Initial Stratification Research Articles

Biocultural determinants of overweight-obesity among adult women experiencing the nutritional transition in the Democratic Republic of Congo.

The African Great Lakes region is experiencing rapid urbanization, which is leading to a nutritional transition and its related chronic diseases. Similar to other Great Lakes countries, the nutritional transition in the Democratic Republic of Congo (DRC) is reflected by increased non-communicable diseases, including morbid obesity. The 2014 Demographic Health Survey (DHS) revealed a rising incidence of overweight among women, ranging from 10% in 2001 to 16% in 2014. Furthermore, over 20% of individuals in several provinces of the DRC are classified as overweight-obese. This study aimed to investigate the prevalence as well as the main biocultural determinants of overweight-obesity among adult women in the DRC. In a cross-sectional survey, including a representative sample of adult Congolese women living in the South Kivu province, participants were randomly recruited using a two-stage cluster sampling technique after an initial urban-rural stratification. The estimation of the was based on previous results from DHS. Thus, a total of 495 individuals were selected, including 325 urban and 170 rural subjects. Data were collected from households by dietitians who were specifically trained for this survey. In this study population, the prevalence of overweight-obesity was 33.6%, with 7.1% classified as obese. The prevalence of obesity was significantly higher among urban people, while all subjects with obesity were from the older age group (>35 years). Using binomial logistic regressions, it was observed that overweight-obesity had a significant positive correlation with the duration of urban residence, namely, Migrants' status: "New residents" 4.6 [1.9-11.7] p < 0.003, "Long term residents" 8.7 [3.5-21.5] p < 0.001; Socio-economic status (SES): "High" 2.4 [1.1-5.3] p < 0.03, and Stoutness valorization: "Yes" 6.1 [3.4-10.9] p < 0.001. In a pathway analysis conducted based on a structural equation model (SEM), we discovered that urban residence and SES were associated with an increase in overweight-obesity, with a positive correlation with processed food consumption and a negative correlation with physical activity. Age was associated with an increase in overweight-obesity through a negative association with physical activity, whereas stoutness valorization directly increased overweight-obesity. In order to properly guide public health policies, public authorities in the DRC should consider the main findings of this original study, which identify how socio-demographic and socio-ecological factors contribute jointly to the rising prevalence of overweight-obesity in the country.

Enhancing structural durability in marine concrete piles with initial defects: RS-AAT-induced advection to suppress chloride ion penetration

Chlorine-induced corrosion in unsaturated, cracked, and delaminated reinforced concrete structures is a major cause of lifespan decline in marine wet and dry zones. Reverse-seepage and Saturation based Active Anti-corrosion Technology (RS-AAT) has the scientific basis and application potential to solve this problem due to its unique saturation and reverse-seepage effects provided by structural construction means. This study introduces an analytical framework for understanding time-dependent chloride ion permeation in concrete pipe piles, incorporating the combined impact of cracks, delamination, and RS-AAT anti-corrosion approach. The analytical approach is validated through finite element method simulations and a comprehensive 90-day indoor experiment, which simulate marine submerged and tidal conditions. Extensive parametric analysis further elucidates advection-induced suppression of chloride ion diffusion by RS-AAT in cracked and delaminated conditions, considering chloride ion diffusion coefficient and water permeability coefficient, reverse-seepage pressure, initial crack characteristics and centrifugal stratification. Results show that RS-AAT substantially inhibits chloride ion penetration and lengthens the lifespan of concrete piles, even initially cracked or delaminated. This work provides a basis for RS-AAT’s application and optimization as an innovative approach to enhancing marine concrete infrastructure.

The Role of the Nephrologist in the Treatment and Prevention of Nephrolithiasis

Abstract Nephrolithiasis is a disease with a high risk of recurrence: 50% within five years and up to 80–90 % within 10 years after the first episode. Often, with this diagnosis, there is only symptomatic treatment with the aim of expelling the kidney stone and removing the pain. In such patients, however, initial stratification of the risk of recurrence based on the risk factors present is essential. Every patient with nephrolithiasis, whether it is a single episode or recurrent, should follow general measures to prevent kidney stones. Depending on the results of the kidney stone analysis and the risk of recurrence, it is necessary to carry out a specialised nephrological metabolic examination which is performed by a nephrologist in Slovakia, with subsequent personalised recommendations depending on the cause of recurrent nephrolithiasis. These include dietary and regimen measures, as well as pharmacological treatment. In the following article we summarize specific measures for individual types of nephrolithiasis, as well as basic preventive measures for the recurrence of kidney stones, with a focus on dietary risk and protective factors.

Constraints on the Long-term Existence of Dilute Cores in Giant Planets

Post-Cassini ring seismology analysis suggests the existence of a stable stratification inside Saturn that extends from the center to ∼60% of its radius, in what is recognized today as Saturn’s dilute core. Similarly, gravity measurements on Jupiter suggest the existence of a dilute core of weekly constrained radial extent. These cores are likely in a double-diffusive regime, which prompts the question of their long-term stability. Indeed, previous direct numerical simulation (DNS) studies in triply periodic domains have shown that, in some regimes, double-diffusive convection tends to spontaneously form shallow convective layers, which coarsen until the region becomes fully convective. In this paper, we study the conditions for layering in double-diffusive convection using different boundary conditions, in which temperature and composition fluxes are fixed at the domain boundaries. We run a suite of DNSs varying microscopic diffusivities of the fluid and the strength of the initial stratification. We find that convective layers still form as a result of the previously discovered γ-instability, which takes place whenever the local stratification drops below a critical threshold that only depends on the fluid diffusivities. We also find that the layers grow once formed, eventually occupying the entire domain. Our work thus recovers the results of previous studies, despite the new boundary conditions, suggesting that this behavior is universal. The existence of Saturn’s stably stratified core, today, therefore suggests that this threshold has never been reached, which places a new constraint on scenarios for the planet’s formation and evolution.

Is MRI ready to replace biopsy during active surveillance?

Active surveillance (AS) is a conservative management option recommended for patients diagnosed with low-risk prostate cancer (PCa) and selected cases with intermediate-risk PCa. The adoption of prostate MRI in the primary diagnostic setting has sparked interest in its application during AS. This review aims to examine the role and performance of multiparametric MRI (mpMRI) across the entire AS pathway, from initial stratification to follow-up, also relative to the utilization of the Prostate Cancer Radiological Estimation of Change in Sequential Evaluation (PRECISE) criteria. Given the high negative predictive value of mpMRI in detecting clinically significant PCa (csPCa), robust evidence supports its use in patient selection and risk stratification at the time of diagnosis or confirmatory biopsy. However, conflicting results have been observed when using MRI in evaluating disease progression during follow-up. Key areas requiring clarification include addressing the clinical significance of MRI-negative csPCa, optimizing MRI quality, determining the role of biparametric MRI (bpMRI) or mpMRI protocols, and integrating artificial intelligence (AI) for improved performance. CLINICAL RELEVANCE STATEMENT: MRI plays an essential role in the selection, stratification, and follow up of patients in active surveillance (AS) for prostate cancer. However, owing to existing limitations, it cannot fully replace biopsies in the context of AS. KEY POINTS: Multiparametric MRI (mpMRI) has become a crucial tool in active surveillance (AS) for prostate cancer (PCa). Conflicting results have been observed regarding multiparametric MRI efficacy in assessing disease progression. Standardizing MRI-guided protocols will be critical in addressing current limitations in active surveillance for prostate cancer.

From Audience to Evaluator: When Visibility into Prior Evaluations Leads to Convergence or Divergence in Subsequent Evaluations Among Professionals

Collective evaluation processes, which offer individuals an opportunity to assess quality, have transcended mainstream sectors (e.g., books, restaurants) to permeate professional contexts from within and across organizations to the gig economy. This paper introduces a theoretical framework to understand how evaluators’ visibility into prior evaluations influences the subsequent evaluation process: the likelihood of evaluating at all and the value of the evaluations that end up being submitted. Central to this discussion are the conditions under which evaluations converge—are more similar to prior evaluations—or diverge—are less similar—as well as the mechanisms driving observed outcomes. Using a quasinatural experiment on a platform where investment professionals submit and evaluate investment recommendations, I compare evaluations that are made with and without the possibility of prior ratings influencing the subsequent evaluation process. I find that when prior ratings are visible, convergence occurs. The visibility of prior evaluations decreases the likelihood that a subsequent evaluation occurs by about 50%, and subsequent evaluations become 54%–63% closer to the visible rating. Further analysis suggests that peer deference is a dominant mechanism driving convergence, and only professionals with specialized expertise resist peer deference. Notably, there is no evidence that initial ratings are related to long-term performance. Thus, in this context, convergence distorts the available quality signal for a recommendation. These findings underscore how the structure of evaluation processes can perpetuate initial stratification, even among professionals with baseline levels of expertise. Supplemental Material: The online appendix is available at https://doi.org/10.1287/orsc.2017.11285 .

Study on water transfer characteristics and desulfurization effect during the separation of fine low rank lignite in the dry dense medium fluidized bed

Coal is an important support for the development of the national economy. Lignite has high utilization value. This paper utilizes a dry dense medium fluidized bed for separation of low rank high sulfur lignite across the size range of 6–0 mm. The study focuses on the spatial diffusion and transfer characteristics of material moisture in the fluidized bed, systematically analyzes the influence of material moisture on the bed fluidization characteristics and the bed density spatial uniform stability, explores the diffusion and separation characteristics of the material in the bed, and determines the material separation time domain. The experimental results indicate that when t = 60 s, the high concentration area of the whole bed is distributed in the center, and the low concentration area is distributed in the side wall At when t = 360 s, the high concentration area of the upper bed is distributed near the side wall, and the high concentration area of the middle and lower layers are distributed in the center of the bed. At t = 420 s, the high concentration area in the upper layer gradually disappears, and the separation of high and low-density particles is completed in the middle layer, achieving stratification. When the bed layer moisture content is 0.5 % and the air flow is 16.3 cm/s, the bed pressure drop tends to stabilize, and the bed fluidization effect is better, reaching its peak moisture content. The fluctuation in bed layer spatial density distribution is significant, especially in the central area of the upper layer (within the circular area 0 ≤ R ≤ 3 cm), where the density distribution fluctuation is most pronounced, with an average density of 1.67 g/cm3. The fluctuation amplitude of the middle bed density is relatively low, with an average density of 1.65 g/cm3. The fluctuation amplitude of the lower bed density is the smallest, with an average density of 1.53 g/cm3. When t = 0–120 s, the ash content of each layer along the bed height is close to the raw coal, which belongs to the material diffusion distribution time domain. When t = 120–240 s, the material is stratified locally, which belongs to the material initial stratification time domain. When t = 240–420 s, the high and low density particles achieve orderly stratification, which belongs to the material sorting time domain The results show that the clean coal yield was 74.68 %, sulfur content is 0.98 %, ash content is 9.96 %, gangue yield is 25.32 %, sulfur content is 18.69 %, ash content is 58.32 %, Ep is 0.65 g/cm3. The high-precision dry separation of fine grained low rank high sulfur lignite was realized.

Innova4Health: an integrated approach for prevention of recurrence and personalized treatment of Major Depressive Disorder.

Major Depressive Disorder (MDD) is a prevalent mental health condition characterized by persistent low mood, cognitive and physical symptoms, anhedonia (loss of interest in activities), and suicidal ideation. The World Health Organization (WHO) predicts depression will become the leading cause of disability by 2030. While biological markers remain essential for understanding MDD's pathophysiology, recent advancements in social signal processing and environmental monitoring hold promise. Wearable technologies, including smartwatches and air purifiers with environmental sensors, can generate valuable digital biomarkers for depression assessment in real-world settings. Integrating these with existing physical, psychopathological, and other indices (autoimmune, inflammatory, neuroradiological) has the potential to improve MDD recurrence prevention strategies. This prospective, randomized, interventional, and non-pharmacological integrated study aims to evaluate digital and environmental biomarkers in adolescents and young adults diagnosed with MDD who are currently taking medication. The study implements a sensor-integrated platform built around an open-source "Pothos" air purifier system. This platform is designed for scalability and integration with third-party devices. It accomplishes this through software interfaces, a dedicated app, sensor signal pre-processing, and an embedded deep learning AI system. The study will enroll two experimental groups (10 adolescents and 30 young adults each). Within each group, participants will be randomly allocated to Group A or Group B. Only Group B will receive the technological equipment (Pothos system and smartwatch) for collecting digital biomarkers. Blood and saliva samples will be collected at baseline (T0) and endpoint (T1) to assess inflammatory markers and cortisol levels. Following initial age-based stratification, the sample will undergo detailed classification at the 6-month follow-up based on remission status. Digital and environmental biomarker data will be analyzed to explore intricate relationships between these markers, depression symptoms, disease progression, and early signs of illness. This study seeks to validate an AI tool for enhancing early MDD clinical management, implement an AI solution for continuous data processing, and establish an AI infrastructure for managing healthcare Big Data. Integrating innovative psychophysical assessment tools into clinical practice holds significant promise for improving diagnostic accuracy and developing more specific digital devices for comprehensive mental health evaluation.

Effects of an Annular Baffle on Heat Transfer to an Immersed Coil Heat Exchanger in Thermally Stratified Tanks

Abstract The effect of a cylindrical baffle on heat transfer to an immersed heat exchanger is investigated in initially thermally stratified tanks. The heat exchanger is located in the annular region created by the baffle and the tank wall. Three different cases of initial thermal stratification are explored, and in each case, experiments are conducted with and without the baffle in the stratified tank and in a comparable isothermal tank with the same initial energy, enabling exploration of the role of the baffle in a stratified tank and the role of stratification in tanks with or without the baffle. The baffle maintains the high initial temperature of the upper zone of the stratified tank for 10–16 min, as cool plumes that form on the heat exchanger are confined to the annular baffle region until they exit at the bottom of the tank. Regardless of stratification, the baffle always improves heat transfer to the immersed heat exchanger. In the isothermal tanks, the baffle increases total energy extracted in the first 30 min of discharge by over 20%. In stratified tanks, the baffle increases total energy extracted in 30 min of discharge by 9–16%. Initially, improvement in heat transfer in stratified tanks is due to the higher driving temperature differences around the heat exchanger. Later, after all the water from the hot zone has entered and flowed through the baffle, the tank is basically isothermal, and velocity increases as the fluid temperature drops, maintaining rates of heat transfer higher than that in the tank without the baffle. Stratification improves heat transfer in tanks without a baffle because, by design, the driving temperature difference between the heat exchanger wall and the surrounding fluid is considerably higher. However, in tanks with the baffle, stratification has only a modest positive effect on heat transfer to the immersed heat exchanger.

Impact of shallow sills on circulation regimes and submarine melting in glacial fjords

Abstract. The increased melting and rapid retreat of marine-terminating glaciers is a key contributor to sea-level rise. In glacial fjords with shallow sills common in Patagonia, Alaska, and other systems, these bathymetric features can act as a first-order control on the dynamics. However, our understanding of how this shallow bathymetry interacts with the subglacial discharge from the glacier and impacts the fjord circulation, water properties, and rates of submarine melting is limited. To address this gap, we conduct idealized numerical simulations using a coupled plume–ocean fjord model spanning a wide range of initial ocean conditions, sill depths, and subglacial discharge. A previously documented circulation regime leads to strong mixing and vertical transport over the sill, where up to ∼ 70 % of the colder water from the upper-layer outflow is refluxed into the deeper layer, cooling the incoming warm oceanic water by as much as 1 ∘C and reducing the stratification near the glacier front. When the initial stratification is relatively strong or the subglacial discharge is relatively weak, an additional unsteady circulation regime arises where the freshwater flow can become trapped below the sill depth for weeks to months, creating an effective cooling mechanism for the deep water. We also find that submarine melting often increases when a shallow sill is added to a glacial fjord due to the reduction of stratification – which increases submarine melting – dominating over the cooling effect as the oceanic inflow is modified by the presence of the sill. These results underscore that shallow-silled fjords can have distinct dynamics that strongly modulate oceanic properties and the melting rates of marine-terminating glaciers.

An Online Assimilation Method to Improve the Numerical Forecast of Sea Fog Using Microwave Radiometer‐Retrieved Cloud Water Path

AbstractNumerical forecast of the sea fog is sensitive to the initial moist stratification within the marine atmospheric boundary layer (MABL). This study develops an online assimilation method to improve the MABL thermal and moist structures in sea fog ensemble forecasts based on the Weather Research and Forecasting model and Grid‐point Statistical Interpolation/EnKF system. It uses the satellite‐retrieved cloud water path (CWP) as the indicator of sea fog and low‐level stratus to determine the best ensemble members at each grid point. The relative humidity and cloud water profiles are extracted from the best members to generate a series of pseudo‐observations, which are assimilated to update all the members by EnKF method. The new method significantly improves the ensemble forecast of five widespread advection fog events over the Yellow Sea, which can be attributed to the decrease of both missed and spurious fog areas. The case study shows that assimilating the information of both humidity and cloud water outperforms assimilating either of them, while the impact of directly assimilating CWP observation is insignificant. The analysis increments of cloud water, thermal and moist structures in MABL together contribute to the correction of forecasted sea fog. The generation of pseudo‐observations can use the dynamic compatibility of the model to alleviate the impact of erroneous data in the observation, leading to the low sensitivity of the new method to CWP retrieval error.

Population assessment of the Endangered Forty-spotted Pardalote Pardalotus quadragintus on Maria Island, Tasmania

The Forty-spotted Pardalote Pardalotus quadragintus is one of the smallest birds in Australia and is endemic to Tasmania, where it occurs only in forest or woodland containing White Gum Eucalyptus viminalis. It is listed as Endangered under the Tasmanian Threatened Species Protection Act 1995 and Commonwealth Environment Protection and Biodiversity Conservation Act 1999. A habitat-stratified survey of Forty-spotted Pardalotes on Maria Island, off the eastern coast of Tasmania, was undertaken in August 2023 to provide a robust estimate of the population. Initial stratification using available vegetation mapping overestimated the availability of suitable habitat based on survey-site habitat evaluations. Forty-spotted Pardalotes were detected at 14 of 74 survey sites, with all detections being at sites where White Gum was the main tree species present. Their mean density was 1.66 birds per hectare, with an estimated total population of 847 birds (CV 0.38, confidence intervals 404–1776 birds). This estimate is consistent with previous uncorrected count-based estimates, although comparisons with historical counts are highly subjective given the substantial methodological differences. Only ~5% of Maria Island supports the preferred habitat for this species and further research on the requirements for, and abundance of, suitable microhabitat is recommended to further refine population estimates and guide conservation management actions.

Abstract 16736: Comparison of Pulmonary Arterial Hypertension Risk Assessment Tools Using a Harmonized FDA Dataset

Introduction: One-year mortality risk for a pulmonary arterial hypertension (PAH) patient is the most substantial. Accordingly, the initial risk stratification should be the most accurate to ensure appropriate aggressiveness of the primary treatment choices. According to PAH guidelines, the European 3-strata system is recommended at baseline for risk assessment. However, the US REVEAL2.0 and REVEAL Lite risk scores also provide high performances. Yet, comparison of risk assessment performances at baseline in the same dataset of patients is still missing. Hypothesis: REVEAL 2.0 provide higher discrimination performances than the European 3-strata system at baseline. We aim to compare the discrimination power at baseline of the currently available tools. Methods: Treatment naïve PAH patients from 6 PAH trials were provided by the FDA and harmonized (AMBITION n=500, ARIES n=126, PATENT n=221, PHIRST n=77, GRIPHON n=231, and SERAPHIN n=270). Kaplan-Meier and log-rank tests were performed for each of the following tools: noninvasive FRENCH method (FR), European 3-strata system (E3), COMPERA2.0 4-strata (CO), REVEAL2.0 (RE), and REVEAL Lite (RL). Their C-indices were compared. A total of 100 bootstrap samples were obtained from the original data providing a robust method for comparing across the different tools. Results: Among the 1,425 patients, 78% were female, 54% NYHA 3-4 with a median age of 51(38, 64) yo, 6-min walking distance of 365(295, 418)m, mPAP of 49(38, 59) mmHg, PVR 9.3(6.2, 13.5) WU. At baseline, the C-index for FR, CO, E3, RL, and RE were 0.64, 0.67, 0.68, 0.69, 0.73, respectively. Out of the 100 bootstrap samples, 99% led to a better C-index for RE compared to E3, with a statistically significant paired t-test (p&lt;e -40 ) as well as RL compared to E3 (p&lt; e-8 ). Forrest plots of 95%CI for the C-index differences among the 100 bootstrap samples showed that RE was the best performer, followed by RL, while the E3 and FR models were comparable and worse than the others. Conclusions: REVEAL 2.0 and REVEAL Lite risk scores perform better than the European-3 strata, COMPERA-4 strata, and the noninvasive FRENCH models in predicting 1-year survival at baseline and should be considered as the initial stratification scheme in future guidelines.

An “objective” definition of potential vorticity. Generalized evolution equation and application to the study of coastal upwelling instability

In this paper, we propose a form for potential vorticity (PV), rescaled using the Lorenz’s rearranged density profile, the novelty being that we here take into account its time evolution. We argue this rescaled PV is more representative of the dynamics, in particular to evaluate the respective impact of mixing and friction on the generation of geostrophic circulation. The impact of mixing at global scale, which only modifies the global stratification at rest, is taken into account in the evolution equation of this “objective” definition of PV, in the sense that it scales the PV changes with respect to its effect on the circulation. Numerically, we show that all terms can be calculated coherently using a single computation cell.We illustrate our purpose by studying the instability of coastal upwelling currents, using a numerical model at high resolution. The configuration is a periodic flat channel on the f-plane with vertical walls at the southern and northern boundaries. A constant wind is applied over a fluid at rest with an initial linear stratification. An upwelling current forms at the northern coast. After a few days, instabilities develop and vortices eventually emerge with surface intensified cyclones and subsurface anticyclones. We show that these instabilities and eddies are associated with (rescaled) PV anomalies, triggered by mixing and friction.We describe rescaled PV budgets in a layer bounded between the surface and an isopycnal level. Eulerian and Lagrangian diagnostics allow to analyze irreversible PV production terms, distinguishing the influence of advection, friction (associated with wind stress) and mixing. We find that friction plays the main role, generating negative PV anomalies, while mixing acts to dampen this negative PV production. The association of this negative PV anomaly with the outcropping front leads to the baroclinic destabilization of the upwelling front, creating subsurface anticyclonic vortices and surface intensified cyclonic vortices. Varying the strength of the wind forcing shows that mixing is the most sensitive process, with a net effect that is strongly reduced or even reversed with moderate to weak winds.When the dynamics is fully turbulent, with filaments and vortices of small sizes, the PV production by mixing and friction is enhanced but the Lagrangian diagnostics are more difficult to analyze, since fluctuations at grid scale become significant and numerical effects – associated with imperfections of the numerical schemes – spoil the PV budget calculation.

Stratification Breakdown in Antarctic Coastal Polynyas. Part I: Influence of Physical Factors on the Destratification Time Scale

Abstract This study examines the process of water-column stratification breakdown in Antarctic coastal polynyas adjacent to an ice shelf with a cavity underneath. This first part of a two-part sequence seeks to quantify the influence of offshore katabatic winds, alongshore winds, air temperature, and initial ambient stratification on the time scales of polynya destratification through combining process-oriented numerical simulations and analytical scaling. In particular, the often-neglected influence of wind-driven circulation on the lateral transport of the water formed at the polynya surface—which we call Polynya Source Water (PSW)—is systematically examined here. First, an ice shelf–sea ice–ocean coupled numerical model is adapted to simulate the process of PSW formation in polynyas of various configurations. The simulations highlight that (i) before reaching the bottom, majority of the PSW is actually carried away from the polynya by katabatic wind–induced offshore outflow, diminishing water-column mixing in the polynya and intrusion of the PSW into the neighboring ice shelf cavity, and (ii) alongshore coastal easterly winds, through inducing onshore Ekman transport, reduce offshore loss of the PSW and enhance polynya mixing and PSW intrusion into the cavity. Second, an analytical scaling of the destratification time scale is derived based on fundamental physical principles to quantitatively synthesize the influence of the physical factors, which is then verified by independent numerical sensitivity simulations. This work provides insights into the mechanisms that drive temporal and cross-polynya variations in stratification and PSW formation in Antarctic coastal polynyas, and establishes a framework for studying differences among the polynyas in the ocean.

A Note on Stratification Errors in the Analysis of Clinical Trials

Stratification in both the design and analysis of randomized clinical trials is common. Despite features in automated randomization systems to reconfirm the stratifying variables, incorrect values of these variables may be entered. These errors are often detected during subsequent data collection and verification. Questions remain about whether to use the mis-reported initial stratification or the corrected values in subsequent analyses. It is shown that the likelihood function resulting from the design of randomized clinical trials supports the use of the corrected values. New definitions are proposed that characterize misclassification errors as “ignorable” and “nonignorable.” Ignorable errors may depend on the correct strata and any other modeled baseline covariates, but they are otherwise unrelated to potential treatment outcomes. Data management review suggests most misclassification errors are arbitrarily produced by distracted investigators, so they are ignorable or at most weakly dependent on measured and unmeasured baseline covariates. Ignorable misclassification errors may produce a small increase in standard errors, but other properties of the planned analyses are unchanged (e.g., unbiasedness, confidence interval coverage). It is shown that unbiased linear estimation in the absence of misclassification errors remains unbiased when there are non-ignorable misclassification errors, and the corresponding confidence intervals based on the corrected strata values are conservative.

3D hydrodynamic simulations of massive main-sequence stars – I. Dynamics and mixing of convection and internal gravity waves

ABSTRACT We performed 3D hydrodynamic simulations of the inner $\approx 50{{\ \rm per\ cent}}$ radial extent of a $25\,\,\mathrm{\mathrm{M}_\odot }$ star in the early phase of the main sequence and investigate core convection and internal gravity waves in the core-envelope boundary region. Simulations for different grid resolutions and driving luminosities establish scaling relations to constrain models of mixing for 1D applications. As in previous works, the turbulent mass entrainment rate extrapolated to nominal heating is unrealistically high ($1.58\times 10^{-4}\,\,\mathrm{\mathrm{M}_\odot \, {\mathrm{yr}}^{-1}}$), which is discussed in terms of the non-equilibrium response of the simulations to the initial stratification. We measure quantitatively the effect of mixing due to internal gravity waves excited by core convection interacting with the boundary in our simulations. The wave power spectral density as a function of frequency and wavelength agrees well with the GYRE eigenmode predictions based on the 1D spherically averaged radial profile. A diffusion coefficient profile that reproduces the spherically averaged abundance distribution evolution is determined for each simulation. Through a combination of eigenmode analysis and scaling relations it is shown that in the N2-peak region, mixing is due to internal gravity waves and follows the scaling relation DIGW-hydro ∝ L4/3 over a $\gtrapprox 2\,\,\mathrm{\mathrm{dex}}$ range of heating factors. Different extrapolations of the mixing efficiency down to nominal heating are discussed. If internal gravity wave mixing is due to thermally enhanced shear mixing, an upper limit is $D_\mathrm{IGW}\lessapprox 2$ to $3\times 10^{4}\,\,\mathrm{cm^2\, s^{-1}}$ at nominal heating in the N2-peak region above the convective core.

Early Neurodevelopmental Assessments of Neonates Discharged From the Neonatal Intensive Care Unit: A Physiatrist's Perspective.

The survival rate of children admitted in the neonatal intensive care unit (NICU) after birth is on the increase; hence, proper evaluation and care of their neurodevelopment has become an important issue. Neurodevelopmental assessments of individual domains regarding motor, language, cognition, and sensory perception are crucial in planning prompt interventions for neonates requiring immediate support and rehabilitation treatment. These assessments are essential for identifying areas of weakness and designing targeted interventions to improve future functional outcomes and the quality of lives for both the infants and their families. However, initial stratification of risk to select those who are in danger of neurodevelopmental disorders is also important in terms of cost-effectiveness. Efficient and robust functional evaluations to recognize early signs of developmental disorders will help NICU graduates receive interventions and enhance functional capabilities if needed. Several age-dependent, domain-specific neurodevelopmental assessment tools are available; therefore, this review summarizes the characteristics of these tools and aims to develop multidimensional, standardized, and regular follow-up plans for NICU graduates in Korea.

Unique physical processes of canyon reservoirs regulate the timing and size of algal blooms - based on a study in Three Gorges Reservoir

The management and remediation of algal blooms on a global scale are primarily focused on controlling nutrient inputs, with an emphasis on limiting phosphorus inputs from point and non-point sources. It is well known, however, that physical factors such as water temperature, water column stability and advective flow also play critical roles in the timing and size of algal blooms. For nutrient control programs to be effective, it is essential to understand the relative importance of hydrological processes associated with nutrient dynamics and bioavailability. This study examines the relative importance of physical processes in hyper-eutrophic canyon reservoirs in regulating the development of algal blooms. We hypothesized that water column stability determines when algal blooms develop as well as the potential size of the bloom. To test the hypothesis, the study was implemented in Gaoyang Lake located in the middle of the Pengxi River, a 1st- order tributary in the Three Gorges Reservoir. The CE-QUAL-W2 model was applied to verify the lacustrine nature of Gaoyang Lake. We sampled the lake for 33 consecutive days from April 15th to May 17th in 2019. Algal composition and abundance, chlorophyll-a concentration, and different forms of P from the surface, middle and bottom of the water column, respectively, and available phosphorus in sediment were sampled and measured daily. Water temperature, dissolved oxygen, chlorophyll-a and water velocity were measured in situ daily. We demonstrate that:1. During the initial stratification period, a surface density layer (SDL) was formed as a result of a lack of turbulent wind mixing. The formation of the SDL initiated the development of algal blooms as a result of surface optimum temperatures being achieved early in the year. Although the SDL maintained the algal community within the euphotic zone, it also limited nutrient influx to the surface waters resulting in a decline of bioavailable phosphorus.2. Surface cooling events, however, weakened the SDL resulting in enhanced nutrient flux into the upper water column. The nutrient supply resulted in the formation of subsequent and more severe algal blooms when the SDL was re-established.Our results demonstrate that physical processes such as the formation and stability of the SDL can be used to predict the occurrence and size of algal blooms in canyon reservoirs. To control algal blooms, we suggest conducting further research to regulate the development and stability of SDL through interventions such as artificial mixing or flow modification during critical time periods. These approaches may provide rapid remediation options for managing harmful algal blooms.

Phagocyte-related S100 proteins and cytokines in acute lymphoblastic leukemia and their prognostic value

In this retrospective cohort study, we evaluated the level of biomarkers of inflammation like phagocyte-related S100 proteins and a panel of cytokines in 128 children with pre-B ALL and 22 with T-ALL. The biomarkers were evaluated at diagnosis and during antileukemic therapy (day 29 and after six months) and we evaluated their correlation with basic laboratory values. Further, for the children with pre-B ALL, we evaluated whether the biomarkers could predict the outcome of ALL expressed as minimal residual disease (MRD), relapse, and death. The levels of S100A9, S100A12, IL-1beta, IL-12p70, IL-13, IL-17, IL-18, and MPO serum levels increased significantly as chemotherapy was initiated. The difference was most pronounced for S100A9 and S100A12, which had strong positive correlations with the neutrophil counts. In contrast, TNF-alpha, IL-6, IL-10, CCL-2, MMP-3, and CD25 serum levels decreased after chemotherapy. Although none of these biomarkers appear to be an independent predictor of outcomes, in predictive models with MRD as the outcome, AUC increased from 76% (95% CI 68–84%) when using initial risk group stratification alone to 83% (95% CI 73–91%) in a multivariate predictive model including initial risk group stratification and the biomarkers S100A12, TNF-alpha, and IL-10.