Hybrid Numerical-Analytical Scheme for Locally Inhomogeneous Elastic Waveguides

Numerical simulation of guided wave excitation, propagation, and diffraction in laminate structures with local inhomogeneities (obstacles) is associated with high computational cost due to the need for a mesh-based approximation of extended domains with a rigorous account for the radiation conditions at infinity. To obtain computationally efficient solutions, hybrid numerical-analytical approaches are currently being developed, based on linking a numerical solution in a local vicinity of the source and/or obstacles with an explicit analytical representation in the external semi-infinite domain. However, the developed methods are generally not widely spread because the possibility of such coupling with an external multimode wave field is generally not provided in standard finite-element (FE) software. We propose a scheme that allows the use of the FE software as a black box for the required correct matching of local numerical and global analytical solutions (FEM-An). The FEM is used to obtain a set of local numerical solutions that serve as a basis in the inner domain. These solutions satisfy the boundary conditions induced by guided wave modes so that they fit correctly with the modal expansion in the outer region. The expansion coefficients of both FE and modal decompositions are determined then from the condition of stress and displacement continuity at the interface between the inner and outer domains. This scheme was numerically validated against analytical solutions to test problems and FE solutions for long waveguide sections with perfect match layer absorbing conditions at the ends (FEM PML). Along the way, it turned out that the FEM-PML approach gives an incorrect result in the backward-wave bands and at high frequencies. The application of the FEM-An hybrid scheme is illustrated by examples of Lamb wave diffraction by elastic inclusions and delaminations

Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021

Background: Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050. Methods: Using forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8–63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0–45·0] in 2050) and south Asia (31·7% [29·2–34·1] to 15·5% [13·7–17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4–40·3) to 41·1% (33·9–48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6–25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5–43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5–17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7–11·3) in the high-income super-region to 23·9% (20·7–27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5–6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2–26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [–0·6 to 3·6]). Interpretation: Globally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

Ten golden rules for optimal antibiotic use in hospital settings: the WARNING call to action

Antibiotics are recognized widely for their benefits when used appropriately. However, they are often used inappropriately despite the importance of responsible use within good clinical practice. Effective antibiotic treatment is an essential component of universal healthcare, and it is a global responsibility to ensure appropriate use. Currently, pharmaceutical companies have little incentive to develop new antibiotics due to scientific, regulatory, and financial barriers, further emphasizing the importance of appropriate antibiotic use. To address this issue, the Global Alliance for Infections in Surgery established an international multidisciplinary task force of 295 experts from 115 countries with different backgrounds. The task force developed a position statement called WARNING (Worldwide Antimicrobial Resistance National/International Network Group) aimed at raising awareness of antimicrobial resistance and improving antibiotic prescribing practices worldwide. The statement outlined is 10 axioms, or “golden rules,” for the appropriate use of antibiotics that all healthcare workers should consistently adhere in clinical practice

Computing and Information PETROV-GALERKIN METHOD WITH LOCAL GREEN’S FUNCTIONS IN SINGULARLY PERTURBED CONVECTION-DIFFUSION PROBLEMS

Abstract. Previous theoretical and computational investigations have shown high efficiency of the local Green’s function method for the numerical solution of singularly perturbed problems with sharp boundary layers. However, in several space variables those functions, used as projectors in the Petrov-Galerkin scheme, cannot be derived in a closed analytical form. This is an obstacle for the application of the method when applied to multi-dimensional problems. The present work proposes a semi-analytical approach to calculate the local Green’s function, which opens a way to effective practical application of the method. Besides very accurate approximation, the matrix stencils obtained with these functions allow the use of fast and stable iterative solution of the large sparse algebraic systems that arise from the grid-discretization. The advantages of the method are illustrated by numerical examples. Key Words. Convection-diffusion equation, Petrov-Galerkin discretization, Fourier transform, integral equations, iterative solution. 1

Associations between depression, anxiety and medication adherence among patients with arterial hypertension: Comparison between persons exposed and non-exposed to radiation from the Semipalatinsk Nuclear Test Site

In this study, we investigated the association between depression, anxiety and medication adherence in patients with arterial hypertension living in East Kazakhstan region. The sample size included 795 patients, of whom 403 patients were exposed to radiation at the Semipalatinsk Nuclear Test Site from 1949 to 1989, while 395 patients were unexposed to radiation due to their very remote residence from the Site at the same period. Both exposed and unexposed patients showed no significant differences concerning body mass index, smoking habit, the presence of hypercholesterolemia, and hypertension grade. Patients with arterial hypertension previously exposed to radiation had significantly higher rates of low medication adherence, subclinical and clinical depression, situational anxiety of moderate and severe grade, and personal anxiety of moderate grade. A logistic regression analysis allowed us to identify the presence of significant positive association between medication adherence and anxiety in exposed patients (OR = 4041 (95%CI:1709-9556) p = 0.001) and marginal association (OR = 2998 (95%CI:1008-8915) p = 0.048) between the same parameters in unexposed patients. It might prove to be useful to introduce psychological and medical counseling with an emphasis on strengthening of medication adherence and to inform the local population about radiation effects and dosimetry data

Growth from the Melt and Properties Investigation of ScF3 Single Crystals

ScF3 optical quality bulk crystals of the ReO3 structure type (space group P m 3 ¯ m , a = 4.01401(3) Å) have been grown from the melt by Bridgman technique, in fluorinating atmosphere for the first time. Aiming to substantially reduce vaporization losses during the growth process graphite crucibles were designed. The crystal quality, optical, mechanical, thermal and electrophysical properties were studied. Novel ScF3 crystals refer to the low-refractive-index (nD = 1.400(1)) optical materials with high transparency in the visible and IR spectral region up to 8.7 µm. The Vickers hardness of ScF3 (HV ~ 2.6 GPa) is substantially higher than that of CaF2 and LaF3 crystals. ScF3 crystals possess unique high thermal conductivity (k = 9.6 Wm−1К−1 at 300 K) and low ionic conductivity (σ = 4 × 10−8 Scm−1 at 673 К) cause to the structural defects in the fluorine sublattice

Tuberculosis in the Russian Federation: Dynamics of the Epidemic Indicators before and after COVID-19 Pandemic

The measures taken against tuberculosis (TB) in recent years in the Russian Federation have been highly effective. Unfortunately, the COVID-19 pandemic may seriously undermine the progress that has been made in the fight against TB. The aim of this study was to assess changes in the epidemiological rates of tuberculosis in the Russian Federation before and after the COVID-19 pandemic. Materials and methods. The analysis was conducted by considering the main epidemiological indicators of tuberculosis, according to the federal statistics for the period from 2017 to 2021. The parameters were estimated according to the data received from 11 areas in the North-Western region. Statistical analysis was carried out using the free software computing environment R (v.3.5.1) and the commercial software package Statistical Package for the Social Sciences (SPSS Statistics for Windows, version 24.0, IBM Corp., 2016). Research results. We found a positive correlation between the incidence among the overall population and the incidence among children aged 0–17, inclusively (r = 0.55 in 2017, r = 0.60 in 2020, and r = 0.53 in 2021). Along with the received regularities, a different trend is shown in the data analysis of general incidence and health X-ray examination for tuberculosis among the general population. The correlation has decreased threefold from 2017 (r = 0.72) to 2020 (r = 0.32); this negative trend might be the result of factors such as the quality of X-ray screening examinations among the general population, and the reduced assessment objectivity of the tuberculosis incidence rate. Conclusions. In assessing the correlation between general incidence and incidence in children under 17 years of age, as well as between incidence and mortality in the Russian Federation, a positive correlation was found with an increasing trend. Such a discrepancy might be due to decreases in the occupational health examination coverage among the general population. Therefore, in the years ahead, we can expect epidemiological indicators to increase incidence and mortality, including child mortality, associated with the insufficient detection of tuberculosis among the population during the COVID-19 pandemic

Evaluation of Effective Elastic Properties of Nitride NWs/Polymer Composite Materials Using Laser-Generated Surface Acoustic Waves

In this paper we demonstrate a high potential of transient grating method to study the behavior of surface acoustic waves in nanowires-based composite structures. The investigation of dispersion curves is done by adjusting the calculated dispersion curves to the experimental results. The wave propagation is simulated using the explicit integral and asymptotic representations for laser-generated surface acoustic waves in layered anisotropic waveguides. The analysis of the behavior permits to determine all elastic constants and effective elastic moduli of constituent materials, which is important both for technological applications of these materials and for basic scientific studies of their physical properties