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The dynamics of thin volatile droplets comprising of binary mixtures deposited on a heated substrate are investigated. Using lubrication theory, we develop a novel one-sided model to predict the spreading and retraction of an evaporating sessile axisymmetric droplet formed of a volatile binary mixture on a substrate with high wettability. A thin droplet with a moving contact line is considered, taking into account the variation of liquid properties with concentration as well as the effects of inertia. The parameter space is explored and the resultant effects on wetting and evaporation are evaluated. Increasing solutal Marangoni stress enhances spreading rates in all cases, approaching those of superspreading liquids. To validate our model, experiments are conducted with binary ethanol–water droplets spreading on hydrophilic glass slides heated from below. The spreading rate is quantified, revealing that preferential evaporation of the more volatile component (ethanol) at the contact line drives superspreading, leading in some cases to a contact line instability. Good qualitative agreement is found between our model and experiments, with quantitative agreement being achieved in terms of spreading rate.
Potential effectiveness of harvest weed seed control (HWSC) systems depends upon seed shatter of the target weed species at crop maturity, enabling its collection and processing at crop harvest. However, seed retention likely is influenced by agroecological and environmental factors. In 2016 and 2017, we assessed seed shatter phenology in thirteen economically important broadleaf weed species in soybean [Glycine max (L.) Merr.] from crop physiological maturity to four weeks after physiological maturity at multiple sites spread across fourteen states in the southern, northern, and mid-Atlantic U.S. Greater proportions of seeds were retained by weeds in southern latitudes and shatter rate increased at northern latitudes. Amaranthus species seed shatter was low (0 to 2%), whereas shatter varied widely in common ragweed (Ambrosia artemisiifolia L.) (2 to 90%) over the weeks following soybean physiological maturity. Overall, the broadleaf species studied shattered less than ten percent of their seeds by soybean harvest. Our results suggest that some of the broadleaf species with greater seed retention rates in the weeks following soybean physiological maturity may be good candidates for HWSC.
As herbicide-resistant weeds become more problematic, producers will consider the use of cover crops to suppress weeds. Weed suppression from cover crops may occur especially in the label-mandated buffer areas of dicamba-resistant soybean where dicamba use is not allowed. Three cover crops terminated at three timings with three herbicide strategies were evaluated for their effect on weed suppression in dicamba-resistant soybean. Delaying termination until soybean planting or after and using cereal rye or cereal rye + crimson clover increased cover-crop biomass by at least 40% compared to terminating early or using a crimson clover–only cover crop. Densities of problematic weed species were evaluated in early summer before a blanket POST application. Plots with cereal rye had 75% less horseweed compared to crimson clover at two of four site-years. Cereal rye or the mixed cover crop terminated at or after soybean planting reduced waterhemp densities by 87% compared to early termination timings of crimson clover and the earliest termination timing of the mix at one of two site-years. Cover crops were not as effective in reducing waterhemp densities as they were in reducing horseweed densities. This difference was due to a divergence in emergence patterns; waterhemp emergence generally peaks after termination of the cover crop, whereas horseweed emergence coincides with establishment and rapid vegetative growth of cereal rye. Cover crops alone were generally not as effective as was using a high-biomass cover crop combined with an herbicide strategy that contained dicamba and residual herbicides. However, within label-mandated buffer areas where dicamba cannot be used, a cover crop containing cereal rye with delayed termination until soybean planting combined with residual herbicides could be used to improve suppression of horseweed and waterhemp.
This is the first report on the association between trauma exposure and depression from the Advancing Understanding of RecOvery afteR traumA(AURORA) multisite longitudinal study of adverse post-traumatic neuropsychiatric sequelae (APNS) among participants seeking emergency department (ED) treatment in the aftermath of a traumatic life experience.
Methods
We focus on participants presenting at EDs after a motor vehicle collision (MVC), which characterizes most AURORA participants, and examine associations of participant socio-demographics and MVC characteristics with 8-week depression as mediated through peritraumatic symptoms and 2-week depression.
Results
Eight-week depression prevalence was relatively high (27.8%) and associated with several MVC characteristics (being passenger v. driver; injuries to other people). Peritraumatic distress was associated with 2-week but not 8-week depression. Most of these associations held when controlling for peritraumatic symptoms and, to a lesser degree, depressive symptoms at 2-weeks post-trauma.
Conclusions
These observations, coupled with substantial variation in the relative strength of the mediating pathways across predictors, raises the possibility of diverse and potentially complex underlying biological and psychological processes that remain to be elucidated in more in-depth analyses of the rich and evolving AURORA database to find new targets for intervention and new tools for risk-based stratification following trauma exposure.
Seed shatter is an important weediness trait on which the efficacy of harvest weed seed control (HWSC) depends. The level of seed shatter in a species is likely influenced by agroecological and environmental factors. In 2016 and 2017, we assessed seed shatter of eight economically important grass weed species in soybean [Glycine max (L.) Merr.] from crop physiological maturity to four weeks after maturity at multiple sites spread across eleven states in the southern, northern, and mid-Atlantic U.S. From soybean maturity to four weeks after maturity, cumulative percent seed shatter was lowest in the southern U.S. regions and increased as the states moved further north. At soybean maturity, the percent of seed shatter ranged from 1 to 70%. That range had shifted to 5 to 100% (mean: 42%) by 25 days after soybean maturity. There were considerable differences in seed shatter onset and rate of progression between sites and years in some species that could impact their susceptibility to HWSC. Our results suggest that many summer annual grass species are likely not ideal candidates for HWSC, although HWSC could substantially reduce their seed output at during certain years.
Associations of socioenvironmental features like urbanicity and neighborhood deprivation with psychosis are well-established. An enduring question, however, is whether these associations are causal. Genetic confounding could occur due to downward mobility of individuals at high genetic risk for psychiatric problems into disadvantaged environments.
Methods
We examined correlations of five indices of genetic risk [polygenic risk scores (PRS) for schizophrenia and depression, maternal psychotic symptoms, family psychiatric history, and zygosity-based latent genetic risk] with multiple area-, neighborhood-, and family-level risks during upbringing. Data were from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally-representative cohort of 2232 British twins born in 1994–1995 and followed to age 18 (93% retention). Socioenvironmental risks included urbanicity, air pollution, neighborhood deprivation, neighborhood crime, neighborhood disorder, social cohesion, residential mobility, family poverty, and a cumulative environmental risk scale. At age 18, participants were privately interviewed about psychotic experiences.
Results
Higher genetic risk on all indices was associated with riskier environments during upbringing. For example, participants with higher schizophrenia PRS (OR = 1.19, 95% CI = 1.06–1.33), depression PRS (OR = 1.20, 95% CI = 1.08–1.34), family history (OR = 1.25, 95% CI = 1.11–1.40), and latent genetic risk (OR = 1.21, 95% CI = 1.07–1.38) had accumulated more socioenvironmental risks for schizophrenia by age 18. However, associations between socioenvironmental risks and psychotic experiences mostly remained significant after covariate adjustment for genetic risk.
Conclusion
Genetic risk is correlated with socioenvironmental risk for schizophrenia during upbringing, but the associations between socioenvironmental risk and adolescent psychotic experiences appear, at present, to exist above and beyond this gene-environment correlation.
Ureteroscopy is a minimally invasive surgical procedure for the removal of kidney stones. A ureteroscope, containing a hollow, cylindrical working channel, is inserted into the patient's kidney. The renal space proximal to the scope tip is irrigated, to clear stone particles and debris, with a saline solution that flows in through the working channel. We consider the fluid dynamics of irrigation fluid within the renal pelvis, resulting from the emerging jet through the working channel and return flow through an access sheath. Representing the renal pelvis as a two-dimensional rectangular cavity, we investigate the effects of flow rate and cavity size on flow structure and subsequent clearance time of debris. Fluid flow is modelled with the steady incompressible Navier–Stokes equations, with an imposed Poiseuille profile at the inlet boundary to model the jet of saline, and zero-stress conditions on the outlets. The resulting flow patterns in the cavity contain multiple vortical structures. We demonstrate the existence of multiple solutions dependent on the Reynolds number of the flow and the aspect ratio of the cavity using complementary numerical simulations and particle image velocimetry experiments. The clearance of an initial debris cloud is simulated via solutions to an advection–diffusion equation and we characterise the effects of the initial position of the debris cloud within the vortical flow and the Péclet number on clearance time. With only weak diffusion, debris that initiates within closed streamlines can become trapped. We discuss a flow manipulation strategy to extract debris from vortices and decrease washout time.
This paper investigates the steady axisymmetric structure of the cold boundary-layer flow surrounding fire whirls developing over localized fuel sources lying on a horizontal surface. The inviscid swirling motion found outside the boundary layer, driven by the entrainment of the buoyant turbulent plume of hot combustion products that develops above the fire, is described by an irrotational solution, obtained by combining Taylor's self-similar solution for the motion in the axial plane with the azimuthal motion induced by a line vortex of circulation
$2 {\rm \pi}\Gamma$
. The development of the boundary layer from a prescribed radial location is determined by numerical integration for different swirl levels, measured by the value of the radial-to-azimuthal velocity ratio
$\sigma$
at the initial radial location. As in the case
$\sigma =0$
, treated in the seminal boundary-layer analysis of Burggraf et al. (Phys. Fluids, vol. 14, 1971, pp. 1821–1833), the pressure gradient associated with the centripetal acceleration of the inviscid flow is seen to generate a pronounced radial inflow. Specific attention is given to the terminal shape of the boundary-layer velocity near the axis, which displays a three-layered structure that is described by matched asymptotic expansions. The resulting composite expansion, dependent on the level of ambient swirl through the parameter
$\sigma$
, is employed as boundary condition to describe the deflection of the boundary-layer flow near the axis to form a vertical swirl jet. Numerical solutions of the resulting non-slender collision region for different values of
$\sigma$
are presented both for inviscid flow and for viscous flow with moderately large values of the controlling Reynolds number
$\Gamma /\nu$
. The velocity description provided is useful in mathematical formulations of localized fire-whirl flows, providing consistent boundary conditions accounting for the ambient swirl level.
Non-medical opioid use (NMOU) is a growing crisis. Cancer patients at elevated risk of NMOU (+risk) are frequently underdiagnosed. The aim of this paper was to develop a nomogram to predict the probability of +risk among cancer patients receiving outpatient supportive care consultation at a comprehensive cancer center.
Method
3,588 consecutive patients referred to a supportive care clinic were reviewed. All patients had a diagnosis of cancer and were on opioids for pain. All patients were assessed using the Edmonton Symptom Assessment Scale (ESAS), Screener and Opioid Assessment for Patients with Pain (SOAPP-14), and CAGE-AID (Cut Down-Annoyed-Guilty-Eye Opener) questionnaires. “+risk” was defined as an SOAPP-14 score of ≥7. A nomogram was devised based on the risk factors determined by the multivariate logistic regression model to estimate the probability of +risk.
Results
731/3,588 consults were +risk. +risk was significantly associated with gender, race, marital status, smoking status, depression, anxiety, financial distress, MEDD (morphine equivalent daily dose), and CAGE-AID score. The C-index was 0.8. A nomogram was developed and can be accessed at https://is.gd/soappnomogram. For example, for a male Hispanic patient, married, never smoked, with ESAS scores for depression = 3, anxiety = 3, financial distress = 7, a CAGE score of 0, and an MEDD score of 20, the total score is 9 + 9+0 + 0+6 + 10 + 23 + 0+1 = 58. A nomogram score of 58 indicates the probability of +risk of 0.1.
Significance of results
We established a practical nomogram to assess the +risk. The application of a nomogram based on routinely collected clinical data can help clinicians establish patients with +risk and positively impact care planning.
To disrupt cycles of health inequity, traceable to dietary inequities in the earliest stages of life, public health interventions should target improving nutritional wellbeing in preconception/pregnancy environments. This requires a deep engagement with pregnant/postpartum people (PPP) and their communities (including their health and social care providers, HSCP). We sought to understand the factors that influence diet during pregnancy from the perspectives of PPP and HSCP, and to outline intervention priorities.
Design:
We carried out thematic network analyses of transcripts from ten focus group discussions (FGD) and one stakeholder engagement meeting with PPP and HSCP in a Canadian city. Identified themes were developed into conceptual maps, highlighting local priorities for pregnancy nutrition and intervention development.
Setting:
FGD and the stakeholder meeting were run in predominantly lower socioeconomic position (SEP) neighbourhoods in the sociodemographically diverse city of Hamilton, Canada.
Participants:
All local, comprising twenty-two lower SEP PPP and forty-three HSCP.
Results:
Salient themes were resilience, resources, relationships and the embodied experience of pregnancy. Both PPP and HSCP underscored that socioeconomic-political forces operating at multiple levels largely determined the availability of individual and relational resources constraining diet during pregnancy. Intervention proposals focused on cultivating individual and community resilience to improve early-life nutritional environments. Participants called for better-integrated services, greater income supports and strengthened support programmes.
Conclusions:
Hamilton stakeholders foregrounded social determinants of inequity as main factors influencing pregnancy diet. They further indicated a need to develop interventions that build resilience and redistribute resources at multiple levels, from the household to the state.
In 2019, a 42-year-old African man who works as an Ebola virus disease (EVD) researcher traveled from the Democratic Republic of Congo (DRC), near an ongoing EVD epidemic, to Philadelphia and presented to the Hospital of the University of Pennsylvania Emergency Department with altered mental status, vomiting, diarrhea, and fever. He was classified as a “wet” person under investigation for EVD, and his arrival activated our hospital emergency management command center and bioresponse teams. He was found to be in septic shock with multisystem organ dysfunction, including circulatory dysfunction, encephalopathy, metabolic lactic acidosis, acute kidney injury, acute liver injury, and diffuse intravascular coagulation. Critical care was delivered within high-risk pathogen isolation in the ED and in our Special Treatment Unit until a diagnosis of severe cerebral malaria was confirmed and EVD was definitively excluded.
This report discusses our experience activating a longitudinal preparedness program designed for rare, resource-intensive events at hospitals physically remote from any active epidemic but serving a high-volume international air travel port-of-entry.
Introduction: Emergency department (ED) buprenorphine/naloxone inductions for opioid use disorder are an effective and safe way to initiate addictions care in the ED. Kelowna General Hospital's ED buprenorphine/naloxone (KEDSS) program was implemented in September 2018 in order to respond to a community need for accessible and evidence-based addictions care. The objective of our program evaluation study was to examine the implementation of the first five months of the KEDSS program through evaluating patient characteristics and service outcomes. Methods: The KEDSS treatment pathway consists of a standardized protocol (pre-printed order set) to facilitate buprenorphine/naloxone induction and stabilization in the acute care setting (ED and inpatient wards) at Kelowna General Hospital, a community academic hospital. All patients referred to the outpatient addictions clinic via the order set during September 2018-January 2019 (the first 5 months) were included in the study population. A retrospective descriptive chart review was completed. Outcome measures included population characteristics (sociodemographic information, clinical characteristics) and service outcomes (number of patients initiated, patient follow-up). Descriptive statistics and bivariate analyses using t-tests or Pearson's χ2 statistic, as appropriate, were conducted to compare the ED-initiated group with the inpatient-initiated group. Results: During the first five months of the KEDSS program, a total of 35 patients (26% female, mean age 36.6 years, 54% homeless) were started on the treatment pathway, 16 (46%) in the ED. Compared to the inpatient-initiated group, the ED-initiated group were less likely to have psychiatric comorbidities (ED 1.0 vs. inpatient 1.5, p = 0.002), require methadone or sustained-release oral morphine (ED 13% vs. inpatient 37%, p = 0.048), and have attended follow-up (ED 56% vs. inpatient 84%, p = 0.004). Conclusion: This study provides a preliminary look at a new opioid agonist therapy (OAT) treatment pathway (KEDSS) at Kelowna General Hospital, and provides insight into the population that is accessing the program. We found that the majority of patients who are started on buprenorphine/naloxone in the ED are seen in follow-up at the addictions clinic. Future work will examine ongoing follow-up and OAT adherence rates in the study population to quantify the program's impact on improving access to addictions treatment within this community hospital setting.
Single nucleotide polymorphisms (SNPs) contribute small increases in risk for late-onset Alzheimer's disease (LOAD). LOAD SNPs cluster around genes with similar biological functions (pathways). Polygenic risk scores (PRS) aggregate the effect of SNPs genome-wide. However, this approach has not been widely used for SNPs within specific pathways.
Objectives
We investigated whether pathway-specific PRS were significant predictors of LOAD case/control status.
Methods
We mapped SNPs to genes within 8 pathways implicated in LOAD. For our polygenic analysis, the discovery sample comprised 13,831 LOAD cases and 29,877 controls. LOAD risk alleles for SNPs in our 8 pathways were identified at a P-value threshold of 0.5. Pathway-specific PRS were calculated in a target sample of 3332 cases and 9832 controls. The genetic data were pruned with R2 > 0.2 while retaining the SNPs most significantly associated with AD. We tested whether pathway-specific PRS were associated with LOAD using logistic regression, adjusting for age, sex, country, and principal components. We report the proportion of variance in liability explained by each pathway.
Results
The most strongly associated pathways were the immune response (NSNPs = 9304, = 5.63 × 10−19, R2 = 0.04) and hemostasis (NSNPs = 7832, P = 5.47 × 10−7, R2 = 0.015). Regulation of endocytosis, hematopoietic cell lineage, cholesterol transport, clathrin and protein folding were also significantly associated but accounted for less than 1% of the variance. With APOE excluded, all pathways remained significant except proteasome-ubiquitin activity and protein folding.
Conclusions
Genetic risk for LOAD can be split into contributions from different biological pathways. These offer a means to explore disease mechanisms and to stratify patients.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
This study investigated subjective memory complaints in older adults and the roles of setting, response bias, and personality.
Design:
Cognitively normal older adults from two settings completed questionnaires measuring memory complaints, response bias, and personality.
Settings:
(A) Neuroimaging study with community-based recruitment and (B) academic memory clinic.
Participants:
Cognitively normal older adults who (A) volunteer for research (N = 92) or (B) self-referred to a memory clinic (N = 20).
Measurements:
Neuropsychological evaluation and adjudication of normal cognitive status were done by the neuroimaging study or memory clinic. This study administered self-reports of subjective memory complaints, response bias, five-factor personality, and depressive symptoms. Primary group differences were examined with secondary sensitivity analyses to control for sex, age, and education differences.
Results:
There was no significant difference in over-reporting response bias between study settings. Under-reporting response bias was higher in volunteers. Cognitive complaints were associated with response bias for two cognitive complaint measures. Neuroticism was positively associated with over-reporting in evaluation-seekers and negatively associated with under-reporting in volunteers. The relationship was reversed for Extraversion. Under-reporting bias was positively correlated with Agreeableness and Conscientiousness in volunteers.
Conclusion:
Evaluation-seekers do not show bias toward over-reporting symptoms compared to volunteers. Under-reporting response bias may be important to consider when screening for memory impairment in non-help-seeking settings. The Memory Functioning Questionnaire was less sensitive to reporting biases. Over-reporting may be a facet of higher Neuroticism. Findings help elucidate psychological influences on self-perceived cognitive decline and help seeking in aging and may inform different strategies for assessment by setting.
This paper considers the significant role of cross-sectional geometry on resistance in co-axial pipe flows. We consider an axially flowing viscous fluid in between two long and thin elliptical coaxial cylinders, one inside the other. The outer cylinder is stationary, while the inner cylinder (rod) is free to move. The rod poses a resistance to the axial flow, while the viscous fluid poses a resistance to any motion of the rod. We show that the equations for flow in the axial direction – driven by a prescribed flux – and for flow within the cross-section of the domain – driven by the motion of the rod – decouple in the asymptotic limit of small cylinder aspect ratio into axial Poiseuille flow and transverse Stokes flow, respectively. The objective of this paper is to calculate numerically the axial and cross-sectional resistances and to determine their dependence on cross-sectional geometry – i.e. rod position and the ellipticities of the rod and bounding cylinder. We characterise axial resistance, first for three reduced parameter spaces that have not been fully analysed in the literature: (i) a circle in an ellipse, (ii) an ellipse in a circle and (iii) an ellipse in an ellipse of equal eccentricity and orientation, before extending our geometric parameter space to determine the overall optimal geometry to minimise axial flow resistance for fixed cross-sectional area. Cross-sectional resistance is characterised via coefficients in a Stokes resistance matrix and we highlight the interdependent effects of cross-sectional ellipticity and boundary interactions.
Psychotropic prescription rates continue to increase in the United States (USA). Few studies have investigated whether social-structural factors may play a role in psychotropic medication use independent of mental illness. Food insecurity is prevalent among people living with HIV in the USA and has been associated with poor mental health. We investigated whether food insecurity was associated with psychotropic medication use independent of the symptoms of depression and anxiety among women living with HIV in the USA.
Methods
We used cross-sectional data from the Women's Interagency HIV Study (WIHS), a nationwide cohort study. Food security (FS) was the primary explanatory variable, measured using the Household Food Security Survey Module. First, we used multivariable linear regressions to test whether FS was associated with symptoms of depression (Center for Epidemiologic Studies Depression [CESD] score), generalised anxiety disorder (GAD-7 score) and mental health-related quality of life (MOS-HIV Mental Health Summary score; MHS). Next, we examined associations of FS with the use of any psychotropic medications, including antidepressants, sedatives and antipsychotics, using multivariable logistic regressions adjusting for age, race/ethnicity, income, education and alcohol and substance use. In separate models, we additionally adjusted for symptoms of depression (CESD score) and anxiety (GAD-7 score).
Results
Of the 905 women in the sample, two-thirds were African-American. Lower FS (i.e. worse food insecurity) was associated with greater symptoms of depression and anxiety in a dose–response relationship. For the psychotropic medication outcomes, marginal and low FS were associated with 2.06 (p < 0.001; 95% confidence interval [CI] = 1.36–3.13) and 1.99 (p < 0.01; 95% CI = 1.26–3.15) times higher odds of any psychotropic medication use, respectively, before adjusting for depression and anxiety. The association of very low FS with any psychotropic medication use was not statistically significant. A similar pattern was found for antidepressant and sedative use. After additionally adjusting for CESD and GAD-7 scores, marginal FS remained associated with 1.93 (p < 0.05; 95% CI = 1.16–3.19) times higher odds of any psychotropic medication use. Very low FS, conversely, was significantly associated with lower odds of antidepressant use (adjusted odds ratio = 0.42; p < 0.05; 95% CI = 0.19–0.96).
Conclusions
Marginal FS was associated with higher odds of using psychotropic medications independent of depression and anxiety, while very low FS was associated with lower odds. These complex findings may indicate that people experiencing very low FS face barriers to accessing mental health services, while those experiencing marginal FS who do access services are more likely to be prescribed psychotropic medications for distress arising from social and structural factors.