Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

Bose-Einstein condensation (BEC) has been observed in a dilute gas of sodium atoms. A Bose-Einstein condensate consists of a macroscopic population of the ground state of the system, and is a coherent state of matter. In an ideal gas, this phase transition is purely quantum-statistical. The study of BEC in weakly interacting systems which can be controlled and observed with precision holds the promise of revealing new macroscopic quantum phenomena that can be understood from first principles.

Bose-Einstein condensation in a gas of sodium atoms

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Introduction to the Modern Theory of Dynamical Systems

Chaos, fractional kinetics, and anomalous transport

Definition and properties of Lagrangian coherent structures from finite-time Lyapunov exponents in two-dimensional aperiodic flows

We examine the transport properties of a particular two-dimensional, inviscid incompressible flow using dynamical systems techniques. The velocity field is time periodic and consists of the field induced by a vortex pair plus an oscillating strainrate field. In the absence of the strain-rate field the vortex pair moves with a constant velocity and carries with it a constant body of fluid. When the strain-rate field is added the picture changes dramatically; fluid is entrained and detrained from the neighbourhood of the vortices and chaotic particle motion occurs. We investigate the mechanism for this phenomenon and study the transport and mixing of fluid in this flow. Our work consists of both numerical and analytical studies. The analytical studies include the interpretation of the invariant manifolds as the underlying structure which govern the transport. For small values of strain-rate amplitude we use Melnikov's technique to investigate the behaviour of the manifolds as the parameters of the problem change and to prove the existence of a horseshoe map and thus the existence of chaotic particle paths in the flow. Using the Melnikov technique once more we develop an analytical estimate of the flux rate into and out of the vortex neighbourhood. We then develop a technique for determining the residence time distribution for fluid particles near the vortices that is valid for arbitrary strainrate amplitudes. The technique involves an understanding of the geometry of the tangling of the stable and unstable manifolds and results in a dramatic reduction in computational effort required for the determination of the residence time distributions. Additionally, we investigate the total stretch of material elements while they are in the vicinity of the vortex pair, using this quantity as a measure of the effect of the horseshoes on trajectories passing through this region. The numerical work verifies the analytical predictions regarding the structure of the invariant manifolds, the mechanism for entrainment and detrainment and the flux rate.

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An analytical study of transport, mixing and chaos in an unsteady vortical flow

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Transport in two-dimensional maps

Here we develop the topological approximation method which gives a new description of the mixing and transport processes in chaotic two-dimensional time-periodic Hamiltonian flows. It is based upon the structure of the homoclinic tangle, and supplies a detailed solution to a transport problem for this class of systems, the characteristics of which are typical to chaotic, yet not ergodic dynamical systems. These characteristics suggest some new criteria for quantifying transport and mixing-hence chaos-in such systems. The results depend on several parameters, which are found by perturbation analysis in the near integrable case, and numerically otherwise. The strength of the method is demonstrated on a simple model. We construct a bifurcation diagram describing the changes in the homoclinic tangle as the physical parameters are varied. From this diagram we find special regions in the parameter space in which we approximate the escape rates from the vicinity of the homoclinic tangle, finding nontrivial self-similar solutions as the forcing magnitude tends to zero. We compare the theoretical predictions with brute force calculations of the escape rates, and obtain satisfactory agreement.

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Homoclinic tangles-classification and applications

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Transport rates of a class of two-dimensional maps and flows

It is proved that periodic and homoclinic trajectories which are tangent to the boundary of any scattering (ergodic) billiard produce elliptic islands in the `nearby' Hamiltonian flows i.e. in a family of two-degrees-of-freedom smooth Hamiltonian flows which converge to the singular billiard flow smoothly where the billiard flow is smooth and continuously where it is continuous. Such Hamiltonians exist; indeed, sufficient conditions are supplied, and thus it is proved that a large class of smooth Hamiltonians converges to billiard flows in this manner. These results imply that ergodicity may be lost in the physical setting, where smooth Hamiltonians which are arbitrarily close to the ergodic billiards, arise.

Vered Rom-Kedar

Papers

An analytical study of transport, mixing and chaos in an unsteady vortical flow

Transport in two-dimensional maps

Homoclinic tangles-classification and applications

Transport rates of a class of two-dimensional maps and flows

Elliptic islands appearing in near-ergodic flows