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In liquid spray applications, the sprays are often created by the formation and destabilization of a liquid sheet or jet. The disadvantage of such atomization processes is that the breakup is often highly irregular, causing a broad distribution of droplet sizes. As these sizes are controlled by the ligament corrugation and size, a monodisperse spray should consist of ligaments that are both smooth and of equal size. A straightforward way of creating smooth and equally sized ligaments is by droplet impact on a mesh. In this work we show that this approach does however not produce monodisperse droplets, but instead the droplet size distribution is very broad, with a large number of small satellite drops. We demonstrate that the fragmentation is controlled by a jet instability, where initial perturbations caused by the injection process result in long-wavelength disturbances that determine the final ligament breakup. During destabilization the crests of these disturbances are connected by thin ligaments which are the leading cause of the large number of small droplets. A secondary coalescence process, due to small relative velocities between droplets, partly masks this effect by reducing the amount of small droplets. Of the many parameters in this system, we describe the effect of varying the mesh size, mesh rigidity, impact velocity and wetting properties, keeping the liquid properties the same by focusing on water droplets only. We further perform lattice Boltzmann modelling of the impact process that reproduces key features seen in the experimental data.

Soils can potentially be turned into net carbon sinks for atmospheric carbon to offset anthropogenic greenhouse gas emissions. Occlusion of soil organic carbon in soil aggregates is a key mechanism, which temporarily protects it from decomposition by soil organisms. Filamentous fungi are recognized for their positive role in the formation and stabilization of aggregates. In this review, we assess the current knowledge of the contribution of fungi to soil aggregation and set a new research agenda to quantify fungal-mediated aggregation across different climates and soils. Our review highlights three main knowledge gaps: (1) the lack of quantitative data and mechanistic understanding of aggregate turnover under field conditions, (2) lack of data on the biochemical and biological mechanisms by which filamentous fungi influence soil aggregation, and (3) uncharacterized contribution of soil fungi across environments. Adopting a trait-based approach to increase the level of mechanistic understanding between fungal diversity and soil structure seems promising, but will need additional experiments in which fungal diversity is manipulated by either removal through sieving or dilution, or addition through using synthetic communities of cultured fungi. We stress the importance of integrating ecological and physicochemical perspectives for accurate modelling of soil aggregation and soil organic carbon cycling, which is needed to successfully predict the effects of land management strategies.

We investigate which property of non-Newtonian fluids determines the deceleration of a high-speed impacting object. Using high-speed camera footage, we measure the velocity decrease of a high-speed spherical object impacting a typical Newtonian fluid (water) as a reference and compare it with a shear thickening fluid (cornstarch) and a shear thinning viscoelastic fluid (a weakly cross-linked polymer gel). Three models describing the kinetic energy loss of the object are considered: fluid inertia, shear thickening and viscoelasticity. By fitting the three models to the experimental data, we conclude that the viscoelastic model works best for both the cornstarch and the polymer gel. Since the cornstarch is also viscoelastic, we conclude that the ability to stop objects of these complex fluids is given by their viscoelasticity rather than shear thickening or shear thinning.

Objective: To critically review studies evaluating the effects of external rhythmical cueing on gait in patients with Parkinson's disease. Methods: Articles published from 1966 to January 2005 were searched by two physiotherapists in MEDLINE, PiCarta, PEDRo, Cochrane, DocOnline, CINAHL and SUMSEARCH. To be included, articles had to investigate the effects of external rhythmical cueing (i.e., auditory, visual or tactile cueing) on gait parameters in patients with idiopathic Parkinson's disease. Both controlled and noncontrolled studies were included. Based on the type of design and methodological quality a meta-analysis or best-evidence synthesis was applied. Results: Twenty-four studies (total number of patients = 626) out of the 159 screened studies were evaluated in this systematic review. Two out of 24 were randomized controlled trails (RCT), both of high methodological quality. One RCT did not focus specifically on external rhythmical cueing of individual patients with Parkinson's disease, but on group exercises in general, including walking with cues. All other studies were pre-experimental studies. Best-evidence synthesis showed strong evidence for improving walking speed with the help of auditory cues. Insufficient evidence was found for the effectiveness of visual and somatosensory cueing. Conclusion: Only one high-quality study, specifically focused on the effects of auditory rhythmical cueing, suggesting that the walking speed of patients with Parkinson's disease can be positively influenced. However, it is unclear whether positive effects identified in the laboratory can be generalized to improved activities of daily living (ADLs) and reduced frequency of falls in the community. In addition, the sustainability of a cueing training programme remains uncertain.

Background Autoantibodies to glial, myelin and neuronal antigens have been reported in a range of central demyelination syndromes and autoimmune encephalopathies in children, but there has not been a systematic evaluation across the range of central nervous system (CNS) autoantibodies in childhood-acquired demyelinating syndromes (ADS). Methods Children under the age of 16 years with first-episode ADS were identified from a national prospective surveillance study; serum from 65 patients had been sent for a variety of diagnostic tests. Antibodies to astrocyte, myelin and neuronal antigens were tested or retested in all samples. Results Fifteen patients (23%) were positive for at least one antibody (Ab): AQ4-Ab was detected in three; two presenting with neuromyelitis optica (NMO) and one with isolated optic neuritis (ON). Myelin oligodendrocyte glycoprotein (MOG)-Ab was detected in seven; two with acute disseminated encephalomyelitis (ADEM), two with ON, one with transverse myelitis (TM) and two with clinically isolated syndrome (CIS). N-Methyl-D-Aspartate receptor (NMDAR)-Ab was found in two; one presenting with ADEM and one with ON. Voltage-gated potassium channel (VGKC)-complex antibodies were positive in three; one presenting with ADEM, one with ON and one with CIS. GlyR-Ab was detected in one patient with TM. All patients were negative for the VGKC-complex-associated proteins LGI1, CASPR2 and contactin-2. Conclusions A range of CNS-directed autoantibodies were found in association with childhood ADS. Although these antibodies are clinically relevant when associated with the specific neurological syndromes that have been described, further studies are required to evaluate their roles and clinical relevance in demyelinating diseases.

Two individuals with pyruvate dehydrogenase (PDH) deficiency due to missense mutations in the gene for the E1α subunit (PDHA1) presented during childhood with dystonia. The first patient, a male, presented at age 4 years with dystonia affecting the lower limbs, which responded to treatment with combined carbidopa and levodopa. The second patient, a female, was first investigated at age 6 years because of a dystonic gait disorder. In both patients, the main clue to the biochemical diagnosis was a raised concentration of lactate in the cerebrospinal fluid. PDH activity was significantly reduced in cultured fibroblasts in both cases. Dystonia is a previously unrecognized major manifestation of PDH deficiency and is of particular interest as the mutations in the PDHA1 gene in these patients have both been identified previously in individuals with typical presentations of the condition.

We present a case of acute disseminated encephalomyelitis after mastoid surgery in an 11-year-old child. The aim of this paper is to increase awareness about a previously unreported and an unusual neurological complication of cholesteatoma and mastoid surgery.

ObjectiveWith the emergence of experimental therapies for Duchenne muscular dystrophy (DMD), it is fundamental to understand the natural history of this disorder to properly design clinical trials. The aims of this study were to assess the effects produced on motor function by different DMD genotypes and early initiation of glucocorticoids.MethodsThrough the NorthStar Network, standardised clinical data including the NorthStar Ambulatory Assessment score (NSAA) on 513 ambulant UK boys with DMD were analysed from 2004 to 2012. For the analysis of the genetic subpopulation, we also included data from 172 Italian boys with DMD. NSAA raw scores were converted into linear scores.ResultsOn the linearised NSAA, we observed an average decline of 8 units/year (4 units on raw NSAA analysis) after age 7. The median age at loss of ambulation (LOA) was 13 years (95% CI 12.1 to 13.5); 2 years prior to LOA, the estimated mean linearised NSAA score was 42/100 (13/34 raw scale). Starting glucocorticoids between 3 and 5 years conferred an additional gain in motor function of 3 units/year (1.3 raw units) up to age 7. When analysing the effect of genotype in the UK and Italian cumulative cohorts, individuals with deletions amenable to exons 44 and 46 skipping declined at a slower rate over 2 years (9 units (4 raw units), p<0.001), while 53 and 51 skippable deletions showed a faster decline of 14 (4.5; p<0.001) and 5 linearised units (2.4 NSAA units; p=0.02), respectively.ConclusionsOur study provides a novel insight on the current natural history of DMD, which will be instrumental for the design of future clinical trials.

Aim The number of known neuromuscular conditions has increased significantly with recent advances detailing molecular characteristics and this can present a diagnostic challenge. In addition to the clinical presentation and investigations such as muscle biopsy and neurophysiology the magnetic resonance imaging (MRI) pattern of muscle involvement can provide useful information towards achieving a diagnosis. Our aim was to evaluate the use of skeletal muscle MRI as a diagnostic tool in a relatively small neuromuscular service. Methods Children with a suspected neuromuscular disorder but without a specific diagnosis had muscle MRI performed. All children had T1-weighted imaging at two levels (the thigh and lower limb). Some cases also had T2-weighted or short tau inversion recovery (STIR) imaging. The scans were jointly reviewed by a paediatric neurologist and a radiologist with an interest in musculoskeletal imaging. Results Since 2007 13 children have had skeletal muscle MRI in this centre. In 3 patients the pattern of MRI involvement contributed directly to the diagnosis and in 2 cases it helped direct the muscle biopsy. In a further 3 patients a normal MRI helped in a decision to avoid, or at least defer, a muscle biopsy. Details of their clinical presentations and MRI findings are presented. Conclusion Muscle MRI is a useful tool in the diagnostic process of children with suspected neuromuscular disorders. We believe that our experience demonstrates its benefits in a relatively small service.

When a droplet hits a surface fast enough, droplet splashing can occur: smaller secondary droplets detach from the main droplet during impact. While droplet splashing on smooth surfaces is by now well understood, the surface roughness also affects at which impact velocity a droplet splashes. In this study, the influence of the surface roughness on droplet splashing is investigated. By changing the root mean square roughness of the impacted surface, we show that the droplet splashing velocity is only affected when the droplet roughness is large enough to disrupt the spreading droplet lamella and change the droplet splashing mechanism from corona to prompt splashing. Finally, using Weber and Ohnesorge number scaling models, we also show that the measured splashing velocity for both water and ethanol on surfaces with different roughness and water-ethanol mixtures collapse onto a single curve, showing that the droplet splashing velocity on rough surfaces scales with the Ohnesorge number defined with the surface roughness length scale.