Effect of supervised exercise on physical function and balance in patients with intermittent claudication

Background The aim of the study was to identify whether a standard supervised exercise programme (SEP) for patients with intermittent claudication improved specific measures of functional performance including balance. Methods A prospective observational study was performed at a single tertiary vascular centre. Patients with symptomatic intermittent claudication (Rutherford grades 1–3) were recruited to the study. Participants were assessed at baseline (before SEP) and 3, 6 and 12 months afterwards for markers of lower-limb ischaemia (treadmill walking distance and ankle : brachial pressure index), physical function (6-min walk, Timed Up and Go test, and Short Physical Performance Battery (SPPB) score), balance impairment using computerized dynamic posturography with the Sensory Organization Test (SOT), and quality of life (VascuQoL and Short Form 36). Results Fifty-one participants underwent SEP, which significantly improved initial treadmill walking distance (P = 0·001). Enrolment in a SEP also resulted in improvements in physical function as determined by 6-min maximum walking distance (P = 0·006), SPPB score (P < 0·001), and some domains of both generic (bodily pain, P = 0·025) and disease-specific (social domain, P = 0·039) quality of life. Significant improvements were also noted in balance, as determined by the SOT (P < 0·001). Conclusion Supervised exercise improves both physical function and balance impairment

ACA Implementation Monitoring and Tracking: New York Site Visit Report

Examines New York's progress in implementing the 2010 federal healthcare reform, including an executive order to establish a health insurance exchange, legislation to enact insurance reforms, and the debate over implementing the Basic Health Program

False positive probabilties for all Kepler Objects of Interest: 1284 newly validated planets and 428 likely false positives

We present astrophysical false positive probability calculations for every Kepler Object of Interest (KOI)---the first large-scale demonstration of a fully automated transiting planet validation procedure. Out of 7056 KOIs, we determine that 1935 have probabilities <1% to be astrophysical false positives, and thus may be considered validated planets. 1284 of these have not yet been validated or confirmed by other methods. In addition, we identify 428 KOIs likely to be false positives that have not yet been identified as such, though some of these may be a result of unidentified transit timing variations. A side product of these calculations is full stellar property posterior samplings for every host star, modeled as single, binary, and triple systems. These calculations use 'vespa', a publicly available Python package able to be easily applied to any transiting exoplanet candidate.Comment: 20 pages, 8 figures. Published in ApJ. Instructions to reproduce results can be found at https://github.com/timothydmorton/koi-fp

Classifying the unknown: discovering novel gravitational-wave detector glitches using similarity learning

The observation of gravitational waves from compact binary coalescences by LIGO and Virgo has begun a new era in astronomy. A critical challenge in making detections is determining whether loud transient features in the data are caused by gravitational waves or by instrumental or environmental sources. The citizen-science project \emph{Gravity Spy} has been demonstrated as an efficient infrastructure for classifying known types of noise transients (glitches) through a combination of data analysis performed by both citizen volunteers and machine learning. We present the next iteration of this project, using similarity indices to empower citizen scientists to create large data sets of unknown transients, which can then be used to facilitate supervised machine-learning characterization. This new evolution aims to alleviate a persistent challenge that plagues both citizen-science and instrumental detector work: the ability to build large samples of relatively rare events. Using two families of transient noise that appeared unexpectedly during LIGO's second observing run (O2), we demonstrate the impact that the similarity indices could have had on finding these new glitch types in the Gravity Spy program

Determination of Uncertainties for Analytically Derived Material Properties to Be Used in Monte Carlo Based Orion Heatshield Sizing

Ablative materials are often used for spacecraft heatshields to protect underlying structures from the extreme environments associated with atmospheric reentry. NASA's Orion EM-1 capsule has been designed to use a molded Avcoat material system. In order to determine the required heatshield thickness, a Monte Carlo approach to the sizing process was proposed. To perform the Monte Carlo simulation, statistical uncertainties on all material property input parameters were required. Obtaining these values for measured properties is straightforward, however input parameters that are derived analytically have historically used uncertainties based on engineering judgment. A MATLAB program was created to use laboratory generated thermogravimetric analysis (TGA) data to calculate uncertainties on the Arrhenius parameters for molded Avcoat. Uncertainties associated with the normalized ablation rate and pyrolysis gas enthalpy were also generated using a wrapper script and the ACE code. These uncertainties could then be tied directly to measured values of individual elemental constituents. The resulting uncertainty values will allow for a probabilistic sizing approach on molded Avcoat with a higher level of confidence in the input parameters

Mutations in the mitochondrial cysteinyl-tRNA synthase gene, CARS2, lead to a severe epileptic encephalopathy and complex movement disorder

Background: Mitochondrial disease is often suspected in cases of severe epileptic encephalopathy especially when a complex movement disorder, liver involvement and progressive developmental regression are present. Although mutations in either mitochondrial DNA or POLG are often present, other nuclear defects in mitochondrial DNA replication and protein translation have been associated with a severe epileptic encephalopathy. Methods: and results We identified a proband with an epileptic encephalopathy, complex movement disorder and a combined mitochondrial respiratory chain enzyme deficiency. The child presented with neurological regression, complex movement disorder and intractable seizures. A combined deficiency of mitochondrial complexes I, III and IV was noted in liver tissue, along with increased mitochondrial DNA content in skeletal muscle. Incomplete assembly of complex V, using blue native polyacrylamide gel electrophoretic analysis and complex I, using western blotting, suggested a disorder of mitochondrial transcription or translation. Exome sequencing identified compound heterozygous mutations in CARS2, a mitochondrial aminoacyl-tRNA synthetase. Both mutations affect highly conserved amino acids located within the functional ligase domain of the cysteinyl-tRNA synthase. A specific decrease in the amount of charged mt-tRNACys was detected in patient fibroblasts compared with controls. Retroviral transfection of the wild-type CARS2 into patient skin fibroblasts led to the correction of the incomplete assembly of complex V, providing functional evidence for the role of CARS2 mutations in disease aetiology. Conclusions: Our findings indicate that mutations in CARS2 result in a mitochondrial translational defect as seen in individuals with mitochondrial epileptic encephalopathy

Thrombin Receptors on Human Platelets INITIAL LOCALIZATION AND SUBSEQUENT REDISTRIBUTION DURING PLATELET ACTIVATION

Platelet responses to thrombin are at least partly mediated by a G-protein-coupled receptor whose NH2 terminus is a substrate for thrombin. In the present studies we have examined the location of thrombin receptors in resting platelets and followed their redistribution during platelet activation. The results reveal several new aspects of thrombin receptor biology. 1) On resting platelets, approximately two-thirds of the receptors were located in the plasma membrane. The remainder were present in the membranes of the surface connecting system. 2) When platelets were activated by ADP or a thromboxane analog, thrombin receptors that were initially in the surface connecting system were exposed on the platelet surface, increasing the number of detectable receptors by 40% and presumably making them available for subsequent activation by thrombin. 3) Platelet activation by thrombin rapidly abolished the binding of the antibodies whose epitopes are sensitive to receptor cleavage and left the platelets in a state refractory to both thrombin and the agonist peptide, SFLLRN. This was accompanied by a 60% decrease in the binding of receptor antibodies directed COOH-terminal to the cleavage site irrespective of whether the receptors were activated proteolytically by thrombin or nonproteolytically by SFLLRN. 4) The loss of antibody binding sites caused by thrombin was due in part to receptor internalization and in part to the shedding of thrombin receptors into membrane microparticles, especially under conditions in which aggregation was allowed to occur. However, at least 40% of the cleaved receptors remained on the platelet surface. 5) Lacking the ability to synthesize new receptors and lacking an intracellular reserve of preformed receptors comparable to that found in endothelial cells, platelets were unable to repopulate their surface with intact receptors following exposure to thrombin. This difference underlies the ability of endothelial cells to recover responsiveness to thrombin rapidly while platelets do not, despite the presence on both of the same receptor for thrombin

Measuring the properties of f−f-mode oscillations of a protoneutron star by third generation gravitational-wave detectors

Core-collapse supernovae are among the astrophysical sources of gravitational waves that could be detected by third-generation gravitational-wave detectors. Here, we analyze the gravitational-wave strain signals from two- and three-dimensional simulations of core-collapse supernovae generated using the code F{\sc{ornax}}. A subset of the two-dimensional simulations has non-zero core rotation at the core bounce. A dominant source of time changing quadrupole moment is the $l=2$ fundamental mode ($f-$ mode) oscillation of the proto-neutron star. From the time-frequency spectrogram of the gravitational-wave strain we see that, starting $\sim 400$ ms after the core bounce, most of the power lies within a narrow track that represents the frequency evolution of the $f-$mode oscillations. The $f-$mode frequencies obtained from linear perturbation analysis of the angle-averaged profile of the protoneutron star corroborate what we observe in the spectrograms of the gravitational-wave signal. We explore the measurability of the $f-$mode frequency evolution of protoneutron star for a supernova signal observed in the third-generation gravitational-wave detectors. Measurement of the frequency evolution can reveal information about the masses, radii, and densities of the proto-neutron stars. We find that if the third generation detectors observe a supernova within 10 kpc, we can measure these frequencies to within $\sim$90\% accuracy. We can also measure the energy emitted in the fundamental $f-$mode using the spectrogram data of the strain signal. We find that the energy in the $f-$mode can be measured to within 20\% error for signals observed by Cosmic Explorer using simulations with successful explosion, assuming source distances within 10 kpc.Comment: 17 pages, 11 figures, 2 table