Relationship Between Body Adiposity and Arterial Stiffness in Young Indian Adults

ABSTRACT Background: Obesity is one of the major cardiovascular risk factors and is linked with arterial stiffness. This study was undertaken to establish the relationship between regional adiposity and arterial stiffness using simple noninvasive techniques. Methods: In total, 181 young Asian Indian adults aged 18–28 years (mean age 21.9 ± 2.2) were measured for adiposity and arterial stiffness. Total body fat percentage was derived from skinfold thickness of various body sites. Body mass index and waist‑hip‑ratio were also measured. Arterial stiffness was measured using a SphygmoCor with a carotid‑radial pulse wave analysis technique. Results: Significant gender differences were observed on anthropometric variables including skinfold thickness (P < 0.05) and all the arterial stiffness variables (P < 0.05) except pulse wave velocity. Systolic pressure, augmentation pressure, augmentation index (AIx), AIx at 75% heart rate, and aortic systolic pressure had statistically significant correlations with all three adiposity variables (P < 0.05). Significant correlations were found in a higher number of variables in the females. Physical activity had negative correlations with arterial stiffness and adiposity variables (P < 0.05). Conclusion: Arterial stiffness measured by carotid‑radial pulse wave analysis is strongly related to adiposity measured from skinfold thickness in females. Females had higher arterial stiffness and adiposity compared with men. These findings could be helpful in future research using noninvasive arterial stiffness measurements

Using pupillometry and gaze-based metrics for understanding drivers’ mental workload during automated driving

This Horizon2020-funded driving simulator-based study on automated driving investigated the effect of different car-following scenarios, and takeover situations, on drivers’ mental workload, as measured by eye tracking-based metrics of pupil diameter and self-reported workload ratings. This study incorporated a mixed design format, with 16 drivers recruited for the SAE Level 2 (L2; SAE International, 2021) automation group, who were asked to monitor the driving and road environment during automation, and 16 drivers in the Level 3 (L3) automation group, who engaged in a non-driving related task (NDRT; Arrows task) during automation. Drivers in each group undertook two experimental drives, lasting about 18 min each. To manipulate perceived workload, difficulty of the driving task was controlled by incorporating a lead vehicle which maintained either a Short (0.5 s) or Long (1.5 s) Time Headway (THW) condition during automated car-following (ACF). Each ACF session was followed by a subsequent request to takeover, which happened either in the presence or absence of a lead vehicle. Results from standard deviation of pupil diameter values indicated that drivers’ mental workload levels fluctuated significantly more when monitoring the drive during L2 ACF, compared to manual car-following (MCF). Additionally, we found that drivers’ mental workload, as indicated by their mean pupil diameter, increased steeply around takeovers, and was further exacerbated by the presence of a lead vehicle during the takeovers, especially in the Short THW condition, for both groups. Pupil diameter was found to be sensitive to subtle variations in mental workload, and closely resembled the trend seen in self-reported workload ratings. Further research is warranted to assess the feasibility of using eye-tracking-based metrics along with other physiological sensors, especially in real-world settings, to understand whether they can be used as real-time indicators of drivers’ mental workload, in future driver state monitoring systems

Engaging in NDRTs affects drivers’ responses and glance patterns after silent automation failures

The aim of this study was to understand driver responses to “silent” failures in automated driving, where automation failed during a simulator drive, without a take-over warning. The effect of a visual non-driving related task (NDRT) and a road-based vigilance task presented drivers’ take-over response and visual attention was also investigated. Currently, automated driving systems face a number of limitations that require control to be handed back to the driver. Much of the research to date has focused on explicit take-over requests (ToRs) and shows that drivers struggle to resume control safely, exacerbated by disengagement from the driving task, for instance, due to the presence of NDRTs. However, little is known about whether, and how, drivers will respond to more subtle automation failures that come without a warning, and how this is affected by NDRT engagement. Thirty participants drove a simulated automated drive in two conditions, which had 6 silent automation failures each (3 on a Curve, 3 in a Straight), with no ToRs. In one condition, drivers were required to constantly monitor the road, which was enforced by a road-based vigilance task (VMS Only). In the other, drivers performed an additional visual NDRT, requiring them to divide their attention (VMS + Arrows). Results showed that, in both conditions, all drivers eventually detected and responded to all silent automation failures. However, engaging in an additional NDRT during automation resulted in significantly more lane excursions and longer take-over times. Adding a visual NDRT not only changed the distribution of drivers’ visual attention before and after the failure but also how they divided their attention between information on the road environment and the human–machine interface, which provided information on automation status. These results provide support for how driver monitoring systems may be used to detect drivers’ visual attention to the driving task and surroundings, and used as a tool for encouraging driver intervention, when required

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements

Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study

Introduction: The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. Methods: In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. Findings: Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2–6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p&lt;0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5–5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p&lt;0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4–10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p&lt;0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32–4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP &gt;5mg/L, OR 3·55 [1·23–11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. Interpretation: After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Retinopathy of prematurity-An overview

Retinopathy of prematurity (ROP) is a vasoproliferative disease that affects premature infants. ROP is on a rise in India as a result of the improved neonatal care and better neonatal survival rate. Identifying and screening of at-risk premature infants performed by an experienced ophthalmologist remains the most important strategy in the management of ROP. In developing countries, the introduction of Retcam-assisted screening enables screening and follow-up of the rural population where an experienced ophthalmologist may not be available. Currently, laser photocoagulation of avascular retina has replaced cryotherapy as the gold standard treatment for ROP depending on the severity of disease. Among the various ongoing treatment approaches currently under trial to suppress the neovascularization, anti-vascular endothelial growth factor drugs provide valuable and encouraging information, especially in Zone 1 disease. Although many ongoing animal trials aimed at finding an ideal treatment have come out with newer treatment options, their safety and efficacy in humans are yet to be established