97 research outputs found

    Transport of a passive scalar in wide channels with surface topography

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    We generalize classical dispersion theory for a passive scalar to derive an asymptotic long-time convection-diffusion equation for a solute suspended in a wide, structured channel and subject to a steady low-Reynolds-number shear flow. Our theory, valid for small roughness amplitudes of the channel, holds for general surface shapes expandable as a Fourier series. We determine an anisotropic dispersion tensor, which depends on the characteristic wavelengths and amplitude of the surface structure. For surfaces whose corrugations are tilted with respect to the applied flow direction, we find that dispersion along the principal direction (i.e., the principal eigenvector of the dispersion tensor) is at an angle to the main flow direction and becomes enhanced relative to classical Taylor dispersion. In contrast, dispersion perpendicular to it can decrease compared to the short-time diffusivity of the particles. Furthermore, for an arbitrary surface shape represented in terms of a Fourier decomposition, we find that each Fourier mode contributes at leading order a linearly-independent correction to the classical Taylor dispersion tensor.Comment: under consideration for publication in the Journal of Physics: Condensed Matter (JPCM

    Predicting responders to prone positioning in mechanically ventilated patients with COVID-19 using machine learning

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    Background: For mechanically ventilated critically ill COVID-19 patients, prone positioning has quickly become an important treatment strategy, however, prone positioning is labor intensive and comes with potential adverse effects. Therefore, identifying which critically ill intubated COVID-19 patients will benefit may help allocate labor resources. Methods: From the multi-center Dutch Data Warehouse of COVID-19 ICU patients from 25 hospitals, we selected all 3619 episodes of prone positioning in 1142 invasively mechanically ventilated patients. We excluded episodes longer than 24 h. Berlin ARDS criteria were not formally documented. We used supervised machine learning algorithms Logistic Regression, Random Forest, Naive Bayes, K-Nearest Neighbors, Support Vector Machine and Extreme Gradient Boosting on readily available and clinically relevant features to predict success of prone positioning after 4 h (window of 1 to 7 h) based on various possible outcomes. These outcomes were defined as improvements of at least 10% in PaO2/FiO2 ratio, ventilatory ratio, respiratory system compliance, or mechanical power. Separate models were created for each of these outcomes. Re-supination within 4 h after pronation was labeled as failure. We also developed models using a 20 mmHg improvement cut-off for PaO2/FiO2 ratio and using a combined outcome parameter. For all models, we evaluated feature importance expressed as contribution to predictive performance based on their relative ranking. Results: The median duration of prone episodes was 17 h (11-20, median and IQR, N = 2632). Despite extensive modeling using a plethora of machine learning techniques and a large number of potentially clinically relevant features, discrimination between responders and non-responders remained poor with an area under the receiver operator characteristic curve of 0.62 for PaO2/FiO2 ratio using Logistic Regression, Random Forest and XGBoost. Feature importance was inconsistent between models for different outcomes. Notably, not even being a previous responder to prone positioning, or PEEP-levels before prone positioning, provided any meaningful contribution to predicting a successful next proning episode. Conclusions: In mechanically ventilated COVID-19 patients, predicting the success of prone positioning using clinically relevant and readily available parameters from electronic health records is currently not feasible. Given the current evidence base, a liberal approach to proning in all patients with severe COVID-19 ARDS is therefore justified and in particular regardless of previous results of proning. Keywords: Acute respiratory distress syndrome; COVID-19; Mechanical ventilation

    The Impact of a Complement-Based Assortment Organization on Purchases

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    This article examines whether and why organizing product categories according to the consumption goal they serve (i.e., complement-based assortment organization) may increase purchases compared with organizing product categories according to their attributes or physical characteristics (i.e., substitute-based assortment organization). Across two field experiments, a virtual reality experiment, and a lab experiment, the authors show that a complement-based assortment organization, compared with a substitute-based assortment organization, leads to increased numbers of purchases and increased expenditures. Ease of visualization of the consumption process mediates the results. The impact of the complement-based organization on purchases is more pronounced for less involved consumers and for consumers with a less specific shopping goal. These findings have both theoretical and practical implications

    Kebahagiaan Sebagai Suatu Proses Pembelajaran

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    Happiness is one of the most meaningful positive emotion dan related to motivation to do many things. In order to gain happiness, a lot of people become passive and not going to do anything. In fact, there are many simple things to do to feel the flow experiences and get happiness. This might be happened because happiness is an adaptive behavior that can be learned by anybody. When someone recognize that happiness is something to be realized he/she should fight for his/her happiness by starting little fun things

    Accessible and reliable neurometric testing in humans using a smartphone platform

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    Tests of human brain circuit function typically require fixed equipment in lab environments. We have developed a smartphone-based platform for neurometric testing. This platform, which uses AI models like computer vision, is optimized for at-home use and produces reproducible, robust results on a battery of tests, including eyeblink conditioning, prepulse inhibition of acoustic startle response, and startle habituation. This approach provides a scalable, universal resource for quantitative assays of central nervous system function.</p

    The association between palliative care team consultation and hospital costs for patients with advanced cancer: An observational study in 12 Dutch hospitals

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    Background: Early palliative care team consultation has been shown to reduce costs of hospital care. The objective of this study was to investigate the association between palliative care team (PCT) consultation and the content and costs of hospital care in patients with advanced cancer. Material and Methods: A prospective, observational study was conducted in 12 Dutch hospitals.

    “We have been working overnight without sleeping”: traditional birth attendants’ practices and perceptions of post-partum care services in rural Tanzania

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    Background: In many low-income countries, formal post-partum care utilization is much lower than that of skilled delivery and antenatal care. While Traditional Birth Attendants (TBAs) might play a role in post-partum care, research exploring their attitudes and practices during this period is scarce. Therefore, the aim of this study was to explore TBAs’ practices and perceptions in post-partum care in rural Tanzania. Methods: Qualitative in-depth interview data were collected from eight untrained and three trained TBAs. Additionally, five multiparous women who were clients of untrained TBAs were also interviewed. Interviews were conducted in February 2013. Data were digitally recorded and transcribed verbatim. Qualitative content analysis was used to analyze data. Results: Our study found that TBAs take care of women during post-partum with rituals appreciated by women. They report lacking formal post-partum care training, which makes them ill-equipped to detect and handle post-partum complications. Despite their lack of preparation, they try to provide care for some post-partum complications which could put the health of the woman at risk. TBAs perceive that utilization of hospital-based post-partum services among women was only important for the baby and for managing complications which they cannot handle. They are poorly linked with the health system. Conclusions: This study found that the TBAs conducted close follow-ups and some of their practices were appreciated by women. However, the fact that they were trying to manage certain post-partum complications can put women at risk. These findings point out the need to enhance the communication between TBAs and the formal health system and to increase the quality of the TBA services, especially in terms of prompt referral, through provision of training, mentoring, monitoring and supervision of the TBA servic

    Large-scale ICU data sharing for global collaboration: the first 1633 critically ill COVID-19 patients in the Dutch Data Warehouse

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    Beyond the ‘Migrant Network’? Exploring assistance received in the migration of brazilians to Portugal and the Netherlands

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    This paper explores the tenability of three important critiques to the ‘migrant network’ approach in migration studies: (1) the narrow focus on kin and community members, which connect prospective migrants in origin countries with immigrants in the destination areas, failing to take due account of sources of assistance beyond the ‘migrant network’ like institutional or online sources; (2) that it is misleading to assume a general pattern in the role of migrant networks in migration, regardless of contexts of arrival or departure, including the scale and history of migration or the immigration regime; and (3) that ‘migrant networks’ are not equally relevant to all migrants, and that important differences may exist between labour migrants and other types of migrants like family migrants or students. Drawing on survey data on the migration of Brazilians to Portugal and the Netherlands we find support for these critiques but also reaffirm the relevance of ‘migrant networks’.info:eu-repo/semantics/publishedVersio
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