The study of a bi-stable wake region of a generic squareback vehicle using tomographic PIV

This paper demonstrates the use of large scale tomographic PIV to study the wake region of a Windsor model. This forms part of a larger study intending to understand the mechanisms that drive drag force changes when rear end optimizations are applied. For the first time, tomographic PIV has been applied to a large airflow volume (0.125m3, 500 x 500 x 500mm), which is of sufficient size to capture the near wake of a 25% scale Windsor model in a single measurement. The measurement volume is illuminated using a 200mJ double pulsed Nd:Yag laser fitted with a volume optic and seeded with 300μm helium filled soap bubbles generated by a novel high output seeder. Images were captured using four 4M Pixel LaVision cameras. The tomographic results are shown to produce high quality data with the setup used, but further improvements and tests at higher Reynolds number could be conducted if an additional seeding rake was used to increase seeding density. Proper Orthogonal Decomposition (POD) was applied to both the 2D and tomographic data to show the presence of a bi-stable wake structur

A systematic review of selected interventions to reduce juvenile re-offending. Technical Report.

What do we want to know? Persistent juvenile re-offending remains an area of concern for public policy, due to the social, economic and health impacts of such offending on victims and offenders. A large proportion of criminal offences are committed by repeat offenders. The broad purpose of this systematic review was to review the research evidence on a selected range of interventions to reduce re-offending by juveniles to try and identify more effective interventions. What did we find and what are the implications? When compared to standard diversion (caution and monitoring) there was consistent evidence of reductions in re-offending from the following intervention: Pre-sentencing diversion with personal skills training and reparation The intervention included: - personal skills training/ counselling about anger management, personal responsibility and decision making. - some form of reparation to the community/ victim of crime. - family involvement. When compared to standard residential placement there was consistent evidence of reductions in re-offending from the following intervention: • Community based family residential placement for female juvenile offenders The intervention included: - residential placement for six months to a year in small group supportive ‘family type’ environment. - personal skills training/counselling which is about anger management, personal responsibility and decision making. - monitoring and use of appropriate incentives and sanctions. Promising effects The following interventions were classified as having promising positive effects with limited or inconsistent evidence: • ‘Teen Courts’ compared to other diversion • Community based family residential placements compared to standard residential placements for male juvenile offenders Insufficient evidence There was insufficient evidence identified to assess the impact of the following interventions: • Secure incarceration compared to community sentence • Psycho-dynamic counselling compared to normal court interventions • Pre-sentence diversions compared to court community sentence • Multi-component diversion for persistent offenders (comparison not clear) • Multi-component diversion for mixed groups of offence severity (comparison not clear) • Supported transition from secure incarceration to community compared to no or limited support • Probation plus sports counselling compared to probation only • Violence re-education programme compared to court imposed community service What are the implications? The results suggest that those interventions where there is consistent evidence of beneficial effect could be priorities for possible implementation accompanied by rigorous evaluation in the UK context as the evidence on the effects of this intervention in this review all came from the USA. The ‘promising’ interventions could be considered priorities for further rigorous evaluation. How did we get these results? The review was undertaken in a number of stages. The first stage consisted of identifying all studies that met the review inclusion criteria published between 1998 and 2007. Descriptive information about these studies was collected and used as a ‘map’ of research in the field of interventions to reduce juvenile re-offending. At this point there were 94 studies included the map. A further round of coding was undertaken to help identify sub-groups of studies. The results of this coding were discussed with the steering group and a decision was made at that point to focus on a number of subgroups for the in-depth review. At this stage detailed data extraction was undertaken to assess the quality of the studies and facilitate synthesis of the findings of the selected studies in order to provide answers to the review questions

Geometry of the ergodic quotient reveals coherent structures in flows

Dynamical systems that exhibit diverse behaviors can rarely be completely understood using a single approach. However, by identifying coherent structures in their state spaces, i.e., regions of uniform and simpler behavior, we could hope to study each of the structures separately and then form the understanding of the system as a whole. The method we present in this paper uses trajectory averages of scalar functions on the state space to: (a) identify invariant sets in the state space, (b) form coherent structures by aggregating invariant sets that are similar across multiple spatial scales. First, we construct the ergodic quotient, the object obtained by mapping trajectories to the space of trajectory averages of a function basis on the state space. Second, we endow the ergodic quotient with a metric structure that successfully captures how similar the invariant sets are in the state space. Finally, we parametrize the ergodic quotient using intrinsic diffusion modes on it. By segmenting the ergodic quotient based on the diffusion modes, we extract coherent features in the state space of the dynamical system. The algorithm is validated by analyzing the Arnold-Beltrami-Childress flow, which was the test-bed for alternative approaches: the Ulam's approximation of the transfer operator and the computation of Lagrangian Coherent Structures. Furthermore, we explain how the method extends the Poincar\'e map analysis for periodic flows. As a demonstration, we apply the method to a periodically-driven three-dimensional Hill's vortex flow, discovering unknown coherent structures in its state space. In the end, we discuss differences between the ergodic quotient and alternatives, propose a generalization to analysis of (quasi-)periodic structures, and lay out future research directions.Comment: Submitted to Elsevier Physica D: Nonlinear Phenomen

Effects of Mavacamten on Measures of Cardiopulmonary Exercise Testing Beyond Peak Oxygen Consumption: A Secondary Analysis of the EXPLORER-HCM Randomized Trial

IMPORTANCE: Mavacamten, a cardiac myosin inhibitor, improved peak oxygen uptake (pVO2) in patients with symptomatic obstructive hypertrophic cardiomyopathy (HCM) in the EXPLORER-HCM study. However, the full extent of mavacamten's effects on exercise performance remains unclear. OBJECTIVE: To investigate the effect of mavacamten on exercise physiology using cardiopulmonary exercise testing (CPET). DESIGN, SETTING, AND PARTICIPANTS: Exploratory analyses of the data from the EXPLORER-HCM study, a randomized, double-blind, placebo-controlled, phase 3 trial that was conducted in 68 cardiovascular centers in 13 countries. In total, 251 patients with symptomatic obstructive HCM were enrolled. INTERVENTIONS: Patients were randomly assigned in a 1:1 ratio to mavacamten or placebo. MAIN OUTCOMES AND MEASURES: The following prespecified exploratory cardiovascular and performance parameters were assessed with a standardized treadmill or bicycle ergometer test protocol at baseline and week 30: carbon dioxide output (VCO2), minute ventilation (VE), peak VE/VCO2 ratio, ventilatory efficiency (VE/VCO2 slope), peak respiratory exchange ratio (RER), peak circulatory power, ventilatory power, ventilatory threshold, peak metabolic equivalents (METs), peak exercise time, partial pressure of end-tidal carbon dioxide (PETCO2), and VO2/workload slope. RESULTS: Two hundred fifty-one patients were enrolled. The mean (SD) age was 58.5 (11.9) years and 59% of patients were male. There were significant improvements with mavacamten vs placebo in the following peak-exercise CPET parameters: peak VE/VCO2 ratio (least squares [LS] mean difference, -2.2; 95% CI, -3.05 to -1.26; P < .001), peak METs (LS mean difference, 0.4; 95% CI, 0.17-0.60; P < .001), peak circulatory power (LS mean difference, 372.9 mL/kg/min × mm Hg; 95% CI, 153.12-592.61; P = .001), and peak PETCO2 (LS mean difference, 2.0 mm Hg; 95% CI, 1.12-2.79; P < .001). Mavacamten also improved peak exercise time compared with placebo (LS mean difference, 0.7 minutes; 95% CI, 0.13-1.24; P = .02). There was a significant improvement in nonpeak-exercise CPET parameters, such as VE/VCO2 slope (LS mean difference, -2.6; 95% CI, -3.58 to -1.52; P < .001) and ventilatory power (LS mean difference, 0.6 mm Hg; 95% CI, 0.29-0.90; P < .001) favoring mavacamten vs placebo. CONCLUSIONS AND RELEVANCE: Mavacamten improved a range of CPET parameters beyond pVO2, indicating consistent and broad benefits on maximal exercise capacity. Although improvements in peak-exercise CPET parameters are clinically meaningful, the favorable effects of mavacamten on submaximal exertional tolerance provide further insights into the beneficial impact of mavacamten in patients with obstructive HCM. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03470545

Proton Therapy With Concurrent Chemotherapy for Thoracic Esophageal Cancer: Toxicity, Disease Control, and Survival Outcomes

PURPOSE: When treating esophageal cancer with radiation therapy, it is critical to limit the dose to surrounding structures, such as the lung and/or heart, as much as possible. Proton radiation therapy allows a reduced radiation dose to both the heart and lungs, potentially reducing the risk of cardiopulmonary toxicity. Here, we report disease control, survival, and toxicity outcomes among patients with esophageal cancer treated with proton radiation therapy and concurrent chemotherapy (chemoradiation therapy; CRT) with or without surgery. MATERIALS AND METHODS: We enrolled 17 patients with thoracic esophageal carcinoma on a prospective registry between 2010 and 2021. Patients received proton therapy to a median dose of 50.4-GyRBE (range, 50.4-64.8) in 1.8-Gy fractions.Acute and late toxicities were graded per the Common Terminology Criteria for Adverse Events, version 4.0 (US National Cancer Institute, Bethesda, Maryland). In addition, disease control, patterns of failure, and survival outcomes were collected. RESULTS: Nine patients received preoperative CRT, and 8 received definitive CRT. Overall, 88% of patients had adenocarcinoma, and 12% had squamous cell carcinoma. With a median follow-up of 2.1 years (range, 0.5-9.4), the 3-year local progression-free, disease-free, and overall survival rates were 85%, 66%, and 55%, respectively. Two patients (1 with adenocarcinoma and 1 with squamous cell carcinoma) recurred at the primary site after refusing surgery after a complete clinical response to CRT. The most common acute nonhematologic and hematologic toxicities, respectively, were grades 1 to 3 esophagitis and grades 1 to 4 leukopenia, both affecting 82% of patients. No acute cardiopulmonary toxicities were observed in the absence of surgical resection. Reagarding surgical complications, 3 postoperative cardiopulmonary complications occurred as follows: 1 grade 1 pleural effusion, 1 grade 3 pleural effusion, and 1 grade 2 anastomotic leak. Two severe late CRT toxicities occurred: 1 grade 5 tracheoesophageal fistula and 1 grade 3 esophageal stenosis requiring a feeding tube. CONCLUSION: Proton radiation therapy is a safe, effective treatment for esophageal cancer with increasing evidence supporting its role in reducing cardiopulmonary toxicity

The use of 2-D speckle tracking echocardiography in assessing adolescent athletes with left ventricular hypertrabeculation meeting the criteria for left ventricular non-compaction cardiomyopathy

BACKGROUND: Current echocardiographic criteria cannot accurately differentiate exercise induced left ventricular (LV) hypertrabeculation in athletes from LV non-compaction cardiomyopathy (LVNC). This study aims to evaluate the role of speckle tracking echocardiography (STE) in characterising LV myocardial mechanics in healthy adolescent athletes with and without LVNC echocardiographic criteria. METHODS: Adolescent athletes evaluated at three sports academies between 2014 and 2019 were considered for this observational study. Those meeting the Jenni criteria for LVNC (end-systolic non-compacted/compacted myocardium ratio > 2 in any short axis segment) were considered LVNC+ and the rest LVNC-. Peak systolic LV longitudinal strain (Sl), circumferential strain (Sc), rotation (Rot), corresponding strain rates (SRl/c) and segmental values were calculated and compared using a non-inferiority approach. RESULTS: A total of 417 participants were included, mean age 14.5 ± 1.7 years, of which 6.5% were LVNC+ (n = 27). None of the athletes showed any additional LVNC clinical criteria. All average Sl, SRl Sc, SRc and Rot values were no worse in the LVNC+ group compared to LVNC- (p values range 0.0003-0.06), apart from apical SRc (p = 0.2). All 54 segmental measurements (Sl/Sc SRl/SRc and Rot) had numerically comparable means in both LVNC+ and LVNC-, of which 69% were also statistically non-inferior. CONCLUSIONS: Among healthy adolescent athletes, 6.5% met the echocardiographic criteria for LVNC, but showed normal LV STE parameters, in contrast to available data on paediatric LVNC describing abnormal myocardial function. STE could better characterise the myocardial mechanics of athletes with LV hypertrabeculation, thus allowing the transition from structural to functional LVNC diagnosis, especially in suspected physiological remodelling

Shared Microexponents: A Little Shifting Goes a Long Way

This paper introduces Block Data Representations (BDR), a framework for exploring and evaluating a wide spectrum of narrow-precision formats for deep learning. It enables comparison of popular quantization standards, and through BDR, new formats based on shared microexponents (MX) are identified, which outperform other state-of-the-art quantization approaches, including narrow-precision floating-point and block floating-point. MX utilizes multiple levels of quantization scaling with ultra-fine scaling factors based on shared microexponents in the hardware. The effectiveness of MX is demonstrated on real-world models including large-scale generative pretraining and inferencing, and production-scale recommendation systems

An integrated spatio-temporal view of riverine biodiversity using environmental DNA metabarcoding 2

Anthropogenically forced changes in global freshwater biodiversity demands better monitoring approaches. Consequently, environmental DNA (eDNA) analysis is enabling ecosystem-scale biodiversity assessment, yet the accurate spatiotemporal resolution at which robust biodiversity information can be detected remains ambiguous. Here, using intensive, annual spatiotemporal eDNA sampling across space (five rivers in the USA and Europe, with an upper range of 20-35 km between samples), time (19 timepoints across 2017 to 2018) and environmental conditions (river flow, pH, conductivity, temperature and rainfall), we characterise the resolution at which information on diversity across the animal kingdom can be gathered from rivers. In space, beta diversity was mainly dictated by turnover, on a scale of tens of kilometres, highlighting that diversity measures are not confounded by eDNA from upstream. Fish communities showed nested assemblages along some rivers, coinciding with habitat use. Across time, seasonal life history events, including salmon and eel migration, were detected. Finally, effects of abiotic factors were taxon-specific, reflecting habitat filtering of communities rather than environmental effects on DNA molecules. We conclude that riverine eDNA metabarcoding can measure biodiversity at spatiotemporal scales relevant to species and community ecology, demonstrating its utility in delivering insights into river ecology during an epoch of environmental change

The use of 2-D speckle tracking echocardiography in differentiating healthy adolescent athletes with right ventricular outflow tract dilation from patients with arrhythmogenic cardiomyopathy

AIMS: Echocardiographic assessment of adolescent athletes for arrhythmogenic cardiomyopathy (ACM) can be challenging owing to right ventricular (RV) exercise-related remodelling, particularly RV outflow tract (RVOT) dilation. The aim of this study is to evaluate the role of RV 2-D speckle tracking echocardiography (STE) in comparing healthy adolescent athletes with and without RVOT dilation to patients with ACM. METHODS AND RESULTS: A total of 391 adolescent athletes, mean age 14.5 ± 1.7 years, evaluated at three sports academies between 2014 and 2019 were included, and compared to previously reported ACM patients (n = 38 definite and n = 39 borderline). Peak systolic RV free wall (RVFW-Sl), global and segmental strain (Sl), and corresponding strain rates (SRl) were calculated. The participants meeting the major modified Task Force Criteria (mTFC) for RVOT dilation were defined as mTFC+ (n = 58, 14.8%), and the rest as mTFC- (n = 333, 85.2%). Mean RVFW-Sl was -27.6 ± 3.4% overall, -28.2 ± 4.1% in the mTFC+ group and - 27.5 ± 3.3% in the mTFC- group. mTFC+ athletes had normal RV-FW-Sl when compared to definite (-29% vs -19%, p < 0.001) and borderline ACM (-29% vs -21%, p < 0.001) cohorts. In addition, all mean global and regional Sl and SRl values were no worse in the mTFC+ group compared to the mTFC- (p values range < 0.0001 to 0.1, inferiority margin of 2% and 0.1 s-1 respectively). CONCLUSIONS: In athletes with RVOT dilation meeting the major mTFC, STE evaluation of the RV can demostrate normal function and differentiate physiological remodelling from pathological changes found in ACM, improving screening in grey-area cases