From Disks to Channels: Dynamics of Active Nematics Confined to an Annulus

Confinement can be used to systematically tame turbulent dynamics occurring in active fluids. Although periodic channels are the simplest geometries to study confinement numerically, the corresponding experimental realizations require closed racetracks. Here, we computationally study 2D active nematics confined to such a geometry -- an annulus. By systematically varying the annulus inner radius and channel width, we bridge the behaviors observed in the previously studied asymptotic limits of the annulus geometry: a disk and an infinite channel. We identify new steady-state behaviors, which reveal the influence of boundary curvature and its interplay with confinement. We also show that, below a threshold inner radius, the dynamics are insensitive to topological constraints imposed by boundary conditions. We explain this insensitivity through a simple scaling analysis. Our work sheds further light on design principles for using confinement to control the dynamics of active nematics

A Bibliometric Overview of the Field of Type-2 Fuzzy Sets and Systems [Discussion Forum]

© 2005-2012 IEEE. Fuzzy Sets and Systems is an area of computational intelligence, pioneered by Lotfi Zadeh over 50 years ago in a seminal paper in Information and Control. Fuzzy Sets (FSs) deal with uncertainty in our knowledge of a particular situation. Research and applications in FSs have grown steadily over 50 years. More recently, we have seen a growth in Type-2 Fuzzy Set (T2 FS) related papers, where T2 FSs are utilized to handle uncertainty in realworld problems. In this paper, we have used bibliometric methods to obtain a broad overview of the area of T2 FSs. This method analyzes information on the bibliographic details of published journal papers, which includes title, authors, author address, journals and citations, extracted from the Science and Social Science Citation Indices in the Web of Science (WoS) database for the last 20 years (1997-2017). We have compared the growth of publications in the field of FSs, and its subset T2 FSs, identified highly cited papers in T2 FSs, highly cited authors, key institutions, and main countries with researchers involved in T2 FS related research

Clinical Characteristics of Patients Classified as Very High Risk and Not Very High Risk Based on the 2018 AHA/ACC Multi-Society Cholesterol Guideline

Background The 2018 AHA/ACC Cholesterol Guideline recommendation to classify ASCVD patients as very high-risk (VHR) vs not-VHR (NVHR) has important implications for ezetimibe and PCSK9 inhibitor eligibility. We aimed to define the clinical characteristics of these two groups within a large multi-state healthcare system in the Western U.S. Methods We performed a retrospective cohort analysis of patients defined as having ASCVD in 2018 using EHR ICD-10 codes. VHR was defined by ≥2 major ASCVD events (ACS ≤12 months, history of MI \u3e12 months, ischemic stroke, or symptomatic PAD) or 1 major ASCVD event and ≥2 high-risk conditions (age ≥65, DM, HTN, smoking, HeFH, CKD, CHF, persistently elevated LDL-C, or prior CABG/PCI). Patients not meeting these criteria were classified as NVHR. Results A total of 180,669 ASCVD patients were identified: 104,123 (58%) were VHR and 76,546 (42%) were NVHR. Mean age and gender was 70.1±13.4 years, 54% male and 73.1±11.9 years, 55% male for the NVHR and VHR groups, respectively. Among patients with a history of MI or recent ACS, 99% and 96% were classified as VHR, respectively (Table). Age ≥65, HTN and DM were the most prevalent high-risk conditions. Conclusion Criteria used to predict future CV risk largely divide ASCVD patients into groups of similar prevalence. Nearly all ACS/MI patients were VHR. With growing emphasis on individualized risk assessment and intense LDL-C reduction, opportunity exists to further refine risk prediction within these two at-risk groups

Accuracy of 23 Equations for Estimating LDL Cholesterol in a Clinical Laboratory Database of 5,051,467 Patients

Background: Alternatives to the Friedewald low-density lipoprotein cholesterol (LDL-C) equation have been proposed. Objective: To compare the accuracy of available LDL-C equations with ultracentrifugation measurement. Methods: We used the second harvest of the Very Large Database of Lipids (VLDbL), which is a population-representative convenience sample of adult and pediatric patients (N = 5,051,467) with clinical lipid measurements obtained via the vertical auto profile (VAP) ultracentrifugation method between October 1, 2015 and June 30, 2019. We performed a systematic literature review to identify available LDL-C equations and compared their accuracy according to guideline-based classification. We also compared the equations by their median error versus ultracentrifugation. We evaluated LDL-C equations overall and stratified by age, sex, fasting status, and triglyceride levels, as well as in patients with atherosclerotic cardiovascular disease, hypertension, diabetes, kidney disease, inflammation, and thyroid dysfunction. Results: Analyzing 23 identified LDL-C equations in 5,051,467 patients (mean±SD age, 56±16 years; 53.3% women), the Martin/Hopkins equation most accurately classified LDL-C to the correct category (89.6%), followed by the Sampson (86.3%), Chen (84.4%), Puavilai (84.1%), Delong (83.3%), and Friedewald (83.2%) equations. The other 17 equations were less accurate than Friedewald, with accuracy as low as 35.1%. The median error of equations ranged from –10.8 to 18.7 mg/dL, and was best optimized using the Martin/Hopkins equation (0.3, IQR–1.6 to 2.4 mg/dL). The Martin/Hopkins equation had the highest accuracy after stratifying by age, sex, fasting status, triglyceride levels, and clinical subgroups. In addition, one in five patients who had Friedewald LDL-C 70 mg/dL by the Martin/Hopkins equation. Conclusions: Most proposed alternatives to the Friedewald equation worsen LDL-C accuracy, and their use could introduce unintended disparities in clinical care. The Martin/Hopkins equation demonstrated the highest LDL-C accuracy overall and across subgroups

Evaluation of a social franchising and telemedicine programme and the care provided for childhood diarrhoea and pneumonia, Bihar, India

OBJECTIVE: To evaluate the impact on the quality of the care provided for childhood diarrhoea and pneumonia in Bihar, India, of a large-scale, social franchising and telemedicine programme - the World Health Partners' Sky Program. METHODS: We investigated changes associated with the programme in the knowledge and performance of health-care providers by carrying out 810 assessments in a representative sample of providers in areas where the programme was and was not implemented. Providers were assessed using hypothetical patient vignettes and the standardized patient method both before and after programme implementation, in 2011 and 2014, respectively. Differences in providers' performance between implementation and nonimplementation areas were assessed using multivariate difference-in-difference linear regression models. FINDINGS: The programme did not significantly improve health-care providers' knowledge or performance with regard to childhood diarrhoea or pneumonia in Bihar. There was a persistent large gap between knowledge of appropriate care and the care actually delivered. CONCLUSION: Social franchising has received attention globally as a model for delivering high-quality care in rural areas in the developing world but supporting data are scarce. Our findings emphasize the need for sound empirical evidence before social franchising programmes are scaled up

Developing Standard Treatment Workflows—way to universal healthcare in India

Primary healthcare caters to nearly 70% of the population in India and provides treatment for approximately 80–90% of common conditions. To achieve universal health coverage (UHC), the Indian healthcare system is gearing up by initiating several schemes such as National Health Protection Scheme, Ayushman Bharat, Nutrition Supplementation Schemes, and Inderdhanush Schemes. The healthcare delivery system is facing challenges such as irrational use of medicines, over- and under-diagnosis, high out-of-pocket expenditure, lack of targeted attention to preventive and promotive health services, and poor referral mechanisms. Healthcare providers are unable to keep pace with the volume of growing new scientific evidence and rising healthcare costs as the literature is not published at the same pace. In addition, there is a lack of common standard treatment guidelines, workflows, and reference manuals from the Government of India. Indian Council of Medical Research in collaboration with the National Health Authority, Govt. of India, and the WHO India country office has developed Standard Treatment Workflows (STWs) with the objective to be utilized at various levels of healthcare starting from primary to tertiary level care. A systematic approach was adopted to formulate the STWs. An advisory committee was constituted for planning and oversight of the process. Specialty experts' group for each specialty comprised of clinicians working at government and private medical colleges and hospitals. The expert groups prioritized the topics through extensive literature searches and meeting with different stakeholders. Then, the contents of each STW were finalized in the form of single-pager infographics. These STWs were further reviewed by an editorial committee before publication. Presently, 125 STWs pertaining to 23 specialties have been developed. It needs to be ensured that STWs are implemented effectively at all levels and ensure quality healthcare at an affordable cost as part of UHC