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This study presents the design and realization of a dual-port multiple-input–multiple-output (MIMO) filtering antenna system. The device shows good response in the frequency rage 1 (4.1 to 7.125 GHZ) frequency band, which handles most of the cellular mobile communication traffic. First, the single element ultra-wideband (UWB) filtenna is designed by combining a UWB antenna and a band-reject filter (BRF) where the antenna works in the frequency range from 1 to 11 GHz and the BRF is rejecting the frequency range of 3–3.42 GHz with 3.2 GHz as its resonant frequency. Finally, the proposed two-port MIMO filtenna combines two single element UWB filtennas in antiparallel manner which shows impedance bandwidth from 2.59 to 7.1 GHz with a band notch from 3 to 3.42 GHz. The structure is built on cost-efficient FR4 substrate (εr = 4.4, tanδ = 0.02) of dimensions 0.68${{\boldsymbol{\lambda }}_{\boldsymbol{c}}}$×0.27${{\boldsymbol{\lambda }}_{\boldsymbol{c}}}$×0.01${{\boldsymbol{\lambda }}_{\boldsymbol{c}}}$ (mm3), which is compact in size and utilizes a defected ground structure for further miniaturization. The proposed design is simulated using Ansys HFSS software, and after fabrication, it is measured, and the output shows good results for the proposed application. The designed antenna system is suitable for fifth-generation (5G) wideband systems.
Previous studies have shown that patients who are readmitted to the hospital from a skilled nursing facility (SNF) have a higher mortality rate. The objective of this study is to determine factors associated with high mortality rate for older adults who require hospital readmission while on presumed short stay in SNF to trigger a goals-of-care discussion.
Methods
Retrospective study of 847 patients aged 65 and above who were discharged from 1 large urban academic medical center to multiple SNF in 2019.
Results
Charts of 847 patients admitted to SNF after an acute hospital stay were reviewed; their overall 1-year mortality rate was 28.3%. The 1-year mortality rate among individuals readmitted to the hospital within 30 days of discharge to SNF was 50%, whereas for those who did not require readmission, the rate was 22%. For the most common diagnostic categories of nervous system, and musculoskeletal, patients with readmission to hospital within 30 days of discharge to SNF had a roughly threefold higher 1-year mortality rate. Worse frailty score on hospital readmission, poor nutrition, and weight loss were the most impactful individual factors carrying a higher degree of mortality of up to 83%.
Significance of results
Hospital discharge to SNF and readmission from SNF within 30 days, further decline in functional status, and malnutrition characterize high-risk groups that should trigger care preference and prognostic discussions with patients as these events may be markers of vulnerability and are associated with high 1-year mortality rates.
V5579 Sgr was a fast nova discovered in 2008 April 18.784 UT. We present the optical spectroscopic observations of the nova observed from the Castanet Tolosan, SMARTS, and CTIO observatories spanning over 2008 April 23 to 2015 May 11. The spectra are dominated by hydrogen Balmer, Fe II, and O I lines with P-Cygni profiles in the early phase, typical of an Fe II class nova. The spectra show He I and He II lines along with forbidden lines from N, Ar, S, and O in the nebular phase. The nova showed a pronounced dust formation episode that began about 20 days after the outburst. The dust temperature and mass were estimated using the WISE data from spectral energy distribution (SED) fits. The PAH-like features are also seen in the nova ejecta in the mid-infrared Gemini spectra taken 522 d after the discovery. Analysis of the light curve indicates values of $t_2$ and $t_3$ about 9 and 13 days, respectively, placing the nova in the category of fast nova. The best-fit cloudy model of the early decline phase JHK spectra obtained on 2008 May 3 and the nebular optical spectrum obtained on 2011 June 2 shows a hot white dwarf source with $T_{BB}$$\sim$ 2.6 $\times$ 10$^5$ K having a luminosity of 9.8 $\times$ 10$^{36}$ ergs s$^{-1}$. Our abundance analysis shows that the ejecta is significantly enhanced relative to solar, O/H = 32.2, C/H = 15.5, and N/H = 40.0 in the early decline phase and O/H = 5.8, He/H = 1.5, and N/H = 22.0 in the nebular phase.
To evaluate how study characteristics and methodological aspects compare based on presence or absence of industry funding, Hughes et al. conducted a systematic survey of randomized controlled trials (RCTs) published in three major medical journals. The authors found industry-funded RCTs were more likely to be blinded, post results on a clinical trials registration database (ClinicalTrials.gov), and accrue high citation counts.1 Conversely, industry-funded trials had smaller sample sizes and more frequently used placebo as the comparator, used a surrogate as their primary outcome, and had positive results.
The objective of this prospective observational study was to assess the growth and body composition of term small-for-gestational-age (SGA) infants from birth to 6 months and evaluate the effect of catch-up growth (CUG) on body composition. Term SGA newborns were recruited at birth. Anthropometry and body composition were evaluated at 3 days, 6, 10 and 14 weeks, and 6 months. Fat and fat-free mass (FM and FFM) were compared between infants with and without CUG (increase in weight Z-score by > 0·67) by air displacement plethysmography. Factors that could affect body composition and CUG, including parents’ BMI and stature, infants’ birth weight, sex and feeding, were evaluated. A total of 143 SGA newborns (sixty-six boys) with birth weight of 2336 (sd 214) g were enrolled; 109 were followed up till 6 months. Median weight Z-score increased from −2·3 at birth to −1·3 at 6 months, with 51·9 % of infants showing CUG. Infants with CUG had higher FM (1796 (sd 491) g v. 1196 (sd 474) g, P < 0·001) but similar FFM (4969 (sd 508) g v. 4870 (sd 622) g, P = 0·380), and consequently higher FM percentage (FM%) (26·5 (sd 5·8) v. 19·7 (sd 6·9), P < 0·001), compared with those without CUG. Lower birth weight, exclusive breast-feeding and higher parental stature were positively associated with CUG. In conclusion, CUG in term SGA infants in the first 6 months of life was almost entirely attributable to greater gain in FM. Follow-up of this cohort will provide insight into the long-term effect of disproportionate gain in FM in early infancy in SGA babies.
This article proposes a framework of linked software agents that continuously interact with an underlying knowledge graph to automatically assess the impacts of potential flooding events. It builds on the idea of connected digital twins based on the World Avatar dynamic knowledge graph to create a semantically rich asset of data, knowledge, and computational capabilities accessible to humans, applications, and artificial intelligence. We develop three new ontologies to describe and link environmental measurements and their respective reporting stations, flood events, and their potential impact on population and built infrastructure as well as the built environment of a city itself. These coupled ontologies are deployed to dynamically instantiate near real-time data from multiple fragmented sources into the World Avatar. Sequences of autonomous agents connected via the derived information framework automatically assess consequences of newly instantiated data, such as newly raised flood warnings, and cascade respective updates through the graph to ensure up-to-date insights into the number of people and building stock value at risk. Although we showcase the strength of this technology in the context of flooding, our findings suggest that this system-of-systems approach is a promising solution to build holistic digital twins for various other contexts and use cases to support truly interoperable and smart cities.
Oscillatory flows have become an indispensable tool in microfluidics, inducing inertial effects for displacing and manipulating fluid-borne objects in a reliable, controllable and label-free fashion. However, the quantitative description of such effects has been confined to limit cases and specialized scenarios. Here we develop an analytical formalism yielding the equation of motion of density-mismatched spherical particles in oscillatory background flows, generalizing previous work. Inertial force terms are systematically derived from the geometry of the flow field together with analytically known Stokes number dependences. Supported by independent, first-principles direct numerical simulations, we find that these forces are important even for nearly density-matched objects such as cells or bacteria, enabling their fast displacement and separation. Our formalism thus consistently incorporates particle inertia into the Maxey–Riley equation, and in doing so provides a generalization of Auton's modification to added mass, as well as recovering the description of acoustic radiation forces on particles as a limiting case.
The interaction of focused high power laser beam with solid targets leads to acceleration of charged particles among other by non-linear effects in the plasma. In this experiment, the hot electrons are characterized from the interaction of sub-nanosecond and kilo-joule class laser pulse with thin metal foil targets (Cu, Ta, Ti, Sn, Pb). The energy distribution functions of electrons were measured by angularly resolved multichannel electron spectrometer. The hot electron temperatures were observed in range from 30 to 80 keV for laser intensities between ${\sim}10^{15}$ and $3 \times 10^{16}\ \mathrm{W\,cm^{-2}}$. The measured energy distribution and electron temperature were compared with published results and known scaling laws at higher laser intensities. For foil targets of different materials, the temperature and flux of hot electrons were scaled with target thickness in the range of 1–100 $\unicode{x03BC}\mathrm{m}$ from low Z to high Z materials where Z is the atomic number. The profile of conversion efficiency from laser energy to hot electrons is discussed in the energy range from 100 to 600 J. For the given laser and target parameters, the nonlinear behaviour of conversion efficiency and relevant physics are also described in detail.
OBJECTIVES/GOALS: Assess molecular and cellular mechanisms of allograft loss in kidney biopsies using digital spatial profiling and clinical outcomes data. METHODS/STUDY POPULATION: Patients with chronic allograft dysfunction (CGD), enrolled in the Deterioration of Kidney Allograft Function (DeKAF) study, with or without eventual allograft loss, were included. CGD was defined as a >25% increase in creatinine over 3 months relative to a baseline. Kidney biopsy tissue was assessed by Nanostring GeoMX digital spatial profiling (DSP) after staining with anti-pan-cytokeratin, anti-CD45, anti-CD68, Syto-13, to identify specific cell populations, and Nanostring’s Whole Transcriptome Atlas (WTA), to quantify the distribution of transcripts across the biopsy. Up to 14 regions of interest (ROIs) were selected, with or without glomerulus. CIBERSORT was used to perform cell deconvolution. Clinical and outcomes data were from the DeKAF study and United States Renal Data System. RESULTS/ANTICIPATED RESULTS: Macrophage (M1) cell population abundance was significantly different in ROIs with glomerulus between graft loss and no graft loss. Principle component analysis of differentially expressed genes resulted in transcriptomes in ROIs that cluster together by clinical outcome of graft loss or no graft loss. There were 203 DEGs in ROIs with glomerulus that were different by graft loss or no graft loss. By pathway analysis, these 203 DEGS were enriched in the T-cell activation, integrin signaling and inflammation pathways. DISCUSSION/SIGNIFICANCE: DSP of kidney allograft biopsies allows for the identification and quantification of specific cell types, such as macrophages and molecular transcripts as potential drug targets. This data can be used to understand mechanisms of kidney allograft loss and may lead to improved immune suppression in kidney transplant recipients.
The interface performance between clay–sand mixtures and concrete structures is governed by the mixture's composition and its physical properties. Moisture content and particle-size distribution play important roles in deciding the mixture's arrangement of soil particles, porosity, hydraulic conductivity and behaviour under various mechanical loadings. Application of a polymer interfacial coating can improve the bond performance between soils and concrete mainly via interfacial friction/mechanical interlocking. The present work analyses the development of interfacial strength between clay–sand mixtures and a polymer coating with changes in particle gradation. The multi-scale mechanisms at the interface are investigated, giving primary attention to soil porosity. A 50:50 clay–sand mixture exhibited a greater interfacial adhesive performance compared to other soil mixtures. In addition, the moisture-controlled pores and gradation-controlled pores demonstrated differences in macroscale interfacial strength. Both mercury intrusion porosimetry (MIP) and 129Xe nuclear magnetic resonance (NMR) were utilized to detect the pore structure of the mixtures. 129Xe-NMR revealed the pore distribution of the mixtures as ranging from macropores to nanopores, and MIP complemented the pore information by determining the critical pore entry diameter in the macropore regime. Mesopores dominated with increasing fine sand content until a threshold value was reached; thereafter, merging of pores occurred and macropores dominated.
Individuals with mood disorders are predisposed to metabolic dysfunction, while those with metabolic dysregulation such as diabetes and obesity experience more severe depressive symptoms. Both metabolic dysfunction and mood disorders are independently associated with cognitive deficits. Therefore, given their close association, this study aimed to explore the association between metabolic dysfunction in individuals with mood disorders in relation to cognitive outcomes. A comprehensive search comprised of these three domains was carried out; a random-effects meta-analysis pooling mean cognitive outcomes was conducted (PROSPERO ID: CRD42022295765). Sixty-three studies were included in this review; 26 were synthesized in a quantitative meta-analysis. Comorbid metabolic dysregulation was associated with significantly lower global cognition among individuals with mood disorders. These trends were significant within each mood disorder subgroup, including major depressive disorder, bipolar disorder, and self-report depression/depressive symptoms. Type 2 diabetes was associated with the lowest cognitive performance in individuals with mood disorders, followed by peripheral insulin resistance, body mass index ⩾25 kg/m2, and metabolic syndrome. Significant reduction in scores was also observed among individual cognitive domains (in descending order) of working memory, attention, executive function, processing speed, verbal memory, and visual memory. These findings demonstrate the detrimental effects of comorbid metabolic dysfunction in individuals with mood disorders. Further research is required to understand the underlying mechanisms connecting mood disorders, metabolism, and cognition.
During the first half of 2020, the difference in savings from mortgage refinancing between high- and low-income borrowers was 10 times higher than before. This was the result of two factors: high-income borrowers increased their refinancing activity more than otherwise comparable low-income borrowers and, conditional on refinancing, they captured slightly larger improvements in interest rates. Refinancing inequality increases with the severity of the COVID-19 pandemic and is characterized by an underrepresentation of low-income borrowers in the pool of applications. We estimate a difference of $5 billion in savings between the top income quintile and the rest of the market.
Caregivers are integral to health and social care systems in South Asian countries yet are themselves at higher risk of mental illness. Interventions to support caregiver mental health developed in high-income contexts may be contextually inappropriate in the Global South. In this mixed-methods study, we evaluated the implementation and scaling of a locally developed mental health group intervention for caregivers and others in Uttarakhand, India. We describe factors influencing implementation using the updated Consolidated Framework for Implementation Research, and selected implementation outcomes. Key influencing factors we found in common with other programs included: an intervention that was relevant and adaptable; family support and stigma operating in the outer setting; training and support for lay health worker providers, shared goals, and relationships with the community and the process of engaging with organisational leaders and service users within the inner setting. We identified further factors including the group delivery format, competing responsibilities for caregivers and opportunities associated with the partnership delivery model as influencing outcomes. Implementation successfully reached target communities however attrition of 20% of participants highlights the potential for improving outcomes by harnessing enablers and addressing barriers. Findings will inform others implementing group mental health and caregiver interventions in South Asia.
Seizure freedom without deficits is the primary goal for epilepsy surgery. However, patients with medically refractory epilepsy commonly suffer from many co-morbidities related to mood, cognition, and sleep as well as social problems and resultant stigma. While epilepsy surgery literature does describe quality of life (QOL) and neuropsychological outcomes, there is a paucity of information on various common non-seizure outcomes, especially pertaining to mood, sleep, cognition, and social aspects. The objective of this study was to evaluate the role of various non-seizure parameters on post-epilepsy surgery QOL.
Methods:
Consecutive adult patients operated for refractory epilepsy at least 1 year prior to initiation of this study were included and classified as seizure-free (group 1) or non-seizure-free (group 2). QOL was assessed using the QOLIE-31 instrument; patients with a T score less than 40 were categorized as “poor QOL.” Non-seizure parameters assessed were cognition, mood disturbances, social improvement, social stigma, and sleep disturbances. Categorization into “good” and “poor” outcome subgroups on each item was carried out by dichotomization of scores.
Results:
Thirty-seven patients (16 F) [mean age 23.5 ± 5.6 years] were evaluated; 26 were seizure-free (group 1). In this group, impaired memory, lower language scores, depression, not having been employed, not receiving education prior to surgery, and experiencing social stigma were factors significantly associated with poor QOL. In group 2, all patients had poor QOL scores.
Conclusion:
Non-seizure factors related to common epilepsy co-morbidities and social issues are highly prevalent among seizure-free patients reporting poor QOL after epilepsy surgery.
Adequate nutrition is necessary during childhood and early adolescence for adequate growth and development. Hence, the objective of the study was to assess the association between dietary intake and blood levels of minerals (calcium, iron, zinc, and selenium) and vitamins (folate, vitamin B12, vitamin A, and vitamin D) in urban school going children aged 6–16 years in India, in a multicentric cross-sectional study. Participants were enrolled from randomly selected schools in ten cities. Three-day food intake data was collected using a 24-h dietary recall method. The intake was dichotomised into adequate and inadequate. Blood samples were collected to assess levels of micronutrients. From April 2019 to February 2020, 2428 participants (50⋅2 % females) were recruited from 60 schools. Inadequate intake for calcium was in 93⋅4 % (246⋅5 ± 149⋅4 mg), iron 86⋅5 % (7⋅6 ± 3⋅0 mg), zinc 84⋅0 % (3⋅9 ± 2⋅4 mg), selenium 30⋅2 % (11⋅3 ± 9⋅7 mcg), folate 73⋅8 % (93⋅6 ± 55⋅4 mcg), vitamin B12 94⋅4 % (0⋅2 ± 0⋅4 mcg), vitamin A 96⋅0 % (101⋅7 ± 94⋅1 mcg), and vitamin D 100⋅0 % (0⋅4 ± 0⋅6 mcg). Controlling for sex and socioeconomic status, the odds of biochemical deficiency with inadequate intake for iron [AOR = 1⋅37 (95 % CI 1⋅07–1⋅76)], zinc [AOR = 5⋅14 (95 % CI 2⋅24–11⋅78)], selenium [AOR = 3⋅63 (95 % CI 2⋅70–4⋅89)], folate [AOR = 1⋅59 (95 % CI 1⋅25–2⋅03)], and vitamin B12 [AOR = 1⋅62 (95 %CI 1⋅07–2⋅45)]. Since there is a significant association between the inadequate intake and biochemical deficiencies of iron, zinc, selenium, folate, and vitamin B12, regular surveillance for adequacy of micronutrient intake must be undertaken to identify children at risk of deficiency, for timely intervention.
This article presents a system architecture and a set of interfaces that can build scalable information systems capable of large city modeling based on dynamic geospatial knowledge graphs to avoid pitfalls of Web 2.0 applications while blending artificial and human intelligence during the knowledge enhancement processes. We designed and developed a GeoSpatial Processor, an SQL2SPARQL Transformer, and a geospatial tiles ordering tasks and integrated them into a City Export Agent to visualize and interact with city models on an augmented 3D web client. We designed a Thematic Surface Discovery Agent to automatically upgrade the model’s level of detail to interact with thematic parts of city objects by other agents. We developed a City Information Agent to help retrieve contextual information, provide data concerning city regulations, and work with a City Energy Analyst Agent that automatically estimates the energy demands for city model members. We designed a Distance Agent to track the interactions with the model members on the web, calculate distances between objects of interest, and add new knowledge to the Cities Knowledge Graph. The logical foundations and CityGML-based conceptual schema used to describe cities in terms of the OntoCityGML ontology, together with the system of intelligent autonomous agents based on the J-Park Simulator Agent Framework, make such systems capable of assessing and maintaining ground truths with certainty. This new era of GeoWeb 2.5 systems lowers the risk of deliberate misinformation within geography web systems used for modeling critical infrastructures.
Cavitation inception in the turbulent shear layer developing behind a backward-facing step occurs at multiple points along quasi-streamwise vortices (QSVs), at a rate that increases with the Reynolds number (Re). This study investigates the evolution of the unsteady pressure field and the distribution of nuclei within and around the QSVs. The time-resolved volumetric velocity in the non-cavitating flow is measured using tomographic particle tracking, and the pressure is determined by spatial integration of the material acceleration. Analysis in Eulerian and Lagrangian reference frames reveals that the pressure is lower, and its minima last longer within the QSVs compared with the surrounding flow. The intermittent low pressure regions, whose sizes and shapes are consistent with those of the cavities, are likely to be preceded by axial vortex stretching and followed by contraction. Such phenomena have been observed before in simulations of stretched vortex elements. For the same axial straining, the pressure minima last longer with increasing Re, a trend elucidated in terms of viscous diffusion of the stretched vortex core. The impact of nuclei availability is studied under ‘natural’ and controlled seeding. Owing to differences in the saturation level of non-condensable gas, the microbubble concentration in the shear layer decreases with increasing Re, in contrast to the rate of cavitation events. Minor differences in entrainment rate into the shear layer also do not explain the substantial Re effects on cavitation inception. Hence, the Re scaling of inception appears to be dominated by trends of the pressure field.
Modelling the noise emitted by turbulent jets is made difficult by their acoustic inefficiency: only a tiny fraction of the near-field turbulent kinetic energy is propagated to the far field as acoustic waves. As a result, jet-noise models must accurately capture this small, acoustically efficient component hidden among comparatively inefficient fluctuations. In this paper, we identify this acoustically efficient near-field source from large-eddy simulation data and use it to inform a predictive model. Our approach uses the resolvent framework, in which the source takes the form of nonlinear fluctuation terms that act as a forcing on the linearised Navier–Stokes equations. First, we identify the forcing that, when acted on by the resolvent operator, produces the leading spectral proper orthogonal decomposition modes in the acoustic field for a Mach 0.4 jet. Second, the radiating components of this forcing are isolated by retaining only portions with a supersonic phase speed. This component makes up less than 0.05 % of the total forcing energy but generates most of the acoustic response, especially at peak (downstream) radiation angles. Finally, we propose an empirical model for the identified acoustically efficient forcing components. The model is tested at other Mach numbers and flight-stream conditions and predicts noise within 2 dB accuracy for a range of frequencies, downstream angles and flight conditions.
We find that mortgage loans originated after the adoption of the inevitable disclosure doctrine (IDD; a mechanism discouraging loan officers’ labor mobility) have a lower default probability, a higher loan modification rate, and a lower foreclosure rate. These effects are unaccompanied by any reduction in loan supply and contribute to more stable housing prices. Using the adoption of the Uniform Trade Secrets Act as an alternative identification generates consistent results. Overall, our findings suggest that restricting loan officers’ labor mobility leads to better ex ante screening and ex post monitoring, improving the origination efficiency for U.S. residential mortgage loans.