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Eigenmodes of averaged small-amplitude perturbations to a turbulent channel flow – which is one of the most fundamental canonical flows – are identified for the first time via an extensive set of high-fidelity graphics processing unit accelerated direct numerical simulations. While the system governing averaged small-amplitude perturbations to turbulent channel flow remains unknown, the fact such eigenmodes can be identified constitutes direct evidence that it is linear. Moreover, while the eigenvalue associated with the slowest-decaying anti-symmetric eigenmode mode is found to be real, the eigenvalue associated with the slowest-decaying symmetric eigenmode mode is found to be complex. This indicates that the unknown linear system governing the evolution of averaged small-amplitude perturbations cannot be self-adjoint, even for the case of a uni-directional flow. In addition to elucidating aspects of the flow physics, the findings provide guidance for development of new unsteady Reynolds-averaged Navier–Stokes turbulence models, and constitute a new and accessible benchmark problem for assessing the performance of existing models, which are used widely throughout industry.
All Fire and Emergency Services (FES) personnel must balance FES work with their other responsibilities. Given that women tend to take on a greater responsibility for management of household/domestic activities than men, the on-call component of their FES work may be associated with very different challenges. Despite this, women have rarely been the focus of on-call research.
To explore women’s on-call experiences in the FES by examining coping styles and strategies, with the goal of helping to innovate the way women are supported in FES roles.
Relevant findings from two studies are included. The first study involved FES personnel from two agencies in Australia (n=24) who participated in a semi-structured interview. The second study was an anonymous online survey to determine work characteristics, sleep, stress, and coping in on-call workers more broadly, with workers from all industries across Australia (n=228) invited to participate.
Interview data identified two major themes in terms of coping with on-call work. Support (from family, social, and work), planning, and preparation were identified as important in helping women cope in the context of on-call unpredictability. Results from the survey (43% women) showed that on-call workers were an engaged group in terms of their coping, with 67% classified as having a positive coping style and 58% of women indicating that they agreed/strongly agreed with the statement, “I cope well with on-call work.”
Taken together, these data highlight engagement with positive coping by women who do on-call work, including in the FES. Importantly, positive coping strategies, such as talking about emotions, problem-solving, and seeking support have been linked to increased shift work tolerance in other populations. Coping style and strategies represent modifiable variables which could be specifically applied to assist women to manage the unique challenges associated with on-call work in the FES.
Distribution of cesium and silver ion-exchanged onto columns of zeolites may be measured directly and non-destructively on the column with the use of radioisotope-excited energy dispersive X-ray fluorescence. Quantitative accounting of the exchanged metals is obtained without elution.
Culture-based studies, which focus on individual organisms, have implicated stethoscopes as potential vectors of nosocomial bacterial transmission. However, the full bacterial communities that contaminate in-use stethoscopes have not been investigated.
We used bacterial 16S rRNA gene deep-sequencing, analysis, and quantification to profile entire bacterial populations on stethoscopes in use in an intensive care unit (ICU), including practitioner stethoscopes, individual-use patient-room stethoscopes, and clean unused individual-use stethoscopes. Two additional sets of practitioner stethoscopes were sampled before and after cleaning using standardized or practitioner-preferred methods.
Bacterial contamination levels were highest on practitioner stethoscopes, followed by patient-room stethoscopes, whereas clean stethoscopes were indistinguishable from background controls. Bacterial communities on stethoscopes were complex, and community analysis by weighted UniFrac showed that physician and patient-room stethoscopes were indistinguishable and significantly different from clean stethoscopes and background controls. Genera relevant to healthcare-associated infections (HAIs) were common on practitioner stethoscopes, among which Staphylococcus was ubiquitous and had the highest relative abundance (6.8%–14% of contaminating bacterial sequences). Other HAI-related genera were also widespread although lower in abundance. Cleaning of practitioner stethoscopes resulted in a significant reduction in bacterial contamination levels, but these levels reached those of clean stethoscopes in only a few cases with either standardized or practitioner-preferred methods, and bacterial community composition did not significantly change.
Stethoscopes used in an ICU carry bacterial DNA reflecting complex microbial communities that include nosocomially important taxa. Commonly used cleaning practices reduce contamination but are only partially successful at modifying or eliminating these communities.
Oldowan sites in primary geological context are rare in the archaeological record. Here we describe the depositional environment of Oldowan occurrences at Kanjera South, Kenya, based on field descriptions and granulometric analysis. Excavations have recovered a large Oldowan artefact sample as well as the oldest substantial sample of archaeological fauna. The deposits at Kanjera South consist of 30 m of fluvial, colluvial and lacustrine sediments. Magneto- and biostratigraphy indicate the Kanjera South Member of the Kanjera Formation was deposited during 2.3–1.92 Ma, with 2.0 Ma being a likely age for the archaeological occurrences. Oldowan artefacts and associated fauna were deposited in the colluvial and alluvial silts and sands of beds KS1–3, in the margins of a lake basin. Field descriptions and granulometric analysis of the sediment fine fraction indicate that sediments from within the main archaeological horizon were emplaced as a combination of tractional and hyperconcentrated flows with limited evidence of debris-flow deposition. This style of deposition is unlikely to significantly erode or disturb the underlying surface, and therefore promotes preservation of surface archaeological accumulations. Hominins were repeatedly attracted to the site locale, and rapid sedimentation, minimal bone weathering and an absence of bone or artefact rounding further indicate that fossils and artefacts were quickly buried.
Ecosystem services related to biodiversity, including cultural services, are essential for agricultural production such as viticulture. In agricultural landscapes, pesticides and mechanization threaten biodiversity, lead to landscape simplification and may reduce ecosystem services. On the other hand, consumers are more and more aware of environmental issues in food production. We investigated if landscape complexity, including soil management practices, was (i) appreciated by visitors and (ii) presented by winegrowers and tourism professionals in the French vineyards with the designation of geographical origin (DGO) ‘Coteaux du Layon’. Our goal was to determine if landscape complexity provides cultural ecosystem services such as aesthetics beneficial for the wine trade and the DGO region's attractiveness. We analyzed the iconographic content and the composition of landscape photographs on 50 websites to investigate if local winegrowers and tourism professionals associate biodiversity in the landscape and soil management practices with wine promotion. A questionnaire was realized to study the perception of local landscapes by interviewing 192 visitors of the region. The benefits of landscape complexity and soil management practices favoring biodiversity in viticulture were known and appreciated by many visitors, even if photographs of wine and traditional practices appeared to encourage wine purchasing. Local winegrowers’ representation of the DGO region only partially served these preferences; instead they mainly presented the wine-growing region by photographs focusing on wine bottles and vineyards. Consumer's preferences showed that complex landscapes could provide cultural ecosystem services that winegrowers are still less aware of. Therefore, complexity-targeted landscape planning including vegetation cover in soil management should be included in policy recommendations as agroecological measures for sustainable DGO production.
An estimated 293,300 healthcare-associated cases of Clostridium difficile infection (CDI) occur annually in the United States. To date, research has focused on developing risk prediction models for CDI that work well across institutions. However, this one-size-fits-all approach ignores important hospital-specific factors. We focus on a generalizable method for building facility-specific models. We demonstrate the applicability of the approach using electronic health records (EHR) from the University of Michigan Hospitals (UM) and the Massachusetts General Hospital (MGH).
We utilized EHR data from 191,014 adult admissions to UM and 65,718 adult admissions to MGH. We extracted patient demographics, admission details, patient history, and daily hospitalization details, resulting in 4,836 features from patients at UM and 1,837 from patients at MGH. We used L2 regularized logistic regression to learn the models, and we measured the discriminative performance of the models on held-out data from each hospital.
Using the UM and MGH test data, the models achieved area under the receiver operating characteristic curve (AUROC) values of 0.82 (95% confidence interval [CI], 0.80–0.84) and 0.75 ( 95% CI, 0.73–0.78), respectively. Some predictive factors were shared between the 2 models, but many of the top predictive factors differed between facilities.
A data-driven approach to building models for estimating daily patient risk for CDI was used to build institution-specific models at 2 large hospitals with different patient populations and EHR systems. In contrast to traditional approaches that focus on developing models that apply across hospitals, our generalizable approach yields risk-stratification models tailored to an institution. These hospital-specific models allow for earlier and more accurate identification of high-risk patients and better targeting of infection prevention strategies.
There is growing interest in linking vitamin D deficiency with autism spectrum disorders (ASDs). The association between vitamin D deficiency during gestation, a critical period in neurodevelopment, and ASD is not well understood.
To determine the association between gestational vitamin D status and ASD.
Based on a birth cohort (n=4334), we examined the association between 25-hydroxyvitamin D (25OHD), assessed from both maternal mid-gestation sera and neonatal sera, and ASD (defined by clinical records; n=68 cases).
Individuals in the 25OHD-deficient group at mid-gestation had more than twofold increased risk of ASD (odds ratio (OR)=2.42, 95% confidence interval (CI) 1.09 to 5.07, P=0.03) compared with the sufficient group. The findings persisted in analyses including children of European ethnicity only.
Mid-gestational vitamin D deficiency was associated with an increased risk of ASD. Because gestational vitamin D deficiency is readily preventable with safe, inexpensive and readily available supplementation, this risk factor warrants closer scrutiny.
Numerous glaciological data have been obtained from measurements carried out on Glacier d’Argentière, Mont Blanc area, France, since the beginning of the 20th century. Moreover, data on annual mass balance, ice-flow velocity, thickness variation and length fluctuation have been obtained from yearly measurements performed since 1975. This dataset provides an excellent opportunity to analyze the relationships between surface mass balance and dynamic response over time periods during which net mass balance changed from positive to negative. Following a positive specific-net-balance period between 1960 and 1981, the ablation zone experienced a large increase in thickness and ice-flow velocities. Conversely, the highly negative specific-net-balance period since 1982 has led to strong thinning, deceleration and retreat of the tongue. The response of these observed dynamics to surface mass balance is analyzed from ice-flux calculations performed on three transverse cross-sections. Our results reveal that the ice fluxes are largely accommodated by ice-flow velocities. Velocity fluctuations are synchronous over the entire area studied. In the largest part of the glacier, no compressing/extending flow change has been observed over the last 30 years and thickness changes are solely driven by surface mass-balance changes. However, on the tongue of the glacier, thickness changes do not depend on surface mass balance but are mainly driven by changes in the longitudinal strain rate.
Variance analysis of the long time series of mass balances recorded on Glacier de Sarennes (45°07’ N, 6°07’ E) France, since 1949 shows that the variability can be separated linearly in two spatial and temporal terms. Annual balances deviate from their mean values over the period of record by an annual amount that is uniform over the glacier. Annual balances at each stake are therefore highly correlated, and sampling at a single site would be acceptable to record the annual deviation. A result of the linear character of the variance is the possibility of obtaining a systematic error-free estimate of the annual glacier-total budget by combining the mean annual balance obtained from photogrammetry and the annual deviation obtained from the variance analysis, rather than using the traditional area integration of balances at each stake.
The mass balance of Glacier de Sarennes, French Alps, has been measured since 1949, using the glaciological method based on core and ablation stake data, and area extrapolations, to find the overall glacier balance. The cumulative balance obtained in this way is very dependent on systematic errors that can increase linearly with the number, N, of measurement years, whereas random errors rise with . The volumetric-balance method based on aerial photogrammetry provides results whose errors do not depend on the number of years. This method was used to test field measurements for the period 1952–2003 and gives a mass balance of −32.30 ± 1.04 m w.e. compared to −34.89 ± 1.15 m w.e. based on field data. The discrepancy between the two methods is discussed on the basis of a careful error analysis. Moreover, the possibility of using the volumetric method to detect biases in field measurements is evaluated in terms of two types of errors. The number and locations of measurement sites required to account for all the spatial and temporal variabilities of the mass balance is discussed by variance analysis. Methodological implications and recommendations are presented to provide mass-balance measurements of the best possible accuracy.
Supraglacial Lac de Rochemelon was formed 50 years ago behind an ice dam and grew steadily until 2004. In October 2004, the volume of the lake reached 650 000 m3, bringing its surface within 0.2 m of the top of the ice dam. To eliminate the threat to towns located below in the event of an overflow, the lake was drained artificially in October 2004 and during the summer of 2005. Once the volume had been reduced to 250 000 m3 by siphoning, a channel was dug with explosives and the remaining water overflowed naturally. This offered a very good opportunity to investigate the breaching of an ice dam accompanied by thermal erosion of the drainage channel. Extensive field measurements were carried out during drainage. Analysis of the energy dissipated in the channel reveals that only half of the available energy was used for breach erosion. A numerical model was used to simulate the evolution of a number of variables during drainage and to study the sensitivity of discharge and ice erosion to different parameters, revealing a high sensitivity to water temperature. Model simulations indicate that natural drainage of this lake at the beginning of October 2004 would have led to a peak discharge of <6 m3 s−1.
Temporal trends related to recent climatic fluctuations are extracted from the longest glacier-wide winter and summer mass-balance series recorded in the Alps, at Glacier de Sarennes, France. For this, all point balances measured at the glacier surface are used, and different statistical models are developed and tested. First, Lliboutry’s linear variance analysis model is extended to the two seasonal components of the balance. The explicit modelling of variability sources and correlations is proved useful for appropriately quantifying uncertainties in the different components of the balance and estimating missing data. Next, a non-exchangeable structure is added to model the winter and summer balance time series. Two change points separating different underlying trends are thus detected. The first change was in 1976, with a shift of +23% in the winter balance. The second was in 1982 for the summer balance series. These systematic changes explain 20–30% of the variability of the different components of the balance, the rest being made up of random interannual fluctuations. Simplified and/or less physically based models are less efficient in capturing data variability. As a result, the cumulative glacier-wide balance shows systematic parabolic trends, which result in an accelerated mass loss for Glacier de Sarennes over the last 25 years.
Extensive field measurements and historical data have been used to re-analyse the cause of the outburst flood from Glacier de Tête Rousse that devastated the village of Saint-Gervais–Le Fayet, French Alps in 1892, causing 175 fatalities. The origin of this disaster was the rupture of an intraglacial cavity in Glacier de Tête Rousse that released 200 000 m3 of water and ice. All previous studies have concluded that the intraglacial cavity was formed from a crevasse that was filled and enlarged by meltwater. The re-analysis presented here suggests that the reservoir of the upper cavity did not originate as an enlarging crevasse. The origin of the meltwater reservoir was more likely a supraglacial lake formed before 1878 during a period of negative mass balance. Following a period of positive mass balance after 1878, the lake was hidden until the outburst flood of 1892. This means that such hazards may be detected by checking regularly for the formation of a lake on the surface of the glacier before it is hidden.
Mass-balance and dynamic measurements carried out on glacier de Saint Sorlin since 1957 provide a good opportunity to study the dynamics of this glacier. Ice-flow analysis shows that dynamic changes have been important over the last 40 years and that these changes are not consistent with the concepts usually used in glacier modelling. Present velocities are larger than the 1960 velocities, although the thickness decreased everywhere (10–30 m in the ablation zone). A simple numerical ice-flow model which does not include longitudinal stress gradients has been used to investigate these phenomena. This model allows us to infer the sliding velocity from observed surface and calculated deformation velocities. We conclude that: (1) the sliding velocity cannot be described by Weertman analysis or empirical relations which link the sliding to the thickness and surface slope; (2) the inferred sliding velocity is uniform over at least half of the glacier; and (3) there is no clear link between the sliding process and the quantity of water coming from surface ablation. Furthermore, it may not be reasonable to calibrate model flow parameters from geometry changes because the surface geometry is relatively insensitive to velocity changes over some decades.
Simulations of glacier evolution are needed to assess future changes in the runoff regime of mountain catchments. A simplified parameterized model is applied here to simulate future thickness changes and glacier retreat of Mer de Glace, French Alps. A normalized thickness change function describing the spatial distribution of surface-elevation changes as a function of elevation has been determined. The model reveals that under present climatic conditions Mer de Glace will continue to shrink dramatically in the coming decades, retreating by 1200 m between now and 2040. The method has certain limitations related to the uncertainties of the normalized function based on thickness change data. An error of 10% in the normalized function leads to uncertainties of 46%, 30% and 18% in Mer de Glace front, surface area and glacier-wide mass-balance changes respectively in 2040. Because the difference of the normalized function largely exceeds 10% from one glacier to another, even within a given glacier size class and elevation range, it would be very risky to extrapolate the normalized function to unmeasured glaciers. Consequently, the method is applicable only on glaciers where past surface elevation changes are well constrained.
Very large volumes of ice break off regularly from Taconnaz hanging glacier, French Alps. During winter, when the snow mantle is unstable, these collapses can trigger very large avalanches that represent a serious threat to inhabited areas below. Photogrammetric measurements have been performed over 1 year to assess the volume and frequency of the largest collapses. Major collapses occur when the glacier reaches a critical geometry. After a major ice collapse, the glacier is in a minimal position and subsequently recharges over 6 months to reach the maximum position again. This critical geometry is a necessary but not sufficient condition for further large collapses. Large collapses do not systematically occur in the maximum position, as ice is often removed by disintegration into small ice blocks. For two major collapses, the volume of ice breaking off has been assessed at ~275 000 m3. Photogrammetric measurements were used to determine an ice flux of 820 000 m3 a–1 through the studied ice stream, in agreement with an assessment based on ice-flow modeling. This ice flux estimation was used to determine the average ice volumes breaking off over surveyed periods.
The deadliest outburst flood from an englacial cavity occurred on Glacier de Tête Rousse in the Mont Blanc area, French Alps, in 1892. A subglacial reservoir was discovered in the same glacier in 2010 and drained artificially in 2010, 2011 and 2012 to protect the 3000 inhabitants downstream. The mechanism leading to the spontaneous refilling of the cavity following these pumping operations has been analyzed. For this purpose, the subglacial water volume changes between 2010 and 2013 were reconstructed. The size of the cavity following the pumping was found to have decreased from 53500 m3 in 2010 to 12 750 m3 in 2013. Creep and the partial collapse of the cavity roof explain a large part of the volume loss. Analysis of cavity filling showed a strong relationship between measured surface melting and the filling rate, with a time delay of 4–6 hours. A permanent input of 15 m3 d−1, not depending on surface melt, was also found. The meltwater and rain from the surface is conveyed to bedrock through crevasses and probably through a permeable layer of rock debris at the glacier bed. The drainage pathway permeability was estimated at 0.054 ms−1 from water discharge measurements and dye-tracing experiments.
Observations show that glaciers around the world are in retreat and losing mass. Internationally coordinated for over a century, glacier monitoring activities provide an unprecedented dataset of glacier observations from ground, air and space. Glacier studies generally select specific parts of these datasets to obtain optimal assessments of the mass-balance data relating to the impact that glaciers exercise on global sea-level fluctuations or on regional runoff. In this study we provide an overview and analysis of the main observational datasets compiled by the World Glacier Monitoring Service (WGMS). The dataset on glacier front variations (∼42 000 since 1600) delivers clear evidence that centennial glacier retreat is a global phenomenon. Intermittent readvance periods at regional and decadal scale are normally restricted to a subsample of glaciers and have not come close to achieving the maximum positions of the Little Ice Age (or Holocene). Glaciological and geodetic observations (∼5200 since 1850) show that the rates of early 21st-century mass loss are without precedent on a global scale, at least for the time period observed and probably also for recorded history, as indicated also in reconstructions from written and illustrated documents. This strong imbalance implies that glaciers in many regions will very likely suffer further ice loss, even if climate remains stable.
Introduction: Children with moderate cellulitis are often treated with IV antibiotics in the hospital setting, as per recommendations. Previously in our hospital, a protocol using daily IV ceftriaxone with follow-up at the day treatment center (DTC) was used to avoid admission. In 2013, a new protocol was implanted and suggested the use of high dose (HD) oral cephalexin with follow-up at the DTC for those patients. The aim of this study was to evaluate the safety and efficacy of the HD cephalexin protocol to treat moderate cellulitis in children as outpatient. Methods: A retrospective chart review was conducted. Children were included if they presented to the ED between January 2014 and 2016 and were diagnosed with a moderate cellulitis sufficiently severe to request a follow up at DTC and who were treated according to the standard of care with the HD oral cephalexin (100 mg/kg/day) protocol. Descriptive statistics for clinical characteristics of patients upon presentation, as well as for treatment characteristics in the ED and DTC were analyzed. Treatment failure was defined as: need for admission at the time of DTC evaluation, change for IV treatment in DTC or return visit to the ED. Outcomes were compared to historic controls treated with IV ceftriaxone at the DTC, where admission was avoided in 80% of cases. Results: During the study period, 682 children with cellulitis were diagnosed in our ED. Of these, 117 patients were treated using the oral HD cephalexin outpatient protocol. Success rate was 89.5% (102/114); 3 patients had an alternative diagnosis at DTC. Treatment failure was reported in 12 cases; 10 patients (8.8%) required admission, one (0.9%) received IV antibiotics at DTC, and one (0.9%) had a return visit to the ED without admission or change to the treatment. This compares favorably with the previous study using IV ceftriaxone (success rate of 80%). No severe deep infections were reported or missed; 4 patients required drainage. The mean number of visits per patient required at the DTC was 1.6. Conclusion: Treatment of moderate cellulitis requiring a follow-up in a DTC, using an oral outpatient protocol with HD cephalexin is a secure and effective option. By reducing hospitalization rate and avoiding the need for painful IV insertion, HD cephalexin is a favourable option in the management of moderate cellulitis for pediatric patients, when no criteria of toxicity are present.