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Cavitation inception and the associated flow structure in the tip region of a ducted propeller are investigated experimentally at varying advance ratios (J) using high-speed imaging and stereoscopic particle image velocimetry (SPIV) measurements in a refractive index-matched facility. At design and higher J values, inception occurs in axially aligned secondary vortices, located between the blade suction side and the tip leakage vortex (TLV), circumferentially after the trailing edge. With decreasing J, the inception shifts first to the TLV, and then along its core towards the leading edge. High-resolution SPIV data follow the evolution of TLV, tip leakage flow, near wake and several secondary vortices. Time-resolved SPIV at 30 kHz enables calculation of all three mean vorticity components, hence capturing axial vortices, and identifies the origin of flow structures. At high J values, inception occurs when quasi-axial vortices are stretched by the circumferential TLV and co-rotating secondary vortices located in the shear layer connecting the TLV to the suction side blade tip. With decreasing J, inception shifts to the TLV and towards the leading edge owing to earlier rollup and higher vortex strength, along with earlier breakup, evidenced by high core turbulence and a decrease in peak vorticity despite an increase in circulation.
Significant changes in Taiwan’s psychiatric services over recent decades include expansion of community-based clinics and implementation of the Schizophrenia Pay-for-Performance programme.
Aims
This study aimed to assess the trend of the quality of healthcare for individuals with schizophrenia, using various indicators of the treatment process and outcomes between 2010 and 2019.
Method
Individuals with schizophrenia were identified using Taiwan’s National Health Insurance claims database. The quality of healthcare for individuals with schizophrenia was assessed using treatment process and outcome indicators, including antipsychotic types, medication adherence, daily dose for antipsychotics and concurrent use of other psychotropic agents. Outcome indicators included all-cause mortality, suicide deaths, psychiatric hospitalisation, emergency department visits and employment status.
Results
Antipsychotic medication usage has shifted towards second-generation antipsychotics (SGAs) and long-acting injectable antipsychotics (LAIs), with declines in first-generation antipsychotics. The percentage of medication adherence declined, while that of individuals with an adequate daily dose increased. Concurrently, anticholinergic and benzodiazepine use decreased while antidepressant and mood stabiliser use increased. Outcome indicators showed no significant change in all-cause mortality or suicide rates over time, but there were reductions in psychiatric hospitalisations and emergency department visits. Employment rates increased overall, particularly in urban areas.
Conclusions
The quality of healthcare for individuals with schizophrenia, as measured by treatment process and outcome indicators, improved alongside changes in Taiwan’s psychiatric services; however, causality cannot be inferred from our findings. Future research should evaluate the effectiveness of psychiatric service policies and continuously monitor healthcare quality to further enhance the lives of individuals with schizophrenia.
An experimental investigation is conducted to examine the tonal noise generation and flow structures of under-expanded jets interacting with a flat plate. The study combines surface pressure, far-field noise and time-resolved Schlieren visualisations to analyse jet dynamics across a range of isentropic Mach numbers (1.1–1.44) and jet-to-plate distances ($H/D$ = 1, 1.5 and 2.5). The results reveal a distinctly non-monotonic relationship between plate height and the amplitude of screech and plate-induced tones. This behaviour is governed by the constructive and destructive interference between the direct acoustic feedback waves of the jet and those reflected from the plate surface. This interference dictates whether the inherent screech mechanism is suppressed or a new plate-induced tone is amplified. Dynamic mode decomposition and wavenumber-spectral analysis reveal that the plate interaction disrupts the balance between downstream-propagating Kelvin–Helmholtz instabilities and upstream-travelling acoustic waves, fundamentally altering the jet’s resonant feedback loops. A key contribution of this work is the establishment of a direct link between flow dynamics and acoustics through advanced statistical analysis. It is shown that the plate installation asymmetrically amplifies the energy of coherent structures within the jet’s lower shear layer. Crucially, the energy content of these dominant shear-layer structures is found to be the primary driver of the far-field tonal noise magnitude. These findings provide a deeper understanding of the complex coupling between flow and acoustics in installed supersonic jets and offer refined guidance for the development of noise mitigation strategies.
In this article, I center substantial improvement in subnational democracy in the U.S. states as an object of inquiry and seek to explain it. I theorize that strong unions, high Democratic Party control of state government, an especially liberal Democratic Party, a large population of people of color, and a particularly liberal public mood may each contribute to substantial improvement in democratic quality. Using Coincidence Analysis (CNA), a configurational causal method, I assess the evidence for my hypotheses. The CNA identifies three alternative paths to substantial improvement in electoral democracy in the states. The results of my analysis highlight that substantial improvement in electoral democracy is the product of political struggle centrally involving unions and the Democratic Party.
The present experiments investigated the combustion dynamics of single and coaxial laminar diffusion flames within a closed cylindrical acoustic waveguide, focusing on their response to acoustic forcing at a pressure antinode. Nine alternative fuel injectors were used to examine the effect of injector jet diameter and configuration, tube wall thickness, annular-to-inner area and velocity ratio, and jet Reynolds number (below 100) on flame behaviour under different applied frequencies and pressure perturbation amplitudes. Fundamental flame–acoustic coupling phenomena were identified, all of which involved symmetric flame perturbations. These included sustained oscillatory combustion (SOC), multi-frequency periodic liftoff and reattachment (PLOR), permanent flame lift-off (PFLO) with low-level oscillations, and flame blowoff (BO). The phase lag between acoustic forcing and flame response was quantified, providing valuable insights into the coupling dynamics and transition behaviours. Findings revealed how various geometrical and flow characteristics could affect flame stability and resistance to blowoff, even under similar acoustic forcing conditions. Analysis of high-speed spatiotemporal visible imaging using proper orthogonal decomposition (POD) uncovered additional distinct phase portraits and spectral signatures associated with instability transitions, which, coupled with specific dynamical characteristics, enabled new insights into the relevance of injector geometrical characteristics and flow conditions in addressing acoustically coupled combustion instabilities.
This study presents a conceptual replication of Jacob et al.’s (2018) comparison of L2 early-stage processing of derived vs. inflected words. Previous studies on this issue focused predominantly on L2 learners from morphologically complex, alphabetic L1s, and generally showed L2 decompositional processing of derived but not inflected words. This replication study examined whether the previous claim for a qualitative difference in L2 early-stage processing of derived and inflected words could generalize to L2 English learners from a morphologically isolating, logographic L1, i.e., Chinese learners of L2 English. Results from a masked priming lexical decision task showed qualitatively the same magnitude of priming in the derivational, inflectional, and form control conditions for Chinese learners of English, suggesting reliance on surface form information in the early-stage processing of both derived and inflected words. Results of the current study add to the literature on L2 early-stage processing of derived vs. inflected words.
Iron deficiency anemia is a major health problem worldwide. Iron is an essential micronutrient in the human body; its demand increases with fetal growth and gestation. Although it has been reported that glucose metabolism is also affected by iron deficiency, only few studies have investigated the influence of iron deficiency during gestation and in offspring. In this study, glucose metabolism in newborns was investigated in terms of maternal iron deficiency prior to pregnancy in a rat model. Briefly, rats were divided into control (CL) and iron deficiency (ID) groups. The levels of serum glucose and insulin and the protein expression of liver GLUT2 in neonates born to dams in the ID group increased. In contrast, the mRNA and protein expression levels of GLUT2 and GLUT4 in the skeletal muscle tended to decrease. In addition, the expression of p-Akt (Thr308), which is involved in GLUT4 membrane translocation, decreased, suggesting that GLUT4 translocation to the plasma membrane may not have been sufficiently promoted. These results suggest that maternal iron deficiency may influence glucose metabolism in neonates and potentially increase the risk of developing metabolic abnormalities and lifestyle-related diseases later in life.
Archaeological evidence suggests that the transition to food-producing economies in the Western Valleys of northern Chile led to a decline in foraging in highland areas around AD 650, yet colonial records from the sixteenth and eighteenth centuries attest to the continued existence of foraging groups. Taking the Camarones River Basin as a test case, this study identifies small-scale settlements and hunting installations in upland areas using remote-sensing data. In considering these new data alongside ethnohistorical accounts, the author proposes that foraging endured into the late colonial era, possibly coexisting with herder and agropastoral communities and precipitating tethered settlement patterns.
While around one-fifth of UK secondary school pupils exhibit clinically significant eating pathology, in-school mental health provision does not include interventions to address such eating pathology.
Aims:
This preliminary qualitative study aimed to explore the views of staff, parents and pupils, on the idea of introducing a school-based brief cognitive behavioural therapy programme for non-underweight eating disorders.
Method:
31 pupils, 22 parents and 27 staff participated in 12 focus groups across four schools. The semi-structured interview guide covered topics around the practicalities of a potential eating disorders treatment programme, the acceptability of the intervention, and likelihood of future uptake.
Results:
Five over-arching themes and 12 subthemes emerged, reflecting the scale of eating and body image concerns, management limitations, and the importance of prioritising mental health over education. Advantages, challenges, considerations, and solutions were proposed for an in-school eating disorders treatment programme.
Conclusions:
These qualitative data show that there is support for an appropriately implemented in-school delivery of brief, evidence-based treatment, demonstrating the potential scope of such an approach to support children and adolescents to receive early help with their eating problems and body image concerns.
Beginning in the late 1820s, gymnastics for adults and children became a noted phenomenon within some Irish cities. Predominantly led by foreign gymnastic instructors, the gymnastics wave marked a specific movement of transnationalism within Irish health and education. This article considers Dublin-based gymnastic instructors and physicians, weaving together histories of medicine, gender and transnationalism. Irish children’s bodies became a site of intense focus in the early nineteenth century, and medical and health tracts concerning children’s gymnastics reveal broader fears around the impact of modernity, the deficiencies of education and the socialisation of young people. Increasingly, children’s exercise became viewed as being of utmost importance to both the development of the individual and, more importantly, to the vitality of the nation itself. This contributes significantly to the historiography of Irish childhood by focusing not just on discourses, but on the bodies they sought to mould.
Few village-born social movements have influenced international relations as much as the campaign against Myitsone Dam in Burma (Myanmar). This village-born resistance led in 2011 to the suspension of a major Burmese and Chinese infrastructure project. This suspension became a symbol of democratization in Burma and a much-discussed setback of Chinese development-investment abroad. However, research literature on the Myitsone Dam has tended to conflate the local rural resistance with the broader ethnic Kachin and Burmese anti-dam movements. In contrast, this study focuses specifically on the local villages directly affected by the project, exploring their diverse stories and responses to the mega-project. Combining diverse published sources with ethnographic fieldwork and interviews done since 2010, it tells a story of repression, resistance, social divisions, and complex relations with outsiders. This is a two-part article series. This article here – Part 1 – examines what occurred before the mega-project’s suspension. It tells the Myitsone Dam’s rural story from its earliest days until the mega-project’s fall: from 2002 to 2011. This story begins with the unexpected arrival of Japanese visitors and traces the village struggles up to the project’s dramatic downfall.
Existing guidelines on overviews of reviews and umbrella reviews recommend an assessment of the certainty of evidence, but provide limited guidance on ‘how to’ apply the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) to such a complex evidence synthesis. We share our experience of developing a ‘general principles’ approach to applying GRADE to a complex overview of reviews. The approach was developed in an iterative and exploratory manner during the planning and conduct of an overview of reviews of a novel molecular imaging technique for the staging of prostate cancer, involving a formal review by a group of 11 methodologists/health services researchers. This approach was developed during the evidence synthesis process, piloted, and then applied to our ongoing overview of reviews. A ‘general principles’ approach of applying the domains of GRADE to an overview of reviews and arriving at an overall summary judgement for each outcome is presented. Our approach details additional factors to consider, including addressing both the primary study risk of bias as assessed by the included reviews and the risk of bias of the systematic reviews themselves, as well as the statistical heterogeneity observed in meta-analyses conducted within the included reviews. Our approach distilled key principles from the relevant GRADE guidelines and allowed us to apply GRADE to a complex body of evidence in a consistent and transparent way. The approach taken and the methods used to develop our approach may inform researchers working on overviews of reviews, umbrella reviews, or future methodological guidelines.
We report detection and analysis of the largest ever low-frequency sample of Crab giant pulses (GPs) detected in frequency band 200 – 231.25 MHz. In total about ∼95000 GPs were detected, which, to our knowledge is the largest low-frequency sample of Crab GPs presented in the literature. The observations were performed between 2024-12-14 and 2025-03-31 with the Engineering Development Array 2, a prototype station of the low-frequency Square Kilometre Array telescope. The fluence distribution of GPs in the entire sample is very well characterised with a single power law N(F) ∝ Fα, where α =−3.17 ± 0.02 for all GPs, and αMP = −3.13 ± 0.02 and αIP =−3.59 ± 0.06 for GPs at the phases of the main pulse and low-requency interpulse respectively. We do not observe flattening of the fluence distribution at the higher fluences. Although, the index of the power law fluence distribution remained approximately constant over the observing period, the normalisation of the distribution was strongly anti-correlated (coefficient ≈ −0.9) with the scatter broadening time. The timescale (∼ weeks) of these variations indicates that intrinsic GP emission was modulated by the refractive scintillation as the signals propagated through the Crab Nebula and ISM. As a result, the measured fluence distribution was augmented for lower (τ ≈ 2 ms) and diminished for higher (τ ≈ 5 ms) scatter broadening time τ causing the GP detection rate to vary between 3000 and 100 per hour respectively (the correlation coefficient ≈-0.9). Furthermore, for the first time at low-frequencies we observe indications of positive correlation (correlation coefficient ≈0.7) between the scatter broadening time (τ) and dispersion measure. Our modelling favours the screen size ∼ 10−5 pc with mean electron density ∼ 400e−cm−3 located within 100 pc from the pulsar (Crab Nebula or Perseus arm of the Milky Way galaxy). The observed frequency scaling of the scattering broadening time β ≈ −3.6 ± 0.1 (where τ ∝ νβ) is in agreement with the previous measurements. The observed maximum spectral luminosities ∼ 1025 erg/Hz/s approach those of the weakest pulses from some repeating Fast Radio Bursts (FRBs). However, the distribution of pulse arrival times is consistent with a purely random Poisson process, and we do not find evidence of clustering. Overall, our results agree with the current views that GPs from extra-galactic Crab-like pulsars can be responsible for some very weak repeating FRBs, but cannot explain the entire FRB population. Finally, these results demonstrate an enormous transient science potential of individual SKA-Low stations, which can be unlocked by milli-second all-sky imaging.
Medication Use Evaluations (MUEs) are structured quality improvement tools used to optimize medication use within healthcare systems. MUEs can explore safety concerns, high costs, or inappropriate use associated with any medication, among other factors. This can offer a valuable opportunity for Antimicrobial Stewardship Programs (ASPs) to promote stewardship goals, which often overlap with these concerns for specific antimicrobials. MUEs can also provide an avenue to promote interdisciplinary collaboration with targeted groups relevant to the ASP’s goals as well as an opportunity to give trainees ownership of system-facing stewardship projects. Stewardship pharmacists may often have experience with leading this process as part of their training, but MUEs represent a gap in training for physicians. Here we provide guidance on how stewardship physicians can engage in the MUE process, from identifying relevant topics to interpreting findings and supporting implementation efforts, allowing them to contribute effectively even without prior MUE experience.
Pipeline inspection robots play a crucial role in maintaining the integrity of pipeline systems across various industries. In this paper, a novel pipeline inspection robot is designed based on a four degrees-of-freedom (DOF) generalized parallel mechanism (GPM). First, a four DOF mechanism is introduced using numerical and graph synthesis. The design employs numerical and graph synthesis methods to achieve an ideal symmetric configuration, enhancing the robot’s adaptability and mobility. The coupling mid-platform, inspired by parallelogram mechanisms, enables synchronized contraction motion, allowing the robot to adjust to different pipe diameters. Then, the constraints of the pipeline inspection robot in the elbow are analyzed based on task requirements. Through kinematic and performance analyses using screw theory, the mechanism’s feasibility in practical applications is confirmed. Theoretical analysis, simulations, and experiments demonstrate the robot’s ability to achieve active steering in T-branches and elbows. Experimental validation in straight and bent pipes shows that the robot meets the expected speed targets and can successfully navigate complex pipeline environments. This research highlights the potential of GPMs in advancing the capabilities of pipeline inspection robots for real-world applications.
George III was a family man, a modest eater, and a thoughtful ruler who wrote about the big questions of the day, from royal sovereignty to the best methods of agriculture to feed a modern nation. His writings provide a glimpse of his version of monarchy, which placed him at the head of a national family, where he embodied the habits of self-regulation and temperance in keeping with the sensibilities of late eighteenth-century manhood. This article brings together George’s meals and his essays, considering the histories of food, masculinity, and self-fashioning, to argue that George was a monarch who embodied a new form of masculinity, as marked by his agricultural interests and insistence on a modest diet. His eating habits, along with his intellectual interests and public persona, bring us to the intersection between the private man and the public monarch. Drawing on newly digitized data, alongside contemporary caricatures and descriptions, and George’s own writing, we argue that moderation was central to George’s creation of an image that appealed to the emerging British nation of the late eighteenth century; food was central to this image, highlighting both his masculine self-control and his ability to be useful to the nation.