed along with recent advances. Covers combustion of gaseous, liquid and solid fuels and subsonic and supersonic flows. This detailed insight into the turbulence-combustion coupling with turbulence and other physical aspects, shared by a number of the world leading experts in the field, makes this an excellent reference for graduate students, researchers and practitioners in the field.
The coexistence of underweight (UW) and overweight (OW)/obese (OB) at the population level is known to affect iron deficiency (ID) anaemia (IDA), but how the weight status affects erythropoiesis during pregnancy is less clear at a population scale. This study investigated associations between the pre-pregnancy BMI (pBMI) and erythropoiesis-related nutritional deficiencies.
Design:
Anthropometry, blood biochemistry and 24-h dietary recall data were collected during prenatal care visits. The weight status was defined based on the pBMI. Mild nutrition deficiency-related erythropoiesis was defined if individuals had an ID, folate depletion or a vitamin B12 deficiency.
Setting:
The Nationwide Nutrition and Health Survey in Taiwan (Pregnant NAHSIT 2017–2019).
Participants:
We included 1456 women aged 20 to 45 years with singleton pregnancies.
Results:
Among these pregnant women, 9·6 % were UW, and 29·2 % were either OW (15·8 %) or OB (13·4 %). A U-shaped association between the pBMI and IDA was observed, with decreased odds (OR; 95 % CI) for OW subjects (0·6; 95 % CI (0·4, 0·9)) but increased odds for UW (1·2; 95 % CI (0·8, 2·0)) and OB subjects (1·2; 95 % CI (0·8, 1·8)). The pBMI was positively correlated with the prevalence of a mild nutritional deficiency. Compared to normal weight, OB pregnant women had 3·4-fold (3·4; 95 % CI (1·4, 8·1)) higher odds for multiple mild nutritional deficiencies, while UW individuals had lowest odds (0·3; 95 % CI (0·1, 1·2)). A dietary analysis showed negative relationships of pBMI with energy, carbohydrates, protein, Fe and folate intakes, but positive relationship with fat intakes.
Conclusion:
The pre-pregnancy weight status can possibly serve as a good nutritional screening tool for preventing IDA during pregnancy.
This study aimed to analyse the survival of patients admitted to Brazilian hospitals due to the COVID-19 and estimate prognostic factors. This is a retrospective, multicentre cohort study, based on data from 46 285 hospitalisations for COVID-19 in Brazil. Survival functions were calculated using the Kaplan–Meier's method. The log-rank test compared the survival functions for each variable and from that, hazard ratios (HRs) were calculated, and the proportional hazard model was used in Cox multiple regression. The smallest survival curves were the ones for patients at the age of 68 years or more, black/mixed race, illiterate, living in the countryside, dyspnoea, respiratory distress, influenza-like outbreak, O2 saturation <95%, X-ray change, length of stay in the intensive care unit (ICU), invasive ventilatory support, previous heart disease, pneumopathy, diabetes, Down's syndrome, neurological disease and kidney disease. Better survival was observed in the influenza-like outbreak and in an asthmatic patient. The multiple model for increased risk of death when they were admitted to the ICU HR 1.28, diabetes HR 1.17, neurological disease HR 1.34, kidney disease HR 1.11, heart disease HR 1.14, black or mixed race of HR 1.50, asthma HR 0.71 and pneumopathy HR 1.12. This reinforces the importance of socio-demographic and clinical factors as a prognosis for death.
Dynamic soaring improves the endurance of Unmanned Aerial Vehicles (UAVs) by obtaining energy from the horizontal wind shear gradient. The use of dynamic soaring in small solar UAVs can mitigate the trade-off between energy capacity and battery weight to achieve continuous all-day flight. The goal of this study is to determine the optimal energy acquisition methods for small solar UAVs using dynamic soaring and to decrease the battery weight to achieve all-day flight. A dynamic soaring UAV model that considers the influence of the wind shear gradient and a solar power energy model are established. The conditions to obtain a closed-loop energy system during daytime and nighttime flights are discussed, and the minimum mass of the energy system required for these conditions is determined. Simulations of single-cycle circular flights and a 72-h continuous flight of a small solar UAV are performed. The analyses and simulation results show that: (1) the combination of dynamic soaring and solar technology significantly reduces the energy consumption and reduces the required battery weight, (2) the flight speed and flight attitude angles have significant effects on the optimal total energy acquisition and (3) wind fields with a large horizontal gradient and strong solar illumination provide energy and load advantages.
Post-stroke depression (PSD) is the most common psychiatric complication facing stroke survivors and has been associated with increased distress, physical disability, poor rehabilitation, and suicidal ideation. However, the pathophysiological mechanisms underlying PSD remain unknown, and no objective laboratory-based test is available to aid PSD diagnosis or monitor progression.
Methods:
Here, an isobaric tags for relative and absolute quantitation (iTRAQ)-based quantitative proteomic approach was performed to identify differentially expressed proteins in plasma samples obtained from PSD, stroke, and healthy control subjects.
Results:
The significantly differentiated proteins were primarily involved in lipid metabolism and immunoregulation. Six proteins associated with these processes – apolipoprotein A-IV (ApoA-IV), apolipoprotein C-II (ApoC-II), C-reactive protein (CRP), gelsolin, haptoglobin, and leucine-rich alpha-2-glycoprotein (LRG) – were selected for Western blotting validation. ApoA-IV expression was significantly upregulated in PSD as compared to stroke subjects. ApoC-II, LRG, and CRP expression were significantly downregulated in both PSD and HC subjects relative to stroke subjects. Gelsolin and haptoglobin expression were significantly dysregulated across all three groups with the following expression profiles: gelsolin, healthy control > PSD > stroke subjects; haptoglobin, stroke > PSD > healthy control.
Conclusions:
Early perturbation of lipid metabolism and immunoregulation may be involved in the pathophysiology of PSD. The combination of increased gelsolin levels accompanied by decreased haptoglobin levels shows promise as a plasma-based diagnostic biomarker panel for detecting increased PSD risk in post-stroke patients.