Reverse Cascade Research Articles

Hypercholesterolemia in children and adolescents: focus on the familial variant

Familial hypercholesterolemia is characterized by a significant increase in serum low-density lipoprotein cholesterol concentration, which even in the absence of other risk factors leads to the development of atherosclerotic vascular lesions beginning in childhood. With significant prevalence in the population, familial hypercholesterolemia is rarely diagnosed in time due to the Long absence of clinical manifestations. Today the urgent task is to develop and implement programs of primary detection of familial hypercholesterolemia in children and adolescents. Early detection of patients with familial hypercholesterolemia and timely initiation of adequate lipid-lowering therapy will curb the rate of atherosclerosis progression, which will significantly reduce disability and mortality from cardiovascular diseases in older age groups. There are four types of screening: cascade, targeted, opportunistic and universal. Cascade screening is currently considered the most effective and cost-effective way to identify new patients with familial hypercholesterolemia among relatives of an index patient, the patient with the established diagnosis. Targeted screening is based on searching for individuals with familial hypercholesterolemia among groups of patients with the early development of atherosclerotic vascular lesions, for example, in cardiology or neurology hospitals. Opportunistic screening is a non-systematic, sporadic determination of cholesterol levels in patients seeking medical care for any reason. It is most applicable in primary care health care settings. Universal screening is a mass screening of certain age groups and is a highly effective way of early diagnosis, especially in combination with reverse cascade screening of parents, siblings, and other relatives of the index patient. Implementation of programs of early childhood detection of familial hypercholesterolemia, setting up systems of adequate routing of patients, timely prescription of effective lipid-lowering therapy will contribute to health preservation and prolongation of working age, development, and preservation of labor potential of the country.

Double-Frequency-Shift Acousto-Optic Modulator with Controllable Pulse Pair Frequency Difference

A scheme for controlling the frequency difference of output pulse pair with double frequency shift loops is proposed. The frequency shift system includes two loop elements of 20 and 200 MHz. The first one carries out a single selective positive frequency shift of 1–20 MHz, and the second one can satisfy a single fixed positive frequency shift of 200 MHz. The reverse cascade technology of two acousto-optic crystals is introduced to solve the limitation of the small frequency shift of crystal size. A multichannel synchronization signal completes the time domain control of each acousto-optic modulator. Finally, the frequency shift difference of the output pulse pair ranges of 0–2 GHz, and the frequency shift accuracy is 5 MHz.

Study of the Aerodynamic Characteristics on the ‎Computed Flowfield During Thrust Reversers Operation

With the increasing of the bypass ratio of modern aero-engines, the problem of wing-engine interference is more prominent, especially for the layout design of engine nacelle. The reverse thrust cascade is widely used in turbofan engines with high bypass ratio. In order to meet the requirements of the integrated analysis of airframe, wing, engine nacelle and hanger, the aerodynamic characteristics of aircraft/engine integration configuration with reverse cascade is numerically studied via CFD (Computational Fluid Dynamics) method. The streamline distribution, iso-surface of total temperature, vorticity distribution and total reverse thrust efficiency on different engine nacelle layouts are compared and analyzed in details. The results show that the lift coefficient of the wing decreases by 21.2% and 45.02% respectively as the engine moves forwards horizontally by 11%L and 21.2%L. The lift coefficient of the wing decreases by 2.4% and 4.82% respectively as the engine moves subsidence by -3.5%L and 3.5%L. The influential region of the reverser airflow in the radial and circumferential direction without airframe interference is significantly larger than that in the case with aircraft/engine integration. The reverser flow is susceptible to be interfered by the adjacent fuselage and wing sections, and the development of reverse thrust flow is significantly limited. Compared to the baseline nacelle location, the reverse thrust performs badly as engine nacelle moves backward and lateral horizontally. The total reverse thrust efficiency decreases gradually as the engine nacelle moves forward horizontally.

Prevention of Atherosclerotic Cardiovascular Disease in Children with Familial Hypercholesterolemia.

Familial hypercholesterolemia (FH), a common inherited disorder of LDL-C metabolism that predisposes to premature cardiovascular disease, is underdiagnosed. Despite recommendations for screening all children and initiation of lipid-lowering medication beginning at 8-10years of age, adherence to guidelines is low. Most individuals with FH are inadequately treated, especially women and children. The purpose of this review is to discuss current literature and recommendations for the diagnosis and treatment of heterozygous FH (HeFH) in the pediatric population. Twenty-year outcome data demonstrate lower rates of atherosclerotic cardiovascular disease (ASCVD) related events and death in individuals with FH who were treated with statins from childhood, compared to those who initiated statins in adulthood. While diagnosis rates of FH are slowly improving, most clinicians do not adhere to recommendations for cholesterol screening in youth. Identifying youth with FH offers the opportunity for early intervention to prevent ASCVD and identify affected relatives through reverse cascade screening.

Pilot study of universal screening of children and child-parent cascade testing for familial hypercholesterolaemia in Australia.

Familial hypercholesterolaemia (FH) is a common and treatable cause of premature coronary artery disease. However, the majority of individuals with FH remain undiagnosed. This study investigated the feasibility, acceptability and cost-effectiveness of screening children aged 1-2 years for FH at the time of an immunisation. Children 1-2 years of age were offered screening for FH with a point-of-care total cholesterol (TC) test by capillary-collected blood sample at the time of an immunisation. An additional blood sample was taken to allow genetic testing if the TC level was above the 95th percentile (>5.3 mmol/L). Parents of children diagnosed with FH were offered testing. Following detection of the affected parent, cascade testing of their first-degree blood relatives was performed. We screened 448 children with 32 (7.1%) having a TC≥ 5.3 mmol/L. The FH diagnosis was confirmed in three children (1:150 screened). Reverse cascade testing of other family members identified a further five individuals with FH; hence, eight new cases of FH were diagnosed from screening 448 children (1:56 screened). Ninety-six percent of parents would screen future children for FH. The approach was cost-effective, at $3979 per quality-adjusted life year gained. In Western Australia, universal screening of children aged 1-2 years for FH, undertaken at the time of an immunisation, was a feasible and effective approach to detect children, parents and other blood relatives with FH. The approach was acceptable to parents and is potentially a highly cost-effective detection strategy for families at risk of FH.

Barotropic and Baroclinic Inverse Kinetic Energy Cascade in the Antarctic Circumpolar Current

AbstractStratified geostrophic turbulence theory predicts an inverse energy cascade for the barotropic (BT) mode. Satellite altimetry has revealed a net inverse cascade in the baroclinic (BC) mode. Here the spatial variabilities of BT and BC kinetic energy fluxes in the Antarctic Circumpolar Current (ACC) were investigated using ECCO2 data, which synthesize satellite data and in situ measurements with an eddy-permitting general circulation model containing realistic bathymetry and wind forcing. The BT and BC inverse kinetic energy cascades both reveal complex spatial variations that could not be explained fully by classical arguments. For example, the BC injection scales match better with most unstable scales than with the first-mode deformation scales, but the opposite is true for the BT mode. In addition, the BT and BC arrest scales do not follow the Rhines scale well in terms of spatial variation, but show better consistency with their own energy-containing scales. The reverse cascade of the BT and BC modes was found related to their EKE, and better correlation was found between the BT inverse cascade and barotropization. Speculations of the findings were proposed; however, further observations and modeling experiments are needed to test these interpretations. Spectral flux anisotropy exhibits a feature associated with oceanic jets that is consistent with classical expectations. Specifically, the spectral flux along the along-stream direction remains negative at scales up to that of the studied domain (~2000 km), while that in the perpendicular direction becomes positive close to the scale of the width of a typical jet.

Spatially evolving cascades in temporal planar jets

Abstract

The Istanbul Convention’s Evidentiary Requirements in the light of Laws on Self-Defence and Mitigating Criminal Responsibility

The article argues that the Council of Europe Convention on Preventing and Combating Violence against Women and Domestic Violence (Istanbul Convention), a comprehensive international treaty, may necessitate deep changes in its Parties’ domestic legal regimes, including reconceptualising laws on circumstances excluding or mitigating criminal responsibility and related evidentiary issues in domestic cases. The article first presents the theoretical underpinnings of a understanding of and criminal laws. It then proceeds to present different approaches to law reform that have contemplated laws on circumstances that exclude criminal responsibility, mostly in the context of homicides committed by battered women. Traditional approaches to law reform demonstrate how a reconsideration of a single legal concept requires reconsideration of all legal principles governing the structure of that concept and causes a cascade effect. This, in turn, requires specific evidentiary considerations, including the context in which a crime is perpetrated, namely the dynamics of abusive partner relationships, social framework evidence, and the ‘demystification’ of against women. The article suggests that the Istanbul Convention’s emphasis on investigation and evidence and the promotion of a gendered understanding of violence may potentially open the question of criminal responsibility of female offenders by elevating rules of evidence to criminal law provisions (in a reverse cascade effect).

The role of the “monopole” instability in the evolution of two-dimensional turbulent free shear layers

The role of instability in the growth of a two-dimensional, temporally evolving, “turbulent” free shear layer is analyzed using vortex-gas simulations that condense all dynamics into the kinematics of the Biot–Savart relation. The initial evolution of perturbations in a constant vorticity layer is found to be in accurate agreement with the linear stability theory of Rayleigh. There is then a stage of non-universal evolution of coherent structures that is closely approximated not by Rayleigh stability theory, but by the Karman–Rubach–Lamb linear instability of monopoles, until the neighboring coherent structures merge. After several mergers, the layer evolves eventually to a self-preserving reverse cascade, characterized by a universal spread rate found by Suryanarayanan, Narasimha, and Hari Dass [“Free turbulent shear layer in a point vortex gas as a problem in nonequilibrium statistical mechanics,” Phys. Rev. E 89, 013009 (2014)] and a universal value of the ratio of dominant spacing of structures (Λf) to the layer thickness (δω). In this universal, self-preserving state, the local amplification of perturbation amplitudes is accurately predicted by Rayleigh theory for the locally existing “base” flow. The model of Morris, Giridharan, and Lilley [“On the turbulent mixing of compressible free shear layers,” Proc. R. Soc. London, Ser. A 431, 219–243 (1990)], which computes the growth of the layer by balancing the energy lost by the mean flow with the energy gain of the perturbation modes (computed from an application of Rayleigh theory), is shown, however, to provide a non-universal asymptotic state with initial condition dependent spread rate and spectra. The reason is that the predictions of the Rayleigh instability, for a flow regime with coherent structures, are valid only at the special value of Λf/δω achieved in the universal self-preserving state.

Numerical Simulation of Ocean Circulation with Ultrahigh Spatial Resolution

This paper provides an overview of publications related to the study of submesoscale ocean variability. The significant progress achieved recently in understanding the special role of submesoscale processes in the formation of ocean circulation and ocean–atmosphere interaction, including modulation of the heat and gas exchange of the two media and their impact on the flux of biogenic elements into the top layer of the ocean, is emphasized. The necessity of conducting a study of submesoscale ocean variability in order to improve the quality of short-term marine forecasts is noted. Marine forecasts of the new level will be based on models with ultrahigh spatial resolution. The models will allow one to describe the reverse cascade of energy in the submesoscale range. In connection with the fact that new instruments capable of conducting 2–10 km surface observations of seas and oceans will be launched in the next five years, the possibilities of using the Black Sea as a testing area for the development of numerical models of circulation in a basin with a resolution of no less than a kilometer and improving methods of analysis and assimilation of observational technologies of the next generation are discussed.

1-m-Nitrobenzoyl semicarbazide: reversible colorimetric cascade indicators for fluoride and moisture

A very simple and effective strategy for an instant, in-field reversible colorimetric cascade indicator of fluoride and moisture at very low concentrations has been developed.

An improved KFDD based reversible circuit synthesis method

Since reversible logic has promising applications in domains like low-power design and quantum computing, it is necessary to efficiently design high-performance reversible logic circuits. In this paper, in order to reduce the number of qubits while achieving low quantum cost, the Kronecker functional decision diagram (KFDD) based reversible circuit synthesis method is improved by using two strategies. One is to generate a locally optimal reversible cascade for each of the KFDD nodes by performing transformations on the function represented by a node and using a gate library consisting of NOT, CNOT, Toffoli gates and mixed-polarity Peres gates. This strategy helps reduce the quantum cost and the number of qubits. The other is to map KFDD nodes to their locally optimal reversible cascades level by level via breadth-first traversal of the KFDD. This strategy reduces the number of qubits by using the circuit line labeled by an input variable of the KFDD as the target line of a reversible gate. Comparison results are presented in tabular and graphical forms. Compared to the existing decision diagram based reversible circuit synthesis methods, the proposed method can reduce both the quantum cost and the number of qubits in many cases. Compared to other state-of-the-art synthesis methods for reversible circuits, the proposed method can achieve much lower quantum cost but still incurs a high number of qubits for many functions. However, it can achieve the minimum number of qubits for a few irreversible functions while achieving much lower quantum cost. In addition, the proposed method is very time efficient.

Dynamical Effects of Neuron Activation Gradient on Hopfield Neural Network: Numerical Analyses and Hardware Experiments

Hyperbolic tangent function, a bounded monotone differentiable function, is usually taken as a neuron activation function, whose activation gradient, i.e. gain scaling parameter, can reflect the response speed in the neuronal electrical activities. However, the previously published literatures have not yet paid attention to the dynamical effects of the neuron activation gradient on Hopfield neural network (HNN). Taking the neuron activation gradient as an adjustable control parameter, dynamical behaviors with the variation of the control parameter are investigated through stability analyses of the equilibrium states, numerical analyses of the mathematical model, and experimental measurements on a hardware level. The results demonstrate that complex dynamical behaviors associated with the neuron activation gradient emerge in the HNN model, including coexisting limit cycle oscillations, coexisting chaotic spiral attractors, chaotic double scrolls, forward and reverse period-doubling cascades, and crisis scenarios, which are effectively confirmed by neuron activation gradient-dependent local attraction basins and parameter-space plots as well. Additionally, the experimentally measured results have nice consistency to numerical simulations.

Blended Wing Body Thrust Reverser Cascade Feasibility Evaluation Through CFD

Airplane thrust reverser could significantly reduce the landing distance of a conventional civil turbofan. Control of the thrust reverser can be performed by a hydraulic and/or electric system. This study investigates whether this system can be used for blended wing body (BWB) civil airplanes as their engines are located over the wing body. Computational fluid dynamics (CFD) is used to analyze the feasibility of a thrust reverser cascade applied to BWB airplanes. This is selected because of its rapidity and low cost when compared to traditional wind tunnel tests. Analyses are performed on a 300-seating BWB (BWB300) landing configuration. The results show that the thrust reverser cascade can be applied to BWB300. Furthermore, the results also reveal that the probability of foreign object damage problems occurring during the BWB300 landing process when the thrust reverser cascade is working is low. Increasing the reverse mass flow component along the landing reverse direction can increase the thrust reverser efficiency. However, this would also increase the thrust reverser closing velocity. Therefore, when the thrust reverser design is performanced for BWB, a tradeoff between the efficiency and closing velocity should be considered.

What Is Known About Preventing, Detecting, and Reversing Prescribing Cascades: A Scoping Review.

To systematically describe the resources available on preventing, detecting, and reversing prescribing cascades using a scoping review methodology. We searched Medline, EMBASE, PsychINFO, CINAHL, Cochrane Library, and Sociological Abstracts from inception until July 2017. Other searches (Google Scholar, hand searches) and expert consultations were performed for resources examining how to prevent, detect, or reverse prescribing cascades. We used these three categories along the prescribing continuum as an organizing framework to categorize and synthesize resources. Of 369 resources identified, 58 met inclusion criteria; 29 of these were categorized as preventing, 20 as detecting, and 9 as reversing prescribing cascades. Resources originated from 14 countries and mostly focused on older adults. The goal of preventing resources was to educate and increase general awareness of the concept of prescribing cascades as a way to prevent inappropriate prescribing and to illustrate application of the concept to specific drugs (e.g., anticholinergics) and conditions (e.g., inflammatory bowel disease). Detecting resources included original investigations or case reports that identified prescribing cascades using health administrative data, patient cohorts, and novel sources such as social media. Reversing prescribing cascade resources focused on the medication review process and deprescribing initiatives. Prescribing cascades are a recognized problem internationally. By learning from the range of resources to prevent, detect, and reverse prescribing cascades, this review contributes to improving drug prescribing, especially in older adults. J Am Geriatr Soc 66:2079-2085, 2018.

Sequential decision-making with group identity

In sequential decision-making experiments, participants often conform to the decisions of others rather than reveal private information – resulting in less information produced and potentially lower payoffs for the group. This paper asks whether experimentally induced group identity affects players’ decisions to conform, even when payoffs are only a function of individual actions. As motivation for the experiment, we show that U.S. Supreme Court Justices in preliminary hearings are more likely to conform to their same-party predecessors when the share of predecessors from their party is high. Lab players, in turn, are more likely to conform to the decisions of in-group members when their share of in-group predecessors is high. We find that exposure to information from in-group members increases the probability of reverse information cascades (herding on the wrong choice), reducing average payoffs. Therefore, alternating decision-making across members of different groups may improve welfare in sequential decision-making contexts.

Challenges to fisheries advice and management due to stock recovery

AbstractDuring the 20th century, many large-bodied fish stocks suffered from unsustainable fishing pressure. Now, signs of recovery are appearing among previously overfished large-bodied fish stocks. This new situation raises the question of whether current fisheries advice and management procedures, which were devised and optimized for depleted stocks, are well-suited for the management of recovered stocks. We highlight two challenges for fisheries advice and management: First, recovered stocks are more likely to show density-dependent growth. We show how the appearance of density-dependent growth will make reference points calculated with current procedures inaccurate. Optimal exploitation of recovered large-bodied fish stocks will therefore require accounting for density-dependent growth. Second, we show how a biomass increase of large-bodied piscivorous fish will lead to a reverse trophic cascade, where their increased predation mortality on forage fish reduces forage fish productivity and abundance. The resulting decrease in maximum sustainable yield of forage fish stocks could lead to conflicts between forage and large-piscivore fisheries. Avoiding such conflicts requires that choices are made between the exploitation of interacting fish stocks. Failure to account for the changed ecological state of recovered stocks risks creating new obstacles to sustainable fisheries management.

Asymptotically exact codimension-four dynamics and bifurcations in two-dimensional thermosolutal convection at high thermal Rayleigh number: Chaos from a quasi-periodic homoclinic explosion and quasi-periodic intermittency

Using a perturbation method, we solve asymptotically the nonlinear partial differential equations that govern double-diffusive convection (with heat and solute diffusing) in a two-dimensional rectangular domain near a critical point in parameter space where the linearized operator has a quadruple-zero eigenvalue. The asymptotic solution near this codimension-four point is found to depend on two slow-time-dependent amplitudes governed by two nonlinearly-coupled Van der Pol–Duffing equations. Through numerical approximation of the 3-dimensional Poincaré map in the four-dimensional state space of the amplitude equations, we detect and analyze the bifurcations of the amplitude equations as the thermal Rayleigh number, RT, is increased (for RS≪RT, the solute Rayleigh number) with all other parameters fixed. The bifurcations observed include: Hopf, pitchfork and Neimark–Sacker bifurcations of limit cycles, symmetric and asymmetric saddle–node bifurcations of 2-tori, and reverse torus-doubling cascades. In addition, chaotic solutions are found numerically to emerge via two different types of routes: (1) a route involving a homoclinic explosion in the Poincaré map and; (2) type-I intermittency routes near saddle–node bifurcations of 2-tori. The homoclinic explosion occurs when two unstable 2-tori form homoclinic connections with a saddle limit cycle, thereby creating a homoclinic butterfly in the Poincaré map that leads to a discrete Lorenz-like attractor.

Universal screening at age 1–2 years as an adjunct to cascade testing for familial hypercholesterolaemia in the UK: A cost-utility analysis

Background and aimsFamilial hypercholesterolaemia (FH) is widely underdiagnosed. Cascade testing (CT) of relatives has been shown to be feasible, acceptable and cost-effective in the UK, but requires a supply of index cases. Feasibility of universal screening (US) at age 1–2 years was recently demonstrated. We examined whether this would be a cost-effective adjunct to CT in the UK, given the current and plausible future undiagnosed FH prevalence. MethodsSeven cholesterol and/or mutation-based US ± reverse cascade testing (RCT) alternatives were compared with no US in an incremental analysis with a healthcare perspective. A decision model was used to estimate costs and outcomes for cohorts exposed to the US component of each strategy. RCT case ascertainment was modelled using recent UK CT data, and probabilistic Markov models estimated lifetime costs and health outcomes for the cohorts screened under each alternative. 1000 Monte Carlo simulations were run for each model, and average outcomes reported. Further uncertainty was explored deterministically. Threshold analysis investigated the association between undiagnosed FH prevalence and cost-effectiveness. ResultsA strategy involving cholesterol screening followed by diagnostic genetic testing and RCT was the most cost-effective modelled (incremental cost-effectiveness ratio (ICER) versus no US £12,480/quality adjusted life year (QALY); probability of cost-effectiveness 96·8% at £20,000/QALY threshold). Cost-effectiveness was robust to both deterministic sensitivity analyses and threshold analyses that modelled ongoing case ascertainment at theoretical maximum levels. ConclusionsThese findings support implementation of universal cholesterol screening followed by diagnostic genetic testing and RCT for FH, under a UK conventional willingness-to-pay threshold.

Analytical and semi‐analytical kinetics models for design and optimization of double‐resistance resin in pulp and carbon in pulp processes with both reversible and irreversible nature

AbstractThe current study was aimed at developing a package of “model + algorithm” for the design of resin in pulp (RIP) and carbon in pulp (CIP) processes of gold, uranium, and base metals. For this purpose, we first formulated a double‐resistance model for irreversible adsorption (accompanied by chemical reaction) in CSTRs, and modified the McKay et al. semi‐analytical model for reversible uptake in a similar system. We then devised two algorithms for the design and optimization of reversible and irreversible RIP and CIP cascades. The developed algorithms were applied on the extraction of copper, uranium, and gold. The packages are able to specify the optimum number of stages, reactor volume (V), resin flow rate (m.), and resin hold up (φs). This shows an evident advantage over the McCabe‐Thiele method, whose only result is the number of stages. The new methods have only two adjustable parameters of diffusivity (Deff) and liquid film coefficient (k), whose determination can be carried out through simple batch experiments. As an additional work, this study also presents a method for mathematical troubleshooting for the Mc Kay et al. model.