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Using direct numerical simulation of hydrodynamic turbulence with helicity forcing applied at all scales, a near-maximum helical turbulent state is obtained, with an inverse energy cascade at scales larger than the energy forcing scale and a forward helicity cascade at scales smaller than the energy forcing scale. In contrast to previous studies using decimated triads, our simulations contain all possible triads. By computing the shell-to-shell energy fluxes, we show that the inverse energy cascade results from weakly non-local interactions among homochiral triads. Varying the helicity injection range of scales leads to necessary conditions to obtain an inverse energy cascade.
Background: Increasing Emergency Department (ED) stretcher occupancy with admitted patients at our tertiary care hospital has contributed to long Physician Initial Assessment (PIA) times. As of Oct 2019, median PIA was 2.3 hours and 90th percentile PIA was 5.3 hours, with a consequent 71/74 PIA ranking compared to all Ontario EDs. Ambulatory zone (AZ) models are more commonly used in community EDs compared to tertiary level EDs. An interdisciplinary team trialled an AZ model for five days in our ED to improve PIA times. Aim Statement: We sought to decrease the median PIA for patients in our ED during the AZ trial period as compared to days with similar occupancy and volume. Measures & Design: The AZ was reserved for patients who could walk from a chair to stretcher. In this zone, ED rooms with stretchers were for patient assessment only; when waiting for results or receiving treatment, patients were moved into chairs. We removed nursing assignment ratios to increase patient flow. Our outcome measure was the median PIA for all patients in our ED. Our balancing measure was the 90th percentile PIA, which could increase if we negatively impacted patients who require stretchers. The median and 90th percentile PIA during the AZ trial were compared to similar occupancy and volume days without the AZ. Additional measures included ED Length of Stay (LOS) for non-admitted patients, and patients who leave without being seen (LWBS). Clinicians and patients provided qualitative feedback through surveys. Evaluation/Results: The median PIA during the AZ trial was 1.5 hours, compared to 2.1 hours during control days. Our balancing measure, the 90th percentile PIA was 3.7 hours, compared to 5.0 during control days. A run chart revealed both median and 90th percentile PIA during the trial were at their lowest points over the past 18 months. The number of LWBS patients decreased during the trial; EDLOS did not change. The majority of patients, nurses, and physicians felt the trial could be implemented permanently. Discussion/Impact: Although our highly specialized tertiary care hospital faces unique challenges and high occupancy pressures, a community-hospital style AZ model was successful in improving PIA. Shorter PIA times can improve other quality metrics, such as timeliness of analgesia and antibiotics. We are working to optimize the model based on feedback before we cycle another trial. Our findings suggest that other tertiary care EDs should consider similar AZ models.
To assess the role of white-tailed deer (Odocoileus virginianus, WTD) in the epidemiology of toxoplasmosis, we conducted a national survey of WTD across the USA for Toxoplasma gondii infection. To do this, we combined serology with parasite isolation to evaluate the prevalence and genetic diversity of T. gondii in this game species. From October 2012 to March 2019, serum and tissues were collected from 914 WTD across the USA. Serum samples were screened for antibodies to T. gondii, and then the tissues of seropositive WTD were bioassayed in mice. Antibodies were detected in 329 (36%) of 914 WTD tested by the modified agglutination test (positive reaction at 1:25 or higher). Viable T. gondii was isolated from the heart of 36 WTD from 11 states. Three of the 36 isolates were pathogenic but not highly virulent to outbred Swiss Webster mice and all 36 isolates could be propagated further in cell culture and were genotyped. For genotyping, DNA extracted from cell culture-derived tachyzoites was characterized by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) using the genetic markers SAG1, SAG2, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1 and Apico. Genotyping revealed seven ToxoDB PCR-RFLP genotypes, including 24 isolates for genotype #5 (haplogroup 12), four isolates for #2 (type III, haplogroup 3), three isolates for genotypes #1 (type II, haplogroup 2), two isolates for genotypes #3 (type II, haplogroup 2) and one isolate each for #39, #221 and #224. Genotype #5 was the most frequently isolated, accounting for 66.6% (24 of 36) of the isolates. Combining the 36 isolates from this study with previously reported 69 isolates from WTD, 15 genotypes have been identified. Among these, 50.4% (53/105) isolates belong to genotype #5. Our results indicate moderate genetic diversity of T. gondii in WTD. The results also indicate that undercooked venison should not be consumed by humans or fed to cats.
is a smooth bounded domain in
. This work generalizes the well-known works on the Lyapunov inequality for extremal Pucci’s equations with gradient nonlinearity.
For the first time in the literature, experimental determination of entire sets of exact interdiffusion coefficients in quaternary and quinary alloy systems is reported. Using the method of body-diagonal diffusion couple, a set of nine quaternary interdiffusion coefficients were evaluated in Fe–Ni–Co–Cr and a set of sixteen quinary interdiffusion coefficients were determined in a Fe–Ni–Co–Cr–Mn system, both at approximately equimolar compositions. Regions of uphill interdiffusion and zero flux planes were observed for nickel and cobalt in quinary couples, indicating the existence of strong diffusional interactions in Fe–Ni–Co–Cr–Mn alloys. The strong diffusional interactions were also manifested in the large magnitudes of cross coefficients in both the systems. The existence of strong diffusional interactions in high-entropy alloys (HEAs) as observed through experimentally determined interdiffusion coefficients in this study establishes beyond doubt the fact that cross interdiffusion coefficients cannot be ignored in HEAs.
A growing number of studies have tested the association between intimate partner violence (IPV) and the unintendedness of pregnancy or birth, and most have suggested that unintendedness of pregnancy is a cause of IPV. However, about nine in every ten women face violence after delivering their first baby. This study examined the effects of the intendedness of births on physical IPV using data from the National Family Health Survey (2015–16). The multivariate logistic regression model analysis found that, compared with women with no unwanted births (2.9%), physical IPV was higher among those women who had unwanted births (6.9%, p<0.001), followed by those who had mistimed births (4.4 %, p<0.001), even after adjusting for several women’s individual and socioeconomic characteristics. Thus, the reduction of women with mistimed and unwanted births could reduce physical IPV in India. The study highlights the unfinished agenda of family planning in the country and argues for the need to integrate family planning and Reproductive, Maternal and Child Health Care (RMNCH) services to yield multi-sectoral outcomes, including the elimination of IPV.
Data-driven materials design informed by legacy data-sets can enable the education of a new workforce, promote openness of the scientific process in the community, and advance our physical understanding of complex material systems. The performance of structural materials, which are controlled by competing factors of composition, grain size, particle size/distribution, residual strain, cannot be modelled with single-mechanism physics. The design of optimal processing route must account for the coupled nature of the creation of such factors, and requires students to learn machine learning and statistical modelling principles not taught in the conventional undergraduate or graduate level Materials Science and Engineering curricula. Therefore, modified curricula with opportunities for experiential learning are paramount for workforce development. Projects with real-world data provide an opportunity for students to establish fluency in the iterative steps needed to solve relevant scientific and engineering process design questions.
Neonatal aortic thrombosis is a rare occurrence but can be life-threatening. Most aortic thrombosis in neonates is related to umbilical artery catheters. A case of a neonate with a spontaneous aortic thrombosis is described here along with a comprehensive review of the literature for cases of neonatal aortic thrombosis not related to any intravascular device or procedure. The aetiologies of these spontaneous thromboses and the relevance of hypercoagulable disorders are discussed. The cases were analysed for odds of death by treatment method adjusted for era. The reference treatment method was thrombolysis and anticoagulation. No other treatment modality had significantly lower odds than the reference. Surgery alone had higher odds for death than the reference, but this may be confounded by severity of case. The management recommendations for clinicians encountering neonates with spontaneous neonatal aortic thrombosis are discussed.
Shock–shock interaction structures and a newly discovered dynamic instability in granular streams resulting from such interactions are presented. Shock waves are generated by placing two similar triangular wedges in a gravity-driven granular stream. When the shock waves interact, grains collapse near the centre region of the wedges and a slow-moving concentrated diamond-shaped streak of grains is formed that grows as the inclination of the channel is increased. The diamond streak, under certain geometric conditions, is found to become unstable and start oscillating in the direction transverse to the mainstream. When the wedges are placed too close to each other, the granular flux of the incoming stream is unable to pass through the small gap, resulting in the formation of a single bow shock enveloping both the wedges. Experiments are performed for a wide range of flow speeds, wedge angles and wedge separations to investigate the interaction zone. We discuss a possible mechanism for the formation of the central streak and the associated dynamic instability observed for specific physical parameters.
While the burden of dementia is increasing in low- and middle-income countries, there is a low rate of diagnosis and paucity of research in these regions. A major challenge to study dementia is the limited availability of standardised diagnostic tools for use in populations with linguistic and educational diversity. The objectives of the study were to develop a standardised and comprehensive neurocognitive test battery to diagnose dementia and mild cognitive impairment (MCI) due to varied etiologies, across different languages and educational levels in India, to facilitate research efforts in diverse settings.
A multidisciplinary expert group formed by Indian Council of Medical Research (ICMR) collaborated towards adapting and validating a neurocognitive test battery, that is, the ICMR Neurocognitive Tool Box (ICMR-NCTB) in five Indian languages (Hindi, Bengali, Telugu, Kannada, and Malayalam), for illiterates and literates, to standardise diagnosis of dementia and MCI in India.
Following a review of existing international and national efforts at standardising dementia diagnosis, the ICMR-NCTB was developed and adapted to the Indian setting of sociolinguistic diversity. The battery consisted of tests of cognition, behaviour, and functional activities. A uniform protocol for diagnosis of normal cognition, MCI, and dementia due to neurodegenerative diseases and stroke was followed in six centres. A systematic plan for validating the ICMR-NCTB and establishing cut-off values in a diverse multicentric cohort was developed.
A key outcome was the development of a comprehensive diagnostic tool for diagnosis of dementia and MCI due to varied etiologies, in the diverse socio-demographic setting of India.
Feral swine are known reservoirs of various pathogens, including Toxoplasma gondii. Here, we report the first national survey of viable T. gondii in feral swine in the USA. We paired serological surveys with parasite isolation and bioassay to evaluate the prevalence and genetic diversity of these parasites. From 2012–2017, sera and tissues from 1517 feral swine across the USA were collected for the isolation of viable T. gondii. Serum samples were initially screened for antibodies to T. gondii, and then the tissues of seropositive feral swine were bioassayed in mice. Antibodies were detected in 27.7% of feral swine tested by the modified agglutination test (1:25 or higher). Antibody positive rates increased significantly with age, with 10.1% of juveniles, 16.0% of sub-adults and 38.4% of adults testing seropositive. Myocardium (50 g) from 232 seropositive feral swine was digested in pepsin and bioassayed in mice. Viable T. gondii was isolated from 78 feral swine from 21 states. Twelve of the 78 isolates were pathogenic to outbred Swiss Webster mice and 76 of the 78 isolates could be propagated further in cell culture and were genotyped. For genotyping, deoxyribonucleic acid extracted from cell culture-derived tachyzoites was characterized by polymerase chain reaction restriction fragment length polymorphism using the genetic markers SAG1, SAG2, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1 and Apico. Genotyping revealed 15 ToxoDB genotypes, including 43 isolates for genotype #5 (haplogroup 12), 11 isolates for #24, four isolates for #2 (haplogroup 3), two isolates for each of genotypes #3 (haplogroup 2), #4 (haplogroup 12), #216, #221, #289 and #297 and one isolate for each of genotypes #1 (haplogroup 2), #39, #66, #260, #261 and #299. Genotype #5 was the most frequently isolated, accounted for 57% (43/76) of the isolates, followed by #24, accounted for 14% (11/76). Genotypes #260, #289, #297 and #299 are new types. Genotype #289 was highly virulent to mice and originated from feral swine collected in Louisiana on the same day at the same location. Genotype #216 was previously demonstrated to be highly virulent to mice. Our results indicate moderate genetic diversity of T. gondii in feral swine in the USA, with the genotype #5 (haplogroup 12) dominant in the continental USA, whereas genotype #24 (10/14) was dominant in Hawaii, suggesting different population structures of the parasites among the two distinct geographical locations.
Natural swimmers rely for their survival on sensors that gather information from the environment and guide their actions. The spatial organization of these sensors, such as the visual fish system and lateral line, suggests evolutionary selection, but their optimality remains an open question. Here, we identify sensor configurations that enable swimmers to maximize the information gathered from their surrounding flow field. We examine two-dimensional, self-propelled and stationary swimmers that are exposed to disturbances generated by oscillating, rotating and D-shaped cylinders. We combine simulations of the Navier–Stokes equations with Bayesian experimental design to determine the optimal arrangements of shear and pressure sensors that best identify the locations of the disturbance-generating sources. We find a marked tendency for shear stress sensors to be located in the head and the tail of the swimmer, while they are absent from the midsection. In turn, we find a high density of pressure sensors in the head along with a uniform distribution along the entire body. The resulting optimal sensor arrangements resemble neuromast distributions observed in fish and provide evidence for optimality in sensor distribution for natural swimmers.
Multifunctional materials with excellent biocompatibility and electron-transport properties are critical for the pursuit of point-of-care biosensing devices. The authors report the synthesis of zinc oxide–reduced graphene oxide (ZnO–rGO) nanocomposite for the fabrication of an electrochemical immunosensing test-bed for noninvasive onsite detection of oral cancer biomarker (interleukin-8, IL8). The immunosensor showed successful detection of IL8 at low concentration ranges, i.e., 100 fg/mL–5 ng/mL with a sensitivity of 12.46 ± 0.82 µA mL/ng and a detection limit of 51.53 ± 0.43 pg/mL. These results have been validated through in vitro investigations using real saliva samples spiked with IL8.
In hydrodynamic and MHD (magnetohydrodynamic) turbulence, formal expressions for the transfer rates rely on integrals over wavenumber triads
. As an example
denotes the kinetic energy transfer rate to the mode
, from the two other modes in the triad,
. However as noted by Kraichnan (Phys. Rev., vol. 111, 1958, pp. 1747–1747), in
, what fraction of the energy transferred to the mode
and which from
is unknown. Such an expression is thus incongruent with the customary description of turbulence in terms of two-scale energy exchange. Notwithstanding this issue, Dar et al. (Physica D, vol. 157 (3), 2001, pp. 207–225) further decomposed these transfers into separate contributions from
, thus introducing the concept of mode-to-mode transfers that they applied to MHD turbulence. Doing so, they had to set aside additional transfers circulating within each triad, but failed to calculate them. In the present paper we explain how to derive the complete expressions of the mode-to-mode transfers, including the circulating transfers. We do it for kinetic energy and kinetic helicity in hydrodynamic turbulence, for kinetic energy, magnetic energy and magnetic helicity in MHD turbulence. We find that the degree of non-uniqueness of the energy transfers derived from the induction equation is a priori higher than the one derived from the Navier–Stokes equations. However, separating the contribution of magnetic advection from magnetic stretching, the energy mode-to-mode transfer rates involving the magnetic field become uniquely defined, in striking contrast to the hydrodynamic case. The magnetic helicity mode-to-mode transfer rate is also found to be uniquely defined, contrary to kinetic helicity in hydrodynamics. We find that shell-to-shell transfer rates have the same properties as mode-to-mode transfer rates. Finally calculating the fluxes, we show how the circulating transfers cancel in accordance with conservation laws.
The research paper addresses the problem of estimating aerodynamic parameters using a Gauss-Newton-based optimisation method. The process of the optimisation method lies on the principle of minimising the residual error between the measured and simulated responses of the system. Usually, the simulated response is obtained by integrating the dynamic equations of the system, which is found to be susceptible to the initial values, and the integration method. With the advent of the feedforward neural network, the data-driven regression methods have been widely used for identification of the system. Among them, a variant of feedforward neural network, extreme learning machine, which has proven the performance in terms of computational cost, generalisation, and so forth, has been addressed to predict the responses in the present study. The real flight data of longitudinal and lateral-directional motion have been considered to estimate their respective aerodynamic parameters. Furthermore, the estimates have been validated with the values of the classical estimation methods, such as the equation-error and filter-error methods. The sample standard deviations of the estimates demonstrate the effectiveness of the proposed method. Lastly, the proof-of-match exercise has been conducted with the other set of flight data to validate the estimated parameters.
In this paper, an electromagnetic band gap (EBG) metasurface (MS) superstrate-based circularly polarized antenna for the WiMAX (3.5 GHz) band is proposed. The proposed structure comprises a 2 × 2 slot-loaded rectangular patch MS array that can be perceived as a polarization-dependent EBG MS superstrate. Furthermore, to achieve circular polarization, the proposed antenna has an inclined coupling slot onto the ground with a conventional coplanar waveguide feed line. The proposed antenna has a compact structure with a low profile of 0.037λ0 (λ0 stands for the free-space wavelength at 3.48 GHz) and a ground size of 30 × 30 mm2. The measured results show that the −10 dB impedance bandwidth for the proposed antenna is 34.6% and the 3-dB axial ratio (AR) bandwidth is 6.8% with a peak gain of 3.91 dBi in the desired operating band. Good agreement between the simulated and the measured results verifies the performance of the proposed antenna.
Chemically modified polymer coatings have been synthesized using a blend of soft polymeric material polydimethylsiloxane (h-PDMS) incorporated with stiff polymer epoxy resin (EP) and was cross-linked using silane compatibilizer 3-aminopropyltriethoxysilane (APTES). A comparative analysis has been carried out between neat epoxy coating (N-EP) and epoxy–hydroxy-terminated polydimethylsiloxane (EP-hPD) blends to study the influence of blending ratio on various properties to cater marine applications. An increase of 144.4% in the Young’s modulus (E) and 37.5% increment in adhesion strength at 30 wt% h-PDMS content was observed as compared with N-EP. The water contact angle results demonstrated a substantial increase in contact angle from 52.3° to 90.1° at 30 wt% h-PDMS content as compared to N-EP. Taber abrasion results revealed a decrease in weight loss (mg/1000 cycles) by 24.1 and 17.7% at 10 and 30 wt% loading of h-PDMS in comparison to N-EP. The surface roughness of N-EP and 30 wt% EP-hPD blend were found to be 33.4 nm and 41.4 nm, respectively. To determine the applicability of the developed blend coatings obligatory tests such as field immersion study and chemical resistance evaluation were conducted, and optimum performance was manifested by EP-hPD blend at an EP:h-PDMS ratio of 70:30.
According to the celebrated Bolgiano–Obukhov (Bolgiano, J. Geophys. Res., vol. 64 (12), 1959, pp. 2226–2229; Obukhov, Dokl. Akad. Nauk SSSR, vol. 125, 1959, p. 1246) phenomenology for moderately stably stratified turbulence, the energy spectrum in the inertial range shows a dual scaling: the kinetic energy follows (i)
, and (ii)
is the Bolgiano wavenumber. The
scaling, akin to passive scalar turbulence, is a direct consequence of the assumption that buoyancy is insignificant for
. We revisit this assumption, and using the constancy of kinetic and potential energy fluxes and simple theoretical analysis, we find that the
spectrum is absent. This is because the velocity field at small scales is too weak to establish a constant kinetic energy flux as in passive scalar turbulence. A quantitative condition for the existence of the second regime is also derived in the paper.
Infants with single ventricle physiology have arterial oxygen saturations between 75 and 85%. Home monitoring with daily pulse oximetry is associated with improved interstage survival. They are typically sent home with expensive, bulky, hospital-grade pulse oximeters. This study evaluates the accuracy of both the currently used Masimo LNCS and a relatively inexpensive, portable, and equipped with Bluetooth technology study device, by comparing with the gold standard co-oximeter.
Prospective, observational study.
Single institution, paediatric cardiac critical care unit, and neonatal ICU.
Twenty-four infants under 12 months of age with baseline oxygen saturation less than 90% due to cyanotic CHD.
Measurements and Results:
Pulse oximetry with WristOx2 3150 with infant sensors 8008 J (study device) and Masimo LCNS saturation sensor connected to a Philips monitor (hospital device) were measured simultaneously and compared to arterial oxy-haemoglobin saturation measured by co-oximetry. Statistical analysis evaluated the performances of each and compared to co-oximetry with Schuirmann’s TOST equivalence tests, with equivalence defined as an absolute difference of 5% saturation or less. Neither the study nor the hospital device met the predefined standard for equivalence when compared with co-oximetry. The study device reading was on average 4.0% higher than the co-oximeter, failing to show statistical equivalence (p = 0.16). The hospital device was 7.4% higher than the co-oximeter and also did not meet the predefined standard for equivalence (p = 0.97).
Both devices tended to overestimate oxygen saturation in this patient population when compared to the gold standard, co-oximetry. The study device is at least as accurate as the hospital device and offers the advantage of being more portable with Bluetooth technology that allows reliable, efficient data transmission. Currently FDA-approved, smaller portable pulse oximeters can be considered for use in home monitoring programmes.