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The essence of sub-critical transition of oscillatory boundary-layer flows is the non-modal growth of finite-amplitude disturbances. The current understanding of the mechanisms of the orderly and bypass transitions of oscillatory boundary-layer flows is limited. The present study adopts optimisation approaches to predict the maximum energy amplification of two- and three-dimensional perturbations in response to the optimal initial disturbance with or without external forcing. A series of direct numerical simulations are also performed to compare with the results obtained from the stability analyses. In particular, the optimal initial perturbation similar to a Tollmien–Schlichting (T–S) wave yields the largest transient growth under the combined effects of the Orr mechanism and inflectional point instability. With a considerable level of two-dimensional disturbance, the vortex tube nonlinearly develops from the T–S-like wave, and then either deforms into a $\varLambda$-vortex in the near-wall region or rolls up to the free shear region. The further burst of turbulence can follow the first pathway as K-type transition or the second one as vortex tube breakdown due to the elliptical instability. Additionally, non-modal growth can initiate the inception of streaky structures by favourable three-dimensional initial perturbations and/or forcing. The secondary instabilities responsible for the streak breakdown are classified as the varicose (symmetric) and sinuous (anti-symmetric) modes. Under a sufficiently high level of three-dimensional disturbance, the bypass transition is predominantly characterised by the formation of the sinuous mode and turbulent spots, which leads to the suppression of inflection point instability.
Violent respiratory events play critical roles in the transmission of respiratory diseases, such as coughing and sneezing, between infectious and susceptible individuals. In this work, large-scale multiphase flow large-eddy simulations have been performed to simulate the coughing jet from a human's mouth carrying pathogenic or virus-laden droplets by using a weakly compressible smoothed particle hydrodynamics method. We explicitly model the cough jet ejected from a human mouth in the form of a mixture of two-phase fluids based on the cough velocity profile of the exhalation flow obtained from experimental data and the statistics of the droplets’ sizes. The coupling and interaction between the two expiratory phases and ambient surrounding air are examined based on the interaction between the gas particles and droplet particles. First, the results reveal that the turbulence of the cough jet determines the dispersion of the virus-laden droplets, i.e. whether they fly up evolving into aerosols or fall down to the ground. Second, the droplet particles have significant effects on the evolution of the cough jet turbulence; for example, they increase the complexity and butterfly effect introduced by the turbulence disturbance. Our results show that the prediction of the spreading distance of droplet particles often goes beyond the social distancing rules recommended by the World Health Organization, which reminds us of the risks of exposure if we do not take any protecting protocol.
Autism spectrum disorder (ASD) is a neurodevelopmental condition, with symptoms appearing in the early developmental period. Little is known about its current burden at the global, regional and national levels. This systematic analysis aims to summarise the latest magnitudes and temporal trends of ASD burden, which is essential to facilitate more detailed development of prevention and intervention strategies.
The data on ASD incidence, prevalence, disability-adjusted life years (DALYs) in 204 countries and territories between 1990 and 2019 came from the Global Burden of Disease Study 2019. The average annual percentage change was calculated to quantify the secular trends in age-standardised rates (ASRs) of ASD burden by region, sex and age.
In 2019, there were an estimated 60.38 × 104 [95% uncertainty interval (UI) 50.17–72.01] incident cases of ASD, 283.25 × 105 (95% UI 235.01–338.11) prevalent cases and 43.07 × 105 (95% UI 28.22–62.32) DALYs globally. The ASR of incidence slightly increased by around 0.06% annually over the past three decades, while the ASRs of prevalence and DALYs both remained stable over the past three decades. In 2019, the highest burden of ASD was observed in high-income regions, especially in high-income North America, high-income Asia Pacific and Western Europe, where a significant growth in ASRs was also observed. The ASR of ASD burden in males was around three times that of females, but the gender difference was shrunk with the pronounced increase among females. Of note, among the population aged over 65 years, the burden of ASD presented increasing trends globally.
The global burden of ASD continues to increase and remains a major mental health concern. These substantial heterogeneities in ASD burden worldwide highlight the need for making suitable mental-related policies and providing special social and health services.
Very few studies have emphasized the effects of high-pressure sintering on snow density evolution, even though snow as a type of engineering material is widely used in construction engineering in cold regions for snow pavement, snow runway and polar infrastructure. This study presents new experimental results of snow densification under high pressures of up to 100 MPa for a temperature range from −3.5 to −17.3°C and uniaxial compression at the temperature of −10°C and constant strain rates from 5 × 10−4 to 10−1 s−1. Results reveal that density evolution of snow to ice under high-pressure sintering can be achieved in a wide temperature range within a duration as short as 5 min. The compressive strength of snow-sintered ice was ~1.2–2.2 times as large as that of water-frozen ice reported by previous work. The orthogonal experiment showed that pressure is a more significant factor affecting the final density in comparison with sintering temperature and time. The increased rates of ice fabrication, low limitations on temperature and reliable sintered snow strength indicate that snow-ice engineering, such as airport construction in Greenland and Antarctica, can be improved by high-pressure sintering of snow to overcome the harsh environment.
We experimentally, numerically and theoretically investigate the nonlinear interaction between a cavitation bubble and the interface of two immiscible fluids (oil and water) on multiple time scales. The underwater electric discharge method is utilized to generate a cavitation bubble near or at the interface. Both the bubble dynamics on a short time scale and the interface evolution on a much longer time scale are recorded via high-speed photography. Two mechanisms are found to contribute to the fluid mixing in our system. First, when a bubble is initiated in the oil phase or at the interface, an inertia-dominated high-speed liquid jet generated from the collapsing bubble penetrates the water–oil interface, and consequently transports fine oil droplets into the water. The critical standoff parameter for jet penetration is found to be highly dependent on the density ratio of the two fluids. Furthermore, the pinch-off of an interface jet produced long after the bubble dynamics stage is reckoned as the second mechanism, carrying water droplets into the oil bulk. The dependence of the bubble jetting behaviours and interface jet dynamics on the governing parameters is systematically studied via experiments and boundary integral simulations. Particularly, we quantitatively demonstrate the respective roles of surface tension and viscosity in interface jet dynamics. As for a bubble initiated at the interface, an extended Rayleigh–Plesset model is proposed that well predicts the asymmetric dynamics of the bubble, which accounts for a faster contraction of the bubble top and a downward liquid jet.
The majority of plant viral disease is transmitted and spread by insect vectors in the field. The small brown planthopper, Laodelphax striatellus (Fallén), is the only efficient vector for rice black-streaked dwarf virus (RBSDV), a devastating plant virus that infects multiple grain crops, including rice, maize, and wheat. Adenosine triphosphate (ATP)-binding cassette (ABC) transporters participate in various biological processes. However, little is known about whether ABC transporters affect virus infection in insects. In this study, RBSDV accumulation was significantly reduced in L. striatellus after treatment with verapamil, an effective inhibitor of ABC transporters. Thirty-four ABC transporter genes were identified in L. striatellus and expression analysis showed that LsABCF2 and LsABCG9 were significantly upregulated and downregulated, respectively, after RBSDV infection. LsABCF2 and LsABCG9 were expressed during all developmental stages, and LsABCG9 was highly expressed in the midgut of L. striatellus. Knockdown of LsABCF2 promoted RBSDV accumulation, while knockdown of LsABCG9 suppressed RBSDV accumulation in L. striatellus. Our data showed that L. striatellus might upregulate the expression of LsABCF2 and downregulate LsABCG9 expression to suppress RBSDV infection. These results will contribute to understanding the effects of ABC transporters on virus transmission and provide theoretical basis for virus management in the field.
Nutritional Risk Screening index is a standard tool to assess nutritional risk, but epidemiological data are scarce on controlling nutritional status (CONUT) as a prognostic marker in acute haemorrhagic stroke (AHS). We aimed to explore whether the CONUT may predict a 3-month functional outcome in AHS. In total, 349 Chinese patients with incident AHS were consecutively recruited, and their malnutrition risks were determined using a high CONUT score of ≥ 2. The cohort patients were divided into high-CONUT (≥ 2) and low-CONUT (< 2) groups, and primary outcomes were a poor functional prognosis defined as the modified Rankin Scale (mRS) score of ≥ 3 at post-discharge for 3 months. Odds ratios (OR) with 95 % confidence intervals (CI) for the poor functional prognosis at post-discharge were estimated by using a logistic analysis with additional adjustments for unbalanced variables between the high-CONUT and low-CONUT groups. A total of 328 patients (60·38 ± 12·83 years; 66·77 % male) completed the mRS assessment at post-discharge for 3 months, with 172 patients at malnutrition risk at admission and 104 patients with a poor prognosis. The levels of total cholesterol and total lymphocyte counts were significantly lower in high-CONUT patients than low-CONUT patients (P = 0·012 and < 0·001, respectively). At 3-month post discharge, there was a greater risk for the poor outcome in the high-CONUT compared with the low-CONUT patients at admission (OR: 2·32, 95 % CI: 1·28, 4·17). High-CONUT scores independently predict a 3-month poor prognosis in AHS, which helps to identify those who need additional nutritional managements.
The effects of early thiamine use on clinical outcomes in critically ill patients with acute kidney injury (AKI) are unclear. The purpose of this study was to investigate the associations between early thiamine administration and clinical outcomes in critically ill patients with AKI. The data of critically ill patients with AKI within 48 h after ICU admission were extracted from the Medical Information Mart for Intensive Care III (MIMIC III) database. PSM was used to match patients early receiving thiamine treatment to those not early receiving thiamine treatment. The association between early thiamine use and in-hospital mortality due to AKI was determined using a logistic regression model. A total of 15 066 AKI patients were eligible for study inclusion. After propensity score matching (PSM), 734 pairs of patients who did and did not receive thiamine treatment in the early stage were established. Early thiamine use was associated with lower in-hospital mortality (OR 0·65; 95 % CI 0·49, 0·87; P < 0·001) and 90-d mortality (OR 0·58; 95 % CI 0·45, 0·74; P < 0·001), and it was also associated with the recovery of renal function (OR 1·26; 95 % CI 1·17, 1·36; P < 0·001). In the subgroup analysis, early thiamine administration was associated with lower in-hospital mortality in patients with stages 1 to 2 AKI. Early thiamine use was associated with improved short-term survival in critically ill patients with AKI. It was possible beneficial role in patients with stages 1 to 2 AKI according to the Kidney Disease: Improving Global Outcomes criteria.
The aim of this study was to investigate the long-term outcome of quality of life (QOL) in the lower-limb amputees 10 years after the 2008 Sichuan earthquake.
In the cross-sectional study, 66 lower-limb amputees were recruited. The prosthetics-related QOL was assessed using the Prosthetic Evaluation Questionnaire (PEQ) in terms of the scales of utility, appearance, sounds, residual limb health, perceived response, frustration, social burden, ambulation, and well-being. The score of each PEQ subscale was calculated and compared among the cohorts with different demographic characteristics.
The PEQ scores showed that the scales of sounds, residual limb health, and frustration were still low in the lower-limb amputees 10 years after the 2008 Sichuan earthquake. The comparison of PEQ scales among cohorts with different demographic characteristics indicated that the potential demographic risk factors, namely, age, marital status, educational level, living independence, and comorbidity, were associated with prosthesis-related QOL.
The prosthesis-related QOL of the lower-limb amputees 10 years after the 2008 Sichuan earthquake has been partly documented in this study. The potential demographic risk factors associated with QOL of amputees were also identified. These findings could enhance the understanding of prosthesis-related QOL of lower-limb amputees sustained in an earthquake and facilitate the optimization of post-disaster rehabilitation strategies.
Anxiety disorders are widespread across the world. A systematic understanding of the disease burden, temporal trend and risk factors of anxiety disorders provides the essential foundation for targeted public policies on mental health at the national, regional, and global levels.
The estimation of anxiety disorders in the Global Burden of Disease Study 2019 using systematic review was conducted to describe incidence, prevalence and disability-adjusted life years (DALYs) in 204 countries and regions from 1990 to 2019. We calculated the estimated annual percentage change (EAPC) to quantify the temporal trends in anxiety disorders burden by sex, region and age over the past 30 years and analysed the impact of epidemiological and demographic changes on anxiety disorders.
Globally, 45.82 [95% uncertainty interval (UI): 37.14, 55.62] million incident cases of anxiety disorders, 301.39 million (95% UI: 252.63, 356.00) prevalent cases and 28.68 (95% UI: 19.86, 39.32) million DALYs were estimated in 2019. Although the overall age-standardised burden rate of anxiety disorders remained stable over the past three decades, the latest absolute number of anxiety disorders increased by 50% from 1990. We observed huge disparities in both age-standardised burden rate and changing trend of anxiety disorders in sex, country and age. In 2019, 7.07% of the global DALYs due to anxiety disorders were attributable to bullying victimisation, mainly among the population aged 5–39 years, and the proportion increased in almost all countries and territories compared with 1990.
Anxiety disorder is still the most common mental illness in the world and has a striking impact on the global burden of disease. Controlling potential risk factors, such as bullying, establishing effective mental health knowledge dissemination and diversifying intervention strategies adapted to specific characteristics will reduce the burden of anxiety disorders.
The aim of this study was to assess the current status of disease-related knowledge and to analyze the relationship among the general condition, illness perception, and psychological status of patients with coronavirus disease 2019 (COVID-19).
A hospital-based cross-sectional study was conducted on 118 patients using convenience sampling. The general questionnaire, disease-related knowledge questionnaire of COVID-19, Illness Perception Questionnaire (IPQ), and Profile of Mood States (POMS) were used to measure the current status of participants.
The overall average score of the disease-related knowledge of patients with COVID-19 was (79.19 ± 14.25), the self-care situation was positively correlated with knowledge of prevention and control (r = 0.265; P = 0.004) and total score of disease-related knowledge (r = 0.206; P = 0.025); the degree of anxiety was negatively correlated with the knowledge of diagnosis and treatment (r = −0.182; P = 0.049). The score of disease-related knowledge was negatively correlated with negative cognition (volatility, consequences, emotional statements) and negative emotions (tension, fatigue, depression) (P < 0.05); positively correlated with positive cognition (disease coherence) and positive emotion (self-esteem) (P < 0.05).
It was recommended that we should pay more attention to the elderly and low-income groups, and increase the knowledge about diagnosis and treatment of COVID-19 and self-care in the future health education for patients.
Single-crystal and powder X-ray diffraction data, collected at room temperature, unit-cell parameters and space group for eluxadoline nitrate monohydrate, C32H35N5O5⋅2HNO3⋅H2O, are reported [a = 11.066(5) Å, b = 13.452(6) Å, c = 24.373(9) Å, unit-cell volume V = 3628.15 Å3, Z = 4, ρcal = 1.344 g⋅cm−3, and space group P212121]. All the diffraction peaks in the experimental pattern have been indexed and are consistent with the P212121 space group.
In December 2019, cases of severe coronavirus 2019 (COVID-19) infection rapidly progressed to acute respiratory failure. This study aims to assess the association between the neutrophil-to-lymphocyte ratio (NLR) and the incidence of severe COVID-19 infection. A retrospective cohort study was conducted on 210 patients with COVID-19 infection who were admitted to the Central Hospital of Wuhan from 27 January 2020 to 9 March 2020. Peripheral blood samples were collected and examined for lymphocyte subsets by flow cytometry. Associations between tertiles of NLR and the incidence of severe illness were analysed by logistic regression.
Of the 210 patients with COVID-19, 87 were diagnosed as severe cases. The mean NLR of the severe group was higher than that of the mild group (6.6 vs. 3.3, P < 0.001). The highest tertile of NLR (5.1–19.7) exhibited a 5.9-fold (95% CI 1.3–28.5) increased incidence of severity relative to that of the lowest tertile (0.6–2.5) after adjustments for age, diabetes, hypertension and other confounders. The number of T cells significantly decreased in the severe group (0.5 vs. 0.9, P < 0.001). COVID-19 might mainly act on lymphocytes, particularly T lymphocytes. NLR was identified as an early risk factor for severe COVID-19 illness. Patients with increased NLR should be admitted to an isolation ward with respiratory monitoring and supportive care.
In this work ice breaking caused by a pair of interacting collapsing bubbles was studied by an experimental approach. The bubbles were generated by an underwater electric discharge simultaneously, positioned either horizontally or vertically below a floating ice plate and observed via high-speed photography. The bubble-induced shock waves, which turn out to be crucial to the fracturing of the ice, were visualized using a shadowgraph method and also measured using pressure transduces. Unique bubble behaviour was observed, including bubble coalescence, bubble splitting, inclined counter-jets and asymmetric toroidal bubble collapse. Bubble dynamic properties, such as jet speed, jet energy and bubble centre displacement, were measured. Shock wave emission and ice breaking capability of the two bubbles were investigated over a range of inter-bubble and bubble–boundary distances. Regions where the damaging potential of the bubble pair are strengthened or weakened were summarized and possible reasons for the variation in the ice breaking capability were analysed based on bubble morphology, jet characteristics and shock wave pressure. The findings may contribute to more efficient ice breaking and also inspire new ways to manipulate cavitation bubble damage.
The oxidation behavior of the selective laser melting (SLM)–fabricated Inconel 718 was investigated through isothermal oxidation testing at 650 °C for 500 h and compared with that of the as-cast and as-forged specimens at the same testing conditions. The effect of microstructure and surface roughness on the oxidation behavior of the SLM-fabricated, as-cast, and as-forged Inconel 718 specimens was examined. The result shows that Inconel 718 fabricated by SLM with the unique layer structure exhibited a better resistance to the 500 h oxidation at 650 °C compared with as-cast and as-forged 718 with coarse dendritic structure and uniform equiaxed grain microstructure, respectively. The influence of the surface roughness on the long-time oxidation resistance of SLM specimens is not pronounced compared with that of as-cast and as-forged specimens. The tiny dendrites instead of grain boundaries are a major influencing factor for the oxidation process of SLM specimens. The surface roughness has more evident influence on the oxidation resistance of as-forged specimens than that of the as-cast ones subjected to the 500 h oxidation at 650 °C.
Malnutrition and acute kidney injury (AKI) are common complications in hospitalised patients, and both increase mortality; however, the relationship between them is unknown. This is a retrospective propensity score matching study enrolling 46 549 inpatients, aimed to investigate the association between Nutritional Risk Screening 2002 (NRS-2002) and AKI and to assess the ability of NRS-2002 and AKI in predicting prognosis. In total, 37 190 (80 %) and 9359 (20 %) patients had NRS-2002 scores <3 and ≥3, respectively. Patients with NRS-2002 scores ≥3 had longer lengths of stay (12·6 (sd 7·8) v. 10·4 (sd 6·2) d, P < 0·05), higher mortality rates (9·6 v. 2·5 %, P < 0·05) and higher incidence of AKI (28 v. 16 %, P < 0·05) than patients with normal nutritional status. The NRS-2002 showed a strong association with AKI, that is, the risk of AKI changed in parallel with the score of the NRS-2002. In short- and long-term survival, patients with a lower NRS-2002 score or who did not have AKI achieved a significantly lower risk of mortality than those with a high NRS-2002 score or AKI. Univariate Cox regression analyses indicated that both the NRS-2002 and AKI were strongly related to long-term survival (AUC 0·79 and 0·71) and that the combination of the two showed better accuracy (AUC 0·80) than the individual variables. In conclusion, malnutrition can increase the risk of AKI and both AKI and malnutrition can worsen the prognosis that the undernourished patients who develop AKI yield far worse prognosis than patients with normal nutritional status.
The High-degree Cubature Kalman Filter (HCKF) is proposed as a novel methodology based on the arbitrary degree spherical rule, which can achieve better performance than the traditional Kalman filter. However, it also has a large calculation burden when used in a high-dimension and high-degree of accuracy estimation system. The number of sampling points of an HCKF increases polynomially with increasing state-space dimensions, which further increases the calculation burden. The reduction of the number of the state-space dimensions is the main contribution of this study. A strategy for HCKF based on the partitioning of the state-space and orthogonal principle is introduced, referred to as the Multiple Robust HCKF (MRHCKF). It is shown that this technique can effectively reduce the calculation burden for the high-dimension system with robust performance. Numerical simulations are performed for the example of high-dimension relative position and attitude estimation to show that the proposed method can obtain nearly the same performance as the HCKF, while drastically reducing computational complexity.
Although it is crucial to improve the treatment status of people with severe mental illness (SMI), it is still unknown whether and how socioeconomic development influences their treatment status.
To explore the change in treatment status in people with SMI from 1994 to 2015 in rural China and to examine the factors influencing treatment status in those with SMI.
Two mental health surveys using identical methods and ICD-10 were conducted in 1994 and 2015 (population ≥15 years old, n = 152 776) in the same six townships of Xinjin County, Chengdu, China.
Compared with 1994, individuals with SMI in 2015 had significantly higher rates of poor family economic status, fewer family caregivers, longer duration of illness, later age at first onset and poor mental status. Participants in 2015 had significantly higher rates of never being treated, taking antipsychotic drugs and ever being admitted to hospital, and lower rates of using traditional Chinese medicine or being treated by traditional/spiritual healers. The factors strongly associated with never being treated included worse mental status (symptoms/social functioning), older age, having no family caregivers and poor family economic status.
Socioeconomic development influences the treatment status of people with SMI in contemporary rural China. Relative poverty, having no family caregivers and older age are important factors associated with a worse treatment status. Culture-specific, community-based interventions and targeted poverty-alleviation programmes should be developed to improve the early identification, treatment and recovery of individuals with SMI in rural China.
CrFeNiTix (x = 0.2, 0.3, 0.4, 0.5, and 0.6 molar ratio) compositionally complex alloys were fabricated by vacuum arc melting to investigate the microstructure, hardness, and compressive properties. The results revealed that CrFeNiTix alloys consisted of the principal face-centered cubic (FCC) phase and body-centered cubic (BCC) solid solution, with an amount of (Ni, Ti)-rich hexagonal close-packed phase. CrFeNiTix alloys exhibited the typical dendrite. Ti0.2 and Ti0.3 alloys were composed of FCC and BCC solid solutions in the dendrite, as well as ε (Ni3Ti) and R (Ni2.67Ti1.33) phases in the inter-dendrite, simultaneously. For Ti0.4, Ti0.5, and Ti0.6 alloys, (Fe, Cr)-rich solid solution separated out and ε phase transformed into R phase gradually. Meanwhile, TEM analysis indicated that Ti0.4 alloy matrix consisted of the principal FCC phase containing (Ni, Ti)-rich intragranular nanoprecipitates. The hardness values of CrFeNiTix alloys were increased with the addition of Ti content and the high compressive strength of CrFeNiTix alloys was maintained, which was attributed to the solid solution strengthening and precipitation hardening.