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The individual effects of strain rate and temperature on the strain hardening rate of a quenched and partitioned steel have been examined. During quasistatic tests, resistive heating was used to simulate the deformation-induced heating that occurs during high-strain-rate deformation, while the deformation-induced martensitic transformation was tracked by a combination of x-ray and electron backscatter diffraction. Unique work hardening rates under various thermal–mechanical conditions are discussed, based on the balance between the concurrent dislocation slip and transformation-induced plasticity deformation mechanisms. The diffraction and strain hardening data suggest that the imposed strain rate and temperature exhibited dissonant influences on the martensitic phase transformation. Increasing the strain rate appeared to enhance the martensitic transformation, while increasing the temperature suppressed the martensitic transformation.

Patients with diabetes mellitus admitted to hospital with COVID-19 caused by infection with the novel coronavirus (SARS-CoV-2) have poorer outcomes. However, the drivers for this are not fully elucidated. We performed a retrospective cohort study, including detailed pre-hospital and presenting clinical and biochemical factors of 889 patients diagnosed with COVID-19 in three constituent hospitals of a large London NHS Trust. 62% of patients with severe COVID-19 were of non-White ethnic backgrounds and the prevalence of diabetes was 38%. 323 (36%) patients met the primary outcome of death or admission to the intensive care unit (ICU) within 30 days of diagnosis. Male gender, advancing age and the Clinical Frailty Scale, an established measure of multimorbidity, independently predicted poor outcomes on multivariate analysis. Diabetes did not confer an independent risk for adverse outcomes in COVID-19, although patients with diabetes and ischaemic heart disease were at particular risk. Additional risk factors which significantly and independently associated with poorer outcomes in patients with diabetes were age, male gender and lower platelet count. Antiplatelet medication was associated with a lower risk of death/ICU admission and should be evaluated in randomised clinical trials amongst high risk patient groups.

Around the beginning of the Late Middle Ages, the countryside of North-Brabant (NL) experienced a series of major developments, one of which was a widespread relocation of rural settlements, abandoning the traditional settlement areas on the topographic area known as the coversand ridges. A new survey of high medieval and late medieval rural settlement sites found that this relocation happened over the course of a longer period than previously assumed. Rather than being an abrupt desertion in the first half of the 13th century, the process of abandonment started in the late 12th century and continued until the middle of the 14th century. Moreover, the relocation was not an abrupt break, but part of a gradual movement in tandem with the expansion of arable land, which reached the boundaries of the most suitable soils. Given the long-term development, the relocation cannot be attributed directly to the incorporation of the territories in the Duchy of Brabant or the emergence of cities. The hypothesis that it reflects a shift in agriculture towards sheep husbandry can be disproven. The final departure from the coversand ridges is most likely tied to the complex combination of changing property relations, the emergence of an early market economy, and agricultural or artisanal specialisation that led to village formation. The incorporation into the Brabantic political network, economy, and administration will most certainly have furthered this development. To understand the development, archaeological data need to be collected in historical villages and hamlets. In addition, a better understanding is required of the nature of the observed diversity of rural settlement, both in archaeological sites and historical villages.

ObjectiveTo evaluate several early outcome measures following diagnosis of psychogenic nonsyncopal collapse (PNSC).MethodsOver a 34-month period, a prospective cohort study was conducted of patients referred for tilt-table evaluation of fainting and orthostatic intolerance. Clinical histories were obtained and anxiety and depressive symptom questionnaires were completed prior to testing. Among 539 patients referred, 100 (18.6%) were diagnosed with PNSC. Outcome data were collected by telephone or during routine follow-up a median of 572 days postdiagnosis.ResultsEighty-four patients (84%) provided outcome data. Following communication of the diagnosis, 32 patients (38%) had immediate PNSC resolution. Attack resolution occurred in 44% by 1 month, 51% by 6 months, 52% by 12 months, 69% after 12 months, and 31% continued to have PNSC at the time of follow-up. Patients with continued PNSC had higher anxiety scores than patients with immediate resolution (p = 0.047). Following diagnosis, emergency department visits for fainting decreased from 78.6% to 20.2% (p = 0.017), and management by psychology or psychiatry increased from 26.2% to 76.2% (p < 0.001). During the follow-up period, 8 patients (9.5%) were hospitalized for suicidal ideation, a median of 253 (range 33–470) days postdiagnosis; 12 patients (14.3%) developed new (non-PNSC) conversion disorders, a median of 86 (range 9–504) days postdiagnosis. Suicidal ideation was associated with higher anxiety (p = 0.007) but not higher depression scores.ConclusionsThe diagnostic rate of PNSC parallels that of PNES among patients referred for tertiary care evaluations. The improvements in attack frequency following PNSC diagnosis must be tempered by the potential risks of self-harm and the development of new conversion disorders.

Multiple gene expression alterations have been linked to Alzheimer’s disease (AD), implicating multiple metabolic pathways in its pathogenesis. However, a clear distinction between AD-specific gene expression changes and those resulting from non-specific responses to toxic aggregating proteins has not been made. We investigated alterations in gene expression induced by human β-amyloid peptide (Aβ) in a Caenorhabditis elegans Alzheimer’s disease model. Aβ-induced gene expression alterations were compared to those caused by a synthetic aggregating protein to identify Aβ-specific effects. Both Aβ-specific and non-specific alterations were observed. Among Aβ-specific genes were those involved in aging, proteasome function, and mitochondrial function. An intriguing observation was the significant overlap between gene expression changes induced by Aβ and those induced by Cry5B, a bacterial pore-forming toxin. This led us to hypothesize that Aβ exerts its toxic effect, at least in part, by causing damage to biological membranes. We provide in vivo evidence consistent with this hypothesis. This study distinguishes between Aβ-specific and non-specific mechanisms and provides potential targets for therapeutics discovery.

In 2010 Highway Capacity Manual, one preferably determines free-flow speed by deriving it from a speed study involving the existing facility or on a comparable facility if the facility is in the planning stage. Many have used a ‘rule of thumb’ by adding 10 km/h (5 mi/h) above the posted limit to obtain free-flow speed without justification. Two team members using a radar gun and manual tally sheets collected 1668 speed observations at ten sites during several weeks. Each site had a unique posted speed limit sign ranging from 30 km/h (20 mi/h) to 120 km/h (75 mi/h). Five sites were on urban streets. Three sites were on multilane highways, and two on freeways. Goodness-of-fit test results revealed that a Gaussian distribution generally fit the speed distributions at each site at a 5% level of significance. The best-fit model had a correlation coefficient of +0.99. The posted speed limit variable was significant at 5% level of significance. Examining data by highway type revealed that average free-flow speeds are strongly associated with posted speed limits with correlation coefficients of +0.99, +1.00, and +1.00 for urban streets, multilane highways, and freeways, respectively.