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From 2014 to 2020, we compiled radiocarbon ages from the lower 48 states, creating a database of more than 100,000 archaeological, geological, and paleontological ages that will be freely available to researchers through the Canadian Archaeological Radiocarbon Database. Here, we discuss the process used to compile ages, general characteristics of the database, and lessons learned from this exercise in “big data” compilation.
The COVID-19 pandemic has disrupted lives and livelihoods, and people already experiencing mental ill health may have been especially vulnerable.
Aims
Quantify mental health inequalities in disruptions to healthcare, economic activity and housing.
Method
We examined data from 59 482 participants in 12 UK longitudinal studies with data collected before and during the COVID-19 pandemic. Within each study, we estimated the association between psychological distress assessed pre-pandemic and disruptions since the start of the pandemic to healthcare (medication access, procedures or appointments), economic activity (employment, income or working hours) and housing (change of address or household composition). Estimates were pooled across studies.
Results
Across the analysed data-sets, 28% to 77% of participants experienced at least one disruption, with 2.3–33.2% experiencing disruptions in two or more domains. We found 1 s.d. higher pre-pandemic psychological distress was associated with (a) increased odds of any healthcare disruptions (odds ratio (OR) 1.30, 95% CI 1.20–1.40), with fully adjusted odds ratios ranging from 1.24 (95% CI 1.09–1.41) for disruption to procedures to 1.33 (95% CI 1.20–1.49) for disruptions to prescriptions or medication access; (b) loss of employment (odds ratio 1.13, 95% CI 1.06–1.21) and income (OR 1.12, 95% CI 1.06 –1.19), and reductions in working hours/furlough (odds ratio 1.05, 95% CI 1.00–1.09) and (c) increased likelihood of experiencing a disruption in at least two domains (OR 1.25, 95% CI 1.18–1.32) or in one domain (OR 1.11, 95% CI 1.07–1.16), relative to no disruption. There were no associations with housing disruptions (OR 1.00, 95% CI 0.97–1.03).
Conclusions
People experiencing psychological distress pre-pandemic were more likely to experience healthcare and economic disruptions, and clusters of disruptions across multiple domains during the pandemic. Failing to address these disruptions risks further widening mental health inequalities.
Motivated by the desire to understand complex transient behaviour in fluid flows, we study the dynamics of an air bubble driven by the steady motion of a suspending viscous fluid within a Hele-Shaw channel with a centred depth perturbation. Using both experiments and numerical simulations of a depth-averaged model, we investigate the evolution of an initially centred bubble of prescribed volume as a function of flow rate and initial shape. The experiments exhibit a rich variety of organised transient dynamics, involving bubble breakup as well as aggregation and coalescence of interacting neighbouring bubbles. The long-term outcome is either a single bubble or multiple separating bubbles, positioned along the channel in order of increasing velocity. Up to moderate flow rates, the life and fate of the bubble are reproducible and can be categorised by a small number of characteristic behaviours that occur in simply connected regions of the parameter plane. Increasing the flow rate leads to less reproducible time evolutions with increasing sensitivity to initial conditions and perturbations in the channel. Time-dependent numerical simulations that allow for breakup and coalescence are found to reproduce most of the dynamical behaviour observed experimentally, including enhanced sensitivity at high flow rate. An unusual feature of this system is that the set of steady and periodic solutions can change during temporal evolution because both the number of bubbles and their size distribution evolve due to breakup and coalescence events. Calculation of stable and unstable solutions in the single- and two-bubble cases reveals that the transient dynamics is orchestrated by weakly unstable solutions of the system that can appear and disappear as the number of bubbles changes.
The coronavirus disease 2019 (COVID-19) pandemic is likely to lead to a significant increase in mental health disorders among healthcare workers (HCW).
Aims
We evaluated the rates of anxiety, depressive and post-traumatic stress disorder (PTSD) symptoms in a population of HCW in the UK.
Method
An electronic survey was conducted between the 5 June 2020 and 31 July 2020 of all hospital HCW in the West Midlands, UK using clinically validated questionnaires: the 4-item Patient Health Questionnaire(PHQ-4) and the Impact of Event Scale-Revised (IES-R). Univariate analyses and adjusted logistic regression analyses were performed to estimate the strengths in associations between 24 independent variables and anxiety, depressive or PTSD symptoms.
Results
There were 2638 eligible participants who completed the survey (female: 79.5%, median age: 42 years, interquartile range: 32–51). The rates of clinically significant symptoms of anxiety, depression and PTSD were 34.3%, 31.2% and 24.5%, respectively. In adjusted analysis a history of mental health conditions was associated with clinically significant symptoms of anxiety (odds ratio (OR) = 2.3, 95% CI 1.9–2.7, P < 0.001), depression (OR = 2.5, 95% CI 2.1–3.0, P < 0.001) and PTSD (OR = 2.1, 95% CI 1.7–2.5, P < 0.001). The availability of adequate personal protective equipment (PPE), well-being support and lower exposure to moral dilemmas at work demonstrated significant negative associations with these symptoms (P ≤ 0.001).
Conclusions
We report higher rates of clinically significant mental health symptoms among hospital HCW following the initial COVID-19 pandemic peak in the UK. Those with a history of mental health conditions were most at risk. Adequate PPE availability, access to well-being support and reduced exposure to moral dilemmas may protect hospital HCW from mental health symptoms.
OBJECTIVES/SPECIFIC AIMS: Background: Delirium is a well described form of acute brain organ dysfunction characterized by decreased or increased movement, changes in attention and concentration as well as perceptual disturbances (i.e., hallucinations) and delusions. Catatonia, a neuropsychiatric syndrome traditionally described in patients with severe psychiatric illness, can present as phenotypically similar to delirium and is characterized by increased, decreased and/or abnormal movements, staring, rigidity, and mutism. Delirium and catatonia can co-occur in the setting of medical illness, but no studies have explored this relationship by age. Our objective was to assess whether advancing age and the presence of catatonia are associated with delirium. METHODS/STUDY POPULATION: Methods: We prospectively enrolled critically ill patients at a single institution who were on a ventilator or in shock and evaluated them daily for delirium using the Confusion Assessment for the ICU and for catatonia using the Bush Francis Catatonia Rating Scale. Measures of association (OR) were assessed with a simple logistic regression model with catatonia as the independent variable and delirium as the dependent variable. Effect measure modification by age was assessed using a Likelihood ratio test. RESULTS/ANTICIPATED RESULTS: Results: We enrolled 136 medical and surgical critically ill patients with 452 matched (concomitant) delirium and catatonia assessments. Median age was 59 years (IQR: 52–68). In our cohort of 136 patients, 58 patients (43%) had delirium only, 4 (3%) had catatonia only, 42 (31%) had both delirium and catatonia, and 32 (24%) had neither. Age was significantly associated with prevalent delirium (i.e., increasing age associated with decreased risk for delirium) (p=0.04) after adjusting for catatonia severity. Catatonia was significantly associated with prevalent delirium (p<0.0001) after adjusting for age. Peak delirium risk was for patients aged 55 years with 3 or more catatonic signs, who had 53.4 times the odds of delirium (95% CI: 16.06, 176.75) than those with no catatonic signs. Patients 70 years and older with 3 or more catatonia features had half this risk. DISCUSSION/SIGNIFICANCE OF IMPACT: Conclusions: Catatonia is significantly associated with prevalent delirium even after controlling for age. These data support an inverted U-shape risk of delirium after adjusting for catatonia. This relationship and its clinical ramifications need to be examined in a larger sample, including patients with dementia. Additionally, we need to assess which acute brain syndrome (delirium or catatonia) develops first.
Motivated by the reopening mechanics of strongly collapsed airways, we study the steady propagation of an air finger through a collapsed oil-filled channel with a single compliant wall. In a previous study using fully compliant elastic tubes, a ‘pointed’ air finger was found to propagate at high speed and low pressure, which, if clinically accessible, offers the potential for rapid reopening of highly collapsed airways with minimal tissue damage (Heap & Juel Phys. Fluids, vol. 20 (8), 2008, 081702). The mechanism underlying the selection of that pointed finger, however, remained unexplained. In this paper, we identify the required selection mechanism by conducting an experimental study in a simpler geometry: a rigid rectangular Hele-Shaw channel with an elastic top boundary. The constitutive behaviour of this elasto-rigid channel is nonlinear and broadly similar to that of an elastic tube, but unlike the tube, the channel’s cross-section adopts self-similar shapes from the undeformed state to the point of first near wall contact. The ensuing simplification of the vessel geometry enables the systematic investigation of the reopening dynamics in terms of increasing initial collapse. We find that for low levels of initial collapse, a single centred symmetric finger propagates in the channel and its shape is set by the tip curvature. As the level of collapse increases, the channel cross-section develops a central region of near opposite wall contact, and the finger shape evolves smoothly towards a ‘flat-tipped’ finger whose geometry is set by the strong depth gradient near the channel walls. We show that the flat-tipped mode of reopening is analogous to the pointed finger observed in tubes. Its propagation is sustained by the vessel’s extreme cross-sectional profile at high collapse, while vessel compliance is necessary to stabilise it. A simple scaling argument based on the dissipated power reveals that this reopening mode is preferred at higher propagation speeds when it becomes favourable to displace the elastic channel wall rather than the viscous fluid.
Dietary advice is fundamental in the prevention and management of type 2 diabetes (T2DM). Advice is improved by individual assessment but existing methods are time-consuming and require expertise. We developed a twenty-five-item questionnaire, the UK Diabetes and Diet Questionnaire (UKDDQ), for quick assessment of an individual’s diet. The present study examined the UKDDQ’s repeatability and relative validity compared with 4 d food diaries.
Design
The UKDDQ was completed twice with a median 3 d gap (interquartile range=1–7 d) between tests. A 4 d food diary was completed after the second UKDDQ. Diaries were analysed and food groups were mapped on to the UKDDQ. Absolute agreement between total scores was examined using intra-class correlation (ICC). Agreement for individual items was tested with Cohen’s weighted kappa (κw).
Setting
South West of England.
Subjects
Adults (n 177, 50·3 % women) with, or at high risk for, T2DM; mean age 55·8 (sd 8·6) years, mean BMI 34·4 (sd 7·3) kg/m2; participants were 91 % White British.
Results
The UKDDQ showed excellent repeatability (ICC=0·90 (0·82, 0·94)). For individual items, κw ranged from 0·43 (‘savoury pastries’) to 0·87 (‘vegetables’). Total scores from the UKDDQ and food diaries compared well (ICC=0·54 (0·27, 0·70)). Agreement for individual items varied and was good for ‘alcohol’ (κw=0·71) and ‘breakfast cereals’ (κw=0·70), with no agreement for ‘vegetables’ (κw=0·08) or ‘savoury pastries’ (κw=0·09).
Conclusions
The UKDDQ is a new British dietary questionnaire with excellent repeatability. Comparisons with food diaries found agreements similar to those for international dietary questionnaires currently in use. It targets foods and habits important in diabetes prevention and management.
We examine the sensitivity of Saffman–Taylor fingers to controlled variations in channel depth by investigating the effects of centred, rectangular occlusions in Hele-Shaw channels. For large occlusions, the geometry is known to support symmetric, asymmetric and oscillatory propagation states when air displaces a more viscous fluid from within the channel. A previously developed depth-averaged model is found to be in quantitative agreement with laboratory experiments once the aspect ratio (width/height) of the tube’s cross-section reaches a value of 40. We find that the multiplicity of solutions at finite occlusion heights arises through interactions of the single stable and multiple unstable solutions already present in the absence of the occlusion: the classic Saffman–Taylor viscous fingering problem. The sequence of interactions that occurs with increasing occlusion height is the same for all aspect ratios investigated, but the occlusion height required for each interaction decreases with increasing aspect ratio. Thus, the system becomes more sensitive as the aspect ratio increases in the sense that multiple solutions are provoked for smaller relative depth changes. We estimate that the required depth changes become of the same order as the typical roughnesses of the experimental system ($1~{\rm\mu}\text{m}$) for aspect ratios beyond 155, which we conjecture underlies the extreme sensitivity of experiments conducted in such Hele-Shaw channels.
Weight loss is crucial for treating type 2 diabetes mellitus (T2DM). It remains unclear which dietary intervention is best for optimising glycaemic control, or whether weight loss itself is the main reason behind observed improvements. The objective of this study was to assess the effects of various dietary interventions on glycaemic control in overweight and obese adults with T2DM when controlling for weight loss between dietary interventions. A systematic review of randomised controlled trials (RCT) was conducted. Electronic searches of Medline, Embase, Cinahl and Web of Science databases were conducted. Inclusion criteria included RCT with minimum 6 months duration, with participants having BMI≥25·0 kg/m2, a diagnosis of T2DM using HbA1c, and no statistically significant difference in mean weight loss at the end point of intervention between dietary arms. Results showed that eleven studies met the inclusion criteria. Only four RCT indicated the benefit of a particular dietary intervention over another in improving HbA1c levels, including the Mediterranean, vegan and low glycaemic index (GI) diets. However the findings from one of the four studies showing a significant benefit are questionable because of failure to control for diabetes medications and poor adherence to the prescribed diets. In conclusion there is currently insufficient evidence to suggest that any particular diet is superior in treating overweight and obese patients with T2DM. Although the Mediterranean, vegan and low-GI diets appear to be promising, further research that controls for weight loss and the effects of diabetes medications in larger samples is needed.
The behavior of marine-terminating ice sheets, such as the West Antarctic ice sheet, is of interest due to the possibility of rapid grounding-line retreat and consequent catastrophic loss of ice. Critical to modeling this behavior is a choice of basal rheology, where the most popular approach is to relate the ice-sheet velocity to a power-law function of basal stress. Recent experiments, however, suggest that near-grounding line tills exhibit Coulomb friction behavior. Here we address how Coulomb conditions modify ice-sheet profiles and stability criteria. The basal rheology necessarily transitions to Coulomb friction near the grounding line, due to low effective stresses, leading to changes in ice-sheet properties within a narrow boundary layer. Ice-sheet profiles ‘taper off’ towards a flatter upper surface, compared with the power-law case, and basal stresses vanish at the grounding line, consistent with observations. In the Coulomb case, the grounding-line ice flux also depends more strongly on flotation ice thickness, which implies that ice sheets are more sensitive to climate perturbations. Furthermore, with Coulomb friction, the ice sheet grounds stably in shallower water than with a power-law rheology. This implies that smaller perturbations are required to push the grounding line into regions of negative bed slope, where it would become unstable. These results have important implications for ice-sheet stability in a warming climate.
Microdroplet deposition is a technology that spans applications from tissue engineering to microelectronics. Our new high-speed imaging measurements reveal how sequential linear deposition of overlapping droplets on flat uniform substrates leads to striking non-uniform morphologies for moderate contact angles. We develop a simple physical model, which for the first time captures the post-impact dynamics drop-by-drop: surface-tension drives liquid redistribution, contact-angle hysteresis underlies initial non-uniformity, while viscous effects cause subsequent periodic variations.
Extending participation and social connectivity is now widely accepted as central to adding life to years as well as healthy years to life, while participation in the life of the community is seen as critical to well-being (Sen, 1992, p 39), and capable of addressing older people's rights, extending inclusion, reducing exclusion, easing demand on national budgets and building social cohesion. The central conundrums of increasing participation and social connectivity are, first, the intermeshing of personal, local, meso and macro level factors in shaping participation and social connectivity, and second, how the drive towards increased participation can be included in framing policy in such a way that participation is individually meaningful, social connectivity is enhanced and benefits flow to participants and to society in general. Underlying the application of the concepts of participation and social connectivity to older people is the idea that old age places people outside the mainstream: that older people's participation and social connectivity is wanting in scale or scope, that they do want or should want to participate more and that it is chiefly the impediment of old age that constrains their participation. Categorised as outside the mainstream, older people become defined by their age rather than those other salient aspects of their social identity, class, sexuality, ethnicity, education, histories and personal outlook that policy makers and implementers find difficult to respond to in relation to older people. This chapter examines older people's experiences of participation and social connectivity across a range of geographical and social locations within the UK and within low and middle-income countries, in order to test conceptualisations of older people's participation and social connectivity against experience, and to begin to trace the individual, local, meso and macro factors and linkages that need to be addressed to extend meaningful participation and engagement for people who happen to be older.
We consider the propagation of an air finger into a wide fluid-filled channel with a spatially varying depth profile. Our aim is to understand the origin of the multiple coexisting families of both steady and oscillatory propagating fingers previously observed in experiments in axially uniform channels each containing a centred step-like occlusion. We find that a depth-averaged model can reproduce all the finger propagation modes observed experimentally. In addition, the model reveals new modes for symmetric finger propagation. The inclusion of a spatially variable channel depth in the depth-averaged equations leads to: (i) a variable mobility coefficient within the fluid domain due to variations in viscous resistance of the channel; and (ii) a variable transverse curvature term in the dynamic boundary condition that modifies the pressure jump over the air–liquid interface. We use our model to examine the roles of these two distinct effects and find that both contribute to the steady bifurcation structure, while the transverse curvature term is responsible for the distinctive oscillatory propagation modes.
Using spectroscopic observations and photometric light curves of 280 nearby M dwarfs from the MEarth exoplanet transit survey, we examine the relationships between magnetic activity (quantified by Hα emission), rotation period, and stellar age (derived from three-dimensional space velocities). Although we have known for decades that a large fraction of mid-late-type M dwarfs are magnetically active, it was not clear what role rotation played in the magnetic field generation (and subsequent chromospheric heating). Previous attempts to investigate the relationship between magnetic activity and rotation in mid-late-type M dwarfs were hampered by the limited number of M dwarfs with measured rotation periods (and the fact that vsini measurements only probe rapid rotation). However, the photometric data from the MEarth survey allows us to probe a wide range of rotation periods for hundreds of M dwarf stars (from less than one to over 100 days). Over all M spectral types we find that magnetic activity decreases with longer rotation periods, including late-type, fully convective M dwarfs. We find that the most magnetically active (and hence, most rapidly rotating) stars are consistent with a kinematically young population, while slow-rotators are less active or inactive and appear to belong to an older, dynamically heated stellar population.