Extensions of Green\u27s Function Discretization for Modeling Acoustics in Inhomogeneous Media

This research examines two new methods to numerically model linear field equations with spatially varying coefficients, with a particular focus on the acoustic velocity potential equation. The methods are based on a new field discretization technique, Green\u27s function discretization (GFD), which was primarily developed to model the Hehnholtz equation for frequency domain acoustics problems in homogeneous media. GFD can be used to model acoustics in inhomogeneous media by assuming constant media properties across each computational stencil. The methods presented herein correct GFD for variations in the media across each stencil in two distinct ways: via a Fredholm volume integral, and by a particular solution to a perturbation expansion. To evaluate these methods, boundary value problem test cases have been numerically evaluated to determine gains in accuracy in one and two dimensions. The results demonstrate that the ability of GFD to model the effects of an inhomogeneous medium on acoustics can be significantly increased using corrections factors computed from these new methods

Evaluation of a hypothetical source method for discretization of the Helmholtz equation

This research examines the accuracy and benefits of a new discretization for linear field equations, with a particular focus on the Helmholtz equation. Instead of the typical Boundary Element Method (BEM) or integral methods, this technique uses local Green\u27s functions to set up a block tri-diagonal system of equations. The Green\u27s functions are computed with respect to local and hypothetical sources to generate an under-determined system of equations. Singular value decomposition (SYD) and pseudo-inversion is then applied to find the least-norm, least-squares local discretization. The local discretizations are then placed in a matrix along with appropriate boundary conditions to solve for the entire field implicitly. The results compare the new discretization with finite difference techniques, showing that the relative accuracy of the new discretization is several orders of magnitude better than the finite difference techniques for reduced frequency approaching the resonant frequenc

Diminishing Use of Liver Biopsy among Liver Transplant Recipients for Hepatitis C.

Background and Aims: Hepatitis C virus (HCV) cirrhosis is the leading indication for liver transplantation in the United States and recurrent HCV following liver transplantation is a major cause of allograft loss and mortality. Liver biopsies are commonly used to identify recurrent HCV and determine the need for antiviral therapy. The introduction of direct-acting antiviral agents (DAAs) has changed the management of recurrent HCV infection. This study aimed to describe the role of liver biopsies in liver transplant recipients with HCV after the introduction of DAAs. Methods: A retrospective analysis was performed looking at the rate of liver biopsies post-liver transplantation for HCV. The analysis included 475 adult liver transplants for hepatitis C performed at the University of California, Los Angeles from January 1, 2006 to October 1, 2015. Patients were divided into two eras, pre- and post-introduction of DAAs on December 1, 2013. Results: In the era before the introduction of DAAs, the percentage of patients biopsied was significantly higher compared to the era after the introduction of DAAs (56.1% vs. 26.9%, p < 0.001). Conclusions: The introduction of DAAs has changed the management of liver biopsy following liver transplantation and the management of recurrent HCV. Given that DAAs are well tolerated and have high efficacy, liver biopsies are no longer routinely used to justify the use antiviral therapy following liver transplantation

Wave uplift pressures on horizontal platforms

The major objective of the study has been to investigate in detail the rapidly-varying peak uplift pressure and the slowly-varying positive and negative uplift pressures that are known to be exerted by waves against the underside of a horizontal pier or platform located above the still water level, but not higher than the crests of the incident waves. In a "two-dimensional" laboratory study conducted in a 100-ft long by 15-in.-wide by 2-ft-deep wave tank with a horizontal smooth bottom, individually generated solitary waves struck a rigid, fixed, horizontal platform extending the width of the tank. Pressure transducers were mounted flush with the smooth soffit, or underside, of the platform. The location of the transducers could be varied. The problem of adequate dynamic and spatial response of the transducers was investigated in detail. It was found that unless the radius of the sensitive area of a pressure transducer is smaller than about one-third of the characteristic width of the pres sure distribution, the peak pressure and the rise-time will not be recorded accurately. A procedure was devised to correct peak pressures and rise-times for this transducer defect. The hydrodynamics of the flow beneath the platform are described qualitatively by a simple analysis, which relates peak pressure and positive slowly-varying pressure to the celerity of the wave front propagating beneath the platform, and relates negative slowly-varying pressure to the process by which fluid recedes from the platform after the wave has passed. As the wave front propagates beneath the platform, its celerity increases to a maximum, then decreases. The peak pressure similarly increases with distance from the seaward edge of the platform, then decreases. Measured peak pressure head, always found to be less than five times the incident wave height above still water level, is an order of magnitude less than reported shock pressures due to waves breaking against vertical walls; the product of peak pressure and rise-time, considered as peak impulse, is of the order of 20% of reported shock impulse due to waves breaking against vertical walls. The maximum measured slowly-varying uplift pressure head is approximately equal to the incident wave height less the soffit clearance above still water level. The normalized magnitude and duration of negative pressure appears to depend principally on the ratio of soffit clearance to still water depth and on the ratio of platform length to still water depth

Managing Tidal Inlets

Sandy inlets are in a dynamic equilibrium between wave-driven littoral drift acting to close them, and tidal flows keeping them open. Their beds are in a continual state of suspension and deposition, so their bathymetry and even location are always in flux. Even so, a nearly linear relationship between an inlet’s cross-sectional flow area and the inshore tidal prism is maintained - except when major wind and/or runoff events act to close or widen an inlet. Inlet location can be stabilized by jetties, but dredging may still be necessary to maintain a navigable channel. Armoring with rock large enough to resist erosion can protect an inlet bed or river mouth from excessive storm flow erosion.  Armoring can also be used as a stratagem to close inlets

Red Flags, Red Herrings, and Common Ground: An Expert Study in Response to State Reading Policy

In many U.S. states, legislation seeks to define effective instruction for beginning readers, creating an urgent need to turn to scholars who are knowledgeable about ongoing reading research. This mixed-methods study considers the extent to which recognized literacy experts agreed with recommendations about instruction that were included on a state’s reading initiative website. Our purpose was to guide implementation and inform policy-makers. In alignment with the initiative, experts agreed reading aloud, comprehension, vocabulary, fluency, phonological awareness, and phonics all deserve a place in early literacy instruction. Additionally, they agreed some components not included on the website warranted attention, such as motivation, oral language, reading volume, writing, and needs-based instruction. Further, experts cautioned against extremes in describing aspects of early reading instruction. Findings suggest that experts’ knowledge of the vast body of ongoing research about reading can be a helpful guide to policy formation and implementation

Rotavirus vaccine impact and socioeconomic deprivation: an interrupted time-series analysis of gastrointestinal disease outcomes across primary and secondary care in the UK.

Background Rotavirus causes severe gastroenteritis in infants and young children worldwide. The UK introduced the monovalent rotavirus vaccine (Rotarix®) in July 2013. Vaccination is free of charge to parents, with two doses delivered at 8 and 12 weeks of age. We evaluated vaccine impact across a health system in relation to socioeconomic deprivation. Methods We used interrupted time-series analyses to assess changes in monthly health-care attendances in Merseyside, UK, for all ages, from July 2013 to June 2016, compared to predicted counterfactual attendances without vaccination spanning 3–11 years pre-vaccine. Outcome measures included laboratory-confirmed rotavirus gastroenteritis (RVGE) hospitalisations, acute gastroenteritis (AGE) hospitalisations, emergency department (ED) attendances for gastrointestinal conditions and consultations for infectious gastroenteritis at community walk-in centres (WIC) and general practices (GP). All analyses were stratified by age. Hospitalisations were additionally stratified by vaccine uptake and small-area-level socioeconomic deprivation. Results The uptake of the first and second doses of rotavirus vaccine was 91.4% (29,108/31,836) and 86.7% (27,594/31,836), respectively. Among children aged < 5 years, the incidence of gastrointestinal disease decreased across all outcomes post-vaccine introduction: 80% (95% confidence interval [CI] 70–87%; p < 0.001) for RVGE hospitalisation, 44% (95% CI 35–53%; p < 0.001) for AGE hospitalisations, 23% (95% CI 11–33%; p < 0.001) for ED, 32% (95% CI 7–50%; p = 0.02) for WIC and 13% (95% CI -3–26%; p = 0.10) for GP. The impact was greatest during the rotavirus season and for vaccine-eligible age groups. In adults aged 65+ years, AGE hospitalisations fell by 25% (95% CI 19–30%; p < 0.001). The pre-vaccine risk of AGE hospitalisation was highest in the most socioeconomically deprived communities (adjusted incident rate ratio 1.57; 95% CI 1.51–1.64; p < 0.001), as was the risk for non-vaccination (adjusted risk ratio 1.54; 95% CI 1.34–1.75; p < 0.001). The rate of AGE hospitalisations averted per 1,000 first doses of vaccine was higher among infants in the most deprived communities compared to the least deprived in 2014/15 (28; 95% CI 25–31 vs. 15; 95% CI 12–17) and in 2015/16 (26; 95% CI 23–30 vs. 13; 95% CI 11–16). Conclusions Following the introduction of rotavirus vaccination, incidence of gastrointestinal disease reduced across the health-care system. Vaccine impact was greatest among the most deprived populations, despite lower vaccine uptake. Prioritising vaccine uptake in socioeconomically deprived communities should give the greatest health benefit in terms of population disease burden

Natural variation in gestational cortisol is associated with patterns of growth in marmoset monkeys (Callithrix geoffroyi)

High levels of prenatal cortisol have been previously reported to retard fetal growth. Although cortisol plays a pivotal role in prenatal maturation, heightened exposure to cortisol can result in lower body weights at birth, which have been shown to be associated with adult diseases like hypertension and cardiovascular disease. This study examines the relationship between natural variation in gestational cortisol and fetal and postnatal growth in marmoset monkeys. Urinary samples obtained during the mother’s gestation were analyzed for cortisol. Marmoset body mass index (BMI) was measured from birth through 540 days in 30- or 60-day intervals. Multi-level modeling was used to test if marmoset growth over time was predicted by changes in gestational cortisol controlling for time, sex, litter, and litter size. The results show that offspring exposed to intra-uterine environments with elevated levels of cortisol had lower linear BMI rates of change shortly after birth than did offspring exposed to lower levels of cortisol, but exhibited a higher curvilinear growth rate during adolescence. Average daily change in gestational cortisol during the first trimester had a stronger relationship with postnatal growth than change during the third trimester. Higher exposure to cortisol during gestation does alter developmental trajectories, however there appears to be a catch-up period during later post-natal growth. These observations contribute to a larger discussion about the relationship of maternal glucocorticoids on offspring development and the possibility of an earlier vulnerable developmental window

Persisting high prevalence of pneumococcal carriage among HIV-infected adults receiving antiretroviral therapy in Malawi:a cohort study

OBJECTIVE: HIV-infected adults have high rates of pneumococcal carriage and invasive disease. We investigated the effect of antiretroviral therapy (ART) on pneumococcal carriage in HIV-infected adults prior to infant pneumococcal conjugate vaccine (PCV) rollout. DESIGN: Observational cohort study. METHODS: We recruited HIV-infected adults newly attending a rural HIV clinic in northern Malawi between 2008 and 2010. Nasopharyngeal samples were taken at baseline and after 6, 12, 18 and 24 months. We compared pneumococcal carriage by ART status using generalized estimated equation models adjusted for CD4 cell count, sex, seasonality, and other potential confounders. RESULTS: In total, 336 individuals were included, of which 223 individuals started ART during follow-up. Individuals receiving ART had higher pneumococcal carriage than individuals not receiving ART (25.9 vs. 19.8%, P = 0.03) particularly for serotypes not included in PCV13 (16.1 vs. 9.6% P = 0.003). Following adjustment, increased carriage of non-PCV13 serotypes was still observed for individuals on ART, but results for all serotypes were nonsignificant [all serotypes: adjusted risk ratio (aRR) 1.22 (0.95-1.56); non-PCV13 serotypes: aRR 1.72, 95% CI 1.13-2.62]. CONCLUSION: Pneumococcal carriage in HIV-infected adults in Malawi remained high despite use of ART, consistent with failure of mucosal immune reconstitution in the upper respiratory tract. There was evidence of increased carriage of non-PCV13 serotypes. HIV-infected adults on ART could remain an important reservoir for pneumococcal diversity post infant pneumococcal vaccine introduction. Control of pneumococcal disease in African HIV remains a priority