Periodic forcing of a shock train in Mach 2.0 flow

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/143010/1/6.2017-0088.pd

Unsteadiness characteristics and three-dimensional leading shock structure of a Mach 2.0 shock train

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/143115/1/6.2017-0087.pd

PaleoENSO reconstructions of the Holocene and Last Glacial Period

In this study, specimens of Tridacna sp., which are reef dwelling bivalve molluscs and have been shown to live up to 60 years, collected from the Huon Peninsula, Papua New Guinea, were sampled for geochemical profiles. The Huon Peninsula is in the heart of the Western Pacific Warm Pool (WPWP), which plays a key role in ENSO dynamics. The uplifted reef terraces of the Huon Peninsula have been extensively studied, and are well dated, which gives the opportunity to reconstruct the local climate of this region at key intervals during the past. Previous work on Tridacna sp. has shown that they precipitate their aragonite shell in equilibrium with the surrounding seawater, and the δ18O profile of a modern T. gigas from the Huon Peninsula has been shown to correlate with precipitation and temperature anomalies, and the Niño 3.4 temperature anomaly record. Fossil samples from this region are therefore assumed to have the ability to capture changes in δ18O attributable to ENSO. Seasonally resolved δ18O measurements from Tridacna sp. from early Holocene and Marine Isotope Stage 3 (MIS3) reefs were used to reconstruct changes in mean climate, seasonality and inter-annual variability (e.g. ENSO). Reconstructions of the mean state tend to agree with previously published studies of Holocene and MIS3 climate, showing similar temperatures to today during the early Holocene, and an average cooling of 2- 3°C during MIS3. The early Holocene Tridacna sp. samples show a reduction in seasonality, consistent with the reduction in seasonal insolation at this time, while those from MIS3 show variable seasonality between 30-60ka. ENSO appears to have been supressed during the early Holocene by up to 50% compared with the late 20th century, which is consistent with coral data and modelling studies. During MIS3, ENSO appears to have been more variable with some records showing anomalous warm and cool events as strong as those seen in the modern T. gigas, used here as a benchmark. Trace element profiles derived from the Tridacna sp. used in this study show a tentative link with temperature and local productivity, but these relationships are subject to species specific and intra-shell effects

Flow Separation Associated with 3-D Shock-Boundary Layer Interaction (SBLI)

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140423/1/6.2014-1138.pd

Pathological eating behaviours and risk of retinopathy in diabetes: a systematic review and meta-analysis

Background- Diabetes mellitus can cause several long-term macrovascular and microvascular complications including nephropathy, neuropathy, and retinopathy (DR). Several studies have reported positive associations between eating pathologies and DR; however, these studies have not been aggregated and sub-grouped into type of pathological eating behaviour, and the differences in risk according to type of eating behaviour is unknown. The aim of this review, therefore, was to aggregate risks of DR in populations with and without pathological eating behaviours, stratified according to eating behaviour. Methods- A systematic review and meta-analysis was conducted. Major databases and grey literature were search from inception until 1/6/2021. Studies reporting the prevalence of pathological eating behaviours (against a control group with no pathological eating behaviours) in diabetic people with and without DR were included. Odds ratios were calculated from primary data. Results- Seven studies with eight independent outcomes with a total of 1162 participants were included. The odds ratio of DR in the total pooled analysis was 2.94 (95%CI 1.86–4.64; p = <0.001; I2 = 29.59). Two types of eating behaviour yielded enough data for sub-group analysis. Eating disorder not otherwise specified yielded an odds ratio of 2.73 (95%CI 1.81–4.10; p = <0.001; I2 = 0.00), and binge eating disorder yielded an non-significant odds ratio of 0.92 (95%CI 0.31–2.77; p = 0.887;I2 = 0.00). Discussion- The likelihood of DR increases almost three times in the presence of pathological eating behaviours. More studies are required to confirm this in clinical populations stratified by eating disorder. Practitioners working with people with diabetes should closely monitor eating behaviours to preclude this risk

Relationship Between Intermittent Separation and Vortex Structure in a Three-Dimensional Shock/Boundary-Layer Interaction

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140686/1/1.J053905.pd

Indications for genetic referral: a guide for healthcare providers

Geneticists and genetic counselors are often asked what may be appropriate reasons for referral to a genetics service. The Professional Practice and Guidelines Committee of the American College of Medical Genetics has generated lists of the more common reasons for referral and provide them for use by genetics professionals and other healthcare providers for guidance. The lists are divided into pediatric, prenatal, and adult indications

Mental health support across the sight loss pathway: a qualitative exploration of eye care patients, optometrists, and ECLOs

BACKGROUND: The process of becoming visually impaired or blind is undoubtedly a highly emotional experience, requiring practical and psychological support. Information on mental health support provision in the UK across the sight-loss pathway, however, is largely unknown, especially amongst healthcare practitioners that are often sought after for advice: the referring optometrist and eye clinic liaison officer (ECLO). This study aims to ascertain the perceived accessibility and quality of mental health support across the sight-loss pathway. METHODS: Semi-structured individual interviews were conducted with patients with a diagnosed eye condition who had received care from a hospital eye service, referring optometrists, and ECLOs. Following interview transcription, results were synthesised in a narrative analysis. RESULTS: A total of 28 participants were included in the analysis, of which 17 were participants with various eye conditions, five were referring optometrists, and five were ECLOs. After analysis, three broad themes emerged: (1) The emotional trauma of diagnosis (2) Availability of mental health support; (3) The point where mental health support is most needed across the sight-loss pathway. Several patients reporting that they had received no offer of support nor were they signposted to any possible sources. Referring optometrists and ECLO’s agreed. CONCLUSION: It is important that referring optometrists are aware of the need for mental health support services and can signpost to local support services including the third sector anytime during the referral process. Future large-scale, UK-wide research into referral practice and signposting for mental health support for patients is warranted, to identify how services can be improved in order to ensure that the wellbeing of patients is maintaine

Understanding the determinants of COVID-19 vaccination intention and willingness to pay: findings from a population-based survey in Bangladesh

Background- Several coronavirus disease (COVID-19) vaccines have already been authorized and distributed in different countries all over the world, including Bangladesh. Understanding public acceptance of such a novel vaccine is vital, but little is known about the topic. Objectives- This study aimed to investigate the determinants of intention to receive a COVID-19 vaccine and willingness to pay (WTP) among people in Bangladesh. Methods- An anonymous and online-based survey of Bangladeshi people (mean age = 29.96 ± 9.15 years; age range = 18–60 years) was conducted using a self-reported questionnaire consisting of socio-demographics, COVID-19 experience, and vaccination-related information as well as the health belief model (HBM). Multivariable logistic regression was performed to determine the factors influencing COVID-19 vaccination intent and WTP. Results- Of the 894 participants, 38.5% reported a definite intention to receive a COVID-19 vaccine, whereas 27% had a probable intention, and among this intent group, 42.8% wanted to get vaccinated as soon as possible. Older age, feeling optimistic about the effectiveness of COVID-19 vaccination, believing that vaccination decreases worries and risk of COVID-19 infection, and being less concerned about side effects and safety of COVID-19 vaccination under the HBM construct were found to be significant factors in COVID-19 vaccination intention. Most of the participants (72.9%) were willing to pay for a COVID-19 vaccine, with a median (interquartile range [IQR]) amount of BDT 400/US$4.72 (IQR; BDT 200–600/US$ 2.36–7.07) per dose. Factors associated with higher WTP were younger age, being male, having higher education, residing in an urban area, having good self-rated health status, positivity towards COVID-19 vaccination's effectiveness, and being worried about the likelihood of getting infected with COVID-19. Participants who were COVID-19 vaccination intent preferred an imported vaccine over a domestically-made vaccine (22.9% vs. 14.8%), while 28.2% preferred a routine immunization schedule. Conclusion- The findings indicate a considerable proportion of Bangladeshi people intended to get vaccinated and had WTP for the COVID-19 vaccine. However, urgent education and awareness programs are warranted to alleviate public skepticism regarding the COVID-19 vaccination

Velo-Cardio-Facial Syndrome: 30 Years of Study

Velo-cardio-facial syndrome is one of the names that has been attached to one of the most common multiple anomaly syndromes in humans. The labels DiGeorge sequence, 22q11 deletion syndrome, conotruncal anomalies face syndrome, CATCH 22, and Sedlačková syndrome have all been attached to the same disorder. Velo-cardio-facial syndrome has an expansive phenotype with more than 180 clinical features described that involve essentially every organ and system. The syndrome has drawn considerable attention because a number of common psychiatric illnesses are phenotypic features including attention deficit disorder, schizophrenia, and bipolar disorder. The expression is highly variable with some individuals being essentially normal at the mildest end of the spectrum, and the most severe cases having life-threatening and life-impairing problems. The syndrome is caused by a microdeletion from chromosome 22 at the q11.2 band. Although the large majority of affected individuals have identical 3 megabase deletions, less than 10% of cases have smaller deletions of 1.5 or 2.0 megabases. The 3 megabase deletion encompasses a region containing 40 genes. The syndrome has a population prevalence of approximately 1:2,000 in the United States, although incidence is higher. Although initially a clinical diagnosis, today velo-cardio-facial syndrome can be diagnosed with extremely high accuracy by fluorescence in situ hybridization and several other laboratory techniques. Clinical management is age dependent with acute medical problems such as congenital heart disease, immune disorders, feeding problems, cleft palate, and developmental disorders occupying management in infancy and preschool years. Management shifts to cognitive, behavioral, and learning disorders during school years, and then to the potential for psychiatric disorders including psychosis in late adolescence and adult years. Although the majority of people with velo-cardio-facial syndrome do not develop psychosis, the risk for severe psychiatric illness is 25 times higher for people affected with velo-cardio-facial syndrome than that of the general population. Therefore, interest in understanding the nature of psychiatric illness in the syndrome remains strong