Persons living with dementia are at risk of becoming lost. While return discussions after missing incidents are common with children, these discussions are seldom done with persons living with dementia. Our objective was to describe the use of return discussions with persons living with dementia according to the literature and practice. We conducted a scoping review using 19 databases to locate scholarly and grey literature on return discussions, followed by 20 semi-structured interviews with first responders and service providers in Canada and the United Kingdom (UK). Eleven scholarly and 94 grey sources were included, most from the UK, related to missing children, none included persons with dementia. According to participants, although there was no standardized procedure, there were themes about conditions that facilitate return discussions. This was the first study to examine return discussion practice in dementia, and results can inform development of evidence-based protocols.

Validating the theoretical work on Rayleigh–Taylor instability (RTI) through experiments with an exceptionally clean and well-characterized initial condition has been a long-standing challenge. Experiments were conducted to study the three-dimensional RTI of an SF$_6$–air interface at moderate Atwood numbers. A novel soap film technique was developed to create a discontinuous gaseous interface with controllable initial conditions. Spectrum analysis revealed that the initial perturbation of the soap film interface is half the size of an entire single-mode perturbation. The correlation between the initial interface perturbation and Atwood numbers was determined. Due to the steep and highly curved feature of the initial soap film interface, the early-time evolution of RTI exhibits significant nonlinearity. In the quasi-steady regime, various potential flow models accurately predict the late-time bubble velocities by considering the channel width as the perturbation wavelength. Differently, the late-time spike velocities are described by these potential flow models using the wavelength of the entire single-mode perturbation. These findings indicate that the bubble evolution is influenced primarily by the spatial constraint imposed by walls, while the spike evolution is influenced mainly by the initial curvature of the spike tip. Consequently, a recent potential flow model was adopted to describe the time-varying amplitude growth induced by RTI. Furthermore, the self-similar growth factors for bubbles and spikes were determined from experiments and compared with existing studies, revealing that a large amplitude in the initial soap film interface promotes the spike development.

Worldwide, over 55-million people have dementia, and the number will triple by 2050. Persons living with dementia are exposed to risks secondary to cognitive challenges including getting lost. The adverse outcomes of going missing include injuries, death, and premature institutionalization. In this scoping review, we investigate risk factors associated with going missing among persons living with dementia. We searched and screened studies from four electronic databases (Medline, CINAHL, Embase, and Scopus), and extracted relevant data. We identified 3,376 articles, of which 73 met the inclusion criteria. Most studies used quantitative research methods. We identified 27 variables grouped into three risk factor domains: (a) demographics and personal characteristics, (b) health conditions and symptoms, and (c) environmental and contextual antecedents. Identification of risk factors associated with getting lost helps to anticipate missing incidents. Risk factors can be paired with proactive strategies to prevent incidents and inform policies to create safer communities.

Shock-tube experiments are performed on the convergent Richtmyer–Meshkov (RM) instability of a multimode interface. The temporal growth of each Fourier mode perturbation is measured. The hydrodynamic instabilities, including the RM instability and the additional Rayleigh–Taylor (RT) effect, imposed by the convergent shock wave on the dual-mode interface, are investigated. The mode-coupling effect on the convergent RM instability coupled with the RT effect is quantified. It is evident that the amplitude growths of all first-order modes and second-order harmonics and their couplings depend on the variance of the interface radius, and are influenced by the mode-coupling from the very beginning. It is confirmed that the mode-coupling mechanism is closely related to the initial spectrum, including azimuthal wavenumbers, relative phases and initial amplitudes of the constituent modes. Different from the conclusion in previous studies on the convergent single-mode RM instability that the additional RT effect always suppresses the perturbation growth, the mode-coupling might result in the additional RT effect promoting the instability of the constituent Fourier mode. By considering the geometry convergence, the mode-coupling effect and other physical mechanisms, second-order nonlinear solutions are established to predict the RM instability and the additional RT effect in the cylindrical geometry, reasonably quantifying the amplitude growths of each mode, harmonic and coupling. The nonlinear solutions are further validated by simulations considering various initial spectra. Last, the temporal evolutions of the mixed mass and normalized mixed mass of a shocked multimode interface are calculated numerically to quantify the mixing of two fluids in the cylindrical geometry.

Menaquinone-7 (MK-7), a multipotent vitamin K2, possesses a wide range of biological activities, a precise curative effect and excellent safety. A simple and rapid LC-APCI-MS/MS method for the determination of MK-7 in human plasma with single liquid–liquid extraction (LLE) extraction and 4·5-min analysis time has been developed and validated. Four per cent bovine serum albumin (BSA) was used as surrogate matrix for standard curves and endogenous baseline subtraction. This method was reproducible and reliable and was used to analyse of MK-7 in human plasma. The endogenous circadian rhythm and bioavailability of MK-7 were investigated in two randomised single-dose, open, one-way clinical trials (Study I and Study II). A total of five healthy male subjects were enrolled in Study I and 12 healthy male subjects in Study II. Single-dose (1 mg) of MK-7 was given to each subject under fasting condition, and all eligible subjects were given a restricting VK2 diet for 4 d prior to drug administration and during the trial. The experiment results of Study I demonstrated that endogenous MK-7 has no circadian rhythm in individuals. Both studies showed MK-7 are absorbed with peak plasma concentrations at about 6 h after intake and has a very long half-life time.

The meta-surface is introduced into the design of band-notched monopole antennas with single/dual/triple notched bands around 3.6/5.5/7.2 GHz for ultra-wideband (UWB) communication. We show that strong coupling effects between the meta-surface and the antenna would be created through tuning the orientations of the meta-cells according to the field distributions on the antenna surface, and eventually, filter the unwanted radiations of the antenna. Especially, by simply attaching different meta-surfaces on the back of the antenna, the band-notched properties are shown to be changeable without hurting the original structure of the antenna. Both simulation and measurement results demonstrate the monopole with replaceable meta-surfaces has achieved an UWB operating band ranging from 3 to 9 GHz for voltage standing wave ratio (VSWR) ≤ 2 with single/dual/triple notched bands covering frequencies around 3.6/5.5/7.2 GHz. Such a design would obtain significant notched performances for the desired bands and maintain the good radiations in the operating frequency, which make it a suitable candidate for UWB applications.

Shock-tube experiments on various two-bubble and two-spike interfaces are performed to examine the dependence of bubble competition and spike competition on the initial spectra and density ratio of the interface. The differences in the influences of bubble competition and spike competition on the Richtmyer–Meshkov instability are highlighted for the first time. The bubble-competition effect is mainly dependent on the initial spectra of the two-bubble configuration. In contrast, the spike-competition effect is determined by both the initial spectra and density ratio. The extended buoyancy–drag model is adopted to explain the variation of the drag force imposed on the long-wavelength and short-wavelength structures as the initial conditions change. Based on the spectrum analysis, it is found that the constituent modes of two-bubble and two-spike interfaces have different contributions to the long-wavelength and short-wavelength perturbation growths. A generalised, nonlinear, analytical model is then established to quantify the bubble-competition effect and spike-competition effect considering arbitrary initial spectra and density ratio. The bubble-competition effect is believed to be stronger than the spike-competition effect at a high density ratio because it suppresses the high-frequency perturbation growth more evidently.

Excess body weight and hyperlipidaemia cause severe health problems and have social implications. Amycenone is an active substance extracted from Yamabushitake mushrooms with no reports of its activity against excess body weight and hyperlipidaemia. This research clarifies the effects and mechanisms of action of amycenone on the inhibition of body weight excess and hyperlipidaemia attenuation using KK-Ay mice. Amycenone or water was administered to 8-week-old male KK-Ay mice by gavage for 8 weeks. Their body weight and food intake were recorded during the experiment. At the end of the experimental period, the mice were dissected, and blood samples, lipid metabolism-related organs and tissues were collected and stored for further analysis. Amycenone treatment suppressed body weight gain and improved serum levels of fasting blood glucose and non-esterified fatty acids. Additionally, serum and hepatic cholesterol and triacylglycerol levels were reduced after this treatment, whereas the phosphorylation levels of AMPK, PKA and HSL increased and the expression level of FAS decreased. The protein level of C/EBPβ and gene expression level of Cpt1 were higher in the perirenal adipose tissue of amycenone-treated KK-Ay mice. Furthermore, amycenone phosphorylated AMPK, PKA and ACC, and PPARγ expression was lower in the mesenteric adipose tissue. The phosphorylation levels of AMPK, LKB1, PKA and ACC were also induced, and FAS expression level was reduced in the liver of the amycenone-treated group. Amycenone could reduce excess body weight and attenuate hyperlipidaemia in KK-Ay mice by inhibiting lipogenesis and promoting lipolysis through lipid metabolism pathway stimulation and fatty acid β-oxidation acceleration.

Shock-tube experiments on eight kinds of two-dimensional multi-mode air–SF$_6$ interface with controllable initial conditions are performed to examine the dependence of perturbation growth on initial spectra. We deduce and demonstrate experimentally that the amplitude development of each mode is influenced by the mode-competition effect from quasi-linear stages. It is confirmed that the mode-competition effect is closely related to initial spectra, including the wavenumber, the phase and the initial amplitude of constituent modes. By considering both the mode-competition effect and the high-order harmonics effect, a nonlinear model is established based on initial spectra to predict the amplitude growth of each individual mode. The nonlinear model is validated by the present experiments and data in the literature by considering diverse initial spectra, shock intensities and density ratios. Moreover, the nonlinear model is successfully extended based on the superposition principle to predict the growths of the total perturbation width and the bubble/spike width from quasi-linear to nonlinear stages.

In this retrospective cohort study of patients presenting to a national direct-to-consumer medical practice, we found that provider geographic location is a stronger driver of antibiotic prescribing than patient location. Physicians in the Northeast and South are significantly more likely than physicians in the West to prescribe antibiotics for upper respiratory infection and bronchitis.

ABSTRACT IMPACT: Novel adipokines like tetranectin help explain why some people progress from obesity to diseases like diabetes, atherosclerosis, and dislipidemia OBJECTIVES/GOALS: Obesity has an established association with diabetes, dyslipidemia, and atherosclerosis. Preventing progression from obesity to insulin resistance requires understanding of the regulatory mechanisms involved in the loss of insulin sensitivity. Adipose tissue is well known to function as an endocrine organ that produces many kinds of adipokines. METHODS/STUDY POPULATION: Blood sample analysis from human patients and mice was used to determine associations between tetranectin and obesity. Samples were tested with a monoclonal anti-tetranectin antibody for detection with western blot. A tetranectin mutant knock out mouse line was compared to wild type littermates on high fat diet for 4 months. Insulin tolerance tests and glucose tolerance were used to determine progression to insulin resistance and glucose intolerance. Histological analysis of metabolic tissue was used to demonstrate adipocyte hypertrophy and liver steatosis. RESULTS/ANTICIPATED RESULTS: In the current study, we report the identification and initial characterization of a novel adipokine tetranectin. Tetranectin, which is coded by the C-type lectin domain family 3 member B (CLEC3B) gene, is ubiquitously expressed in various mouse tissues, whereas it is highly enriched in white adipose tissue. We found that the serum level of tetranectin was much higher in both obese and diabetic patients. Knocking out the tetranectin gene in mice protected against glucose intolerance in males but reduced insulin and glucose tolerance in females, without effects on food intake and body weight for either sex. Mechanistically, tetranectin targets liver tissues and its deficiency increases lipid accumulation in hepatocytes in females. DISCUSSION/SIGNIFICANCE OF FINDINGS: We have identified a novel adipokine which mediates a different metabolic crosstalk among tissues to maintain systemic glucose and lipid metabolism in different genders. Further investigation of tetranectin’s function could yield a new target for precise therapeutic treatment for obesity and its associated metabolic diseases in different genders

Chronic tubulointerstitial nephropathy (CTIN) is one of the most common kidney diseases. However, treatment for CTIN has multiple limits. Adjuvant therapy through nutritional regulation has become a hot research topic at present. Icariin (ICA), an extraction of Chinese herbal medicine epimedium, has many pharmacological functions including anti-inflammation and tonifying kidney. Selenomethionine (SeMet) possesses the effects of antioxidant and lightening nephrotoxicity. However, little is known about the combined nephroprotection of them. This study was investigated to evaluate the joint effects of ICA and SeMet on CTIN and explore the mechanism. Based on a novel CTIN model developed in our previous study, mice were randomly divided into five groups (a: control; b: model; c: model + ICA; d: model + SeMet; e: model + ICA + SeMet). Renal tubule epithelial cells were treated with cyclosporine A and ochratoxin A without/with ICA or/and SeMet. The results showed that ICA or/and SeMet ameliorated CTIN by inhibiting the uptrends of blood urine nitrogen, serum creatinine, urine protein, urine gravity, histopathological damage degree and collagen I deposition. ICA or/and SeMet also increased cell proliferation and decreased apoptosis and the expression of transforming growth factor-beta 1 and α-smooth muscle actin. Emphatically, ICA and SeMet joint had better nephroprotection than alone in most indexes including fibrosis. Furthermore, ICA and SeMet joint decreased the activation of toll-like receptor 4 (TLR4)/NFκB pathway induced by CTIN. TLR4 overexpression counteracted the joint protection of ICA and SeMet. Therefore, ICA and SeMet in combination could protect against CTIN through blocking TLR4/NFκB pathway. The study will provide novel insights to explore an adjuvant therapeutic orientation.

We report the first shock-tube experiments on dual-mode Richtmyer–Meshkov instability (RMI). An extended soap-film technique is adopted to generate a dual-mode gaseous interface such that its initial wavenumber ($k_0$) and phase of the fundamental waves are well controlled. By extracting interfacial contours from the distinct schlieren images, a Fourier analysis is performed from linear to weakly nonlinear stages and the growth of each basic wave is obtained. A noticeable difference between the growth of each basic mode and the corresponding single-mode RMI is observed, which suggests evident mode coupling effects in the dual-mode RMI. For dual-mode interfaces with in-phase $k_0$ and $k_0/2$ waves, the mode coupling suppresses (promotes) the growth of the $k_0$ ($k_0/2$) mode, while for interfaces with anti-phase $k_0$ and $k_0/2$ modes, the growth of the $k_0$ ($k_0/2$) mode is weakly influenced (evidently inhibited). However, for the combination of $k_0$ and $k_0/3$ waves, the mode coupling has a negligible influence on the growth of each basic wave. The modal theory of Haan (Phys. Fluids B, vol. 3, 1991, pp. 2349–2355), originally for multi-mode Rayleigh–Taylor instability, is reformulated for the dual-mode RMI, and it is found that this model overestimates the present experimental results for ignoring the nonlinear saturation. This model is then modified by accounting for both the mode coupling and nonlinear saturation, which well predicts the experimental results not only for the growth of the basic waves but also for the growth of second harmonics.

Richtmyer–Meshkov instability of the SF6 gas layer surrounded by air is experimentally investigated. Using the soap film technique, five kinds of gas layer with two sharp interfaces are generated such that the development of each individual interface is highlighted. The flow patterns are determined by the amplitudes and phases of two corrugated interfaces. For a layer with both interfaces planar, the interface velocity shows that the reflected rarefaction waves from the second interface accelerate the first interface motion. For a layer with the second interface corrugated but the first interface planar, the reflected rarefaction waves make the first interface develop with the same phase as the second interface. For a layer with the first interface corrugated but the second interface planar, the rippled shock seeded from the first interface makes the second interface develop with the same phase as the first interface and the layer evolves into an ‘upstream mushroom’ shape. For two interfaces corrugated with opposite (the same) phase but a larger amplitude for the first interface, the layer evolves into ‘sinuous’ shape (‘bow and arrow’ shape, which has never been observed previously). For the interface amplitude growth in the linear stage, the waves’ effects are considered in the model to give a better prediction. In the nonlinear stage, the effect of the rarefaction waves on the first interface evolution is quantitatively evaluated, and the nonlinear growth is well predicted. It is the first time in experiments to quantify the interfacial instability induced by the rarefaction waves inside the heavy gas layer.

Mangrove species have developed nutrient conservation mechanisms to adapt to oligotrophic intertidal environments. However, nutrient enrichment occurs worldwide, particularly in estuarine and coastal regions. Mangrove species may change their adaptive strategies if nutrient availability increases substantially. To understand how nutrient resorption (a major nutrient conservation strategy) responds to nutrient enrichment, a common mangrove species in China, Aegiceras corniculatum (black mangrove), was selected, and saplings were cultivated in nutrient-enriched soils. After one year, neither N nor P resorption efficiency showed significant variations with nutrient availability and there was no difference between N and P resorption efficiency. Overall, nutrient resorption efficiency of A. corniculatum remained at ∼40%, lower than the global average levels of evergreen plants (∼50%), indicating incomplete resorption of nutrients. Incomplete resorption was also evidenced by the nutrient concentrations, resorption proficiency and N: P ratio of plant leaves. Collectively, these results indicate that black mangrove can maintain constant nutrient resorption efficiency under eutrophic conditions.

In recent years, there has been an increasing interest in detecting disease-related rare variants in sequencing studies. Numerous studies have shown that common variants can only explain a small proportion of the phenotypic variance for complex diseases. More and more evidence suggests that some of this missing heritability can be explained by rare variants. Considering the importance of rare variants, researchers have proposed a considerable number of methods for identifying the rare variants associated with complex diseases. Extensive research has been carried out on testing the association between rare variants and dichotomous, continuous or ordinal traits. So far, however, there has been little discussion about the case in which both genotypes and phenotypes are ordinal variables. This paper introduces a method based on the γ-statistic, called OV-RV, for examining disease-related rare variants when both genotypes and phenotypes are ordinal. At present, little is known about the asymptotic distribution of the γ-statistic when conducting association analyses for rare variants. One advantage of OV-RV is that it provides a robust estimation of the distribution of the γ-statistic by employing the permutation approach proposed by Fisher. We also perform extensive simulations to investigate the numerical performance of OV-RV under various model settings. The simulation results reveal that OV-RV is valid and efficient; namely, it controls the type I error approximately at the pre-specified significance level and achieves greater power at the same significance level. We also apply OV-RV for rare variant association studies of diastolic blood pressure.

Epidemiological data for Toxoplasma gondii regarding malignancy have gained increasing attention; however, the information about T. gondii infection among children with malignant lymphoma (ML) in China is unclear. Therefore, 314 children with lymphoma and 314 healthy children, age- and gender-matched, were recruited to estimate the seroprevalence of T. gondii in the participants and identify the risk factors of infection. Blood samples from all participants were collected and examined for T. gondii IgG and IgM antibodies using ELISA. The results showed that the overall seroprevalence of T. gondii antibodies (including IgG and/or IgM) in ML patients and healthy controls was 19.8% and 9.9%, respectively. Contact with the cats, consumption of oysters and history of chemotherapy were estimated to be the risk factors for T. gondii infection in children with lymphoma by multivariable logistic regression analysis, whereas in healthy children, contact with cats and consumption of oysters were the risk factors. Moreover, among various histological types of lymphoma, individuals with NK/T-cell lymphoma, B-small lymphocytic lymphoma, marginal zone B-lymphoma and Hodgkin's lymphoma had a higher seroprevalence than healthy controls (P < 0.05). These findings indicated the high prevalence of T. gondii infection in children with lymphoma, and hence, efforts should be performed to evaluate the effect of the infection further in lymphoma patients.

The excessive use of plastic, especially polystyrene (PS), has caused serious environmental pollution. The efficient utilization of plastics and the conversion of plastics into value-added carbon materials are the concerns of researchers. Herein, we propose novel “pyrolysis–deposition” method to convert one popular plastic substance, PS, into ordered mesoporous carbons (OMCs). During the synthesis process, PS is pyrolyzed into small organic gases under high temperature, which is then adsorbed through capillary adsorption into the mesoporous of SBA-15 in the presence of catalyst. The obtained OMCs have high specific surface area, uniform pore size, and ordered pore structure. The OMCs exhibit specific capacitance of 118 F/g at a current density of 0.2 A/g and electrochemical stability of 87.2% at a current density of 2 A/g after 5000 cycles. The pyrolysis–deposition strategy provides a new idea to convert waste plastics into high-performance carbon materials for electrochemical applications.

High-fidelity experiments of Richtmyer–Meshkov instability on a single-mode air/$\text{SF}_{6}$ interface are carried out at weak shock conditions. The soap-film technique is extended to create single-mode gaseous interfaces which are free of small-wavelength perturbations, diffusion layers and three-dimensionality. The interfacial morphologies captured show that the instability evolution evidently involves the smallest experimental uncertainty among all existing results. The performances of the impulsive model and other nonlinear models are thoroughly examined through temporal variations of the perturbation amplitude. The individual growth of bubbles or spikes demonstrates that all nonlinear models can provide a reliable forecast of bubble development, but only the model of Zhang & Guo (J. Fluid Mech., vol. 786, 2016, pp. 47–61) can reasonably predict spike development. The distinct images of the interface morphology obtained also provide a rare opportunity to extract interface contours such that a spectral analysis of the interfacial contours can be performed, which realizes the first direct validation of the high-order nonlinear models of Zhang & Sohn (Phys. Fluids, vol. 9, 1997, pp. 1106–1124) and Vandenboomgaerde et al. (Phys. Fluids, vol. 14 (3), 2002, pp. 1111–1122) in terms of the fundamental mode and high-order harmonics. It is found that both models show a very good and almost identical accuracy in predicting the first two modes. However, the model of Zhang & Sohn (1997) becomes much more accurate in modelling the third-order harmonics due to the fewer simplifications used.