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Background Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic and debilitating disease that is characterized by unexplained physical fatigue unrelieved by rest. Symptoms also include cognitive and sensory dysfunction, sleeping disturbances, orthostatic intolerance, and gastrointestinal problems. A syndrome clinically similar to ME/CFS has been reported following well-documented infections with the coronaviruses SARS-CoV and MERS-CoV. At least 10% of COVID-19 survivors develop post acute sequelae of SARS-CoV-2 infection (PASC). Although many individuals with PASC have evidence of structural organ damage, a subset have symptoms consistent with ME/CFS including fatigue, post exertional malaise, cognitive dysfunction, gastrointestinal disturbances, and postural orthostatic intolerance. These common features in ME/CFS and PASC suggest that insights into the pathogenesis of either may enrich our understanding of both syndromes, and could expedite the development of strategies for identifying those at risk and interventions that prevent or mitigate disease. Methods Using regression, Bayesian and enrichment analyses, we conducted targeted and untargeted metabolomic analysis of 888 metabolic analytes in plasma samples of 106 ME/CFS cases and 91 frequency-matched healthy controls. Results In ME/CFS cases, regression, Bayesian and enrichment analyses revealed evidence of peroxisomal dysfunction with decreased levels of plasmalogens. Other findings included decreased levels of several membrane lipids, including phosphatidylcholines and sphingomyelins, that may indicate dysregulation of the cytidine-5’-diphosphocholine pathway. Enrichment analyses revealed decreased levels of choline, ceramides and carnitines, and increased levels of long chain triglycerides (TG) and hydroxy-eicosapentaenoic acid. Elevated levels of dicarboxylic acids were consistent with abnormalities in the tricarboxylic acid cycle. Using machine learning algorithms with selected metabolites as predictors, we were able to differentiate female ME/CFS cases from female controls (highest AUC=0.794) and ME/CFS cases without self-reported irritable bowel syndrome (sr-IBS) from controls without sr-IBS (highest AUC=0.873). Conclusion Our findings are consistent with earlier ME/CFS work indicating compromised energy metabolism and redox imbalance, and highlight new abnormalities that may provide insights into the pathogenesis of ME/CFS., One Sentence Summary: Plasma levels of plasmalogens are decreased in patients with myalgic encephalomyelitis/chronic fatigue syndrome suggesting peroxisome dysfunction.

BACKGROUND: India, with the declaration of COVID-19 as a pandemic, started imposing restrictions in the country th and initiated a nationwide lockdown under Section 6 of the Disaster Management Act, 2005 on 24 March 2020, followed by four phases of lockdown and then gradual unlock of the country. The rationale behind the same was to avoid social contact. Alcohol dispensing was also stopped during this time and was among the rst services to be reopened by the States. We propose in this paper that this lifting of ban on alcohol sale during the pandemic has led to a signicant increase in the number of COVID-19 cases in the country. METHODS: This is a prospective, observational study, done by collecting data from the Aargya Setu App, which is a mobile application launched by the Ministry of Health and Family Welfare on 2 April 2020 for contact tracing and elf assessment of COVID-19. The data of cumulative number of cases in 12 selected states of the country were compared before and after the lift of ban of alcohol and signicance was shown by the paired t test. RESULTS: The number of COVID-19 positive cases in the country during nationwide lockdown with simultaneous ban on alcohol sale when compared to cumulative number of cases after the lift of ban of alcohol sale during Lockdown and initial Unlock is statistically signicant (p = 0.04) CONCLUSION: We found that the decision to restart the sale of Alcohol could have been a factor for rise in number of cases in the country in the given timeframe. The decision to start the sale has also not been in accordance with the Indian Constitution and against the nation's founding ethics.

Improvements in tumor immunotherapies depend on better understanding of the anti-tumor T cell response. By studying human tumor-draining lymph nodes (TDLNs), we found that activated CD8(+) T cells in TDLNs shared functional, transcriptional, and epigenetic traits with TCF1(+) stem-like cells in the tumor. The phenotype and TCR overlap suggested that these TDLN cells were precursors to tumor-resident stem-like CD8(+) T cells. Murine tumor models revealed that tumor-specific CD8(+) T cells were activated in TDLNs but lacked an effector phenotype. These stem-like cells migrated into the tumor, where additional co-stimulation from antigen-presenting cells drove effector differentiation. This model of CD8(+) T cell activation in response to cancer is different from that of canonical CD8(+) T cell activation to acute viruses, and it proposes two stages of tumor-specific CD8(+) T cell activation: initial activation in TDLNs and subsequent effector program acquisition within the tumor after additional co-stimulation.

Blue light cystoscopy is utilized to assist Urologists highlight potentially malignant -bladder lesions that might otherwise be undetected by standard cystoscopic techniques. There is a paucity of published studies in the literature regarding the histopathologic findings in this setting, especially regarding false positive lesions. A search was performed for patients who underwent blue light cystoscopy at our institution from 2017 to 2021. Clinicopathologic data was obtained. One hundred cases were included in the study. The mean patient age was 69 years (range: 33-97 years), with a male predominance (3.5:1). Of these cases, 69 were malignant lesions. Twenty-nine cases were high grade urothelial carcinoma (UCa), including 17/29 (58.6%) that were non-invasive, 7/29 (24.1%) invasive into lamina propria, and 5/29 (17.2%) invasive into muscularis propria (Detrusor muscle). Twenty-seven cases were non-invasive low grade UCa, 12 cases were urothelial carcinoma in situ, and 1 case was prostatic adenocarcinoma. Thirty-one cases were benign lesions, including 11/31 (35%) inflammation, 4/31 (13%) nephrogenic adenoma, 3/31 (10%) each: therapy related changes; cystitis cystica et glandularis; reactive changes/atypia, 2/31 (7%) foreign body reaction, 1/31 (3%) each: urothelial papilloma, urethral polyp, squamous metaplasia, focal atypia, and biopsy site changes. Although most cases were malignant, a significant number of benign entities (false positives) were also identified. Correlation between the histopathologic and blue light cystoscopy findings could play a critical role in further stratification and management of patients undergoing this procedure, including surveillance protocols.

Introduction:Bacillus Calmette-Guerin production is limited worldwide with stuttering shortages affecting patient access. Our institution received 50 vials of bacillus Calmette-Guerin label...

Background Pneumococcus is a diverse pathogen, with >90 serotypes, each of which has a distinct polysaccharide capsule. Pneumococci can switch capsules, evading vaccine pressure. Certain serotype pairs are more likely to occur on the same genetic background as a results of serotype switching, but the drivers of these patterns are not well understood. Methods We used the PubMLST and Global Pneumococcal Sequencing Project databases to quantify the number of genetic lineages on which different serotype pairs occur together. We also quantified the genetic diversity of each serotype. Regression model were used to evaluate the relationship between shared polysaccharide components and the frequency of serotype co-occurrence and diversity. Results A number of serotype pairs occurred together on the same genetic lineage more commonly than expected. Co-occurrence of between-serogroup pairs was more common when both serotypes had glucose as a component of the capsule (and, potentially, glucuronic acid, any-N-acetylated sugar, or ribitol). Diversity also varied markedly by serotype and was associated with the presence of specific sugars in the capsule. Conclusions Certain pairs of serotypes are more likely to co-occur on the same genetic background. These patterns were correlated with shared polysaccharide components. This might reflect adaptation of strains to produce capsules with specific characteristics.

Background Pneumococcus is exposed to a variety of temperature and oxygen levels in the upper respiratory tract and as it invades the lung, tissues, and blood. We sought to determine the effect of environmental variability on growth in vitro and to assess variability between strains. We evaluated the effect of temperature and oxygen on the growth of 256 isolates representing 53 serotypes, recovered from healthy carriers and disease patients. Strains were grown at a range of temperatures, anaerobically or in ambient air with catalase, and were monitored by reading the optical density. Regression models evaluated variation in the characteristics of the growth curves. Results Most isolates grew to the maximal density at low temperatures (~33C) and under aerobic conditions. There was considerable variability between strains, and some of this variability was linked to serotype. However, capsule-switch experiments suggest that the production of different capsules might not be sufficient to explain this variation, suggesting there could be interactions between the capsule and genetic background. Conclusions Pneumococcal strains vary in how they respond to environmental variations, some of this variation can be explained by the capsule type being produced, but capsule production itself is not sufficient to explain the variability. This variability could help to explain why different lineages of pneumococcus are more common in carriage or disease.

Objectives To develop a clinically applicable predictive model to quantitate the risk of estimated glomerular filtration rate (eGFR) decline to ≤45 mL/min/1.73 m2 after radical nephrectomy (RN) to better inform decisions between RN and partial nephrectomy (PN). Patients and methods Our prospectively maintained kidney cancer registry was reviewed for patients with a preoperative eGFR >60 mL/min/1.73 m2 who underwent RN for a localized renal mass. New baseline renal function was indexed. We used multivariable logistic regression to develop a predictive nomogram and evaluated it using receiver-operating characteristic (ROC) analysis. Decision-curve analysis was used to assess the net clinical benefit. Results A total of 668 patients met the inclusion criteria, of whom 183 (27%) experienced a decline in eGFR to ≤45 mL/min/1.73 m2 . On multivariable analysis, increasing age (P = 0.001), female gender (P ~11%. Conclusions The decision to perform RN vs PN is multifaceted. We have provided a simple quantitative tool to help identify patients at risk of a postoperative eGFR of ≤45 mL/min/1.73 m2 , who may be stronger candidates for nephron preservation.

Objective To perform a comprehensive histopathologic review of sporadic resected solitary cT1 renal masses comparing those with and without radiographic involvement of the hilum. Materials and Methods A prospectively maintained database was queried for all cT1 renal masses undergoing resection classified per the R.E.N.A.L. nephrometry score. Hilar masses were defined as tumors that abut the main renal artery or vein on cross-sectional imaging. Demographic, treatment, renal mass, and histopathologic characteristics were compared between hilar and nonhilar renal masses. Multivariate regression model analyses were performed to assess factors associated with renal mass upstaging and disease recurrence. Results A total of 1324 stage 1 renal masses met criteria for analysis of which 226 (17.1%) were defined as hilar. Hilar masses were larger, scored with higher complexity, and more likely to undergo a radical nephrectomy. On histopathologic analysis, we found no difference between hilar and nonhilar masses regarding the incidence of malignancy, presence of high nuclear grade, or risk of upstaging. On multivariate analysis, a tumor's hilar location was not associated with upstaging or disease recurrence. Conclusion We present a comprehensive histopathologic review of a large cohort of cT1 hilar lesions noting no difference in the risk of malignancy, high nuclear grade, upstaging, or recurrence when compared to nonhilar lesions. Together, these data suggest that there is no compelling cancer-specific rationale to perform a radical nephrectomy when managing renal hilar tumors.

5G technology has number of existing generations of wireless technologies in terms of their portal, efficiency, effectiveness, and cost-benefit analysis. The paper puts a focus on the evolution and development of various generations of mobile wireless technology along with their significance and advantages of one over the other. From past several decades, mobile wireless technologies have experience 4 or 5 generations of technology revolution and evolution, namely from 1G to 4G. The Current research in mobile wireless technology concentrates on promoting the implementation of LTE technology and 5G technology. At present, the term is not officially used. In 5G, the research on the development of World Wide Wireless internet access (WWW), Dynamic adhoc Wireless Networks (DAWN) and Real Wireless World. In this paper, we focusa new network architecture for the next-generation of mobile networks, 5G. In this architecture, the mobile device will have the ability to get to the Radio Access Technology - RAT based on certain user-defined criteria.

To compare operative outcomes between the dorsal lumbotomy (DL) and laparoscopic nephrectomy (LN) approaches for patients with end stage renal disease (ESRD) undergoing nephrectomy. DL operative technique is also described.We performed a retrospective review of all patients undergoing DL nephrectomy at Emory University from 2008-2020. Cases were matched with control patients with ESRD who had undergone LN. Parameters evaluated included operative time, estimated blood loss, length of stay, postoperative narcotic requirements, and complication rates. Statistical analysis performed with SPSS.43 DL patients and 86 LN patients were assessed. DL had shorter total OR time (173min vs 198min; P = 0.001) and surgery time (101min vs 135min; P0.001) compared to LN. There was a trend towards decreased mean length of stay among the DL group (2.65d vs 3.14d; P = 0.069) as well as daily narcotic requirement measured in oral morphine equivalents (54.8mg/day vs 73.6mg/day, P = 0.051). There were no differences in estimated blood loss, perioperative complication rates, ICU admissions, or 30-day readmissions. Limitations include retrospective design and small sample size.Among patients with ESRD, DL was found to be safe and effective compared to LN, with shorter operative times, a trend towards decreased length of stay and post-operative narcotic requirements, and similar perioperative complication rates. DL should be considered as an approach for nephrectomy in this patient population.

A twin-fluid atomizer configuration is simulated by means of the two-dimensional (2D) weakly compressible smoothed particle hydrodynamics (SPH) method and compared to experiments. The gas-to-liquid ratio (GLR), the momentum flux ratio, and the velocity ratio are set constant for different ambient pressures, which lead to different gaseous flow sections. The objectives of this study are (i) to investigate the effect of ambient pressure at constant global parameters and (ii) to verify the capability of 2D SPH to qualitatively predict the proper disintegration mechanism and to recover the correct evolution of the spray characteristics. The setup consists of an axial liquid jet of water fragmented by a coflowing high-speed air stream (Ug = 80 m/s) in a pressurized atmosphere up to 16 bar. The results are compared to the experiment and presented in terms of (i) mean velocity profiles, (ii) drop size distributions, and (iii) Sauter mean diameter (SMD) of the spray. It is found that there exists an optimal pressure to minimize the mean size of the spray droplets. Finally, two new quantities related to atomization are presented: (i) the breakup activity that quantifies the number of breakup events per time and volume unit and (ii) the fragmentation spectrum of the whole breakup chain, which characterize the cascade phenomenon in terms of probability. The breakup activity confirms the presence of the optimal pressure, and the fragmentation spectrum gives information on the type of breakup, depending on the ambient pressure.

Advanced bladder cancer is largely a lethal disease that has demonstrated little improvement in survival trends over the past 50 years. Five-year survival for advanced bladder cancer has remained at about 8% since 1973; though, as in most diseases, survival outcomes are not evenly distributed among different sociodemographic groups (1).

Inguinal lymphadenectomy remains under performed in patients with invasive penile cancer. Using a large national cancer registry we assessed temporal trends in inguinal lymphadenectomy performance and evaluated the impact of the procedure on survival in patients in whom inguinal lymphadenectomy was an absolute indication (T1b-4 N0/x-1) according to NCCNWe queried the National Cancer Database for all cases of nonmetastatic, T1b-4 N0/x-1 squamous cell carcinoma of the penis from 2004 to 2014. Multivariable logistic regression models adjusting for patient, demographic, and clinicopathological characteristics were used to examine the association between available covariates and receipt of inguinal lymphadenectomy. Cox proportional hazards regression analysis was then done to assess the impact of clinical and pathological variables on overall survival. Propensity score weighted analysis was performed to assess the effect of inguinal lymphadenectomy on overall survival.A total of 2,224 patients met analysis criteria, of whom 606 (27.2%) underwent inguinal lymphadenectomy. Following adjustment the procedure was more likely in younger patients, those who presented with palpable adenopathy (cN1), those treated at an academic facility and those with a more contemporary diagnosis. On survival analysis controlling for all known and measured confounders inguinal lymphadenectomy was associated with improved overall survival (HR 0.79, 95% CI 0.74-0.84, p0.001).At hospitals that report to the National Cancer Database the overall rate of inguinal lymphadenectomy in patients with invasive penile cancer was only 27.2%. Inguinal lymphadenectomy was associated with increased overall survival, justifying the procedure as an important quality metric for performance reporting in patients with invasive penile cancer.

Background: Statin use is widespread among the general population. Data suggest a potentially beneficial effect of statin therapy on renal function following surgery. The impact of statins on post-partial nephrectomy (PN) renal function is unknown. We hypothesized that perioperative statin use may be associated with reduced rates of acute kidney injury (AKI) in patients undergoing PN. Objectives: To evaluate the effect of perioperative statin use on AKI rates in patients undergoing PN. Materials & Methods: 1,056 patients undergoing PN were identified from a prospectively-maintained institutional renal mass database. Exclusion criteria included lack of preoperative serum creatinine (Cr), concurrent surgeries, and those with baseline Cr

A Correction to this paper has been published: https://doi.org/10.1038/s42003-021-01866-z

This paper addresses the problem of computational and hardware complexity in higher order constellation Multiple Input Multiple Output (MIMO) detectors. A novel Segregated K-Best detection (SKD) algorithm is proposed to serve as low complexity near optimal detector for MIMO receivers. The algorithm reduces detection complexity by choosing an optimal value of K depending upon the layer of traversal. This allows lesser number of nodes to be traversed leading to reduced complexity with only slight degradation in error rate performance. Hardware Descriptive Language (HDL) implementation of SKD is performed using ‘one symbol detection per cycle architecture’ and a compatible ‘sequential linear sort’ algorithm is proposed for sorting in SKD. The proposed design achieves a throughput as high as 802 Mbps with latency of 19.83 ns.

Anatomic tumor complexity can be objectively measured and reported using nephrometry. Various scoring systems have been developed in an attempt to correlate tumor complexity with intraoperative and postoperative outcomes. Nephrometry may also predict tumor biology in a noninvasive, reproducible manner. Other scoring systems can help predict surgical complexity and the likelihood of complications, independent of tumor characteristics. The accumulated data in this new field provide provocative evidence that objectifying anatomic complexity can consolidate reporting mechanisms and improve metrics of comparisons. Further prospective validation is needed to understand the full descriptive and predictive ability of the various nephrometry scores.

The efficacy of partial nephrectomy (PN) in setting of pT3a pathologic-upstaged renal cell carcinoma (RCC) is controversial. We compared oncologic and functional outcomes of radical nephrectomy (RN) and PN in patients with upstaged pT3a RCC.This was a multicenter retrospective analysis of patients with cT1-2N0M0 RCC upstaged to pT3a postoperatively. The primary outcome was recurrence-free survival, with secondary outcomes of overall survival and de novo estimated glomular filtration rate (eGFR) 60. Multivariable analysis was performed to identify predictive factors for oncologic outcomes. Kaplan-Meier analyses (KMA) were obtained to elucidate survival outcomes.A total of 929 patients had pT3a upstaging (686 [72.6%] RN; 243 [25.7%] PN; mean follow-up, 48 months). Tumor size was similar (RN 7.7 cm vs. PN 7.3 cm; P = .083). PN had decreased ΔeGFR (6.1 vs. RN 19.4 mL/min/1.73mIn pathologically upstaged pT3a RCC, PN did not adversely affect risk of recurrence and provided functional benefit. Surgical decision-making in patients at risk for T3a upstaging should be individualized and driven by tumor as well as functional risks.

Salvage radical prostatectomy has historically yielded a poor functional outcome and a high complication rate. However, recent reports of robotic salvage radical prostatectomy have demonstrated improved results. In this study we assessed salvage radical prostatectomy functional outcomes and complications when comparing robotic and open approaches.We retrospectively collected data on salvage radical prostatectomy for recurrent prostate cancer after local nonsurgical treatment at 18 tertiary referral centers from 2000 to 2016. The Clavien-Dindo classification was applied to classify complications. Complications and functional outcomes were evaluated by univariable and multivariable analysis.We included 395 salvage radical prostatectomies, of which 186 were open and 209 were robotic. Robotic salvage radical prostatectomy yielded lower blood loss and a shorter hospital stay (each p0.0001). No significant difference emerged in the incidence of major and overall complications (10.1%, p=0.16, and 34.9%, p=0.67), including an overall low risk of rectal injury and fistula (1.58% and 2.02%, respectively). However, anastomotic stricture was more frequent for open salvage radical prostatectomy (16.57% vs 7.66%, p0.01). Overall 24.6% of patients had had severe incontinence, defined as 3 or more pads per day, for 12 or 6 months. On multivariable analysis robotic salvage radical prostatectomy was an independent predictor of continence preservation (OR 0.411, 95% CI 0.232-0.727, p=0.022). Limitations include the retrospective nature of the study and the absence of a standardized surgical technique.In this contemporary series to our knowledge salvage radical prostatectomy showed a low risk of major complications and better functional outcomes than previously reported. Robotic salvage radical prostatectomy may reduce anastomotic stricture, blood loss and hospital stay, and improve continence outcomes.

INTRODUCTION AND OBJECTIVES:Impact of positive margins in partial nephrectomy (PN) is controversial. Conflicting data suggest varying conclusions regarding outcomes and survival. We sought to chara...

INTRODUCTION AND OBJECTIVES:Level 1 evidence shows that mTOR inhibition is associated with clinically significant reductions in tumor size in angiomyolipomas (AMLs) associated with Tuberous Scleros...

INTRODUCTION AND OBJECTIVES:Criteria for staging of T1 renal tumors into T1a (≤4cm) and T1b (4cm< and ≤7cm) have remained unchanged since 1997. Advancements in tumor biology have led to great understanding of the heterogeneous potential of T1 renal tumors. We hypothesized that a three-tier classification may more rationally risk stratify T1 renal masses than the current T1a/T1b system.METHODS:Multicenter (UCSD, Emory, Fox Chase Cancer Center, Ospadele San Raffaele) retrospective analysis of patients with cT1 renal cell carcinoma (RCC) undergoing partial or radical nephrectomy. Patients were stratified by tumor size into three groups cT1a (≤2cm, very low risk), cT1b (2cm< and ≤5cm, low risk), and cT1c (5cm< and ≤7cm, intermediate risk). Primary outcome was recurrence-free survival (RFS). Secondary outcome was overall survival (OS). Multivariable Cox Regression analysis (MVA) and Kaplan-Meier analyses (KMA) were utilized for outcomes.RESULTS:4710 patients were stratified into proposed T1 groups (T1a=856, T1...

INTRODUCTION AND OBJECTIVES:Salvage radical prostatectomy (sRP) has been associated with high complication rates and poor functional outcomes in the past, while latest sRP series have shown a subst...

INTRODUCTION AND OBJECTIVES:A curative option in men with biochemical recurrence (BCR) after primary treatment is represented by salvage radical prostatectomy (sRP). To enhance cancer control and b...

Despite improvements in medical management of advanced prostate cancer (aPC), it continues to be a leading cause of cancer death in men. Contemporary management of men with aPC is complex and requires resources to be more readily available at high-volume facilities.To determine the relationship between facility volume and survival in men with aPC.The National Cancer Database (NCDB) was queried from 2004 to 2013 for aPC, defined as T4, N+, or M+ disease, identifying 64815 patients. Six predefined patient cohorts were evaluated. Cohort "A" included all patients with aPC. "B" cohorts included only M0 patients. "C" cohorts included only M1 patients. Facilities were divided into quartiles based on median treatment volume (patients/yr).Diagnosis and management of aPC at an NCDB-reporting facility.Overall survival (OS) was assessed as a function of facility volume. Multivariable Cox regression models were fitted. Cox regressions using natural cubic splines were used to test for nonlinear relationships between volume and OS.OS improved as facility volume increased (top quartile vs bottom quartile, hazard ratio 0.82, 95% confidence interval 0.77-0.88, p0.001) and was consistent across patient cohorts. Spline models demonstrate a continuous decrease in hazard of death as volume increases. Limitations include the retrospective analysis and a lack of precise treatment information.In this retrospective analysis of nearly 65000 men who presented with aPC, we demonstrate an association between higher facility volume and improvements in OS. This OS advantage persisted with similar magnitudes of effect after narrowing the cohorts by disease and treatment characteristics.In this retrospective review of the National Cancer Database, we analyzed the association between treatment facility volume and survival in men who are diagnosed with advanced prostate cancer. We found that survival improved as volume increased, indicating a possible imbalance of resources and expertise that favors higher-volume facilities.

Sleep is a critical process that is well-conserved across mammalian species, and perhaps most animals, yet its functions and underlying mechanisms remain poorly understood. Identification of genes and pathways that can influence sleep may shed new light on these functions. Genomic screens enable the detection of previously unsuspected molecular processes that influence sleep. In this study, we report results from a large-scale phenotyping study of sleep-wake parameters for a population of single-gene knockout mice. Sleep-wake parameters were measured using a high throughput, non-invasive piezoelectric system called PiezoSleep. Knockout mice generated on a C57BL6/N (B6N) background were monitored for sleep and wake parameters for five days. By analyzing data from over 6000 mice representing 343 single gene knockout lines, we identified 122 genes influencing traits like sleep duration and bout length that have not been previously implicated in sleep, including those that affect sleep only during a specific circadian phase. PiezoSleep also allows assessment of breath rates during sleep and this was integrated as a supplemental tool in identifying aberrant physiology in these knockout lines. Sex differences were evident in both normal and altered sleep behavior. Through a combination of genetic and phenotypic associations, and known QTLs for sleep, we propose a set of candidate genes playing specific roles in sleep. The high “hit rate” demonstrates that many genes can alter normal sleep behaviors through a variety of mechanisms. Further investigation of these genes may provide insight into the pathways regulating sleep, functional aspects of sleep, or indirect potentially pathological processes that alter normal sleep.

A twin-fluid atomizer configuration is simulated by means of the 2D weakly-compressible Smooth Particle Hydrodynamics method, and compared to experiments. The Gas-to-Liquid-Ratio, the momentum flux ratio and the velocity ratio are set constant for different ambient pressures, which leads to different gaseous flow sections. The objectives of this study are to (i) investigate the effect of ambient pressure at constant global parameters, and (ii) to verify the capability of 2D SPH to qualitatively predict the proper disintegration mechanism and to recover the correct evolution of the spray characteristics. The setup consists of an axial liquid jet of water fragmented by a co-flowing high-speed air stream (Ug = 80 m/s) in a pressurized atmosphere up to 16 bar. The results are compared to the experiment, and presented in terms of (i) mean velocity profiles, (ii) drop size distributions and (iii) Sauter Mean Diameter of the spray. It is found that there exists an optimal pressure to minimize the mean size of the spray droplets. Finally, two new quantities related to atomization are presented: (i) the breakup activity that quantifies the number of breakup events per time and volume unit and (ii) the fragmentation spectrum of the whole breakup chain, which characterizes the cascade phenomenon in terms of probability. The breakup activity confirms the presence of the optimal pressure and the fragmentation spectrum gives information on the type of breakup, depending on the ambient pressure.