Evaluation of human obstructive sleep apnea using computational fluid dynamics.

Obstructive sleep apnea (OSA) severity might be correlated to the flow characteristics of the upper airways. We aimed to investigate the severity of OSA based on 3D models constructed from CT scans coupled with computational fluid dynamics (CFD) simulations. The CT scans of seven adult patients diagnosed with OSA were used to reconstruct the 3D models of the upper airways and CFD modeling and analyses were performed. Results from the fluid simulations were compared with the apnea-hypopnea index. Here we show a correlation between a CFD-based parameter, the adjusted pressure coefficient (Cp*), and the respective apnea-hypopnea index (Pearson's r = 0.91, p = 0.004), which suggests that the anatomical-based model coupled with CFD could provide functional and localized information for different regions of the upper airways

Perceived Impact of Technology Adoption: Red Light Camera

This position paper evaluates the growing use of red light cameras (RLCs) across the United States and the growing concerns associated with this technology. RLCs are quite simply the installation of cameras at traffic intersections that are designed to photograph and catch drivers that run red lights. In a perfect world, the use of RLCs would appear to be innocent enough and encourage safety on our roads. However, the growing use of RLCs has created many problems. There are three main issues (legality, safety, and money) that have arisen from the introduction of RLCs. This study found that despite all of the concerns about the legality of RLCs, they have withstood most of the challenges against them

The snomipede : a parallel platform for scanning near-field photolithography.

Using scanning near-field lithography (SNP), it is possible to pattern molecules at surfaces with a resolution as good as 9 nm [M. Montague, R. E. Ducker, K. S. L. Chong, R. J. Manning, F. J. M. Rutten, M. C. Davies and G. J. Leggett, Langmuir 23 (13), 7328–7337 (2007)]. However, in common with other scanning probe techniques, SNP has previously been considered a serial process, hindering its use in many applications. IBM’s “Millipede” addresses this problem by utilizing an array of local probes operating in parallel. Here, we describe the construction of two instruments (Snomipedes) that integrate near-field optical methods into the parallel probe paradigm and promise the integration of top–down and bottom–up fabrication methods over macroscopic areas. Both are capable of performing near-field lithography with 16 probes in parallel spanning approximately 2 mm. The instruments can work in both ambient and liquid environments, key to many applications in nanobiology. In both, separate control of writing is possible for each probe. We demonstrate the deprotection of self-assembled monolayers of alkylsilanes with photocleavable protecting groups and subsequent growth of nanostructured polymer brushes from these nanopatterned surfaces by atom-transfer radical polymerization

A novel, high-rate, anaerobic digester to treat high-solids waste ensuring reuse and good sanitation planning

A consortium of UK universities is working on developing a novel anaerobic digester that will treat pit latrine waste and transform it into a safe and valuable product. Physico-chemical characteristics of fresh human waste and pit latrine sludge are being determined. This is informing the development of a bioreactor containing biofilms, or slimes, of several microbial ‘trophic’ groups growing preferentially on distinct surfaces and materials. The ecologically-engineered bioreactor design will optimise the efficiency of the treatment and underpin successful digestion of high-solids waste. The potential use of the digestate will be reused in agriculture to recycle nutrients and prevent environmental, and watercourse pollution. Attitudes to sanitation, as well as to resource recovery from, and reuse of, waste, are being investigated so the participatory sanitation planning process can work effectively

Biopsychosocial factors of gaming disorder: a systematic review employing screening tools with well-defined psychometric properties

Background and aimsConsidering the growing number of gamers worldwide and increasing public concerns regarding the negative consequences of problematic gaming, the aim of the present systematic review was to provide a comprehensive overview of gaming disorder (GD) by identifying empirical studies that investigate biological, psychological, and social factors of GD using screening tools with well-defined psychometric properties.Materials and methodsA systematic literature search was conducted through PsycINFO, PubMed, RISS, and KISS, and papers published up to January 2022 were included. Studies were screened based on the GD diagnostic tool usage, and only five scales with well-established psychometric properties were included. A total of 93 studies were included in the synthesis, and the results were classified into three groups based on biological, psychological, and social factors.ResultsBiological factors (n = 8) included reward, self-concept, brain structure, and functional connectivity. Psychological factors (n = 67) included psychiatric symptoms, psychological health, emotion regulation, personality traits, and other dimensions. Social factors (n = 29) included family, social interaction, culture, school, and social support.DiscussionWhen the excess amount of assessment tools with varying psychometric properties were controlled for, mixed results were observed with regards to impulsivity, social relations, and family-related factors, and some domains suffered from a lack of study results to confirm any relevant patterns.ConclusionMore longitudinal and neurobiological studies, consensus on a diagnostic tool with well-defined psychometric properties, and an in-depth understanding of gaming-related factors should be established to settle the debate regarding psychometric weaknesses of the current diagnostic system and for GD to gain greater legitimacy in the field of behavioral addiction

Comparative effectiveness of less commonly used systemic monotherapies and common combination therapies for moderate to severe psoriasis in the clinical setting.

BACKGROUND: The effectiveness of psoriasis therapies in real-world settings remains relatively unknown. OBJECTIVE: We sought to compare the effectiveness of less commonly used systemic therapies and commonly used combination therapies for psoriasis. METHODS: This was a multicenter cross-sectional study of 203 patients with plaque psoriasis receiving less common systemic monotherapy (acitretin, cyclosporine, or infliximab) or common combination therapies (adalimumab, etanercept, or infliximab and methotrexate) compared with 168 patients receiving methotrexate evaluated at 1 of 10 US outpatient dermatology sites participating in the Dermatology Clinical Effectiveness Research Network. RESULTS: In adjusted analyses, patients on acitretin (relative response rate 2.01; 95% confidence interval [CI] 1.18-3.41), infliximab (relative response rate 1.93; 95% CI 1.26-2.98), adalimumab and methotrexate (relative response rate 3.04; 95% CI 2.12-4.36), etanercept and methotrexate (relative response rate 2.22; 95% CI 1.25-3.94), and infliximab and methotrexate (relative response rate 1.72; 95% CI 1.10-2.70) were more likely to have clear or almost clear skin compared with patients on methotrexate. There were no differences among treatments when response rate was defined by health-related quality of life. LIMITATIONS: Single time point assessment may result in overestimation of effectiveness. CONCLUSIONS: The efficacy of therapies in clinical trials may overestimate their effectiveness as used in clinical practice. Although physician-reported relative response rates were different among therapies, absolute differences were small and did not correspond to differences in patient-reported outcomes

Multidrug resistant pulmonary tuberculosis treatment regimens and patient outcomes: an individual patient data meta-analysis of 9,153 patients.

Treatment of multidrug resistant tuberculosis (MDR-TB) is lengthy, toxic, expensive, and has generally poor outcomes. We undertook an individual patient data meta-analysis to assess the impact on outcomes of the type, number, and duration of drugs used to treat MDR-TB

Suzaku observations of the hard X-ray variability of MCG-6-30-15: the effects of strong gravity around a Kerr black hole

Suzaku has, for the first time, enabled the hard X-ray variability of the Seyfert 1 galaxy MCG-6-30-15 to be measured. The variability in the 14-45 keV band, which is dominated by a strong reflection hump, is quenched relative to that at a few keV. This directly demonstrates that the whole reflection spectrum is much less variable than the power-law continuum. The broadband spectral variability can be decomposed into two components - a highly variable power-law and constant reflection - as previously inferred from other observations in the 2-10 keV band. The strong reflection and high iron abundance give rise to a strong broad iron line, which requires the inner disc radius to be at about 2 gravitational radii. Our results are consistent with the predictions of the light bending model which invokes the very strong gravitational effects expected very close to a rapidly spinning black hole.Comment: accepted for publication in PASJ Suzaku special issu

Albuminuria Testing in Hypertension and Diabetes:An Individual-Participant Data Meta-Analysis in a Global Consortium

Albuminuria is an under-recognized component of chronic kidney disease definition, staging, and prognosis. Guidelines, particularly for hypertension, conflict on recommendations for urine albumin-to-creatinine ratio (ACR) measurement. Separately among 1 344 594 adults with diabetes and 2 334 461 nondiabetic adults with hypertension from the chronic kidney disease Prognosis Consortium, we assessed ACR testing, estimated the prevalence and incidence of ACR ≥30 mg/g and developed risk models for ACR ≥30 mg/g. The ACR screening rate (cohort range) was 35.1% (12.3%-74.5%) in diabetes and 4.1% (1.3%-20.7%) in hypertension. Screening was largely unrelated to the predicted risk of prevalent albuminuria. The median prevalence of ACR ≥30 mg/g across cohorts was 32.1% in diabetes and 21.8% in hypertension. Higher systolic blood pressure was associated with a higher prevalence of albuminuria (odds ratio [95% CI] per 20 mm Hg in diabetes, 1.50 [1.42-1.60]; in hypertension, 1.36 [1.28-1.45]). The ratio of undetected (due to lack of screening) to detected ACR ≥30 mg/g was estimated at 1.8 in diabetes and 19.5 in hypertension. Among those with ACR/g, the median 5-year incidence of ACR ≥30 mg/g across cohorts was 23.9% in diabetes and 21.7% in hypertension. Incident albuminuria was associated with initiation of renin-angiotensin-aldosterone system inhibitors (incidence-rate ratio [95% CI], diabetes 3.09 [2.71-3.53]; hypertension 2.87 [2.29-3.59]). In conclusion, despite similar risk of albuminuria to those with diabetes, ACR screening in patients with hypertension was low. Our findings suggest that regular albuminuria screening should be emphasized to enable early detection of chronic kidney disease and initiation of treatment with cardiovascular and renal benefits