Exploiting electronic health records for research on atrial fibrillation: risk factors, subtypes, and outcomes

BACKGROUND: Electronic health records (EHRs), collected on large populations in routine clinical care, may hold novel insights into the heart rhythm disorder atrial fibrillation (AF). AIM: To exploit EHRs to investigate, validate and extend evidence for AF risk factors, subtypes, and outcomes. METHODS: The CALIBER dataset (1997–2010) linking primary care, secondary care, and mortality records for a representative subset of the UK population was used (i) to model associations between cardiovascular disease (CVD) risk factors and incident AF, including AF with (AF+) and AF without (AF–) intercurrent CVD, (ii) to create EHR definitions for eight AF subtypes (structural, focal, polygenic, postoperative, valvular, monogenic, respiratory and AF in athletes) and (iii) to investigate stroke outcomes by CHA2DS2-VASc, sex, and warfarin use. RESULTS: Among 1,949,052 individuals, 50,097 developed incident AF: 12,652 (25.3%) with AF+ and 37,445 (74.7%) with AF–. Smoking (HR [95%CI] for AF+ vs. AF–: 1.66 [1.56,1.77] vs. 1.21 [1.16,1.25]), hypertension (2.19 [2.11,2.27] vs. 1.65 [1.62,1.69]), and diabetes (2.03 [1.94,2.12] vs. 1.45 [1.41,1.49]) showed consistent direct associations with AF+ and AF–, while heavy drinking (1.17 [0.81,1.67] vs. 1.99 [1.68,2.34]) and total cholesterol levels (0.99 [0.96,1.02] vs. 0.85 [0.84,0.87]) showed inconsistent associations with AF+ and AF–. EHR definitions for AF subtypes were created by combining 2813 diagnosis, medication, and procedure codes. There were 12,751 individuals with AF and valvular heart disease. Prosthetic replacements, mitral stenosis and aortic stenosis showed higher HR [95%CI] for stroke, thromboembolism and mortality (1.13 [1.02,1.24], 1.20 [1.05,1.36], and 1.27 [1.19,1.37] respectively). The net-clinical benefit (NCB [95%CI] per 100 person-years) of warfarin was shown from CHA2DS2-VASc≥2 in men (0.5 [0.1,0.9]) and CHA2DS2-VASc≥3 in women (1.5 [1.1,1.9]). CONCLUSION: AF is a heterogeneous condition associated with diverse disease mechanisms. EHRs can help refine understanding of risk factors, subtypes, and outcomes with relevance for clinical practice

PROFITABILITY OF GEOGRAPHIC DIVERSIFICATION STRATEGY

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Oxidation and reduction rates for organic carbon in the Amazon mainstream tributary and floodplain, inferred from distributions of dissolved gases

Concentrations of CO2, O2, CH4, and N2O in the Amazon River system reflect an oxidation-reduction sequence in combination with physical mixing between the floodplain and the mainstem. Concentrations of CO2 ranged from 150 microM in the Amazon mainstem to 200 to 300 microM in aerobic waters of the floodplain, and up to 1000 microM in oxygen-depleted environments. Apparent oxygen utilization (AOU) ranged from 80 to 250 microM. Methane was highly supersaturated, with concentrations ranging from 0.06 microM in the mainstem to 100 microM on the floodplain. Concentrations of N2O were slightly supersaturated in the mainstem, but were undersaturated on the floodplain. Fluxes calculated from these concentrations indicated decomposition of 1600 g C sq m y(-1) of organic carbon in Amazon floodplain waters. Analysis of relationships between CH4, O2, and CO2 concentrations indicated that approximately 50 percent of carbon mineralization on the floodplain is anaerobic, with 20 percent lost to the atmoshphere as CH4. The predominance of anaerobic metabolism leads to consumption of N2O on the flood plane. Elevated concentrations of CH4 in the mainstem probably reflect imput from the floodplain, while high levels of CO2 in the mainstem are derived from a combination of varzea drainage and in situ respiration

Function and regulation of kinesin-1, -2 and -3

In this work the functions of the microtubule motors kinesin-1, -2 and -3 have been analysed in various settings. The reconstitution of microtubule-dependent motor activity in vitro has been primarily used to dissect the contributions of individual motors to cargo motility in two specific scenarios. Initially the regulation of kinesin-1 in a cell cycle-dependent manner has been examined by studying the ability of rat liver endoplasmic reticulum (ER) tubules to move in cytosols prepared from Xenopus laevis egg extracts arrested in interphase, meiosis or mitosis. It was found that kinesin-1-driven ER motility is significantly disrupted during metaphase in vitro. This is likely due to the recruitment or loss of binding partners which has a concomitant influence upon kinesin-1 activity. This work presents the first evidence that kinesin-1-driven ER movement, and not simply network morphology, varies during cell division. Furthermore, it is postulated that the replication of such regulation of kinesin-1 activity in vivo may contribute to the well documented changes in organelle positioning and cargo transit through membrane trafficking pathways which occur during cell division.The fungal metabolite brefeldin A (BFA) induces tubulation of several compartments located within the secretory and endocytic pathways in a microtubule-dependent fashion. The identity of the motor(s) responsible for this motility remains unconfirmed and controversial since several reports with conflicting data have been published. The contributions of kinesin-1, -2 and -3 to these processes have been investigated using in vitro motility assays in which rat liver Golgi membranes were combined with Xenopus laevis egg extract cytosol in the presence of BFA. Function blocking antibodies and dominant negative proteins were used to perturb the activities of various kinesin motors. This data indicates a particular isoform of kinesin-3, KIF1C, is solely responsible for the movement of BFA-induced tubules in vitro. This work was complemented by in vivo immunofluorescence studies using the HeLaM cultured cell line. Transient transfections of dominant negative proteins, or siRNA-mediated depletion, were used to disrupt the activities of various kinesin motors, either in isolation or in combination with each other. This approach revealed a contribution of KIF1C and kinesin-1 to the movement of early endosomal BFA-induced tubules in vivo.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Memory effects and L\'evy walk dynamics in intracellular transport of cargoes

We demonstrate the phenomenon of cumulative inertia in intracellular transport involving multiple motor proteins in human epithelial cells by measuring the empirical survival probability of cargoes on the microtubule and their detachment rates. We found the longer a cargo moves along a microtubule, the less likely it detaches from it. As a result, the movement of cargoes is non-Markovian and involves a memory. We observe memory effects on the scale of up to 2 seconds. We provide a theoretical link between the measured detachment rate and the super-diffusive Levy walk-like cargo movement.Comment: 9 pages, 6 figure

Variable-order fractional master equation and clustering of particles: non-uniform lysosome distribution

In this paper, we formulate the space-dependent variable-order fractional master equation to model clustering of particles, organelles, inside living cells. We find its solution in the long time limit describing non-uniform distribution due to a space dependent fractional exponent. In the continuous space limit, the solution of this fractional master equation is found to be exactly the same as the space-dependent variable-order fractional diffusion equation. In addition, we show that the clustering of lysosomes, an essential organelle for healthy functioning of mammalian cells, exhibit space-dependent fractional exponents. Furthermore, we demonstrate that the non-uniform distribution of lysosomes in living cells is accurately described by the asymptotic solution of the space-dependent variable-order fractional master equation. Finally, Monte Carlo simulations of the fractional master equation validate our analytical solution.Comment: arXiv admin note: text overlap with arXiv:1902.0308

A human infertility-associated KASH5 variant promotes mitochondrial localization

KASH5 is the most recently identified member of the KASH domain family of tail anchored, outer nuclear membrane (ONM) and endoplasmic reticulum (ER) proteins. During meiosis prophase I, KASH5 and SUN1 form a complex that spans the nuclear envelope and which links the telomeres of meiotic chromosomes to cytoplasmic dynein. This connection is essential for homologous chromosome dynamics and pairing. A recent study identified a variant in human KASH5 (L535Q) that correlated with male infertility associated with azoospermia. However, no molecular mechanism was described. Here, we report that this amino acid substitution, within the KASH5 transmembrane domain (TMD) has no predicted effects on secondary structure. However, the overall hydrophobicity of the L535Q TMD, is calculated to be lower than the wild-type KASH5, based on the GES (Goldman–Engelman–Steitz) amino acid hydrophobicity scale. This change in hydrophobicity profoundly affects the subcellular localization of KASH5. Through a series of amino acid substitution studies, we show that the L535Q substitution perturbs KASH5 localization to the ER and ONM and instead results in mistargeting to the mitochondria membrane. We suggest that this mislocalization accounts for the infertility and azoospermia phenotype in patients.Other Information Published in: Scientific Reports License: https://creativecommons.org/licenses/by/4.0See article on publisher's website: http://dx.doi.org/10.1038/s41598-021-89439-2</p

T Cell Receptor Engagement Leads to Phosphorylation of Clathrin Heavy Chain during Receptor Internalization

T cell receptor (TCR) internalization by clathrin-coated vesicles after encounter with antigen has been implicated in the regulation of T cell responses. We demonstrate that TCR internalization after receptor engagement and TCR signaling involves inducible phosphorylation of clathrin heavy chain (CHC) in both CD4+ and CD8+ human T cells. Studies with mutant Jurkat T cells implicate the Src family kinase Lck as the responsible enzyme and its activity in this process is influenced by the functional integrity of the downstream signaling molecule ZAP-70. CHC phosphorylation positively correlates with ligand-induced TCR internalization in both CD4+ and CD8+ T cells, and CHC phosphorylation as a result of basal Lck activity is also implicated in constitutive TCR endocytosis by CD4+ T cells. Remarkably, irreversible CHC phosphorylation in the presence of pervanadate reduced both constitutive and ligand-induced TCR internalization in CD4+ T cells, and immunofluorescence studies revealed that this inhibition affected the early stages of TCR endocytosis from the plasma membrane. Thus, we propose that CHC phosphorylation and dephosphorylation are involved in TCR internalization and that this is a regulatory mechanism linking TCR signaling to endocytosis

Identification of bacteria on the surface of clinically infected and non-infected prosthetic hip joints removed during revision arthroplasties by 16S rRNA gene sequencing and by microbiological culture

It has been postulated that bacteria attached to the surface of prosthetic hip joints can cause localised inflammation, resulting in failure of the replacement joint. However, diagnosis of infection is difficult with traditional microbiological culture methods, and evidence exists that highly fastidious or non-cultivable organisms have a role in implant infections. The purpose of this study was to use culture and culture-independent methods to detect the bacteria present on the surface of prosthetic hip joints removed during revision arthroplasties. Ten consecutive revisions were performed by two surgeons, which were all clinically and radiologically loose. Five of the hip replacement revision surgeries were performed because of clinical infections and five because of aseptic loosening. Preoperative and perioperative specimens were obtained from each patient and subjected to routine microbiological culture. The prostheses removed from each patient were subjected to mild ultrasonication to dislodge adherent bacteria, followed by aerobic and anaerobic microbiological culture. Bacterial DNA was extracted from each sonicate and the 16S rRNA gene was amplified with the universal primer pair 27f/1387r. All 10 specimens were positive for the presence of bacteria by both culture and PCR. PCR products were then cloned, organised into groups by RFLP analysis and one clone from each group was sequenced. Bacteria were identified by comparison of the 16S rRNA gene sequences obtained with those deposited in public access sequence databases. A total of 512 clones were analysed by RFLP analysis, of which 118 were sequenced. Culture methods identified species from the genera Leifsonia (54.3%), Staphylococcus (21.7%), Proteus (8.7%), Brevundimonas (6.5%), Salibacillus (4.3%), Methylobacterium (2.2%) and Zimmermannella (2.2%). Molecular detection methods identified a more diverse microflora. The predominant genus detected was Lysobacter, representing 312 (60.9%) of 512 clones analysed. In all, 28 phylotypes were identified: Lysobacter enzymogenes was the most abundant phylotype (31.4%), followed by Lysobacter sp. C3 (28.3%), gamma proteobacterium N4-7 (6.6%), Methylobacterium SM4 (4.7%) and Staphylococcus epidermidis (4.7%); 36 clones (7.0%) represented uncultivable phylotypes. We conclude that a diverse range of bacterial species are found within biofilms on the surface of clinically infected and non-infected prosthetic hip joints removed during revision arthroplasties