Simulation of aerosol transmission on a Boeing 737 airplane with intervention measures for COVID-19 mitigation.

Identifying economically viable intervention measures to reduce COVID-19 transmission on aircraft is of critical importance especially as new SARS-CoV2 variants emerge. Computational fluid-particle dynamic simulations are employed to investigate aerosol transmission and intervention measures on a Boeing 737 cabin zone. The present study compares aerosol transmission in three models: (a) a model at full passenger capacity (60 passengers), (b) a model at reduced capacity (40 passengers), and (c) a model at full capacity with sneeze guards/shields between passengers. Lagrangian simulations are used to model aerosol transport using particle sizes in the 1-50 µm range, which spans aerosols emitted during breathing, speech, and coughing. Sneeze shields placed between passengers redirect the local air flow and transfer part of the lateral momentum of the air to longitudinal momentum. This mechanism is exploited to direct more particles to the back of the seats in front of the index patient (aerosol source) and reduce lateral transfer of aerosol particles to other passengers. It is demonstrated that using sneeze shields on full capacity flights can reduce aerosol transmission to levels below that of reduced capacity flights without sneeze shields.

A comparison of CFPD, compartment, and uniform distribution models for radiation dosimetry of radionuclides in the lung.

Radioactive aerosols that arise from natural sources and nuclear accidents can be a long-term hazard to human health. Despite the heterogeneous particle deposition in the respiratory tract, uniform aerosol doses have long been assumed in respiratory radiation dosimetry predictions, such as in the compartment and uniform distribution models. It is unclear how these deposition patterns affect internal radiation doses, which are critical in the health assessment of radioactive hazards. This work seeks to quantify the radio-dosimetry sensitivity to initial deposition patterns by comparing computational and compartment/uniform models. A new approach was developed to implement the compartment model into voxel phantoms (e.g. VIP-man) for radiation dosimetry. The calculated radiation fluence, energy deposition density and organ doses were compared to those obtained from coupling computational fluid-particle dynamics (CFPD) with Monte Carlo radiation transport and to those obtained from uniform source distribution approximation. The results show that the source particle distribution within the respiratory system substantially influences the radiation dosimetry distribution. The compartment and uniform models underestimated aerosol deposition in the crania ridge, leading to lower doses in the trachea and surrounding organs. For 0.5 MeV gammas, the CFPD-Monte Carlo N-particle (MCNP) model predicted a tracheal dose twice that of the compartment model and four times the uniform model. For 1 MeV betas, the CFPD-MCNP-predicted tracheal dose is 2.6 times that of the compartment model and 14 times the uniform model. Compared to the compartment/uniform models, the CFPD approach predicted a 50% lower beta dose in the lung but higher beta doses in the heart (six times), liver (four times) and stomach (2.5 times). It is suggested that including compartments for the lung periphery and tracheal carina ridge may improve the dosimetry accuracy of compartment models.

Numerical investigation of aerosol transport in a classroom with relevance to COVID-19.

The present study investigates aerosol transport and surface deposition in a realistic classroom environment using computational fluid-particle dynamics simulations. Effects of particle size, aerosol source location, glass barriers, and windows are explored. While aerosol transport in air exhibits some stochasticity, it is found that a significant fraction (24%-50%) of particles smaller than 15 µm exit the system within 15 min through the air conditioning system. Particles larger than 20 µm almost entirely deposit on the ground, desks, and nearby surfaces in the room. Source location strongly influences the trajectory and deposition distribution of the exhaled aerosol particles and affects the effectiveness of mitigation measures such as glass barriers. Glass barriers are found to reduce the aerosol transmission of 1 µm particles from the source individual to others separated by at least 2.4 m by ∼92%. By opening windows, the particle exit fraction can be increased by ∼38% compared to the case with closed windows and reduces aerosol deposition on people in the room. On average, ∼69% of 1 µm particles exit the system when the windows are open.

Real-Time Resting-State Functional Magnetic Resonance Imaging Using Averaged Sliding Windows with Partial Correlations and Regression of Confounding Signals.

Background/Introduction: There is considerable interest in using real-time functional magnetic resonance imaging (fMRI) for monitoring functional connectivity dynamics. To date, the majority of real-time resting-state fMRI studies have examined a limited number of brain regions. This is, in part, due to the computational demands of traditional seed- and independent component analysis-based methods, in particular when using increasingly available high-speed fMRI methods. Methods: This study describes a computationally efficient, real-time, seed-based, resting-state fMRI analysis pipeline using moving averaged sliding-windows (ASW) with partial correlations and regression of motion parameters and signals from white matter and cerebrospinal fluid. Results: Analytical and numerical analyses of ASW correlation and sliding-window regression as a function of window width show selectable bandpass filter characteristics and effective suppression of artifactual correlations resulting from signal drifts and transients. The analysis pipeline is compatible with multislab echo-volumar imaging and simultaneous multislice echo-planar imaging with repetition times as short as 136 msec. High-speed, resting-state fMRI data in healthy controls demonstrate the effectiveness of this approach for minimizing artifactual correlations in white and gray matter, which was comparable to conventional regression across the entire scan. Integrating sliding-window averaging (width: W1) within a second-level sliding-window (width: W2) enabled monitoring of intra- and internetwork correlation dynamics of up to 12 resting-state networks with bandpass filter characteristics determined by the first-level sliding-window and temporal resolution W1 + W2. Conclusions: The computational performance and confound tolerance make this seed-based, resting-state fMRI approach suitable for real-time monitoring of data quality and resting-state connectivity dynamics in neuroscience and clinical research studies. Impact statement Using averaged sliding-windows for seed-based correlation and regression of confounding signals provides a powerful model-free approach to increase tolerance to artifactual signal transients in resting-state analysis. The algorithmic efficiency of this sliding-window approach enables real-time, seed-based, resting-state functional magnetic resonance imaging (fMRI) of multiple networks with computation of connectivity matrices and online monitoring of data quality. Integration of a second-level sliding-window enables mapping of resting-state connectivity dynamics. Sensitivity and tolerance to confounding signals compare favorably with conventional correlation and confound regression across the entire scan. This methodological advance has the potential to enhance the clinical utility of resting-state fMRI and facilitate neuroscience applications.

Radiation Dosimetry of Inhaled Radioactive Aerosols: CFPD and MCNP Transport Simulations of Radionuclides in the Lung.

Despite extensive efforts in studying radioactive aerosols, including the transmission of radionuclides in different chemical matrices throughout the body, the internal organ-specific radiation dose due to inhaled radioactive aerosols has largely relied on experimental deposition data and simplified human phantoms. Computational fluid-particle dynamics (CFPD) has proven to be a reliable tool in characterizing aerosol transport in the upper airways, while Monte Carlo based radiation codes allow accurate simulation of radiation transport. The objective of this study is to numerically assess the radiation dosimetry due to particles decaying in the respiratory tract from environmental radioactive exposures by coupling CFPD with Monte Carlo N-Particle code, version 6 (MCNP6). A physiologically realistic mouth-lung model extending to the bifurcation generation G9 was used to simulate airflow and particle transport within the respiratory tract. Polydisperse aerosols with different distributions were considered, and deposition distribution of the inhaled aerosols on the internal airway walls was quantified. The deposition mapping of radioactive aerosols was then registered to the respiratory tract of an image-based whole-body adult male model (VIP-Man) to simulate radiation transport and energy deposition. Computer codes were developed for geometry visualization, spatial normalization, and source card definition in MCNP6. Spatial distributions of internal radiation dosimetry were compared for different radionuclides (131I, 134,137Cs, 90Sr-90Y, 103Ru and 239,240Pu) in terms of the radiation fluence, energy deposition density, and dose per decay.

Airflow and Particle Deposition in Acinar Models with Interalveolar Septal Walls and Different Alveolar Numbers.

Unique features exist in acinar units such as multiple alveoli, interalveolar septal walls, and pores of Kohn. However, the effects of such features on airflow and particle deposition remain not well quantified due to their structural complexity. This study aims to numerically investigate particle dynamics in acinar models with interalveolar septal walls and pores of Kohn. A simplified 4-alveoli model with well-defined geometries and a physiologically realistic 45-alveoli model was developed. A well-validated Lagrangian tracking model was used to simulate particle trajectories in the acinar models with rhythmically expanding and contracting wall motions. Both spatial and temporal dosimetries in the acinar models were analyzed. Results show that collateral ventilation exists among alveoli due to pressure imbalance. The size of interalveolar septal aperture significantly alters the spatial deposition pattern, while it has an insignificant effect on the total deposition rate. Surprisingly, the deposition rate in the 45-alveoli model is lower than that in the 4-alveoli model, indicating a stronger particle dispersion in more complex models. The gravity orientation angle has a decreasing effect on acinar deposition rates with an increasing number of alveoli retained in the model; such an effect is nearly negligible in the 45-alveoli model. Breath-holding increased particle deposition in the acinar region, which was most significant in the alveoli proximal to the duct. Increasing inhalation depth only slightly increases the fraction of deposited particles over particles entering the alveolar model but has a large influence on dispensing particles to the peripheral alveoli. Results of this study indicate that an empirical correlation for acinar deposition can be developed based on alveolar models with reduced complexity; however, what level of geometry complexity would be sufficient is yet to be determined.

Numerical study of dynamic glottis and tidal breathing on respiratory sounds in a human upper airway model.

BACKGROUND: Human snores are caused by vibrating anatomical structures in the upper airway. The glottis is a highly variable structure and a critical organ regulating inhaled flows. However, the effects of the glottis motion on airflow and breathing sound are not well understood, while static glottises have been implemented in most previous in silico studies. The objective of this study is to develop a computational acoustic model of human airways with a dynamic glottis and quantify the effects of glottis motion and tidal breathing on airflow and sound generation. METHODS: Large eddy simulation and FW-H models were adopted to compute airflows and respiratory sounds in an image-based mouth-lung model. User-defined functions were developed that governed the glottis kinematics. Varying breathing scenarios (static vs. dynamic glottis; constant vs. sinusoidal inhalations) were simulated to understand the effects of glottis motion and inhalation pattern on sound generation. Pressure distributions were measured in airway casts with different glottal openings for model validation purpose. RESULTS: Significant flow fluctuations were predicted in the upper airways at peak inhalation rates or during glottal constriction. The inhalation speed through the glottis was the predominating factor in the sound generation while the transient effects were less important. For all frequencies considered (20-2500 Hz), the static glottis substantially underestimated the intensity of the generated sounds, which was most pronounced in the range of 100-500 Hz. Adopting an equivalent steady flow rather than a tidal breathing further underestimated the sound intensity. An increase of 25 dB in average was observed for the life condition (sine-dynamic) compared to the idealized condition (constant-rigid) for the broadband frequencies, with the largest increase of approximately 40 dB at the frequency around 250 Hz. CONCLUSION: Results show that a severely narrowing glottis during inhalation, as well as flow fluctuations in the downstream trachea, can generate audible sound levels.

Forward osmosis process for dialysis fluid regeneration.

In a preliminary experiment, 38% of the spent dialysis fluid water was reclaimed by a forward osmosis process through a cellulose triacetate membrane. The simplicity of forward osmosis and its minimal external energy requirements may allow the construction of a small bulk device that can reclaim a considerable portion of the water used in the patient's dialysis process. For developing an acceptable ambulatory dialysis system, decreasing the bulk of the fluid and equipment carried on the patient is essential. Forward osmosis may feasibly be used for dialysis fluid regeneration in ambulatory dialysis systems.

The effect of mild hyperuricemia on urinary transforming growth factor beta and the progression of chronic kidney disease.

Although mild hyperuricemia is common in patients with renal disease, it has usually been considered a marker of reduced nephron mass rather than a risk factor for progression of kidney disease. On the other hand, experiments in a rat model demonstrated important deleterious effects of mild hyperuricemia on several aspects of renal structure and function. In the present investigation, the impact of the discontinuation of allopurinol therapy on the control of hypertension and the rate of progression of chronic kidney disease was considered. The present work involved 50 patients, suffering from stage 3 and 4 chronic kidney disease. All of them were on chronic allopurinol therapy for the treatment of mild hyperuricemia. Their blood pressure, serum creatinine and uric acid levels were followed for 12 months following allopurinol withdrawal. Urinary transforming growth factor beta-1 (TGF-beta1) was assayed by a solid-phase enzyme-linked immunosorbent assay. After allopurinol withdrawal, significant worsening of hypertension, significant acceleration of the rate of loss of kidney function and a significant increase in the urinary excretion of TGF-beta1 were observed in the group of patients who were not receiving pharmacological blockers of the renin-angiotensin system. In conclusion, asymptomatic hyperuricemia has a deleterious effect on the progression of chronic kidney disease and the control of hypertension. This effect was blocked by treatment with renin-angiotensin system blockers.