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Motivated by the explosive launch of Sphagnum spores, this experimental study investigates how the vortices generated from two different sources, a piston–cylinder apparatus and a translating bluff body, interact with each other. While there have been numerous studies on the formation of a single vortex ring or multiple vortex rings, little is known about the effect of a translating bluff body on the formation of the coupled vortices. By varying the stroke ratio of the piston and the velocity ratio of the body to the piston, three distinct modes are identified for the mutual interaction between the starting jet from the piston and the wake from the cap: spill mode, attached mode and detached mode. The transitions between the vortex modes are predicted with simple analytical models. For the attached mode that appears at a velocity ratio intermediate between those of the spill mode and the detached mode, the merged flow structure becomes similar to a single vortex ring in the absence of the bluff body. By virtue of stable propagation following the cap, the vortex of the attached mode is capable of transporting a significant fluid volume initially inside the cylinder over a long distance, which shows its effectiveness in transport using a ballistic mechanism.
This paper deals with design of an alternative secure Blockchain network framework to prevent damages from an attacker. The alliance concept from the strategic management perspectives is applied on the top of a general stochastic game framework. This new enhanced hybrid theoretical model is designed to find the best strategies toward preparation for preventing a network malfunction from an attacker through strategic alliances with other genuine nodes and it is developed based on the combination of a strategic management framework and a conventional stochastic model based on the Blockchain Governance Game. Analytically, tractable results for decision-making parameters are fully obtained to predict of the moment for operations and also to provide the optimal number of allegiance nodes to protect a Blockchain network. This research helps those whom are considering initial coin offering or launching new Blockchain-based services by enhancing security features through strategic alliances in a decentralized network.
We report our experience with an emergency room (ER) shutdown related to an accidental exposure to a patient with coronavirus disease 2019 (COVID-19) who had not been isolated.
A 635-bed, tertiary-care hospital in Daegu, South Korea.
To prevent nosocomial transmission of the disease, we subsequently isolated patients with suspected symptoms, relevant radiographic findings, or epidemiology. Severe acute respiratory coronavirus 2 (SARS-CoV-2) reverse-transcriptase polymerase chain reaction assays (RT-PCR) were performed for most patients requiring hospitalization. A universal mask policy and comprehensive use of personal protective equipment (PPE) were implemented. We analyzed effects of these interventions.
From the pre-shutdown period (February 10–25, 2020) to the post-shutdown period (February 28 to March 16, 2020), the mean hourly turnaround time decreased from 23:31 ±6:43 hours to 9:27 ±3:41 hours (P < .001). As a result, the proportion of the patients tested increased from 5.8% (N=1,037) to 64.6% (N=690) (P < .001) and the average number of tests per day increased from 3.8±4.3 to 24.7±5.0 (P < .001). All 23 patients with COVID-19 in the post-shutdown period were isolated in the ER without any problematic accidental exposure or nosocomial transmission. After the shutdown, several metrics increased. The median duration of stay in the ER among hospitalized patients increased from 4:30 hours (interquartile range [IQR], 2:17–9:48) to 14:33 hours (IQR, 6:55–24:50) (P < .001). Rates of intensive care unit admissions increased from 1.4% to 2.9% (P = .023), and mortality increased from 0.9% to 3.0% (P = .001).
Problematic accidental exposure and nosocomial transmission of COVID-19 can be successfully prevented through active isolation and surveillance policies and comprehensive PPE use despite longer ER stays and the presence of more severely ill patients during a severe COVID-19 outbreak.
The purpose of this study was to investigate differences in the perception of disaster issues between disaster directors and general health care providers in Gyeonggi Province, South Korea.
The Gyeonggi provincial committee distributed a survey to acute care facility personnel. Survey topics included awareness of general disaster issues, hospital preparedness, and training priorities. The questionnaire comprised multiple choices and items scored on a 10-point Likert scale. We analyzed the discrepancies and characteristics of the responses.
Completed surveys were returned from 43 (67%) of 64 directors and 145 (55.6%) of 261 health care providers. In the field of general awareness, the topic of how to triage in disaster response showed the greatest discrepancies. In the domain of hospital level disaster preparedness, individual opinions varied most within the topics of incident command, manual preparation. The responses to “accept additional patients in disaster situation” showed the biggest differences (> 21 versus 6~10).
In this study, there were disaster topics with discrepancies and concordances in perception between disaster directors and general health care providers. The analysis would present baseline information for the development of better training programs for region-specific core competencies, knowledge, and skills required for the effective response.
A number of microorganisms were hypothesised as an aetiology of the Kawasaki disease. Unfortunately, no specific agent that provides reproducible evidence has yet been reported. We report two cases of extremely rare Kawasaki disease with tsutsugamushi disease. These case reports suggest that Kawasaki disease can rarely occur concurrently or immediately after a rickettsial illness such as tsutsugamushi disease.
A certain degree of pulmonary stenosis after total correction of tetralogy of Fallot has been considered acceptable. But the long-term outcomes are not well understood. We observed the natural course of immediate pulmonary stenosis and investigated related factors for progression.
Fifty-two patients with acceptable pulmonary stenosis immediately after operation were enrolled. Acceptable pulmonary stenosis was defined as peak pressure gradient between 15 and 45 mmHg by Doppler echocardiography. Latent class linear mixed model was used to differentiate patients with progressed pulmonary stenosis, and the factors related to progression were analysed.
Pulmonary stenosis progressed in 14 patients (27%). Between the progression group and no progression group, there were no significant differences in operative age, sex, and the use of the transannular patch technique. However, immediate gradient was higher in the progression group (32.1 mmHg versus 25.7 mmHg, p = 0.009), and the cut-off value was 26.8 mmHg (sensitivity = 65.3%, specificity = 65.8%). Main stenosis at the sub-valve was observed more frequently in the progression group (85.7% versus 52.6%, p = 0.027). Despite no difference in the preoperative pulmonary valve z value, the last follow-up pulmonary valve z value was significantly lower in the progression group (−1.15 versus 0.35, p = 0.002).
Pulmonary stenosis immediately after tetralogy of Fallot total correction might progress in patients with immediate pulmonary stenosis higher than ≥26.8 mmHg and the main site was sub-valve area.
The purpose of this study was to explore musicians’ approaches to performance during practice and identify the factors that underpinned their approaches. We hypothesised that musicians would be able to recall their focus, knowledge and thoughts of their own repertoire during music performance and that such data would reveal musicians’ cognitive behaviours during the performance. By analysing musicians’ retrospective verbal protocols, we found that musicians used four main reasoning processes – study, static analysis, intuition and performer’s analysis – in their approach to music performance. The findings show that musicians utilise multiple cognitive behaviours for music performance. The implications for instrumental music teaching are discussed.
The purpose of this study was to examine whether people with ultra-high risk for psychosis showed biases as well as deficits in facial emotional recognition which were well-established findings in people with schizophrenia. Forty-five people with ultra- high risk (UHR) for psychosis, 30 people with first-episode (FE) schizophrenia and 40 healthy controls were asked to recognize the emotional category of facial emotional photographs. The stimuli were selected from the standard emotional photographs of Japanese and Caucasian Facial Expressions of Emotion (JACFEE) which depicting the basic emotions of happiness, disgust, sadness, anger, surprise, fear, and contempt. To examine the accurate and biased attribution of facial emotion recognition, unbiased hit rates and misattrbution rates of each emotion were calculated. The common abnormalities observed in the UHR for psychosis and FE schizophrenia group were lower unbiased hit rate for fear faces (UHR< controls: p = 0.027, FE< controls: p = 0.029) and higher contempt misattribution rate to faces (UHR>controls: p = 0.022, FE< controls: p = 0.088) compared with healthy controls. Unbiased hit rates for fear in UHR for psychosis and FE schizophrenia group were correlated with negative symptoms, and these correlations were found in other negative emotions in FE schizophrenia. These findings suggest that the bias as well as deficits of facial emotional recognition may be already present in the (putative) prodromal stages of schizophrenia and could be a possible trait markers for the social cognition.
Early consciousness recovery after cardiac arrest (CA) is one of the most explicit and self-evident prognostic factors for clinical outcomes. We aimed to evaluate the prognostic value of electroencephalography (EEG) phenotypes according to the American Clinical Neurophysiology Society’s Critical Care EEG classification for predicting early recovery after CA.
Consecutive patients admitted to the ICU after CA were enrolled. We analyzed Glasgow Coma Scale (GCS) score within 10 days after CA and evaluated mortality within 28 days according to EEG pattern subtype.
Among the total of 71 patients, 9 had periodic discharges (PDs) EEG pattern, 4 had rhythmic delta activity (RDA), 8 had spike-and-wave (SW), 22 had low voltage, 5 had burst suppression, and 23 had other EEG patterns. Initial GCS scores, GCS scores 3 days after CA (or 3 days after targeted temperature management [TTM]), and 10 days after CA (or 10 days after TTM) were significantly different among EEG subtypes (p < 0.001, respectively) (Table 2). GCS scores were significantly higher in RDA and the other EEG group compared to the PDs, SW, low voltage, and burst suppression groups (p < 0.001). Significant group × time interactions were observed for the follow-up period between EEG phenotypes (p < 0.001) demonstrating the most increase in the other EEG pattern group.
Consciousness states were significantly worse in the PDs, SW, burst suppression, and low-voltage groups compared to the RDA and the other EEG pattern within 10 days after CA. The degree of consciousness recovery differed significantly by EEG pattern subtype within 10 days.
This article analyzes the transfer of tacit knowledge between countries and continents, based on a case from the shipbuilding industry. The South Korean shipbuilder Hyundai Heavy Industries (HHI) was established in the early 1970s and had by the late 1980s become the world’s leading shipbuilder. Aided by foreign loan capital, HHI acquired technology through foreign licenses and imported equipment. However, shipbuilding is about more than hardware. This article presents and analyzes another important means of knowledge transfer: the acquisition of tacit knowledge in the form of shipbuilding skills, including shipyard processes and operations. This transfer was mainly accomplished through the “import” of foreign managers and the dispatch abroad of South Korean employees. One important element, which we investigate in detail, was the Korean personnel that HHI sent in 1972 to the Scott Lithgow shipyards in Scotland to observe and learn. Based on archival sources and interviews, we detail the manner in which tacit knowledge could be transferred across language and cultural barriers.
Low rates of bystander cardiopulmonary resuscitation (CPR) were identified as a shortcoming in the “chain of survival” for out-of-hospital cardiac arrest (OHCA) care in the Korean city of Ansan. This study sought to evaluate the effect of an initiative to increase bystander CPR and quality of out-of-hospital resuscitation on outcome from OHCA. The post-intervention data were used to determine the next quality improvement (QI) target as part of the “Plan-Do-Study-Act” (PDSA) model for QI.
The study hypothesis was that bystander CPR, return of spontaneous circulation (ROSC), and survival to discharge after OHCA would increase in the post-intervention period.
This was a retrospective pre/post study. The data from the pre-intervention period were abstracted from 2008–2011 and the post-intervention period from 2012–2013. The effect of the intervention on the odds of ROSC and survival to hospital discharge was determined using a generalized estimating equation to account for confounders and the effect of clustering within medical centers. The analysis was then used to identify other factors associated with outcomes to determine the next targets for intervention in the chain of survival for cardiac arrest in this community.
Rates of documented bystander CPR increased from 13% in the pre-intervention period to 37% in the post-intervention period. The overall rate of ROSC decreased from 18.4% to 14.3% (risk difference −4.1%; 95% CI, −7.1%–1.0%), whereas survival to hospital discharge increased from 3.9% to 5.0% (risk difference 1.1%; 95% CI, −1.8%–3.8%), and survival with good neurologic outcome increased from 0.8% to 1.6% (risk difference 0.8%; 95% CI, −0.8%–2.4%). In multivariable analyses, there was no association between the intervention and the rate of ROSC or survival to hospital discharge. The designated level of the treating hospital was a significant predictor of both survival and ROSC.
In this case study, there were no observed improvements in outcomes from OHCA after the targeted intervention to improve out-of-hospital CPR. However, utilizing the PDSA model for QI, the designated level of the treating hospital was found to be a significant predictor of survival in the post-period, identifying the next target for intervention.
We present a model of political networks that integrates both the choice of trade partners (the extensive margin) and trade volumes (the intensive margin). Our model predicts that regimes secure in their survival, including democracies as well as some consolidated authoritarian regimes, will trade more on the extensive margin than vulnerable autocracies, which will block trade in products that would expand interpersonal contact among their citizens. We apply a two-stage Bayesian LASSO estimator to detailed measures of institutional features and highly disaggregated product-level trade data encompassing 131 countries over a half century. Consistent with our model, we find that (a) political institutions matter for the extensive margin of trade but not for the intensive margin and (b) the effects of political institutions on the extensive margin of trade vary across products, falling most heavily on those goods that involve extensive interpersonal contact.
Conventional silicon-based electronics have faced challenges in the realization of soft bioelectronics, such as wearable and implantable integrated devices, which necessitate electrically and mechanically interactive biotic–abiotic interfacing without disturbing the daily life of the user or posing biocompatibility issues. Recently, much effort has been directed at overcoming the mechanical limitations of conventional rigid electronics by replacement of bulky, thick, and rigid electronic materials with biocompatible, soft, and nanoscale electronic materials, which exhibit intrinsic mechanical deformability as well as superior electrical properties. Recent advances in the synthesis of unconventional nanomaterials, surface functionalization methods, and integrated device fabrication techniques have resulted in further improvements in the performance of nanomaterials-based soft bioelectronics. Numerous studies have focused on the biological, electrical, and mechanical analyses of heterogeneous nanomaterial–biosystem interfaces as well as the development of efficient integration processes of soft nanomaterials into devices. In this article, we summarize the latest advances and future prospects in nanomaterials synthesis, processing, and integration strategies for flexible and stretchable bioelectronics, and their application to wearable and implantable devices.
The oriental armyworm, Mythimna separata is an important crop pest in eastern Asia. Nocturnal insects, including nocturnal moths, have phototactic behavior to an artificial light source. Phototactic behavior in insects is species-specific in response to different wavelengths of light sources. Our previous study showed that green (520 nm) light emitting diode (LED) light resulted in a significantly higher phototactic behavior in M. separata moths compared to the other wavelength LED lights. The goal of the present study is to investigate the influence of green light illumination on biological characteristics of different developmental stages in M. separata. Our results revealed that when different developmental stages of M. separata were exposed to the green light illumination in a dark period, several biological characteristics in all developmental stages except for egg stage were positively changed, but those of F1 generation M. separata which are next generation of the adults exposed to the green light did not significantly change compared with the control level. These findings suggest that green light illumination at night (or dark period) has a positive effect on the development and longevity of M. separata.
We present a young soldier presenting with aborted sudden cardiac death, who was found to have concomitant hypertrophic cardiomyopathy and Wolff–Parkinson–White syndrome. Along with pathological haemodynamic features of hypertrophic cardiomyopathy, an easily-inducible re-entrant tachycardia was clearly documented in our patient. Given the fatal potential of supraventricular tachycardia in hypertrophic cardiomyopathy, we postulated that his tachyarrhythmia could potentially trigger the event. Upon his refusal to receive implantable cardioverter/defibrillator therapy, we ablated anatomical arrhythmogenic substrate instead, and he remained uneventfully over 3 years on β-blocker.
Nancy Abelmann passed away on January 6, 2016, at the age of fifty-six. She received her PhD from the University of California, Berkeley in 1990, after completing her dissertation under Nelson Graburn. That same year, she was hired by the University of Illinois, Urbana-Champaign, where she worked for two and a half decades. She was a beloved teacher, mentor, and colleague to many, and she was a key figure in multiple departments and centers. At the time of her death, she held the Harold E. Preble Professorship in Anthropology, Asian American Studies, East Asian Languages and Cultures, and Women and Gender Studies and was also Associate Vice Chancellor for Research.
In 2005, using a famous lemma of Atkin and Swinnerton-Dyer (Some properties of partitions, Proc. Lond. Math. Soc. (3) 4 (1954), 84–106), Yesilyurt (Four identities related to third order mock theta functions in Ramanujan’s lost notebook, Adv. Math. 190 (2005), 278–299) proved four identities for third order mock theta functions found on pages 2 and 17 in Ramanujan’s lost notebook. The primary purpose of this paper is to offer new proofs in the spirit of what Ramanujan might have given in the hope that a better understanding of the identities might be gained. Third order mock theta functions are intimately connected with ranks of partitions. We prove new dissections for two rank generating functions, which are keys to our proof of the fourth, and the most difficult, of Ramanujan’s identities. In the last section of this paper, we establish new relations for ranks arising from our dissections of rank generating functions.
An index of biomarkers derived from dietary factors (diet–biomarker-related index) identifies foods and nutrients that encompass physiological potentials and provides scientific evidence for dietary patterns that increase the risk of disease associated with specific biomarkers. Although men and women have different dietary patterns and physiological characteristics, sex is not often considered when investigators develop a diet–biomarker-related index. We aimed to review whether epidemiological studies developed diet–biomarker-related indices in a sex-specific way.
We systematically searched for epidemiological studies that developed diet–biomarker-related indices, including (i) biomarker prediction indices that include dietary factors as explanatory variables and (ii) dietary patterns to explain biomarker variations, in the PubMed and EMBASE databases. We qualitatively reviewed the sex consideration in index development.
We identified seventy-nine studies that developed a diet–biomarker-related index. We found that fifty-four studies included both men and women. Of these fifty-four studies, twenty-nine (53·7 %) did not consider sex, eleven (20·3 %) included sex in the development model, seven (13·0 %) considered sex but did not include sex in the development model, and seven (13·0 %) derived a diet–biomarker-related index for men and women separately. A list of selected dietary factors that explained levels of biomarkers generally differed by sex in the studies that developed a diet–biomarker-related index in a sex-specific way.
Most studies that included both men and women did not develop the diet–biomarker-related index in a sex-specific way. Further research is needed to identify whether a sex-specific diet–biomarker-related index is more predictive of the disease of interest than an index without sex consideration.
We introduce a model that extends the standard vote choice model to encompass text. In our model, votes and speech are generated from a common set of underlying preference parameters. We estimate the parameters with a sparse Gaussian copula factor model that estimates the number of latent dimensions, is robust to outliers, and accounts for zero inflation in the data. To illustrate its workings, we apply our estimator to roll call votes and floor speech from recent sessions of the US Senate. We uncover two stable dimensions: one ideological and the other reflecting to Senators’ leadership roles. We then show how the method can leverage common speech in order to impute missing data, recovering reliable preference estimates for rank-and-file Senators given only leadership votes.