Effect of Contrast-Enhanced Echocardiograms on the Prognosis of Infective Endocarditis

Objective - Infective endocarditis (IE) is an infectious disease of the cardiac valves where bacteria colonize the valves; typically, via the formation of vegetations. Recent research has shown that the microbubbles in a contrast-enhanced ultrasound (CEUS) examination can move and dislodge bacterial vegetations in vitro. This study investigated whether CEUS resulted in faster resolution of IE in vivo by dislodging the vegetations. Methods - This IRB approved retrospective study reviewed 36 patients who were diagnosed with IE via echocardiography. Data was sourced from patients within the Jefferson University Hospital’s Cardiology EMR system by searching for contrast and vegetation from January 1st, 2013 – January 1st, 2018. Fifteen patients were not given contrast, whereas 21 patients were given contrast via agitated saline (n=16) or an ultrasound contrast agent (n=5). All patients received an echocardiogram after blood cultures confirmed an infection, but before resolution of infection (defined by negative blood cultures). A student’s t-test was used for analyses. Results - The study population was heterogeneous in terms of sex (67.5% male) and race (70% Caucasian, 25% African American, and 5% Asian), with an average age of 51±20 years, and an average BMI of 29.65±7.43 in the contrast group and 27.67±3.16 in the non-contrast group (p=0.37). Following ultrasound, no patients had documented stroke, pulmonary embolism, or systemic blood clot, which physicians could have attributed to a thrombus resulting from dislodging of bacterial vegetation. Overall, blood cultures did not clear faster in patients receiving CEUS compared to those undergoing standard echocardiography, (2.63±2.69 days vs. 1.34 ±1.11 days, p=0.09). CEUS also did not shorten the admission length in patients with IE, (16.9±7.7 days vs. 19.9±12.1 days; p=0.36). Conclusion - Based on this limited sample size, patients who underwent CEUS did not have a different prognosis when compared to patients who received a non-contrast echocardiogram

The Pressure Model of Terrorism: A Behavioralist Model for Ethnonational Terrorism in Western Europe, 1945-2000

The purpose of this study is to determine which factors affect an ethnonational group\u27s decision to utilize terrorism to obtain their desired outcomes. Current theories have reached an answer, but theoretical underpinnings of those answers are disparate and weak. Thus, in answering this question, a new model of terrorism is necessary - one which spans the four primary levels of analysis. I do this using a weak rational choice model as a cross-level link, and using psychological models as a basis for the individual-level actions. While the model is not unequivocally and universally supported by the tests, it is able to explain several previous findings in the literature and to explain the counter-intuitive findings regarding democracies. The model is then applied to two real-life examples, the Ulster Catholics and the Scots, to determine what light it can shed on the differences in outcomes for those not too dissimilar groups. These findings reveal that the 1985 Anglo-Irish Agreement was doomed to failure because the underlying terrorism action pressure was too great, while the 1998 Good Friday Accord had a much greater probability of success because the terrorism action pressure acting on the Ulster Catholics was significantly lower in the mid-1990s. Finally, several suggestions are made to reduce the probability of an outbreak of terrorism among a state\u27s ethnonational minorities. While past use of terrorism is, by far, the best indicator of future use, other factors show importance as indicators. The percent of youth in the state, economic differentials, level of democracy in the state, and globalization all increase the probability that the group will become a terrorist group. These results are especially important, especially given the current trends in the world. These trends, namely globalization, increased economic differences within and among states, and the increased number of adolescents in the world, are coming together to create an opportunity to either avert a catastrophic increase in terrorist events, or to allow it to occur

Diffusion of particles in an expanding sphere with an absorbing boundary

We study the problem of particles undergoing Brownian motion in an expanding sphere whose surface is an absorbing boundary for the particles. The problem is akin to that of the diffusion of impurities in a grain of polycrystalline material undergoing grain growth. We solve the time dependent diffusion equation for particles in a d-dimensional expanding sphere to obtain the particle density function (function of space and time). The survival rate or the total number of particles per unit volume as a function of time is evaluated. We have obtained particular solutions exactly for the case where d=3 and a parabolic growth of the sphere. Asymptotic solutions for the particle density when the sphere growth rate is small relative to particle diffusivity and vice versa are derived.Comment: 12 pages. To appear in J. Phys. A: Math. Theor. 41 (2008

Accounting for genetic interactions improves modeling of individual quantitative trait phenotypes in yeast.

Experiments in model organisms report abundant genetic interactions underlying biologically important traits, whereas quantitative genetics theory predicts, and data support, the notion that most genetic variance in populations is additive. Here we describe networks of capacitating genetic interactions that contribute to quantitative trait variation in a large yeast intercross population. The additive variance explained by individual loci in a network is highly dependent on the allele frequencies of the interacting loci. Modeling of phenotypes for multilocus genotype classes in the epistatic networks is often improved by accounting for the interactions. We discuss the implications of these results for attempts to dissect genetic architectures and to predict individual phenotypes and long-term responses to selection

Tree measures and the number of segregating sites in time-structured population samples

BACKGROUND: Time-structured genetic samples are a valuable source of information in population genetics because they provide several correlated observations of the underlying evolutionary processes. In this paper we study basic properties of the genetic variation in time-structured samples as reflected in the genealogies relating individuals and the number of segregating sites observed. Our emphasis is on "measurably evolving populations" i.e. populations from which it is possible to obtain time-structured samples that span a significant interval of evolutionary time. RESULTS: We use results from the coalescent process to derive properties of time-structured samples. In the first section we extend existing results to attain measures on coalescent trees relating time-structured samples. These include the expected time to a most recent common ancestor, the expected total branch length and the expected length of branches subtending only ancient individuals. The effect of different sampling schemes on the latter measure is studied. In the second section we study the special case where the full sample consists of a group of contemporary extant samples and a group of contemporary ancient samples. As regards this case, we present results and applications concerning the probability distribution of the number of segregating sites where a mutation is unique to the ancient individuals and the number of segregating sites where a mutation is shared between ancient and extant individuals. CONCLUSION: The methodology and results presented here is of use to the design and interpretation of ancient DNA experiments. Furthermore, the results may be useful in further development of statistical tests of e.g. population dynamics and selection, which include temporal information