Empowerment or Engagement? Digital Health Technologies for Mental Healthcare

We argue that while digital health technologies (e.g. artificial intelligence, smartphones, and virtual reality) present significant opportunities for improving the delivery of healthcare, key concepts that are used to evaluate and understand their impact can obscure significant ethical issues related to patient engagement and experience. Specifically, we focus on the concept of empowerment and ask whether it is adequate for addressing some significant ethical concerns that relate to digital health technologies for mental healthcare. We frame these concerns using five key ethical principles for AI ethics (i.e. autonomy, beneficence, non-maleficence, justice, and explicability), which have their roots in the bioethical literature, in order to critically evaluate the role that digital health technologies will have in the future of digital healthcare

A Genome-wide Linkage Analysis and Mutation Analysis of Hereditary Congenital Blepharoptosis in a Japanese Family

Hereditary congenital ptosis (PTOS) is defined as drooping of the upper eyelid without any other accompanying symptoms and distinguished from syndromic blepharoptosis.Two previous linkage analyses assigned a PTOS locus (PTOS1) to 1p32-p34.1 and another (PTOS2) to Xq24-q27.1. In addition, in a sporadic case with a balanced chromosomal translocation t(1;8)(p34.3;q21.12), the ZFHX4 (zinc finger homeodomain 4) gene was found to be disrupted at the 8q21.12 breakpoint, but there was no gene at the 1p34.3 breakpoint, suggesting the existence of the third PTOS locus (PTOS1) at 8q21.12. We carried out a genome-wide linkage analysis in a Japanese PTOS family and calculated two-point and multipoint LOD scores with reduced penetrance. Haplotype analysis gave three candidate disease-responsible regions, i.e., 8q21.11-q22.1, 12q24.32-q24.33 and 14q21.1-q23.2. Although the family size is too small to define one of them, 8q21.11-q22.1 is a likely candidate region, because it contains the previously reported translocation breakpoint above. We thus performed mutation, Southern-blot and methylation analyses of ZFHX4, but could not find any disease specific change in the family. Nevertheless, our data may support the localization of PTOS1.長崎大学学位論文 学位記番号:博（医歯薬）甲第153号 博士（医学）学位授与年月日:平成20年3月19

An LES Turbulent Inflow Generator using A Recycling and Rescaling Method

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.The present paper describes a recycling and rescaling method for generating turbulent inflow conditions for Large Eddy Simulation. The method is first validated by simulating a turbulent boundary layer and a turbulent mixing layer. It is demonstrated that, with input specification of mean velocities and turbulence rms levels (normal stresses) only, it can produce realistic and self-consistent turbulence structures. Comparison of shear stress and integral length scale indicates the success of the method in generating turbulent 1-point and 2-point correlations not specified in the input data. With the turbulent inlet conditions generated by this method, the growth rate of the turbulent boundary/mixing layer is properly predicted. Furthermore, the method can be used for the more complex inlet boundary flow types commonly found in industrial applications, which is demonstrated by generating non-equilibrium turbulent inflow and spanwise inhomogeneous inflow. As a final illustration of the benefits brought by this approach, a droplet-laden mixing layer is simulated. The dispersion of droplets in the near-field immediately downstream of the splitter plate trailing edge where the turbulent mixing layer begins is accurately reproduced due to the realistic turbulent structures captured by the recycling/rescaling method

The effectiveness of home versus community-based weight control programmes initiated soon after breast cancer diagnosis: a randomised controlled trial

BackgroundBreast cancer diagnosis may be a teachable moment for lifestyle behaviour change and to prevent adjuvant therapy associated weight gain. We assessed the acceptability and effectiveness of two weight control programmes initiated soon after breast cancer diagnosis to reduce weight amongst overweight or obese women and prevent gains in normal-weight women.MethodsOverweight or obese (n?=?243) and normal weight (n?=?166) women were randomised to a three-month unsupervised home (home), a supervised community weight control programme (community) or to standard written advice (control). Primary end points were change in weight and body fat at 12 months. Secondary end points included change in insulin, cardiovascular risk markers, quality of life and cost-effectiveness of the programmes.ResultsForty-three percent of eligible women were recruited. Both programmes reduced weight and body fat: home vs. control mean (95% CI); weight ?2.3 (?3.5, ?1.0) kg, body fat ?1.6 (?2.6, ?0.7) kg, community vs. control; weight ?2.4 (?3.6, ?1.1) kg, body fat ?1.4 (?2.4, ?0.5) kg (all p?<?0.001). The community group increased physical activity, reduced insulin, cardiovascular disease risk markers, increased QOL and was cost-effective.ConclusionsThe programmes were equally effective for weight control, but the community programme had additional benefits.Clinical trial registrationISRCTN6857614

The Influence of Velocity Ratio on the Evolution of Streamwise Vortices in the Simulated Plane Mixing Layer

In this paper we perform Large Eddy Simulations of the plane turbulent mixing layer, to assess the effect of the velocity ratio parameter on the evolution of the streamwise vortex structure in the flow. The mixing layers originate from a physically-correlated inflow condition. A simulation performed against reference experimental flow conditions produces reliable flow statistics, and the velocity ratio parameter is subsequently varied by changing the low-speed freestream velocity of the flow. It is found that the residual streamwise vorticity in the flow upstream of the splitter plate is amplified, and subsequently realigns into a single row of spatially stationary streamwise vortices. The distance required for this realignment process decreases with increasing values of the velocity ratio parameter. Once formed, the average spacing of the spatially stationary streamwise vortices evolves in a stepwise fashion, with the overall spanwise wavelength of the streamwise structure scaling linearly with the local vorticity thickness. This scaling is independent of the velocity ratio parameter for all values tested here