612 research outputs found
Statistics of Earthquakes in Simple Models of Heterogeneous Faults
Simple models for ruptures along a heterogeneous earthquake fault zone are
studied, focussing on the interplay between the roles of disorder and dynamical
effects. A class of models are found to operate naturally at a critical point
whose properties yield power law scaling of earthquake statistics. Various
dynamical effects can change the behavior to a distribution of small events
combined with characteristic system size events. The studies employ various
analytic methods as well as simulations.Comment: 4 pages, RevTex, 3 figures (eps-files), uses eps
Gutenberg Richter and Characteristic Earthquake Behavior in Simple Mean-Field Models of Heterogeneous Faults
The statistics of earthquakes in a heterogeneous fault zone is studied
analytically and numerically in the mean field version of a model for a
segmented fault system in a three-dimensional elastic solid. The studies focus
on the interplay between the roles of disorder, dynamical effects, and driving
mechanisms. A two-parameter phase diagram is found, spanned by the amplitude of
dynamical weakening (or ``overshoot'') effects (epsilon) and the normal
distance (L) of the driving forces from the fault. In general, small epsilon
and small L are found to produce Gutenberg-Richter type power law statistics
with an exponential cutoff, while large epsilon and large L lead to a
distribution of small events combined with characteristic system-size events.
In a certain parameter regime the behavior is bistable, with transitions back
and forth from one phase to the other on time scales determined by the fault
size and other model parameters. The implications for realistic earthquake
statistics are discussed.Comment: 21 pages, RevTex, 6 figures (ps, eps
Analysis of the genetic basis of height in large Jewish nuclear families.
Despite intensive study, most of the specific genetic factors that contribute to variation in human height remain undiscovered. We conducted a family-based linkage study of height in a unique cohort of very large nuclear families from a founder (Jewish) population. This design allowed for increased power to detect linkage, compared to previous family-based studies. Loci we identified in discovery families could explain an estimated lower bound of 6% of the variance in height in validation families. We showed that these loci are not tagging known common variants associated with height. Rather, we suggest that the observed signals arise from variants with large effects that are rare globally but elevated in frequency in the Jewish population
Universal mean moment rate profiles of earthquake ruptures
Earthquake phenomenology exhibits a number of power law distributions
including the Gutenberg-Richter frequency-size statistics and the Omori law for
aftershock decay rates. In search for a basic model that renders correct
predictions on long spatio-temporal scales, we discuss results associated with
a heterogeneous fault with long range stress-transfer interactions. To better
understand earthquake dynamics we focus on faults with Gutenberg-Richter like
earthquake statistics and develop two universal scaling functions as a stronger
test of the theory against observations than mere scaling exponents that have
large error bars. Universal shape profiles contain crucial information on the
underlying dynamics in a variety of systems. As in magnetic systems, we find
that our analysis for earthquakes provides a good overall agreement between
theory and observations, but with a potential discrepancy in one particular
universal scaling function for moment-rates. The results reveal interesting
connections between the physics of vastly different systems with avalanche
noise.Comment: 13 pages, 5 figure
Sleep Apnea and Fetal Growth Restriction (SAFER) study: Protocol for a pragmatic randomised clinical trial of positive airway pressure as an antenatal therapy for fetal growth restriction in maternal obstructive sleep apnoea
INTRODUCTION: Fetal growth restriction (FGR) is a major contributor to fetal and neonatal morbidity and mortality with intrauterine, neonatal and lifelong complications. This study explores maternal obstructive sleep apnoea (OSA) as a potentially modifiable risk factor for FGR. We hypothesise that, in pregnancies complicated by FGR, treating mothers who have OSA using positive airway pressure (PAP) will improve birth weight and neonatal outcomes.
METHODS AND ANALYSIS: The Sleep Apnea and Fetal Growth Restriction study is a prospective, block-randomised, single-blinded, multicentre, pragmatic controlled trial. We enrol pregnant women aged 18-50, between 22 and 31 weeks of gestation, with established FGR based on second trimester ultrasound, who do not have other prespecified known causes of FGR (such as congenital anomalies or intrauterine infection). In stage 1, participants are screened by questionnaire for OSA risk. If OSA risk is identified, participants proceed to stage 2, where they undergo home sleep apnoea testing. Participants are determined to have OSA if they have an apnoea-hypopnoea index (AHI) â„5 (if the oxygen desaturation index (ODI) is also â„5) or if they have an AHI â„10 (even if the ODI is \u3c5). These participants proceed to stage 3, where they are randomised to nightly treatment with PAP or no PAP (standard care control), which is maintained until delivery. The primary outcome is unadjusted birth weight; secondary outcomes include fetal growth velocity on ultrasound, enrolment-to-delivery interval, gestational age at delivery, birth weight corrected for gestational age, stillbirth, Apgar score, rate of admission to higher levels of care (neonatal intensive care unit or special care nursery) and length of neonatal stay. These outcomes are compared between PAP and control using intention-to-treat analysis.
ETHICS AND DISSEMINATION: This study has been approved by the Institutional Review Boards at Washington University in St Louis, Missouri; Hadassah Hebrew University Medical Center, Jerusalem; and the University of Rochester, New York. Recruitment began in Washington University in November 2019 but stopped from March to November 2020 due to COVID-19. Recruitment began in Hadassah Hebrew University in March 2021, and in the University of Rochester in May 2021. Dissemination plans include presentations at scientific conferences and scientific publications.
TRIAL REGISTRATION NUMBER: NCT04084990
Sequestering HMGB1 via DNA-conjugated beads ameliorates murine colitis
Inflammatory bowel disease (IBD) is chronic inflammation of the gastrointestinal tract that affects millions of people worldwide. Although the etiology of IBD is not clear, it is known that products from stressed cells and enteric microbes promote intestinal inflammation. High mobility group box 1 (HMGB1), originally identified as a nuclear DNA binding protein, is a cytokine-like protein mediator implicated in infection, sterile injury, autoimmune disease, and IBD. Elevated levels of HMGB1 have been detected in inflamed human intestinal tissues and in feces of IBD patients and mouse models of colitis. Neutralizing HMGB1 activity by administration of anti-HMGB1 antibodies or HMGB1-specific antagonist improves clinical outcomes in animal models of colitis. Since HMGB1 binds to DNA with high affinity, here we developed a novel strategy to sequester HMGB1 using DNA immobilized on sepharose beads. Screening of DNA-bead constructs revealed that B2 beads, one linear form of DNA conjugated beads, bind HMGB1 with high affinity, capture HMGB1 ex vivo from endotoxin-stimulated RAW 264.7 cell supernatant and from feces of mice with colitis. Oral administration of B2 DNA beads significantly improved body weight, reduced colon injury, and suppressed colonic and circulating cytokine levels in mice with spontaneous colitis (IL-10 knockout) and with dextran sulfate sodium-induced colitis. Thus, DNA beads reduce inflammation by sequestering HMGB1 and may have therapeutic potential for the treatment of IBD
Utility of the ACC/AHA Lesion Classification to Predict Outcomes After Contemporary DES Treatment:Individual Patient Data Pooled Analysis From 7 Randomized Trials
BACKGROUND: Use of the modified American College of Cardiology (ACC)/American Heart Association (AHA) lesion classification as a prognostic tool to predict shortâ and longâterm clinical outcomes after percutaneous coronary intervention in the modern drugâeluting stent era is uncertain. METHODS AND RESULTS: Patientâlevel data from 7 prospective, randomized trials were pooled. Clinical outcomes of patients undergoing single lesion percutaneous coronary intervention with secondâgeneration drugâeluting stent were analyzed according to modified ACC/AHA lesion class. The primary end point was target lesion failure (TLF: composite of cardiac death, target vessel myocardial infarction, or ischemiaâdriven target lesion revascularization). Clinical outcomes to 5âyears were compared between patients treated for noncomplex (class A/B1) versus complex (class B2/C) lesions. Eight thousand five hundred sixteen patients (age 63.1±10.8âyears, 70.5% male) were analyzed. Lesions were classified as A, B1, B2, and C in 7.9%, 28.5%, 33.7%, and 30.0% of cases, respectively. Target lesion failure was higher in patients undergoing percutaneous coronary intervention of complex versus noncomplex lesions at 30âdays (2.0% versus 1.1%, P=0.004), at 1âyear (4.6% versus 3.0%, P=0.0005), and at 5âyears (12.4% versus 9.2%, P=0.0001). By multivariable analysis, treatment of ACC/AHA class B2/C lesions was significantly associated with higher rate of 5âyear target lesion failure (adjusted hazard ratio, 1.39 [95% CI, 1.17â1.64], P=0.0001) driven by significantly higher rates of target vessel myocardial infarction and ischemiaâdriven target lesion revascularization. CONCLUSIONS: In this pooled largeâscale analysis, treating complex compared with noncomplex lesions according to the modified ACC/AHA classification with secondâgeneration drugâeluting stent was associated with worse 5âyear clinical outcomes. This historical classification system may be useful in the contemporary era for predicting early and late outcomes following percutaneous coronary intervention
Aftershocks driven by afterslip and fluid pressure sweeping through a faultâfracture mesh
A variety of physical mechanisms are thought to be responsible for the triggering and spatiotemporal evolution of aftershocks. Here we analyze a vigorous aftershock sequence and postseismic geodetic strain that occurred in the Yuha Desert following the 2010 Mw 7.2 El MayorâCucapah earthquake. About 155,000 detected aftershocks occurred in a network of orthogonal faults and exhibit features of two distinct mechanisms for aftershock triggering. The earliest aftershocks were likely driven by afterslip that spread away from the main shock with the logarithm of time. A later pulse of aftershocks swept again across the Yuha Desert with square root time dependence and swarmâlike behavior; together with local geological evidence for hydrothermalism, these features suggest that the events were driven by fluid diffusion. The observations illustrate how multiple driving mechanisms and the underlying fault structure jointly control the evolution of an aftershock sequence
Percutaneous Coronary Interventions Using a Ridaforolimus-Eluting Stent in Patients at High Bleeding Risk.
BACKGROUND: Patients treated with percutaneous coronary intervention are often considered to be at a high bleeding risk (HBR). Drug-eluting stents have been shown to be superior to bare-metal stents in patients with HBR, even when patients were given abbreviated periods of dual antiplatelet therapy (DAPT). Short DAPT has not been evaluated with the EluNIR ridaforolimus-eluting stent. The aim of this study was to evaluate the safety and efficacy of a shortened period of DAPT following implantation of the ridaforolimus-eluting stent in patients with HBR. METHODS AND RESULTS: This was a prospective, multicenter, binational, single-arm, open-label trial. Patients were defined as HBR according to the LEADERS-FREE (Prospective Randomized Comparison of the BioFreedom Biolimus A9 Drug-Coated Stent versus the Gazelle Bare-Metal Stent in Patients at High Bleeding Risk) trial criteria. After percutaneous coronary intervention, DAPT was given for 1âmonth to patients presenting with stable angina. In patients presenting with an acute coronary syndrome, DAPT was given for 1 to 3âmonths, at the investigator's discretion. The primary end point was a composite of cardiac death, myocardial infarction, or stent thrombosis up to 1âyear (Academic Research Consortium definite and probable). Three hundred fifteen patients undergoing percutaneous coronary intervention were enrolled, and 56.4% presented with acute coronary syndrome; 33.7% were receiving oral anticoagulation. At 1âyear, the primary end point occurred in 15 patients (4.9%), meeting the prespecified performance goal of 14.1% (P<0.0001). Stent thrombosis (Academic Research Consortium definite and probable) occurred in 2 patients (0.6%). Bleeding Academic Research Consortium type 3 and 5 bleeding occurred in 6 patients (1.9%). CONCLUSIONS: We observed favorable results in patients with HBR who underwent percutaneous coronary intervention with a ridaforolimus-eluting stent and received shortened DAPT, including a low rate of ischemic events and low rate of stent thrombosis. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03877848
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