Utility of the Framingham risk score to predict the presence of coronary atherosclerosis in patients with rheumatoid arthritis

The prevalence of ischemic heart disease and atherosclerosis is increased in patients with rheumatoid arthritis (RA). In the general population, but not in patients with systemic lupus erythematosus, the Framingham risk score identifies patients at increased cardiovascular risk and helps determine the need for preventive interventions. We examined the hypothesis that the Framingham score is increased and associated with coronary-artery atherosclerosis in patients with RA. The Framingham score and the 10-year cardiovascular risk were compared among 155 patients with RA (89 with early disease, 66 with long-standing disease) and 85 control subjects. The presence of coronary-artery calcification was determined by electron-beam computed tomography. The Framingham score was compared in patients with RA and control subjects, and the association between the risk score and coronary-artery calcification was examined in patients. Patients with long-standing RA had a higher Framingham score (14 [11 to 18]) (median [interquartile range]) compared to patients with early RA (11 [8 to 14]) or control subjects (12 [7 to 14], P < 0.001). This remained significant after adjustment for age and gender (P = 0.015). Seventy-six patients with RA had coronary calcification; their Framingham risk score was higher (14 [12 to 17]) than that of 79 patients without calcification (10 [5 to 14]) (P < 0.001). Furthermore, a higher Framingham score was associated with a higher calcium score (odds ratio [OR] = 1.20, 95% confidence interval [CI] 1.12 to 1.29, P < 0.001), and the association remained significant after adjustment for age and gender (OR = 1.15, 95% CI 1.02 to 1.29, P = 0.03). In conclusion, a higher Framingham risk score is independently associated with the presence of coronary calcification in patients with RA

Cross-correlating Carbon Monoxide Line-intensity Maps with Spectroscopic and Photometric Galaxy Surveys

Line-intensity mapping (LIM or IM) is an emerging field of observational work, with strong potential to fit into a larger effort to probe large-scale structure and small-scale astrophysical phenomena using multiple complementary tracers. Taking full advantage of such complementarity means, in part, undertaking line-intensity surveys with galaxy surveys in mind. We consider the potential for detection of a cross-correlation signal between COMAP and blind surveys based on photometric redshifts (as in COSMOS) or based on spectroscopic data (as with the HETDEX survey of Lyman-$\alpha$ emitters). We find that obtaining $\sigma_z/(1+z)\lesssim0.003$ accuracy in redshifts and $\gtrsim10^{-4}$ sources per Mpc$^3$ with spectroscopic redshift determination should enable a CO-galaxy cross spectrum detection significance at least twice that of the CO auto spectrum. Either a future targeted spectroscopic survey or a blind survey like HETDEX may be able to meet both of these requirements.Comment: 19 pages + appendix (31 pages total), 16 figures, 6 tables; accepted for publication in Ap

EMPOWERing older people and their communities to manage their own CARE (EMPOWERCARE): Evaluation study of a social innovation initiative across four European countries

This paper outlines the evaluation strategy of the EMPOWERCARE, an EU Interreg 2 Seas funded social innovation project, which involves a partnership of local authorities, universities and non-governmental organisations from four European countries: Belgium, France, the Netherlands and the United Kingdom. Partners are working in collaboration with local people aged 65+, and those aged 50+ with at least one chronic condition, to respond to current gaps in the care of older people. The project aims specifically to contribute to person-centred care and technology knowledge transfer whilst reducing isolation, loneliness and increasing solidarity amongst older people and their communities. During the project, partners are jointly developing a strategy for implementing good-practice models, a workforce transformation approach via shared training and a technology blueprint with emphasis on caring digital technologies to address the rising demand for health and social care services for older people. The project addresses this challenge by drawing on community assets, involving older people in decisions about their own health and wellbeing, enabling them to keep healthier and in their own homes and communities safely for longer. The project’s evaluation aims to measure the impact of the EMPOWERCARE initiative across 7 pilot sites in the 4 participating countries. Given the Covid-19 pandemic, the evaluation design has been developed with a view to being agile and able to respond to complex and shifting situations, and especially so in terms of what and how data are collected. A realist synthesis approach (Pawson & Tilley, 2004) guides the evaluation within a descriptive case study design (Yin 2003) to identify and contextualise the project strategies that are influential within and across the 7 different case study sites. The evaluation uses multiple interdisciplinary methods, such as surveys, Photovoice and Social Return on Investment, to capture a range of perspectives across three timepoints, baseline (T0), mid-point (T1) and end-point (T2). Online surveys are conducted with both end-users and the workforce in all pilot sites at T0 and T2. At T1, end-users are actively involved in creating visual data through Photovoice to capture their lived experiences with local initiatives in pilot sites. Visual data are going to be displayed at pilot site exhibitions targeted to key local stakeholders and members of the workforce. Focus groups will be conducted with all participants reflecting on the visual data exhibition to explore insights about the initiative from current and future perspectives. This aspect is informed by a Social Return on Investment approach. The sequential data collection of multiple sources and longitudinal study design identify patterns of change and impact. The evaluation design will deliver a theory-driven rich explanation of what works about EMPOWERCARE and for whom, why, how and in what circumstances it works. The analysis of the evaluation findings will contribute to a more empowered person-centred approach, with more inclusive and caring digital health solutions that will allow policy makers to develop localised, efficient and social-value driven services to meet the rising needs of older people in the European regions

Endothelial Function in Systemic Lupus Erythematosus: Relationship to Disease Activity, Cardiovascular Risk Factors, Corticosteroid Therapy, and Coronary Calcification

Elizabeth Turner2, Victor Dishy1, Cecilia P Chung2, Paul Harris4, Rosanna Pierce5, Yu Asanuma1, Annette Oeser1, Tebeb Gebretsadik3, Ayumi Shintani3, Paolo Raggi6, C Michael Stein1,21Division of Clinical Pharmacology, 2Division of Rheumatology, 3Department of Medicine; Center of Health Services Research, Department of Biostatistics; 4General Clinical Research Center; 5Department of Vascular Surgery, Vanderbilt University School of Medicine, Nashville, TN, USA; 6Section of Cardiology, Tulane University School of Medicine, New Orleans, LA, USAObjectives: Endothelial dysfunction is frequently present in patients with systemic lupus erythematosus and may increase their risk of premature coronary artery disease. In this pilot study we have characterized the relationship between endothelial function, measures of disease activity, and cardiovascular risk factors in patients with lupus.Methods: Clinical characteristics and cardiovascular risk factors were evaluated in 20 patients with lupus. Flow-mediated dilation of the brachial artery was measured using high resolution ultrasound and the presence or absence of coronary calcification determined by electronbeam computed tomography. The relationship between these variables and flow-mediated dilation was determined using Spearman correlation coefficients (RHO) and Mann Whitney-Wilcoxon tests.Results: Twenty patients (17 female) median age (interquartile range) 42.5 (32.0&ndash;47.5) years were studied. The median flow-mediated vasodilation was 3.6% (1.7%&ndash;7.7%). In patients with coronary calcification (n = 6), flow-mediated dilation was 2.1% (&ndash;0.42%&ndash;3.6%) compared with 4.0% (3.5%&ndash;8.3%) in those without (p = 0.12). There was no significant relationship between flow-mediated dilation and markers of disease activity, duration of disease, and cardiovascular risk factors. Lower flow-mediated dilation was associated with duration of corticosteroid therapy (RHO = &ndash;0.44, p = 0.05).Conclusions: In these preliminary results, endothelial dysfunction is associated with longterm exposure to corticosteroids.Keywords: flow-mediated dilation, endothelium, inflammation, atherosclerosis, systemic lupus erythematosu

Streaming fragment assignment for real-time analysis of sequencing experiments

We present eXpress, a software package for efficient probabilistic assignment of ambiguously mapping sequenced fragments. eXpress uses a streaming algorithm with linear run time and constant memory use. It can determine abundances of sequenced molecules in real time and can be applied to ChIP-seq, metagenomics and other large-scale sequencing data. We demonstrate its use on RNA-seq data and show that eXpress achieves greater efficiency than other quantification methods

CCAT-prime: Science with an Ultra-widefield Submillimeter Observatory at Cerro Chajnantor

We present the detailed science case, and brief descriptions of the telescope design, site, and first light instrument plans for a new ultra-wide field submillimeter observatory, CCAT-prime, that we are constructing at a 5600 m elevation site on Cerro Chajnantor in northern Chile. Our science goals are to study star and galaxy formation from the epoch of reionization to the present, investigate the growth of structure in the Universe, improve the precision of B-mode CMB measurements, and investigate the interstellar medium and star formation in the Galaxy and nearby galaxies through spectroscopic, polarimetric, and broadband surveys at wavelengths from 200 um to 2 mm. These goals are realized with our two first light instruments, a large field-of-view (FoV) bolometer-based imager called Prime-Cam (that has both camera and an imaging spectrometer modules), and a multi-beam submillimeter heterodyne spectrometer, CHAI. CCAT-prime will have very high surface accuracy and very low system emissivity, so that combined with its wide FoV at the unsurpassed CCAT site our telescope/instrumentation combination is ideally suited to pursue this science. The CCAT-prime telescope is being designed and built by Vertex Antennentechnik GmbH. We expect to achieve first light in the spring of 2021.Comment: Presented at SPIE Millimeter, Submillimeter, and Far-Infrared Detectors and Instrumentation for Astronomy IX, June 14th, 201

Joint power spectrum and voxel intensity distribution forecast on the CO luminosity function with COMAP

We develop a framework for joint constraints on the CO luminosity function based on power spectra (PS) and voxel intensity distributions (VID), and apply this to simulations of COMAP, a CO intensity mapping experiment. This Bayesian framework is based on a Markov chain Monte Carlo (MCMC) sampler coupled to a Gaussian likelihood with a joint PS + VID covariance matrix computed from a large number of fiducial simulations, and re-calibrated with a small number of simulations per MCMC step. The simulations are based on dark matter halos from fast peak patch simulations combined with the $L_\text{CO}(M_\text{halo})$ model of Li et al. (2016). We find that the relative power to constrain the CO luminosity function depends on the luminosity range of interest. In particular, the VID is more sensitive at both small and large luminosities, while the PS is more sensitive at intermediate luminosities. The joint analysis is superior to using either observable separately. When averaging over CO luminosities ranging between $L_\text{CO} = 10^4-10^7L_\odot$, and over 10 cosmological realizations of COMAP Phase 2, the uncertainties (in dex) are larger by 58 % and 30 % for the PS and VID, respectively, when compared to the joint analysis (PS + VID). This method is generally applicable to any other random field, with a complicated likelihood, as long a fast simulation procedure is available.Comment: 13 pages, 5 figures. As accepted to Ap

International criteria for electrocardiographic interpretation in athletes: Consensus statement.

Sudden cardiac death (SCD) is the leading cause of mortality in athletes during sport. A variety of mostly hereditary, structural or electrical cardiac disorders are associated with SCD in young athletes, the majority of which can be identified or suggested by abnormalities on a resting 12-lead electrocardiogram (ECG). Whether used for diagnostic or screening purposes, physicians responsible for the cardiovascular care of athletes should be knowledgeable and competent in ECG interpretation in athletes. However, in most countries a shortage of physician expertise limits wider application of the ECG in the care of the athlete. A critical need exists for physician education in modern ECG interpretation that distinguishes normal physiological adaptations in athletes from distinctly abnormal findings suggestive of underlying pathology. Since the original 2010 European Society of Cardiology recommendations for ECG interpretation in athletes, ECG standards have evolved quickly, advanced by a growing body of scientific data and investigations that both examine proposed criteria sets and establish new evidence to guide refinements. On 26-27 February 2015, an international group of experts in sports cardiology, inherited cardiac disease, and sports medicine convened in Seattle, Washington (USA), to update contemporary standards for ECG interpretation in athletes. The objective of the meeting was to define and revise ECG interpretation standards based on new and emerging research and to develop a clear guide to the proper evaluation of ECG abnormalities in athletes. This statement represents an international consensus for ECG interpretation in athletes and provides expert opinion-based recommendations linking specific ECG abnormalities and the secondary evaluation for conditions associated with SCD

Friedmann Equation and Stability of Inflationary Higher Derivative Gravity

Stability analysis on the De Sitter universe in pure gravity theory is known to be useful in many aspects. We first show how to complete the proof of an earlier argument based on a redundant field equation. It is shown further that the stability condition applies to $k \ne 0$ Friedmann-Robertson-Walker spaces based on the non-redundant Friedmann equation derived from a simple effective Lagrangian. We show how to derive this expression for the Friedmann equation of pure gravity theory. This expression is also generalized to include scalar field interactions.Comment: Revtex, 6 pages, Add two more references, some typos correcte