On the starting process of strongly nonlinear vortex/Rayleigh-wave interactions

An oncoming two-dimensional laminar boundary layer that develops an unstable inflection point and becomes three-dimensional is described by the Hall-Smith (1991) vortex/wave interaction equations. These equations are now examined in the neighbourhood of the position where the critical surface starts to form. A consistent structure is established in which an inviscid core flow is matched to a viscous buffer-layer solution where the appropriate jump condition on the transverse shear stress is satisfied. The final result is a bifurcation equation for the (constant) amplitude of the wave pressure. A representative classical velocity profile is considered to illustrate solutions of this equation for a range of values of the wave-numbers

Field Trials of Health Interventions: A Toolbox

Before new interventions can be used in disease control programmes, it is essential that they are carefully evaluated in “field trials”, which may be complex and expensive undertakings. Descriptions of the detailed procedures and methods used in trials that have been conducted in the past have generally not been published. As a consequence, those planning such trials have few guidelines available and little access to previously accumulated knowledge. In this book the practical issues of trial design and conduct are discussed fully and in sufficient detail for the text to be used as a “toolbox” by field investigators. The toolbox has now been extensively tested through use of the first two editions and this third edition is a comprehensive revision, incorporating the many developments that have taken place with respect to trials since 1996 and involving more than 30 contributors. Most of the chapters have been extensively revised and 7 new chapters have been added

The effect of targeted treatment on people with patellofemoral pain: A pragmatic, randomised controlled feasibility study

Background: Targeted treatment, matched according to specific clinical criteria e.g. hip muscle weakness, may result in better outcomes for people with patellofemoral pain (PFP). However, to ensure the success of future trials, a number of questions on the feasibility of a targeted treatment need clarification. The aim of the study was to explore the feasibility of matched treatment (MT) compared to usual care (UC) management for a subgroup of people with PFP determined to have hip weakness and to explore the mechanism of effect for hip strengthening. Methods: In a pragmatic, randomised controlled feasibility study, 24 participants with PFP (58% female; mean age 29 years) were randomly allocated to receive either MT aimed specifically at hip strengthening, or UC over an eight-week period. The primary outcomes were feasibility outcomes, which included rates of adherence, attrition, eligibility, missing data and treatment efficacy. Secondary outcomes focused on the mechanistic outcomes of the intervention, which included hip kinematics. Results: Conversion to consent (100%), missing data (0%), attrition rate (8%) and adherence to both treatment and appointments ( > 90%) were deemed successful endpoints. The analysis of treatment efficacy showed that the MT group reported a greater improvement for the Global Rating of Change Scale (62% vs. 9%) and the Anterior Knee Pain Scale (-5.23 vs. 1.18) but no between-group differences for either average or worst pain. Mechanistic outcomes showed a greatest reduction in peak hip internal rotation angle for the MT group (13.1% vs. -2.7%). Conclusion: This feasibility study indicates that a definitive randomised controlled trial investigating a targeted treatment approach is achievable. Findings suggest the mechanism of effect of hip strengthening may be to influence kinematic changes in hip function in the transverse plane

Understanding patterns of care for musculoskeletal patients using routinely collected National Health Service data from general practices in England

Musculoskeletal conditions are extremely common and represent a costly and growing problem in the United Kingdom. Understanding patterns of care and how they vary between individual patients and patient groups is necessary for effective and efficient disease management. In this article, we present a novel approach to understanding patterns of care for musculoskeletal patients in which trajectories are constructed from clinical and administrative data that are routinely collected by clinicians and healthcare professionals. Our approach is applied to routinely collected National Health Service data for musculoskeletal patients who were registered to a set of general practices in England and highlights both known and previously unreported variations in the prescribing of opioid analgesics by gender and presence of pre-existing depression. We conclude that the application of our approach to routinely collected National Health Service data can extend the dimensions over which patterns of care can be understood for musculoskeletal patients and for patients with other long-term conditions

Drug misuse, tobacco smoking, alcohol and other social determinants of tuberculosis in UK-born adults in England: a community-based case-control study

Addressing social determinants of tuberculosis (TB) is essential to achieve elimination, including in low-incidence settings. We measured the association between socio-economic status and intermediate social determinants of health (SDHs, including drug misuse, tobacco smoking and alcohol), and TB, taking into account their clustering in individuals. We conducted a case-control study in 23–38 years old UK-born White adults with frst tuberculosis episode, and randomly selected age and sex frequencymatched community controls. Data was collected on education, household overcrowding, tobacco smoking, alcohol and drugs use, and history of homelessness and prison. Analyses were done using logistic regression models, informed by a formal theoretical causal framework (Directed Acyclic Graph). 681 TB cases and 1183 controls were recruited. Tuberculosis odds were four times higher in subjects with education below GCSE O-levels, compared to higher education (OR=3.94; 95%CI: 2.74, 5.67), after adjusting for other TB risk factors (age, sex, BCG-vaccination and stays ≥3 months in Africa/Asia). When simultaneously accounting for respective SDHs, higher tuberculosis risk was independently associated with tobacco smoking, drugs use (especially injectable drugs OR=5.67; 95%CI: 2.68, 11.98), homelessness and area-level deprivation. Population Attributable Fraction estimates suggested that tobacco and class-A drug use were, respectively, responsible for 18% and 15% of TB cases in this group. Our fndings suggest that socio-economic deprivation remains a driver of tuberculosis in England, including through drugs misuse, tobacco smoking, and homelessness. These fndings further support the integration of health and social services in high-risk young adults to improve TB control eforts

Fan-Intake interaction under high incidence

In this paper, we present an extensive numerical study on the interaction between the downstream fan and the flow separating over an intake under high incidence. The objectives of this investigation are twofold: (a) to gain qualitative insight into the mechanism of fan–intake interaction and (b) to quantitatively examine the effect of the proximity of the fan on the inlet distortion. The fan proximity is altered using the key design parameter, L/D, where D is the diameter of the intake, and L is the distance of the fan from the intake lip. Both steady and unsteady Reynolds-averaged numerical simulations (RANS) were carried out. For the steady calculations, a low-order fan model has been used, while a full 3D geometry has been used for the unsteady RANS. The numerical methodology is also thoroughly validated against the measurements for the intake-only and fan-only configurations on a high bypass ratio turbofan intake and fan, respectively. To systematically study the effect of fan on the intake separation and explore the design criteria, a simplified intake–fan configuration has been considered. In this fan–intake model, the proximity of the fan to the intake separation (L/D) can be conveniently altered without affecting other parameters. The key results indicate that, depending on L/D, the fan has either suppressed the level of the postseparation distortion or increased the separation-free operating range. At the lowest L/D (∼0.17), around a 5 deg increase in the separation-free angle of incidence was achieved. This delay in the separation-free angle of incidence decreased with increasing L/D. At the largest L/D (∼0.44), the fan was effective in suppressing the postseparation distortion rather than entirely eliminating the separation. Isentropic Mach number distribution over the intake lip for different L/D's revealed that the fan accelerates the flow near the casing upstream of the fan face, thereby decreasing the distortion level in the immediate vicinity. However, this acceleration effect decayed rapidly with increasing upstream distance from the fan-face.</jats:p

Temperature effects on export production in the open ocean

A pelagic food web model was formulated with the goal of developing a quantitative understanding of the relationship between total production, export production, and environmental variables in marine ecosystems. The model assumes that primary production is partitioned through both large and small phytoplankton and that the food web adjusts to changes in the rate of allochthonous nutrient inputs in a way that maximizes stability, i.e., the ability of the system to return to steady state following a perturbation. The results of the modeling exercise indicate that ef ratios, defined as new production/total production = export production/total production, are relatively insensitive to total production rates at temperatures greater than ∼25°C and lie in the range 0.1‐0.2. At moderate to high total production rates, ef ratios are insensitive to total production and negatively correlated with temperature. The maximum ef ratios are ∼0.67 at high rates of production and temperatures of 0°−10°C. At temperatures less than ∼20°C, there is a transition from low ef ratios to relatively high ef ratios as total production increases from low to moderate values. This transition accounts for the hyperbolic relationship often presumed to exist between ef ratios and total production. At low rates of production the model predicts a negative correlation between production and ef ratios, a result consistent with data collected at station ALOHA (22°45′N, 158°W) in the North Pacific subtropical gyre. The predictions of the model are in excellent agreement with results reported from the Joint Global Ocean Flux Study (JGOFS) and from other field work. In these studies, there is virtually no correlation between total production and ef ratios, but temperature alone accounts for 86% of the variance in the ef ratios. Model predictions of the absolute and relative abundance of autotrophic and heterotrophic microorganisms are in excellent agreement with data reported from field studies. Combining the ef ratio model with estimates of ocean temperature and photosynthetic rates derived from satellite data indicates that export production on a global scale is ∼20% of net photosynthesis. The results of the model have important implications for the impact of climate change on export production, particularly with respect to temperature effects

Dynamics of trimming the content of face representations for categorization in the brain

To understand visual cognition, it is imperative to determine when, how and with what information the human brain categorizes the visual input. Visual categorization consistently involves at least an early and a late stage: the occipito-temporal N170 event related potential related to stimulus encoding and the parietal P300 involved in perceptual decisions. Here we sought to understand how the brain globally transforms its representations of face categories from their early encoding to the later decision stage over the 400 ms time window encompassing the N170 and P300 brain events. We applied classification image techniques to the behavioral and electroencephalographic data of three observers who categorized seven facial expressions of emotion and report two main findings: (1) Over the 400 ms time course, processing of facial features initially spreads bilaterally across the left and right occipito-temporal regions to dynamically converge onto the centro-parietal region; (2) Concurrently, information processing gradually shifts from encoding common face features across all spatial scales (e.g. the eyes) to representing only the finer scales of the diagnostic features that are richer in useful information for behavior (e.g. the wide opened eyes in 'fear'; the detailed mouth in 'happy'). Our findings suggest that the brain refines its diagnostic representations of visual categories over the first 400 ms of processing by trimming a thorough encoding of features over the N170, to leave only the detailed information important for perceptual decisions over the P300

Widespread association between the ericoid mycorrhizal fungus Rhizoscyphus ericae and a leafy liverwort in the maritime and sub-Antarctic

A recent study identified a fungal isolate from the Antarctic leafy liverwort Cephaloziella varians as the ericoid mycorrhizal associate Rhizoscyphus ericae. However, nothing is known about the wider Antarctic distribution of R. ericae in C. varians, and inoculation experiments confirming the ability of the fungus to form coils in the liverwort are lacking. Using direct isolation and baiting with Vaccinium macrocarpon seedlings, fungi were isolated from C. varians sampled from eight sites across a 1875-km transect through sub- and maritime Antarctica. The ability of an isolate to form coils in aseptically grown C. varians was also tested. Fungi with 98–99% sequence identity to R. ericae internal transcribed spacer (ITS) region and partial large subunit ribosomal (r)DNA sequences were frequently isolated from C. varians at all sites sampled. The EF4/Fung5 primer set did not amplify small subunit rDNA from three of five R. ericae isolates, probably accounting for the reported absence of the fungus from C. varians in a previous study. Rhizoscyphus ericae was found to colonize aseptically-grown C. varians intracellularly, forming hyphal coils. This study shows that the association between R. ericae and C. varians is apparently widespread in Antarctica, and confirms that R. ericae is at least in part responsible for the formation of the coils observed in rhizoids of field-collected C. varians