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•A quick and simple synthesis methodology is used to obtain Bi2MoO6/ZnO heterostructures.•The morphology of ZnO evolves from rods to flowers with the addition of Bi2MoO6.•The ...heterostructure ZN8B1 presents excellent photocatalytic properties for degradation of methylene blue and diclofenac under sunlight.•The powder immobilized on a glass plate with epoxy resin shows good reusability in 10 cycles.
In this study, the Bi2MoO6/ZnO heterostructures were quickly and easily obtained using the sonochemical method and impregnated on a glass plate using epoxy resin. The influence of increasing the percentage of ZnO (1:1, 2:1, 4:1 and 8:1% by weight) in relation to Bi2MoO6 on the formation of the heterostructure was investigated. The XRD results of the heterostructures indicated the presence of ZnO phases with a hexagonal structure and Bi2MoO6 with an orthorhombic structure. According to FESEM and HRTEM analyses, the morphology of ZnO is controlled with the addition of Bi2MoO6. The photocatalytic activity of the heterostructures was evaluated using a mixture (MIX) of methylene blue dye and diclofenac potassium, obtaining photocatalytic efficiency of 99.7 % and 90 % in 100 min under solar irradiation, with the ZN8B1 heterostructure, respectively. Aiming to increase the reuse of the material, the ZN8B1 heterostructure was impregnated into a glass plate, obtaining an efficiency of on average 65.2 % for 10 reuse cycles, showing that the impregnate can be applied to effluent treatment. The evaluation of the effect of photocatalyst dosage, contaminant concentration and pH effect was carried out with the MIX solution in order to simulate real conditions. Furthermore, a possible photocatalytic mechanism was proposed based on inhibition tests, verifying that the •O2– and •OH radicals were the dominant active species, which followed the Z-scheme mechanism.
In this paper, we propose a regression model where the response variable is beta prime distributed using a new parameterization of this distribution that is indexed by mean and precision parameters. ...The proposed regression model is useful for situations where the variable of interest is continuous and restricted to the positive real line and is related to other variables through the mean and precision parameters. The variance function of the proposed model has a quadratic form. In addition, the beta prime model has properties that its competitor distributions of the exponential family do not have. Estimation is performed by maximum likelihood. Furthermore, we discuss residuals and influence diagnostic tools. Finally, we also carry out an application to real data that demonstrates the usefulness of the proposed model.
Background Imaging variables, including airway diameter, wall thickness, and air trapping, have been found to be important metrics when differentiating patients with severe asthma from those with ...nonsevere asthma and healthy subjects. Objective The objective of this study was to identify imaging-based clusters and to explore the association of the clusters with existing clinical metrics. Methods We performed an imaging-based cluster analysis using quantitative computed tomography–based structural and functional variables extracted from the respective inspiration and expiration scans of 248 asthmatic patients. The imaging-based metrics included a broader set of multiscale variables, such as inspiratory airway dimension, expiratory air trapping, and registration-based lung deformation (inspiration vs expiration). Asthma subgroups derived from a clustering method were associated with subject demographics, questionnaire results, medication history, and biomarker variables. Results Cluster 1 was composed of younger patients with early-onset nonsevere asthma and reversible airflow obstruction and normal airway structure. Cluster 2 was composed of patients with a mix of patients with nonsevere and severe asthma with marginal inflammation who exhibited airway luminal narrowing without wall thickening. Clusters 3 and 4 were dominated by patients with severe asthma. Cluster 3 patients were obese female patients with reversible airflow obstruction who exhibited airway wall thickening without airway narrowing. Cluster 4 patients were late-onset older male subjects with persistent airflow obstruction who exhibited significant air trapping and reduced regional deformation. Cluster 3 and 4 patients also showed decreased lymphocyte and increased neutrophil counts, respectively. Conclusions Four image-based clusters were identified and shown to be correlated with clinical characteristics. Such clustering serves to differentiate asthma subgroups that can be used as a basis for the development of new therapies.
Background Sleep difficulties are commonly reported by patients with asthma; however, the prevalence of insomnia and its association with disease burden and well-being is unknown. We aimed to ...determine the prevalence of insomnia, defined as combined sleep-specific complaints with associated daytime symptoms, among a large sample of adults with asthma, and to compare well-being, asthma control, and asthma-related health care utilization in individuals with asthma and insomnia and those without insomnia. Methods Baseline data from adults with physician-confirmed asthma enrolled in the Severe Asthma Research Program III was used for analyses (N = 714). Participants completed the Insomnia Severity Index (ISI), Asthma Control Test, Asthma Quality of Life Questionnaire, and Hospital Anxiety and Depression Scale. Results Insomnia (ISI ≥ 10) was identified in 263 participants (37%). Presence of insomnia was associated with higher levels of depression and anxiety symptoms and poorer quality of life. Those with insomnia had a 2.4-fold increased risk for having not well-controlled asthma and a 1.5-fold increased risk for asthma-related health care utilization in the past year compared with those without insomnia. Conclusions Insomnia is highly prevalent in asthma and is associated with adverse outcomes. Further studies are needed to gain a better understanding of the interaction between insomnia and asthma control.
Severe asthma is a complex heterogeneous disease associated with older age and obesity. The presence of eosinophilic (type 2) inflammation in some but not all patients with severe asthma predicts ...responsiveness to current treatments, but new treatment approaches will require a better understanding of non-type 2 mechanisms of severe asthma. We considered the possibility that systemic inflammation, which arises in subgroups of obese and older patients, increases the severity of asthma. Interleukin-6 (IL-6) is a biomarker of systemic inflammation and metabolic dysfunction, and we aimed to explore the association between IL-6 concentrations, metabolic dysfunction, and asthma severity.
In this cross-sectional analysis, patients were recruited from two cohorts: mainly non-severe asthmatics from the University of California San Francisco (UCSF) and mainly severe asthmatics from the Severe Asthma Research Program (SARP). We generated a reference range for plasma IL-6 in a cohort of healthy control patients. We compared the clinical characteristics of asthmatics with plasma IL-6 concentrations above (IL-6 high) and below (IL-6 low) the upper 95% centile value for plasma IL-6 concentration in the healthy cohort. We also compared how pulmonary function, frequency of asthma exacerbations, and frequency of severe asthma differed between IL-6 low and IL-6 high asthma populations in the two asthma cohorts.
Between Jan 1, 2005, and Dec 31, 2014, we recruited 249 patients from UCSF and between Nov 1, 2012, and Oct 1, 2014, we recruited 387 patients from SARP. The upper 95th centile value for plasma IL-6 concentration in the healthy cohort (n=93) was 3·1 pg/mL, and 14% (36/249) of UCSF cohort and 26% (102/387) of the SARP cohort had plasma IL-6 concentrations above this upper limit. The IL-6 high patients in both asthma cohorts had a significantly higher average BMI (p<0·0001) and a higher prevalence of hypertension (p<0·0001) and diabetes (p=0·04) than the IL-6 low patients. IL-6 high patients also had significantly worse lung function and more frequent asthma exacerbations than IL-6 low patients (all p values <0·0001). Although 80% (111/138) of IL-6 high asthmatic patients were obese, 62% (178/289) of obese asthmatic patients were IL-6 low. Among obese patients, the forced expiratory volume in 1 s (FEV1) was significantly lower in IL-6 high than in IL-6 low patients (mean percent predicted FEV1=70·8% SD 19·5 vs 78·3% 19·7; p=0·002), and the percentage of patients reporting an asthma exacerbation in the past 1-2 years was higher in IL-6 high than in IL-6 low patients (66% 73/111 vs 48% 85/178; p=0·003). Among non-obese asthmatics, FEV1 values and the frequency of asthma exacerbations within the past 1-2 years were also significantly worse in IL-6 high than in IL-6 low patients (mean FEV1 66·4% SD 23·1 vs 83·2% 20·4 predicted; p<0·0001; 59% 16/27 vs 34% 108/320; p=0·01).
Systemic IL-6 inflammation and clinical features of metabolic dysfunction, which occur most commonly in a subset of obese asthma patients but also in a small subset of non-obese patients, are associated with more severe asthma. These data provide strong rationale to undertake clinical trials of IL-6 inhibitors or treatments that reduce metabolic dysfunction in a subset of patients with severe asthma. Plasma IL-6 is a biomarker that could guide patient stratification in these trials.
NIH and the Parker B Francis Foundation.
We focus on the development of diagnostic tools and an R package called MNB for a multivariate negative binomial (MNB) regression model for detecting atypical and influential subjects. The MNB model ...is deduced from a Poisson mixed model in which the random intercept follows the generalized log-gamma (GLG) distribution. The MNB model for correlated count data leads to an MNB regression model that inherits the features of a hierarchical model to accommodate the intraclass correlation and the occurrence of overdispersion simultaneously. The asymptotic consistency of the dispersion parameter estimator depends on the asymmetry of the GLG distribution. Inferential procedures for the MNB regression model are simple, although it can provide inconsistent estimates of the asymptotic variance when the correlation structure is misspecified. We propose the randomized quantile residual for checking the adequacy of the multivariate model and derive global and local influence measures from the multivariate model to assess influential subjects. Finally, two applications are presented in the data analysis section. The code for installing the MNB package and the code used in the two examples is exhibited in the Appendices.
Some reports indicate longitudinal variability in sputum differential cell counts, whereas others describe stability. Highly variable sputum eosinophil percentages are associated with greater lung ...function loss than persistently elevated eosinophil percentages, but elevated neutrophils are linked to more severe asthma.
To examine sputum granulocyte stability or variability longitudinally and associations with important clinical characteristics.
The SARP III (Severe Asthma Research Program III) cohort underwent comprehensive phenotype characterization at baseline and annually over 3 years. Adult subjects with acceptable sputum levels were assigned to one of three longitudinal sputum groups: eosinophils predominantly <2%, eosinophils predominantly ≥2%, or highly variable eosinophil percentages (>2 SDs determined from independent, repeated baseline eosinophil percentages). Subjects were similarly assigned to one of three longitudinal neutrophil groups with a 50% cut point.
The group with predominantly <2% sputum eosinophils had the highest lung function (prebronchodilator FEV
% predicted,
< 0.01; FEV
/FVC ratio,
< 0.001) at baseline and throughout 3 years compared with other eosinophil groups. Healthcare use did not differ, although the highly variable eosinophil group reported more asthma exacerbations at Year 3. Longitudinal neutrophil groups showed few differences. However, a combination of predominantly ≥2% eosinophil and ≥50% neutrophil groups resulted in the lowest prebronchodilator FEV
% predicted (
= 0.049) compared with the combination with predominantly <2% eosinophils and<50% neutrophils.
Subjects with predominantly ≥2% sputum eosinophils in combination with predominantly ≥50% neutrophils showed greater loss of lung function, whereas those with highly variable sputum eosinophils had greater healthcare use.
The gaming industry plays a crucial role in the realm of entertainment within our society. However, from Monopoly to Flight Simulators, serious games have also been appealing tools for learning a new ...language, conveying values, or training skills. The resurgence of Artificial Intelligence (AI) and data science in the last decade presents a unique window of opportunity for its integration into video games. This integration is of particular interest due to the vast amount of data that can be collected through a game, which is needed to feed the AI algorithms. This paper aims to identify relevant research paths in the intersection of serious games, AI, and computational social science, particularly in their utilization as novel research tools to comprehend human behavior and society. To provide a comprehensive context, we also present an overview of the serious game research field identifying the most prominent application areas and analyzing applications of AI in serious games that hold great potential for computational social science research. The goal of our work is to establish a valuable framework for researchers interested in utilizing serious games as a novel tool for AI-supported social research.
The Severe Asthma Research Program cohort includes subjects with persistent asthma who have undergone detailed phenotypic characterization. Previous univariate methods compared features of mild, ...moderate, and severe asthma.
To identify novel asthma phenotypes using an unsupervised hierarchical cluster analysis.
Reduction of the initial 628 variables to 34 core variables was achieved by elimination of redundant data and transformation of categorical variables into ranked ordinal composite variables. Cluster analysis was performed on 726 subjects.
Five groups were identified. Subjects in Cluster 1 (n = 110) have early onset atopic asthma with normal lung function treated with two or fewer controller medications (82%) and minimal health care utilization. Cluster 2 (n = 321) consists of subjects with early-onset atopic asthma and preserved lung function but increased medication requirements (29% on three or more medications) and health care utilization. Cluster 3 (n = 59) is a unique group of mostly older obese women with late-onset nonatopic asthma, moderate reductions in FEV(1), and frequent oral corticosteroid use to manage exacerbations. Subjects in Clusters 4 (n = 120) and 5 (n = 116) have severe airflow obstruction with bronchodilator responsiveness but differ in to their ability to attain normal lung function, age of asthma onset, atopic status, and use of oral corticosteroids.
Five distinct clinical phenotypes of asthma have been identified using unsupervised hierarchical cluster analysis. All clusters contain subjects who meet the American Thoracic Society definition of severe asthma, which supports clinical heterogeneity in asthma and the need for new approaches for the classification of disease severity in asthma.
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