30 research outputs found
Associations of lifetime concussion history and repetitive head impact exposure with resting-state functional connectivity in former collegiate American football players: An NCAA 15-year follow-up study
The objective of this study was to examine associations of lifetime concussion history (CHx) and an advanced metric of lifetime repetitive head impact exposure with resting-state functional connectivity (rsFC) across the whole-brain and among large-scale functional networks (Default Mode; Dorsal Attention; and Frontoparietal Control) in former collegiate football players. Individuals who completed at least one year of varsity collegiate football were eligible to participate in this observational cohort study (n = 48; aged 36-41 years; 79.2% white/ Caucasian; 12.5±4.4 years of football played; all men). Individuals were excluded if they reported history/suspicion of psychotic disorder with active symptoms, contraindications to participation in study procedures (e.g., MRI safety concern), or inability to travel. Each participant provided concussion and football playing histories. Self-reported concussion history was analyzed in two different ways based on prior research: dichotomous "High"(â„3 concussions; n = 28) versus "Low"(<3 concussions; n = 20); and four ordinal categories (0-1 concussion [n = 19]; 2-4 concussions [n = 8]; 5-7 concussions [n = 9]; and â„8 concussions [n = 12]). The Head Impact Exposure Estimate (HIEE) was calculated from football playing history captured via structured interview. Resting-state fMRI and T1-weighted MRI were acquired and preprocessed using established pipelines. Next, rsFC was calculated using the Seitzman et al., (2020) 300-ROI functional atlas. Whole-brain, within-network, and between-network rsFC were calculated using all ROIs and network-specific ROIs, respectively. Effects of CHx and HIEE on rsFC values were examined using separate multivariable linear regression models, with a-priori α set to 0.05. We observed no statistically significant associations between rsFC outcomes and either CHx or HIEE (ps â„ .12). Neither CHx nor HIEE were associated with neural signatures that have been observed in studies of typical and pathological aging. While CHx and repetitive head impacts have been associated with changes in brain health in older former athletes, our preliminary results suggest that associations with rsFC may not be present in early midlife former football players
Aerobic and anaerobic energy expenditure during rest and activity in montane Bufo b. boreas and Rana pipiens
The relations of standard and active aerobic and anaerobic metabolism and heart rate to body temperature ( T b ) were measured in montane groups of Bufo b. boreas and Rana pipiens maintained under field conditions. These amphibians experience daily variation of T b over 30°C and 23°C, respectively (Carey, 1978). Standard and active aerobic and anaerobic metabolism, heart rate, aerobic and anaerobic scope are markedly temperature-dependent with no broad plateaus of thermal independence. Heart rate increments provide little augmentation of oxygen transport during activity; increased extraction of oxygen from the blood probably contributes importantly to oxygen supply during activity. Development of extensive aerobic capacities in Bufo may be related to aggressive behavior of males during breeding. Standard metabolic rates of both species are more thermally dependent than comparable values for lowland relatives. Thermal sensitivity of physiological functions may have distinct advantages over thermally compensated rates in the short growing season and daily thermal fluctuations of the montane environment.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47726/1/442_2004_Article_BF00348070.pd
The Cholecystectomy As A Day Case (CAAD) Score: A Validated Score of Preoperative Predictors of Successful Day-Case Cholecystectomy Using the CholeS Data Set
Background
Day-case surgery is associated with significant patient and cost benefits. However, only 43% of cholecystectomy patients are discharged home the same day. One hypothesis is day-case cholecystectomy rates, defined as patients discharged the same day as their operation, may be improved by better assessment of patients using standard preoperative variables.
Methods
Data were extracted from a prospectively collected data set of cholecystectomy patients from 166 UK and Irish hospitals (CholeS). Cholecystectomies performed as elective procedures were divided into main (75%) and validation (25%) data sets. Preoperative predictors were identified, and a risk score of failed day case was devised using multivariate logistic regression. Receiver operating curve analysis was used to validate the score in the validation data set.
Results
Of the 7426 elective cholecystectomies performed, 49% of these were discharged home the same day. Same-day discharge following cholecystectomy was less likely with older patients (OR 0.18, 95% CI 0.15â0.23), higher ASA scores (OR 0.19, 95% CI 0.15â0.23), complicated cholelithiasis (OR 0.38, 95% CI 0.31 to 0.48), male gender (OR 0.66, 95% CI 0.58â0.74), previous acute gallstone-related admissions (OR 0.54, 95% CI 0.48â0.60) and preoperative endoscopic intervention (OR 0.40, 95% CI 0.34â0.47). The CAAD score was developed using these variables. When applied to the validation subgroup, a CAAD score of â€5 was associated with 80.8% successful day-case cholecystectomy compared with 19.2% associated with a CAAD score >5 (pâ<â0.001).
Conclusions
The CAAD score which utilises data readily available from clinic letters and electronic sources can predict same-day discharges following cholecystectomy
Whole-genome sequencing reveals host factors underlying critical COVID-19
Critical COVID-19 is caused by immune-mediated inflammatory lung injury. Host genetic variation influences the development of illness requiring critical care1 or hospitalization2,3,4 after infection with SARS-CoV-2. The GenOMICC (Genetics of Mortality in Critical Care) study enables the comparison of genomes from individuals who are critically ill with those of population controls to find underlying disease mechanisms. Here we use whole-genome sequencing in 7,491 critically ill individuals compared with 48,400 controls to discover and replicate 23 independent variants that significantly predispose to critical COVID-19. We identify 16 new independent associations, including variants within genes that are involved in interferon signalling (IL10RB and PLSCR1), leucocyte differentiation (BCL11A) and blood-type antigen secretor status (FUT2). Using transcriptome-wide association and colocalization to infer the effect of gene expression on disease severity, we find evidence that implicates multiple genesâincluding reduced expression of a membrane flippase (ATP11A), and increased expression of a mucin (MUC1)âin critical disease. Mendelian randomization provides evidence in support of causal roles for myeloid cell adhesion molecules (SELE, ICAM5 and CD209) and the coagulation factor F8, all of which are potentially druggable targets. Our results are broadly consistent with a multi-component model of COVID-19 pathophysiology, in which at least two distinct mechanisms can predispose to life-threatening disease: failure to control viral replication; or an enhanced tendency towards pulmonary inflammation and intravascular coagulation. We show that comparison between cases of critical illness and population controls is highly efficient for the detection of therapeutically relevant mechanisms of disease
Human parainfluenza virus surveillance in pediatric patients with lower respiratory tract infections: a special view of parainfluenza type 4
Objective: Characterize the role of human parainfluenza virus and its clinical features in Brazilian children under 2 years of age presenting with acute lower respiratory tract infections. Methods: Realâtime assays were used to identify strains of human parainfluenza virus and other common respiratory viruses in nasopharyngeal aspirates. One thousand and two children presenting with acute lower respiratory tract illnesses were enrolled from February 2008 to August 2010. Results: One hundred and four (10.4%) patients were human parainfluenza virus positive, of whom 60 (57.7%) were positive for human parainfluenza virusâ3, 30 (28.8%) for human parainfluenza virusâ4, 12 (11.5%) for human parainfluenza virusâ1, and two (1.9%) for human parainfluenza virusâ2. Seven (6.7%) patients had more than one strain of human parainfluenza virus detected. The most frequent symptoms were tachypnea and cough, similar to other viral respiratory infections. Clinical manifestations did not differ significantly between human parainfluenza virusâ1, â2, â3, and â4 infections. Human parainfluenza virusâ1, â3, and â4 were present in the population studied throughout the three years of surveillance, with human parainfluenza virusâ3 being the predominant type identified in the first two years. Conclusion: Human parainfluenza viruses contribute substantially to pediatric acute respiratory illness (ARI) in Brazil, with nearly 30% of this contribution attributable to human parainfluenza virusâ4. Resumo: Objetivo: Caracterizar o papel do VPHâ4 e suas caracterĂsticas clĂnicas em crianças brasileiras com menos de dois anos de idade com infecçÔes agudas do trato respiratĂłrio inferior. MĂ©todos: Ensaios em tempo real foram utilizados para identificar tipos de VPH e outros vĂrus respiratĂłrios comuns em aspirados nasofarĂngeos. Mil e duas crianças com doença aguda do trato respiratĂłrio inferior foram inscritas para participar de fevereiro de 2008 a agosto de 2010. Resultados: 104 (10,4%) pacientes eram VPH positivos, dos quais 60 (57,7%) eram positivos para VPHâ3, 30 (28,8%) para VPHâ4, 12 (11,5%) para VPHâ1 e dois (1,9%) para VPHâ2. Sete (6,7%) apresentaram mais de um tipo de VPH detectado. Os sintomas mais frequentes foram tosse e taquipneia, semelhantes a outras infecçÔes respiratĂłrias virais. As manifestaçÔes clĂnicas nĂŁo diferiram de forma significativa entre as infecçÔes por VPHâ1, â2, â3 e â4. Os VPHâ1, â3 e â4 estavam presentes na população estudada ao longo dos trĂȘs anos de vigilĂąncia, e o VPHâ3 foi o tipo predominante identificado nos primeiros dois anos. ConclusĂŁo: Os VPHs contribuem substancialmente para a DRA pediĂĄtrica no Brasil com quase 30% dessa contribuição atribuĂvel ao VPHâ4. Keywords: Human parainfluenza virus, Respiratory virus, Pediatric patients, Acute respiratory illness, Human respirovirus 4, Palavrasâchave: VĂrus da parainfluenza humana, VĂrus respiratĂłrio, Pacientes pediĂĄtricos, Doença respiratĂłria aguda, RespirovĂrus humano