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We present a simple, novel kinematic criterion – that uses only the horizontal velocity fields and is free of arbitrary thresholds – to separate line plumes from local boundary layers in a plane close to the hot plate in turbulent convection. We first show that the horizontal divergence of the horizontal velocity field ($\boldsymbol {\nabla _H} \boldsymbol {\cdot } \boldsymbol {u}$) has negative and positive values in two-dimensional (2D), laminar similarity solutions of plumes and boundary layers, respectively. Following this observation, based on the understanding that fluid elements predominantly undergo horizontal shear in the boundary layers and vertical shear in the plumes, we propose that the dominant eigenvalue ($\lambda _D$) of the 2D strain rate tensor is negative inside the plumes and positive inside the boundary layers. Using velocity fields from our experiments, we then show that plumes can indeed be extracted as regions of negative $\lambda _D$, which are identical to the regions with negative $\boldsymbol {\nabla _H} \boldsymbol {\cdot } \boldsymbol {u}$. Exploring the connection of these plume structures to Lagrangian coherent structures (LCS) in the instantaneous limit, we show that the centrelines of such plume regions are captured by attracting LCS that do not have dominant repelling LCS in their vicinity. Classifying the flow near the hot plate based on the distribution of eigenvalues of the 2D strain rate tensor, we then show that the effect of shear due to the large-scale flow is felt more in regions close to where the local boundary layers turn into plumes. The lengths and areas of the plume regions, detected by the $\boldsymbol {\nabla _H}\boldsymbol {\cdot }\boldsymbol {u}$ criterion applied to our experimental and computational velocity fields, are then shown to agree with our theoretical estimates from scaling arguments. Using velocity fields from numerical simulations, we then show that the $\boldsymbol {\nabla _H}\boldsymbol {\cdot }\boldsymbol {u}$ criterion detects all the upwellings, while the available criteria based on temperature and flux thresholds miss some of these upwellings. The plumes detected by the $\boldsymbol {\nabla _H}\boldsymbol {\cdot }\boldsymbol {u}$ criterion are also shown to be thicker at Prandtl numbers ($Pr$) greater than one, expectedly so, due to the thicker velocity boundary layers of the plumes at $Pr>1$.
The launch of the Sentinel-1B satellite in April 2016 completed the two-satellite synthetic aperture radar (SAR) constellation of the European Copernicus Sentinel-1 mission. The European Space Agency executed the calibration of this sensor during the commissioning phase and an independent calibration by the German Aerospace Center (DLR) in 2016. The calibration parameters must be monitored to assess the stability of the instrument. This study reports the temporal stability assessment of radiometric calibration and image quality parameters of Sentinel-1B SAR data using the corner reflector (CR) array, Surat Basin, Australia. Impulse response functions generated from the CRs in the satellite images were used to derive the image quality parameters. The average radar cross-section difference between estimated and theoretical values (38.40 dB m2) was 0.53 dB m2 for 1.5 m CRs, which is accordant with the absolute radiometric accuracy specified for the Sentinel-1 SAR system. Derived image quality parameters viz. the mean peak-to-side lobe ratio, mean integrated side lobe ratio, and spatial resolutions in the range and azimuth directions were found to be accordant with the specified value for the Sentinel-1 SAR system. The results indicate the excellent quality of the Sentinel-1B data.
The evidence informing the management of cardiovascular risk in patients with psychiatric disorders is weak.
Methods
This cohort study used data from all patients, aged ≥ 30, registered in 140 primary care practices (n = 524,952) in London to estimate the risk of developing diabetes, hypertension, hyperlipidemia, tobacco consumption, obesity, and physical inactivity, between 2005 and 2015, for patients with a previous diagnosis of schizophrenia, depression, anxiety, bipolar or personality disorder. The role of antidepressants, antipsychotics and social deprivation in these associations was also investigated. The age at detection of cardiovascular risk factor was compared between patients with and without psychiatric disorders. Variables, for exposures and outcomes, defined from general practitioners records, were analysed using multivariate regression.
Results
Patients with psychiatric disorders had an increased risk for cardiovascular risk factors, especially diabetes, with hazard ratios: 2.42 (2.20–2.67) to 1.31 (1.25–1.37), hyperlipidemia, with hazard ratios: 1.78 (1.60–1.97) to 1.25 (1.23–1.28), and obesity. Antidepressants, antipsychotics and social deprivation did not change these associations, except for smoking and physical inactivity. Antidepressants were associated with higher risk of diabetes, hypertension and hyperlipidemia. Antipsychotics were associated with a higher risk of diabetes. Antidepressants and antipsychotics were associated with lower risk of other risk factors. Patients with psychiatric conditions have later detection of cardiovascular risk factors. The interpretation of these results should acknowledge the lower rates of detection of risk factors in mentally ill patients.
Conclusions
Cardiovascular risk factors require special clinical attention among patients with psychiatric disorders. Further research could study the effect of antidepressants and antipsychotics on cardiovascular risk factors.
Ample amount of data suggests role of REM sleep deprivation as the cause and effect of mania. In the present model, we have tried to implement behavioral sensitization to sleep deprivation, conditions mimicking natural circumstances, so as to produce an animal model with symptomatology resembling very close to human mania. Pre-clinical and clinical studies have shown that mania is often co-morbid with multiple sclerosis, therefore we sought to find out whether myelin integrity is disrupted and if lithium could protect against such damage.
Objectives
(1) To analyse mania-like behavior after REM sleep deprivation. (2) To analyse any damage to myelin under TEM.
Aims
We wanted to see if there could be any damage to myelin after behavioral sensitization to stress.
Methods
Rats were sleep deprived by classical flowerpot or platform method. OFT was performed to assess behavior of rats. The analysis was performed over 5 min, separated into 5 bins of 1 min each. Behavioral scores included total square entries, inner square entries, time spent in center, rearing frequency, time spent rearing, number of grooming bouts, time spent grooming defecation and time spent still. TEM was performed to study changes in myelination in two distinct regions of brain, DG and VTA.
Results
It was observed that the REM sleep deprived rats had mania like symptoms. REM sleep deprivation lead to demyelination in DG and VTA. Lithium treatment restored myelination per se.
Conclusions
The result suggests the involvement of myelin damage in the pathogenesis of mania, Li offers protection against such damage.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
We present a combined experimental and numerical study of an idealized model of the propulsive stroke of the turning manoeuvre in fish. Specifically, we use the framework of Lagrangian coherent structures (LCSs) to describe the kinematics of the flow that results from a thin plate performing a large angle rotation about its tip in still fluid. Temporally and spatially well-resolved velocity fields are obtained using a two-dimensional, incompressible finite-volume solver, and are validated by comparisons with experimentally measured velocity fields and alternate numerical simulations. We then implement the recently proposed variational theory of LCSs to extract the hyperbolic and elliptic LCSs in the numerically generated velocity fields. Detailed LCS analysis is performed for a plate motion profile described by $\dot{\unicode[STIX]{x1D703}}(t)=\unicode[STIX]{x1D6FA}_{max}\sin ^{2}(\unicode[STIX]{x1D714}t)$ during $0\leqslant t\leqslant t_{o}$ and zero otherwise. The stopping time $t_{o}$ is given by $t_{o}=\unicode[STIX]{x03C0}/\unicode[STIX]{x1D714}=10~\text{s}$, the value of $\unicode[STIX]{x1D6FA}_{max}$ chosen to give a stopping angle of $\unicode[STIX]{x1D703}_{max}=90^{\circ }$, resulting in a Reynolds number $Re=c^{2}\unicode[STIX]{x1D6FA}_{max}/\unicode[STIX]{x1D708}=785.4$, where $c$ is the plate chord length and $\unicode[STIX]{x1D708}=10^{-6}~\text{m}^{2}~\text{s}^{-1}$ the kinematic viscosity of water. The flow comprises a starting and a stopping vortex, resulting in a pair of oppositely signed vortices of unequal strengths that move away from the plate in a direction closely aligned with the final plate orientation at $t/t_{o}\approx 2$. The hyperbolic LCSs are shown to encompass the fluid material that is advected away from the plate for $t>t_{o}$, henceforth referred to as the advected bulk. The starting and stopping vortices, identified using elliptic LCSs and hence more objective than Eulerian vortex detection methods, constitute only around two thirds of the advected bulk area. The advected bulk is traced back to $t=0$ to identify five distinct lobes of fluid that eventually form the advected bulk, and hence map the long-term fate of various regions in the fluid at $t=0$. The five different lobes of fluid are then shown to be delineated by repelling LCS boundaries at $t=0$. The linear momentum of the advected bulk region is shown to account for approximately half of the total impulse experienced by the plate in the direction of its final orientation, thus establishing its dynamical significance. We provide direct experimental evidence for the kinematic relevance of hyperbolic and elliptic LCSs using novel dye visualization experiments, and also show that attracting hyperbolic LCSs provide objective characterization of the spiral structures often observed in vortical flows. We conclude by showing that qualitatively similar LCSs persist for several other plate motion profiles and stopping angles as well.
Childhood varicella vaccination has not yet been introduced in the UK. To inform decision-making about future vaccine programmes, data on the burden of varicella in general practice over a 10-year period (01/01/2005–31/12/2014) was calculated by age and ethnicity, using anonymised data from >8 million individuals in the Clinical Practice Research Datalink. Varicella consultations peaked at 20 603 in 2007, then decreased annually in all age groups to 11 243 in 2014. Each year, consultation rates were common among infants, were highest among 1–3 year olds (61·2 consultations/1000 person-years in 2007, 39·7/1000 person-years in 2014) and then fell with increasing age to <1·0/1000 person-years at ages ⩾20 years. Varicella acquisition appeared to be delayed in some ethnic groups, with lower consultation rates for children aged <3 years but increased rates for older children and adults aged ⩽40 years among those of black African, Afro-Caribbean, South Asian or other Asian ethnicity. Decreasing general practice consultation rates over time could reflect changes in healthcare utilisation, with patients seeking care in alternative settings such as Accident and Emergency Departments, although current data prevent full assessment of this. Availability of data on varicella diagnoses across all health settings would enable estimation of the total healthcare burden due to varicella and the cost-effectiveness of introducing varicella vaccination.
Anxiety disorders are the most common mental health problem worldwide. However, the evidence on the association between anxiety disorders and risk of stroke is limited. This systematic review and meta-analysis presents a critical appraisal and summary of the available evidence on the association between anxiety disorders and risk of stroke.
Methods
Cohort studies reporting risk of stroke among patients with anxiety disorders were searched in PubMed, Embase, PsycINFO, Scopus, and the Web of Science, from database inception to June 2016. The quality of the studies was assessed using standard criteria. A meta-analysis was undertaken to obtain pooled estimates of the risk of stroke among patients with anxiety disorders.
Results
Eight studies, including 950,759 patients, from the 11,764 references initially identified, were included in this review. A significantly increased risk of stroke for patients with anxiety disorders was observed, with an overall hazard ratio: 1.24 (1.09–1.41), P = 0.001. No significant heterogeneity between studies was detected and the funnel plot suggested that publication bias was unlikely. Limited evidence suggests that the risk of stroke is increased shortly after the diagnosis of anxiety and that risk of stroke may be higher for patients with severe anxiety.
Conclusions
Anxiety disorders are a very prevalent modifiable condition associated with risk of stroke increased by 24%. This evidence could inform the development of interventions for the management of anxiety and the prevention of stroke. Further studies on the risk of stroke in patients with anxiety, and the explanatory factors for this association, are required.
Low birth weight is associated with adverse health outcomes. If birth weight records are not available, studies may use recalled birth weight. It is unclear whether this is reliable. We performed a systematic review and meta-analysis of studies comparing recalled with recorded birth weights. We followed the Meta-Analyses of Observational Studies in Epidemiology (MOOSE) statement and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched MEDLINE, EMBASE and Cumulative Index to Nursing and Allied Health Literature (CINAHL) to May 2015. We included studies that reported recalled birth weight and recorded birth weight. We excluded studies investigating a clinical population. Two reviewers independently reviewed citations, extracted data, assessed risk of bias. Data were pooled in a random effects meta-analysis for correlation and mean difference. In total, 40 studies were eligible for qualitative synthesis (n=78,997 births from 78,196 parents). Agreement between recalled and recorded birth weight was high: pooled estimate of correlation in 23 samples from 19 studies (n=7406) was 0.90 [95% confidence interval (CI) 0.87–0.93]. The difference between recalled and recorded birth weight in 29 samples from 26 studies (n=29,293) was small [range −86–129 g; random effects estimate 1.4 g (95% CI −4.0–6.9 g)]. Studies were heterogeneous, with no evidence for an effect of time since birth, person reporting, recall bias, or birth order. In post-hoc subgroup analysis, recall was higher than recorded birth weight by 80 g (95% CI 57–103 g) in low and middle income countries. In conclusion, there is high agreement between recalled and recorded birth weight. If birth weight is recalled, it is suitable for use in epidemiological studies, at least in high income countries.
Studies have linked ethnic differences in depression rates with neighbourhood ethnic density although results have not been conclusive. We looked at this using a novel approach analysing whole population data covering just over one million GP patients in four London boroughs.
Method
Using a dataset of GP records for all patients registered in Lambeth, Hackney, Tower Hamlets and Newham in 2013 we investigated new diagnoses of depression and antidepressant use for: Indian, Pakistani, Bangladeshi, black Caribbean and black African patients. Neighbourhood effects were assessed independently of GP practice using a cross-classified multilevel model.
Results
Black and minority ethnic groups are up to four times less likely to be newly diagnosed with depression or prescribed antidepressants compared to white British patients. We found an inverse relationship between neighbourhood ethnic density and new depression diagnosis for some groups, where an increase of 10% own-ethnic density was associated with a statistically significant (p < 0.05) reduced odds of depression for Pakistani [odds ratio (OR) 0.81, 95% confidence interval (CI) 0.70–0.93], Indian (OR 0.88, CI 0.81–0.95), African (OR 0.88, CI 0.78–0.99) and Bangladeshi (OR 0.94, CI 0.90–0.99) patients. Black Caribbean patients, however, showed the opposite effect (OR 1.26, CI 1.09–1.46). The results for antidepressant use were very similar although the corresponding effect for black Caribbeans was no longer statistically significant (p = 0.07).
Conclusion
New depression diagnosis and antidepressant use was shown to be less likely in areas of higher own-ethnic density for some, but not all, ethnic groups.
To report the International Nosocomial Infection Control Consortium surveillance data from 40 hospitals (20 cities) in India 2004–2013.
METHODS
Surveillance using US National Healthcare Safety Network’s criteria and definitions, and International Nosocomial Infection Control Consortium methodology.
RESULTS
We collected data from 236,700 ICU patients for 970,713 bed-days
Pooled device-associated healthcare-associated infection rates for adult and pediatric ICUs were 5.1 central line–associated bloodstream infections (CLABSIs)/1,000 central line–days, 9.4 cases of ventilator-associated pneumonia (VAPs)/1,000 mechanical ventilator–days, and 2.1 catheter-associated urinary tract infections/1,000 urinary catheter–days
In neonatal ICUs (NICUs) pooled rates were 36.2 CLABSIs/1,000 central line–days and 1.9 VAPs/1,000 mechanical ventilator–days
Extra length of stay in adult and pediatric ICUs was 9.5 for CLABSI, 9.1 for VAP, and 10.0 for catheter-associated urinary tract infections. Extra length of stay in NICUs was 14.7 for CLABSI and 38.7 for VAP
Crude extra mortality was 16.3% for CLABSI, 22.7% for VAP, and 6.6% for catheter-associated urinary tract infections in adult and pediatric ICUs, and 1.2% for CLABSI and 8.3% for VAP in NICUs
Pooled device use ratios were 0.21 for mechanical ventilator, 0.39 for central line, and 0.53 for urinary catheter in adult and pediatric ICUs; and 0.07 for mechanical ventilator and 0.06 for central line in NICUs.
CONCLUSIONS
Despite a lower device use ratio in our ICUs, our device-associated healthcare-associated infection rates are higher than National Healthcare Safety Network, but lower than International Nosocomial Infection Control Consortium Report.
Infect. Control Hosp. Epidemiol. 2016;37(2):172–181
Stars are changing entities in a constant evolution during their lives. At non-secular time scales – from seconds to years – the effect of dynamical processes such as convection, rotation, and magnetic fields can modify the stellar oscillations. Convection excites acoustic modes in solar-like stars, while rotation and magnetic fields can perturb the oscillation frequencies, lifting the degeneracy in the azimuthal component m of the eigenfrequencies (see Chapter 9 for the case in which rotation is slow and first-order perturbative theory can be used). Moreover, the interaction between rotation, convection, and magnetic fields can produce magnetic dynamos, which sometimes yield to regular magnetic activity cycles.
In this chapter we review how stellar dynamics can be studied and explain what long-term seismic observations can bring to the understanding of this field. Thus, we show how we can study some properties of the convective time scales operating in a star like the Sun. We also compare the stratified information we can obtain on the internal (radial) differential rotation from main-sequence solar-like stars to the Sun, and to more evolved subgiants and giants. We complement this information on the internal rotation with the determination of the surface (latitudinal differential) rotation obtained directly from the lightcurves. Indeed, when stars are active there can be spots on their surfaces dimming the light emitted. When the star rotates, the emitted light will be modulated by the presence of these spots with a period corresponding to the rotation rate at the active latitudes (where the spots develop). We finally give a brief summary of stellar magnetic studies based on spectroscopic observations and then we discuss the use of seismology to better understand the stellar magnetism of solar-like stars and the existence of possible magnetic cycles. We conclude this chapter by discussing the seismology of fast rotating stars and, from a theoretical point of view, what are the current challenges to infer properties of the internal structure and dynamics of intermediate-and high-mass stars.
To study consumer knowledge and use of food labels.
Design
A cross-sectional study employing both quantitative and qualitative methods. Intercept interviews were conducted with 1832 consumers at supermarket sites selected using a stratified random sampling procedure. This information was triangulated with twenty-one focus group discussions.
Setting
New Delhi and Hyderabad, two metro-cities from north and south India.
While the national urban literacy rate is 84 %, about 99 % of the study participants were educated. About 45 % reported that they buy pre-packaged foods once weekly and about a fifth buy them every day. Taste, quality, convenience and ease of use are the main reasons for buying pre-packaged foods. Although 90 % of consumers across the age groups read food labels, the majority (81 %) looked only for the manufacturing date or expiry/best before date. Of those who read labels, only a third checked nutrition information and ingredients. Nutrient information on labels was not often read because most consumers either lacked nutrition knowledge or found the information too technical to understand. About 60 % read quality symbols. A positive association was found between education level and checking various aspects of food labels. Women and girls concerned about ‘fat’ and ‘sugar’ intake read the nutrition facts panel.
Conclusions
The intention of promoting healthy food choices through use of food labels is not being completely met. Since a majority of people found it difficult to comprehend nutrition information, there is a need to take up educational activities and/or introduce new forms of labelling.
The dynamo process is believed to drive the magnetic activity of stars like the Sun that have an outer convection zone. Large spectroscopic surveys showed that there is a relation between the rotation periods and the cycle periods: the longer the rotation period is, the longer the magnetic activity cycle period will be. We present the analysis of F stars observed by Kepler for which individual p modes have been measure and with surface rotation periods shorter than 12 days. We defined magnetic indicators and proxies based on photometric observations to help characterise the activity levels of the stars. With the Kepler data, we investigate the existence of stars with cycles (regular or not), stars with a modulation that could be related to magnetic activity, and stars that seem to show a flat behaviour.
Brodifacoum was evaluated in the laboratory against the two gerbils, Tatera indica and Meriones hurrianae and the house rat, Rattus rattus. The acute oral LD50 for these rodents was found to be 0·10 mg/kg, 0·083 mg/kg and 0·77 mg/kg respectively. Feeding tests with 0·002% and 0·005% brodifacoum produced a 100% mortality after a 3-day feeding period in the gerbils and after a 4-day period in R. rattus. The anticoagulant is toxic at both the concentrations to all three species but is less palatable in comparison to plain baits. Results of this laboratory evaluation indicates that 0·002% brodifacoum-treated bait can be effectively used against T. indica, M. hurrianae and R. rattus.
To report an unusual case of pseudoaneurysm formation following ingestion of a thin wire.
Method:
Case report, including management, and review of the world literature concerning pseudoaneurysm and its management.
Results:
A 15-year-old boy presented as an emergency with a two-week history of painful swallowing, and a one-week history of a progressively enlarging, right-sided swelling of the lower neck. A foreign body had been ingested two weeks previously. Radiological investigation showed a pseudoaneurysm of the right common carotid artery. The neck was explored, the foreign body removed and the common carotid artery repaired. The patient was discharged on the 10th post-operative day without neurovascular complication.
Conclusion:
This is an unusual presentation of pseudoaneurysm of the common carotid artery following accidental ingestion of a foreign body, reported for its rarity and management.
Individually caged northern palm squirrels, Funambulus pennanti, were fed with bait containing 0·025% warfarin or fumarin, 0·0075% chlorophacinone or 0·005% brodifacoum for a fixed number of days varying from 1 to 14. Brodifacoum (WBA 8119) was found most toxic since 66% and 70% of the animals died after one and two days' feeding respectively. Chlorophacinone killed 70% of the squirrels after three days' feeding. Squirrels were relatively tolerant to warfarin and fumarin since the mortality after a period of 14 days' feeding was only 58% and 75% respectively.
A house to house survey was done from October 1972 to March 1974, covering 52952 individuals of urban population at Lucknow and 50156 individuals of rural population of Unnao district, to find out the incidence of polio-like paralysis in our population. Among 12874 urban children up to 8 years old 8·2/1000 had polio-like paralysis while 4·6/1000 children of the rural population of 13554 children were affected. The incidence was significantly higher in the urban population. In the preschool age group almost 1 out of every 100 children was affected. A higher number of children were affected during 1968–9 and 1971–2, though it did not reach epidemic proportion. The findings show that paralytic polio is a serious problem in our country where poliomyelitis is endemic: this is contrary to the views generally held so far.
In the present study rubella HI antibodies were determined in cases of congenital malformation and bad obstetric history to determine the role of rubella in such cases in India, as it has been reported to be rare in Japan in contrast to Western countries. The incidence of antibodies was statistically significant in cases of congenital eye, c.n.s., visceral and miscellaneous malformations and cases of spontaneous abortion and still-birth compared with controls of matching age groups. This is further supported by the demonstration of IgM antibodies in seven cases of congenital malformations and ten cases of spontaneous abortion. Our findings show that congenital rubella is not rare in India.
To compare the procedure, results and complications of conventional septoplasty with those of endoscopic septoplasty, in cases of limited septal deviation and septal spurs.
We included in the study 80 patients presenting with limited septal deviation, septal spur with nasal obstruction, or deviated septum with septal correction was required in order to access the ostio-meatal complex (OMC) for functional endoscopic sinus surgery. Of these 12 were children with septal deviation producing significant nasal obstruction. All patients were divided into two groups- with one undergoing conventional and the other endoscopic septoplasty. Post-operative assessment was carried out one month, three months and one to two years after the procedure.
Result:
Post-operative complications such as haemorrhage, infraorbital oedema, nasal pain and in-patient hospital was slightly more in the conventional septoplasty group.
Conclusion:
No statistically significant difference was found between the conventional and endoscopic septoplasty groups, as assessed by subjective and objective evaluation.