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Dynamics of two-dimensional flow past a rigid flat plate with a trailing closed flexible filament acting as a deformable afterbody are investigated numerically by an immersed boundary-lattice Boltzmann method for the fluid flow and a finite element method for the filament motion. The effects of Reynolds number ($Re$) and length ratio ($Lr$) on the flow patterns and dynamics of the rigid-flexible coupling system are studied. Based on our numerical results, five typical state modes have been identified in $Lr\unicode{x2013}Re$ plane in terms of the filament shape and corresponding dynamics, i.e. static deformation, micro-vibration, multi-frequency flapping, periodic flapping and chaotic flapping modes, respectively. Benefiting from the passive flow control by using the flexible filament as a deformable afterbody, the coupled system may enjoy a significant drag reduction (up to $22\,\%$) compared with bare plate scenarios ($Lr=1$). Maximum drag reduction achieved at $L_{c,{min}} \in [1.8, 2]$ is often accompanied by the onset of the system state transition. The flow characteristic and its relation to the change in hydrodynamic drag are further explored in order to reveal the underlying mechanisms of the counterintuitive dynamical behaviour of the coupled system. The scaling laws for the form drag and the friction drag, which arise from the pressure and viscous effects, respectively, are proposed to estimate the overall drag acting on the system. The results obtained in the present study may shed some light on understanding the dynamical behaviour of rigid-flexible coupling systems.
This study is performed to figure out how the presence of diabetes affects the infection, progression and prognosis of 2019 novel coronavirus disease (COVID-19), and the effective therapy that can treat the diabetes-complicated patients with COVID-19. A multicentre study was performed in four hospitals. COVID-19 patients with diabetes mellitus (DM) or hyperglycaemia were compared with those without these conditions and matched by propensity score matching for their clinical progress and outcome. Totally, 2444 confirmed COVID-19 patients were recruited, from whom 336 had DM. Compared to 1344 non-DM patients with age and sex matched, DM-COVID-19 patients had significantly higher rates of intensive care unit entrance (12.43% vs. 6.58%, P = 0.014), kidney failure (9.20% vs. 4.05%, P = 0.027) and mortality (25.00% vs. 18.15%, P < 0.001). Age and sex-stratified comparison revealed increased susceptibility to COVID-19 only from females with DM. For either non-DM or DM group, hyperglycaemia was associated with adverse outcomes, featured by higher rates of severe pneumonia and mortality, in comparison with non-hyperglycaemia. This was accompanied by significantly altered laboratory indicators including lymphocyte and neutrophil percentage, C-reactive protein and urea nitrogen level, all with correlation coefficients >0.35. Both diabetes and hyperglycaemia were independently associated with adverse prognosis of COVID-19, with hazard ratios of 10.41 and 3.58, respectively.
The propulsion of a pitching flexible plate in a uniform flow is investigated numerically. The effects of bending stiffness ($K$), pitching amplitude ($A_L$) and frequency ($St$) on the wake patterns, thrust generations and propulsive performances of the fluid–plate system are analysed. Four typical wake patterns, i.e. von Kármán, reversed von Kármán, deflected and chaotic wakes, emerge from various kinematics, and the $St-A_L$ wake maps are given for various $K$. The drag-to-thrust transitions (DTT) and the wake transitions (WT) between the von Kármán and reversed von Kármán wakes are examined. Results indicate that the WT and DTT boundaries can be scaled by the chord-averaged distance of travel, $\mathcal {L}$, which leads to $\mathcal {L}\times St \approx 1$ and $\mathcal {L}\times St \approx 1.2$, respectively. Further, the resonance mechanism for the performance enhancement is revealed and confirmed in a wide range of parameters. The dimensionless average speed of plate, $\mathcal {U^*}\left (=\mathcal {L}\times St\right )$, is adopted merely to characterize the propulsive performances. For the first time, the $\mathcal {U^*}$-based scaling laws for the thrust and power are revealed in pitching rigid and flexible plates for various $A_L$ and $St$. This study may deepen our understanding of biological swimming and flying, and provide a guide for bionic design.
The pandemic caused by severe acute respiratory syndrome coronavirus 2 is sweeping the world, threatening millions of lives and drastically altering our ways of living. According to current studies, failure to either activate or eliminate inflammatory responses timely and properly at certain stages could result in the progression of the disease. In other words, robust immune responses to coronavirus disease 2019 (COVID-19) are critical. However, they do not theoretically present in some special groups of people, including the young, the aged, patients with autoimmunity or cancer. Differences also do occur between men and women. Our immune system evolves to ensure delicate coordination at different stages of life. The innate immune cells mainly consisted of myeloid lineage cells, including neutrophils, basophils, eosinophils, dendritic cells and mast cells; they possess phagocytic capacity to different degrees at different stages of life. They are firstly recruited upon infection and may activate the adaptive immunity when needed. The adaptive immune cells, on the other way, are comprised mainly of lymphoid lineages. As one grows up, the adaptive immunity matures and expands its memory repertoire, accompanied by an adjustment in quantity and quality. In this review, we would summarise and analyse the immunological characteristics of these groups from the perspective of the immune system ‘evolution’ as well as ‘revolution’ that has been studied and speculated so far, which would aid the comprehensive understanding of COVID-19 and personalised-treatment strategy.
In this paper, a novel self-adaptive underactuated robot hand with rigid-flexible coupling fingers (SAU-RFC hand) is proposed. The seven degrees of freedom (DOFs) SAU-RFC hand is driven by four servomotors, consists of three fingers, including two side-turning (ST) fingers and one non-side-turning finger. Specially, the ST fingers can perform synchronous reverse rotation laterally with each other. Each finger with three joints and two DOFs introduces a flexible structure, and the inner part of the proximal phalanx that makes most of the contact with the object is replaced by a flexible belt. The fingers can generate flexion/extension under the pull of the flexible belt, and the middle and distal phalanxes are mechanically coupled through a four-bar linkage. In particular, the flexible belt in the inner direction of the finger will deform, while it will not deform in the outer direction since the outer is a rigid structure. The flexible belt not only plays the role of transmitting power but also has the effect of uniformizing the contact force. Due to the rigid-flexible finger structure, the developed robot hand has a higher self-adaptive grasping ability for objects with different shapes, sizes, and hardness. In addition, the kinematic and kinetic analyses of SAU-RFC hand are performed. A contact force distribution model is established for the flexible belt, which demonstrates its effect of promoting uniform force distribution theoretically. In the end, experiments are conducted on different objects to verify the performance of SAU-RFC hand.
While the detrimental effect of interparental conflict on adolescent depression is well-established, the underlying mechanisms linking the two continue to be inadequately understood. This study investigated the mediating role of family functioning and the moderating role of cultural beliefs about adversity in the association between interparental conflict and adolescent depression. The samples included 651 Chinese adolescents (mean age at Time 1 = 13.27 years; 56.5% girls) from a two-wave longitudinal study with data spanning 1 year. The findings from path modeling analyses provided evidence for the mediating role of family functioning; these findings indicated that interparental conflict can damage family functioning, which in turn exacerbates the risk of adolescent depression. The moderating role of cultural beliefs about adversity was also demonstrated by interactions between interparental conflict and cultural beliefs about adversity, as well as, family functioning and cultural beliefs about adversity. The results indicated a buffering role of cultural beliefs about adversity on the deleterious effect of interparental conflict on adolescent depression. They also suggested that lower levels of family functioning was associated with increased depression among adolescents were lower in cultural beliefs about adversity.
Extensive magmatism in NE China, eastern Central Asian Orogenic Belt, has produced multi-stage granitic plutons and accompanying W mineralization. The Narenwula complex in the southwestern Great Xing’an Range provides important insights into the petrogenesis, geodynamic processes and relationship with W mineralization. The complex comprises granodiorites, monzogranites and granite porphyry. Mafic microgranular enclaves are common in the granodiorites, and have similar zircon U–Pb ages as their host rocks (258.5–253.9 Ma), whereas the W-bearing granitoids yield emplacement ages of 149.8–148.1 Ma. Permian granodiorites are I-type granites that are enriched in large-ion lithophile elements and light rare earth elements, and depleted in high field strength elements and heavy rare earth elements. Both the mafic microgranular enclaves and granodiorites have nearly identical zircon Hf isotopic compositions. The results suggest that the mafic microgranular enclaves and granodiorites formed by the mixing of mafic and felsic magmas. W-bearing granitoids are highly fractionated A-type granites, enriched in Rb, Th, U and Pb, and depleted in Ba, Sr, P, Ti and Eu. They have higher W concentrations and Rb/Sr ratios, and lower Nb/Ta, Zr/Hf and K/Rb ratios than the W-barren granodiorites. These data and negative ϵHf(t) values (–6.0 to –2.1) suggest that they were derived from the partial melting of ancient lower crust and subsequently underwent extreme fractional crystallization. Based on the regional geology, we propose that the granodiorites were generated in a volcanic arc setting related to the subduction of the Palaeo-Asian Ocean, whereas the W-bearing granitoids and associated deposits formed in a post-orogenic extensional setting controlled by the Mongol–Okhotsk Ocean and Palaeo-Pacific Ocean tectonic regimes.
Most glaciers on the Tibetan Plateau have experienced continuous mass losses in response to global warming. However, the seasonal dynamics of glaciers on the southeastern Tibetan Plateau have rarely been reported in terms of glacier surface elevation and velocity. This paper presents a first attempt to explore the seasonal dynamics of the debris-covered Dagongba Glacier within the southeastern Tibetan Plateau. We use the multitemporal unoccupied aerial vehicle images collected over the lower ablation zone on 8 June and 17 October 2018, and 13 May 2019, and then perform an analysis concerning climatic fluctuations. The results reveal that the mean surface elevation decrease of the Dagongba Glacier during the warm season ($2.81\pm 0.44$ m) was remarkably higher than the cold season ($0.72\pm 0.45$ m). Particularly notable glacier surface elevation changes were found around supraglacial lakes and ice cliffs where ice ablation rates were $\sim$3 times higher than the average. In addition, a larger longitudinal decline of glacier surface velocity was observed in the warm season than that in the cold season. In terms of further comparative analysis, the Dagongba Glacier experienced a decrease in surface velocity between 1982–83 and 2018–19, with a decrease in the warm season possibly twice as large as that in the cold season.
The article aims to estimate and forecast the transmissibility of shigellosis and explore the association of meteorological factors with shigellosis. The mathematical model named Susceptible–Exposed–Symptomatic/Asymptomatic–Recovered–Water/Food (SEIARW) was used to explore the feature of shigellosis transmission based on the data of Wuhan City, China, from 2005 to 2017. The study applied effective reproduction number (Reff) to estimate the transmissibility. Daily meteorological data from 2008 to 2017 were used to determine Spearman's correlation with reported new cases and Reff. The SEIARW model fit the data well (χ2 = 0.00046, p > 0.999). The simulation results showed that the reservoir-to-person transmission of the shigellosis route has been interrupted. The Reff would be reduced to a transmission threshold of 1.00 (95% confidence interval (CI) 0.82–1.19) in 2035. Reducing the infectious period to 11.25 days would also decrease the value of Reff to 0.99. There was a significant correlation between new cases of shigellosis and atmospheric pressure, temperature, wind speed and sun hours per day. The correlation coefficients, although statistically significant, were very low (<0.3). In Wuhan, China, the main transmission pattern of shigellosis is person-to-person. Meteorological factors, especially daily atmospheric pressure and temperature, may influence the epidemic of shigellosis.
This study aimed to identify predictors of limitations in basic activities of daily living (BADL) among people with severe disabilities.
Methods:
4075 long-term care beneficiaries with severe disabilities in Guangzhou, China, were included during July 2018 and March 2019. BADL was assessed using the Barthel index (BI). Muscle strength was measured by using the Lovett Rating Scale. Age, gender, comorbidities, and muscle strengths were collected as independent variables. Chi-square Automatic Interaction Detector (CHAID) method was used to examine associations between independent variables and item scores of the BI.
Results:
Muscle strength and history of stroke were parent node and child node for most of BADL limitations, respectively. Upper limb muscle strength (≤ 3) was a major predictor for dependence in feeding, grooming, toileting, dressing, and transfer, while lower limb muscle strength (≤ 3) was a major predictor for limitation in mobility.
Conclusions:
Muscle strength was the strongest predictor of BADLs among people with severe disability. Muscle strength grading may be optimal for designing supporting strategies for people with severe disabilities.
Deficits in event-related potential (ERP) including duration mismatch negativity (MMN) and P3a have been demonstrated widely in chronic schizophrenia (SZ) but inconsistent findings were reported in first-episode patients. Psychotropic medications and diagnosis might contribute to different findings on MMN/P3a ERP in first-episode patients. The present study examined MMN and P3a in first episode drug naïve SZ and bipolar disorder (BPD) patients and explored the relationships among ERPs, neurocognition and global functioning.
Methods
Twenty SZ, 24 BPD and 49 age and sex-matched healthy controls were enrolled in this study. Data of clinical symptoms [Positive and Negative Symptoms Scale (PANSS), Young Manic Rating Scale (YMRS), Hamilton Depression Rating Scale (HAMD)], neurocognition [Wechsler Adult Intelligence Scale (WAIS), Cattell's Culture Fair Intelligence Test (CCFT), Delay Matching to Sample (DMS), Rapid Visual Information Processing (RVP)], and functioning [Functioning Assessment Short Test (FAST)] were collected. P3a and MMN were elicited using a passive auditory oddball paradigm.
Results
Significant MMN and P3a deficits and impaired neurocognition were found in both SZ and BPD patients. In SZ, MMN was significantly correlated with FAST (r = 0.48) and CCFT (r = −0.31). In BPD, MMN was significantly correlated with DMS (r = −0.54). For P3a, RVP and FAST scores were significant predictors in SZ, whereas RVP, WAIS and FAST were significant predictors in BPD.
Conclusions
The present study found deficits in MMN, P3a, neurocognition in drug naïve SZ and BPD patients. These deficits appeared to link with levels of higher-order cognition and functioning.
When a mixture of viscous oil and non-colloidal particles displaces air between two parallel plates, the shear-induced migration of particles leads to the gradual accumulation of particles on the advancing oil–air interface. This particle accumulation results in the fingering of an otherwise stable fluid–fluid interface. While previous works have focused on the resultant instability, one unexplored yet striking feature of the experiments is the self-similarity in the concentration profile of the accumulating particles. In this paper, we rationalise this self-similar behaviour by deriving a depth-averaged particle transport equation based on the suspension balance model, following the theoretical framework of Ramachandran (J. Fluid Mech., vol. 734, 2013, pp. 219–252). The solutions to the particle transport equation are shown to be self-similar with slight deviations, and in excellent agreement with experimental observations. Our results demonstrate that the combination of the shear-induced migration, the advancing fluid–fluid interface and Taylor dispersion yield the self-similar and gradual accumulation of particles.
Non-alcoholic fatty liver disease (NAFLD) was defined in 1980 and has the same histological characteristics as alcoholic liver disease except for alcohol consumption. After 40 years, the understanding of this disease is still imperfect. Without specific drugs available for treatment, the number of patients with NAFLD is increasing rapidly, and NAFLD currently affects more than one-quarter of the global population. NAFLD is mostly caused by a sedentary lifestyle and excessive energy intake of fat and sugar. To ameliorate or avoid NAFLD, people commonly replace high-fat foods with high-carbohydrate foods (especially starchy carbohydrates) as a way to reduce caloric intake and reach satiety. However, there are few studies that concentrate on the effect of carbohydrate intake on liver metabolism in patients with NAFLD, much fewer than the studies on fat intake. Besides, most of these studies are not systematic, which has made identification of the mechanism difficult. In this review, we collected and analysed data from studies on human and animal models and, surprisingly, found that carbohydrates and liver steatosis could be linked by inflammation. This review not only describes the effects of carbohydrates on NAFLD and body lipid metabolism but also analyses and predicts possible molecular pathways of carbohydrates in liver lipid synthesis that involve inflammation. Furthermore, the limitations of recent research and possible targets for regulating inflammation and lipogenesis are discussed. This review describes the effects of starchy carbohydrates, a nutrient signal, on NAFLD from the perspective of inflammation.
The association between blood transfusion and ventilator-associated events (VAEs) has not been fully understood. We sought to determine whether blood transfusion increases the risk of a VAE.
Design:
Nested case-control study.
Setting:
This study was based on a registry of healthcare-associated infections in intensive care units at West China Hospital system.
Patients:
1,657 VAE cases and 3,293 matched controls were identified.
Methods:
For each case, 2 controls were randomly selected using incidence density sampling. We defined blood transfusion as a time-dependent variable, and we used weighted Cox models to calculate hazard ratios (HRs) for all 3 tiers of VAEs.
Results:
Blood transfusion was associated with increased risk of ventilator-associated complication-plus (VAC-plus; HR, 1.47; 95% CI, 1.22–1.77; P <.001), VAC-only (HR, 1.29; 95% CI, 1.01–1.65; P = .038), infection-related VAC-plus (IVAC-plus; HR, 1.78; 95% CI, 1.33–2.39; P < .001), and possible ventilator-associated pneumonia (PVAP; HR, 2.10; 95% CI, 1.10–3.99; P = .024). Red blood cell (RBC) transfusion was also associated with increased risk of VAC-plus (HR, 1.34; 95% CI, 1.08–1.65; P = .007), IVAC-plus (HR, 1.70; 95% CI, 1.22–2.36; P = .002), and PVAP (HR, 2.49; 95% CI, 1.17–5.28; P = .018). Compared to patients without transfusion, the risk of VAE was significantly higher in patients with RBC transfusions of >3 units (HR, 1.73; 95% CI, 1.25–2.40; P = .001) but not in those with RBC transfusions of 0–3 units.
Conclusion:
Blood transfusions were associated with increased risk of all tiers of VAE. The risk was significantly higher among patients who were transfused with >3 units of RBCs.
Anticipatory pleasure deficits are closely correlated with negative symptoms in schizophrenia, and may be found in both clinical and subclinical populations along the psychosis continuum. Prospection, which is an important component of anticipatory pleasure, is impaired in individuals with social anhedonia (SocAnh). In this study, we examined the neural correlates of envisioning positive future events in individuals with SocAnh.
Methods
Forty-nine individuals with SocAnh and 33 matched controls were recruited to undergo functional MRI scanning, during which they were instructed to simulate positive or neutral future episodes according to cue words. Two stages of prospection were distinguished: construction and elaboration.
Results
Reduced activation at the caudate and the precuneus when prospecting positive (v. neutral) future events was observed in individuals with SocAnh. Furthermore, compared with controls, increased functional connectivity between the caudate and the inferior occipital gyrus during positive (v. neutral) prospection was found in individuals with SocAnh. Both groups exhibited a similar pattern of brain activation for the construction v. elaboration contrast, regardless of the emotional context.
Conclusions
Our results provide further evidence on the neural mechanism of anticipatory pleasure deficits in subclinical individuals with SocAnh and suggest that altered cortico-striatal circuit may play a role in anticipatory pleasure deficits in these individuals.
To investigate the clinical impact of ventilator-associated events (VAEs) on adverse prognoses and risk factors for mortality among intensive care unit (ICU) patients receiving invasive mechanical ventilation (IMV) based on an ICU healthcare-associated infection (ICU-HAI) registry.
Design:
A cohort study was conducted based on an ICU-HAI registry including 30,830 patients between 2015 and 2018.
Setting:
The study was conducted using data from 5 adult ICUs of a referral hospital.
Patients:
Adult patients in the ICU-HAI registry who received ≥4 consecutive IMV days.
Methods:
Clinical outcomes and mortality risk factors for VAEs were analyzed using propensity score matching (PSM), multivariate regression models, and sensitivity analyses.
Results:
Of 6,426 included patients, 1,803 developed 1,899 VAEs. After PSM, patients with VAEs did have prolonged length of stay in the ICU and in the hospital, increased hospitalization costs, longer days on mechanical ventilation, higher proportion of ≥9 days on mechanical ventilation, higher rate of failure in extubating mechanical ventilation, and excess all-cause mortality in the ICU. Older age (adjusted OR [aOR], 1.02), higher APACHE II score on ICU admission (aOR, 1.06), pneumonia (aOR, 1.49), blood transfusion (aOR 1.43), immunosuppressive drugs (aOR, 1.69), central-line catheter (aOR, 2.06), and ≥2 VAEs in the ICU (aOR, 1.99) were associated with higher risks for all-cause mortality in an ICU.
Conclusions:
Patients with VAEs indeed had poorer clinical outcomes. Older age, higher APACHE II score on ICU admission, pneumonia, blood transfusion, immunosuppressive drugs, central-line catheter, and ≥2 VAEs in the ICU were risk factors for all-cause mortality of VAE patients in the ICU.
This article contends that prior research on the behaviour of Chinese local cadres pays limited attention to their motivation for avoiding blame. Using qualitative data from three field studies conducted in Guangdong province, the study focuses on blame avoidance in the cadre responsibility system, which is recognized as an important instrument for state capacity building. Our analysis uncovers three major discursive strategies used by grassroots cadres to manage blame either before or after it is apportioned: de-legitimating performance standards, re-attributing blame and transferring blame risk. We find that local cadres have a role as blame makers in shifting blame and accusations. This finding challenges the conventional view, which typically sees local officials as blame takers. The article concludes by elaborating on the wider implications of this finding and proposing avenues for future research.