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Obtaining accurate field statistics continues to be one of the major challenges in turbulence theory and modelling. From the various existing modelling approaches, multifractal models have been successful in capturing intermittency in velocity gradient and increment distributions. Moreover, superstatistical models from non-equilibrium statistical mechanics have shown the capacity to model probability density functions (p.d.f.s) of various statistical turbulent quantities as ensembles of simpler stochastic processes. Here, we present an approach that generates field statistics in the form of a characteristic functional by promoting a model for multifractal increment statistics to an ensemble of Gaussian fields. By carefully designing the correlation function and the corresponding weight of each subensemble, we are able to define a functional that exhibits multifractal two-point inertial-range and dissipation-range statistics, and that blends into realistic large-scale behaviour. Additionally, the method is capable of producing multifractal statistics with any of the widely used singularity spectra. We characterise the fidelity of our approach through comparisons to literature results from direct numerical simulations. Overall, our framework thereby bridges between three different perspectives: superstatistics, multifractals and functional approaches to turbulence.
Public policies contribute to structural racism and health inequities. To dismantle structural racism and advance health equity, methods aligning scientific evidence, community priorities, and political will are needed to implement equity-focused interventions. This study combined community-based participatory research and legal epidemiology methods to inform local policy in East Point, Georgia. The community informed a comprehensive policy approach to address social determinants of health (SDOH) and advance health equity and identified East Point’s Comprehensive Plan Update as an opportunity to advance health equity through policy. Key findings informed a legal epidemiology study to assess variation in including equity and health equity in comprehensive plans across 32 jurisdictions. Limited adoption of equity and health equity provisions were found, revealing opportunities to inform the East Point policymaking process. Research findings were summarized and disseminated to the community and policymakers. In 2023, East Point adopted equity, health, and health equity into its comprehensive plan for the first time. This case study demonstrates that collaborative, multi-sector, community-centered approaches can support policy interventions that address historical race-based, health-harming policies, and thereby dismantle structural racism. Inclusion of health equity in East Point’s comprehensive plan provides a foundation for future implementation of policies that address SDOH and health inequities.
DeGAUSS is a privacy-preserving application that ingests addresses and generates output that includes latitude, longitude, census tract, deprivation index and drive times to major hospitals. The application uses a complex command line interface and a container management platform to perform analysis. Our objective was to develop a user-friendly DeGAUSS-based application that simplifies place-based analysis. We also enabled automated geomarker generation by providing an API modality to DeGAUSS.
Methods:
We developed a self-service platform based on the DeGAUSS application. The application was linked to user authentication platforms. The self-service application can be implemented as an API, enabling high-volume geocoding transactions. We surveyed active users for feedback.
Results:
The self-service geomarker application was deployed at Children’s Mercy and the University of Kansas Medical Center. During the period evaluated, more than 2 million addresses were geocoded for 24 users through the user interface and more than 15 million addresses through the API. Users expressed high satisfaction with the system. All respondents used the census block group feature and the core geocoding. Most respondents, 60%, used the deprivation index and 30% used the drive time feature. Population health and social determinants of health were the most common uses (80% each) followed by health equity analyses (70%).
Conclusion:
Population health and social determinants of health research require access to precise geographic information about patients or research subjects. The self-service geomarker capability enables users who may not be comfortable with a command line interface to generate geocoded addresses in support of their research and analysis.
Identifying studies for inclusion in realist syntheses using title and abstract screening is challenging given the need to unearth explanatory insights to build context–mechanism–outcome configurations. Such insights may only be uncovered through full-text paper reading. To address this issue, a novel approach for identifying studies has been developed called Reverse Chronology Quota Record Screening (RCQRS). Results of database searches are screened in reverse chronology, and in stages, to fill quotas matching the requirements of the review. RCQRS may be beneficial in any of the following circumstances: (a) the timeframe to complete the synthesis is short; (b) the scope of inquiry is not fully defined, (c) the availability of suitable literature is beyond the screening capacity of the reviewers; or (d) the availability of literature is sparse and reviewers seek to extrapolate insights from other areas. In contrast to RCQRS, exhaustive title and abstract screening (i.e., screening entire database results) may hamper study selection due to being overwhelming in volume and time-intensive, resulting in a causally thin cohort of papers for analysis. RCQRS used in stages, and in conjunction with other search strategies (e.g., hand searching, backward citation tracking, and expert solicitation) can support creative, robust analytical insights with causally rich extrapolations. Using the Horizon-EU funded SERENITY study on deprescribing in palliative care as a case example, the benefits and limitations of RCQRS are explored. Finally, a checklist template is offered for teams who wish to reflect on, and transparently report, the use of RCQRS in their realist synthesis.
In a retrospective cohort of 6363 neonates admitted to three NICUs, there was no reduction in Staphylococcus aureus acquisition when comparing pre- and post-pandemic incidence rates. While additional infection prevention practices introduced during the pandemic helped prevent SARS-CoV-2 transmission, these practices may not have reduced S. aureus transmission to infants.
Background: Ventilator associated events (VAE) due to changes in positive end expiratory pressure (PEEP) or fraction of inspired oxygen (FiO2) are associated with adverse outcomes for patients in the intensive care unit (ICU). Accurately identifying VAEs is important to improve the quality of care and outcomes for ICU patients. However, we have identified “false-positive” VAEs that are triggered by stylistic manipulation in ventilator settings, or knobmanship, without “true” VAEs that are preceded by signs of hypoxia. This knobmanship creates an undue burden for Infection Preventionists to differentiate clinically relevant VAEs that impact patient outcomes from “false-positive” VAEs. Methods: We utilized the Center for Disease Control and Prevention’s National Healthcare Safety Network definition to retrospectively identify VAEs in the pre-pandemic and post-pandemic eras. Of the five ICUs monitored for VAEs, the Neurosciences ICU had the greatest number of events in 2022 and 2023. Working with the NSICU, a pilot study using an initial PEEP of 6 millimeters of mercury (mmHg) rather than 5 mmHg for all intubated patients was conducted. We hypothesized that this would reduce the incidence of “false-positive” VAE without causing adverse patient outcomes. Results: Out of 283 reported VAEs from the pre-pandemic period of January 1, 2019, to December 31, 2020, 59 (21%) were due to ventilator changes in PEEP or Fi02 without preceding hypoxia. Post-pandemic evaluation from January 1, 2022, to December 31, 2022, identified “false-positive” VAE in 56 (41%) out of 137 VAE cases. Eighty-two (59%) of the 137 VAE cases were due to changes in PEEP from 5 mmHg to 8 mmHg. After changing the starting PEEP in the NSICU to 6 mmHg from 5 mmHg, from October 1, 2024, to December 1, 2024, only 1 VAE was identified compared to an average of 10 for similar quarters in 2022 and 2023. Despite this change, no adverse events or concerns were noted by the primary ICU team or respiratory therapists. Discussion: With thoughtful changes in knobmanship we reduced the burden of “false-positive” VAE without leading to adverse patient outcomes. Conclusions: Alteration in starting PEEP can reduce the burden of VAE that are not clinically relevant and allow Infection Preventionists the opportunity to critically analyze clinically relevant VAEs to improve ICU patient outcomes.
The study investigated the effects of replacing maize with enzyme-supplemented Dried Date Fruit Pulp (DDFP) in the diets of broiler chickens. 576-day-old commercial broiler chicks (Arbor Acre Plus) were randomly selected and distributed into 8 treatment groups of 72 birds each. Each treatment was divided into six replicates of 12 birds on a weight-equalisation basis. The treatments consisted of 4 levels of DDFP (0, 100, 200 and 300 g/kg) and 2 levels of enzyme supplementation (with or without). The data obtained were subjected to an Analysis of Variance in a 4 × 2 factorial arrangement. Birds fed 300 g/kg DDFP recorded the least weight gain (971 g) and final weight (1013 g) across the treatments at the starter phase, while there were no significant (P > 0.05) differences in the final weight, weight gain, feed intake and feed conversion ratio of birds fed with DDFP and maize-based diets at the finisher phase. DDFP inclusion reduced the experimental birds’ feeding cost (NGN/kg) and cost/kg weight gain (NGN/kg WG). Enzyme supplementation increased serum protein and glucose concentrations. Reduced (P < 0.05) EE and CF digestibility coefficients were seen in birds fed 30% DDFP at the finisher phase. Carcass indices, ileal digesta viscosity and caecal total bacteria were not negatively influenced. It was concluded that DDFP could replace up to 200 g/kg maize in broiler chicken diets at the starter phase and up to 300 g/kg at the finisher phase without any deleterious effects on health and performance.
The physical fidelity of turbulence models can benefit from a partial resolution of fluctuations, but doing so often comes with an increase in computational cost. To explore this trade-off in the context of wall-bounded flows, this paper introduces a framework for turbulence-resolving integral simulations (TRIS) with the goal of efficiently resolving the largest motions using a two-dimensional, three-component representation of the flow defined by instantaneous wall-normal integrals of velocity and pressure. Self-sustaining turbulence with qualitatively realistic large-scale structures is demonstrated for TRIS on an open-channel (half-channel) flow configuration using moment-of-momentum integral equations derived from Navier–Stokes with relatively simple closure approximations. Evidence from direct numerical simulations (DNS) suggests that TRIS can theoretically resolve $35\,\%{-}40\,\%$ of the turbulent skin friction enhancement for friction Reynolds numbers between $180$ and $5200$, without a noticeable decrease or increase as a function of Reynolds number. The current implementation of TRIS can match this resolution while simulating one flow through time in ${\sim}1$ minute on a single processor, even for very large Reynolds numbers. The framework facilitates a detailed apples-to-apples comparison of predicted statistics against data from DNS. Comparisons at friction Reynolds numbers of $395$ and $590$ show that TRIS generates a relatively accurate representation of the flow, while highlighting discrepancies that demonstrate a need for improving the closure models. The present results for open-channel flow represent a proof of concept for TRIS as a new approach for wall-bounded turbulence modelling, motivating extension to more general flow configurations such as boundary layers on immersed objects.
This study introduces the prostate cancer linear energy transfer sensitivity index (PCLSI) as a novel method to predict relative biological effectiveness (RBE) in prostate cancer using linear energy transfer (LET) in proton therapy based on screening for DNA repair mutations.
Materials and Methods:
Five prostate cancer cell lines with DNA repair mutations known to cause sensitivity to LET and DNA repair inhibitors were examined using published data. Relative Du145 LET sensitivity data were leveraged to deduce the LET equivalent of olaparib doses. The PCLSI model was built using three of the prostate cancer cell lines (LNCaP, 22Rv1 and Du145) with DNA mutation frequency from patient cohorts. The PCLSI model was compared against two established RBE models, McNamara and McMahon, for LET-optimized prostate cancer treatment plans.
Results:
The PCLSI model relies on the presence of eight DNA repair mutations: AR, ATM, BRCA1, BRCA2, CDH1, ETV1, PTEN and TP53, which are most likely to predict increased LET sensitivity and RBE in proton therapy. In the LET-optimized plan, the PCLSI model indicates that prostate cancer cells with these DNA repair mutations are more sensitive to increased LET than the McNamara and McMahon RBE models, with expected RBE increases ranging from 11%–33% at 2keV/µm.
Conclusions:
The PCLSI model predicts increasing RBE as a function of LET in the presence of certain genetic mutations. The integration of LET-optimized proton therapy and genetic mutation profiling could be a significant step toward the use of individualized medicine to improve outcomes using RBE escalation without the potential toxicity of physical dose escalation.
Poor weight gain in infants with single ventricle cardiac physiology between stage 1 and stage 2 palliative surgeries is associated with worse outcomes. The growth of infants with single ventricle physiology, enrolled in home monitoring programmes in the United Kingdom, has not been widely described.
Aim:
To explore the growth of infants with single ventricle physiology supported by a home monitoring programme, at a tertiary centre in the South of England.
Methods:
A retrospective review of two cohorts, comparing weight gain amongst infants with single ventricle physiology, before and following the implementation of a home monitoring programme. Inclusion was dependent on a diagnosis compatible with single ventricle physiology during the interstage.
Results:
Enrolment into a home monitoring programme (cohort 2) was associated with 55% more infants being discharged home during the interstage period (p < 0.05). Interstage mortality did not differ between cohorts. There were no differences in interstage growth velocity between cohorts (cohort 1 23.98 ± 11.7 g/day and cohort 2 23.82 ± 8.3 g/day); however, infants in cohort 2 experienced less growth deceleration early in life, and achieved catch-up growth at 12-23 months. Interstage nasogastric feeding, regardless of the cohort, was associated with worse growth outcomes.
Conclusion:
A home monitoring programme for infants with single ventricle physiology provides the opportunity for infants to be safely discharged home to their families and cared for at home during the interstage. Infants in the home monitoring programme experienced better growth, achieving weight restoration at 12–23 months.
Foliar-applied postemergence applications of glufosinate are often applied to glufosinate-resistant crops to provide nonselective weed control without significant crop injury. Rainfall, air temperature, solar radiation, and relative humidity near the time of application have been reported to affect glufosinate efficacy. However, previous research may have not captured the full range of weather variability to which glufosinate may be exposed before or following application. Additionally, climate models suggest more extreme weather will become the norm, further expanding the weather range to which glufosinate can be exposed. The objective of this research was to quantify the probability of successful weed control (efficacy ≥85%) with glufosinate applied to some key weed species across a broad range of weather conditions. A database of >10,000 North American herbicide evaluation trials was used in this study. The database was filtered to include treatments with a single postemergence application of glufosinate applied to waterhemp [Amaranthus tuberculatus (Moq.) Sauer], morningglory species (Ipomoea spp.), and/or giant foxtail (Setaria faberi Herrm.) <15 cm in height. These species were chosen because they are well represented in the database and listed as common and troublesome weed species in both corn (Zea mays L.) and soybean [Glycine max (L.) Merr.] (Van Wychen 2020, 2022). Individual random forest models were created. Low rainfall (≤20 mm) over the 5 d before glufosinate application was detrimental to the probability of successful control of A. tuberculatus and S. faberi. Lower relative humidity (≤70%) and solar radiation (≤23 MJ m−1 d−1) on the day of application reduced the probability of successful weed control in most cases. Additionally, the probability of successful control decreased for all species when average air temperature over the first 5 d after application was ≤25 C. As climate continues to change and become more variable, the risk of unacceptable control of several common species with glufosinate is likely to increase.
Task planning and its effect on the complexity of second language (L2) written production have been studied extensively. However, the results of these studies are inconclusive, and at times contradictory, potentially as a result of variation in metrics of linguistic complexity. This study is an extension of earlier research syntheses and quantitative meta-analyses on the effects of planning on oral and written L2 production. It examines the identification and selection of linguistic complexity metrics in previous research on planning and its subsequent effects on the linguistic complexity of written L2 production. This research-focused synthesis of studies surveys construct definitions and operational definitions of linguistic complexity in the research domain and provides an overview of rationales for metric selection in the included studies. Methodological implications for future research are discussed in light of the findings.
Foliar-applied postemergence herbicides are a critical component of corn (Zea mays L.) and soybean [Glycine max (L.) Merr.] weed management programs in North America. Rainfall and air temperature around the time of application may affect the efficacy of herbicides applied postemergence in corn or soybean production fields. However, previous research utilized a limited number of site-years and may not capture the range of rainfall and air temperatures that these herbicides are exposed to throughout North America. The objective of this research was to model the probability of achieving successful weed control (≥85%) with commonly applied postemergence herbicides across a broad range of environments. A large database of more than 10,000 individual herbicide evaluation field trials conducted throughout North America was used in this study. The database was filtered to include only trials with a single postemergence application of fomesafen, glyphosate, mesotrione, or fomesafen + glyphosate. Waterhemp [Amaranthus tuberculatus (Moq.) Sauer], morningglory species (Ipomoea spp.), and giant foxtail (Setaria faberi Herrm.) were the weeds of focus. Separate random forest models were created for each weed species by herbicide combination. The probability of successful weed control deteriorated when the average air temperature within the first 10 d after application was <19 or >25 C for most of the herbicide by weed species models. Additionally, drier conditions before postemergence herbicide application reduced the probability of successful control for several of the herbicide by weed species models. As air temperatures increase and rainfall becomes more variable, weed control with many of the commonly used postemergence herbicides is likely to become less reliable.
Members of the genus Scaphanocephalus mature in accipitrids, particularly osprey, Pandion haliaetus, with metacercaria causing Black Spot Syndrome in reef fishes. In most of the world, only the type species, Scaphanocephalus expansus (Creplin, 1842) has been reported. Recent molecular studies in the Western Atlantic, Mediterranean and Persian Gulf reveal multiple species of Scaphanocephalus, but have relied on 28S rDNA, mainly from metacercariae, which limits both morphological identification and resolution of closely related species. Here we combine nuclear rDNA with mitochondrial sequences from adult worms collected in osprey across North America and the Caribbean to describe species and elucidate life cycles in Scaphanocephalus. A new species described herein can be distinguished from S. expansus based on overall body shape and size. Phylogenetic analysis of the whole mitochondrial genome of Scaphanocephalus indicates a close relationship with Cryptocotyle. We conclude that at least 3 species of Scaphanocephalus are present in the Americas and 2 others are in the Old World. Specimens in the Americas have similar or identical 28S to those in the Mediterranean and Persian Gulf, but amphi-Atlantic species are unlikely in light of divergence in cytochrome c oxidase I and the lack of amphi-Atlantic avian and fish hosts. Our results provide insight into the geographic distribution and taxonomy of a little-studied trematode recently linked to an emerging pathology in ecologically important reef fishes.