Visualization of back pain data-A 3-D solution

Traditional approaches to gathering and visualizing pain data rely on two-dimensional (2-D) human body models, where different types of sensation are recorded with various monochrome symbols. We proposean alternative that uses a three-dimensional (3-D) representation of the human body, which can be marked in color to visualize and record pain data

Installed performance assessment of a boundary layer ingesting distributed propulsion system at design point

Boundary layer ingesting systems have been proposed as a concept with great potential for reducing the fuel consumption of conventional propulsion systems and the overall drag of an aircraft. These studies have indicated that if the aerodynamic and efficiency losses were minimised, the propulsion system demonstrated substantial power consumption benefits in comparison to equivalent propulsion systems operating in free stream flow. Previously assessed analytical methods for BLI simulation have been from an uninstalled perspective. This research will present the formulation of an rapid analytical method for preliminary design studies which evaluates the installed performance of a boundary layer ingesting system. The method uses boundary layer theory and one dimensional gas dynamics to assess the performance of an integrated system. The method was applied to a case study of the distributed propulsor array of a blended wing body aircraft. There was particular focus on assessment how local flow characteristics influence the performance of individual propulsors and the propulsion system as a whole. The application of the model show that the spanwise flow variation has a significant impact on the performance of the array as a whole. A clear optimum design point is identified which minimises the power consumption for an array with a fixed configuration and net propulsive force requirement. In addition, the sensitivity of the system to distortion related losses is determined and a point is identi ed where a conventional free-stream propulsor is the lower power option. Power saving coefficient for the configurations considered is estimated to lie in the region of 15%

Can a brief interaction with online, digital art improve wellbeing? A comparative study of the impact of online art and culture presentations on mood, state-anxiety, subjective wellbeing, and loneliness

When experienced in-person, engagement with art has been associated—in a growing body of evidence—with positive outcomes in wellbeing and mental health. This represents an exciting new field for psychology, curation, and health interventions, suggesting a widely-accessible, cost-effective, and non-pharmaceutical means of regulating factors such as mood or anxiety. However, can similar impacts be found with online presentations? If so, this would open up positive outcomes to an even-wider population—a trend accelerating due to the current COVID-19 pandemic. Despite its promise, this question, and the underlying mechanisms of art interventions and impacts, has largely not been explored. Participants (N = 84) were asked to engage with one of two online exhibitions from Google Arts and Culture (a Monet painting or a similarly-formatted display of Japanese culinary traditions). With just 1–2 min exposure, both improved negative mood, state-anxiety, loneliness, and wellbeing. Stepdown analysis suggested the changes can be explained primarily via negative mood, while improvements in mood correlated with aesthetic appraisals and cognitive-emotional experience of the exhibition. However, no difference was found between exhibitions. We discuss the findings in terms of applications and targets for future research

Method for simulating the performance of a boundary layer ingesting propulsion system at design and off-design

Boundary layer ingestion has emerged as a potential propulsion concept on novel aircraft configurations for the future. As these concepts progress, preliminary design tools are required that enable the simulation of these aircraft and the rapid analysis of multiple configurations. Simulation tools for boundary layer ingesting propulsion systems tend to focus on proving performance benefits at design point. However, the simulation of aircraft configurations that utilise boundary layer ingestion requires a method to simulate the propulsion system at a range of flight conditions other than design point. A tool is therefore required to enable simulations at off-design. This research presents a work flow to simulate a boundary layer ingesting propulsion system at design and off-design. The process is intended as a tool for design space exploration and the rapid analysis of concepts at the conceptualisation phase. Boundary layer calculations have been combined with conventional 1-D gas turbine performance methods to predict performance of a propulsion system at design point. This method is then extended to enable simulations at off-design conditions for a range of flight conditions or propulsion system power settings. The formulation provides a thrust-drag representation that supports conventional aircraft simulation tools. A case study of an aircraft configuration which utilises an array of boundary layer ingesting propulsors is used to demonstrate the process. The performance of individual propulsors in the array is compared at off-design. Simulations found that, although each propulsor was sized for the same propulsive force at design point, off-design performance diverged depending on operating conditions. In addition, the performance of the propulsor array as a whole was predicted as a function of altitude and Mach number. The case study is used to draw general conclusions on the performance characteristics of a boundary layer ingesting propulsor

Advanced diagnostic genetic testing in inherited retinal disease: experience from a single tertiary referral centre in the UK National Health Service

In 2013, as part of our genetic investigation of patients with inherited retinal disease, we utilized multigene panel testing of 105 genes known to cause retinal disease in our patient cohorts. This test was performed in a UK National Health Service (NHS) accredited laboratory. The results of all multigene panel tests requested between 1.4.13 and 31.8.14 were retrospectively reviewed. All patients had been previously seen at Moorfields Eye Hospital, London, UK and diagnosed with an inherited retinal dystrophy after clinical examination and detailed retinal imaging. The results were categorized into three groups: (i) Testing helped establish a certain molecular diagnosis in 45 out of 115 (39%). Variants in USH2A (n = 6) and RP1 (n = 4) were most common. (ii) Definitive conclusions could not be drawn from molecular testing alone in 13 out of 115 (11%) as either insufficient pathogenic variants were discovered or those identified were not consistent with the phenotype. (iii) Testing did not identify any pathogenic variants responsible for the phenotype in 57 out of 115 (50%). Multigene panel testing performed in an NHS setting has enabled a molecular diagnosis to be confidently made in 40% of cases. Novel variants accounted for 38% of all identified variants. Detailed retinal phenotyping helped the interpretation of specific variants. Additional care needs to be taken when assessing polymorphisms in genes that have been infrequently associated with disease, as historical techniques were not as rigorous as contemporary ones. Future iterations of sequencing are likely to offer higher sensitivity, testing a broader range of genes, more rapidly and at a reduced cost

Defective monocyte-derived macrophage phagocytosis is associated with exacerbation frequency in COPD

Background Lower airway bacterial colonisation (LABC) in COPD patients is associated with increased exacerbation frequency and faster lung function decline. Defective macrophage phagocytosis in COPD drives inflammation, but how defective macrophage function contributes to exacerbations is not clear. This study investigated the association between macrophage phagocytosis and exacerbation frequency, LABC and clinical parameters. Methods Monocyte-derived macrophages (MDM) were generated from 92 stable COPD patients, and at the onset of exacerbation in 39 patients. Macrophages were exposed to fluorescently labelled Haemophilus influenzae or Streptococcus pneumoniae for 4 h, then phagocytosis measured by fluorimetry and cytokine release by ELISA. Sputum bacterial colonisation was measured by PCR. Results Phagocytosis of H. influenzae was negatively correlated with exacerbation frequency (r = 0.440, p < 0.01), and was significantly reduced in frequent vs. infrequent exacerbators (1.9 × 103 RFU vs. 2.5 × 103 RFU, p < 0.01). There was no correlation for S. pneumoniae. There was no association between phagocytosis of either bacteria with age, lung function, smoking history or treatment with inhaled corticosteroids, or long-acting bronchodilators. Phagocytosis was not altered during an exacerbation, or in the 2 weeks post-exacerbation. In response to phagocytosis, MDM from exacerbating patients showed increased release of CXCL-8 (p < 0.001) and TNFα (p < 0.01) compared to stable state. Conclusion Impaired COPD macrophage phagocytosis of H. influenzae, but not S. pneumoniae is associated with exacerbation frequency, resulting in pro-inflammatory macrophages that may contribute to disease progression. Targeting these frequent exacerbators with drugs that improve macrophage phagocytosis may prove beneficial

Religion/Spirituality, Stress, and Resilience Among Sexual and Gender Minorities: The Religious/Spiritual Stress and Resilience Model

Although many sexual and gender minorities (SGMs) consider themselves religious or spiritual, the impact of this religiousness or spirituality (RS) on their health is poorly understood. We introduce the religious/spiritual stress and resilience model (RSSR) to provide a robust framework for understanding the variegated ways that RS influences the health of SGMs. The RSSR bridges existing theorizing on minority stress, structural stigma, and RS-health pathways to articulate the circumstances under which SGMs likely experience RS as health promoting or health damaging. The RSSR makes five key propositions: (a) Minority stress and resilience processes influence health; (b) RS influences general resilience processes; (c) RS influences minority-specific stress and resilience processes; (d) these relationships are moderated by a number of variables uniquely relevant to RS among SGMs, such as congregational stances on same-sex sexual behavior and gender expression or an individual’s degree of SGM and RS identity integration; and (e) relationships between minority stress and resilience, RS, and health are bidirectional. In this manuscript, we describe the empirical basis for each of the five propositions focusing on research examining the relationship between RS and health among SGMs. We conclude by describing how the RSSR may inform future research on RS and health among SGMs

Decoupling of a Current-Biased Intrinsic Josephson Junction from its Environment

We have observed a dissipative phase diffusion branch in arrays of hysteretic high-Tc intrinsic Josephson junctions. By comparing the data with a thermal activation model we extract the impedance seen by the junction in which phase diffusion is occurring. At the plasma frequency this junction is isolated from its environment and it sees its own large (~ kilo Ohm) impedance. Our results suggest that stacks of Josephson junctions may be used for isolation purposes in the development of a solid state quantum computer

False-negative RT-PCR for COVID-19 and a diagnostic risk score: a retrospective cohort study among patients admitted to hospital

OBJECTIVE: To describe the characteristics and outcomes of patients with a clinical diagnosis of COVID-19 and false-negative SARS-CoV-2 reverse transcription-PCR (RT-PCR), and develop and internally validate a diagnostic risk score to predict risk of COVID-19 (including RT-PCR-negative COVID-19) among medical admissions. DESIGN: Retrospective cohort study. SETTING: Two hospitals within an acute NHS Trust in London, UK. PARTICIPANTS: All patients admitted to medical wards between 2 March and 3 May 2020. OUTCOMES: Main outcomes were diagnosis of COVID-19, SARS-CoV-2 RT-PCR results, sensitivity of SARS-CoV-2 RT-PCR and mortality during hospital admission. For the diagnostic risk score, we report discrimination, calibration and diagnostic accuracy of the model and simplified risk score and internal validation. RESULTS: 4008 patients were admitted between 2 March and 3 May 2020. 1792 patients (44.8%) were diagnosed with COVID-19, of whom 1391 were SARS-CoV-2 RT-PCR positive and 283 had only negative RT-PCRs. Compared with a clinical reference standard, sensitivity of RT-PCR in hospital patients was 83.1% (95% CI 81.2%-84.8%). Broadly, patients with false-negative RT-PCR COVID-19 and those confirmed by positive PCR had similar demographic and clinical characteristics but lower risk of intensive care unit admission and lower in-hospital mortality (adjusted OR 0.41, 95% CI 0.27-0.61). A simple diagnostic risk score comprising of age, sex, ethnicity, cough, fever or shortness of breath, National Early Warning Score 2, C reactive protein and chest radiograph appearance had moderate discrimination (area under the receiver-operator curve 0.83, 95% CI 0.82 to 0.85), good calibration and was internally validated. CONCLUSION: RT-PCR-negative COVID-19 is common and is associated with lower mortality despite similar presentation. Diagnostic risk scores could potentially help triage patients requiring admission but need external validation

A personalized platform identifies trametinib plus zoledronate for a patient with KRAS-mutant metastatic colorectal cancer

Colorectal cancer remains a leading source of cancer mortality worldwide. Initial response is often followed by emergent resistance that is poorly responsive to targeted therapies, reflecting currently undruggable cancer drivers such as KRAS and overall genomic complexity. Here, we report a novel approach to developing a personalized therapy for a patient with treatment-resistant metastatic KRAS-mutant colorectal cancer. An extensive genomic analysis of the tumor's genomic landscape identified nine key drivers. A transgenic model that altered orthologs of these nine genes in the Drosophila hindgut was developed; a robotics-based screen using this platform identified trametinib plus zoledronate as a candidate treatment combination. Treating the patient led to a significant response: Target and nontarget lesions displayed a strong partial response and remained stable for 11 months. By addressing a disease's genomic complexity, this personalized approach may provide an alternative treatment option for recalcitrant disease such as KRAS-mutant colorectal cancer